Combination Of Butorphanol Research Articles

Use of butorphanol as a local anaesthetic for pain management in calves undergoing umbilical hernia repair.

The aim of the study was to compare the analgesic efficacy of butorphanol and lidocaine, alone or in combination, in calves undergoing surgical repair of umbilical hernia. The study was conducted in 60 calves of different breeds. Xylazine 0.3 mg/kg was administered intramuscularly to all animals in the study. The animals were then divided into three groups (n = 20) that received different treatments with lidocaine at 4.5 mg/kg and butorphanol at 0.02 mg/kg. The L group received lidocaine both by infiltration of the surgical planes and intraperitoneally, the B group received butorphanol both by infiltration of the surgical planes and intraperitoneally, and finally the LB group received lidocaine by infiltration of the surgical planes and butorphanol intraperitoneally. Heart and respiratory rates, haemoglobin oxygen saturation, non-invasive blood pressure and temperature were recorded during surgery. Response to the surgical stimulus was scored on a cumulative numerical scale that included percentage changes in HR, RR and SAP. Postoperative pain was assessed by three independent observers, blinded to treatment, using the UNESP-Botucatu Unidimensional Composite Pain Scale (UNESP-Botucatu UCPS-IV) for the assessment of postoperative pain in cattle. The course of physiological variables was appropriate for patients under anaesthesia. No subject required rescue intraoperative analgesia. In group L, 4 subjects at 40 m and 5 subjects at 50 m required postoperative rescue analgesia. Both butorphanol alone and the combination of butorphanol and lidocaine showed excellent intraoperative and postoperative scores. Furthermore, this combination did not cause any cardiopulmonary or other adverse effects. Based on the results of this study, both butorphanol alone and the co-administration of butorphanol and lidocaine administered locally proved to be safe and effective in providing adequate and long-lasting analgesia in calves, helping to reduce postoperative discomfort and maintaining adequate animal welfare.

Comparing the Efficacy of Two Immobilization Drug Combinations for the Chemical Restraint of Bobcats (Lynx rufus).

Chemical immobilization agents that provide rapid induction time, short duration of action, wide margin of safety, and postreversal recovery are important attributes to the handling process of immobilized animals. We evaluated differences in induction, recovery, and physiologic parameters in 23 (13 female, nine adults and four yearlings; 10 male, nine adults and one yearling) free-ranging bobcats (Lynx rufus) chemically immobilized with an intramuscular combination of ketamine (10 mg/kg) and xylazine (KX; 1.5 mg/kg; n=11) or a combination of butorphanol (0.8 mg/kg), azaperone (0.27 mg/kg), and medetomidine (BAM; 0.32 mg/kg; n=12). Induction parameters, time to first effect, hemoglobin oxygen saturation, and anesthesia between bobcats administered KX and BAM were similar. Pulse rate was significantly higher for KX than for BAM. Time to standing and full recovery after reversal were faster for bobcats administered BAM than KX. Six of 11 (55%) bobcats given KX were effectively immobilized with a single injection, and five required additional drugs to allow adequate time for processing. Of 12 bobcats given BAM, six (50%) were effectively immobilized with a single injection, three (25%) individuals were not completely immobilized and required additional doses to allow adequate time for processing, and three (25%) required additional doses after complete arousal during processing. We found that BAM provided reduced sedation and processing times (<30 min), whereas KX provided extended sedation and processing times beyond 30 min. We suggest that researchers increase initial BAM drug volumes for yearling and adult bobcats at time of processing and consider taking appropriate safety precautions when handling free-ranging bobcats.

Reversal of arterial oxygen desaturation with the use of an oxygen concentrator during injectable anaesthesia in feral cats positioned in the Trendelenburg, dorsal or lateral surgical position.

