Comparison of the Effects of Maropitant, Lidocaine, and Dextroketamine Administered by the Intratesticular Route in Dogs Undergoing Elective Orchiectomy
AbstractBackground: Balanced anesthesia achieved with combinations of inhaled and injectable drugs administered systemically or in loco-regional anesthetic blocks, is widely used in veterinary medicine. The use of anesthesia and/or local analgesia has already demonstrated benefits in the performance of elective orchiectomy in different species, there is no literature that evaluates the use of the maropitant intratesticular route. The present study evaluated the cardiorespiratory variables and analgesia produced by intratesticular blockade with maropitant, lidocaine, or dextroketamine during the trans-operative period along with the discharge and anesthetic recovery of dogs that underwent elective orchiectomy.
Materials, Methods & Results: Used twenty-four dogs from routine elective orchiectomy, considered healthy based on the results of clinical and hematological tests. The animals were randomly divided into three groups and was applied intratesticularly 2% lidocaine at a dose of 1 mg/kg (GL), 5% dextrocetamina at a dose of 2.5 mg/kg (GC), or 1% maropitant at a dose of 1 mg/kg (GM). Anesthesia induction was performed with propofol (to effect), and stabilization of inhalational anesthesia was achieved with 1.7 V% of sevoflurane diluted in 100% oxygen administered through a calibrated vaporizer and appropriate anesthetic system based on the animal's weight, being kept under spontaneous ventilation, After induction, we waited 10 min for stabilization of exhaled anesthetic concentration and then administered one of the treatments intratesticularly. After five min from the local block the surgical procedure was started during up to 15 min. Heart rate (HR), respiratory rate (RR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP), oxygen saturation of hemoglobin (SatO2), end-tidal carbon dioxide partial pressure (EtCO2), end-tidal sevoflurane concentration (EtSevo) in exhaled air, and body temperature (T°C) were measured before intratesticular administration of the agent and at specific time points during surgery, in addition to assessments of analgesia and evaluation of discharge and anesthetic recovery. Statistical analysis was performed using the Kolmogorov-Smirnov test (P > 0.10). The parameters HR, RR, SAP, DAP, MAP, T, EtCO2, and SatO2 were evaluated by analysis of variance (ANOVA), followed by the Scott-Knott test (Software R® 3.2.0 - 2013), considering a significance level of P < 0.05. The results did not show inter-drug differences for the evaluated variables.Discussion: It was decided not to use premedication (MPA), so that we could accurately assess the analgesic effect of drugs, lidocaine, dextroketamine and maropitant, on intratesticular block during elective orchiectomy. In this study we demonstrated that these drugs promoted analgesia, because the trans-surgical values were relatively lower compared to baseline and within physiological limits for the species. In addition, it was noted that local analgesia used was efficient since even at the time of ligature and the incision spermatic cord which is described in the literature as the most painful part of the surgical procedure. The post-anesthetic recovery and discharge were quick in the absence of MPA, local analgesia without residual effects and the use of sevoflurane. The sevoflurane has a very low blood gas coefficient solubility, resulting in a recovery fast. Therefore, we can conclude that all of the drugs promoted analgesia and cardiorespiratory stability as well as rapid anesthetic recovery for elective orchiectomy in this species.
Boscan P., Monnet E., Mama K., Twedt D.C., Congdon J. & Steffey E.P. 2011. Effect of maropitant, a NK-1 receptor antagonist, on anesthetic requirements during noxious visceral stimulation of the ovary in dogs. American Journal of Veterinary Research. 72(12): 1576-1579.
Calvey T.N. & Williams N.E. 2008. Local anaesthetics. In: Principles and Practice of Pharmacology for Anaesthetists. 5th edn. Oxford: Blackwell Publishing, pp.149-170.
Cardoso A.R. 2001. Recuperação Pós-Anestésica. In: Yamashita A.M., Takaoka F., Auler Jr. J.O.C. & Iwata N.I. (Eds). Anestesiologia. 5.ed. São Paulo: Atheneu, pp.1129-1141.
Cortopassi S.R.G. & Fantoni D.T. 2010. Medicação pré-anestésica. In: Fantoni D.T. & Cortopassi S.R.G. (Eds). Anestesia em Cães e Gatos. 2.ed. São Paulo: Roca, pp.217-227.
Costantini V.J.A., Corsi M., Dünstl G., Bettelini L., Zonzini L. & Gerrard P. 2015. The NK1 receptor antagonist aprepitant attenuates NK1 agonist induced scratching behaviour in the gerbil after intra-dermal, topical or oral administration. Experimental Dermatology. 24(4): 296-319.
Dinniss A.S., Mellor D.J., Stafford K.J., Bruce R.A. & Ward R.N. 1997. Acute cortisol responses of lambs to castration using a rubber ring and/or a castration clamp with or without local anaesthetic. New Zealand Veterinary Journal. 45(3): 114-121.
