Use of opioids for pain and anesthetic management in horses

Bennett, Rachel C.; Steffey, Eugene

doi:10.1016/s0749-0739(02)00011-1

Cited by 101 publications

(97 citation statements)

References 40 publications

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“…Mu opioid agonists have been shown either to increase the MAC of volatile anaesthetics (Pascoe and others 1993, Steffey and others 2003) or to reduce anaesthetic requirement much less than in other species (Thomasy and others 2006). Although not entirely rational, the apparent MAC-increasing effect of some opioids has led a sustained opinion that opioids are not the best of perioperative analgesics to use in horses (Bennett and Steffey 2002). Two studies which failed to demonstrate antinociception after fentanyl or morphine (Sanchez and others 2007, Figueiredo and others 2012) probably add weight to this viewpoint.…”

Section: Discussionmentioning

confidence: 99%

Postcastration analgesia in ponies using buprenorphine hydrochloride

et al. 2013

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Buprenorphine has recently obtained UK Marketing Authorisation for horses. The analgesic effects are long lasting, and have considerable potential for postoperative pain relief. This observer blinded, randomised study aimed to evaluate postsurgical analgesia in ponies premedicated with buprenorphine prior to castration under intravenous anaesthesia. Ponies received either 0.01 mg/kg bodyweight (BW) buprenorphine (group B) or an equivalent volume of 5 per cent glucose (group C) given intravenously before induction of anaesthesia. Pain was assessed and recorded using dynamic interactive visual analogue scores (DIVAS 0-100) and a Simple Descriptive Scale (SDS 0-3) (high scores=most pain) before and 1, 3, 6, 9, 12 and 24 hours after anaesthesia. Rescue analgesia was given if DIVAS>40 mm. Data were analysed using the Mann-Whitney U test at P<0.05. Median (range) areas under the curve for DIVAS were 63 (0-383) mm hour in group B and 209 (0-391) mm hour in group C (P=0.0348). The SDS was lower in group B than in group C (P=0.038). Three group B and five group C animals required rescue analgesia. Buprenorphine did not produce any serious adverse effects. Buprenorphine at 0.01 mg/kg BW intravenously administered before anaesthesia provided near-comprehensive postoperative analgesia after surgical castration in ponies.

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Section: Discussionmentioning

confidence: 99%

Postcastration analgesia in ponies using buprenorphine hydrochloride

et al. 2013

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“…75,76 OPIOIDS Opioids (Table 4) are generally indicated in moderate to severe pain, however, their analgesic efficacy in horses compared to other species is less well defined, especially when used in clinically common doses. 60,77,78 At higher doses known to produce significant analgesia or antinociception (e.g., butorphanol, methadone, or morphine ≥ 0.1 mg/kg) opioids commonly provoke central excitatory responses, requiring combination with sedatives such as acepromazine or α 2 agonists (Table 4). 60,77,78 In, addition, they decrease gastrointestinal motility and cause colon impaction, thus limiting their long--term use in animals with chronic laminitis.…”

Section: Nsaidsmentioning

confidence: 99%

“…60,77,78 At higher doses known to produce significant analgesia or antinociception (e.g., butorphanol, methadone, or morphine ≥ 0.1 mg/kg) opioids commonly provoke central excitatory responses, requiring combination with sedatives such as acepromazine or α 2 agonists (Table 4). 60,77,78 In, addition, they decrease gastrointestinal motility and cause colon impaction, thus limiting their long--term use in animals with chronic laminitis. Combining lower doses of µ--opioids with low doses of α 2 agonists (preferably in the form of a constant rate infusion [CRI]) may help achieve a desired level of analgesia by making use of the well known analgesic synergism between the two drug classes, while avoiding the profound CNS stimulatory effects of the opioids and hemodynamic effects of the α 2 agonists (Table 4).…”

