Pre-emptive methadone or tramadol analgesia for mastectomy and ovariohysterectomy in bitches

Authors

  • Ricardo A. R. Uscategui São Paulo State University
  • Caio Tiosso São Paulo State University
  • Juliana V. Moro São Paulo State University
  • Giuliano Q. Mostachio University Centre of Rio Preto
  • Luciana C. Padilha-Nakaghi São Paulo State University
  • Marcus A. R. Feliciano São Paulo State University
  • Wilter R. R. Vicente São Paulo State University

DOI:

https://doi.org/10.17533/udea.rccp.v30n1a05

Keywords:

anesthesia, canine, hypercapnia, opioids

Abstract


Background: mastectomy and ovariohysterectomy (OVH) in bitches are critical surgeries and pain control can be challenging. Objective: to evaluate the efficacy of pre-emptive analgesia with methadone (MET) or tramadol (TRA) in postoperative pain intensity, cardiorespiratory effects, and anaesthetic/analgesic consumption in female dogs undergoing mastectomy and OVH. Methods: a prospective randomized blind clinical trial was used to evaluate 48 bitches of various breeds, aged 10 ± 3.7 years, weighing 16 ± 12 Kg, and with multiple mammary tumours. The animals were distributed in two groups: TRA group received 5 mg/Kg tramadol and MET group 0.5 mg/Kg methadone intramuscularly, 10 min prior to anaesthesia induction with propofol followed by maintenance with isoflurane. Heart (HR) and respiratory (RR) rates, mean arterial pressure (MAP), propofol induction dose (PID), oxyhemoglobin saturation (SpO2), end-tidal isoflurane concentration (EtISO), and carbon dioxide pressure (EtCO2) were measured during the intra-operative period. Post-operative pain was evaluated for 12 h and rated according to the Melbourne scale. Rescue analgesia (0.5 mg/Kg methadone, 2 mg/Kg lidocaine, or 0.01 mg/Kg/min ketamine IV) was given when necessary and post-operative analgesic consumption recorded. Statistical tests were used to compare treatments. Results: rescue analgesia requirements, pain score, PID and analgesic consumption were significantly lower (p<0.05) in MET group. The HR was higher in TRA group, while EtCO2 and MAP were higher in MET group (p<0.05). Conclusion: methadone was more effective than tramadol in pre-emptive analgesia but not completely adequate on controlling pain in bitches subjected to unilateral mastectomy and OVH. Methadone led to lower cardiovascular depression and lower propofol dose required for anesthesia induction. However, increased EtCO2 and special care with patient ventilation is advised.

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Author Biographies

Ricardo A. R. Uscategui, São Paulo State University

VM., PhD., Department of Veterinary Clinic and Surgery, São Paulo State University, Jaboticabal, São Paulo, Brazil.

Caio Tiosso, São Paulo State University

VM., PhD., Department of Veterinary Clinic and Surgery, São Paulo State University, Jaboticabal, São Paulo, Brazil.

Juliana V. Moro, São Paulo State University

VM., PhD., Department of Veterinary Clinic and Surgery, São Paulo State University, Jaboticabal, São Paulo, Brazil.

Giuliano Q. Mostachio, University Centre of Rio Preto

VM., PhD., University Center of Rio Preto, Rio Preto, São Paulo, Brazil.

Luciana C. Padilha-Nakaghi, São Paulo State University

VM., PhD., Department of Veterinary Clinic and Surgery, São Paulo State University, Jaboticabal, São Paulo, Brazil.

Marcus A. R. Feliciano, São Paulo State University

VM., PhD., Department of Veterinary Clinic and Surgery, São Paulo State University, Jaboticabal, São Paulo, Brazil.

Wilter R. R. Vicente, São Paulo State University

VM., PhD., Department of Veterinary Clinic and Surgery, São Paulo State University, Jaboticabal, São Paulo, Brazil.

