Preemptive effects of epidural s (+) - ketamine ketamine in the horse's postincisional pain

The aim of this study was to evaluate the pre-emptive effect of epidural ketamine S (+) (SK) or racemic ketamine (RK) admirustration, in post-incisional pain in horses. Were used in a blinded, randomized experimental study, sixteen mixed breed mares, 6±2 years old, weighting 273.2±42.0 kg. An epidural catheter was inserted 24 hours before the trials. The thigh region was shaved bilaterally, and mechanical cutaneous sensibility was measured using von Frey filaments (T-30). U sing the left side as the control one, local anesthesia was performed at the right side. Twenty-five minutes later, SK was injected in G 1 or RK in G2 through the epidural catheter. Five minutes after the ketamine injection, a 10 cm skin incision was made on the right side, and then sutured. Mechanical post-incisional pain was measured using von Frey filaments, at 1,3 and 5 cm around the incision at 15 minutes intervals, for 2 hours, then 4, 6 and 8 hours after suturing. No changes were observed in the heart and respiratory rate and rectal temperature among groups or times of each group. Hind limb ataxia was observed in 62.5% and 12.5% of G 1 and G2 respectively. SK and RK reduced cutaneous sensibility in the right and the left sides to mechanical postincisional pain during all time of experiment. Epidural SK and RK produce similar post - incisional analgesic effects, did not interfere in the cardio-respiratory parameters. The SK induces more intense ataxia in mares and presents a larger analgesic potency in the first 60 minutes after the administration.

O objetivo deste estudo foi avaliar o efeito analgésico da administração prévia de cetamina S (+) ou cetamina, na dor pós-inciosal em eqüinos. Utilizaram-se, em um estudo duplo-cego ao acaso, 16 éguas com idade de 6±2 anos, pesando 273,2±42,0 kg. 24 horas antes do início do experimento introduziu-se um cateter epidural. No dia seguinte, as regiões isquiáticas direita e esquerda foram tricotomizadas e, a sensibilidade cutânea aferida utilizando-se os filamentos de Von Frey, tempo -30 (T-30). Realizou-se bloqueio anestésico em linha, no lado direito e, 25 minutos após administrou-se através do cateter epidural cetamina S(+) no G 1 e cetamina no G 2. Cinco minutos após a injeção de cetamina, realizou-se uma incisão de pele de 10 cm no lado direito, seguida de sutura. Avaliou-se a dor pós-incisional, utilizando-se os filamentos de Von Frey, a 1, 3 e 5 cm ao redor da incisão (lado incindido) e a sensibilidade cutânea (lado controle), em intervalos de 15 minutos, por 2 horas e então, 4, 6 e 8 horas após a sutura de pele. Não foram observadas alterações nas freqüências cardíaca ou respiratória e temperatura retal entre os grupos ou entre os tempos de cada grupo. Observou-se ataxia de membros pélvicos em 62,5% e 12,5% dos animais, para o G 1 e G2, respectivamente. A cetamina S(+) e cetamina reduziram a sensibilidade cutânea no lado direito e esquerdo, para os estímulos mecânicos produzidos pelos filamentos de Von Frey, durante todo os período experimental. A cetamina S(+) e cetamina produziram duração de efeito analgésico similares e não interferiram nos parâmetros cardiorrespiratórios. Observou-se ataxia mais intensa e potência anestésica superior nos primeiros 60 minutos após a administração de cetamina S(+).

Pre-emptive epidural ketamine or S(+)-ketamine in post-incisional pain in dogs: a comparative study.

OBJECTIVE: To compare the pre-emptive analgesic effects of epidural ketamine or S(+)-ketamine on post-incisional hyperalgesia. STUDY DESIGN: Prospective randomized study. ANIMALS: Twenty-four mongrel dogs (1-5 years, weighing 11.9+/-1.8 kg). METHODS: Dogs were anesthetized with propofol (5 mg/kg intravenously) and a lumbosacral epidural catheter was placed. Dogs were randomly allocated to 3 groups, each with 8 dogs. The control group (CG) was administered saline solution (0.3 mL/kg); the ketamine group (KG) ketamine (0.6 mg/kg); and the S(+)-ketamine group (SG) S(+)-ketamine (0.6 mg/kg). The final volume was adjusted to 0.3 mL/kg in all groups. Five minutes after the epidural injection a surgical incision was made in the common pad of the right hind limb and was immediately closed with simple interrupted nylon suture. Respiratory (RR) and heart (HR) rates, rectal temperature (T), sedation (S), lameness score, and mechanical nociceptive threshold by von Frey filaments were evaluated before the propofol anesthesia and at 15, 30, 45, 60, 75, and 90 minutes and then at 2, 4, 6, 8, 12, and 24 hours after epidural injection. RESULTS: There were no differences in RR, HR, T, or S between groups. Motor blockade of the hind limbs was observed during 20+/-3.6 minutes in KG and during 30.6+/-7.5 minutes in SG (mean+/-SD). Mechanical force applied to obtain an aversive response was higher from 45 minutes to 12 hours in KG and from 60 to 90 minutes in SG, when compared with CG. CONCLUSIONS: Pre-emptive epidural ketamine induced no alterations in RR and HR, and reduced post-incisional hyperalgesia for a longer time than did S(+) ketamine. CLINICAL RELEVANCE: Although anesthetic and analgesic potency of S(+) ketamine is twice that of ketamine, the racemic form is seemingly better for post-incisional hyperalgesia.