Comparison of hydromorphone and butorphanol for management of pain in equine patients undergoing elective arthroscopy: a randomized clinical trial.
Abstract: To compare the effects of hydromorphone and butorphanol in horses undergoing arthroscopy and describe the pharmacokinetics of hydromorphone in anesthetized horses. Methods: Randomized controlled clinical trial. Methods: A total of 40 adult horses admitted for elective arthroscopy. Methods: Horses were randomly assigned to be administered intravenous hydromorphone (0.04 mg kg-1; group TxH; n = 19) or butorphanol (0.02 mg kg-1; group TxB; n = 21) prior to surgery as part of a standardized anesthetic protocol. Pain was scored by two observers unaware of group assignment using the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) and a composite pain scale (CPS) prior to surgery (baseline), 2 hours (P2) and 4 hours (P4) following recovery from anesthesia. Blood samples were collected at various time points for determination of plasma hydromorphone concentration using liquid chromatography-tandem mass spectrometry. Data were analyzed with a mixed-effect model. Results: Median (range) baseline EQUUS-FAP was 1.2 (0.0-4.0) with no effect of group, time points or interaction. Baseline CPS was similar between groups. Group TxH baseline CPS was 2.5 (0.0-10.0), increased at P2 [4.5 (0-10.0); p = 0.046] and returned to baseline values at P4 [3.0 (0.0-11.0)]. Group TxB baseline CPS was 2.0 (0.0-8.0), increased at P2 [3.5 (0.0-11.0); p = 0.009] and P4 [5.0 (0.0-11.0); p < 0.001]. Pharmacokinetic terminal half-life was 774 ± 82.3 minutes, area under the curve was 1362 ± 314 ng minutes mL-1, clearance was 30.7 ± 7.23 mL minute-1 kg-1 and volume of distribution at steady state was 884 ± 740 mL kg-1. Conclusions: Hydromorphone, but not butorphanol, decreased CPS back to baseline at P4 after recovery. Conclusions: Hydromorphone may provide superior postoperative analgesia compared with butorphanol in horses undergoing arthroscopy.
Copyright © 2022 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
Publication Date: 2022-06-03 PubMed ID: 35752564DOI: 10.1016/j.vaa.2022.05.006Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Veterinary
Summary
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This study aimed to compare the effects of two drugs, hydromorphone and butorphanol, used for pain management in horses undergoing arthroscopy. The findings suggest that hydromorphone may provide better post-surgery pain relief as compared to butorphanol.
Objective
- The main objective of this research was to compare the effectiveness of hydromorphone and butorphanol as pain relievers in horses undergoing elective arthroscopy (a minimally invasive surgical procedure).
Methods
- The study was a randomized controlled clinical trial, involving 40 adult horses undergoing elective arthroscopy.
- Horses were divided into two groups, with one group receiving intravenous hydromorphone and the other butorphanol prior to surgery.
- Postoperative pain was evaluated using the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) and a composite pain scale (CPS).
- Assessments were made prior to surgery, 2 hours after recovery from anesthesia, and again at 4 hours post-recovery.
- Blood samples were also taken at several intervals to determine hydromorphone concentration in the plasma.
Results
- The study found no significant difference in the baseline EQUUS-FAP scores between the two groups.
- CPS scores increased in both groups at the 2-hour post-recovery mark, but returned to baseline in the hydromorphone group at the 4-hour mark.
- In the butorphanol group, CPS scores continued to rise at the 4-hour mark.
- The pharmacokinetic properties of hydromorphone, including its half-life, area under the curve, clearance rate, and volume of distribution at steady state, were also determined.
Conclusions
- The findings suggest that hydromorphone may be more effective than butorphanol in managing post-operative pain in horses undergoing arthroscopy.
- The research suggests that hydromorphone was able to reduce the CPS scores back to baseline by the 4-hour post-anesthesia mark, providing superior pain relief.
Cite This Article
APA
Reed R, Trenholme N, Skrzypczak H, Chang K, Ishikawa Y, Barletta M, Quandt J, Knych H, Sakai D.
(2022).
Comparison of hydromorphone and butorphanol for management of pain in equine patients undergoing elective arthroscopy: a randomized clinical trial.
Vet Anaesth Analg, 49(5), 490-498.
https://doi.org/10.1016/j.vaa.2022.05.006 Publication
Researcher Affiliations
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA. Electronic address: rreed@uga.edu.
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
- K.L. Maddy Equine Analytical Pharmacology Laboratory, University of California-Davis, Davis, CA, USA.
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
MeSH Terms
- Analgesics, Opioid / therapeutic use
- Animals
- Arthroscopy / veterinary
- Butorphanol
- Horses
- Humans
- Hydromorphone / therapeutic use
- Pain / veterinary
- Pain Measurement / veterinary
Citations
This article has been cited 2 times.- Haralambus R, Juri M, Mokry A, Jenner F. The impact of opioid administration on the incidence of postanaesthetic colic in horses. Front Pain Res (Lausanne) 2024;5:1347548.
- Reed RA, Krikorian AM, Reynolds RM, Holmes BT, Branning MM, Lemons MB, Barletta M, Quandt JE, Burns CC, Dantino SC, Sakai DM. Post-anesthetic CPS and EQUUS-FAP scores in surgical and non-surgical equine patients: an observational study. Front Pain Res (Lausanne) 2023;4:1217034.
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