Hyaluronidase shortens levobupivacaine lumbosacral epidural anaesthesia in dogs

DeRossi, Rafael; Barros, Andrea Lantieri Correa de; Silva-Neto, Amadeu Batista; Pompermeyer, C. T.; Frazílio, Fabrício Oliveira

doi:10.1111/j.1748-5827.2011.01048.x

Cited by 7 publications

(5 citation statements)

References 23 publications

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“…for regions caudal to the thoracolumbar junction [3,30]. Although these volumes are accepted by veterinarians, they were based on subjective clinical data rather than the actual measurement of the volume of the epidural space [4,31,32]. However, the consensus is that the variables that determine the quality and level of lumbosacral epidural blockade are volume, dose, and concentration of the injected drug.…”

Section: Discussionmentioning

confidence: 99%

“…Among the advantages of these blockades are reductions in pain perception during the intraoperative period, elimination of skeletal muscle tone, and decrease in anesthetics requirements [1]. However, several factors can influence the quality of these anesthetic techniques including dose of the local anesthetic, additives such as epinephrine or hyaluronidase, pH adjustment and carbonation, baricity, temperature, mixtures of local anesthetics, and pregnancy [2][3][4]. Although it is a widely used technique, a single dose of local anesthetics administered epidurally provides a short duration of analgesia [3,5].…”

Section: Introductionmentioning

confidence: 99%

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Different Volumes and Concentrations in Fixed Doses of Bupivacaine in Lumbosacral Epidural in Relation to Cranial Spread in Live Dogs

DeRossi

Hermeto

Jardim

et al. 2018

Asian J Pharm Clin Res

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Objective: The objective of this study was to assess whether the volume or concentration of local anesthetic influences its spread and quality of lumbosacral epidural blockade when the total drug dose is fixed.Methods: A total of 30 healthy bitches, undergoing elective ovariohysterectomy received a lumbosacral epidural block with a fixed dose of 0.5 mg/kg b.w. bupivacaine after general anesthesia induction with propofol. Treatment 1 group (low volume, high concentration [LVHC], n=15) received 0.2 mL/kg b.w. of 0.25% bupivacaine, whereas treatment 2 group (high volume, low concentration [HVLC], n=15) received 0.3 ml/kg b.w. of 0.167% bupivacaine. Both solutions contained radio-opaque dye. Heart rate, blood pressure, respiratory rate, rectal temperature, cranial spread, first analgesic rescue, and motor blockade were determined at predetermined intervals.Results: At 5 min, the dorsal cranial spread levels of bupivacaine confirmed by radiographic examination were T8 (T1–T10) for HVLC treatment and T8 (T6–T10) for LVHC treatment (p=0.957). However, there was a significant difference (p=0.029) in the ventral spread levels between HVLC treatment (T2; C7-T6) and LVHC treatment (T6; T5–T11). The first analgesic rescue was needed after 249±58 min in the LVHC treatment group and after 179±32 min in the HVLC treatment group (p=0.0005).Conclusion: It was concluded, if the total dose is fixed, then administration of an HVLC bupivacaine local anesthetic solution in the lumbosacral epidural space seems to produce effective post-operative analgesia for ovariohysterectomy surgery in bitches.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Different Volumes and Concentrations in Fixed Doses of Bupivacaine in Lumbosacral Epidural in Relation to Cranial Spread in Live Dogs

DeRossi

Hermeto

Jardim

et al. 2018

Asian J Pharm Clin Res

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“…Epidural administration of xylazine is known to produce delayed-onset analgesia [ 6 , 7 ]. In dogs, the time to onset of anesthesia with epidural hyaluronidase combined with levobupivacaine is significantly shorter than that with epidural levobupivacaine alone [ 10 ]. In our study, a clear improvement in animal well-being during EEJ was observed in the bulls administered epidural lidocaine, xylazine or xylazine combined with hyaluronidase.…”

Section: Discussionmentioning

confidence: 99%

“…Caudal epidural xylazine might reduce the pain caused by rectal smooth muscle spasms or intrapelvic nerve stimulation [ 17 ], but this drug has the disadvantage of exhibiting delayed onset of analgesia [ 6 , 7 ]. Hyaluronidase is hypothesized to hasten the onset of the block by enhancing the spread of local anesthesia [ 10 , 25 ].…”

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confidence: 99%

Efficacy of caudal epidural injection of lidocaine, xylazine and xylazine plus hyaluronidase in reducing discomfort produced by electroejaculation in bulls

