FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Veterinary sciences2022; 9(4); doi: 10.3390/vetsci9040174

Influence of Butorphanol, Buprenorphine and Levomethadone on Sedation Quality and Postoperative Analgesia in Horses Undergoing Cheek Tooth Extraction.

Abstract: The aim of this prospective clinical trial was to compare the influence of butorphanol, buprenorphine and levomethadone on sedation quality and postoperative analgesia in horses undergoing cheek tooth extraction. Fifty horses were assigned to three groups prior to oral cheek tooth extraction. Horses were treated with acepromazine, followed by a detomidine bolus, one of the three opioids and both a nerve block and gingival anaesthesia. During the surgery, sedation was maintained with a detomidine constant rate infusion. After surgery, the quality of sedation, surgical conditions and severity of the extraction were assessed with a numerical rating scale. To evaluate differences in the quality of analgesia between the three treatments, postoperative pain was estimated with the Equine Utrecht University Scale for Facial Assessment of Pain. Additionally, several parameters that are associated with dental pain were added to this validated pain score, and blood samples were taken to measure serum cortisol. Our analysis showed lower pain scores and a greater analgesic effect with levomethadone and buprenorphine compared with butorphanol, with increased locomotor activity induced by buprenorphine. While cortisol values demonstrated higher response in horses treated with levomethadone and buprenorphine compared to butorphanol, these values could be biased by unrelated stressors.
Get Full Text
Publication Date: 2022-04-06 PubMed ID: 35448672PubMed Central: PMC9029614DOI: 10.3390/vetsci9040174Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research compares how butorphanol, buprenorphine and levomethadone influence the quality of sedation and post-surgery pain relief in horses undergoing cheek tooth extraction. It found that levomethadone and buprenorphine provided better pain relief compared to butorphanol, though buprenorphine-induced increased movement in horses.

Objective of the Research

  • The study aimed to compare the effectiveness of three opioids — butorphanol, buprenorphine, and levomethadone — on the quality of sedation and post-surgery pain relief in horses undergoing cheek tooth extraction. The comparison was done as part of a clinical trial that examined 50 horses.

Methodology

  • The researchers divided the horses into three groups, with each group getting a pre-surgery treatment of acepromazine and detomidine bolus, along with one of the three opioids under study. The selected opioids were pumped into the horses’ bodies through a nerve block combined with gingival anesthesia.
  • Sedation during the procedure was maintained using a detomidine constant rate infusion.
  • Post-surgery, the researchers assessed the quality of sedation, the conditions during the surgery, and the severity of the extraction using a numerical rating scale.
  • The research team also checked the differences in pain relief after the surgery between the three treatments by estimating postoperative pain using the Equine Utrecht University Scale for Facial Assessment of Pain, and additional parameters associated with dental pain.
  • Additionally, the team took blood samples from the horses to measure serum cortisol.

Research Analysis

  • The results showed that horses given levomethadone and buprenorphine experienced lower pain scores, indicating greater pain relief, compared to horses given butorphanol. However, buprenorphine induced more physical movement in horses than the other two opioids.
  • Meanwhile, horses in the levomethadone and buprenorphine groups also showed a higher response in terms of cortisol values as compared to the butorphanol group, potentially indicating a higher level of stress. Nevertheless, these cortisol values could be influenced by stress factors unrelated to the study, such as the environment or handling of the horses.

Cite This Article

APA
Emanuel D, Kästner SBR, Delarocque J, Grob AJ, Bienert-Zeit A. (2022). Influence of Butorphanol, Buprenorphine and Levomethadone on Sedation Quality and Postoperative Analgesia in Horses Undergoing Cheek Tooth Extraction. Vet Sci, 9(4). https://doi.org/10.3390/vetsci9040174

Publication

Veterinary sciences
ISSN: 2306-7381
NlmUniqueID: 101680127
Country: Switzerland
Language: English
Volume: 9
Issue: 4

Researcher Affiliations

Emanuel, Daphna
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
Kästner, Sabine B R
  • Clinic for Small Animals, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
Delarocque, Julien
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
Grob, Anne J
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.
Bienert-Zeit, Astrid
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Buenteweg 9, 30559 Hannover, Germany.

