Comparison of fentanyl and hydromorphone constant rate infusions for pain management in dogs in an intensive care unit
To compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive care unit (ICU). Prospective, randomized, blinded, clinical trial. A total of 29 client-owned dogs. Dogs prescribed a μ-opioid agonist infusion for posts...
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Published in | Veterinary anaesthesia and analgesia Vol. 45; no. 5; pp. 673 - 683 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
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Elsevier Ltd
01.09.2018
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Abstract | To compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive care unit (ICU).
Prospective, randomized, blinded, clinical trial.
A total of 29 client-owned dogs.
Dogs prescribed a μ-opioid agonist infusion for postsurgical or medical pain were randomized to be administered either hydromorphone (0.025 or 0.05 mg kg−1 bolus, followed by a 0.03 mg kg−1 hour−1 infusion) or fentanyl (2.5 or 5 μg kg−1 bolus, followed by a 3 μg kg−1 hour−1 infusion). The technical staff and clinicians were blinded as to which drug was administered. Pain scores, using the Colorado State University Canine Acute Pain Scale, sedation scores and nausea scores were assigned at regular intervals and compared between groups. Dose escalation and de-escalation of the study drug were performed according to set protocols. Adverse clinical signs and all other medications administered were recorded and compared between groups. The study drug was discontinued if the animal remained painful despite dose escalations, or if adverse effects were noted.
The pain scores were of low magnitude and were not significantly different between groups. The use of concurrent analgesia, sedation/anxiolytic medications and antacid/antiemetic medications was not different between groups. Sedation and nausea scores were not statistically different between groups.
Hydromorphone and fentanyl CRIs appear to be equally effective for adequate pain relief in dogs, with no significant differences in adverse effects. Therefore, either drug may be chosen for control of postsurgical or medical pain in an ICU setting. |
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AbstractList | To compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive care unit (ICU).
Prospective, randomized, blinded, clinical trial.
A total of 29 client-owned dogs.
Dogs prescribed a μ-opioid agonist infusion for postsurgical or medical pain were randomized to be administered either hydromorphone (0.025 or 0.05 mg kg
bolus, followed by a 0.03 mg kg
hour
infusion) or fentanyl (2.5 or 5 μg kg
bolus, followed by a 3 μg kg
hour
infusion). The technical staff and clinicians were blinded as to which drug was administered. Pain scores, using the Colorado State University Canine Acute Pain Scale, sedation scores and nausea scores were assigned at regular intervals and compared between groups. Dose escalation and de-escalation of the study drug were performed according to set protocols. Adverse clinical signs and all other medications administered were recorded and compared between groups. The study drug was discontinued if the animal remained painful despite dose escalations, or if adverse effects were noted.
The pain scores were of low magnitude and were not significantly different between groups. The use of concurrent analgesia, sedation/anxiolytic medications and antacid/antiemetic medications was not different between groups. Sedation and nausea scores were not statistically different between groups.
