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The veterinary quarterly2019; 38(1); 129-137; doi: 10.1080/01652176.2018.1546963

Efficacy, chondrotoxicity and plasma concentrations of tramadol following intra-articular administration in horses undergoing arthroscopy: preliminary findings.

Abstract: Intra-articular administration of analgesics is performed to ensure good perioperative pain management avoiding undesirable systemic effects. To evaluate the effect of intra-articular injection of tramadol on postoperative pain after arthroscopy in horses and to determine whether tramadol had a local effect. Before the in vivo study, an in vitro test was performed aiming to evaluate the viability of equine chondrocytes after exposure to various concentrations of tramadol. The concentration identified as most appropriate was used to treat the horses' joints. Twelve horses affected by osteochondrosis were randomly assigned to two groups that were treated intra-articularly at the end of surgery with tramadol (4 mg/mL) and saline, respectively. At predetermined time-points a Composite Pain Scale was applied and blood samples were collected in order to define the extent of tramadol absorption into the systemic circulation. The Mann-Whitney test was used for statistical analysis. Serum of four out of six treated horses revealed traces of tramadol (range 10.6-19.3 ng/mL) sporadically between 0.5 and 4 hours post-treatment, while in the other two horses, no trace of drug was found. Findings suggested that any eventual effect was probably due to local action rather than systemic absorption. The pain scores obtained in tramadol-treated horses were lower between 1 and 6 hours post-administration, than those obtained in the control group, but the differences were not statistically significant. These preliminary results suggest that tramadol, at this concentration, is only mildly beneficial in the pain management of horses after arthroscopy.
Publication Date: 2019-02-19 PubMed ID: 30773122PubMed Central: PMC6831008DOI: 10.1080/01652176.2018.1546963Google Scholar: Lookup
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  • Clinical Trial
  • Veterinary
  • Journal Article

Summary

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The study investigates the effect of applying tramadol, an analgesic, directly into the joints of horses undergoing arthroscopy, while assessing potential chondrotoxicity. The preliminary findings suggest that tramadol may mildly alleviate post-surgery pain, probably due to its local action, while also displaying a minimal presence in the horses’ systemic circulation.

Study Design and Objective

  • The research primarily aimed at assessing the impact of tramadol when applied directly into the horse’s joints during arthroscopy on the post-surgery pain. This method was chosen to avoid any potential systemic side effects.
  • As chondrotoxicity (harmful effects on cartilage) is a critical factor, the study also evaluated the effect of different tramadol concentrations on the viability of horse chondrocytes in an in vitro experiment.
  • The concentration determined to be the most suitable was employed for treating the horses’ joints.
  • Additionally, blood samples were collected at given time-points to evaluate the extent of tramadol absorption into the horses’ systemic circulation.

Methodology and Results

  • 12 horses experiencing osteochondrosis were divided randomly into two groups. The first group received intra-articular tramadol (4 mg/mL) treatment at the end of surgery, while the second group (controls) were treated with saline solution instead.
  • Post-treatment, the horses’ pain levels were assessed using a Composite Pain Scale at deterministic time intervals.
  • Four out of six treated horses showed traces (range 10.6-19.3 ng/mL) of tramadol in their blood sporadically within 0.5 and 4 hours post-treatment. The two other horses displayed no sign of the drug in their system.
  • The pain scores for the tramadol-treated horses were generally lower between 1 and 6 hours post-administration than those recorded in the control group, indicating some level of pain relief. However, these differences were not statistically significant according to Mann-Whitney test.

Implications and Conclusions

  • The initial results imply that tramadol may offer mild pain management benefits to horses following arthroscopy when administered intra-articularly.
  • The sporadic presence of tramadol in the systemic circulation implies that any pain relief observed may be due to its local effect.
  • However, as the differences in pain relief between the tramadol-treated and control groups were statistically insignificant, further research with larger sample size is required to conclusively determine the analgesic efficacy of tramadol in equine arthroscopy.
  • The lack of chondrotoxicity at the selected concentration of tramadol is promising but warrants further examination.

Cite This Article

APA
Di Salvo A, Chiaradia E, Della Rocca G, Giorgi M, Mancini F, Marenzoni ML, Conti MB, Nannarone S. (2019). Efficacy, chondrotoxicity and plasma concentrations of tramadol following intra-articular administration in horses undergoing arthroscopy: preliminary findings. Vet Q, 38(1), 129-137. https://doi.org/10.1080/01652176.2018.1546963

Publication

ISSN: 1875-5941
NlmUniqueID: 7909485
Country: England
Language: English
Volume: 38
Issue: 1
Pages: 129-137

Researcher Affiliations

Di Salvo, Alessandra
  • a Department of Veterinary Medicine , University of Perugia , Perugia , Italy.
Chiaradia, Elisabetta
  • a Department of Veterinary Medicine , University of Perugia , Perugia , Italy.
  • b CSCS-Centro di Studi del Cavallo Sportivo, University of Perugia , Perugia , Italy.
Della Rocca, Giorgia
  • a Department of Veterinary Medicine , University of Perugia , Perugia , Italy.
  • c CeSDA-Centro di Studio sul Dolore Animale, University of Perugia , Perugia , Italy.
Giorgi, Mario
  • d Department of Veterinary Sciences , University of Pisa , Pisa , Italy.
Mancini, Francesco
  • a Department of Veterinary Medicine , University of Perugia , Perugia , Italy.
Marenzoni, Maria Luisa
  • a Department of Veterinary Medicine , University of Perugia , Perugia , Italy.
Conti, Maria Beatrice
  • a Department of Veterinary Medicine , University of Perugia , Perugia , Italy.
  • c CeSDA-Centro di Studio sul Dolore Animale, University of Perugia , Perugia , Italy.
Nannarone, Sara
  • a Department of Veterinary Medicine , University of Perugia , Perugia , Italy.
  • b CSCS-Centro di Studi del Cavallo Sportivo, University of Perugia , Perugia , Italy.
  • c CeSDA-Centro di Studio sul Dolore Animale, University of Perugia , Perugia , Italy.

MeSH Terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use
  • Animals
  • Arthroscopy / veterinary
  • Horse Diseases / chemically induced
  • Horses
  • Injections, Intra-Articular / veterinary
  • Joint Diseases / chemically induced
  • Joint Diseases / diagnosis
  • Joint Diseases / veterinary
  • Pain / prevention & control
  • Random Allocation
  • Tramadol / adverse effects
  • Tramadol / therapeutic use

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