Opioids in horses refer to a class of drugs that interact with opioid receptors in the central nervous system to produce analgesic effects. These substances are used in veterinary medicine for pain management, sedation, and anesthesia in equine patients. Opioids such as morphine, butorphanol, and buprenorphine are commonly administered to horses to alleviate pain associated with surgical procedures, injury, or chronic conditions. The pharmacokinetics and pharmacodynamics of opioids in horses can vary, influencing their efficacy and safety profiles. This topic includes a collection of peer-reviewed research studies and scholarly articles that explore the use, effects, and considerations of opioid administration in equine veterinary practice.
Ho CL, Ko JL, Li CH.The peripheral opioid activity of six homologous beta-endorphins (beta-EPs) were assayed on the guinea pig ileum and the vas deferens of the mouse, the rat and the rabbit. In the guinea pig ileum assay, human beta-EP (beta h-EP) was less potent than camel, turkey, and ostrich beta-EPs, of the same potency as equine beta-EP and more active than des-acetyl salmon beta-EP. In the rat vas deferens, mammalian beta-EPs showed higher activity than those from the bird and the fish, whereas in the mouse vas deferens assay, beta h-EP is more active than those from other species. In the rabbit vas defere...
Dodman NH, Shuster L, Court MH, Dixon R.Crib-biting in horses is a repetitive behavior pattern which may involve the activation of both narcotic receptors and dopamine receptors in the CNS. Crib-biting frequency, determined in 7 nontreated horses under controlled conditions, was usually linear for many hours and ranged from 0.3 to 14.9 bites/min. Intravenous or IM injections of narcotic antagonists decreased these rates to almost zero by about 20 minutes after the injection was given. The duration of the response to a single injection ranged from 20 minutes for naloxone to 4 hours or more for nalmefene and diprenorphine. Effective d...
Roberts MC, Argenzio A.Amitraz, atropine, glycopyrrolate and morphine (but not its derivatives, meperidine [pethidine], oxymorphone and butorphanol) produced similar effects on clinically observed intestinal functions and significantly prolonged intestinal transit, as assessed with polyethylene glycol (PEG). However, their mechanisms of action, particularly on intestinal transport (fluid movement), may differ widely. Loperamide appeared to exert a preferential action on intestinal transport rather than motility, as there was no significant delay in PEG transit. The action of amitraz in perturbing smooth muscle coord...
Woods WE, Weckman T, Wood T, Chang SL, Blake JW, Tobin T.A commercially available radioimmunoassay kit was used to screen for the presence of etorphine in post-race urines from horses racing in Kentucky. Most horse urines contained small amounts of materials which reacted positively in this immunoassay. These materials are apparently endogenous to the horse and were called apparent etorphine equivalents. The levels of these apparent etorphine equivalents in post-race urines from 70 horses were estimated. Their modal level averaged 0.1 ng/ml, the population distribution was log normal, and individual horses showed levels of up to 0.8 ng/ml.
Hon WK, Ng TB.Equine pancreatic acetone powder was extracted with an acetone-water-HCl mixture. An acid acetone powder resulted by adding a copious volume of acetone to the extract. The powder was subjected to salt fractionation, gel filtration and chromatography on CM-cellulose. Steroidogenic activity, ACTH-like immunoreactivity and opiate receptor binding activity were distributed among the CM-cellulose chromatographic fractions derived from material unretarded as well as from material retarded on Sephadex G-25. The data indicates a separation of steroidogenic and opiate receptor binding activities, and t...
Kamerling SG, Dequick DJ, Weckman TJ, Tobin T.Sensitive methods for measuring the analgesic, physiological and behavioural effects of opioids in the horse have recently been developed. Fentanyl, a prototypic mu-opiate receptor agonist, has been previously shown to produce a syndrome characterized by marked analgesia and locomotor stimulation as well as tachycardia, tachypnoea and behavioural arousal. To determine whether other opiate receptors mediate some of the actions of the narcotic analgesics in the horse, an agent with activity at kappa- and to lesser extent mu-receptors was studied using a vigorous experimental protocol. Like fenta...
