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This study evaluated the sedation and the physiological effects produced by three doses of intranasal midazolam in green iguanas. Eight adult iguanas weighing 850 ± 165 grams, received each of five treatments: intramuscular midazolam 2 mg.kg-1 (IM), intranasally administered midazolam at doses of 2 mg.kg-1 (IN2), 3 mg.kg-1 (IN3) and 5 mg.kg-1 (IN5), and intramuscular saline (CON). The degree of sedation, heart rate, respiratory rate and body temperature were assessed from the baseline to 360 minutes post-administrations. The IM treatment induced mild to deep sedation from 10 (9 [8-12]) to 120 minutes (8 [3-9]). Sedation was not achieved in groups IN2 and IN3. When compared to the baseline, mild sedation was achieved in IN5 at 20 (5 [2-6]), 45 (5 [1-6]) and 90 minutes (5 [1-7]). There was a reduction in heart rate only in the IM group at 360 minutes (40 ± 15.1 bpm). Respiratory rate decreased to the baseline only in IN5, at 30 (12 [8-16] mpm) and 90 minutes (12 [8-24] mpm). No changes in body temperature were observed with any of the treatments during the evaluation period. Intranasally administered midazolam at a dose of 5 mg.kg-1, but not at 2 and 3 mg.kg-1, induced mild sedation in green iguanas. However, the effect exhibited a lower intensity and duration compared to the intramuscular dose of 2 mg.kg-1. Therefore, the administration of intranasal midazolam is not a reasonable option compared to the intramuscular route. [ABSTRACT FROM AUTHOR]

To evaluate the effect of intravenous (IV) hydromorphone alone or in combination with midazolam or dexmedetomidine on intraocular pressure (IOP) in dogs. Prospective, randomized, blinded, crossover study. A group of seven healthy, ophthalmologically normal, adult Beagle dogs. A total of four IV drug combinations were evaluated: hydromorphone 0.1 mg kg–1 (H); hydromorphone 0.1 mg kg–1 and dexmedetomidine 0.001 mg kg–1 (HD); hydromorphone 0.1 mg kg–1 and midazolam 0.2 mg kg–1 (HM2); and hydromorphone 0.1 mg kg–1 and midazolam 0.4 mg kg–1 (HM4). Treatment order was randomized, with a 2 week washout period between treatments. IOP and sedation scores were obtained before (T0) and 3, 30, 60, 240 and 480 minutes after drug injection. To account for repeated measurements for each dog across treatments and time points, mixed models were used to compare IOP at T0 by eye and to describe changes from T0 in IOP (averaged across eyes) and sedation scores. In treatment H, IOP increased significantly from baseline levels [predicted mean increase of 5.5 mmHg [95% confidence interval (CI): 3.7–7.3] at T3 (p < 0.001) and 2.7 mmHg (95% CI: 0.9–4.5) at T30 (p = 0.005)]. In treatment HD, mean IOP increased from baseline by 2.3 mmHg (95% CI: 0.5–4.1) at T30 (p = 0.014). In treatment HM2, mean IOP increased by 2.5 mmHg (95% CI: 0.2–4.9) at T30 (p = 0.035). In treatment HM4, IOP did not change significantly from baseline at any time point. Sedation scores over time did not differ significantly between treatments. Injection of IV hydromorphone alone (0.1 mg kg–1) caused a transient increase in IOP and might not be appropriate if an acute increase in IOP is undesirable. Addition of dexmedetomidine or midazolam to hydromorphone, at the doses studied, appears to attenuate this increase in IOP. [ABSTRACT FROM AUTHOR]

Maxillary nerve blocks (MNBs) commonly facilitate dental surgeries in standing horses. The goal of this prospective, blinded, cross-over design trial including 15 client-owned horses was to evaluate 3 methods of sensory function testing for confirming a successful MNB. Testing was performed bilaterally before sedation, 5 min after sedation, and 15 and 30 min after MNB with 0.5% bupivacaine and involved a needle prick dorsal to each naris, hemostat clamping of each nostril, and gingival algometry (measuring sensitivity to pain). Responses to stimulation were numerically scored and scores were summed up to a total score. Total score increases on the blocked side by ≥ 2 between baseline and 30 min Post MNB recordings signified a successful MNB. Sedation in the preceding 6 h, presence of sino-nasal disease, side of dental pathology, age, butorphanol administration, and detomidine dosing (µg/kg/min) throughout the tooth extraction procedure were recorded. In 73% of horses, MNB was successful. Sedation in the preceding 6 h (P =.732), age (P =.936), side of pathology (P =.516), and sino-nasal disease (P =.769) were not associated with total scores. Detomidine dosage and butorphanol use did not differ between horses in which the MNB was considered successful and for those in which it was not (P =.967 and P =.538, respectively). Scores obtained with gingival algometry were less closely associated with total scores (rho =.649) than those obtained with needle prick and nostril clamping (rho =.819 and.892, respectively). Therefore, needle prick and nostril clamping are considered the more reliable methods for use in clinical practice to determine the success of an MNB. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the analgesic effects of dexmedetomidine combined with butorphanol in patients with femoral intertrochanteric fracture, and its effects on patients’ cognitive function and stress. METHODS: A total of 196 patients with femoral intertrochanteric fracture admitted into the Guang’an People’s Hospital from Sept. 2020 to Mar. 2022 were selected to be divided into two groups via random number table method, with 98 patients in each group. The control group was given butorphanol for postoperative analgesia, while the observation group received dexmedetomidine combined with butorphanol for postoperative analgesia. The surgical condition, postoperative analgesic effects, cognitive function, stress levels and incidences of adverse drug reactions were compared between two groups. RESULTS: There were no statistically significant differences in the comparison of surgery duration, intraoperative blood loss and length of post-anesthesia care unit stay between two groups (P>0. 05). There were no statistically significant differences in the comparison of visual analogue scale (VAS) scores in resting and active states at 2 and 48 h after surgery, the Ramsay sedation scores at 2, 12, 24 and 48 h after surgery between two groups (P>0. 05). The VAS scores in resting and active states at 12 and 24 h after surgery were significantly lower in the observation group than those in the control group, with statistically significant differences (P<0. 05). There were no statistically significant differences in the comparison of Mini Mental State Examination (MMSE) scores between two groups before surgery, at 24 and 48 h after surgery (P>0. 05). At 12 h after surgery, the MMSE scores of both groups decreased, and the MMSE score of the observation group was higher than that of the control group, with statistically significant differences ( P < 0. 05). There were no statistically significant differences in the comparison of cortisol (Cor) and norepinephrine (NE) levels between two groups at 2 h after surgery (P>0. 05). At 48 h after surgery, the Cor and NE levels of both groups increased, and those of the observation group were lower than the control group, with statistically significant differences (P<0. 05). The adverse drug reactions in both groups after surgery included skin pruritus, drowsiness, vomiting and nausea. There was no statistically significant difference in the comparison of incidences of adverse drug reactions between observation group and control group [ 7. 14% ( 7 / 98) vs. 11. 22% (11 / 98), P > 0. 05)]. CONCLUSIONS: The combination of dexmedetomidine and butorphanol for postoperative analgesia in patients with femoral intertrochanteric fracture can not only achieve significant analgesic effects, but relieve cognitive impairment and stress response, without increasing the incidence of adverse drug reactions. [ABSTRACT FROM AUTHOR]

The article discusses sedation practices in gastrointestinal endoscopy, highlighting variations in sedation rates, preferred regimens, and patient monitoring practices among endoscopists. The European Society of Gastrointestinal Endoscopy (ESGE) conducted a survey among its members to gather information on sedation practices, training, and patient care during endoscopic procedures. The survey revealed a lack of standardized training in sedation administration, varied sedation options, and limited monitoring tools used post-procedure. Recommendations for new ESGE guidance include standardizing propofol use, improving training, and establishing discharge criteria. The survey emphasizes the need for continuous training, quality improvement initiatives, and standardized practices to enhance patient safety and procedural outcomes in GI endoscopy. [Extracted from the article]