References

Branson KR. Injectable and Alternative Anesthetic Techniques. In: Tranquilli WJ, Thurmon JC, Grimm KA (eds). Lumb & Jones Veterinary Anaesthesia and Analgesia 4nd ed. Oxford: Blackwell Publising; 2007. p. 273-300.

Bufalari A, Adami C, Angeli G, Shor CE. Pain Assessment in Animals. Vet Res Commun 2007; 31(S1):55-58.

Canfrán S, Bustamante R, González P, Cediel R, Re M, Gómez de Segura IA. Comparison of sedation scores and propofol induction doses in dogs after intramuscular administration of dexmedetomidine alone or in combination with methadone, midazolam, or methadone plus midazolam. Vet J 2016; 210:56-60.

Cardozo LB, Cotes LC, Kahvegian MAP, I Rizzo MFC, Otsuki DA, Ferringo CRA, Fantoni DT. Evaluation of the effects of methadone and tramadol on postoperative analgesia and serum interleukin-6 in dogs undergoing orthopaedic surgery. BMC Vet Res 2014; 10:1-7.

Covey-Crump GL, Murison PJ. Fentanyl or midazolam for co-induction of anaesthesia with propofol in dogs. Vet Anaesth Analg 2008; 35:463-472.

Credie RG, Teixeira Neto FJ, Ferreira TH, Aguiar AJ, Restitutti FC, Corrente JE. Effects of methadone on the minimum alveolar concentration of isoflurane in dogs. Vet Anaesth Analg 2010; 37:240-249.

Desborough JP. The stress response to trauma and surgery. Br J Anaesth 2000; 85:109-117.

Duarte LTD, Saraiva RS. Imobilidade: Uma ação essencial dos anestésicos inalatórios. Rev Bras Anestesiol 2005; 55:100-117.

Dyson DH. Perioperative pain management in veterinary patients. Vet Clin North Am Small Anim Pract 2008; 38:1309-1327.

Firth AM, Haldane SL. Development of a scale to evaluate postoperative pain in dogs. J Am Vet Med Assoc 1999; 214:651-659.

Giorgi M, Del Carlo S, Łebkowska-Wieruszewska B, Kowalski CJ, Saccomanni G. Pharmacokinetics of tramadol and metabolites after injective administrations in dogs. Pol J Vet Sci 2010; 13:639-644.

Gottschalk A, Durieux ME, Nemergut EC. Intraoperative methadone improves postoperative pain control in patients undergoing complex spine surgery. Anesth Analg 2011; 112:218-223.

Gourlay GK, Wilson PR, Glynn CJ. Methadone produces prolonged postoperative analgesia. BMJ 1982; 284:630-631.

Grosenbaugh DA, Muir III WW. Accuracy of noninvasive oxyhemoglobin saturation, end-tidal carbon dioxide concentration, and blood pressure monitoring during experimentally induced hypoxemia, hypotension, or hypertension in anesthetized dogs. Am J Vet Res 1998; 59:205-212.

Guedes AGP, Natalini CC, Rude EP, Faria RX. Comparison of tramadol and morphine for pre-medication of dogs undergoing general anaesthesia for orthopedic surgery. Vet Anaesth Analg 2005; 34:1.

Hellebrekers LJ, van den Brom WE, Mol JA. Plasma arginine vasopressin response to intravenous methadone and naloxone in conscious dogs. J Pharmacol Exp Ther 1989; 248:329-333.

Kaur J, Srilata M, Padmaja D, Gopinath R, Bajwa SJS, Kenneth DJ, Kumar PS, Nitish C, Reddy WS. Dose sparing of induction dose of propofol by fentanyl and butorphanol: a comparison based on entropy analysis. SJA 2013; 7:128-133.

Lana SE, Rutteman GR, Withrow SJ. Tumors of the mammary gland. In: Withrow SJ, Vail DM (eds) Withrow & MacEwen’s Small Animal Clinical Oncology 4th edn. St. Louis: Saunders Elsevier; 2007. p. 619-636.