Roger T, Bardon T, Ruckebusch Y.The electrical and mechanical activity of the digestive tract and its response to the administration of opiate agonists and antagonists was assessed from electrodes and strain gauges chronically implanted on the jejunum and the cecocolonic segments in 3 ponies given a diet of hay and concentrates. Before the drugs were given, 10 to 17 migrating myoelectric complexes/day were recorded on the small intestine, and a rhythmic motor activity (base line) was observed on the proximal portion of the colon at the rate of 3.5 to 6.6/hour. Propagated contractions from the proximal to the distal portion o...
Soma LR, Korber K, Anderson T, Hopkins J.The effects of furosemide (0.55 mg/kg IV) on the plasma and urinary fentanyl (PFE UFE) concentrations were studied during steady-state conditions. The PFE during the steady-state period was 0.31 +/- 0.027 ng/ml, with no significant changes occurring, even though the rate of excretion of fentanyl (EX) increased during the 1st hour from 112.0 +/- 21.6 to 534.5 +/- 82.9 ng/minute. The EX returned to control levels within 3 hours, as did the UFE. The injection of furosemide increased glomerular filtration rate from 1.97 +/- 0.21 to 3.81 +/- 0.75 ml/kg/min. The fractional reabsorption decreased fro...
Weld JM, Kamerling SG, Combie JD, Nugent TE, Woods WE, Oeltgen P, Tobin T.The effects of naloxone on the cardiovascular, hematologic and metabolic derangements associated with endotoxic and hemorrhagic shock were studied in unanesthetized horses. In the first of 3 experiments blood glucose and lactate levels, hematocrit, white, red and differential white cell counts, rectal temperature and clinical signs were obtained before and after endotoxin (10 micrograms/Kg) administration in 5 horses. In the second experiment, two groups of 3 horses received either intravenous naloxone (0.04 mg/Kg) or saline, 7 minutes prior to endotoxin. In a third experiment two groups of 4 ...
Nolan AM, Hall LW.The effects of four intravenous combinations, xylazine (0.7 mg/kg)/methadone (0.1 mg/kg), xylazine (0.7 mg/kg)/buprenorphine (0.004 and 0.006 mg/kg) and acepromazine (0.05 mg/kg)/buprenorphine (0.006 mg/kg) on arterial blood pressure, central venous pressure, heart rate, respiratory rate and blood gases were studied in four experimental ponies. With xylazine/buprenorphine and xylazine/methadone onset of sedation was rapid and obvious and although no surgical or diagnostic procedures were carried out, sedation was judged to be satisfactory for the next 30 to 40 minutes. Onset of sedation after ...
Combie JD, Nugent TE, Tobin T.Morphine could be detected in horses dosed with 0.1 mg of drug/kg of body weight for up to 48 hours in blood and 144 hours in urine. This dose of morphine elicited no observable effects and is a suggested analgesic dose. Computer analysis revealed that a 3-compartment open system was the best fitting model with a serum half life (t1/2(beta)) of 87.9 minutes and a urine t1/2(beta) of 101.1 minutes. Binding to equine serum proteins was linear over a drug concentration range of 3.88 X 10(-5)M to 3.50 X 10(-8)M and averaged 31.6%. In RBC-partitioning experiments, 78.1% of the drug was found in the...
Moore AB, Roesel OF, Fessler JF, Bottoms GD.The value of naloxone (1 mg/kg of body weight/hr for 4 hrs), a beta-endorphin antagonist, was assessed in the management of endotoxin-induced shock in ponies. Three groups of 5 ponies each were used: controls, ponies given Escherichia coli endotoxin put untreated, and ponies given endotoxin and then treated with naloxone. Endotoxin-induced changes in hemodynamics, blood chemical values, regional blood flow, plasma enzymes, and energy supplies were measured at selected times during the first 6 hours after endotoxin was given. There was no evidence that beta-endorphins released during shock were...
Nugent TE, Combie JD, Weld JM, Burns P, Tobin T.The enkephalins are small, pentapeptide neurotransmitter molecules which have reportedly been used in racing horses. In our experiments, D-Ala2-Metenkephalinamide and leucine enkephalin were administered to horses intravenously (IV) and intracisternally (IC). Leucine enkephalin had little effect on locomotor activity by either route at doses of 0.01 mg/Kg or less. Methionine enkephalinamide, an enzyme resistant enkephalin analog, had no significant effect when given IV (0.002 and 0.008 mg/kg). Other experiments involving intracisternal dosing with this long acting form at higher levels (0.005-...