To re-audit compliance with an amended sedation protocol following the latest national guidelines. To confirm the improved safety achieved through EEG guidance for drug administration during procedural sedation. Following the revision of the departmental protocol, 14 standards were set. Sedation data and outcomes in 150 consecutive patients undergoing fluoroscopic and combined endoscopic procedures were evaluated against these. Combination sedo-analgesia was titrated by the interventional radiology nurses guided by bispectral index sensor (BIS) measurements to achieve readings between 80 and 85. Doses were stratified by patient age and ASA status. Nasal oxygen was given and standard monitoring including pulse oximetry and capnography were used alongside to assess for complications, notably hypoxaemia of ≤ 94%. 85% were non-vascular procedures, the bulk made up of oesophageal stent insertion, gastrostomy, oesophageal dilatation of radiation strictures and biliary procedures. Mean procedure time was 32.9 minutes (10–170). Mean doses of midazolam and fentanyl were 3.99mg (±1.9) and 92.3μg (±35.4), respectively. 84% of patients were classified as having received light or moderate sedation (BIS 70–89). Three standards for patient sedation were missed, but no patient required sedation reversal or airway management, and none developed hypoxaemia. BIS guidance of sedation administration allows real-time assessment of the patient's response to sedo-analgesia administered and allows prediction about the safety of further drug administration. It identifies patients waking up, allowing this to be anticipated and reduces interruptions of the procedure. It offers clear clinical advantages to interval assessment of patients' response to clinical stimuli and reduces under-as well as oversedation. • BIS is a standardised and continuous assessment of the depth of sedation. • In contrast to clinical assessment, EEG monitoring does not disturb the patient. • BIS improves the accuracy of sedation and reduces airway complications. • The safety of further drug administration can be predicted by EEG monitoring. • The continuous display of BIS increases nurses' confidence in drug administration. [ABSTRACT FROM AUTHOR]

Simple Summary: The induction of general anaesthesia in horses is commonly achieved with a dissociative anaesthetic, usually ketamine, in combination with a benzodiazepine (diazepam or midazolam). Tiletamine is another dissociative anaesthetic commonly used in several animal species, which is marketed in combination with the benzodiazepine zolazepam. Previous studies have already compared ketamine and tiletamine for anaesthesia induction in horses, primarily in the context of TIVA, halothane-based inhalant anaesthesia, or intramuscular general anaesthesia. However, their use has not been explored within a partial intravenous anaesthesia (PIVA) protocol. The purpose of this study was to compare the effects of the ketamine/diazepam (KD) or tiletamine/zolazepam (TZ) combinations used for the induction of general anaesthesia in horses undergoing PIVA (isoflurane-romifidine anaesthesia) for elective surgical procedures. The data collected included induction and recovery times, induction and recovery score, isoflurane requirement, and intraoperative cardiorespiratory parameters. The results showed that the anaesthetic effects of the TZ combination were similar to the KD group in terms of induction and recovery qualities, isoflurane requirements, and hemodynamic and respiratory effects. However, the administration of the TZ combination accounted for longer induction and recovery times. The aim of this retrospective clinical study was to compare the combinations of ketamine/diazepam (KD group) and tiletamine/zolazepam (TZ group) for the induction of general anaesthesia in horses undergoing elective surgery. The data from the clinical and the anaesthetic records of 138 horses from 2021 to 2023 were evaluated, and the horses were divided in two groups: KD (n = 60) and TZ (n = 72). The horses were premedicated with romifidine and methadone IV; anaesthesia was induced with ketamine/diazepam for the KD group and tiletamine/zolazepam for the TZ group and was maintained with isoflurane and a constant rate infusion of romifidine. The data encompassed sex and neuter status, age, breed, weight, American Society of Anaesthesiologists physical status, type of surgical procedure performed under anaesthesia, induction time, induction score, surgery time, recovery time, and the recovery score using a descriptive scale. Baseline heart rate (HR), intraoperative HR, baseline respiratory rate (fR), intraoperative fR, mean arterial pressure (MAP), oxygen saturation (SpO2), and fraction of expired isoflurane (FE'Iso) were also recorded. The induction time was significantly longer (p = 0.004) in the TZ group (60 (40–120)) as compared to the KD group (50 (30–120)). Recovery time was also significantly longer (p ≤ 0.001) in the TZ group (46.5 (15–125)) as compared to the KD group (30 (5–105)). These findings suggested that, in adult horses undergoing elective surgery, TZ could be considered a valid alternative to KD for the induction of general anaesthesia. Additional experimental studies comparing the two induction regimens and their pharmacokinetic and pharmacodynamic characteristics are needed. [ABSTRACT FROM AUTHOR]

This report describes the use of an ultrapotent, opioid‐free anaesthesia with an infusion of butorphanol, ketamine and guaifenesin in two captive adult male greater one‐horned rhinoceros (Rhinoceros unicornis). Animals were premedicated intramuscularly with azaperone (0.05 mg/kg), butorphanol tartrate (0.05 and 0.02 mg/kg, respectively) and an α2‐agonist (detomidine 0.02 mg/kg and medetomidine 0.01 mg/kg, respectively). Once sternolaterally recumbent, rhinoceros were induced with intravenous ketamine (0.02 and 0.05 mg/kg, respectively) and midazolam (7.0 and 8.0 μg/kg, respectively). Intravenous infusions of guaifenesin (15.1 and 25 mg/kg/h, respectively) and of ketamine (22.5 and 29.1 μg/kg/h, respectively) and butorphanol (15.7 and 20.3 μg/kg/h, respectively), allowed stable anaesthesia maintenance for dental procedures to take place. Supplemental boluses of ketamine and α2‐agonist were required during noxious stimulation in both cases. Animals were reversed with intramuscular atipamezole (0.07–0.08 mg/kg) and naltrexone (0.06–0.08 mg/kg), with or without flumazenil (0.10 μg/kg), allowing smooth and quick recovery. [ABSTRACT FROM AUTHOR]

Abstract Colorectal cancer (CRC) stands for a prevailing gastrointestinal neoplasm, concomitant with considerable occurrence and lethality rate. Butorphanol, a synthetic opioid analgesic medication targeting the opiate receptor, has been recently reckoned to harbor anti-oncogenic properties. This study proposes to delineate the impacts of butorphanol on CRC and the interrelated response mechanism. In sigma non-opioid intracellular receptor 1 (SIGMAR1)-overexpressing CRC cells treated by varying concentrations of butorphanol, the functional experiments including CCK-8 method, EDU staining, wound healing and transwell assays severally appraised the capabilities for CRC cells to proliferate, migrate as well as invade. TUNEL staining assayed the cellular apoptotic level. The expressions of proteins implicated in proliferation, metastasis as well as apoptosis were ascertained by Western blot. CB-Dock2 server predicated butorphanol-SIGMAR1 interaction and Western blot also examined SIGMAR1 expression. Noticeably, butorphanol profoundly eliminated the capabilities of CRC cells to proliferate, migrate and invade whilst intensified the cellular apoptotic level with the ascending doses. Butorphanol was identified to possess an interrelation with SIGMAR1 and concentration-dependently lowered SIGMAR1 expression. Elevation of SIGMAR1 partially blunted the affection of butorphanol on the biological events of CRC cells. To sum up, butorphanol may extenuate the aggressive cellular behaviors to produce tumor-suppressing activity on CRC via binding with SIGMAR1.