Fukui S., Ooyama N., Tamura J., Umar M.A., Ishizuka T., Itami T., Iyoshi K., Sano T. & Yamashita K. 2017. Interaction between maropitant and carprofen on sparing of the minimum alveolar concentration for blunting adrenergic response (MAC-BAR) of sevoflurane in dogs. The Journal of Veterinary Medical Science. 79(3): 502-508.
Gomes L.G., Travagin D.R.P., Peres-Cruz T.P.S., Spiller P.R., Winter D.C., Ens M.T.B., Dante L.C., Flôres F.N. & Guimarães L.D. 2015. Influência da lidocaína ou da dexrocetamina pela via intratesticular na anestesia com sevoflurano em cães submetidos a orquiectomia eletiva. Acta Scientiae Veterinariae. 43: 1335.
Greenwood-Van M.B., Gibson M.S., Johnson A.C., Venkova K. & Sutkowski-Markmann D. 2003. NK1 receptor-mediated mechanisms regulate colonic hypersensitivity in the guinea pig. Pharmacology, Biochemistry, and Behavior. 74(4): 1005-1013.
Haga H.A. & Ranheim B. 2005. Castration of piglets: the analgesic effects of intratesticular and intrafunicular lidocaine injection. Veterinary Anaesthesia and Analgesia. 32(1): 1-9.
Haga H.A., Lykkjen S., Revold T. & Ranheim B. 2006. Effect of intratesticular injection of lidocaine on cardiovascular responses to castration in isoflurane-anesthetized stallions. American Journal of Veterinary Research. 67(3): 403-408.
Hill R. 2000. NK1 (substance P) receptor antagonists - why are they not analgesic in humans? Trends in Pharmacological Sciences. 21(7): 244-246.
Huuskonen V., Hughes J.M.L., Bañon E.E. & West E. 2013. Intratesticular lidocaine reduces the response to surgical castration in dogs. Veterinary Anaesthesia and Analgesia. 40(1): 74-82.
Kazama T. & Ikeda K. 1988. Comparison of MAC and the rate of rise of alveolar concentration of sevoflurane, with halothane and isoflurane in the dog. Anesthesiology. 68(3): 435-437.
Laird J.M., Olivar T., Roza C., De Felipe C., Hunt S.P. & Cervero F. 2000. Deficits in visceral pain and hyperalgesia of mice with a disruption of the tachykinin NK1 receptor gene. Neuroscience. 98(2): 345-352.
Laird J. 2001. Gut feelings about tachykinin NK1 receptor antagonists. Trends in Pharmacological Sciences. 22(4): 169.
López-Sanromán F.J., Cruz J.M., Santos M., Mazzini R., Tabanera A. & Tendillo F.J. 2003. Evaluation of the local analgesic effect of ketamine in the palmar digital nerve block at the base of the proximal sesamoid (abaxialsesamoid block) in horses. American Journal of Veterinary Research. 64(4): 475-478.
López-Sanromán F.J., Cruz J.M., Santos M., Mazzini R., Tabanera A. & Tendillo F.J. 2003. Effect of alkalinization on the local analgesic efficacy of ketamine in the abaxialsesamoid nerve block in horses. Journal of Veterinary Pharmacology and Therapeutics. 26(4): 265-269.
Marquez M., Boscan P., Weir H., Vogel P. & Twedt D.C. 2015. Comparison of NK-1 Receptor Antagonist (Maropitant) to Morphine as a Pre-Anaesthetic Agent for Canine Ovariohysterectomy. PLoS ONE. 10(10): 1-10.
McMillan M.W., Seymour C.J. & Brearley J.C. 2012. Effect of intratesticular lidocaine on isoflurane requirements in dogs undergoing routine castration. The Journal of Small Animal Practice. 53(7): 393-397.
Moldal E.R., Eriksen T., Kirpensteijn J., Nodtvedt A., Kristensen A.T., Sparta F.M. & Haga H.A. 2013. Instratesticular and Subcutaneous lidocaine alters the intraoperative haemodynamic responses and heart rate variability in male cats undergoing castration. Veterinary Anaesthesia and Analgesia. 40(1): 63-73.
Molony V., Kent J.E., Hosie B.D. & Graham M.J. 1997. Reduction in pain suffered by lambs at castration. The Veterinary Journal. 153(2): 205-213.
Natalini C.C., Cruz F.S.F. & Bopp S. 2011. Analgesia epidural com clonidina ou sufentanil epidural em cadelas submetidas à ovariosalpingohisterectomia sob anestesia geral inalatória. Acta Scientiae Veterinariae. 39: 992.
Niyom S., Boscan P., Twedt D.C., Monnet E. & Eickhoff J.C. 2013. Effect of maropitant, a neurokinin-1 receptor antagonist, on the minimum alveolar concentration of sevoflurane during stimulation of the ovarian ligament in cats. Veterinary Anaesthesia and Analgesia. 40(4): 425-431.
