Abstract
BackgroundMultimodal analgesia consists of the combination of analgesic drugs at low doses to act in different places along the path of pain. Studies with continuous infusion of analgesic drugs in cats are not common. This study aimed to evaluate the analgesic effect of maropitant, lidocaine and ketamine alone or in combination (intravenous bolus + subsequent continuous intravenous infusion) in the management of acute postoperative pain in cats undergoing ovariohysterectomy. Seventy healthy cats undergoing an ovariohysterectomy received a standard anesthetic protocol consisting of acepromazine and morphine, propofol (anesthesia induction), and isoflurane (anesthesia maintenance). The animals were stratified into seven groups (n = 10 in each group): control (CG), maropitant (MG), lidocaine (LG), ketamine (KG), maropitant + lidocaine (LMG), maropitant + ketamine (KMG), and maropitant + lidocaine + ketamine (LKMG). All drugs were injected first as an intravenous bolus and then by continuous intravenous infusion. During surgery, esophageal temperature, respiratory rate, heart rate, oxygen saturation, expired isoflurane concentration, and partial pressure of carbon dioxide at the end of expiration were evaluated at 7 time points. Postoperative pain was evaluated for 6 h after extubation using the visual analogue scale and the UNESP-Botucatu multidimensional composite pain scale for assessing postoperative pain in cats.ResultsAdverse effects related to maropitant, lidocaine and ketamine infusion were not observed. Pain scores were lower in the MG, KG and LG groups when compared to the CG group using both scales. Although pain scores were also lower in all combination groups than CG, more animals in these groups required rescue analgesia compared to MG. This indicates that the postoperative analgesic effect of all drugs, either alone or in combination, confers analgesia, although the combinations did not promote greater analgesia.ConclusionsContinuous intravenous infusion of maropitant, lidocaine, and ketamine alone induces postoperative analgesic effect in cats undergoing ovariohysterectomy, but combinations of these drugs did not increase the analgesic effect. No adverse effect was observed with any drug or their combination.
Highlights
Multimodal analgesia consists of the combination of analgesic drugs at low doses to act in different places along the path of pain
The study was conducted after obtaining approval by the Ethical Commission in the Use of Animals (CEUA) of the State University of Santa Cruz—UESC, Bahia, in Brazil, and in accordance with the guidelines on care and use of laboratory animals issued by the National Council for Animal Experimentation Control in Brazil
heart rate (HR) of animals in the Control group (CG) group was significantly higher at the time of ovarian pedicles ligation when compared with those in the Lidocaine and maropitant group (LMG), Ketamine and maropitant group (KMG), and LKMG groups
Summary
Multimodal analgesia consists of the combination of analgesic drugs at low doses to act in different places along the path of pain. This study aimed to evaluate the analgesic effect of maropitant, lidocaine and ketamine alone or in combination (intravenous bolus + subsequent continuous intravenous infusion) in the management of acute postoperative pain in cats undergoing ovariohysterectomy. Surgical procedures elicit harmful stimuli, which, if not prevented, can alter the neuroplasticity of the spinal cord and generate central sensitization. Lidocaine blocks sodium channels, preventing the propagation of action potential, and generates sensory and motor blockade for local and regional anesthesia. It can induce local anesthesia and can be used as an analgesic through continuous intravenous (IV) infusion in dogs and humans both intra- and post-operatively [8, 9]. Continuous IV infusion or IV bolus of lidocaine is not frequently used, mainly because of the risk of intoxication and other adverse effects [10, 11]
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