Simple Summary: Medetomidine is a sedative commonly employed in combination with other anesthetics in anesthesia protocols for small animals, but it has the unwanted side effects of markedly increasing blood pressure and decreasing heart rate. Vatinoxan has been shown to counteract such side effects of medetomidine in experimental settings. In this study, the effects of a medetomidine–vatinoxan combination administered to 20 dogs were compared with those of medetomidine alone administered to as many 20 dogs during a short-term, non-experimental surgical procedure. The anesthetic protocol also included a comparison of two other anesthetics, sevoflurane and desflurane. The results show that vatinoxan is also effective in a clinical setting and encourages its inclusion in anesthetic protocols for dogs in which bradycardia and an increase in systemic pressure should be avoided. Further clinical studies are needed to manage the short periods of hypotension, as well as the slight reduction in sedative and pain-relieving medetomidine effects found, particularly when vatinoxan is in combination with desflurane rather than sevoflurane. The aim of this study was to compare the effects of a medetomidine–vatinoxan combination versus medetomidine alone on heart rate (HR) and mean arterial pressure (MAP) in a short-term surgery in dogs. Four groups of 10 dogs were administered as follows: medetomidine and sevoflurane; medetomidine and desflurane; medetomidine–vatinoxan and sevoflurane; and medetomidine–vatinoxan and desflurane. After administration, the increase in MAP soon stopped at 102–104 mmHg in the two groups administered medetomidine–vatinoxan, compared with significantly higher values of 143–126 mmHg achieved in the two groups administered medetomidine alone. The lowest MAPs in the two medetomidine–vatinoxan groups were 46–50 mmHg, while in the medetomidine groups, they were 58–79 mmHg. From 3 min onwards after administration, in the medetomidine–vatinoxan treatments, HR remained at values very close to those of pre-administration, between 83 and 118 beats min−1, while in the medetomidine treatments, it dropped to 36–43 beats min−1 and then slowly rose to reach 71–90 beats min−1. These results encourage the use of vatinoxan in clinical settings, particularly in anesthetic protocols for dogs when bradycardia and an increase in systemic pressure should be avoided. Further clinical studies are needed to manage the short periods of hypotension, as well as the slight reduction in sedative and pain-relieving medetomidine effects found, particularly when vatinoxan is in combination with desflurane rather than sevoflurane. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate if opioid-induced behavioral effects, such as sedation, can be detected using a shuttle box experimental apparatus and whether thermal preference following noxious stimulation using mustard oil is reversed by morphine administration in fish. METHODS: 5 goldfish (Carassius auratus) underwent 2 randomized blinded experimental trials, with a crossover study design. First, opioid effects were tested in a shuttle box without painful stimulus. Fish were injected 5 days apart with butorphanol at 0.4 or 10 mg/kg, morphine at 5 or 10 mg/kg, or saline IM. After 30 minutes, each fish was placed in a shuttle box for 2 hours with a temperature gradient of 26 to 28 °C. Temperature preference, time spent immobile, and swimming velocity were assessed. The second trial consisted of cutaneous noxious stimulation using mustard oil immersion for 5 minutes followed by an assessment of thermal preference for 4 minutes in the shuttle box after either morphine at 10 mg/kg or saline IM injections. Linear mixed models were used to compare treatment groups. RESULTS: Before noxious stimulation, a low dose of morphine caused sedation compared with control group and high-dose morphine and butorphanol treatments. Immersion in mustard oil caused fish to spend more time in the cold area in the control group. Morphine administration reversed this pattern. CONCLUSIONS: The sedative and analgesic effects of opioids were detected through this model. CLINICAL RELEVANCE: The shuttle box model could be used to assess the analgesic effects of other opioids in goldfish while reducing biases associated with the sedative and stimulatory effects of these drugs. [ABSTRACT FROM AUTHOR]

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Background: Intravenous infusions of alpha‐2 adrenoceptor sedatives and opioids can potentially facilitate surgery in donkeys while standing. Literature on this subject matter is scant. Objectives: Evaluation of efficacy of sedation from α2‐adrenoceptors (dexmedetomidine or xylazine) and butorphanol during ovariectomy in standing donkeys. Study design: Randomised, masked in vivo experiment. Methods: Thirteen female donkeys were sedated with butorphanol (0.05 mg/kg bwt followed by 0.05 mg/kg bwt/h) IV. Concomitantly, 6 of the 13 jennies were sedated with dexmedetomidine 2.5 mcg/kg bwt followed by 2.5 mcg/kg bwt/h (Dex‐B group), while seven jennies were sedated with xylazine 0.5 mg/kg bwt followed by 0.5 mg/kg bwt/h (Xyl‐B group). A line block of the left flank and an infiltration block around uterine ligament were performed with lidocaine. While the jennies underwent ovariectomies standing, sedation scores and head height above ground were assessed at 2 and 10 min after sedative boluses and every 10 min thereafter. If sedation was too light or too deep, the dose of dexmedetomidine or xylazine was increased or decreased by 25% of the original infusion rate, while butorphanol infusion rate was constant. Physiological parameters were measured. Normally distributed data were compared using the two‐sample t test while repeatedly measured data were tested for differences between and within groups using repeated measures analysis of variance (ANOVA) by ranks followed by a Wilcoxon test with Tukey Honest Significant Difference for multiple testing. Statistical significance was set at p < 0.05. Results: Both Dex‐B and Xyl‐B caused moderate to marked sedation adequate for ovariectomy in donkeys. Evident sedation was absent by 60 min of termination of infusions. No adverse physiological effects were observed. Main limitations: Study on ovariectomy cases only, no pharmacokinetic profiling. Conclusions: Dexmedetomidine or xylazine and butorphanol sedation is feasible for ovariectomy in standing donkeys. [ABSTRACT FROM AUTHOR]

Background: The aim of our study was to test different anesthetic mixtures in order to identify the most suitable one for a surgical cardiac ischemia-reperfusion model in mice. Methods: 1) Sixty four mice were submitted to one of the 6 combinations of ketamine or alfaxalone associated to xylazine, medetomidine or midazolam. Depth and quality of anesthesia were evaluated via 5 reflex scores. 2) Impact of analgesic (buprenorphine or butorphanol), anesthesia reversal (with atipamezole) and surgery (cardiac ischemia-reperfusion surgery) have been tested in the selected protocols. 3) infarction size has been measured with TTC (Triphenyl Tetrazolium Chloride) method in mice anesthetized with best protocols. Results: Protocol involving medetomidine induced the longest surgical anesthesia: (median = 120, {interquartile range = 100–125}) min with ketamine and 53 {25–100} min with alfaxalone. Butorphanol substitution with buprenorphine did not alter time-related anesthesia parameters. Atipamezole reversal considerably reduced both recovery and immobilization time (respectively 22 {18–30} min and 98 {88–99} min vs. 55 {40–70} min and 143 {131–149} min, in groups with no reversal, p = 0.001) with no impact on infarction size measurement. Conclusion: In this study, the combination alfaxalone/medetomidine/buprenorphine (80/0,3/0,075 mg.kg-1, s.c.) associated with reversal by atipamezole was a reliable anesthetic protocol for murine surgery, particularly for the study of ischemia-reperfusion. [ABSTRACT FROM AUTHOR]

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 0.3mg/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 4.5mg/kg and butorphanol at 0.02mg/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 UCPSIV) 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 40m and 5 subjects at 50m 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 coadministration 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. [ABSTRACT FROM AUTHOR]

The present study was conducted in 12 dogs of different breeds, ages and sexes which were enrolled in a study to evaluate anaesthesia protocols during orthopedic surgeries. Each dog was premeditated with glycopyrrolate and meloxicam before being induced with a combination of dexmedetomidine, butorphanol, midazolam and ketamine administered intramuscularly. Following induction, a loading dose of lignocaine was given and anaesthesia was maintained using a continuous rate infusion (CRI) of dexmedetomidine-midazolam-ketamine-lignocaine (Group I) and xylazine-midazolam-ketamine-lignocaine (Group II). Anaesthetic combinations were assessed using clinical, physiological, hemodynamic, haematological and biochemical observations. The mean induction time was 10.17 ± 0.22 minutes for Group I and 8.67 ± 0.23 minutes for Group II, with optimal intubation conditions and minimal laryngeal reflexes observed. While both groups exhibited excellent analgesia and muscle relaxation, Group II showed a slightly quicker recovery time. Anaesthesia duration in Group II was marginally longer, yet also without significant difference compared to Group I. All dogs in both groups experienced good to excellent recovery quality, with Group I displaying a marginally better recovery overall. Physiological parameters, such as heart rate and rectal temperature, remained stable within normal ranges, although a notable decrease in respiratory rate was recorded. Hemodynamic variables like SpO2 and mean arterial pressure, as well as hematological and biochemical markers, stayed consistent within safe limits. This study demonstrated that both dexmedetomidine and xylazine based CRI protocols offer safe and effective anaesthesia for orthopedic procedures. [ABSTRACT FROM AUTHOR]

