Effects of dexmedetomidine combined with commonly administered opioids on clinical variables in dogs

Nishimura, Lilian Toshiko; Auckburally, Adam; Santilli, Juliana; Vieira, B. H. B.; Garcia, Debora O. Oliveira; Honsho, Cristiane dos Santos; Mattos-Junior, Ewaldo

doi:10.2460/ajvr.79.3.267

Cited by 26 publications

(30 citation statements)

References 28 publications

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“…In sheep, EA with xylazine or clonidine induces mild-to-moderate sedative effects 9 17. In dogs, DEX via the intramuscular route promotes important sedative effects, which can be mistaken for antinociception 11. In the present study, slight to moderate sedation was observed in three treatments, but we cannot rule out the possibility that confusion might occur regarding interpretation between sedation and antinociception.…”

Section: Discussioncontrasting

confidence: 57%

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Clinical effects of epidurally administered dexmedetomidine with or without lidocaine in sheep

Mattos-Junior

Flaherty²,

Nishimura

et al. 2020

Veterinary Record

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BackgroundThe aims of this study were evaluate cardiopulmonary, sedative and antinociceptive effects of dexmedetomidine–lidocaine combination via lumbosacral epidural injection in sheep.MethodsSix Santa Inês breed sheep, 16±6 months old and weighing 42.2 ± 5.7 kg were used. Sheep were subjected to epidural anaesthesia with three treatments: L, lidocaine (1.2 mg/kg), D, dexmedetomidine (2.5 μg/kg) or DL, dexmedetomidine plus lidocaine (2.5 μg/kg + 1.2 mg/kg). Drugs were injected via pre-placed lumbosacral epidural catheters. Cardiopulmonary, arterial blood gases, electrolytes, degree of sedation and antinociceptive aspects were measured before drug administration (T0) and then at 15, 30, 60 and 120 min after drug injection (T15–T120) in all treatments and at T0 to T240 in DL.ResultsThere were significantly increases in PaCO2 at times T60 and T120 in D, and at T30–T120 in DL, compared to baseline. The antinociceptive effects were observed up to 240 min in DL and 60 min in L, and were more intense in DL. Treatment D provided analgesia only in the perineal region, and only at T15.ConclusionThe combination of DEX with lidocaine produced similar cardiopulmonary changes compared with either drug alone, but with greater and more prolonged antinociceptive effects.

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Section: Discussioncontrasting

confidence: 57%

“…In dogs, DEX was found to promote antinociceptive effects at the dose of 10 µg/kg IM, 11 while it is approximately five times more potent via the epidural route in rats 12 . Therefore, we chose to use the dose of 2.5 µg/kg.…”

Section: Discussionmentioning

confidence: 99%

Clinical effects of epidurally administered dexmedetomidine with or without lidocaine in sheep

Mattos-Junior

Flaherty²,

Nishimura

et al. 2020

Veterinary Record

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“…It is common to observe sedation after epidural administration of α 2 -agonists as a result of systemic absorption of the drug [9] . Moreover, co-administration of opioids and α 2agonists might produce more profound and longer lasting sedation [24,25] . In the present study, epidural administration of DEX enhanced previously produced sedation; even though, the probable synergetic effects of MOR and DEX need to be investigated by further studies.…”

Section: Discussionmentioning

confidence: 99%

Orşiektomi Yapılan Sedasyonlu Köpeklerde Epidural Deksmedetomidinin Fizibilite, Reverzibilite ve Kardiyorespiratuvar Etkilerinin Değerlendirilmesi