Leibetseder EN, Mosing M, Jones RS. A comparison of extradural and intravenous methadone on intraoperative isoflurane and postoperative analgesia requirements in dogs. Vet Anaesth Analg 2006; 33:128-136.

Maiante AA, Teixeira Neto FJ, Beier SL, Corrente JE, Pedroso CEBP. Comparison of the cardio-respiratory effects of methadone and morphine in conscious dogs. J Pharmacol Exp Ther 2008; 31:317-328.

Mastrocinque S, Fantoni DA. Comparison of preoperative tramadol and morphine for the control of early postoperative pain in canine ovariohysterectomy. Vet Anaesth Analg 2003; 30:220-228.

Monteiro ED, Junior AR, Assis HM, Campagnol D, Quitzan JG. Comparative study on the sedative effects of morphine, methadone, butorphanol or tramadol, in combination with acepromazine, in dogs. Vet Anaesth Analg 2009; 36:25-33.

Papich MG. Pharmacologic Considerations for opiate Analgesic and Nonsteroidal antinflammatory drugs. Vet Clin North Am Small Anim Pract 2000; 4: 703-728.

Pereira DA, Marques JA, Borges PA, Batista PACS, Oliveira CA, Nunes N, Lopes PCF. Efeitos cardiorrespiratórios da metadona, pelas vias intramuscular e intravenosa, em cadelas submetidas à ovariossalpingo-histerectomia. Braz J Vet Res Anim Sci 2013; 65:967-974.

Pereira J, Lawlor P, Vigano A, Dorgan M, Bruera E. Equianalgesic dose ratios for opioids. A critical review and proposals for long-term dosing. J Pain Symptom Manage 2001; 22:672-687.

Raimundo JM, Pontes LB, Antunes F, Sudo RT, Trachez MM, Zapata-Sudo G. Comparative effects of tramadol on vascular reactivity in normotensive and spontaneously hypertensive rats. Clin Exp Pharmacol Physiol 2008; 35:1197-1203.

Short CE, Bufalari A. Propofol Anesthesia. Vet Clin North Am Small Anim Pract 1999: 29:747-778.

Sarrau S, Jourdan J, Dupuis-Soyris F, Verwaerde P. Effects of Postoperative ketamine infusion on pain control and feeding behaviour in bitches undergoing Mastectomy. J Small An Pract 2007; 48:670-676.

Slingsby LS, Sear JW, Taylor PM, Murrell JC. Effect of intramuscular methadone on pharmacokinetic data and thermal and mechanical nociceptive thresholds in the cat. J Feline Med Surg 2015;24: 1-7.

Stratmann N, Failing K, Richter A, Wehrend A. Mammary tumor recurrence in bitches after regional mastectomy. Vet Surg 2008; 37:82-86.

Teixeira RC, Monteiro ER, Campagnol D, Coelho K, Bressan TF, Monteiro BS. Effects of tramadol alone, in combination with meloxicam or dipyrone, on postoperative pain and the analgesic requirement in dogs undergoing unilateral mastectomy with or without ovariohysterectomy. Vet Anaesth Analg 2013; 40:641-649.

Wordliczek J, Banach M, Garlicki J, Jakowicka-Wordliczek J, Dobrogowski J. Influence of pre- or intra-operational use of tramadol (pre-emptive or preventive analgesia) on tramadol requirement in the early postoperative period. Pol J Pharmacol 2002; 54:693-697.

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Published

2017-01-30

How to Cite

Uscategui, R. A. R., Tiosso, C., Moro, J. V., Mostachio, G. Q., Padilha-Nakaghi, L. C., Feliciano, M. A. R., & Vicente, W. R. R. (2017). Pre-emptive methadone or tramadol analgesia for mastectomy and ovariohysterectomy in bitches. Revista Colombiana De Ciencias Pecuarias, 30(1), 39–47. https://doi.org/10.17533/udea.rccp.v30n1a05

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