IRANIAN JOURNAL OF VETERINARY SURGERY (IJVS) Assessment of Analgesic Efficacy of Intra-articular Tramadol Administration Following Arthroscopic Surgery in Horses-A Pilot Study (original) (raw)
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Iranian Journal of Veterinary Surgery, 2016
Objective-The aim of this study was to evaluate the analgesic efficacy of intra-articular administration of tramadol in horses following arthroscopic surgery. Design-Experimental study. Animals-Ten Warmblood horses Procedures-Horses underwent arthroscopic surgery of the tarsocrural joint (TCJ) (8 horses) and metacarpo-metatarsophalangeal joint (MCPJ/MTPJ) (2 horses). Intra-articular tramadol (2 mg/kg) or saline was administered in randomly selected horses (5 in each group; 4x TCJ and 1x MCPJ/MTPJ) under general anesthesia prior to recovery. After the horses were fully recovered and had returned to the stable two observers, blinded to the treatment scored pain independently at 1, 2, 3, 4, 6, 8, 12 and 24 hours based on a composite measure pain scale (CMPS). Results-Significant difference in pain score (P < 0.001) was observed at any individual time-point between the two groups, except at 24 hours post treatment. A significant lower pain score was detected in tramadol treated group (P < 0.001), up to the twelfth hour after treatment. No significant difference was seen between various times in the saline group (P = 0.09). Conclusion and Clinical Relevance-Analgesic efficacy of intra-articular tramadol administration was demonstrated by significantly reduced pain scores following arthroscopic surgery in horses. This observation might be useful as basis for a multimodal analgesic protocol; however, more detailed studies are warranted.
Veterinary Quarterly
Intra-articular administration of analgesics is performed to ensure good perioperative pain management avoiding undesirable systemic effects. To evaluate the effect of intra-articular injection of tramadol on postoperative pain after arthroscopy in horses and to determine whether tramadol had a local effect. Before the in vivo study, an in vitro test was performed aiming to evaluate the viability of equine chondrocytes after exposure to various concentrations of tramadol. The concentration identified as most appropriate was used to treat the horses' joints. Twelve horses affected by osteochondrosis were randomly assigned to two groups that were treated intra-articularly at the end of surgery with tramadol (4 mg/mL) and saline, respectively. At predetermined time-points a Composite Pain Scale was applied and blood samples were collected in order to define the extent of tramadol absorption into the systemic circulation. The Mann-Whitney test was used for statistical analysis. Serum of four out of six treated horses revealed traces of tramadol (range 10.6-19.3 ng/mL) sporadically between 0.5 and 4 hours post-treatment, while in the other two horses, no trace of drug was found. Findings suggested that any eventual effect was probably due to local action rather than systemic absorption. The pain scores obtained in tramadol-treated horses were lower between 1 and 6 hours post-administration, than those obtained in the control group, but the differences were not statistically significant. These preliminary results suggest that tramadol, at this concentration, is only mildly beneficial in the pain management of horses after arthroscopy.
Analgesic Effect of Intraarticular Tramadol with Morphine after Arthroscopic Knee Surgery
Nepal Orthopaedic Association Journal, 2013
Introduction: Post-operative improved pain control of patients has made arthroscopy as a day care procedure, reducing patient’s expenses and hospital staffs work load. Various analgesic drugs have been administered into the joint following Arthroscopy. Intra-articular injection of morphine has been practiced in many centres all over the world. We aimed to compare the efficacy of intra-articular tramadol and morphine. Tramadol is an opioid drug with similar analgesic properties like morphine. Tramadol unlike morphine is readily available over the counter not being abused and has more favourable side effects. Methods: It was a prospectively randomized double-blind study in which sixty patients having elective arthroscopic surgery of the knee were randomized into two groups. Group A (Tramadol Group) received intra-articular tramadol 50mg and Group B (Morphine Group) received morphine 5mg in equivalent volumes. Post-operative pain using Visual Analogue Score (VAS) between 0 and 10, (0 n...