Pagliosa

DeRossi

Faria

2015

The Journal of Veterinary Medical Science

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To test the hypothesis that epidural administration of lidocaine, xylazine or xylazine plus hyaluronidase provides reduced pain and stress during electroejaculation in bulls, eight 30-month-old Nellore bulls received saline solution (control), 2% lidocaine, 2% xylazine or 2% xylazine plus hyaluronidase injected into the first intercoccygeal (Co1–Co2) epidural space in randomized order. Heart rate, respiratory rate, mean arterial pressure, analgesia, animal behavior and motor blockade were evaluated before treatment and at predetermined intervals during and after treatment. Pain and stress were scored subjectively, and semen quality was evaluated. The onset of anesthetic action was significantly faster with lidocaine (3.0 ± 1.2 min) than with xylazine or xylazine plus hyaluronidase (8.9 ± 1.5 and 5.5 ± 2.6 min, P=0.021 and P=0.012, respectively), and the onset of anesthesia with xylazine plus hyaluronidase was significantly faster than that with xylazine alone (P=0.032). Treatment with xylazine or xylazine plus hyaluronidase resulted in less discomfort than treatment with lidocaine, as indicated by animal behavior. Changes in heart rate, respiratory rate and arterial pressure were within acceptable limits. Penile protrusion and semen emission occurred in all animals during all four treatments. Our results suggest that xylazine plus hyaluronidase reduced discomfort during electroejaculation more effectively than xylazine or lidocaine alone. Further experiments are necessary to determine whether electroejaculation with xylazine plus hyaluronidase is feasible for obtaining semen from Nellore bulls unaccustomed to being handled or restrained.

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“…Experimental and human studies have shown that levobupivacaine is less cardiotoxic than bupivacaine (De Rossi et al 2011) but with higher protein binding (97% versus 95%). This means that < 3% of levobupivacaine is free in the plasma and available to act on other tissues, possibly causing less unwanted side effects (McLeod & Burke 2001).…”

Section: Introductionmentioning

confidence: 99%

Comparison of clinical effects of epidural levobupivacaine morphine versus bupivacaine morphine in dogs undergoing elective pelvic limb surgery

Cerasoli

Tutunaru

Cenani

et al. 2017

Veterinary Anaesthesia and Analgesia

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Objective To evaluate the efficacy, in terms of the amount of rescue analgesia required, and the clinical usefulness of epidural injection of morphine with bupivacaine or levobupivacaine for elective pelvic limb surgery in dogs during a 24-hour perioperative period.Study design Prospective, blinded, randomized clinical study.Animals A group of 26 dogs weighing 31.7 ± 14.2 (mean ± standard deviation) kg and aged 54 ± 36 months.Methods All dogs were premedicated with methadone intravenously (0.2 mg kg e1 ) and anaesthesia induced with diazepam (0.2 mg kg e1 ) and propofol intravenously to effect. After induction of anaesthesia, dogs randomly received a lumbosacral epidural injection of morphine 0.1 mg kg e1 with either levobupivacaine 0.5% (1 mg kg e1 ;group LevoBM) or bupivacaine 0.5% (1 mg kg e1 ; group BM). Cardiovascular, respiratory and temperature values were recorded during the intraand postoperative period. A visual analogue scale, subjective pain scale, sedation scale and the short form of the Glasgow pain scale were assessed every 6 hours after epidural injection during 24 hours. The ability to stand and walk, neurological deficits and other side effects were assessed at the same time points. The amount of rescue analgesia (sufentanil intraoperatively and methadone postoperatively) was recorded.Results No statistically significant differences were found between groups for any of the recorded data, with the exception of the incidence of spontaneous urination and postoperative rescue analgesia requirement. In group LevoBM four dogs spontaneously urinated at recovery while none of the dogs in group BM did (p ¼ 0.03) and seven dogs of group LevoBM required postoperative rescue analgesia versus none of the dogs in the BM group (p ¼ 0.005).Conclusions and clinical relevance Epidural LevoBM is a suitable alternative to BM in healthy dogs during elective pelvic limb surgery. Epidural BM produced more urinary retention but better pain control compared to the same concentration and dose of LevoBM in dogs.

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Hyaluronidase shortens levobupivacaine lumbosacral epidural anaesthesia in dogs

Abstract: Hyaluronidase added to levobupivacaine significantly shortens the duration of epidural anaesthesia with the same dermatome spread into the epidural space in dogs.

Cited by 7 publications

References 23 publications

Different Volumes and Concentrations in Fixed Doses of Bupivacaine in Lumbosacral Epidural in Relation to Cranial Spread in Live Dogs

Different Volumes and Concentrations in Fixed Doses of Bupivacaine in Lumbosacral Epidural in Relation to Cranial Spread in Live Dogs

Efficacy of caudal epidural injection of lidocaine, xylazine and xylazine plus hyaluronidase in reducing discomfort produced by electroejaculation in bulls

Comparison of clinical effects of epidural levobupivacaine morphine versus bupivacaine morphine in dogs undergoing elective pelvic limb surgery

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