A comparative study of intraosseous versus peripheral intravenous infusion of diazepam and phenobarbital in dogs

Abstract

Authors of recent literature have made several references to the use of intraosseous infusion in emergency situations. This method has provided a useful route of medication and fluid administration when peripheral IV access has been unsuccessful. Controlled studies on intraosseous infusion have been limited. To more accurately evaluate the effectiveness of this technique, we administered diazepam to 20 dogs randomly assigned to either peripheral IV (n = 10) or tibial intraosseous (n = 10) groups. Intramedullary placement usually was performed within 15 seconds. Central venous diazepam samples were collected at one-, three-, six-, ten-, and 20-minute intervals. Intraosseous infusion achieved and maintained serum diazepam levels comparable to those achieved by IV administration. This study was repeated with phenobarbital using a different set of 20 dogs with samples collected at one-, three-, six-, and ten-minute intervals. Results were similar in that the levels were comparable regardless of the use of intraosseous or IV administration. Complications using this technique have been few. When peripheral IV access is unobtainable, intraosseous infusion has been shown to be an effective and efficient alternative for administering medications and fluids.