Background: The study aimed to compare the safety and efficacy of intrathecal fentanyl and butorphanol as adjuvants to 0.5% heavy bupivacaine in patients undergoing lower limb orthopedic surgeries. Material and Methods: A prospective, randomized, double-blind study was conducted with 140 patients aged 18-60 years scheduled for elective lower limb orthopedic surgeries under spinal anesthesia. Patients were randomly divided into two groups of 70 each. Group F received 15 mg of 0.5% heavy bupivacaine with 25 µg fentanyl intrathecally, while Group B received 15 mg of 0.5% heavy bupivacaine with 1 mg butorphanol. The total volume of intrathecal injection was standardized to 3.5 mL for both groups. Hemodynamic parameters and block characteristics were monitored at regular intervals, and adverse effects were recorded. Results: Group F demonstrated a faster onset of sensory (4.1 ± 1.2 minutes) and motor block (6.5 ± 1.3 minutes) compared to Group B (5.3 ± 1.4 minutes and 7.2 ± 1.5 minutes, respectively), with statistically significant differences (p < 0.001 for sensory and p = 0.03 for motor). The duration of sensory and motor blocks was also significantly longer in Group F (145.6 ± 20.5 minutes and 130.3 ± 18.6 minutes, respectively) compared to Group B (130.8 ± 22.7 minutes and 115.4 ± 19.8 minutes, p < 0.001 for both). Group F had a longer time to first analgesic request (220.4 ± 30.2 minutes) and lower VAS scores for pain (1.8 ± 0.5) than Group B (195.3 ± 28.7 minutes and 2.1 ± 0.6, p < 0.001 and p = 0.02, respectively). Hemodynamic stability was maintained in both groups, with no significant differences in heart rate or blood pressure at any time point. Pruritus was more frequent in Group F (14.29%) compared to Group B (2.86%, p = 0.02), while other adverse effects were comparable between groups. Conclusion: Intrathecal fentanyl as an adjuvant to 0.5% heavy bupivacaine provided faster onset, longer duration of blocks, and superior analgesia compared to butorphanol, though it was associated with a higher incidence of pruritus. Both drugs maintained stable hemodynamic profiles, demonstrating their safety and effectiveness for spinal anesthesia in lower limb orthopedic surgeries. [ABSTRACT FROM AUTHOR]

The pacarana (Dinomys branickii) is among the rarest of mammals under human care, with few research about the species health. This study is aimed at describing for the first time values for pacaranas under human care for commonly used hematologic and blood chemistry parameters. After the physical restraint, animals were anesthetized with a combination of dexmedetomidine, midazolam, and butorphanol for preventive medical exams. Based on phylogenetic and morphological proximity, the data from the present study were compared with data from a worldwide zoological databank, Zoological Information Management System (ZIMS) for chinchillas (Chinchilla lanigera), prehensile-tailed porcupines (Coendou prehensilis), and capybaras (Hydrochoerus hydrochaeris). For most of the hematological and biochemical values, pacaranas were similar to the data reported to prehensile-tailed porcupines. This information will be valuable for future initiatives to assess the health of individuals arriving in rehabilitation centers and kept in zoological institutions. [ABSTRACT FROM AUTHOR]

This anesthetic case study outlines the rationale behind and describes the successful use of butorphanol as a premedicant and as an intraoperative analgesic in a dog undergoing unilateral arytenoid lateralization. Given the antiemetic, sedative, and analgesic effects of butorphanol, it may be the opioid of choice in certain veterinary surgeries (especially those where anxiolysis, sedation, antiemesis, and moderate analgesia are beneficial). [ABSTRACT FROM AUTHOR]

Simple Summary: Common blue-tongued skinks (Tiliqua scincoides) are popular pets due to their docile temper. Because of their popularity, they are routinely presented to veterinarians for examinations or procedures; however, to date, there has been limited research evaluating sedation protocols for this species. This study aimed to test different sedation combinations in these skinks: alfaxalone alone, alfaxalone with midazolam, dexmedetomidine with midazolam, and a combination of alfaxalone, dexmedetomidine, and midazolam. All four combinations provided safe sedation, but there were different physiologic responses noted. According to our trials, the combinations of all three drugs or alfaxalone with midazolam are recommended for minor procedures. Common blue-tongued skinks (Tiliqua scincoides) are popular pet reptiles; however, there has been limited research to investigate sedatives for this species. The purpose of this study was to measure the physiologic effects of four combinations of alfaxalone, dexmedetomidine, and midazolam for minor procedures such as intubation and blood collection. Eleven common blue-tongued skinks (Tiliqua scincoides) were used for this prospective, randomized cross-over study. The subcutaneous combinations were used as follows: 20 mg/kg alfaxalone (A); 10 mg/kg alfaxalone and 1 mg/kg midazolam (AM); 0.1 mg/kg dexmedetomidine and 1 mg/kg midazolam (DM); and 5 mg/kg alfaxalone, 0.05 mg/kg dexmedetomidine, and 0.5 mg/kg midazolam (ADM). Heart rate, respiratory rate, palpebral reflex, righting reflex, escape reflex, toe pinch withdrawal reflex, tongue flicking, and the possibility of intubation were recorded at baseline and every 5 min for 60 min. Venous blood gases were measured at baseline, full sedation, and recovery. Heart and respiratory rates decreased significantly in all groups, but the reductions were most prominent in DM and ADM. Analgesic effects, as measured by the toe pinch withdrawal reflex, were only observed in DM and ADM. Intubation was possible in all four protocols; however, it was not possible in two DM skinks. Based on these trials, ADM and AM are recommended for minor procedures in blue-tongue skinks. [ABSTRACT FROM AUTHOR]

Simple Summary: Advances in pain research challenge the concept that animals lack pain senses, showing that they have similar neural pathways to humans and experience pain similarly. Understanding brain circuits for effective pain control is crucial for adjusting pain control to individual patient responses and conditions. Pain management in oncological patients aims to lessen the impact of tumor cell development and its consequences on the immune system. Researchers have focused on improving algological approaches to better respond to patient needs, which requires a deeper understanding of how analgesics work, interact with other drugs, and affect patients' conditions. Opioids, although linked to tumor progression, remain the mainstay for managing oncologic pain. Advancements in understanding pain physiopathology have historically challenged animals' absence of pain senses. Studies have demonstrated that animals have comparable neural pain pathways, suggesting that cats and dogs likely experience pain similarly to humans. Understanding brain circuits for effective pain control has been crucial to adjusting pain management to the patient's individual responses and current condition. The refinement of analgesic strategies is necessary to better cater to the patient's demands. Cancer pain management searches to ascertain analgesic protocols that enhance patient well-being by minimizing or abolishing pain and reducing its impact on the immune system and cancer cells. Due to their ability to reduce nerve sensitivity, opioids are the mainstay for managing moderate and severe acute pain; however, despite their association with tumor progression, specific opioid agents have immune-protective properties and are considered safe alternatives to analgesia for cancer patients. [ABSTRACT FROM AUTHOR]

This study aimed to compare the effect of intranasal (IN) and intramuscular (IM) administration of butorphanol and zolazepam‐tiletamine (ZT) combination on intraocular pressure (IOP) and tear secretion (TS) in rabbits. Fourteen healthy male New Zealand White rabbits weighing 3.05 ± 0.72 kg, aged between 1 and 2 years old, were included in the study. Animals randomly received 0.5 mg/kg butorphanol and 15 mg/kg ZT combination either with IN or IM administration. IOP and TS were measured at baseline (T0), and followed by 5, 15, 30, 45, and 60 min after drug administration. The sedation variables, the time to onset of sedation, duration of sedation, and sedation scores were also recorded. The route of administration for the butorphanol and ZT combination had no significant effect on the mean IOP (p =.301) and TS (p =.445). Furthermore, there were no significant changes observed in the IOP (p =.472) and TS (p =.348) over time. The time to onset of sedation was earlier in the IN group (4.57 ± 0.79 min) than in the IM group (5.86 ± 0.9 min; p =.0004). The duration of sedation was significantly longer for IM (57.43 ± 3.41 min) compared with IN (45.0 ± 1.91 min; p <.0001). No significant difference in the sedation score was observed between groups at all time points. In conclusion, both IN and IM administration of the butorphanol and ZT combination in rabbits had similar effects on IOP and TS. [ABSTRACT FROM AUTHOR]