This study observed the effects of oxygen supplementation, via an oxygen concentrator, on peripheral arterial blood oxygenation (SpO2) measured by pulse oximetry in anaesthetised cats undergoing spay in three different surgical positions. A total of 192 female feral cats were investigated for a large-scale trap-neuter-release program. Cats were anaesthetised with an intramuscular combination of butorphanol (0,4 mg / kg), ketamine (7-10 mg / kg) and medetomidine (0,03-0,05 mg / kg). Cats were randomly allocated to undergo spay in either Trendelenburg (TR) (70° downward head tilt), lateral (LR) or dorsal (DR) recumbency. Cats were breathing spontaneously either room air or 2 L/minute oxygen via a tight-fitting face mask. Pulse rate (in beats per minute), respiratory rate (in breaths per minute) and SpO2 (in percentage) were measured at baseline in left lateral recumbency and afterwards continuously after being positioned in allocated surgical position. At the end of surgery, cats were placed again in left recumbency, and all parameters were re-evaluated after five minutes. Overall, 33 % of cats showed severe arterial oxygen desaturation (SpO2 < 90 %) at baseline when breathing room air. When oxygen was supplemented during the procedure, arterial oxygen desaturation resolved in all cats. At the end of the procedure, 29 % of cats were hypoxaemic when oxygen was not supplemented, with an overall higher percentage of hypoxaemic cats in TR as compared to DR and LR recumbencies. All cats recovered well from surgery and were released within 24 hours post-anaesthesia. Arterial oxygen desaturation is frequent in cats anaesthetised with injectable anaesthesia for spay under field conditions. Oxygen supplementation administered via a tight-fitting mask resolved arterial oxygen desaturation in this feral cat population regardless of the surgical position and therefore oxygen supplementation is recommended in any case.

Anaesthetic management and complications of a Humboldt penguin (Spheniscus humboldti) undergoing diagnostic imaging

BackgroundThe presence of a tracheal septum dividing the trachea into two makes intubation one of the main challenges of penguin anaesthesia. Differences in the length and location of the aforementioned tracheal septum have been described in some penguin species. However, to the best of the authors’ knowledge, it has not been reported in Humboldt penguins (Spheniscus humboldti). Therefore, one of the aims of this publication is to report the septal position in this Humboldt penguin. Furthermore, this publication describes the anaesthetic protocol and complications encountered and discusses some of the more important features of penguin anaesthesia. It is anticipated that this case report will aid in future procedures requiring anaesthesia of this penguin species.Case presentationA 25-year-old female Humboldt penguin was anaesthetized at the University College Dublin Veterinary Hospital for radiographs and computed tomography (CT) following three weeks of inappetence. After assessing the health status of the penguin from the clinical history and performing a physical examination, an American Society of Anesthesiologists physical status score of II was assigned and a combination of butorphanol 1 mg/kg and midazolam 1 mg/kg was administered intramuscularly to sedate the penguin. Induction of anaesthesia was performed via a face mask using sevoflurane in oxygen. The airway was intubated with a 4.0 mm Cole tube and anaesthesia was maintained with sevoflurane in oxygen during the entire procedure. Anaesthetic monitoring consisted of an electrocardiogram, pulse oximetry, non-invasive blood pressure, capnography, and body temperature.ConclusionsTracheal bifurcation was identified as the start of the tracheal septum 4.67 cm from the glottis using CT. Most of the anticipated complications of penguin anaesthesia, such as hyperthermia, hypothermia, regurgitation, hypoventilation, and difficulties in intubation were present in this case. However, no major sequalae occurred following the anaesthetic protocol described.

Determination of a safe sedative combination of dexmedetomidine, ketamine and butorphanol for minor procedures in dogs by use of a stepwise optimization method