Journal of Equine Veterinary Science, 2020
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Analgesic Effect of Intra-articular Tramadol Compared With Morphine After Arthroscopic Knee Surgery
Arthroscopy-the Journal of Arthroscopic and Related Surgery, 2005
Purpose: The aim of the study was to compare the analgesic effect of 5 mg intra-articular (IA) morphine with 50 mg IA tramadol. Type of Study: Prospective double-blind randomized trial. Methods: Seventy-five patients having elective arthroscopic surgery of the knee were randomized to receive IA tramadol 50 mg (tramadol group), IA morphine 5 mg (morphine group), or IA normal saline (control group), in equivalent volumes (20 mL). The tourniquet was released 10 minutes after analgesic administration. Verbal pain rating score between 0 and 10 (VRS), supplemental analgesic requirements, and incidence of side effects were recorded postoperatively. Results: Results are given as (median [5-95 percentiles]). The control group had a significantly shorter time to first analgesic request (25 min ) than morphine group, (34 min , P Ͻ .008) and the tramadol group, (33 min , P Ͻ .008). The patients in the control group complained of more severe pain (VRS 7 [4-10]) when they arrived at the postanesthesia care unit compared with the morphine group (VRS 1 [0-9], P ϭ .002) and with the tramadol group (VRS 0 [0-9], P ϭ .002). These treatment benefits were especially prominent in the patients who had meniscectomy or in the subgroup of patients with more than 6 months of preoperative pain. There was no statistical difference between the tramadol and morphine groups in the time to first analgesia, postoperative pain scores after arrival at the postanesthesia care unit, consumption of rescue analgesic, or side effects. Conclusions: We conclude that 50 mg IA tramadol provides analgesia equivalent to 5 mg IA morphine. Level of Evidence: Level II, randomized controlled trial that shows no significant difference and lacks narrow confidence intervals.
Equine Veterinary Journal, 2010
Reasons for performing study: Intra-articular administration of morphine as a local analgesic and anti-inflammatory drug is widely used in human medicine. In equids, little is known about its clinical analgesic and anti-inflammatory efficacy. Objectives: To use an inflammatory orthopaedic pain model to investigate the analgesic and anti-inflammatory effects of intra-articularly administered morphine as a new treatment modality in horses with acute arthritis.e vj_77 412..419 Methods: In a crossover study design, synovitis was induced in the left or right talocrural joint by means of intra-articular injection of 0.5 ng lipopolyssacharide (LPS). The effect of 120 mg morphine, intra-articularly administered at 1 h after induction of synovitis, was evaluated using both physiological and behavioural pain variables. Synovial fluid was sampled at 0, 4, 8, 28 and 52 h after induction of synovitis and analysed for total protein concentration, leucocyte count and for prostaglandin E2, bradykinin and substance P concentrations by ELISA. Ranges of motion of metatarsophalangeal and talocrural joints were measured as kinematic variables with the horses walking and trotting on a treadmill under sound and lame conditions. Clinical lameness scores and several behavioural variables related to the perception of pain were obtained. Results: LPS injection caused marked transient synovitis, resulting in increased concentrations of inflammatory synovial fluid markers, clinical lameness, joint effusion and several behavioural changes, such as increased time spent recumbent, decreased limb loading at rest and decreased time spent eating silage. Intra-articular morphine resulted in a significant decrease in synovial white blood cell count, prostaglandin E2 and bradykinin levels and improvement in clinical lameness, kinematic and behavioural parameters, compared to placebo treatment. Conclusions: Intra-articular morphine offers potent analgesic and anti-inflammatory effects in horses suffering from acute synovitis. Potential relevance: Local administration of opioids may be useful for horses with acute inflammatory joint pain and offers possibilities for multimodal analgesic therapies without opioid-related systemic side effects.