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 48 references
  1. KuKanich B, Wiese A. Opioids. In: Grimm K.A., Lamont L.A., Tranquilli W.J., Greene S.A., Robertson S.A., editors. Veterinary Anaesthesia and Analgesia. Wiley Online Library; Oxford, UK: 2015. pp. 207–222.
  2. Bettschart-Wolfensberger R, Clarke K.W, Vainio O, Aliabadi F.S, Demuth D. Pharmacokinetics of medetomidine in ponies and elaboration of a medetomidine infusion regime which provides a constant level of sedation. Res. Vet. Sci. 1999;67:41–46.
    doi: 10.1053/rvsc.1998.0274pubmed: 10425239google scholar: lookup
  3. Ringer S.K, Portier K.G, Fourel I, Bettschart-Wolfensberger R. Development of a xylazine constant rate infusion with or without butorphanol for standing sedation of horses. Vet. Anaesth. Analg. 2012;39:1–11.
    doi: 10.1111/j.1467-2995.2011.00653.xpubmed: 22103355google scholar: lookup
  4. Gozalo-Marcilla M, de Oliveira A.R, Fonseca M.W, Possebon F.S, Pelligand L, Taylor P.M, Luna S.P.L. Sedative and antinociceptive effects of different detomidine constant rate infusions, with or without methadone in standing horses. Equine Vet. J. 2019;51:530–536.
    doi: 10.1111/evj.13054pubmed: 30485499google scholar: lookup
  5. Gozalo-Marcilla M, Luna S.P, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S. Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses. Vet. Anaesth. Analg. 2019;46:325–334.
    doi: 10.1016/j.vaa.2019.01.005pubmed: 30935776google scholar: lookup
  6. Haunhorst F.R, Hopster K, Schmicke M, Bienert-Zeit A, Kästner S. Clinical effect of buprenorphine or butorphanol, in combination with detomidine and diazepam, on sedation and postoperative pain after cheek tooth extraction in horses. Can. Vet. J. La Rev. Vet. Can. 2022;63:39–46.
    pmc: PMC8682929pubmed: 34975166
  7. Corletto F, Raisis A.A, Brearley J.C. Comparison of morphine and butorphanol as pre-anaesthetic agents in combination with romifidine for field castration in ponies. Vet. Anaesth. Analg. 2005;32:16–22.
    doi: 10.1111/j.1467-2995.2004.00184.xpubmed: 15663735google scholar: lookup
  8. Clarke K.W, England G.C, Goossens L. Sedative and cardiovascular effects of romifidine, alone and in combination with butorphanol, in the horse. J. Vet. Anaesth. 1991;18:25–29.
    doi: 10.1111/j.1467-2995.1991.tb00008.xgoogle scholar: lookup
  9. Kohn C.W, Muir W.W. III. Selected Aspects of the Clinical Pharmacology of Visceral Analgesics and Gut Motility Modifying Drugs in the Horse. J. Vet. Intern. Med. 1988;2:85–91.
    doi: 10.1111/j.1939-1676.1988.tb02799.xpubmed: 3065495google scholar: lookup
  10. Skarda R.T, Muir W.W. Comparison of electroacupuncture and butorphanol on respiratory and cardiovascular effects and rectal pain threshold after controlled rectal distention in mares. Am. J. Vet. Res. 2003;64:137–144.
    doi: 10.2460/ajvr.2003.64.137pubmed: 12602580google scholar: lookup
  11. Sanchez L.C, Elfenbein J.R, Robertson S.A. Effect of acepromazine, butorphanol, or N-butylscopolammonium bromide on visceral and somatic nociception and duodenal Motility in conscious Horses. Am. J. Vet. Res. 2008;69:579–585.
    doi: 10.2460/ajvr.69.5.579pubmed: 18447787google scholar: lookup
  12. Kästner S.B.R. Zur Anwendung von Butorphanol in der Veterinärmedizin. Tierarztl. Prax. Ausg. K Kleintiere Heimtiere 2008;36:393–398.
    doi: 10.1055/s-0038-1622700google scholar: lookup
  13. Giamberardino M.A, Vecchiet L. Pathophysiology of Visceral Pain. Curr. Pain Headache Rep. 1997;1:23–33.
    doi: 10.1007/BF02938147google scholar: lookup
  14. Türp J.C, Hugger A, Schindler H. Praxisnahe diagnostische Klassifikation orofazialer Schmerzen. Schweiz. Mon. Zahnmed. 2004;115:459–466.
    pubmed: 15250176
  15. Andaluz A, Moll X, Abellán R, Ventura R, Carbó M, Fresno L, García F. Pharmacokinetics of buprenorphine after intravenous administration of clinical doses to dogs. Vet. J. 2009;181:299–304.
    doi: 10.1016/j.tvjl.2008.03.001pubmed: 18467137google scholar: lookup