BackgroundIn veterinary practice, most minor procedures such as radiographs, skin biopsies, and wound treatments require sedation. The combination of butorphanol, ketamine, and dexmedetomidine is commonly used, but the ideal dosages for this combination have not been defined. This randomized prospective clinical 3-phases trial initially tested eight clinically relevant combinations of intramuscular administration in 50 dogs (phase 1). The quality of each combination was rated using a purposefully developed negative score (NS; 0-21.5, the lower the NS the better the quality of sedation) to judge the quality of sedation, the occurrence of side effects, and the need for additional anaesthetics. Based on the results of the NS, the eight combinations were divided into “promising” and “unsatisfactory” subgroups. In phase 2, a new combination (N) was calculated and tested in six dogs replacing the worst of the eight initial combinations. This procedure was repeated until the NS could not be improved any further. In phase 3, the best combination was tested in 100 adult dogs undergoing diagnostic or therapeutic procedures.ResultsThe optimal combination established was dexmedetomidine 0.005 mg/kg, ketamine 1 mg/kg, and butorphanol 0.3 mg/kg with a median NS of 1.5 (interquartile range 1.5–2.4). In all 112 dogs receiving this combination, the quality of sedation was satisfactory and no severe side effects were detected.ConclusionsThe application of this optimization method allowed the calculation of an optimal drug combination to sedate cardiovascularly healthy dogs. After having being tested in 112 animals, this combination can consequently be considered safe. Therefore, this combination can now be used in daily clinical practice for cardiovascularly healthy adult dogs undergoing minor procedures.

Butorphanol, Azaperone, and Medetomidine for Chemical Immobilization in Free-Ranging Shiras (Alces alces shirasi) Moose: Ground and Helicopter Darting in Wyoming, USA.

We chemically immobilized a free-ranging moose subspecies, Shiras moose (Alces alces shirasi), using a combination of butorphanol (27.3 mg/mL), azaperone (9.1 mg/mL), and medetomidine (10.9 mg/mL). Ground and helicopter darting with fixed doses of 2 mL and 3 mL, respectively, safely immobilized 13 individuals in Wyoming, USA.

Kedilerde Butorfanol, Medetomidin ve Ketamin Kombinasyon Anestezisi ile Yapılan Ovaryohisterektomi Sırasında Kan Gazı Parametrelerindeki Değişikliklerin Değerlendirilmesi

The aim of this study was to determine the effect of anesthesia with a combination of butorphanol, medetomidine and ketamine on blood gas parameters during ovariohysterectomy in queens. Nineteen queens of different breeds, between 6 and 72 months of age, which were neutered, were used in the study. Before anesthesia, 1 mL of blood was taken from Vena cephalica antebrachi to a heparinized syringe and blood gas parameters were evaluated. Queens determined to be healthy as a result of clinical examination and laboratory analyzes were taken under general anesthesia for ovariohysterectomy. Butorphanol (0.01 mg/kg, IV) was administered for anesthesia induction, medetomidine (0.08 mL/kg, IV) was administered 5 minutes after following the induction and ketamine (5-7.5 mg/kg, IV) was administered intravenously 10 minutes later. At the 10th minute of ketamine administration, blood samples were taken from the queens again. Blood gas parameters such as pH, pCO2, pO2, sO2, Na, Ca, K, Cl, Glu, Lac, BE and HCO3 were evaluated in blood samples taken before and during anesthesia. It was determined that pH, pO2, sO2, BE and HCO3 levels were lower and pCO2 and lactate concentrations were higher in anesthesia-induced queens compared to pre-anesthesia. As a result, it was thought that monitoring blood gas parameters in queens undergoing ovariohysterectomy may be useful to prevent complications that may occur before and after the operation.

Sedative effect with the combination of butorphanol and midazolam on two-dimensional shear wave elastography of pancreas and kidney in healthy dogs

To evaluate the sedative effect of a combination of butorphanol and midazolam on 2-D shear wave elastography (SWE) of the kidneys and pancreas in dogs. 8 clinically healthy dogs. We conducted a 2-D SWE examination of the bilateral kidneys and the pancreas before and after IV of 0.2 mg/kg butorphanol and 0.1 mg/kg midazolam in each dog. We performed 2-D SWE on the left kidney via a subcostal approach with the dog in right lateral recumbency, on the right kidney via the intercostal approach with the dog in left lateral recumbency, and on the right lobe of the pancreas via the subcostal approach. Subsequently, the pancreas and kidney shear wave velocities (SWV) pre- and postsedation were compared. On qualitative evaluation using color mapping, the pancreas and kidneys showed a homogeneous blue-to-green color in pre- and post-sedation 2-D SWE. There was no significant difference in SWV pre- and post-sedation in the pancreas and kidneys. Intravenous administration of a combination of 0.2 mg/kg butorphanol and 0.1 mg/kg midazolam did not change the 2-D SWE of the pancreas and kidneys significantly. The combination of butorphanol and midazolam can be used in healthy dogs for 2-D SWE evaluation of the pancreas and kidneys, especially when the patient is uncooperative during the examination.

