The analgesic and sedative effects of GV20 pharmacopuncture with low-dose hydromorphone in healthy dogs undergoing ovariohysterectomy.

This study evaluates the analgesic efficacy of low-dose hydromorphone administered via pharmacopuncture at Governing Vessel 20 (GV20) for postoperative pain management following canine ovariohysterectomy. Fifty clinically healthy female dogs undergoing ovariohysterectomy were allocated to receive hydromorphone [0.1 mg/kg body weight (BW)] intramuscularly (IM, n = 25) or hydromorphone (0.01 mg/kg BW) pharmacopuncture at GV20 (GV, n = 25) following extubation. This was a prospective, blinded, randomized clinical trial. Pain and sedation scores were evaluated using the Glasgow Composite Measure Pain Scale Short Form (CMPS-SF) at 1, 2, 3, 4, and 12 hours following study treatment. Time of treatment failure (CMPS-SF ≥ 6/24) was recorded and analyzed using Kaplan-Meier survival analysis. Patient demographics and duration of surgery and anesthesia were analyzed using the appropriate unpaired Student's t-test. The Glasgow CMPS-SF and sedation score were analyzed using a repeated measures 2-way analysis of variance (ANOVA) followed by Bonferroni post-test where appropriate. Significance was set a P < 0.05. There were no significant differences in patient demographics, anesthesia and surgery duration, and study treatment failure. The Glasgow CMPS-SF scores were significantly higher for IM compared with GV [2 (0 to 8) versus 1 (0 to 6), respectively; P = 0.044] at 4 hours. Sedation scores were significantly higher for IM compared with GV at 2 [2 (1 to 3) and 1 (1 to 3), respectively; P = 0.0004] and 4 [1 (1 to 3) and 1 (1 to 2), respectively; P = 0.03] hours. Pharmacopuncture with low-dose hydromorphone provided adequate postoperative analgesia in dogs undergoing ovariohysterectomy with reduced sedative effects. Pharmacopuncture is a good alternative in dogs when reduced dosing of opioids is recommended.

Les effets analgésiques et sédatifs de la pharmacopuncture du GV20 avec de l'hydromorphone à faible dose chez des chiens sains subissant une ovariohystérectomie. Cette étude visait à évaluer l'efficacité analgésique de l'hydromorphone à faible dose administrée par pharmacopuncture au Vaisseau Gouverneur 20 (GV20) pour la gestion de la douleur postopératoire après une ovariohystérectomie canine. Cinquante chiennes cliniquement saines subissant une ovariohystérectomie ont été assignées à une pharmacopuncture d'hydromorphone [0,1 mg/kg de poids corporel (PC)] par voie intramusculaire (IM, n = 25) ou d'hydromorphone (0,01 mg/kg de poids corporel) à GV20 (GV, n = 25) après extubation. Il s'agissait d'un essai clinique prospectif, en aveugle et randomisé. Les scores de douleur et de sédation ont été évalués à l'aide de la Glasgow Composite Measure Pain Scale Short Form (CMPS-SF) à 1, 2, 3, 4 et 12 heures après le traitement de l'étude. Le temps d'échec du traitement (CMPS-SF ≥ 6/24) a été enregistré et analysé à l'aide de l'analyse de survie de Kaplan-Meier. Les données démographiques des patients et la durée de la chirurgie et de l'anesthésie ont été analysées à l'aide du test t de Student non apparié approprié. Le Glasgow CMPS-SF et le score de sédation ont été analysés à l'aide d'une analyse de variance à deux voies (ANOVA) à mesures répétées suivie d'un post-test de Bonferroni, le cas échéant. La signification a été fixée à un P < 0,05. Il n'y avait pas de différences significatives dans les caractéristiques démographiques des patients, la durée de l'anesthésie et de la chirurgie et l'échec du traitement de l'étude. Les scores Glasgow CMPS-SF étaient significativement plus élevés pour IM par rapport à GV [2 (0 à 8) versus 1 (0 à 6), respectivement; P = 0,044] à 4 heures. Les scores de sédation étaient significativement plus élevés pour IM par rapport à la GV à 2 [2 (1 à 3) et 1 (1 à 3), respectivement; P = 0,0004] et 4 [1 (1 à 3) et 1 (1 à 2), respectivement; P = 0,03] heures. La pharmacopuncture avec de l'hydromorphone à faible dose a fourni une analgésie postopératoire adéquate chez les chiens subissant une ovariohystérectomie avec des effets sédatifs réduits. La pharmacopuncture est une bonne alternative chez le chien lorsqu'un dosage réduit des opioïdes est recommandé.(Traduit par Dr Serge Messier).