Background: Cough is a common clinical complaint in small animal practice with limited treatment options for chronic underlying conditions. Objectives: The present study aimed to evaluate the efficacy of three antitussive drugs in a novel, minimally invasive canine acute cough model. Methods: Five clinically healthy Beagles were used to create an acute cough model by administering sterile saline via a transtracheally placed central venous catheter. Single‐dose antitussive effects of butorphanol, maropitant and Danpron were assessed. Cough frequency was measured before and at hourly intervals up to 3 h post‐administration of each drug, with a linear mixed model used for statistical analysis. Results: Butorphanol (0.3 m/kg, IM) significantly reduced cough frequency at 1 and 3 h post‐administration. Danpron (0.1 mL/kg, IM) also significantly reduced cough frequency 1 h post‐administration; however, this effect was not sustained at 3 h. Maropitant (1 mg/kg, IM) did not significantly reduce cough frequency. The cough induction method was effective and minimally invasive, with no adverse effects. Conclusion: The present study demonstrated that butorphanol has a potent and prolonged antitussive effect in an acute canine cough model, whereas Danpron shows a transient effect. These findings provide valuable insights into the comparative efficacy of commonly used antitussive drugs in dogs. [ABSTRACT FROM AUTHOR]

Postoperative pain is acute with complex physiological responses to tissue injury. Epidural technique using opioids has been found to provide better pain relief than systemic opioids and also decreased incidence of postoperative complications. AIMS AND OBJECTIVES The aim of this study was to compare the onset, duration, quality of analgesia, cardio-respiratory effects and side effects of epidural butorphanol with epidural fentanyl for the relief of postoperative pain. METHODOLOGY 60 patients of either sex, age group of 18- 60 years, belonging to ASA grade Ι and ΙΙ, posted for elective lower abdominal surgeries were selected. They were randomly divided into 2 groups of 30 each. All surgeries were done under lumbar epidural anaesthesia. Postoperatively, when patient complained of pain, intensity of pain was assessed using Linear Visual analog scale (VAS) and when VAS score was >5, patients received either epidural butorphanol 2mg or epidural fentanyl 100µg diluted to 10ml with normal saline. Onset of analgesia, which is the time interval from administration of study drug till VAS score came down to < 5 was noted in both groups. Duration of analgesia, which is the time interval between start of analgesia (VAS score < 5) till patient complaints of pain (VAS score >5) was noted in both groups. Quality of analgesia was assessed using pain score in both the groups. Cardio-respiratory effects, heart rate, blood pressure and respiratory rate were monitored at regular intervals and were compared between the 2 groups. Side effects like sedation, pruritus, nausea, vomiting, hypotension and respiratory depression were noted. RESULTS Demographic profile (age, sex) was comparable in both groups. The onset of analgesia was clinically and statistically significantly late (6minutes) in butorphanol group when compared to fentanyl group (3minutes). Duration of analgesia was longer in butorphanol group (350 minutes) in comparison to fentanyl group (230 minutes) which was clinically and statistically significant. Quality of analgesia was better in butorphanol group. Sedation was the main side effect in butorphanol group. Incidence of pruritus, vomiting, hypotension and respiratory depression was more in fentanyl group. CONCLUSION Epidural butorphanol provides delayed onset but longer duration and better quality of analgesia than fentanyl with paucity of clinically significant side effects with both groups. [ABSTRACT FROM AUTHOR]

Butorphanol is commonly administered, both by the intravenous and intramuscular routes, to racehorses to facilitate handling for diagnostic procedures. As the administration of butorphanol for therapeutic purposes is considered appropriate, in order to avoid inadvertent positive drug tests, a thorough understanding of the pharmacokinetics of this drug is necessary. In the current study, 12, exercised Thoroughbred horses were administered a single intramuscular dose of 0.1 mg/kg butorphanol, and serum and urine samples were collected at various times post drug administration for determination of butorphanol concentrations using a highly sensitive liquid chromatography tandem mass spectrometry method. Serum data were modeled using a nonlinear mixed effect population PK model. The maximum concentration (Cmax) and time to maximum concentration (Tmax) were 139.9 ± 72.8 ng/mL and 0.43 ± 0.44 h (mean ± SD), respectively. Although likely not clinically relevant, but important for drug testing purposes, a prolonged terminal phase was observed, yielding a terminal half‐life of 7.67 ± 1.86 h. Using the blood screening limits proposed by the Horseracing Integrity and Welfare Unit, the detection time for intramuscular administration of butorphanol was estimated to be 96 h. [ABSTRACT FROM AUTHOR]

In order to increase accuracy and ensure safety during surgical procedures, anaesthesia is a necessary precondition for most diagnostic and surgical procedures in humans and animals. This study was designed to determine the changes in serum biochemical parameters following Acepromazine-Butorphanol-Propofol (ABP-combination) and propofol alone (PRO alone) anaesthesia in dogs. Ten (10) apparently healthy dogs with mean age of 1.59±0.77 years and a mean body weight of 15.5±1.96 kg were obtained from live dog market in Maiduguri, North-eastern Nigeria. The dogs were divided randomly into two groups, ABP-combination and PRO-alone groups. Following premedication with Acepromazine at 0.02mg/kg and Butorphanol at 0.05mg/kg iv., 4mg/kg Propofol was used to induce total intravenous anaesthesia (TIVA) after five minutes of premedication in ABP-combination group, while PRO-alone at 6mg/kg was used to induce anaesthesia without premedication in PRO-alone group. Creatinine (sCr), Alanine aminotransferase (ALT) and Blood urea nitrogen (BUN) were determined using standard laboratory procedures. The ALT, sCr and BUN showed no difference (p>0.05) within the group but were significantly (p<0.05) different between the groups. The levels of Alanine aminotransferase in both ABP and PRO treatments showed significant difference (p<0.05) at 10minutes, 1hour, 6hrs and 24hours. Significant difference (p<0.05) was observed in sCr levels between the two treatments, at 10minutes, 1hour and 6hours respectively. Blood urea nitrogen in both treatments differed (p<0.05) significantly at 6hours and 24hours post anaesthesia. The results of this study showed that ABP-combination following TIVA provides transient non-significant (p>0.05) effect on serum biochemical parameters. Therefore, the combination of ABP can be used during surgical procedures in dog. [ABSTRACT FROM AUTHOR]

To explore the application effect of butorphanol and dezocine combined with enhanced recovery after surgery (ERAS) and systematic analgesia management in pediatric anesthesia. Methods: 97 children who needed surgical treatment were divided into control group (treated with butorphanol and dezocine, n=48) and observation group (treated with ERAS and systematic analgesia management on the basis of control group, n=49) by random number table method. The visual analogue scale (VAS), Wong-Baker facial expression pain scale (FPS) score, Ramsay sedation score, anesthesia awake time, orientation recovery time, mean arterial pressure (MAP), heart rate (HR) and incidence of adverse reactions were compared between two groups. Results: The Ramsay sedation score at 6 h after operation in observation group was higher than that in control group, and FPS and VAS scores were lower than those in control group (P<0.05). From the start of operation until after operation, MAP and HR in observation group were higher than those in control group (P<0.05). Comparison of the incidence of adverse reactions between two groups of children did not show any statistical difference (P>0.05). Conclusion: The application of butorphanol, dezocine combined with ERAS and systematic analgesia management in pediatric anesthesia, which can effectively sedation and analgesia, maintain hemodynamic stability, and have good safety. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the effect of post-surgical photobiomodulation therapy in dogs. Methods: Twenty dogs were selected for elective gastropexy and randomly divided into a control (CG, n = 10) and a PBMT group (PBMTG, n = 10). Pre‑medication consisted of medetomidine and butorphanol. Meloxicam was administered before the procedure. Induction was performed with propofol and maintained with sevoflurane. Local blocks with lidocaine were used. Incisional gastropexy was performed in all animals. PBMTG received PBMT immediately after surgery. The need for postoperative rescue analgesia, if the animal had eaten by the evaluation momen, and pain scores were collected using the Glasgow Composite Measure Pain Scale – Short Form (CMPS‑SF) at 1, 2, 4, 6, 8, 12, 16, 20, and 24 h post‑endotracheal extubation. CMPS‑SF scores were compared with the Mann-Whitney Test and proportions of animals that required rescue analgesia and had eaten with a χ2 test. P was set at < 0.05. Results: No rescue analgesia was needed for any animal. Still, significant differences were observed in CMPS-SF scores between CG and PBMTG between 1 and 4 h post-extubation. PBMTG had a significantly higher proportion of animals eating up to the 8 h post-extubation evaluation moment. Conclusion: Adding post-surgical photobiomodulation to a standard anesthesia and analgesia protocol reduced CMPS-SF scores and increased the proportion of animals that resumed eating compared to the standard protocol alone. [ABSTRACT FROM AUTHOR]