Preliminary investigation into change in packed cell volume (PCV) after administration of two premedication protocols followed by induction and maintenance of anaesthesia in goats

Administration of certain sedative and anaesthetic agents can cause a reduction in circulating packed cell volume (PCV) probably due to sequestration of red cells in the spleen, increasing its size. The effect on PCV after intravenous (IV) administration of butorphanol then diazepam, five minutes apart, or, these premedicants administered in reverse order, followed by propofol and isoflurane anaesthesia have not been investigated in goats. Two cohorts of Saanen goats, one for castration (males, 5 months, 13 goats) and one for experimental orthopaedic surgery for another study (females, 3 to 5 years, 12 goats) were included in this research. Goats were randomized to receive either butorphanol or diazepam first followed by the other agent IV five minutes apart prior to anaesthesia. Four blood samples to analyse PCV were taken per goat (baseline, after the first and second premedicant administration, and after propofol induction). A between and within-subjects design ANOVA was applied to determine the difference in PCV over time between treatment groups. Baseline PCV across all goats had a mean of 0.42 L/L (range 0.28 – 0.78 L/L). Both combinations of butorphanol and diazepam followed by induction of anaesthesia with propofol caused a clinically and statistically significant reduction in PCV (p < 0.001), with values dropping by 29.0% (diazepam-first) and 29.1% (butorphanol-first) from baseline values to the last sample (an overall decrease in PCV of 0.12 L/L for both groups). However, there was no statistical difference between groups (p = 0.696). Results demonstrate that clinicians need to be aware of the magnitude of reduction in PCV that can occur when butorphanol and diazepam are used as premedicants prior to propofol administration.

Effect of a combination of butorphanol and detomidine on endoscopic assessment of laryngeal function in Thoroughbred yearlings.

To the authors' knowledge, the effect of a combination of butorphanol tartrate and detomidine hydrochloride on the laryngeal function and symmetry of the arytenoid cartilages in young Thoroughbred horses has not been examined. Therefore, this study aimed to examine the effects of administration of butorphanol and detomidine on left-to-right rima glottidis ratio (L:R RGR), cross-sectional area of the rima glottidis (CSARG) and grade of laryngeal function of Thoroughbred yearlings examined endoscopically at rest. Forty-six Thoroughbred yearlings underwent laryngeal video endoscopy, at rest, before and after sedation with butorphanol and detomidine. Three clinicians assigned grades of laryngeal function after reviewing the video recordings. The L:R RGR and CSARG were measured at the point of arytenoid cartilages' maximal abduction. Student's t-test was used to compare the L:R RGR and CSARG. Cohen's kappa (κ) was used to compare the intra- and interobserver agreements. Spearman's rank order was used to assess agreement between CSARG and grade of laryngeal function. Sedation had no effect on L:R RGR and CSARG. Mean intraobserver agreement of grade of laryngeal function of unsedated yearlings was 93.1%, and that of sedated yearlings was 92.9%. Mean interobserver agreement of grade of laryngeal function of unsedated yearlings was 92.8%, and that of sedated yearlings was 92.7%. Correlation between CSARG and laryngeal function grade was significant for both groups (p<0.001). Sedating Thoroughbred yearlings with detomidine and butorphanol, before endoscopically examining the larynx, did not significantly affect the grade of laryngeal function.

