Evaluation and comparison of postoperative analgesic effects of dexketoprofen and methadone in dogs

• Published in: Veterinary anaesthesia and analgesia Vol. 45; no. 6; pp. 820 - 830
• Main Authors: Gutiérrez-Bautista, Álvaro J., Morgaz, Juan, Granados, María del Mar, Gómez-Villamandos, Rafael J., Dominguez, Juan M., Fernandez-Sarmiento, José A., Aguilar-García, Daniel, Navarrete-Calvo, Rocío
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.11.2018
• Subjects: Analgesia - veterinary; Analgesics, Opioid - pharmacology; Animals; Anti-Inflammatory Agents, Non-Steroidal - pharmacology; Dexketoprofen; Dogs; Dogs - surgery; Female; Ketoprofen - analogs & derivatives; Ketoprofen - pharmacology; Male; Methadone; Methadone - pharmacology; Orthopedic Procedures - veterinary; Pain, Postoperative - drug therapy; Pain, Postoperative - veterinary; Postoperative analgesia; Postoperative Period; Single-Blind Method; Tromethamine - pharmacology; Dexketoprofen; Methadone; Postoperative analgesia; Dogs
• ISSN: 1467-2987; 1467-2995
• DOI: 10.1016/j.vaa.2018.06.016

To evaluate and compare the analgesic efficacy and adverse effects of dexketoprofen and methadone using a noninferiority trial, during the first 24 postoperative hours in dogs undergoing orthopaedic surgery. Randomized, blinded clinical study. A total of 38 healthy dogs undergoing orthopaedic surgery. Dogs were premedicated with dexmedetomidine [1 μg kg–1 intravenously (IV)] followed by dexketoprofen (1 mg kg–1 IV; group DK) or methadone (0.2 mg kg–1 IV; group M). Anaesthesia was induced with propofol and maintained with isoflurane in 60% oxygen. Postoperatively, dexketoprofen was administered every 8 hours (group DK) and methadone every 4 hours (group M). Analgesia was assessed at baseline and at 1, 2, 4, 6, 18 and 24 hours after extubation using a dynamic and interactive visual analogue scale (DIVAS), the short form of the Glasgow Composite Measure Pain Scale (CMPS-SF), mechanical wound thresholds (MWTs) and plasma cortisol levels. If CMPS-SF score was ≥5, rescue analgesia was administered. Data were analysed using a general linear mixed model, Mann–Whitney U test and chi-squared test as appropriate; a p value <0.05 was considered significant. The CMPS-SF and DIVAS scores were significantly higher in group M compared with group DK and remained higher for a longer period in group M, although the differences were not clinically significant. No significant differences were found in MWT assessment between groups. Plasma cortisol level significantly increased 2 hours after extubation, without significant differences between treatments. Rescue analgesia was administered to three animals (one in group DK; two in group M). We conclude that 1 mg kg–1 IV dexketoprofen administered every 8 hours during the first 24 hours postoperatively is noninferior to methadone in controlling pain after orthopaedic surgery in dog, although frequent pain assessments are recommended to adjust the analgesia plan.