Continuous extradural analgesia in a cow with complex regional pain syndrome (original) (raw)
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2009
Broom, Colleen Macleod Professor da Universidade de Cambridge, U.K., na qualidade de especialista. 2009 LISBOA III To my parents, Pamela and Francis IV Understanding animals (The Far Side, by Garry Larson) "The most crucial limitation to the moral philosophy approach to animal welfare is the fact that what matters to the animal is not what we think or feel but what we do" (In: Animal Welfare: A Cool Eye Towards Eden. J. Webster, 2005) V
Epidural injection of ketamine for caudal analgesia in the cow
Veterinary Anaesthesia and Analgesia, 1999
The objective of the study was to determine the analgesic and sedative effects of epidural ketamine in the cow. Eight healthy cows weighing 350-450 kg were used. One of 3 doses of ketamine (0.5, 1 and 2.0 mg/kg) or a saline control were injected into the epidural space at the first intercoccygeal interspace in random sequence at one-week intervals. Ketamine was diluted in saline (0.9%) before the experiment, and the volume adjusted according to animal size. Analgesia was tested by applying a standard stimulus (needle insertion into the skin and deep muscle) and scored using a 3-point scale. A second voltage-based stimulus was also applied and the responses scored. Another scale was used for scoring the degree of sedation. The response and the degree of sedation were assessed before drug administration and at 2, 5 , 10, 15 min, and every 15 min until 120 min after ketamine or saline administration. Ketamine produced dose-related analgesia of the tail, anus, perineum and vulva but not of the hindlimb area. The effect was dose-dependent in terms of intensity and duration.
Analgesia from a veterinary perspective
British Journal of Anaesthesia, 2008
The last decade has seen continued progress in both the recognition and management of animal pain. This upsurge in the use of analgesics in animals is welcome, but the main areas of use continue to be the control of postoperative or post-trauma pain, and the management of musculoskeletal pain, in companion animals and horses. The management of pain associated with other conditions, such as soft-tissue inflammation or cancer, is still relatively neglected. Pain management in farm animals, and in animals used in biomedical research could also be improved further. Apart from providing some interesting parallels with pain management in people, development of veterinary pain management has potentially much greater significance. For many years, animal pain management has benefited from the use of analgesics used in man. In the future, it may be that a better understanding of animal pain, and in particular chronic pain states, may lead to translation of therapies in the opposite direction.
Epidural analgesia in cattle, buffalo, and camels
Veterinary World, 2016
Epidural analgesia is commonly used in large animals. It is an easy, cheap, and effective technique used to prevent or control pain during surgeries involving the tail, anus, vulva, perineum, caudal udder, scrotum, and upper hind limbs. The objectives of this article were to comprehensively review and summarize all scientific data available in the literature on new techniques and drugs or drug combinations used for epidural anesthesia in cattle, camel, and buffalo. Only articles published between 2006 and 2016 were included in the review. The most common sites for epidural administration in cattle, camels, and buffalos were the sacrococcygeal intervertebral space (S5-Co1) and first intercoccygeal intervertebral space (Co1-Co2). The most frequently used drugs and dosages were lidocaine (0.22-0.5 mg/kg), bupivacaine (0.125 mg/kg), ropivacaine (0.11 mg/kg), xylazine (0.05 mg/kg), medetomidine (15 μg/kg), romifidine (30-50 μg/kg), ketamine (0.3-2.5 mg/kg), tramadol (1 mg/kg), and neostigmine (10 μg/kg), and the clinical applications, clinical effects, recommendations, and side effects were discussed.
