Effects of fentanyl–lidocaine–ketamine versus sufentanil–lidocaine–ketamine on the isoflurane requirements in dogs undergoing total ear canal ablation and lateral bulla osteotomy. (September 2020)

• Record Type: Journal Article
• Authors: Van Wijnsberghe, Anne-Sophie; Marolf, Vincent; Claeys, Stéphanie; Sandersen, Charlotte; Ida, Keila K.
• Is Part Of: Veterinary anaesthesia and analgesia. Volume 47:Number 5(2020)
• Page Start: 595
• Page End: 603
• Publication Date: 2020-09
• Subjects: analgesia -- balanced anaesthesia -- ear canal -- opioids -- pain; Veterinary anesthesia -- Periodicals; 636.089
• DOI: 10.1016/j.vaa.2020.04.009
• Languages: English
• ISSNs: 1467-2987

Abstract

Abstract: Objective: To compare the isoflurane-sparing effects of sufentanil– lidocaine– ketamine (SLK) and fentanyl– lidocaine– ketamine (FLK) infusions in dogs undergoing total ear canal ablation and lateral bulla osteotomy (TECA– LBO). Study design: Randomized blinded clinical study. Animals: A group of 20 client-owned dogs undergoing TECA– LBO. Methods: Intravenous (IV) administration of lidocaine (3 mg kg –1 ) and ketamine (0.6 mg kg –1 ) with fentanyl (5.4 μg kg –1 ; n = 10; FLK group) or sufentanil (0.72 μg kg –1 ; n = 10; SLK group) was immediately followed by the corresponding constant rate infusion (CRI) (lidocaine 3 mg kg –1 hour –1 ; ketamine 0.6 mg kg –1 hour –1 ; either fentanyl 5.4 μg kg –1 hour –1 or sufentanil 0.72 μg kg –1 hour –1 ). Anaesthesia was induced with propofol 3–5 mg kg –1 IV and was maintained with isoflurane. End-tidal isoflurane concentration (Fe ′Iso) was decreased in 0.2% steps every 15 minutes until spontaneous movements were observed (treated with propofol 1 mg kg –1 IV) or an increase of > 30% in heart rate or mean arterial pressure from baseline occurred (treated with rescue fentanyl or sufentanil). Quality of recovery and pain were assessed at extubation using the short-form Glasgow Composite Pain Scale (SF-GCPS), Colorado State University Canine Acute Pain scale (CSU-CAP), and visual analogue scale (VAS). Data were analysed with analysis of variance, t tests, Fisher test and Spearman coefficient ( p < 0.05). Results: Fe ′Iso decreased significantly in SLK group (45%; p = 0.0006) but not in FLK (15%; p = 0.1135) ( p = 0.0136). SLK group had lower scores for recovery quality ( p = 0.0204), SF-GCPS ( p = 0.0071) and CSU-CAP ( p = 0.0273) than FLK at extubation. Intraoperative rescue analgesia and VAS were not significantly different between groups. Conclusions and clinical relevance: Compared with FLK infusion, CRI of SLK at these doses decreased isoflurane requirements, decreased pain scores and improved recovery quality at extubation in dogs undergoing TECA– LBO.