K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine, University of California-Davis, CA, 95616, Davis, USA.
Department of Veterinary Surgery and Radiology, School of Veterinary Medicine, University of California, Davis, USA.
BMC Vet Res. 2020 Oct 1;16(1):368. doi: 10.1186/s12917-020-02564-4.
Meperidine is a synthetic opioid that belongs to the phenylpiperidine class and is a weak mu receptor agonist. In horses there are a limited number of published studies describing the analgesic effects of systemically administered meperidine in horses. The objective of this study was to describe the pharmacokinetics, behavioral and physiologic effects and effect on thermal threshold of three doses of intravenously administered meperidine to horses. Eight University owned horses (four mares and four geldings, aged 3-8 years were studied using a randomized balanced 4-way cross-over design. Horses received a single intravenous dose of saline, 0.25, 0.5 and 1.0 mg/kg meperidine. Blood was collected before administration and at various time points until 96 hours post administration. Plasma and urine samples were analyzed for meperidine and normeperidine by liquid chromatography-mass spectrometry and plasma pharmacokinetics determined. Behavioral and physiologic data (continuous heart rate, step counts, packed cell volume, total plasma protein and gastrointestinal sounds) were collected at baseline through 6 hours post administration. The effect of meperidine administration on thermal nociception was determined and thermal excursion calculated.
Meperidine was rapidly converted to the metabolite normeperidine. The volume of distribution at steady state and systemic clearance (mean ± SD) ranged from 0.829 ± 0.138-1.58 ± 0.280 L/kg and 18.0 ± 1.4-22.8 ± 3.60 mL/min/kg, respectively for 0.5-1.0 mg/kg doses. Adverse effects included increased dose-dependent central nervous excitation, heart rate and cutaneous reactions. Significant effects on thermal nociception were short lived (up to 45 minutes at 0.5 mg/kg and 15 minutes at 1.0 mg/kg).
Results of the current study do not support routine clinical use of IV meperidine at a dose of 1 mg/kg to horses. Administration of 0.5 mg/kg may provide short-term analgesia, however, the associated inconsistent and/or short-term adverse effects suggest that its use as a sole agent at this dose, at best, must be cautiously considered.
哌替啶是一种合成阿片类药物,属于苯哌啶类,是一种弱μ受体激动剂。在马中,有少量已发表的研究描述了全身给予哌替啶在马中的镇痛作用。本研究的目的是描述三种剂量静脉给予哌替啶对马的药代动力学、行为和生理效应及对热阈值的影响。八匹大学拥有的马(四匹母马和四匹骟马,年龄 3-8 岁)使用随机平衡 4 向交叉设计进行研究。马接受单次静脉注射生理盐水、0.25、0.5 和 1.0mg/kg 哌替啶。在给药前和给药后 96 小时内的不同时间点采集血样。通过液相色谱-质谱法分析血浆和尿液中的哌替啶和去甲哌替啶,并确定血浆药代动力学。在给药前通过 6 小时收集行为和生理数据(连续心率、步数、红细胞压积、总血浆蛋白和胃肠道声音)。测定哌替啶给药对热痛觉的影响,并计算热偏移。
哌替啶迅速转化为代谢物去甲哌替啶。稳态分布容积和全身清除率(平均值±标准差)分别为 0.829±0.138-1.58±0.280L/kg 和 18.0±1.4-22.8±3.60mL/min/kg,用于 0.5-1.0mg/kg 剂量。不良反应包括剂量依赖性中枢兴奋、心率增加和皮肤反应增加。对热痛觉的显著影响是短暂的(在 0.5mg/kg 时长达 45 分钟,在 1.0mg/kg 时为 15 分钟)。
本研究结果不支持常规临床使用 1mg/kg 静脉给予哌替啶。给予 0.5mg/kg 可能提供短期镇痛作用,但相关的不一致和/或短期不良反应表明,在该剂量下单独使用,充其量也必须谨慎考虑。