Canadian journal of veterinary research = Revue canadienne de recherche vétérinaire, 2013
The objectives of this study were to determine the analgesic and motor effects of a high-volume intercoccygeal epidural injection of bupivacaine at 2 concentrations in cows. A prospective, randomized, blinded, crossover trial was conducted on 6 adult cows. An indwelling epidural catheter was placed in the first intercoccygeal space and advanced 10 cm cranially. All the cows received 3 treatments with a washout period of 48 h: saline (control), 0.125% bupivacaine (high dose), or 0.0625% bupivacaine (low dose), at a final volume of 0.15 mL per kilogram of body weight, infused manually into the epidural space over a period of 15 min. The anal and tail tone and motor deficits of the pelvic limbs were evaluated in 5 of the cows with use of a numerical rating scale and a visual analogue scale (VAS). Sensory block was assessed in 4 of the cows by the response to needle pricks in different regions with the use of a VAS. Measurements were obtained before and at different time points after in...
Canadian veterinarians' use of analgesics in cattle, pigs, and horses in 2004 and 2005
The Canadian Veterinary Journal La Revue Veterinaire Canadienne, 2007
Anecdotal evidence suggests that many veterinarians may not use analgesics in livestock for routine surgical procedures or painful disease states. To investigate this, we conducted a national mail survey of a random sample of 1431 Canadian veterinarians (response rate, 50.1%). Questions primarily concerned veterinarians' analgesic usage for common surgeries and medical conditions in beef and dairy cattle, pigs, and horses, and attitudes toward pain management. More than 90% of veterinarians used analgesic drugs for equine surgeries, for cesarean section in sows and cows, and for bovine claw amputation and omentopexy. However, in these and other categories, the analgesics used were often inadequate, and many veterinarians did not give analgesics to young animals. When castrated, , 0.001% of piglets received analgesia, compared with 6.9% of beef calves and 18.7% of dairy calves # 6 mo of age, 19.9% of beef calves and 33.2% of dairy calves. 6 mo of age, and 95.8% of horses. Respondents largely agreed that there are no long-acting, cost-effective analgesics available for use in livestock (median rating 8/10; interquartile range 4-9), and that the long or unknown withdrawal periods of some drugs outweighed the benefits of using them (median rating 7/10; interquartile range 4-9). The results indicate an urgent need for veterinarians to manage pain in livestock better. Continuing education would help, as would an increase in the number of approved, cost-effective analgesic drugs with known withdrawal periods. Résumé-Utilisation des analgésiques chez les bovins, les porcs et les chevaux par les vétérinaires canadiens en 2004 et 2005. Résumé. Divers témoignages permettent de présumer que plusieurs vétérinaires pourraient ne pas utiliser d'analgésiques chez les bestiaux lors de procédures chirurgicales de routine ou lors d'épisodes maladifs douloureux. Afin d'étudier ces présomptions, nous avons procédé à une enquête postale nationale sur un échantillon de 1431 vétérinaires canadiens choisis au hasard (taux de réponse, 50,1 %). Les questions portaient particulièrement sur l'usage d'analgésiques par le vétérinaire lors de chirurgies et de problèmes médicaux courants chez les bovins de boucherie et laitiers, les porcs et les chevaux et sur les attitudes dans le contrôle de la douleur. Plus de 90 % des vétérinaires utilisaient des analgésiques pour les chirurgies équines, les césariennes porcines et bovines et pour l'amputation des onglons et l'omentopexie chez les bovins. Cependant, dans ces actes médicaux et dans certains autres, les analgésiques utilisés étaient souvent inadéquats et plusieurs vétérinaires n'en donnaient pas aux jeunes animaux. À la castration, , 0,001 % des porcelets recevaient une analgésie comparé à 6,9 % des veaux de boucheries et 18,7 % des veaux laitiers âgés de moins de 6 mois, 19,9 % des veaux de boucherie et 33,2 % des veaux laitiers âgés de plus de 6 mois et 95,8 % des chevaux. Les répondants étaient largement d'accord pour dire qu'il n'y avait pas d'analgésiques à longue action et d'un bon rapport coût-efficacité disponibles pour utilisation sur les bestiaux (estimation médiane de l'opinion 8/10; étendue interquantile 4-9) et que les désavantages reliés aux périodes de retrait longues ou inconnues de certaines drogues l'emportaient sur les bénéfices (estimation médiane de l'opinion 7/10; étendue interquantile 4-9). Les résultats montrent que les vétérinaires ont un urgent besoin de mieux contrôler la douleur des bestiaux. L'éducation continue pourrait être utile de même qu'une augmentation du nombre d'analgésiques approuvés, d'un bon rapport coût-efficacité et dont les périodes de retrait seraient connues.
