Abstract
Maropitant, an antagonist of neurokinin-1 (NK-1) receptors, blocks the pharmacological action of substance P on the central and peripheral nervous systems. The objective of this study was to compare the antinociceptive and cardiorespiratory effects of the continuous intraoperative infusion of maropitant with ketamine and lidocaine in female dogs undergoing unilateral radical mastectomy. Twenty-four female dogs were used and were divided randomly into two groups (n = 12). The GLK group received ketamine bolus (1.0 mg/kg), lidocaine bolus (1.5 mg/kg), and continuous infusion of ketamine and lidocaine (10 mcg/kg/min and 50 mcg/kg/min), respectively; the GLKM group received the same anesthetic protocol combined with maropitant bolus (1.5 mg/kg/IV) and continuous infusion of maropitant (100 mcg/kg/h). Continuous infusion was initiated at the start of surgery and was maintained until 1 hour postoperatively. Pain was evaluated in the postoperative period using four scales and a digital analgesimeter. Data were analysed using analysis of variance, Student's t-test, Mann–Whitney test, and Friedman's test (P < 0.05). Kaplan–Meier curves were compared using the log-rank test. The results indicated lower pain scores, better survival curves with a lower number of patients requiring rescue analgesia, and lower peripheral sensitization, in the GLKM group than in the GLK group. It was concluded that the coadministration of maropitant with ketamine and lidocaine had an adjuvant effect with minimal cardiorespiratory effects and effective analgesia, improving pain management and patient comfort.
Highlights
Mammary neoplasms are common in small animals and usually affect uncastrated females or animals that have been castrated late [1, 2]
Unilateral radical mastectomy was performed in female dogs by removing the mammary chain and the subcutaneous and lymphatic tissue on one side of the midline. is extensive surgical resection causes much pain because of the degree of tension, flexibility of the involved muscles, and the amount of damaged tissue; the excision of the nodules improves the animal’s quality of life, allows histological diagnosis, and reduces neoplastic progression [1, 2, 4]
The simultaneous administration of two or more analgesic drugs is safer and more effective than using one drug in the anesthetic protocol. e advantages of the bolus technique and continuous infusion of ketamine and lidocaine are well known, and this type of multimodal analgesia is widely used in mastectomies to achieve intraoperative and postoperative analgesia [29,30,31]
Summary
Mammary neoplasms are common in small animals and usually affect uncastrated females or animals that have been castrated late [1, 2]. E pain in this period may be attributed to some extent to the failure in analgesia techniques, compromising the success of patients’ recovery and resulting in acute and chronic pain [1]. It is believed that the use of multimodal protocols improves patient comfort and decreases adverse drug effects [4]. Adjuvant analgesia techniques usually reduce the need for anesthetics, providing adequate pain management and minimal adverse effects. Is protocol provides a constant concentration of these drugs, faster recovery, and normalization of plasma levels [1, 5, 6]. Ese agents may be used at the peripheral level for treating inflammatory bowel diseases, arthritis, inflammation, and cystitis [8,9,10] NK-1 receptor antagonists may be centrally applied as antiemetics and analgesics and for treating urinary incontinence. ese agents may be used at the peripheral level for treating inflammatory bowel diseases, arthritis, inflammation, and cystitis [8,9,10]
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