Combie J, Blake JW, Ramey BE, Tobin T.Morphine was detected in equine biological fluids by a combination of liquid-liquid extraction and column chromatography, followed by derivatization and gas-liquid chromatographic assay, using electron capture detector. Recovery of morphine from the equine biological samples was poor. However, despite an overall recovery of less than 20%, this method had a detection limit of 0.2 ng/ml. Addition of 5,000 U of bovine liver beta-glucuronidase/ml of urine enabled detection of the drug in urine for up to 144 hours after horses were given 0.1 mg of morphine/kg of body weight. Morphine was found for ...
Combie J, Shults T, Nugent EC, Dougherty J, Tobin T.The locomotor responses of horses given morphine and fentanyl were blocked or lessened by administration of naloxone or acepromazine. Naloxone given at the dosage of 0.015 mg/kg completely blocked the locomotor activity induced in horses given fentanyl (0.020 mg/kg of body weight). The locomotor stimulation produced by morphine given at the dosage of 2.4 mg/kg was reduced by 75% of naloxone (0.020 mg/kg). Acepromazine partially blocked the locomotor responses to fentanyl and morphine. This blockade activity reached its peak about 30 minutes after acepromazine was given (IV) and lasted more tha...
Alexander F.The effect of morphine, Tinct. opii, loperamide, pethidine and atropine on intestinal transit and the faecal and urinary excretion of water and electrolytes was studied in ponies. The rate of passage of a particulate marker was slowed by morphine, hastened then slowed by loperamide and Tinct. opii, and hastened by atropine. The liquid marker was slowed by Tinct. opii and hastened then slowed by the other drugs. Only loperamide decreased the faecal sodium excretion. This drug also decreased faecal water and weight; it appeared worthy of clinical trial in diarrhoea. Tinct. opii decreased by morp...
Muir WW, Skarda RT, Sheehan WC.The cardiopulmonary effects of the narcotic agonists morphine, meperidine, oxymorphone, and methadone and of the partial agonist pentazocine were examined in the pain-free adult horse. The drugs produced dysphoric followed by euphoric effects. Increases in heart rate, arterial blood pressure, and cardiac output were observed in all horses with all drugs. Arterial blood pressure remained increased even after heart rate and cardiac output had returned to base-line values. Respiratory rate generally remained unchanged or increased shortly after drug administration and then decreased insignificant...
Lehner AF, Almeida P, Jacobs J, Harkins JD, Karpiesiuk W, Woods WE, Dirikolu L, Bosken JM, Carter WG, Boyles J, Holtz C, Heller T, Nattrass C....Remifentanil (4-methoxycarbonyl-4-[(1-oxopropyl)phenylamino]-1-piperidinepropionic acid methyl ester) is a mu-opioid receptor agonist with considerable abuse potential in racing horses. The identification of its major equine urinary metabolite, 4-methoxycarbonyl-4-[(1-oxopropyl)phenylamino]-1-piperidinepropionic+ ++ acid, an ester hydrolysis product of remifentanil is reported. Administration of remifentanil HCl (5 mg, intravenous) produced clear-cut locomotor responses, establishing the clinical efficacy of this dose. ELISA analysis of postadministration urine samples readily detected fentany...
Knych HK, Steffey EP, White AM, McKemie DS.Tramadol is an analgesic agent used in man and a number of veterinary species. The pharmacokinetics and behavioural effects of tramadol and its active metabolite have been described in mature horses, but not in young foals. Objective: To characterise the pharmacokinetics, metabolism and some induced behavioural and physiological responses following i.v. tramadol administration in the same group of foals on 4 different occasions, from a few days after birth to age 43 days. Methods: Experimental. Methods: Tramadol was administered i.v. (3 mg/kg bwt) to a group of 8 foals on 4 separate occasion...
Alexander SL, Irvine CH, Shand N, Turner J.Removal of opioid inhibition of GnRH neurones is thought to be a critical event in generating the ovulatory surge in some species. In the present study, a nonsurgical technique was used to collect pituitary venous blood samples from eight mares every 0.5-1.0 min for 1 h before and after administration of the opioid receptor antagonist naloxone (0.2 mg kg(-1), i.v.), to investigate whether opioid inhibition is also important in mares. Jugular blood samples were taken at 10-15 min intervals. Mares were studied 0, 1 or 2 days before ovulation. Naloxone administration increased mean rates of GnRH ...
