Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
Vet Anaesth Analg. 2022 Sep;49(5):490-498. doi: 10.1016/j.vaa.2022.05.006. Epub 2022 Jun 3.
To compare the effects of hydromorphone and butorphanol in horses undergoing arthroscopy and describe the pharmacokinetics of hydromorphone in anesthetized horses.
Randomized controlled clinical trial.
A total of 40 adult horses admitted for elective arthroscopy.
Horses were randomly assigned to be administered intravenous hydromorphone (0.04 mg kg; group TxH; n = 19) or butorphanol (0.02 mg kg; group TxB; n = 21) prior to surgery as part of a standardized anesthetic protocol. Pain was scored by two observers unaware of group assignment using the Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) and a composite pain scale (CPS) prior to surgery (baseline), 2 hours (P2) and 4 hours (P4) following recovery from anesthesia. Blood samples were collected at various time points for determination of plasma hydromorphone concentration using liquid chromatography-tandem mass spectrometry. Data were analyzed with a mixed-effect model.
Median (range) baseline EQUUS-FAP was 1.2 (0.0-4.0) with no effect of group, time points or interaction. Baseline CPS was similar between groups. Group TxH baseline CPS was 2.5 (0.0-10.0), increased at P2 [4.5 (0-10.0); p = 0.046] and returned to baseline values at P4 [3.0 (0.0-11.0)]. Group TxB baseline CPS was 2.0 (0.0-8.0), increased at P2 [3.5 (0.0-11.0); p = 0.009] and P4 [5.0 (0.0-11.0); p < 0.001]. Pharmacokinetic terminal half-life was 774 ± 82.3 minutes, area under the curve was 1362 ± 314 ng minutes mL, clearance was 30.7 ± 7.23 mL minute kg and volume of distribution at steady state was 884 ± 740 mL kg.
Hydromorphone, but not butorphanol, decreased CPS back to baseline at P4 after recovery.
Hydromorphone may provide superior postoperative analgesia compared with butorphanol in horses undergoing arthroscopy.
比较氢吗啡酮和布托啡诺在接受关节镜检查的马中的作用，并描述麻醉马中氢吗啡酮的药代动力学。
随机对照临床试验。
共 40 匹接受择期关节镜检查的成年马。
马被随机分配静脉注射氢吗啡酮（0.04mg/kg；TxH 组，n=19）或布托啡诺（0.02mg/kg；TxB 组，n=21），作为标准化麻醉方案的一部分，在手术前。疼痛由两名不知道分组的观察者使用马尤特大学面部疼痛评估量表（EQUUS-FAP）和综合疼痛量表（CPS）进行评分，分别在手术前（基线）、2 小时（P2）和 4 小时（P4）后从麻醉中恢复。在不同时间点采集血样，使用液相色谱-串联质谱法测定血浆氢吗啡酮浓度。数据采用混合效应模型进行分析。
中位数（范围）基线 EQUUS-FAP 为 1.2（0.0-4.0），组间、时间点或相互作用无影响。两组基线 CPS 相似。TxH 组基线 CPS 为 2.5（0.0-10.0），P2 时增加[4.5（0-10.0）；p=0.046]，P4 时恢复到基线值[3.0（0.0-11.0）]。TxB 组基线 CPS 为 2.0（0.0-8.0），P2 时增加[3.5（0.0-11.0）；p=0.009]，P4 时增加[5.0（0.0-11.0）；p<0.001]。药代动力学终末半衰期为 774±82.3 分钟，曲线下面积为 1362±314ng 分钟 mL，清除率为 30.7±7.23mL 分钟 kg，稳态分布容积为 884±740mL kg。
氢吗啡酮而非布托啡诺可使 CPS 在术后 4 小时恢复至基线。
与布托啡诺相比，氢吗啡酮在接受关节镜检查的马中可能提供更好的术后镇痛效果。