Complication with re‐sedation in southern ground hornbills (Bucorvus leadbeateri) following partial reversal of two orally administered sedation protocols

AbstractThe combination of midazolam, medetomidine and azaperone (MMA) was compared with the combination of butorphanol, azaperone and medetomidine (BAM) for the sedation of southern ground hornbills when administered orally in a bait. The BAM combination (30 mg butorphanol, 12 mg azaperone and 12 mg medetomidine per ml of solution) at a dose of 0.14 ml/kg was the only combination that did not result in re‐sedation after reversal. However, induction of sedation was long, and sedation was only deep enough for capture, handling, and minor non‐invasive procedures. The MMA combination and higher doses of the BAM combination resulted in quicker inductions although individuals showed mild to severe signs of re‐sedation, starting at 4 hours after reversal and continuing for as long as 17 hours after reversal. Care should therefore be taken when administering these combinations orally to southern ground hornbills as it appears that absorption, metabolism and excretion are unpredictable in this species.

BUTORPHANOL, AZAPERONE, AND MEDETOMIDINE ANESTHESIA IN FREE-RANGING EASTERN MOOSE (ALCES AMERICANUS).

Fifty-three free-ranging moose (Alces americanus) cows were darted from a helicopter with 3-4 ml of a premix combination of butorphanol (27.3 mg/ml), azaperone (9.1 mg/ml), and medetomidine (10.9 mg/ml; BAM), equivalent to estimated dosages of: butorphanol 0.26 ± 0.08 (mean ± SD) mg/kg, azaperone 0.09 ± 0.03 mg/kg, and medetomidine 0.11 ± 0.03 mg/kg. After a mean chase time (from sighting to darting) of 6.1 ± 5.5 min, the mean induction time (from darting to recumbency) was 8.3 ± 2.6 min. This combination provided a safe and reliable sedation for minor procedures that lasted 30-60 min. Heart rate (50.4 ± 7.0 beats/min), respiratory rate (21.3 ± 11.1 breaths/minute), ETCO2 via nasal canula (43.2 ± 7.0 mmHg), and rectal temperature (38.5°C ± 0.7°C) mostly remained at expected values for wild cervid and bovid species anesthetized with this drug combination. SpO2 (90.0% ± 3.7%) was suggestive of moderate hypoxemia despite intranasal oxygen supplementation (1 L per 100 kg/min). The recovery time to standing was 6.7 ± 3.8 min after reversal with IM naltrexone (3 mg/mg butorphanol) and atipamezole (5 mg/mg medetomidine). Despite a larger volume to inject, this protocol offers an alternative to highly potent opioids, and should be considered for practical or staff safety reasons. On the basis of the results of this study, the use of 4 ml of BAM is considered a safe and effective protocol for immobilization of cow moose under comparable settings.

EVALUATION OF TWO ANESTHETIC COMBINATIONS IN LOWLAND NYALA (TRAGELAPHUS ANGASII).

Fourteen lowland nyala (Tragelaphus angasii) in managed care were successfully anesthetized for a total of 17 anesthetic events using either a combination of butorphanol (0.75 ± 0.15 mg/kg), azaperone (0.25 ± 0.05 mg/kg), and medetomidine (0.30 ± 0.06 mg/kg) (BAM) or medetomidine (0.17 ± 0.01 mg/kg), azaperone (0.22 ± 0.02 mg/kg), and alfaxalone (0.52 ± 0.08 mg/kg) (MAA) delivered intramuscularly via dart. Mean time to initial effect, sternal recumbency, lateral recumbency, handling, and intubation were recorded. The nyala were maintained in sternal recumbency with supplemental oxygenation until 60 min after initial injection. Cardiopulmonary effects were recorded every 5 min after handling until reversal. Arterial blood samples were collected every 15 min for analysis. Level of sedation and quality of recovery were scored. Anesthesia was antagonized with atipamezole (at 5 mg per mg of medetomidine) for both protocols and naltrexone (at 2 mg per mg of butorphanol) for the BAM protocol delivered intramuscularly via hand injection. Mean time to extubation, head control, and standing post reversal were recorded. No hyperthermia, acidemia, apnea, or tachycardia occurred; however, animals did display hypoxemia. Two animals in the BAM cohort required supplementation to facilitate handling. These drug combinations provided satisfactory levels of sedation in most cases for safe handling and minor procedures in lowland nyala under managed care.

