Evaluation of the analgesic effect of fentanyl-ketamine and fentanyl-lidocaine constant rate infusions in isoflurane-anesthetized dogs undergoing thoracolumbar hemilaminectomy.

Abstract

OBJECTIVE\nTo evaluate anesthetic conditions and postoperative analgesia with the use of intraoperative constant rate infusions (CRIs) of fentanyl-lidocaine or fentanyl-ketamine in dogs undergoing thoracolumbar hemilaminectomy.\n\n\nSTUDY DESIGN\nProspective, randomized, blinded, clinical study.\n\n\nANIMALS\nA total of 32 client-owned dogs.\n\n\nMETHODS\nDogs were premedicated with fentanyl (5 μg kg-1) administered intravenously (IV), anesthesia was induced with IV alfaxalone and maintained with isoflurane. Fentanyl (0.083 μg kg-1 minute-1) was infused IV with either ketamine (0.5 mg kg-1; then 40 μg kg-1 minute-1; group KF) or lidocaine (2 mg kg-1; then 200 μg kg-1 minute-1; group LF) assigned randomly. Heart rate, noninvasive arterial pressures, respiratory rate, esophageal temperature, end-tidal partial pressure of carbon dioxide and isoflurane concentration were recorded throughout anesthesia. Maintenance of anesthesia, recovery and postoperative pain (Glasgow Composite Pain Scale) were scored. Cardiopulmonary data were analyzed using a two-way anova with repeated measures, demographics of the two groups with a t test, and scores with Mann-Whitney U test, with p < 0.05.\n\n\nRESULTS\nAll dogs recovered from anesthesia without complications. No significant difference was found between groups for cardiopulmonary variables, total anesthesia time, sedation score and requirement for postoperative sedation or for rescue analgesia. Anesthetic maintenance score was of lower quality in KF than in LF [median (interquartile range): 0 (0-0.5) versus 0 (0-0); p\xa0= 0.032)], but still considered ideal. Recovery score was higher and indicative of less sedation in LF than in KF [1 (1-1.5) versus 0.5 (0-1); p < 0.0001]. Pain score was higher in KF than in LF [2 (1-3) versus 1 (1-2); p\xa0= 0.0009].\n\n\nCONCLUSIONS AND CLINICAL RELEVANCE\nBoth CRIs of KF and LF provided adequate anesthetic conditions in dogs undergoing thoracolumbar hemilaminectomy. Based on requirement for rescue analgesia, postoperative analgesia was adequate in both groups.