Tramadol effects on clinical variables and the mechanical nociceptive threshold in horses
Ciência Rural, 2014
This study assessed the clinical effects and the mechanical antinociceptive potential of intravenous (IV) tramadol in horses.A blinded and randomized study was designed with 7 horses treated with 1 (Tr1), 2 (Tr2) or 3 (Tr3) mg kg-1 of tramadol IV. The heart rate, respiratory rate (fR), arterial pressure, degree of sedation, gastrointestinal motility (GI), behavior changes and the mechanical nociceptive threshold (MNT) were evaluated. The MNT was determined with von Frey device method.Tr3 had a significant increase in their fR and more pronounced behavioral changes than other treatments.The Tr1 showed a significant increase in arterial pressure. The GI reduced significantly, mainly in Tr2. The tramadol did not change the MNT of the horses.The clinical alterations observed with the different treatments were considered mild and transitory, being most evident in Tr2. However the tramadol did not have any analgesic effect with any of the doses evaluated.
BMC Veterinary Research, 2015
Background: The benefit of pre and post-operative administration of non-steroidal anti-inflammatory drugs for the relief of post-operative pain and control of inflammation in horses following orthopaedic surgery has not been previously investigated in controlled clinical field trials, and the utility of such treatment is a matter of ongoing dispute. Recently the utility of post-operative pain management was emphasized. It was therefore our aim to determine the efficacy of meloxicam in horses following partial resection of fractured splint bones. This condition was selected since the limited extent of the insult and the defined surgical intervention allowed the conduct of a randomized, double blinded, placebo-controlled, parallel group, multi-centre clinical field study in a homogenous patient population. Results: Sixty-six client owned horses requiring unilateral partial splint bone resection were recruited in 15 centres in Germany and were allocated in a 1:1 ratio to receive meloxicam, 0.6 mg/kg for 5 days. Lameness at trot grades prior to surgery were similar in the meloxicam and placebo treatment groups but were significantly lower in the meloxicam group on day 6 post surgery. Clinical scores for soft tissue swelling and assessment of analgesic and anti-inflammatory efficacy by the investigators at the end of the study were significantly better for the meloxicam compared to the placebo group. No treatment-related adverse reactions were observed.
Analgesic Effect of Premedication with Tramadol or Butorphanol in Dogs Undergoing Osteosynthesis
The research was carried on 17 adult dogs underwent osteosynthesis. In the anesthetic premedication were included butorphanol + acepromazine + ketamine (group B) or tramadol + acepromazine + ketamine (group T). Induction and maintenance of anesthesia was the same for both groups. Post-operative analgesia was assessed using a dynamic interactive visual analogue scale. Rescue analgesia was provided with butorphanol or tramadol. Orthopedic procedures cause severe and prolonged pain and to provide an adequate level of comfort more rescue analgesia were necessary to dogs in group B compared with dogs in group T. Providing analgesia in orthopaedic intervention is a constant and important concern, having a direct reflection on postoperative evolution. Arrangements for obtaining it are numerous and are based on many types of pharmacological agents. Tramadol is a centrally acting analgesic, and is increasingly used for analgesia in dogs. It has only recently gained significant attention as a...
Animals, 2022
The analgesic efficacy of meloxicam and ketoprofen against equine visceral pain is unclear. The aim of this study was to compare the analgesic efficacy of meloxicam (M) and ketoprofen (K) to flunixin meglumine (F) following inguinal castration. Horses undergoing inguinal castration under general anesthesia were randomly assigned F (1.1 mg/kg), M (0.6 mg/kg) or K (2.2 mg/kg) intravenously two hours pre-operatively and 24 h later. A pain score (out of 31) was recorded blindly by a senior clinician and veterinary student before NSAIDs administration (T0), and after the first (T1) and second (T2) administrations, using a modified post-abdominal surgery pain assessment scale (PASPAS). Pain was classified as mild (score ≤ 7), moderate (score = 8–14) or severe (score > 14). Thirty horses (12 F, 10 M, 8 K) aged 6.2 ± 4.9 years, mostly warmbloods, were included. Horse welfare was not compromised regardless of the drug assigned. There was no statistically significant effect of NSAIDs on pa...