Hydromorphone and fentanyl CRIs appear to be equally effective for adequate pain relief in dogs, with no significant differences in adverse effects. Therefore, either drug may be chosen for control of postsurgical or medical pain in an ICU setting. OBJECTIVETo compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive care unit (ICU).STUDY DESIGNProspective, randomized, blinded, clinical trial.ANIMALSA total of 29 client-owned dogs.METHODSDogs prescribed a μ-opioid agonist infusion for postsurgical or medical pain were randomized to be administered either hydromorphone (0.025 or 0.05 mg kg-1 bolus, followed by a 0.03 mg kg-1 hour-1 infusion) or fentanyl (2.5 or 5 μg kg-1 bolus, followed by a 3 μg kg-1 hour-1 infusion). The technical staff and clinicians were blinded as to which drug was administered. Pain scores, using the Colorado State University Canine Acute Pain Scale, sedation scores and nausea scores were assigned at regular intervals and compared between groups. Dose escalation and de-escalation of the study drug were performed according to set protocols. Adverse clinical signs and all other medications administered were recorded and compared between groups. The study drug was discontinued if the animal remained painful despite dose escalations, or if adverse effects were noted.RESULTSThe pain scores were of low magnitude and were not significantly different between groups. The use of concurrent analgesia, sedation/anxiolytic medications and antacid/antiemetic medications was not different between groups. Sedation and nausea scores were not statistically different between groups.CONCLUSIONS AND CLINICAL RELEVANCEHydromorphone and fentanyl CRIs appear to be equally effective for adequate pain relief in dogs, with no significant differences in adverse effects. Therefore, either drug may be chosen for control of postsurgical or medical pain in an ICU setting. To compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive care unit (ICU). Prospective, randomized, blinded, clinical trial. A total of 29 client-owned dogs. Dogs prescribed a μ-opioid agonist infusion for postsurgical or medical pain were randomized to be administered either hydromorphone (0.025 or 0.05 mg kg−1 bolus, followed by a 0.03 mg kg−1 hour−1 infusion) or fentanyl (2.5 or 5 μg kg−1 bolus, followed by a 3 μg kg−1 hour−1 infusion). The technical staff and clinicians were blinded as to which drug was administered. Pain scores, using the Colorado State University Canine Acute Pain Scale, sedation scores and nausea scores were assigned at regular intervals and compared between groups. Dose escalation and de-escalation of the study drug were performed according to set protocols. Adverse clinical signs and all other medications administered were recorded and compared between groups. The study drug was discontinued if the animal remained painful despite dose escalations, or if adverse effects were noted. The pain scores were of low magnitude and were not significantly different between groups. The use of concurrent analgesia, sedation/anxiolytic medications and antacid/antiemetic medications was not different between groups. Sedation and nausea scores were not statistically different between groups. Hydromorphone and fentanyl CRIs appear to be equally effective for adequate pain relief in dogs, with no significant differences in adverse effects. Therefore, either drug may be chosen for control of postsurgical or medical pain in an ICU setting. |
Author | Kerr, Carolyn L. Bateman, Shane W. Biello, Patricia |
Author_xml | – sequence: 1 givenname: Patricia surname: Biello fullname: Biello, Patricia email: pbiello@uoguelph.ca – sequence: 2 givenname: Shane W. surname: Bateman fullname: Bateman, Shane W. – sequence: 3 givenname: Carolyn L. surname: Kerr fullname: Kerr, Carolyn L. |
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CitedBy_id | crossref_primary_10_3389_fvets_2024_1362730 crossref_primary_10_1016_j_hrthm_2019_06_017 |
Cites_doi | 10.1111/j.1365-2885.2007.00911.x 10.1351/pac200476050941 10.1016/S0304-3959(97)03336-8 10.2460/javma.2001.218.1101 10.2460/ajvr.2005.66.1222 10.1213/00000539-196211000-00017 10.1111/j.1467-2995.2007.00379.x 10.1097/00000542-198601000-00009 10.1097/00000542-198410000-00001 10.1111/vaa.12052 10.2460/javma.2003.222.330 10.1177/106002809603000709 10.1097/00000542-198212000-00009 10.1111/j.1476-4431.2005.04022.x 10.1111/j.1467-2995.2005.00266.x 10.1016/j.anclin.2011.12.002 10.1111/j.1365-2885.2008.00966.x 10.1213/00000539-199103000-00009 10.1111/j.1532-950X.2012.01080.x 10.1016/j.tvjl.2014.10.007 10.2460/javma.2001.218.884 |
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Copyright | 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia Copyright © 2018 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved. |
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Keywords | hydromorphone pain constant rate infusion dog fentanyl |
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Snippet | To compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive care unit... OBJECTIVETo compare the efficacy and quality of analgesia provided by constant rate infusions (CRIs) of hydromorphone and fentanyl in dogs in the intensive... |
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SubjectTerms | constant rate infusion dog fentanyl hydromorphone pain |
Title | Comparison of fentanyl and hydromorphone constant rate infusions for pain management in dogs in an intensive care unit |
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