  16. Poller C, Hopster K, Rohn K, Kästner S.B.R. Nociceptive thermal threshold testing in horses—Effect of neuroleptic sedation and neuroleptanalgesia at different stimulation sites. BMC Vet. Res. 2013;9:135.
    doi: 10.1186/1746-6148-9-135pmc: PMC3708779pubmed: 23837730google scholar: lookup
  17. Rigotti C, de Vries A, Taylor P.M. Buprenorphine provides better anaesthetic conditions than butorphanol for field castration in ponies: Results of a randomised clinical trial. Vet. Rec. 2014;20:623.
    doi: 10.1136/vr.102729pubmed: 25262056google scholar: lookup
  18. Carregaro A.B, Luna S.P.L, Mataqueiro M.I, Queiroz-neto A. De. Effects of buprenorphine on nociception and spontaneous locomotor activity in horses. Am. J. Vet. Res. 2007;68:246–250.
    doi: 10.2460/ajvr.68.3.246pubmed: 17331012google scholar: lookup
  19. MSD Animal Health GmbH. L-Polamivet® ad Us. Vet.[N], Injektionslösung. [(accessed on 1 April 2022)]. Available online: https://www.vetpharm.uzh.ch/tak/02000000/00028503.01.
  20. Kristensen K, Christensen C.B, Christrup L.L. The mu1, mu2, delta, kappa opioid receptor binding profiles of methadone stereoisomers and morphine. Life Sci. 1994;56:45–50.
    doi: 10.1016/0024-3205(94)00937-6pubmed: 7823756google scholar: lookup
  21. Gorman A.L, Elliott K.J, Inturrisi C.E. The d- and l-isomers of methadone bind to the non-competitive site on the N-methyl-D-aspartate (NMDA) receptor in rat forebrain and spinal cord. Neurosci. Lett. 1997;223:5–8.
    doi: 10.1016/S0304-3940(97)13391-2pubmed: 9058409google scholar: lookup
  22. Schatzmann U, Armbruster S, Stucki F, Busato A, Kohler I. Analgesic Effect of Butorphanol and Levomethadone in Detomidine Sedated Horses. J. Vet. Med. Ser. A Physiol. Pathol. Clin. Med. 2001;48:337–342.
    doi: 10.1046/j.1439-0442.2001.00366.xpubmed: 11554491google scholar: lookup
  23. Marroum P.J, Webb A.I, Aeschbacher G, Curry S.H. Pharmacokinetics and pharmacodynamics of acepromazine in horses. Am. J. Vet. Res. 1994;55:1428–1433.
    pubmed: 7998701
  24. Knych H.K, Seminoff K, McKemie D.S, Kass P.H. Pharmacokinetics, pharmacodynamics, and metabolism of acepromazine following intravenous, oral, and sublingual administration to exercised Thoroughbred horses. J. Vet. Pharmacol. Ther. 2018;41:522–535.
    doi: 10.1111/jvp.12494pubmed: 29457257google scholar: lookup
  25. Pascoe P.J, Taylor P.M. Effects of dopamine antagonists on alfentanil-induced locomotor activity in horses. Vet. Anaesth. Analg. 2003;30:165–171.
    doi: 10.1046/j.1467-2995.2003.00134.xpubmed: 14498848google scholar: lookup
  26. van Loon J.P.A.M, Van Dierendonck M.C. Monitoring equine head-related pain with the Equine Utrecht University scale for facial assessment of pain (EQUUS-FAP). Vet. J. 2017;220:88–90.
    doi: 10.1016/j.tvjl.2017.01.006pubmed: 28190503google scholar: lookup
  27. Pehkonen J, Karma L, Raekallio M. Behavioral Signs Associated With Equine Periapical Infection in Cheek Teeth. J. Equine Vet. Sci. 2019;77:144–150.
    doi: 10.1016/j.jevs.2019.03.005pubmed: 31133309google scholar: lookup
  28. Ayala I, Martos N.F, Silvan G, Gutierrez-Panizo C, Clavel J.G, Illera J.C. Cortisol, adrenocorticotropic hormone, serotonin, adrenaline and noradrenaline serum concentrations in relation to disease and stress in the horse. Res. Vet. Sci. 2012;93:103–107.
    doi: 10.1016/j.rvsc.2011.05.013pubmed: 21641009google scholar: lookup
  29. Müller T.M, Hopster K, Bienert-Zeit A, Rohn K, Kästner S.B.R. Effect of butorphanol, midazolam or ketamine on romifidine based sedation in horses during standing cheek tooth removal. BMC Vet. Res. 2017;13:381.
    doi: 10.1186/s12917-017-1299-6pmc: PMC5719754pubmed: 29212478google scholar: lookup
  30. Tremaine H. Oral extraction of equine cheek teeth. Equine Vet. Educ. 2004;16:151–158.
    doi: 10.1111/j.2042-3292.2004.tb00287.xgoogle scholar: lookup
  31. van Loon J.P.A.M, Van Dierendonck M.C. Monitoring acute equine visceral pain with the Equine Utrecht University Scale for Composite Pain Assessment (EQUUS-COMPASS) and the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP): A scale-construction study. Vet. J. 2015;206:356–364.