Ho CL, Ko JL, Li CH.The peripheral opioid activity of six homologous beta-endorphins (beta-EPs) were assayed on the guinea pig ileum and the vas deferens of the mouse, the rat and the rabbit. In the guinea pig ileum assay, human beta-EP (beta h-EP) was less potent than camel, turkey, and ostrich beta-EPs, of the same potency as equine beta-EP and more active than des-acetyl salmon beta-EP. In the rat vas deferens, mammalian beta-EPs showed higher activity than those from the bird and the fish, whereas in the mouse vas deferens assay, beta h-EP is more active than those from other species. In the rabbit vas defere...
Koh RB, Harrison TM.Over the past years, the concept of pain management in veterinary medicine has evolved and led to the establishment of a new concept of multimodal approach to pain management, as the current standard of care. The use of multimodal analgesia combining pharmacologic and nonpharmacologic techniques not only helps optimize the quality and efficacy of analgesia but also may prevent the development of chronic or persistent pain. During the past decade, acupuncture has become more popular and evolved into one of the most used forms of integrative medicine interventions and nonpharmacologic therapeuti...
Hertzsch R, Emmerich IU, Lachenmeier DW, Sproll C, Monakhova YB, Aboling S, Bachmann U, Vervuert I.Opioid alkaloids were identified in the urine of horses during an anti-doping control and in a case of intoxication. In both cases, it was suspected that the horses had ingested poppy-contaminated feed. To verify this suspicion, possible opioid alkaloid sources in Germany were identified through a literature research. Additionally, the contaminated feed was botanically and chemically analysed. The results indicated that both cases were most probably caused by the poppy in the feed. This highlights the previously underestimated risk of an intake of poppy-contaminated feed in horses. Recommendat...
Linardi RL, Stokes AM, Barker SA, Short C, Hosgood G, Natalini CC.Methadone hydrochloride is a synthetic mu-opioid receptor agonist with potent analgesic properties. Oral methadone has been successfully used in human medicine and may overcome some limitations of other analgesics in equine species for producing analgesia with minimal adverse effects. However, there are no studies describing the pharmacokinetics (PK) of oral opioids in horses. The aim of this study was to describe the PK of orally administered methadone (0.1, 0.2 and 0.4 mg/kg) and physical effects in 12 healthy adult horses. Serum methadone concentrations were measured by gas chromatography/m...
Smith RF, Jackson LS, Moore A.An 125I radioimmunoassay to determine the pattern of urinary excretion of etorphine (a semisynthetic opiate agonist) after its administration to horses is described. Three thoroughbred horses were each given 5, 15, 30 and 100 micrograms of etorphine intramuscularly. Urine was collected for up to 72 after administration. The maximum etorphine concentration after administration of a dose of 5 micrograms was 711 pg ml-1 (concentrations were greater than 100 pg ml-1 after 23 h in all three horses); a 15 micrograms gave 2661 pg ml-1 (levels remained above 100 pg ml-1 for more than 44 h in each hors...
Wang CC, Hartmann-Fischbach P, Krueger TR, Wells TL, Simonson A, Compton JC.Due to opiorphin's analgesic and antidepressant functions, its illicit use is rumored in some racing jurisdictions. Opiorphin is very difficult to detect due to its hydrophilic nature and rapid degradation in plasma and urine samples. METHODOLOGY & RESULTS: We have developed a sensitive, reliable method for opiorphin detection and confirmation in equine samples, using EDTA to inhibit analyte degradation between the time of collection and analysis. Opiorphin was extracted by weak cation exchange followed by analysis using HILIC-MS/MS. The method was validated and the LOD was determined to b...
Soma LR, Korber K, Anderson T, Hopkins J.The effects of furosemide (0.55 mg/kg IV) on the plasma and urinary fentanyl (PFE UFE) concentrations were studied during steady-state conditions. The PFE during the steady-state period was 0.31 +/- 0.027 ng/ml, with no significant changes occurring, even though the rate of excretion of fentanyl (EX) increased during the 1st hour from 112.0 +/- 21.6 to 534.5 +/- 82.9 ng/minute. The EX returned to control levels within 3 hours, as did the UFE. The injection of furosemide increased glomerular filtration rate from 1.97 +/- 0.21 to 3.81 +/- 0.75 ml/kg/min. The fractional reabsorption decreased fro...