Tissue Residue Levels of the Tranquilizer Combination of Butorphanol, Azaperone, and Medetomidine, and the Antagonists, Naltrexone, Atipamezole, and Tolazoline, in Black Bears (Ursus americanus) Postimmobilization.

The tranquilizer combination of butorphanol, azaperone, and medetomidine (BAM) has shown good efficacy for immobilization of wildlife, including black bears (Ursus americanus). BAM is antagonized with a combination of naltrexone and atipamezole. We immobilized 19 adult captive wild caught black bears and, except for three bears that were euthanized immediately, bears were recovered with naltrexone and atipamezole. Tissue residues (≥0.01 ppm) for the tranquilizers butorphanol, azaperone, and medetomidine were detected in liver and muscle of all three bears euthanized on day 0 postinjection (PI). Azaperone was not detected after 1 d PI. Residue for medetomidine was detected in two bears: in the liver 3 d PI and in the kidney 6 d PI. Butorphanol was reported in three bears: in fat 5 d PI, in kidney 6 d PI, and, surprisingly, in kidney, muscle, and fat 7 d PI. No tissue residues were detected in the three bears euthanized at 8 d PI. Tissue residues for the antagonists, naltrexone and atipamezole, were detected in bears euthanized 2 and 6 d PI, but not in tissues from animals euthanized at 7 or 8 d PI.

THE USE OF KETAMINE-XYLAZINE OR BUTORPHANOL-AZAPERONE-MEDETOMIDINE TO IMMOBILIZE AMERICAN BLACK BEARS ( URSUS AMERICANUS).

Wildlife anesthetic protocols must offer rapid inductions and recoveries, be physiologically safe, and be minimally regulated. With this in mind, we evaluated differences in induction and recovery times and physiological parameters in 33 American black bears ( Ursus americanus) anesthetized with ketamine-xylazine (KX) or immobilized with a commercial drug combination of butorphanol, azaperone, and medetomidine (BAM). Dose was based on mass estimated from field observations. Bears were housed at Appalachian Bear Rescue, Townsend, Tennessee, US, or free-ranging within the Great Smoky Mountains National Park (Tennessee and North Carolina, US) and chemically immobilized for management purposes. From 11 April to 29 June 2016, we immobilized bears with injection via pole syringe or disposable dart projected from an air-powered dart rifle. Once immobilized, we measured each bear's temperature, respiration (breaths/min), heart rate (beats/min), hemoglobin oxygen saturation (via pulse oximetry), arterial blood gases, and mass (kg). We found no differences in the induction parameters, partial pressures of CO2, and rectal temperatures. The BAM-treated bears had lower heart and respiratory rates that led to lower hemoglobin oxygen saturation levels (from blood gas analysis, SaO2). The SaO2 after treatment with BAM (91.1±0.8%) was lower than with KX (93.4±0.9%). After handling, we reversed KX-treated bears with a x̄=0.2±0.02 mg/kg yohimbine and BAM-treated bears with x̄=1.5±0.1 mg/kg atipamezole and 0.8±0.1 mg/kg naltrexone. We found no differences in the recovery times to increased respiration and to the bear assuming a head-up position. The BAM-treated bears stood and recovered quicker than did KX-treated animals. Based on our observations, BAM appears to offer safe, predictable immobilizations with fewer drawbacks and faster recovery times than KX-treated bears.

