Morphine concentrations in distal thoracic limb synovial fluid following intravenous regional limb perfusion in horses.
Abstract: Twelve adult horses were randomly assigned to 2 groups in a prospective experimental trial. A pneumatic tourniquet (425 mmHg) was placed, under sedation, proximal to the carpus on one randomly chosen thoracic limb. A cephalic vein catheter was placed distal to the tourniquet to establish an intravenous regional limb perfusion technique (IVRLP) with morphine (0.1 mg/kg) diluted with saline 0.9% to 0.1 mL/kg, and the tourniquet left in place for 30 minutes. Horses were euthanized at 1 h (Group I) or 6 h (Group II) following the IVRLP and synovial fluid from the radiocarpal, intercarpal, metacarpophalangeal, distal interphalangeal, and digital flexor tendon sheath was obtained from the injected and contralateral (control) limb immediately after. Morphine concentrations were determined using liquid chromatography-mass spectrometry. An unpaired -test was used to compare morphine concentrations from both groups ( < 0.05). Synovial morphine concentrations were detected in the injected limb in all horses in Group I, except in one horse in the radiocarpal joint, and detected in 5 of 6 horses in Group II. Mean synovial concentrations ranged between 301.8 ± 192.3 and 608 ± 446.6 ng/mL in Group I and between 27.0 ± 17.7 and 136.8 ± 103.6 ng/mL in Group II and were significantly higher in Group I between paired anatomical sites of both groups for the radiocarpal and distal interphalangeal joints, and the digital flexor tendon sheath. In conclusion, concentrations of morphine after IVRLP can be detected in synovial fluid distal to the tourniquet at 1 and 6 hours in horses. Douze chevaux adultes ont été assignés au hasard à deux groupes dans un essai expérimental prospectif. Un garrot pneumatique (425 mmHg) a été placé, sous sédation, à proximité du carpe sur un membre thoracique choisi au hasard. Un cathéter de la veine céphalique a été placé en aval du garrot pour établir une technique de perfusion intraveineuse régionale des membres (IVRLP) avec de la morphine (0,1 mg/kg) diluée avec une solution saline de 0,9 % à 0,1 mL/kg, et le garrot a été laissé en place pendant 30 minutes. Les chevaux ont été euthanasiés 1 h (groupe I) ou 6 h (groupe II) après l’IVRLP et le liquide articulaire de la gaine radiocarpienne, intercarpienne, métacarpo-phalangienne, interphalangienne distale et du tendon fléchisseur digital a été obtenu à partir du membre injecté et controlatéral (témoin) juste après. Les concentrations de morphine ont été déterminées par chromatographie liquide-spectrométrie de masse. Un test de non apparié a été utilisé pour comparer les concentrations de morphine des deux groupes ( < 0,05). Des concentrations de morphine synoviale ont été détectées dans le membre injecté chez tous les chevaux du groupe I, sauf chez un cheval dans l’articulation radiocarpienne et détectées chez 5 des 6 chevaux du groupe II. Les concentrations synoviales moyennes variaient entre 301,8 ± 192,3 et 608 ± 446,6 ng/mL dans le groupe I et entre 27,0 ± 17,7 et 136,8 ± 103,6 ng/mL dans le groupe II et étaient significativement plus élevées dans le groupe I entre les sites anatomiques appariés des deux groupes pour le radiocarpien et les articulations interphalangiennes distales, et la gaine du tendon fléchisseur numérique. En conclusion, les concentrations de morphine après IVRLP peuvent être détectées dans le liquide synovial en aval du garrot à 1 et 6 heures chez les chevaux.(Traduit par Docteur Serge Messier).
Copyright and/or publishing rights held by the Canadian Veterinary Medical Association.
Publication Date: 2023-10-04 PubMed ID: 37790266PubMed Central: PMC10542951
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- Randomized Controlled Trial
- Veterinary
- Journal Article
Summary
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This study investigated how morphine, administered via intravenous regional limb perfusion (IVRLP), is present in the synovial fluid of a horse’s limb. It demonstrated that morphine concentrations can be detected in the joint fluid at both 1 hour and 6 hours after administration.
Research Setup
- The researchers conducted a prospective experimental trial on 12 adult horses which were randomly assigned to two groups.
- A pneumatic tourniquet with a pressure of 425 mmHg was put on a randomly chosen thoracic limb of each horse while they were sedated. This was done proximal to the carpal joint of the horse’s limb.
- A cephalic vein catheter was then placed distal (farther from the origin) to the tourniquet to enable an intravenous regional limb perfusion technique (IVRLP) wherein morphine (at 0.1 mg/kg concentration) was administered after diluting in isotonic saline.
- The tourniquet was left in place for a period of 30 minutes to facilitate the process.
Study Design and Measurements
- Horses were euthanized either one hour (Group I) or six hours (Group II) after the IVRLP. Following this, synovial fluid was collected from five specific regions of the injected limb and the contralateral limb (control limb) to compare the morphine concentrations.
- Morphine concentration in the synovial fluid was determined using liquid chromatography-mass spectrometry technique, a highly sensitive and accurate method.
- Statistical comparison of the morphine concentrations was done using an unpaired t-test.
Results and Conclusion
- Out of Group I, all but one horse showed detectable morphine concentrations in the synovial fluid of the injected limb. In Group II, 5 out of 6 horses had detectable morphine.
- The average concentrations of the drug differed significantly between the two groups and were higher for Group I (ranging between 301.8 and 608 ng/mL) compared to Group II (ranging between 27 and 136.8 ng/mL).
- Higher concentrations of morphine were recorded in the radiocarpal and distal interphalangeal joints, and the digital flexor tendon sheath compared to other areas.
- The study concluded that morphine administered via IVRLP can indeed be detected in the synovial fluid of the distal region in a horse’s limb, at both 1 and 6 hours after administration.
Cite This Article
APA
Valverde A, Cribb N, Arroyo L.
(2023).
Morphine concentrations in distal thoracic limb synovial fluid following intravenous regional limb perfusion in horses.
Can J Vet Res, 87(4), 254-259.
Publication
Researcher Affiliations
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
MeSH Terms
- Horses
- Animals
- Anti-Bacterial Agents
- Synovial Fluid / chemistry
- Morphine
- Prospective Studies
- Perfusion / methods
- Perfusion / veterinary
- Forelimb
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