Hagedorn HW, Meiser H, Zankl H, Schulz R.The misuse of opiates in racehorses relates to their effect of increasing locomotor activity. Because methadone, a narcotic analgesic, has been suspected of use as a doping compound in the past, it was added to the list of banned drugs and should be considered in doping control. Because the literature fails to provide information on detection of methadone in blood or urine of horses, an enzyme-linked immunosorbent assay was developed to monitor this narcotic in equine body fluids. Combined with high-performance liquid chromatography, the immunoassay also served to confirm positives indicated b...
Stanley S, Jeganathan A, Wood T, Henry P, Turner S, Woods WE, Green M, Tai HH, Watt D, Blake J.We have raised antibodies to morphine and etorphine and developed one-step enzyme-linked immunosorbent assays (ELISA) for these drugs as part of a panel of post race tests for drugs in racing horses. These tests are simple, can be completed in 2 h, and can be read by visual inspection. The morphine ELISA has an I50 for morphine of about 1.5 ng/mL, while the etorphine ELISA has an I50 for etorphine of 250 pg/mL. Cross-reactivity studies show that the antimorphine antibody cross-reacts well with levorphanol, hydromorphone, and oxycodone, while the anti-etorphine antibody showed no cross-reactivi...
Harkins JD, Tobin T.Fentanyl and other opioid drugs have their effect in the central nervous system; however, activity at peripheral sites has also been demonstrated. Pain-suppression activity at peripheral sites raises the possibility of skilled individuals producing local anaesthetic effects with small doses of opioid drugs that would be difficult to detect forensically and could be used to affect the outcome of a race. Therefore, the local pain-suppression effect (peripheral nerve inhibition) of fentanyl was tested using an abaxial sesamoid block/hoof withdrawal model. With this model, fentanyl did not produce...
Aurich C, Aurich JE, Klug E.Clinical effects of the opioid antagonist naloxone were investigated in healthy horses. Naloxone caused a transient increase in the frequency of defecations, a softening of the faeces and alterations in the intensity of abdominal borborygmi. Total serum protein concentrations decreased. Behavioural changes like frequent yawning and flehmen occurred, heart rate decreased and respiratory rate tended to increase but no clinical signs of distress or pain were observed. It can be concluded that in healthy animals naloxone had only minor side-effects and could be used to investigate the physiologica...
McDonald J, Gall R, Wiedenbach P, Bass VD, DeLeon B, Brockus C, Stobert D, Wie S, Prange CA, Ozog FJ.A one step enzyme-linked immunosorbent assay (ELISA) test for morphine was evaluated as part of a panel of pre- and post-race tests for narcotic analgesics in racing horses. This ELISA test is very sensitive to morphine with an I-50 for morphine of about 400 pg/ml. The test is also rapid, and ten samples, a normal pre-race complement, can be analyzed in about thirty minutes. The test can be read with an inexpensive spectrophotometer, or even by eye. The test readily detects the presence of morphine or its metabolites in equine blood for up to six hours after administration of sub-therapeutic d...
Hovda LR.This article provides information on the toxicity of some therapeutic drugs, illicit drugs, and supplements. Medications in the therapeutic section are grouped into antibiotics, antipsychotic agents, bronchodilators, nonsteroidal anti-inflammatory drugs, opioids, and sedatives/tranquilizers. The section on illicit drugs and supplements provides information on more specific medications including commonly used or abused human medications and a few that are available only from Internet compounding pharmacies. Many drugs and supplements can be either therapeutic or illicit depending on the dosage ...
Paranjape VV, Knych HK, Berghaus LJ, Giancola S, Cathcart J, Reed RA.Anatomical location-dependent differences in transdermal opioid penetration are well described in human patients. Although this has been investigated in horses with fentanyl, there is no literature available on location-dependent plasma buprenorphine concentrations when administered as a transdermal matrix-type patch. Unassigned: This study aims to compare the plasma concentrations achieved from the matrix-type transdermal buprenorphine patches placed at different anatomical sites (metacarpus, gaskin, and ventral tail base) in healthy adult horses. Unassigned: This is a randomized experimental...