Evaluation of butorphanol–azaperone–medetomidine (BAM) in captive blesbok immobilization (Damaliscus pygargus phillipsi)

ObjectiveThe fixed-dose combination of butorphanol, azaperone and medetomidine (BAM; 30, 12 and 12 mg mL−1, respectively) with subsequent antagonism by naltrexone–atipamezole was evaluated for reversible immobilization of captive blesbok (Damaliscus pygargus phillipsi). Study designProspective, clinical trial. AnimalsSixteen blesbok (four males and twelve females), weighing 52.5−71.0 kg, were immobilized in South Africa. MethodsThe total dose of BAM ranged from 0.5 to 0.7 mL for females and 0.7 to 0.9 mL for males. In seven animals chosen randomly, 8000 units of hyaluronidase was added to the dart. Physiologic variables were recorded every 5 minutes beginning at 10−20 minutes after darting. Arterial blood samples were collected three times at 20, 30 and 40 minutes after darting for analysis of blood acid-base status. ResultsThe mean administered doses of BAM were as follows: butorphanol (0.34 ± 0.08 mg kg−1), azaperone (0.14 ± 0.03 mg kg−1) and medetomidine (0.14 ± 0.03 mg kg−1). The inductions were calm and smooth. The mean induction time was 9.6 ± 3.2 minutes with just BAM and 5.1 ± 0.8 minutes with BAM and hyaluronidase combination. Heart rate (45 ± 6 beats minute−1) and respiratory frequency (38 ± 4 breaths minute−1) were stable throughout immobilization. The mean arterial blood pressure for all animals was stable but elevated (137 ± 7 mmHg). Rectal temperature slightly increased over time but remained within an acceptable range. The recovery time after administering naltrexone and atipamezole was 4.8 ± 0.7 minutes. Conclusion and clinical relevanceThe BAM combination proved to be reliable and effective in blesbok.

The effect of sedation with a combination of butorphanol and midazolam on quantitative contrast-enhanced ultrasonography of duodenum in healthy dogs.

Quantitative contrast-enhanced ultrasonography (CEUS) enables non-invasive and objective evaluation of intestinal perfusion by quantifying the intensity of enhancement on the intestine after microbubble contrast administration. During CEUS scanning, sedation is sometimes necessary to maintain animal cooperation. Nevertheless, the effect of sedative administration on the canine intestinal CEUS is unknown. This study aimed to investigate the effect of sedation with a combination of butorphanol and midazolam on the duodenal CEUS-derived perfusion parameters of healthy dogs. For this purpose, duodenum was imaged following contrast administration (Sonazoid®, 0.01 ml/kg) in six healthy beagles before and after intravenous injection of a combination of butorphanol (0.2 mg/kg) and midazolam (0.1 mg/kg). Furthermore, hemodynamic parameters including blood pressure and heart rate were recorded during the procedure. Five CEUS derived perfusion parameters including time-to-peak (TTP), peak intensity (PI), area under the curve (AUC), wash-in and wash-out rates (WiR and WoR, respectively) before and after sedation were statistically compared. The result showed that no significant change was detected in any of perfusion parameters. Systolic and mean arterial pressures significantly reduced after sedative administration, but diastolic arterial pressure and heart rate did not significantly change. Moreover, no significant partial correlation was observed between perfusion parameters and hemodynamic parameters. Thus, we concluded that the combination did not cause significant influence in duodenal CEUS perfusion parameters and could be a good option for sedation prior to duodenal CEUS in debilitated dogs.

Role of opioids as coinduction agent with propofol and their effect on apnea time, recovery time, and sedation score.

Background:Laryngeal mask airway (LMA) is a supraglottic device which requires lesser depth of anaesthesia, evokes lesser hemodynamic response and causes lesser stimulation of airway as compared to traditional definitive airway device endotracheal tube. Its placement is possible without muscle relaxants thereby allowing maintenance of anaesthesia on spontaneous respiration thus preventing apnoea or minimizing apnoea time. Propofol, the commonly used induction agent, causes cardiorespiratory depression at higher induction doses. To attenuate this, co-induction agents combined with propofol has been a regular I/V anaesthetic technique these days.Aim:Comparing apnoea time, recovery time and sedation scores using propofol-fentanyl and propofol-butorphanol combination.Methodology:Hundred patients scheduled for various elective surgical procedures were randomly selected and divided into two groups of 50 each. As coinduction drug Group F received fentanyl and Group B received butorphanol. In both the groups induction was achieved with I/V propofol and LMA was placed. Apnoea time was noted after induction. Recovery time and sedation scores were recorded after anaesthetic agents were turned off.Results:As compared to group F apnoea time was significantly less and recovery time was significantly more in group B (P < 0.05). Statistically postoperative sedation was significantly higher in group B than in group F at 1/2 hr but clinically, majority were responding to verbal commands. At 1 hour no significant difference in sedation was noted between the groups.Conclusion:Considering respiratory and recovery profile propofol -butorphanol combination is a safer alternative to propofol-fentanyl combination for LMA insertion.