Section: Nsaidsmentioning

confidence: 99%

“…88 Buprenorphine (Buprenex ® ) is a µ--opioid agonist and κ--opioid antagonist, which has been claimed to have a ceiling effect. 77 When applied as a sole analgesic agent in horses, measurable antinociception has been reported to occur at doses of 10 µg/kg or higher but significant excitement and hemodynamic stimulation were noted as well. 89 Walker 90 reported recently about experience with a 5--day administration of buprenorphine in a filly with severe head and neck trauma choosing the sublingual/buccal mucosal route.…”

Section: Nsaidsmentioning

confidence: 99%

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Neuropathic Pain Management in Chronic Laminitis

Driessen

Bauquier

Zarucco

2010

Veterinary Clinics of North America: Equine Practice

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“…Horses may exhibit mild-to-profound sedation, but excitation and increased locomotion can also occur. 17 Morphine remains an option for providing analgesia to horses undergoing potentially painful procedures 18 ; however, the degree of analgesia can vary from profound to none, and increased excitation may occur.…”

mentioning

confidence: 99%

Anesthetic Considerations for Horses with Neurologic Disease

Smith¹

2007

Equine Neurology

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149Neurologic disease can present a variety of challenges for the anesthetist. The unique anatomical features of the brain limit its ability to respond to inflammatory, traumatic, and neoplastic challenges. Horses presenting with spinal cord or peripheral neuropathies can be challenging to the anesthetist due to the increased danger of a large, ataxic patient. The goal of neurologic anesthesia is to maintain adequate nourishment and blood delivery to the brain, minimize the development of seizures, minimize the effects of ataxia on the patient's safety, and prevent further deterioration of neurologic status.An understanding of the anatomy and physiology of the nervous system and how it relates to anesthesia is important in understanding how best to maximize patient safety and minimize morbidity and mortality.The brain is housed entirely within a bony cavity. This rigid structure does not allow for an increase in volume when faced with a traumatic, inflammatory, or neoplastic insult. Minor changes in cerebral blood flow (CBF), cerebrospinal fluid (CSF), or tissue volume (i.e., mass) can quickly result in a moderateto-severe increase in intracranial pressure (ICP). Elevated ICP can cause regional and global cerebral ischemia and hypoxia due to a reduction in cerebral perfusion pressure (CPP) and CBF, and ultimately can lead to potentially fatal displacement of brain and neuronal tissue, including brainstem herniation. 1 CBF is directly proportional to CPP and indirectly proportional to cerebral vascular resistance (CVR). Of these components, only CBF can be easily influenced by the anesthetist and thus is of particular interest.In a normal horse, CBF is under metabolic (chemical), myogenic (autoregulation), and neurogenic factors. 2 This control ensures consistent, high flow of blood to the brain over a range of arterial blood pressures. The mean arterial pressure (MAP) range within which CBF remains under autoregulatory control has not been defined in horses; however, in humans, the CBF remains consistent over 70-140 mm Hg, and animals may have better regulation of flow at lower arterial pressures. 2 Horses, due to their large size, undergo large orthostatic shifts when positioned in lateral or dorsal recumbency for general anesthesia. 3 These fluid shifts can alter MAP and thus have an effect on CPP.Chemical or metabolic factors that influence CBF include cerebral metabolic rate (CMR), the partial pressure of arterial carbon dioxide (P a CO 2 ), the partial pressure of arterial oxygen (P a O 2 ), and temperature. An increase in CMR will lead to an increase in CBF. 2 Anesthetics, both injectable and inhaled, can alter CMR and therefore influence CBF. Likewise, an increase in the temperature of the brain causes an increase in CBF.There is a directly proportionate relationship between CBF and P a CO 2 . These changes are due to intra-and extracellular pH alterations. Hypocapnia and alkalemia lead to a decrease in CBF due to vasoconstriction, resulting in an increase in CVR. Conversely, hypercapnia and acidemia resul...

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Use of opioids for pain and anesthetic management in horses

Cited by 101 publications

References 40 publications

Postcastration analgesia in ponies using buprenorphine hydrochloride

Postcastration analgesia in ponies using buprenorphine hydrochloride

Neuropathic Pain Management in Chronic Laminitis

Anesthetic Considerations for Horses with Neurologic Disease

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