    doi: 10.1016/j.tvjl.2015.08.023pubmed: 26526526google scholar: lookup
  32. Team R.C. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing; Vienna, Austria: 2020.
  33. Wood S.N. Fast stable restricted maximum likelihood and marginal likelihood estimation of semiparametric generalized linear models. J. R. Stat. Soc. 2011;73:3–36.
    doi: 10.1111/j.1467-9868.2010.00749.xgoogle scholar: lookup
  34. Wood S.N, Pia N, Saefken B. Smoothing parameter and model selection for general smooth models (with discussion) ournal. Am. Stat. Assoc. 2016;111:1548–1575.
    doi: 10.1080/01621459.2016.1180986google scholar: lookup
  35. de Grauw J, van Loon T. Clinical effects of two doses of butorphanol with detomidine for intravenous premedication of healthy warmblood horses. Vet. Anaesth. Analg. 2020;47:681–685.
    doi: 10.1016/j.vaa.2019.11.010pubmed: 32792271google scholar: lookup
  36. Kruljc P, Nemec A. Electroencephalographic and electromyographic changes during the use of detomidine and detomidine-butorphanol combination in standing horses. Acta Vet. Hung. 2006;54:35–42.
    doi: 10.1556/avet.54.2006.1.4pubmed: 16613024google scholar: lookup
  37. Taylor P, Coumbe K, Henson F, Scott D, Taylor A. Evaluation of sedation for standing clinical procedures in horses using detomidine combined with buprenorphine. Vet. Anaesth. Analg. 2014;41:14–24.
    doi: 10.1111/vaa.12055pubmed: 23742694google scholar: lookup
  38. Studer N, Diez Bernai S, Thormann W, Levionnois O, Spadavecchia C. The anti-nociceptive effects of levomethadone in standing horses sedated with romifidine. Vet. Anaesth. 2020;48:104743.
    doi: 10.1016/j.vaa.2020.08.011pubmed: 33685821google scholar: lookup
  39. Dönselmann Im Sande P, Hopster K, Kästner S. Einfluss von Morphin, Butorphanol und Levomethadon in unterschiedlicher Dosierung auf den thermischen nozizeptiven Schwellenwert bei Pferden. Tierärztliche Prax. Ausg. G Grosstiere Nutztiere 2017;45:98–106.
    doi: 10.15653/TPG-160655pubmed: 28075433google scholar: lookup
  40. Hopster K. Analgesie bei viszeralen Schmerzen—Was hilft wann und wie lange?. Pferde Spieg. 2017;20:107–112.
    doi: 10.1055/s-0043-112454google scholar: lookup
  41. Löscher W, Ungemach F.R, Kroker R. Pharmakotherapie bei Haus-Und Nutztieren. In: Löscher W., Ungemach F.R., Kroker R., editors. Volume 96. Enke; Bayern, Germany: 2014. p. 179.
  42. Price D.D, Mayer D.J, Mao J, Caruso F.S. NMDA-receptor antagonists and opioid receptor interactions as related to analgesia and tolerance. J. Pain Symptom Manag. 2000;19:7–11.
    doi: 10.1016/S0885-3924(99)00121-9pubmed: 10687332google scholar: lookup
  43. Woolf C.J, Thompson S.W.N. The induction and maintenance of central sensitization is dependent on N-methyl-d-aspartic acid receptor activation; implications for the treatment of post-injury pain hypersensitivity states. Pain 1991;44:293–299.
    doi: 10.1016/0304-3959(91)90100-Cpubmed: 1828878google scholar: lookup
  44. Thomson P.J, Rood J.P. Preemtive analgesia reduces postoperative pain experience following oral day case surgery. Ambul. Surg. 1995;3:144–147.
    doi: 10.1016/0966-6532(95)00016-3google scholar: lookup
  45. Gottschalk A, Wu C.L. New concepts in acute pain therapy. Ann. Long-Term Care. 2004;12:18–24.
  46. Love E.J, Taylor P.M, Murrell J, Whay H.R. Effects of acepromazine, butorphanol and buprenorphine on thermal and mechanical nociceptive thresholds in horses. Equine Vet. J. 2012;44:221–225.
    doi: 10.1111/j.2042-3306.2011.00412.xpubmed: 21696438google scholar: lookup
  47. van Loon J.P.A.M, Macri L. Objective assessment of chronic pain in horses using the horse chronic pain scale (Hcps): A scale-construction study. Animals 2021;11:1826.
    doi: 10.3390/ani11061826pmc: PMC8234780pubmed: 34207290google scholar: lookup
  48. Boman S. Plasma Cortisol Concentrations after Treatment with Methadone Alone or Together with Acepromazine or Detomidine in Horses. Dept. of Biomedical Sciences and Veterinary Public Health; Uppsala, Sweden: 2013.