This study, titled "A Comparative Study Between Epidural Butorphanol and Epidural Buprenorphine for Postoperative Pain Relief in Patients Undergoing Lower Abdominal and Lower Limb Surgeries," involved 100 ASA I and II patients aged 20-60 years. Ethical committee approval was obtained before starting the study. Patients were randomly divided into two groups: Group A (n=50) received 1 mg of Butorphanol tartrate, and Group B (n=50) received 300 mcg of Buprenorphine hydrochloride. In the postoperative period, the study drug was administered via an epidural catheter when patients first reported pain. The mean duration of analgesia for Butorphanol was 5.19±0.747 hours, with a rapid onset and excellent pain relief, though some experienced nausea, vomiting, and pruritus. No motor blockade or other complications were noted. For Buprenorphine, the mean duration of analgesia was 9.85±1.49 hours, with a slower onset compared to Butorphanol. Despite excellent pain relief, there were higher incidences of nausea (14%) and vomiting (20%) compared to Butorphanol (8% and 10%, respectively), while pruritus was less frequent (4% vs. 10%). Two patients (4%) in the Buprenorphine group experienced hypotension, with no motor blockade reported. [ABSTRACT FROM AUTHOR]

General anesthesia in calves is easier to perform under field conditions, total intravenous anesthesia (TIVA) than using inhalation anesthesia. In the present study, cardiopulmonary function, anesthetic effects, quality of arousal, hematology, and blood biochemistry were assessed during continuous infusion of a combination solution of 0.01% xylazine, 0.001% butorphanol, and 0.2% propofol (XBP) at doses of 6 (G6; 10 μg/kg/min xylazine, 1 μg/kg/min butorphanol, 200 μg/kg/min propofol) and 9 mL/kg/h (G9; 15 μg/kg/min xylazine, 1.5 μg/kg/min butorphanol 300 μg/kg/min propofol). For both groups, five castrated Holstein calves received intravenous injections of xylazine (0.2 mg/kg) and propofol (2 mg/kg), followed by a continuous infusion of XBP for 60 min to maintain anesthesia. Respiratory management consisted of tracheal intubation followed by spontaneous inhalation of pure oxygen. Cardiopulmonary, anesthesia, hematology, and blood biochemistry variables were assessed at rest (baseline) and every 5 or 15 min after the start of the XBP infusion. Quality of arousal was assessed based on the swallowing reflex recovery time from the stop of XBP infusion, and the sternal position time and standing time after atipamezole administration. XBP produced adequate sedation, analgesia, and muscle relaxation in all calves and maintained stable anesthesia for 60 min. As XBP infusion time passed, rectal temperature and heart rate became lower, and mean arterial blood pressure increased. In both groups, hematologic and blood biochemical effects were mild. The quality of arousal was not different, and all calves were standing. The results of the present study suggested that XBP is useful for TIVA in calves. [ABSTRACT FROM AUTHOR]

Aim: To compare the effects of midazolam, propofol, and dexmedetomidine monotherapy and combination therapy on the prognosis of intensive care unit (ICU) patients receiving continuous mechanical ventilation (MV). Methods: 11,491 participants from the Medical Information Mart for Intensive Care (MIMIC)-IV database 2008-2019 was included in this retrospective cohort study. The primary outcome was defined as incidence of ventilator-associated pneumonia (VAP), in-hospital mortality, and duration of MV. Univariate and multivariate logistic regression analyses were utilized to evaluate the association between sedation and the incidence of VAP. Univariate and multivariate Cox analyses were performed to investigate the correlation between sedative therapy and in-hospital mortality. Additionally, univariate and multivariate linear analyses were conducted to explore the relationship between sedation and duration of MV. Results: Compared to patients not receiving these medications, propofol alone, dexmedetomidine alone, combination of midazolam and dexmedetomidine, combination of propofol and dexmedetomidine, combination of midazolam, propofol and dexmedetomidine were all association with an increased risk of VAP; dexmedetomidine alone, combination of midazolam and dexmedetomidine, combination of propofol and dexmedetomidine, combination of midazolam, propofol and dexmedetomidine may be protective factor for in-hospital mortality, while propofol alone was risk factor. There was a positive correlation between all types of tranquilizers and the duration of MV. Taking dexmedetomidine alone as the reference, all other drug groupswere found to be associatedwith an increased risk of inhospital mortality. The administration of propofol alone, in combination with midazolam and dexmedetomidine, in combination with propofol and dexmedetomidine, in combination with midazolam, propofol and dexmedetomidine were associated with an increased risk of VAP compared to the use of dexmedetomidine alone. Conclusion: Dexmedetomidine alone may present as a favorable prognostic option for ICU patients with mechanical ventilation MV. [ABSTRACT FROM AUTHOR]

OBJECTIVE To assess the level of anxiolysis achieved by alprazolam and gabapentin in hospitalized cats prior to elective ovariohysterectomy and to evaluate the sedative effects of these agents. ANIMALS 60 client-owned female cats classified as American Society of Anesthesiologists physical status 1, admitted for elective ovariohysterectomy at a veterinary teaching hospital. METHODS The cats were prospectively and randomly allocated into 3 groups. Ninety minutes before evaluation, group G received gabapentin (100 mg/cat), group A received alprazolam (0.125 mg/cat), and group P received no medication (placebo). Stress, enclosure activity, and sedation scores were blindly evaluated. RESULTS Stress scores were similar in cats treated with gabapentin and alprazolam and gabapentin-treated cats had significantly lower stress score than those of the placebo group. Enclosure activity levels did not differ among the groups. Additionally, gabapentin and alprazolam resulted in similar sedation levels 90 minutes after treatment, which differed significantly compared to placebo. CLINICAL RELEVANCE The results of this study suggest that gabapentin provides similar anxiolysis in cats to that of alprazolam when evaluated 90 minutes after administration. Although no difference was noted in sedation levels between gabapentin and alprazolam. both induced deeper sedation than placebo. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study aimed to compare the effects of low-dose subarachnoid injections of 2% lidocaine (LIDO) and 0.5% bupivacaine (BUPI) in goats. ANIMALS: 6 healthy, privately owned female goats. METHODS In this randomized blind crossover clinical trial, each goat received 0.05 mL/kg-1 of LIDO, BUPI, or sterile saline solution into the lumbosacral subarachnoid space, with a seven-day washout. Cardiorespiratory variables, rectal temperature, and somatosensory (pinprick) and motor (ataxia) functions were recorded at baseline (time 0) and 2, 5, 10, 15, and 30 minutes after injection, then every 20 minutes until the goat was standing and able to walk. Time to regain somatosensory and motor functions was compared between treatments using Kaplan-Meier survival curves and the Cox proportional hazards model. Linear mixed-effects models were used to compare cardiorespiratory variables between treatments and over time. A P value ≤ .05 was considered significant. RESULTS: Somatosensory recovery was longer with BUPI, though not statistically significant. The median time to stand was 50 (50, 67) minutes after LIDO injection and 104 (101, 156) minutes after BUPI injection (P = .031). The median time to walk was 72 (54, 85) minutes after LIDO versus 225 (220, 245) minutes after BUPI injection (P = .031). Cardiovascular and respiratory variables showed no significant differences between treatments. CLINICAL RELEVANCE: Despite prolonged ataxia with BUPI, pinprick sensation recovery did not differ. At reduced doses, both LIDO and BUPI are deemed acceptable for short procedures of the flank, pelvic limb, or tail in healthy goats. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the topical antiseptic activity of saline, chlorhexidine (CHX), and povidone-iodine (PI) scrubs on the skin of chickens with or without the addition of DuraPrep (DP). ANIMALS: 7 healthy adult Orpington hens (Gallus gallus domesticus). METHODS: The right apterium corporale laterale was swabbed for standard aerobic bacterial culture and colony-forming unit (CFU) determination. The apterium was divided into 3 areas and treated with sterile saline, CHX, or PI. Samples were collected by swabbing each area before and after additional treatment with DP. CFU's were counted after 48 hours of incubation. Statistical analysis was performed using a linear mixed model with a continuous outcome. RESULTS: Compared to saline, CHX and PI treatment without DP decreased CFU count by 119 (95% CI, 55 to 183; P < .001) and 123 (95% CI, 58 to 187; P < .001), respectively. The application of DP after CHX and PI further decreased CFU counts by 6 (P = .01) and 9 (P = .01), respectively. DP after saline treatment decreased counts by 128 CFU (95% CI, 63 to 192; P < .001). No significant difference was detected between saline, PI, or CHX after DP application (-1.0 CFU; 95% CI, 63.4 to -65.4; P = .98 for both PI and CHX). CLINICAL RELEVANCE: CHX or PI provided greater reductions in bacterial CFU than saline, and all combinations with DP provided similar results. No notable cutaneous reactions were detected at any point. This data suggests that a scrub protocol including CHX or PI with DP is acceptable in surgical site preparation of chickens. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Present an approach to the safe and efficient provision of anesthesia and birth control measures to a large group of primates. ANIMALS: 98 hamadryas baboons (Papio hamadryas) held in a German zoological institution. METHODS: A group of 12 veterinarians, 2 zookeepers, and 6 volunteers anesthetized all animals within 2 days. The baboons were orally premedicated with midazolam (0.1 to 0.5 mg/kg) and anesthetized with medetomidine (40 to 60 μg/kg, IM) and ketamine (2 to 4 mg/kg, IM); isoflurane at rates of 1.5% to 2% was used for maintaining anesthesia if necessary. All animals received a physical examination, prophylactic medication, and tuberculin testing. For population management, the animals received a contraceptive implant (adult females), orchiectomy (young males), or vasectomy (breeding males). Young males received intratesticular blocks with lidocaine. All animals received atipamezole (125 to 150 μg/kg) before recovery. RESULTS: Premedication resulted in anxiolysis, which facilitated separating and darting. Median time from darting to access to the animal was 10 minutes. Mean anesthetic times were 25 minutes for females and 55 minutes for males. The depth of anesthesia was appropriate for the procedures. No fatalities were recorded. One animal was injured by other baboons but recovered after treatment. CLINICAL RELEVANCE: Health management and birth control measures are necessary in baboon troops under human care. Anesthesia and/or contraception of individual animals often leads to intraspecific aggression. This case series describes how to provide anesthesia and contraception to an entire troop as an alternative approach that can be adopted to future similar interventions. [ABSTRACT FROM AUTHOR]

