Abstract
Objective
To compare the effects of hydromorphone and butorphanol in horses undergoing arthroscopy
and describe the pharmacokinetics of hydromorphone in anesthetized horses.
Study design
Randomized controlled clinical trial.
Animals
A total of 40 adult horses admitted for elective arthroscopy.
Methods
Horses were randomly assigned to be administered intravenous hydromorphone (0.04 mg
kg–1; group TxH; n = 19) or butorphanol (0.02 mg kg–1; 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.
Results
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–1, clearance was 30.7 ± 7.23 mL minute–1 kg–1 and volume of distribution at steady state was 884 ± 740 mL kg–1.
Conclusions
Hydromorphone, but not butorphanol, decreased CPS back to baseline at P4 after recovery.
Clinical relevance
Hydromorphone may provide superior postoperative analgesia compared with butorphanol
in horses undergoing arthroscopy.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Veterinary Anaesthesia and AnalgesiaAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Risk factors for colic in horses after general anaesthesia for MRI or nonabdominal surgery: absence of evidence of effect from perianaesthetic morphine.Equine Vet J. 2006; 38: 368-374
- Behavioural assessment of pain in horses and donkeys: application to clinical practice and future studies.Equine Vet J. 2005; 37: 565-575
- Interspecies variation in liver weight, hepatic blood flow, and antipyrine intrinsic clearance: extrapolation of data to benzodiazepines and phenytoin.J Pharmacokinet Biopharm. 1980; 8: 165-176
- Effects of ketamine and alfaxalone on application of a feline pain assessment scale.J Feline Med Surg. 2016; 18: 643-651
- Development of a composite orthopaedic pain scale in horses.Res Vet Sci. 2008; 85: 294-306
- The effects of morphine on the recovery of horses from halothane anaesthesia.Vet Anaesth Analg. 2008; 35: 22-29
- Assessment of agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scoring the recovery of horses from anesthesia by use of subjective grading scales and development of a system for evaluation of the recovery of horses from anesthesia by use of accelerometry.Am J Vet Res. 2017; 78: 668-676
- The effect of postsurgical pain on attentional processing in horses.Vet Anaesth Analg. 2017; 44: 933-942
- Effects of morphine, butorphanol and levomethadone in different doses on thermal nociceptive thresholds in horses.Tierarztl Prax Ausg G Grosstiere Nutztiere. 2017; 45 (In German): 98-106
- Hepatic blood flow in horses during the recuperative period from maximal exercise.Am J Vet Res. 1998; 59: 1476-1480
- Effect of postoperative xylazine administration on cardiopulmonary function and recovery quality after isoflurane anesthesia in horses.Vet Surg. 2013; 42: 877-884
- Analgesic effect of butorphanol in ponies following castration.Equine Vet J. 2009; 41: 552-556
- Pharmacokinetics and pharmacodynamics of hydromorphone hydrochloride in healthy horses.Vet Anaesth Analg. 2020; 47: 509-517
- The pharmacokinetics and pharmacodynamics of intravenous hydromorphone in horses.Vet Anaesth Analg. 2019; 46: 395-404
- Pharmacokinetics and pharmacodynamics of hydromorphone after intravenous and intramuscular administration in horses.Vet Anaesth Analg. 2020; 47: 210-218
- Pain control in horses: what do we really know?.Equine Vet J. 2014; 46: 517-523
- Effects of alpha-2 adrenoceptor agonists during recovery from isoflurane anaesthesia in horses.Equine Vet J. 2003; 35: 170-175
- A retrospective evaluation of the effect of perianesthetic hydromorphone administration on the incidence of postanesthetic signs of colic in horses.Vet Anaesth Analg. 2020; 47: 757-762
- Epidural anesthesia and gastrointestinal motility.Anesth Analg. 1998; 86: 837-844
- A multicentre, prospective, randomised, blinded clinical trial to compare some perioperative effects of buprenorphine or butorphanol premedication before equine elective general anaesthesia and surgery.Equine Vet J. 2016; 48: 442-450
- Pain assessment in horses after orthopaedic surgery and with orthopaedic trauma.Vet J. 2019; 246: 85-91
Article info
Publication history
Published online: June 03, 2022
Accepted:
May 27,
2022
Received:
March 30,
2022
Identification
Copyright
© 2022 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