Citations

This article has been cited 5 times.
  1. Arantes JA, Rabelo IP, Bermudes L, Lacerenza MD, Mendes RP, Corrêa RR, Yamada DI, Valadão CAA, Dória RGS. Optimizing equine standing sedation: continuous infusion of detomidine and butorphanol enhances stability but prolongs ataxia. Front Vet Sci 2025;12:1606585.
    doi: 10.3389/fvets.2025.1606585pubmed: 40919037google scholar: lookup
  2. Maldonado Moreno N, Alves Moreira J, Araujo De Oliveira L, Sanches Gontijo A, Castilho Baldi ML, Rocha Wenceslau R, Beier SL. Analgesic and Gastrointestinal Effects of Methadone in Horses Undergoing Orchiectomy. Animals (Basel) 2025 Aug 11;15(16).
    doi: 10.3390/ani15162358pubmed: 40867687google scholar: lookup
  3. Paranjape VV, Knych HK, Berghaus LJ, Giancola S, Cathcart J, Reed RA. Plasma concentrations of buprenorphine administered via matrix-type transdermal patches applied at three different anatomical locations in healthy adult horses. Front Pain Res (Lausanne) 2024;5:1390322.
    doi: 10.3389/fpain.2024.1390322pubmed: 38962712google scholar: lookup
  4. Paranjape VV, Knych HK, Berghaus LJ, Cathcart J, Giancola S, Craig H, James C, Saksena S, Reed RA. Evaluation of physical variables, thermal nociceptive threshold testing and pharmacokinetics during placement of transdermal buprenorphine matrix-type patch in healthy adult horses. Front Pain Res (Lausanne) 2024;5:1373555.
    doi: 10.3389/fpain.2024.1373555pubmed: 38529072google scholar: lookup
  5. 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.
    doi: 10.3389/fpain.2024.1347548pubmed: 38440199google scholar: lookup
Subscribe to our newsletter
Join 99,727 horse owners like you who receive our email updates on horse health and nutrition.