Background: Percutaneous endoscopic transforaminal discectomy (PETD) is an effective method for treating lumbar disc herniation, and is typically performed under local anesthesia. However, inadequate analgesia during the procedure remains a concern, prompting the search for a medication that can provide optimal pain control with minimal impact on the respiratory and circulatory systems. Objectives: The aim of this study was to observe the effects of different doses of esketamine combined with dexmedetomidine on reducing visual analog scale (VAS) scores during surgical interventions. Methods: One hundred two patients who underwent PETD were randomly divided into a control group (group C: normal saline + dexmedetomidine), an E1 group (0.1 mg kg−1 esketamine + dexmedetomidine), and an E2 group (0.2 mg kg−1 esketamine + dexmedetomidine). The primary outcome was the maximum visual analogue scale (VAS) (score: 0 = no pain and 10 = worst pain) at six time points. The secondary outcomes included the Assessment of Alertness/Sedation Scale (OAA/S) score and mean arterial pressure (BP), heart rate (HR), respiratory rate (RR), and oxygen saturation (SpO2) at 11 time points. The incidence of adverse reactions during and 24 h after the operation and patient satisfaction with the anesthesia were also recorded. Results: Compared with those in group C, the VAS scores of patients in groups E1 and E2 were lower at T6, T7, and T9 (P < 0.05). From T4 to T10, the OAA/S scores of the E1 and E2 groups were both lower than those of group C (P < 0.05), and at the T4–T6 time points, the OAA/S score of the E2 group was lower than that of group E1 (P < 0.05). At T4 and T5, the HR and BP of patients in groups E1 and E2 were greater than those in group C (P < 0.05). Compared with those in group C, the incidences of intraoperative illusion, floating sensation, postoperative dizziness, and hyperalgesia in groups E1 and E2 were significantly greater (P < 0.01). There was no significant difference in patient RR, SpO2, or postoperative satisfaction with anesthesia among the three groups (P > 0.05). Conclusion: The combination of esketamine and dexmedetomidine can reduce VAS scores during certain stages of this type of surgery; it has minimal impact on respiration and circulation. However, this approach is associated with increased incidences of postoperative dizziness and psychiatric side effects, which may also affect patients' compliance with surgical instructions from medical staff. Patient satisfaction was not greater with dexmedetomidine combined with esketamine than with dexmedetomidine alone. Trial Registration: http://www.chictr.org.cn. Identifier: ChiCTR2300068206. Date of registration: 10 February 2023. [ABSTRACT FROM AUTHOR]

Background: Use of sedatives and analgesics is associated with the occurrence of delirium in critically ill patients receiving mechanical ventilation. Dexmedetomidine reduces the occurrence of delirium but may cause hypotension, bradycardia, and insufficient sedation. This substudy aims to determine whether the combination of esketamine with dexmedetomidine can reduce the side effects and risk of delirium than dexmedetomidine alone in mechanically ventilated patients. Methods: This single-center, randomized, active-controlled, superiority trial will be conducted at The First Affiliated Hospital of Nanjing Medical University. A total of 134 mechanically ventilated patients will be recruited and randomized to receive either dexmedetomidine alone or esketamine combined with dexmedetomidine, until extubation or for a maximum of 14 days. The primary outcome is the occurrence of delirium, while the second outcomes include the number of delirium-free days; subtype, severity, and duration of delirium; time to first onset of delirium; total dose of vasopressors and antipsychotics; duration of mechanical ventilation; ICU and hospital length of stay (LOS); accidental extubation, re-intubation, re-admission; and mortality in the ICU at 14 and 28 days. Discussion: There is an urgent need for a new combination regimen of dexmedetomidine due to its evident side effects. The combination of esketamine and dexmedetomidine has been applied throughout the perioperative period. However, there is still a lack of evidence on the effects of this regimen on delirium in mechanically ventilated ICU patients. This substudy will evaluate the effects of the combination of esketamine and dexmedetomidine in reducing the risk of delirium for mechanically ventilated patients in ICU, thus providing evidence of this combination to improve the short-term prognosis. The study protocol has obtained approval from the Medical Ethics Committee (ID: 2022-SR-450). Trial registration: ClinicalTrials.gov: NCT05466708, registered on 20 July 2022. [ABSTRACT FROM AUTHOR]

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Background: This randomized controlled trial aimed to compare the effects of butorphanol and sufentanil on early post-operative cognitive dysfunction (POCD) and systemic inflammation in older surgical patients. Methods: Patients (aged 65  years or above) undergoing surgeries with general anesthesia were randomized to either the butorphanol group (40  μg/kg during anesthesia induction) or the sufentanil group (0.4  μg/kg). Cognitive function changes during the perioperative period were assessed using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) scale up to 3  days after surgery. POCD was defined as a Z-score or composite Z-score greater than 1.96 for both MMSE and MoCA scores. Circulating inflammatory factors, including tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 10 (IL-10), were measured using enzyme-linked immunosorbent assay. Results: The study included 114 patients (median age: 71  years, 57.7% male). Compared to sufentanil, butorphanol significantly reduced the incidence of POCD on the first (11.5% versus 32.7%, p  =  0.017) and third day (3.8% versus 15.4%, p  =  0.046) after surgery. Additionally, patients receiving butorphanol had significantly lower circulating levels of TNF-α and IL-1β at the time of discharge from the post-anesthesia care unit and on the first and third day after surgery (p  <  0.05 for all comparisons). Furthermore, circulating IL-10 levels were significantly higher in patients receiving butorphanol (p  <  0.05 for all comparisons). Conclusion: Administration of butorphanol during anesthesia induction, as opposed to sufentanil, was associated with a significant reduction in the early incidence of POCD in older surgical patients, possibly attributed to its impact on systemic inflammation. [ABSTRACT FROM AUTHOR]