Thermal antinociceptive, sedative and cardiovascular effects of Governing Vessel 1 dexmedetomidine pharmacopuncture in healthy cats.

OBJECTIVE: To compare the antinociceptive, sedative and cardiovascular effects of dexmedetomidine pharmacopuncture at Governing Vessel 1 (GV 1) with dexmedetomidine intramuscular (IM) administration. STUDY DESIGN: Randomized, masked crossover design. ANIMALS: A group of eight healthy female cats. METHODS: Cats were randomly administered either dexmedetomidine (0.005 mg kg-1; Dex-IM) IM or at acupuncture point GV 1 (Dex-P) separated by 1 week. Prior to and up to 120 minutes posttreatment, skin temperature (ST), thermal threshold (TT), heart rate (HR), respiratory rate (fR), sedation, muscle relaxation and auditory response scores were recorded. Parametric data were analyzed using a two-way repeated measures anova followed by Tukey's test for multiple comparisons. Nonparametric data were analyzed using a Friedman test followed by Dunn's multiple comparisons test, and Wilcoxon signed-rank test with Bonferroni correction for multiple comparisons. Significance was set at p ≤ 0.05. RESULTS: There were no differences within or between treatments for ST, fR and auditory response. TT was significantly higher at 30-90 minutes in Dex-P (p ≤ 0.0285) than baseline. TT was significantly higher at 60-90 minutes for Dex-P than for Dex-IM (p ≤ 0.0252). HR was significantly lower at 10-75 minutes in Dex-P (p ≤ 0.0378) and at 5-75 minutes in Dex-IM (p ≤ 0.0132) than baseline. Compared with baseline, sedation scores were higher at 25 minutes (p = 0.0327) and 30 minutes (p = 0.0327), and muscle relaxation scores were higher at 25 minutes (p = 0.0151) and 35 minutes (p = 0.0151) in Dex-P. There were no differences in HR, sedation and muscle relaxation scores between treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Dex-P increased thermal antinociception compared with Dex-IM at the same dose of dexmedetomidine in cats. This antinociceptive effect must be evaluated under clinical situations.

The effects of acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting in healthy dogs.

OBJECTIVE: To evaluate the effect of needling at acupuncture point Pericardium 6 on hydromorphone-induced nausea and vomiting. STUDY DESIGN: Randomized controlled clinical study. ANIMALS: Eighty-one mixed-breed, healthy dogs aged 1.8 ± 1.6 years and weighing 14.5 ± 5.6 kg, admitted for elective ovariohysterectomy (n = 75) or castration (n = 6). METHODS: Dogs were randomly assigned to one of three groups: acupuncture at Pericardium 6 (AT, n = 27); alternative acupuncture at Lung 5 (ST, n = 27), and no acupuncture (CT, n = 27). During time 0-30 minutes (baseline), occurrences of hypersalivation, vomiting and licking were recorded. At 30 minutes, subjects were administered hydromorphone (0.1 mg kg(-1) ) in combination with acepromazine (0.03 mg kg(-1) ) intramuscularly. During time 30-45 minutes (post-injection), occurrences of hypersalivation, vomiting and licking were recorded by an observer unaware of group assignment. Groups were compared using a Kruskal-Wallis test followed by a Dunn's post-test, or Fisher's exact tests when appropriate. RESULTS: There were no significant differences in age, weight or baseline observations among groups. Vomiting incidence post-injection was higher in the CT (20/27, 74.1%) and ST (22/27, 81.5%) groups than in the AT (10/27, 37.0%) group (p = 0.0129 and p = 0.002, respectively). The number of vomiting episodes [median (range)] after opioid administration was higher in the ST [1 (1-6)] than the AT [0 (0-2)] group (p = 0.0040). There were no differences in the median number of vomiting episodes between the ST and CT [1 (0-3)] or AT and CT groups. There were no differences in hypersalivation or licking among groups after hydromorphone-acepromazine administration. CONCLUSIONS AND CLINICAL RELEVANCE: Pericardium 6 acupuncture reduced the incidence of hydromorphone-induced vomiting in healthy dogs. This cost-effective technique can improve patient well-being and comfort during the perioperative period.