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在接受常规卵巢子宫切除术的犬中,口服新型美沙酮-氟康唑-纳曲酮制剂相关的围手术期镇痛

Perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy.

作者信息

KuKanich Butch, KuKanich Kate, Rankin David C, Upchurch David A, Comroe Alyssa, Crauer Brad, Berke Kara, Klocke Emily E, Gonzalez Sara E, Mason Diane, Jensen Gina, Orchard Ron, Fitzgerald Alyson H, Cho Peter, Komp Marissa

出版信息

Am J Vet Res. 2020 Sep;81(9):699-707. doi: 10.2460/ajvr.81.9.699.

Abstract

OBJECTIVE

To determine perioperative analgesia associated with oral administration of a novel methadone-fluconazole-naltrexone formulation in dogs undergoing routine ovariohysterectomy.

ANIMALS

43 healthy female dogs.

PROCEDURES

Dogs were randomly assigned to receive the methadone-fluconazole-naltrexone formulation at 1 of 2 dosages (0.5 mg/kg, 2.5 mg/kg, and 0.125 mg/kg, respectively, or 1.0 mg/kg, 5.0 mg/kg, and 0.25 mg/kg, respectively, PO, q 12 h, starting the evening before surgery; n = 15 each) or methadone alone (0.5 mg/kg, SC, q 4 h starting the morning of surgery; 13). Dogs were sedated with acepromazine, and anesthesia was induced with propofol and maintained with isoflurane. A standard ovariohysterectomy was performed by experienced surgeons. Sedation and pain severity (determined with the Glasgow Composite Pain Scale-short form [GCPS-SF]) were scored for 48 hours after surgery. Rescue analgesia was to be provided if the GCPS-SF score was > 6. Dogs also received carprofen starting the day after surgery.

RESULTS

None of the dogs required rescue analgesia. The highest recorded GCPS-SF score was 4. A significant difference in GCPS-SF score among groups was identified at 6:30 am the day after surgery, but not at any other time. The most common adverse effect was perioperative vomiting, which occurred in 11 of the 43 dogs.

CONCLUSIONS AND CLINICAL RELEVANCE

Oral administration of a methadone-fluconazole-naltrexone formulation at either of 2 dosages every 12 hours (3 total doses) was as effective as SC administration of methadone alone every 4 hours (4 total doses) in dogs undergoing routine ovariohysterectomy. Incorporation of naltrexone in the novel formulation may provide a deterrent to human opioid abuse or misuse.

摘要

目的

确定在接受常规卵巢子宫切除术的犬中,口服一种新型美沙酮-氟康唑-纳曲酮制剂的围手术期镇痛效果。

动物

43只健康雌性犬。

步骤

将犬随机分配,分别以2种剂量之一接受美沙酮-氟康唑-纳曲酮制剂(分别为0.5mg/kg、2.5mg/kg和0.125mg/kg,或1.0mg/kg、5.0mg/kg和0.25mg/kg,口服,每12小时一次,从手术前一晚开始;每组n = 15)或单独使用美沙酮(0.5mg/kg,皮下注射,从手术当天上午开始每4小时一次;13只)。犬用乙酰丙嗪镇静,用丙泊酚诱导麻醉并用异氟烷维持麻醉。由经验丰富的外科医生进行标准的卵巢子宫切除术。术后48小时对镇静和疼痛严重程度(用格拉斯哥综合疼痛量表简表[GCPS-SF]确定)进行评分。如果GCPS-SF评分>6,则提供解救镇痛。犬在术后第二天开始还接受卡洛芬治疗。

结果

没有一只犬需要解救镇痛。记录到的最高GCPS-SF评分为4分。术后第二天上午6:30时,各组间GCPS-SF评分存在显著差异,但在其他任何时间均无差异。最常见的不良反应是围手术期呕吐,43只犬中有11只出现。

结论及临床意义

在接受常规卵巢子宫切除术的犬中,每12小时口服2种剂量之一的美沙酮-氟康唑-纳曲酮制剂(共3剂)与每4小时皮下注射单独的美沙酮(共4剂)效果相同。在新型制剂中加入纳曲酮可能会对人类阿片类药物的滥用或误用起到威慑作用。

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