Objective: To explore the influence of butorphanol pretreatment combined with ultrasound-guided thoracic paraverte- bral nerve block anesthesia (TPVB) on analgesic effect and stress response in patients undergoing thoracoscopic radical resection of lung cancer. Methods: Sixty patients with lung cancer in our hospital were selected from May 2021 to June 2022 and were classified into ob- servation group (n=30) and control group (n=30) by random number table method. Both groups received intravenous anesthesia and were treated with patient-controlled intravenous analgesia (PCIA) after surgery, and the observation group performed ultrasound-guided TPVB before surgery and was given butorphanol pretreatment. The hemodynamics, anesthetic effect, postoperative pain status, stress response and occurrence of adverse reactions were compared between the two groups. Results: Compared with To, the heart rate (HR) and mean arterial pressure (MAP) in the two groups were decreased at T1 (P<0.05). The HR and MAP were increased at T2 in the two groups compared with those at T 1(P<0.05). The HR and MAP at T2 and T3 in observation group were lower compared to control group (P<0.05). The propofol dosage, remifentanil dosage, extubation time and PCIA use frequency in observation group were lower, shorter or less than those in control group (P<0.05). At 8 h, 12 h and 24 h after surgery, the pain degrees at rest and cough in observation group were milder than those in control group(P<0.05). After surgery, the levels of epinephrine (E), cortisol (Cor) and adrenocorticotropic hormone (ACTH) were risen in the two groups (P<0.05), but the observation group had lower levels (P<0.05). There was no significant difference in the total incidence rate of adverse reactions between the two groups (P>0.05). Conclusion: Butorphanol pretreatment combined with ultrasound-guided TPVB can control the hemodynamics and total dosage of opioids of patients undergoing thoracoscopic radical resection of lung cancer, shorten the extubation time, and relieve the postoperative pain and stress response. [ABSTRACT FROM AUTHOR]

Simple Summary: This study aimed to assess the efficacy of a sacrococcygeal epidural (ScE) of 0.25% bupivacaine in preventing sympathetic nervous system activation on feline ovariectomy. During the intraoperative period, traditional hemodynamic variables (heart rate, systolic and median blood pressure, and respiratory rate) and Parasympathetic Tone Activity monitoring were used to assess the activation of the sympathetic nervous system after ScE of 0.25% bupivacaine. This study indicates that implementation of ScE reduces the rise of common hemodynamic variables but does not prevent sympathetic nervous system activation during feline ovariectomy. The ovariectomy (OVE) procedure can trigger somatosensory and visceral peritoneal nociception. Sacrococcygeal epidural (ScE) anesthesia may complement or replace systemic analgesia used for feline OVE, reducing opioid consumption and their related undesirable adverse effects and consequently reducing or completely blocking the sympathetic nervous system activation during this procedure. The present study aimed to evaluate the activation of the sympathetic nervous system resulting from adding an ScE injection of bupivacaine 0.25% (0.3 mL kg−1) in feline OVE and identify whether this translates to hemodynamic variables stability. A Parasympathetic Tone Activity (PTA) monitor was applied given that it performs analysis of heart rate variability (HRV) detecting changes in sympathetic and parasympathetic tone, making it a good tool for detecting activation of the sympathetic nervous system during the study. Two groups of animals were evaluated in five perioperative times, namely, the control group (CG) (n = 18) with systemic analgesia alone and the sacrococcygeal epidural group (ScEG) (n = 20) with 0.25% bupivacaine combined with systemic analgesia. Thirty-eight female cats were selected. All animals assigned to CG and ScEG were premedicated with dexmedetomidine (20 μg kg−1 IM) and methadone (0.2 mg kg−1 IM). General anesthesia was induced with propofol IV ad effectum and maintained with isoflurane in 100% oxygen. Heart rate, non-invasive systolic and median blood pressure, respiratory rate, and instantaneous parasympathetic tone activity were recorded. Compared to systemic analgesia alone (CG), sacrococcygeal epidural (ScEG) reduced the rise of common hemodynamic variables but did not prevent sympathetic nervous system activation. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the application value of butorphanol combined with dexmedetomidine on analgesia and sedation in mechanically ventilated patients with hyperlipidemic severe acute pancreatitis. METHODS: Clinical data of 103 patients with hyperlipidemic severe acute pancreatitis diagnosed and treated in ICU department in the People’ s Hospital of Xiangxi Tujia and Miao Autonomous Prefecture from Mar. 2020 to Feb. 2023 were retrospectively analyzed, which were divided into observation group ( 53 cases, epidural block + butorphanol + dexmedetomidine) and control group (50 cases, epidural block+butorphanol) according to the analgesic and sedative schemes during mechanical ventilation. The analgesic and sedative effects and inflammatory factors levels from before medication to 120 h of medication, and the incidence of adverse drug reaction during treatment were statistically analyzed. RESULTS: In both groups, the Critical Care Pain Observation Tool (CPOT) scores were lower at 48 h of medication, and were in a decrease trend from 48 h to 120 h of medication, the differences were statistically significant compared with those of before medication (P<0. 05); the CPOT scores of the observation group were lower than those of the control group from 48 h to 120 h of medication, with statistically significant differences (P<0. 05). The Ramsay sedation score of both groups at 48 h of medication was higher than that before medication; the score of the observation group was lower than that of the control group from 72 h to 120 h of medication, with statistically significant differences (P<0. 05). After medication, the serum interleukin (IL) 1β, IL-6 and tumour necrosis factor α levels of both groups were lower than those before medication, and those of the observation group were lower than the control group, with statistically significant differences (P<0. 05). In the comparisons of the incidence of adverse drug reactions such as delirium, tremor, hypotension, bradycardia and vomiting between two groups, the differences were not statistically significant ( P>0. 05 ). CONCLUSIONS: The application of butorphanol combined with dexmedetomidine on mechanically ventilated patients with hyperlipidaemic severe acute pancreatitis can strengthen the analgesic and sedative effect, improve the anti-inflammatory effect, without increasing adverse drug reactions. [ABSTRACT FROM AUTHOR]

The goals of this study were to evaluate the effectiveness and physiological effects of alfaxalone-butorphanolmidazolam sedation in cats compared with the common sedation protocol used at our institution; medetomidine-butorphanol-midazolam. Thirty-one cats requiring sedation for various procedures were recruited randomly to receive intramuscular butorphanol (0.4 mg/kg) and midazolam (0.3 mg/kg) combined with alfaxalone (2 mg/kg) (ABM; n=16) or medetomidine (0.02 mg/kg) (MBM; n=15). Physiological variables and sedation quality (scale 7-28; 7=awake, 28=deeply sedated) were collected every 10 minutes until recovery. For medetomidine antagonism, the MBM cats received atipamezole intramuscularly. Induction and recovery times were recorded, and recovery quality was scored (1-4 scale: 1=poor, 4=excellent). Evaluations were performed by one blinded observer. Mann-Whitney U test, Fischer's exact and repeated measures mixedeffects were used for analysis, and p<0.05 was set for significance. Six cats (ABM) and three cats (MBM) required an additional dose. At 10-40 minutes sedation scores were significantly better in the MBM (21-24) compared with ABM group (19-20). Significant lower heart rate, higher blood pressure and respiratory frequency were recorded in the MBM group. Time to recovery was significantly faster (9±7 versus 26±21 minutes) and recovery of better quality (4 [1-4] versus 3 [1-4]) in the MBM compared with the ABM group. During recovery, cats in the ABM group showed opisthotonos, twitching, and paddling, which resolved within an hour. In conclusion, at the doses used, ABM was a viable alternative to MBM with less cardiovascular effects, however, sedation plane was inferior and recovery, longer, accompanied by adverse behaviors. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Veterinary Journal / Revue Vétérinaire Canadienne is the property of Canadian Veterinary Medical Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)