Knych HK, Steinmetz SJ, Traynham ML, McKemie DS, Kass PH.Morphine is an effective analgesic in horses, however, IV administration at therapeutic doses has been shown to produce dose-dependent neuroexcitation and unwanted gastrointestinal effects. The analgesic effects of morphine have, at least in part, been attributed to the morphine-6-glucuronide (M6G) metabolite. Oral administration to horses results in comparable M6G concentrations to that achieved following IV administration of a therapeutic dose without the adverse effects. The anti-nociceptive effects have not yet been reported. In the current study the thermal anti-nociceptive effects of sin...
Otsuka T, Araki M, Mita H, Kambayashi Y, Yoshihara E, Ohta M.We evaluated the clinical efficacy of total intravenous anesthesia (TIVA) with propofol-ketamine-xylazine (PKX) with or without remifentanil for castration in horses. Twenty-four Thoroughbred horses were premedicated with intravenous (IV) xylazine (1.0 mg/kg) and midazolam (0.02 mg/kg) and anesthetized with IV ketamine (1.5 mg/kg) and propofol (1.0 mg/kg). Surgical anesthesia was maintained with constant infusion of propofol (3.0 mg/kg/hr)-ketamine (3.0 mg/kg/hr)-xylazine (1.0 mg/kg/hr) (group PKX: n=8), PKX combined with remifentanil (3.0 µg/kg/hr) (group PKXR3: n=8), or PKX combined with re...
Bustamante R, Segura IÁ, Santiago I.Locoregional techniques promote multimodal analgesia and may reduce general anaesthetic requirements. However, there is limited evidence in foals. The rectus sheath block (RSB) is an interfascial plane block previously described in other species such as dogs, cats, pigs, and calves, and recently in foals, which targets desensitization of ventral abdominal midline. This block may provide an efficacious analgesic alternative for ventral celiotomies and umbilical surgeries. This case series reports the use of a bilateral RSB with 0.25-0.3 mL kg-1 bupivacaine (maximum dose of 2 mg kg-1) per hemiab...
Karačonji IB, Jelača T, Jurič A, Vrdoljak AL.Opiates such as morphine and codeine are substances often misused to improve the performance of racing horses during competitions and are therefore on the International Federation for Equestrian Sports' list of prohibited substances. However, a positive antidoping test may be due to the consumption of feed (mainly lucerne or oats) contaminated by opium poppy containing the alkaloids morphine and codeine. In order to determine whether a positive antidoping test is the result of an intentional abuse of opiates or consumption of feed contaminated by poppies, we optimised conditions for the extrac...
Honkavaara JM, Karikoski NP, Palvas L, Pypendop BH, Rinne VM, Raekallio MR.The aim of the study was to determine the exposure to subcutaneously administered butorphanol in horses pre-treated with intravenous (IV) detomidine, with or without vatinoxan, a peripherally selective alpha-adrenoceptor antagonist. Five healthy, adult horses received three IV treatments 7 days apart, in a randomized, cross-over design: detomidine 20 μg/kg (DET-B), detomidine 20 μg/kg with vatinoxan 200 μg/kg (DETVAT-B) and saline (S-B), all followed by 0.1 mg/kg of butorphanol administered subcutaneously 30 min later. Venous samples were collected between 10 and 270 min after...
Whitelock A, Goodwin W, Dryburgh L, Mshelbwala PP, Rae L, Marwedel L, Lok T, Kemp K, Stewart AJ.To describe Australian practices and attitudes regarding equine analgesia. Methods: Cross-sectional anonymous, voluntary survey of Australian veterinarians treating equine patients. Methods: Australian veterinarians in equine or mixed practices completed a six-section, 60-question survey between November 2019 to August 2020. Information was gathered on demographics, analgesia prescription, pain assessment and attitudes surrounding specific analgesics. Respondents assigned a pain score ranging from 0 to 10 for various conditions; these were averaged to give each respondent an "average pain scor...
Carroll AT, Reed RA, Perlini M, Clough AE, Rocha M, Moorman VJ.To evaluate the effect of cervical epidural injection of morphine alone and morphine in combination with detomidine on recovery from anesthesia in horses. Methods: Blinded, randomized, crossover, Latin square design. Methods: A group of six healthy adult horses aged 9 ± 3 years and weighing 471 ± 76 kg (mean ± standard deviation). Methods: Horses were administered each of three treatments during a 1 hour general anesthetic with a 4 day washout period. Treatments were: 1) cervical epidural injection of saline 0.011 mL kg (S); 2) morphine 0.1 mg kg (M); and 3) morphine 0.1 mg kg with detomidi...