2010
Objective To determine the analgesic and systemic effects of epidural administration of ketamine, lidocaine or a combination of ketamine/lidocaine in standing cattle. Study design Prospective, randomized, experimental trial. Animals Six healthy male cattle weighing between 335 and 373 kg. Methods The animals received 0.5 mg kg)1 of ketamine (K), 0.2 mg kg)1 of 2% lidocaine (L) or 0.25 mg kg)1 ketamine plus 0.1 mg kg)1 lidocaine (KL). All the drugs were injected into the dorsolumbar epidural space via a caudal approach through a non-styletted multiple-port catheter. Each animal received each treatment at random. Evaluations of analgesia, sedation, ataxia, heart rate, arterial pressure, respiratory rate, skin temperature and rectal temperature were obtained at 0 (basal), 5, 10, 15, 30, 45, 60, 75, 90 minutes after epidural injection, and then at 30-minute intervals until loss of analgesia occurred. Skin temperature was taken at these intervals up to 60 minutes. All the animals received a standard noxious stimulus; a 4-point scale was used to score the response. A second scale was used to score ataxia and a third for sedation. Results The duration of analgesia in the upper and lower flanks in cattle was 140 ± 15, 50 ± 14 and 80 ± 22 minutes (mean ± SD) after dorsolumbar epidural KL, K or L, respectively. The cardiovascular changes were within acceptable limits in these clinically healthy cattle. Conclusions Dorsolumbar epidural administration of KL to cattle resulted in longer duration of analgesia of the upper and lower flanks in standing conscious cattle, than the administration of K or L alone. Clinical relevance Further research is necessary to determine whether this combination using this technique provides sufficient analgesia for flank surgery in standing cattle.
Veterinary Anaesthesia and Analgesia, 2013
Objective To evaluate the anti-nociceptive effects of lidocaine, lidocaine-bupivacaine combination or bupivacaine following caudal epidural administration in cows undergoing reproductive procedures. Study design Blinded, randomized experimental study. Animals Thirty seven healthy Holstein cows (mean weight ± SD, 633 ± 41 kg). Methods Animals were allocated randomly to receive one of four treatments: group LID, 0.2 mg kg)1 lidocaine 2%; group LID-BUP, lidocaine-bupivacaine mixture in a 1:1 volume ratio (0.1 mg kg)1 and 0.025 mg kg)1 , respectively); group BUP-LD, 0.05 mg kg)1 bupivacaine 0.5%; and group BUP-HD, 0.06 mg kg)1 bupivacaine 0.5%. The onset and duration of perineal antinociception were determined using superficial and deep pin pricks and the number of cows with complete perineal anti-nociception was recorded. Parameters were compared using ANOVA followed by Duncan's test where relevant. Results Mean ± SD time to onset of anti-nociception following epidural administration of BUP-LD was significantly longer than for LID-BUP (p < 0.05). The duration (in minutes) of perineal anti-nociception was significantly longer following epidural administration of BUP-HD (247 ± 31) versus LID-BUP (181 ± 33) and LID (127 ± 25) minutes respectively. The % of cows with complete antinociception was increased in the group treated with BUP-HD compared to BUP-LD. Severe ataxia or recumbency did not occur in any groups. Conclusions and clinical relevance Epidurally administered bupivacaine, at a dose of 0.06 mg kg)1 , may provide satisfactory caudal epidural anti-nociception for longer-duration obstetric and surgical procedures.