Analgesic interaction between butorphanol and sufentanil

Objective To evaluate the analgesic interaction between butorphanol and sufentanil. Methods Ninety patients, aged 18-64 yr, with body mass index 50% within 15 min after administration.The median effective dose(ED50)and 95% confidence interval(CI)of butorphanol and sufentanil were calculated by probit analysis.Isobolographic analysis was used to analyze the analgesic interaction between butorphanol and sufentanil.When the equivalent dose of two drugs was very different from that selected in group BS1 on the basis of the actually calculated ED50 in B and S groups, the combination of butorphanol and sufentanil in group BS2(n=30)was set at the ratio of 1∶1 based on the actual equivalent dose: the initial dose was butorphanol 0.4 mg plus sufentanil 1.8 μg with 0.1 mg and 0.45 μg increment/decrement for butorphanol and sufentanil, respectively. Results The ED50 of butorphanol was 0.80 mg(95% CI 0.74-0.87 mg), and the ED50 of sufentanil was 3.68 μg(95% CI 3.07-4.41 μg). The ED50 of butorphanol and sufentanil was 0.28 mg(95% CI 0.25-0.32 mg)and 2.82 μg(95% CI 2.52-3.16 μg), respectively, in group BS1.The ED50 of butorphanol and sufentanil was 0.38 mg(95% CI 0.33-0.43 mg)and 1.7 μg(95% CI 1.5-1.9 μg), respectively, in group BS2.The isobolographic analysis showed that the combination of butorphanol and sufentanil at 2∶1 or 1∶1 produced an additive analgesic effect. Conclusion The analgesic effect of butorphanol and sufentanil is additive when combined at the ratio of 2∶1 or 1∶1 based on the equivalent dose. Key words: Butorphanol; Sufentanil; Drug interactions

Evaluation of BAM (butorphanol–azaperone–medetomidine) in captive African lion (Panthera leo) immobilization

ObjectiveThe combination of butorphanol, azaperone and medetomidine (BAM) with subsequent antagonism by naltrexone–yohimbine or naltrexone–atipamezole was evaluated for reversible immobilization of captive African lions (Panthea leo). Study designProspective, clinical trial. AnimalsTwenty lions, 11 males and nine females, weighing 38–284 kg were immobilized in South Africa. MethodsThe BAM volume dose rate administered was 0.005–0.008 mL kg−1 (0.6 mL 100 kg−1). Physiologic variables were recorded every 5 minutes. Four arterial blood samples were collected from all animals at 20, 30, 40 and 50 minutes after immobilization for analysis of blood-gases and acid-base status. ResultsThe actual doses administered were as follows: butorphanol, 0.18±0.03 mg kg−1; azaperone, 0.07±0.01 mg kg−1; and medetomidine, 0.07±0.01 mg kg−1. The inductions were calm and smooth, and induction time ranged from 4 to 10 minutes (7±2 minutes). The amount of time needed to work with each lion was 70 minutes, and no additional drug doses were needed. Heart rate (40±8 beats minute−1) and respiratory frequency (15±4 breaths minute−1) were stable throughout immobilization. The mean arterial blood pressure of all animals was stable but elevated (142±16 mmHg). The rectal temperature slightly increased over time but remained within acceptable range. The recovery time was significantly shorter when using naltrexone and atipamezole (9±1 minutes) compared to using naltrexone and yohimbine (22±7 minutes). Conclusion and clinical relevanceThe BAM combination proved to be reliable for general veterinary anaesthesia in lions. During anaesthesia, minor veterinary procedures such a blood collection, intubation, vaccination and collaring could safely be performed with no additional dosing required.