Rastabi¹,

Naddaf²,

Mosallanejad³

et al. 2019

Kafkas Univ Vet Fak Derg

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The objective of the present study was to evaluate whether epidural dexmedetomidine (DEX) produces sufficient anti-nociception with reversible sedation and cardiorespiratory changes in sedated dogs undergoing orchiectomy. Twelve male dogs weighing 21.7±5.2 kg were used. Dogs received acepromazine (0.025 mg/kg) and morphine (0.25 mg/kg) intramuscularly and a second dose of morphine (0.125 mg/kg) intravenously (IV). DEX (3 µg/kg) was administered epidurally to all dogs (n=12). After confirming complete sensory blockade of the prescrotal region, orchiectomy was performed. If any discomfort was detected during surgery, 2-3 mL lidocaine 1% (maximum two times) was applied into the painful area. Sixty minutes after epidural application, dogs were randomly assigned to receive either treatment of atipamezole (ATP; n=6) or saline (SAL; n=6) IV. None of the dogs required general anesthesia; however, nine out of twelve dogs received lidocaine. The duration of sensory blockade was significantly shorter in ATP than that of SAL. Heart rate, respiratory rate, and rectal temperature showed significantly lower values compared with base after administration of DEX. Administration of atipamezole reversed sedation, sensory blockade and cardiorespiratory changes. In conclusion, epidural DEX did not produce adequate anti-nociception during orchiectomy in sedated dogs. Sedation, sensory blockade and cardiorespiratory changes induced by epidural DEX can be reversed by IV administration of atipamezole.

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“…In addition, both drugs provided antinociceptive effects equivalent to morphine and methadone. 22 Ideally, no change in clinician satisfaction with the anesthetic protocol or workflow should occur if nalbuphine is used to replace butorphanol. The primary goal of this study was to determine whether an anesthetic protocol that uses nalbuphine in combination with dexmedetomidine and tiletamine/zolazepam is as good as one that uses butorphanol from the clinical experience in an environment where this protocol is commonly employed, with non-inferiority being declared if the mean difference between satisfaction scores did not exceed the margin of 1.4 points (20%).…”

Section: Introductionmentioning

confidence: 99%

Use of nalbuphine as a substitute for butorphanol in combination with dexmedetomidine and tiletamine/zolazepam: a randomized non-inferiority trial

Kreisler

Cornell

Smith

et al. 2019

Journal of Feline Medicine and Surgery

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Objectives The goal of this study was to determine whether a drug combination using nalbuphine with dexmedetomidine and tiletamine/zolazepam is non-inferior to one that uses butorphanol. Methods All healthy cats presenting solely for gonadectomy to two trap–neuter–return mobile clinic days were randomly assigned to induction with a combination of tiletamine/zolazepam 3 mg/kg, dexmedetomidine 7.5 µg/kg and either butorphanol or nalbuphine at 0.15 mg/kg. All participants were blinded to the identity of the combinations. The primary endpoint was clinician satisfaction, comprised of the mean of four satisfaction ratings on a 7-point Likert scale (highly dissatisfied through to highly satisfied) recorded for induction, maintenance of anesthesia, surgery and recovery. Exploratory endpoints included each individual score, number of injections, duration of induction, duration of recovery and need for reversal agent. To assess non-inferiority for the primary endpoint and individual scores, the difference and 95% confidence intervals (CIs) of the difference between the mean clinical scores for the nalbuphine and butorphanol-based combinations were calculated and compared with a prespecified non-inferiority margin of 20% (1.4 points). Results Seventy-two cats were enrolled, 36 in each group. The mean ± SD composite score for the combination with nalbuphine was 6.06 ± 0.59 (95% CI 5.86–6.25) points, while the combination with butorphanol was 6.22 ± 0.62 (95% CI 6.01–6.43). The difference between mean scores was 0.17 (–0.12 to 0.45), which did not exceed the prespecified boundary of 1.4, establishing the non-inferiority of nalbuphine. No individual clinical score for nalbuphine was inferior to butorphanol, and there were no significant differences for any secondary endpoints. Conclusions and relevance The clinical experience of the nalbuphine-based combination was non-inferior to the butorphanol-based combination. Nalbuphine is an effective substitute for butorphanol, providing another option if butorphanol is unavailable due to shortage, controlled status or cost, without requiring a change in anesthetic workflow.

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Effects of dexmedetomidine combined with commonly administered opioids on clinical variables in dogs

Cited by 26 publications

References 28 publications

Clinical effects of epidurally administered dexmedetomidine with or without lidocaine in sheep

Clinical effects of epidurally administered dexmedetomidine with or without lidocaine in sheep

Orşiektomi Yapılan Sedasyonlu Köpeklerde Epidural Deksmedetomidinin Fizibilite, Reverzibilite ve Kardiyorespiratuvar Etkilerinin Değerlendirilmesi

Use of nalbuphine as a substitute for butorphanol in combination with dexmedetomidine and tiletamine/zolazepam: a randomized non-inferiority trial

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