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BMC veterinary research2020; 16(1); 19; doi: 10.1186/s12917-020-2242-9

Morphine plasmatic concentration in a pregnant mare and its foal after long term epidural administration.

Abstract: Epidural administration of morphine has been shown to be an effective analgesic strategy in horses; however, the possible occurrence of side effects limits its usage. In order to decrease their frequency, it is important to target the minimal effective plasma concentration and avoid overdosing. As to date species-specific pharmacokinetics data are not available for epidural morphine, the dosing regimen is usually established on the basis of clinical reports and personal experience. In certain physiological conditions, like gestation, the outcome of an empirical dosing scheme can be unpredictable. The aim of this case report is to describe the pharmacological profile of morphine and its metabolites after prolonged epidural administration in a pregnant mare and her foal. Methods: A 20 years old pregnant mare was presented to our hospital because of severe lameness, 2 months before delivery. Following an ineffective systemic pain treatment, an epidural catheter was inserted and morphine administered (initial dose 0.1 mg/kg every 8 h). Due to its efficacy in controlling pain, it was continued until end of gestation. Plasmatic concentration of morphine and its metabolites were assessed in the mare 6 weeks after starting the treatment, and in both the mare and foal during the first days after delivery. Plasmatic values similar to those previously reported in the literature following morphine short term administration through various routes and not accompanied by side effects were found in the mare, except during an excitatory period. Moreover, no evidence of dangerous drug accumulation or significant milk passage was noticed in the foal. Mild reduction of feces production with no signs of colic and two self-limiting episodes of excitement occurred during treatment in the mare. No side effects occurred during gestation and first phases of life in the foal. Conclusions: Prolonged epidural administration of morphine in a pregnant mare allowed good pain control in absence of clinically relevant side effects, in both the mare and her foal. Sudden increase in morphine plasmatic concentration can occur and side effects appear; careful treatment to the lowest effective dose and continuous monitoring of the clinical condition of the treated horse should be performed.
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Publication Date: 2020-01-20 PubMed ID: 31959188PubMed Central: PMC6971975DOI: 10.1186/s12917-020-2242-9Google Scholar: Lookup
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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.

The research focuses on the study of morphine’s impact on a pregnant horse and its foal following long-term epidural administration, investigating the effectiveness and side effects.

Introduction

  • The paper starts by discussing the efficacy of morphine as an analgesic agent in horses when administered epidurally. However, the usage is limited due to the potential side effects.
  • It mentions the importance of balancing the minimal effective plasma concentration of morphine to avoid overdosing, especially in uncertain physiological conditions like pregnancy.

Objective

  • The study aims to examine the pharmacological profile of morphine and its by-products in a pregnant mare and her foal after long-term epidural administration.

Methodology

  • In the study, a pregnant mare of 20 years suffering from severe lameness was administered morphine epidurally. After an initial unsuccessful trial, the mare received morphine at frequent intervals which continued till the end of her gestation period.
  • The research monitored the plasma concentration of morphine and its metabolites in the mare for six weeks from the start of the treatment and in the mare and her foal post-delivery.

Findings

  • The findings reveal no significant side effects in the mare and her foal. The plasma concentration of morphine in the mare was comparable with those reported for short-term administration via various methods and were without side effects, except during an excitatory phase.
  • The study found no evidence of substantial drug accumulation or significant transfer into milk in the foal.

Conclusion

  • The research concludes that long-term epidural administration of morphine in a pregnant mare resulted in effective pain control devoid of clinically significant side effects in both the mare and her foal.
  • It also warns of the possible sudden spike in morphine plasma concentration and suggests that treatment should be kept to the lowest effective dose while continually monitoring the horse’s clinical condition.

Cite This Article

APA
Mirra A, Birras J, Diez Bernal S, Spadavecchia C. (2020). Morphine plasmatic concentration in a pregnant mare and its foal after long term epidural administration. BMC Vet Res, 16(1), 19. https://doi.org/10.1186/s12917-020-2242-9

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 16
Issue: 1
Pages: 19

Researcher Affiliations

Mirra, Alessandro
  • Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland. alessandro.mirra@vetsuisse.unibe.ch.
Birras, Jasmin
  • Swiss Institute for Equine Medicine (ISME), Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, and Agroscope, Bern, Switzerland.
Diez Bernal, Sabina
  • Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland.
Spadavecchia, Claudia
  • Department of Clinical Veterinary Medicine, Anaesthesiology and Pain Therapy Section, Vetsuisse Faculty, University of Bern, Länggassstrasse 124, 3012, Bern, Switzerland.

MeSH Terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / therapeutic use
  • Animals
  • Animals, Newborn / blood
  • Female
  • Horses
  • Injections, Epidural / veterinary
  • Lameness, Animal / drug therapy
  • Morphine / administration & dosage
  • Morphine / adverse effects
  • Morphine / blood
  • Morphine / therapeutic use
  • Morphine Derivatives / blood
  • Pain / prevention & control
  • Pain / veterinary
  • Pregnancy
  • Tendinopathy / veterinary

Conflict of Interest Statement

The authors declare that they have no competing interests.

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Citations

This article has been cited 1 times.
  1. Douglas H, Midon M, Shroff K, Floriano D, Driessen B, Hopster K. Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes. Front Vet Sci 2022;9:995299.
    doi: 10.3389/fvets.2022.995299pubmed: 36387394google scholar: lookup
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