Okano S., Ikeura Y. & Inatomi N. 2002. Effects of tachykinin NK1 receptor antagonists on the viscerosensory response caused by colorectal distention in rabbits. The Journal of Pharmacology and Experimental Therapeutics. 300(3): 925–931.
Perez T.E., Grubb T.L., Greene S.A., Meyer S., Valdez N., Bingman J. & Farnsworth R. 2013. Effects of intratesticular injection of bupivacaine and epidural administration of morphine in dogsundergoing castration. Journal of the American Veterinary Medical Association. 242(5): 631-642.
Portier K.G., Jaillardon L., Leece E.A. & Walsh C.M. 2009. Castration of horses under total intravenous anaesthesia: analgesic effects of lidocaine. Veterinary Anaesthesia and Analgesia. 36(2): 173-179.
Ranheim B., Haga H.A. & Ingebrigsen K. 2005. Distribuition of radioactive lidocaine injected into the testes in piglets. Journal of Veterinary Pharmacology and Therapeutics. 28(5): 481-483.
Ramsey D.S., Kincaid K., Watkins J.A., Boucher J.F., Conder G.A., Eagleson J.S. & Clemence R.G. 2008. Safety and efficacy of injectable and oral maropitant, a selective neurokinin 1 receptor antagonist, in a randomized clinical trial for treatment of vomiting in dogs. Journal of Veterinary Pharmacology and Therapeutics. 31(6): 538-543.
Rost K., Fleischer F. & Nieber K. 2006. Neurokinin 1 receptor antagonists - between hope and disappointment. Medizinische Monatsschrift für Pharmazeuten. 29(6): 200-205.
Ruggieri M.R., Filer-Maerten S., Hieble J.P. & Hay D.W. 2000. Role of neurokinin receptors in the behavioral effect of intravesical antigen infusion in guinea pig bladder. The Journal of Urology. 164(1): 197-202.
Sakurada T., Katsumata K., Yogo H., Tan-No K., Sakurada S., Ohba M. & Kisara K. 1995. The neurokinin-1 receptor antagonist, sendide, exhibits antinociceptive activity in the formalin test. Pain. 60(2): 175-180.
Seliskar A., Zrimsek P., Sredensek J. & Petric A.D. 2013. Comparison of hight definition oscillometric and Doppler ultrasound with invasive blood pressure in anaesthetized dogs. Veterinary Anaesthesia and Analgesia. 40(1): 21-27.
Stafford K.J., Mellor D.J., Todd S.E., Gregory N.G., Bruce R.A. & Ward R.N. 2002. Effects of local anaesthesia or local anaesthesia plus a non-steroidal anti-inflammatory drug on the acute cortisol response of calves to five different methods of castration. Research in Veterinary Science. 73(1): 61-70.
Swallow A., Rioja E., Elmer T. & Dugdale A. 2017. The effect of maropitant on intraoperative isoflurane requirements and postoperative nausea and vomiting in dogs: a randomized clinical trial. Veterinary Anaesthesia and Analgesia. 44(4): 785-793.
Taylor A.A. & Weary D. 2000. Vocal responses of piglets to castration: identifying procedural sources of pain. Applied Animal Behaviour Science. 70(1): 17-26.
Tonner P.H. 2005. Balanced anaesthesia today. Best Practice & Research. Clinical Anaesthesiology. 19(3): 475-484.
Tverskoy M., Oren M., Vaskovich M., Dashkovsky I. & Kissin I. 1996. Ketamine enhances local anesthetic and analgesic effects of bupivacaine by peripheral mechanism: a study in postoperative patients. Neuroscience Letters. 215(1): 5-8.
Ushida T., Tani T., Kanbara T., Zinchuk V.S., Kawasaki M. & Yamamoto H. 2002. Analgesic effects of ketamine ointment in patients with complex regional pain syndrome type 1. Regional Anesthesia and Pain Medicine. 27(5): 524-528.
Warncke T., Jorum E. & Stubhaug A. 1997. Local Treatment with the N-methyl-d- aspartate receptor antagonist Ketamine, inhibit development of secondary hyperalgesia in man by a peripheral action. Neuroscience Letters. 227(1): 1-4.
How to Cite
This journal provides open access to all of its content on the principle that making research freely available to the public supports a greater global exchange of knowledge. Such access is associated with increased readership and increased citation of an author's work. For more information on this approach, see the Public Knowledge Project and Directory of Open Access Journals.
We define open access journals as journals that use a funding model that does not charge readers or their institutions for access. From the BOAI definition of "open access" we take the right of users to "read, download, copy, distribute, print, search, or link to the full texts of these articles" as mandatory for a journal to be included in the directory.
La Red y Portal Iberoamericano de Revistas Científicas de Veterinaria de Libre Acceso reúne a las principales publicaciones científicas editadas en España, Portugal, Latino América y otros países del ámbito latino