Development of a romifidine constant rate infusion with or without butorphanol for standing sedation of horses.
Abstract: To determine constant rate infusion (CRI) protocols for romifidine (R) and romifidine combined with butorphanol (RB) resulting in constant sedation and romifidine plasma concentrations. Methods: Blinded randomized crossover study. Methods: Ten adult research horses. Methods: Part I: After determining normal height of head above ground (HHAG = 100%), loading doses of romifidine (80 μg kg(-1)) with butorphanol (RB: 18 μg kg(-1)) or saline (R) were given intravenously (IV). Immediately afterwards, a butorphanol (RB: 25 μg kg(-1) hour(-1)) or saline (R) CRI was administered for 2 hours. The HHAG was used as marker of sedation depth. Sedation was maintained for 2 hours by additional romifidine (20 μg kg(-1) ) whenever HHAG > 50%. The dose rate of romifidine (μg kg(-1) hour(-1)) required to maintain sedation was calculated for both treatments. Part II: After loading doses, the romifidine CRIs derived from part I were administered in parallel to butorphanol (RB) or saline (R). Sedation and ataxia were evaluated periodically. Romifidine plasma concentrations were measured by HPLC-MS-MS at 0, 5, 10, 15, 30, 45, 60, 90, 105, and 120 minutes. Data were analyzed using paired t-test, Fisher's exact test, Wilcoxon signed rank test, and two-way anova for repeated measures (p < 0.05). Results: There was no significant difference in romifidine requirements (R: 30; RB: 29 μg kg(-1) hour(-1)). CRI protocols leading to constant sedation were developed. Time to first additional romifidine bolus was significantly longer in RB (mean ± SD, R: 38.5 ± 13.6; RB: 50.5 ± 11.7 minutes). Constant plasma concentrations of romifidine were achieved during the second hour of CRI. Ataxia was greater when butorphanol was added. Conclusions: Romifidine bolus, followed by CRI, provided constant sedation assessed by HHAG. Butorphanol was ineffective in reducing romifidine requirements in unstimulated horses, but prolonged the sedation caused by the initial romifidine bolus. Conclusions: Both protocols need to be tested under clinical conditions.
© 2011 The Authors. Veterinary Anaesthesia and Analgesia. © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.
Publication Date: 2011-12-14 PubMed ID: 22151873DOI: 10.1111/j.1467-2995.2011.00681.xGoogle Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Research Support
- Non-U.S. Gov't
- Animal Studies
- Ataxia
- Biochemistry
- Butorphanol
- Clinical Study
- Disease Treatment
- Drug
- Equine Health
- Equine Science
- High-performance Liquid Chromatography (HPLC)
- Horses
- Intravenous Administration
- Pharmacokinetics
- Pharmacology
- Physiology
- Sedation
- Veterinary Care
- Veterinary Medicine
- Veterinary Practice
- Veterinary Research
Summary
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This study aimed to determine protocols for a constant rate infusion (CRI) of the drugs romifidine, used alone or in combination with butorphanol, in order to achieve constant sedation in horses. The findings suggest that both protocols, whether with romifidine alone or in combination with butorphanol, provide constant sedation, though adding butorphanol resulted in greater ataxia, or lack of muscle control.
Methods applied in the research
- The research was conducted as a blinded randomized crossover study on ten adult research horses.
- Initially, the normal height of a horse’s head above the ground (HHAG) was determined and set as 100%.
- Then, loading doses of romifidine, with butorphanol (RB) or saline (R), were administered intravenously.
- Following this, a butorphanol or saline CRI was administered for two hours.
- The HHAG was used as a marker to determine the depth of sedation.
- Additional doses of romifidine were given whenever the HHAG was more than 50% to maintain sedation for two hours.
- The dose rate of romifidine required to maintain sedation was calculated for both treatments.
Results of the Research Study
- The research found no significant difference in the amount of romifidine required whether used singly (R) or with butorphanol (RB).
- The time to first additional dose of romifidine was significantly longer when it was combined with butorphanol.
- During the second hour of constant rate infusion, stable plasma concentrations of romifidian were achieved.
- However, when butorphanol was added to romifidine, it resulted in greater ataxia in the horses.
Conclusions of the Study
- The bolus of romifidine, followed by constant rate infusion, provided constant sedation, as assessed by the horses’ head height above the ground.
- In unstimulated conditions, adding butorphanol did not reduce the need for romifidine, but it did extend the duration of sedation triggered by the initial romifidine dose.
- However, these findings were based on non-clinical conditions, so both protocols need to be tested under clinical conditions for better analysis and refinement.
Cite This Article
APA
Ringer SK, Portier KG, Fourel I, Bettschart-Wolfensberger R.
(2011).
Development of a romifidine constant rate infusion with or without butorphanol for standing sedation of horses.
Vet Anaesth Analg, 39(1), 12-20.
https://doi.org/10.1111/j.1467-2995.2011.00681.x Publication
Researcher Affiliations
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, Switzerland. sringer@vetclinics.uzh.ch
MeSH Terms
- Analgesics, Opioid / administration & dosage
- Anesthetics, Combined / administration & dosage
- Animals
- Butorphanol / administration & dosage
- Conscious Sedation / methods
- Conscious Sedation / veterinary
- Cross-Over Studies
- Female
- Horses / metabolism
- Hypnotics and Sedatives / administration & dosage
- Imidazoles / administration & dosage
- Imidazoles / blood
- Infusions, Intravenous / methods
- Infusions, Intravenous / veterinary
- Male
- Single-Blind Method
Citations
This article has been cited 6 times.- Nannarone S, Giannettoni G, Laurenza C, Giontella A, Moretti G. Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction.. Animals (Basel) 2021 Aug 31;11(9).
- Troya-Portillo L, López-Sanromán J, Villalba-Orero M, Santiago-Llorente I. Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both.. Animals (Basel) 2021 Jul 13;11(7).
- de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Esteves Trindade PH, Prospero Puoli Filho JN, Luna SPL. Development and validation of the facial scale (FaceSed) to evaluate sedation in horses.. PLoS One 2021;16(6):e0251909.
- de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Trindade PHE, Puoli Filho JNP, Luna SPL. Development, Validation, and Reliability of a Sedation Scale in Horses (EquiSed).. Front Vet Sci 2021;8:611729.
- Müller TM, Hopster K, Bienert-Zeit A, Rohn K, Kästner SBR. Effect of butorphanol, midazolam or ketamine on romifidine based sedation in horses during standing cheek tooth removal.. BMC Vet Res 2017 Dec 6;13(1):381.
- Carregaro AB, Freitas GC, Ribeiro MH, Xavier NV, Dória RG. Physiological and analgesic effects of continuous-rate infusion of morphine, butorphanol, tramadol or methadone in horses with lipopolysaccharide (LPS)-induced carpal synovitis.. BMC Vet Res 2014 Dec 21;10:966.
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