Effects of perineural administration of ropivacaine combined with perineural or intravenous administration of dexmedetomidine for sciatic and saphenous nerve blocks in dogs.
Marolf, vincent; Ida, Keila K.; Siluk, Danutaet al.
2021 • In American Journal of Veterinary Research, 82 (6), p. 449-458
[en] OBJECTIVE: To evaluate the effects of using ropivacaine combined with dexmedetomidine for sciatic and saphenous nerve blocks in dogs. ANIMALS: 7 healthy adult Beagles. PROCEDURES: In phase 1, dogs received each of the following 3 treatments in random order: perineural sciatic and saphenous nerve injections of 0.5% ropivacaine (0.4 mL/kg) mixed with saline (0.9% NaCl) solution (0.04 mL/kg; DEX0PN), 0.5% ropivacaine mixed with dexmedetomidine (1 μg/kg; DEX1PN), and 0.5% ropivacaine mixed with dexmedetomidine (2 μg/kg; DEX2PN). In phase 2, dogs received perineural sciatic and saphenous nerve injections of 0.5% ropivacaine and an IV injection of diluted dexmedetomidine (1 μg/kg; DEX1IV). For perineural injections, the dose was divided equally between the 2 sites. Duration of sensory blockade was evaluated, and plasma dexmedetomidine concentrations were measured. RESULTS: Duration of sensory blockade was significantly longer with DEX1PN and DEX2PN, compared with DEX0PN; DEX1IV did not prolong duration of sensory blockade, compared with DEX0PN. Peak plasma dexmedetomidine concentrations were reached after 15 minutes with DEX1PN (mean ± SD, 348 ± 200 pg/mL) and after 30 minutes DEX2PN (816 ± 607 pg/mL), and bioavailability was 54 ± 40% and 73 ± 43%, respectively. The highest plasma dexmedetomidine concentration was measured with DEX1IV (1,032 ± 415 pg/mL) 5 minutes after injection. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that perineural injection of 0.5% ropivacaine in combination with dexmedetomidine (1 μg/kg) for locoregional anesthesia in dogs seemed to balance the benefit of prolonging sensory nerve blockade while minimizing adverse effects.
Sandersen, Charlotte ; Université de Liège - ULiège > Dépt d'Ens. et de Clinique des animaux de Compagnie (DCC) > Anesthésiologie et réanimation des animaux de compagnie
Language :
English
Title :
Effects of perineural administration of ropivacaine combined with perineural or intravenous administration of dexmedetomidine for sciatic and saphenous nerve blocks in dogs.
Publication date :
2021
Journal title :
American Journal of Veterinary Research
ISSN :
0002-9645
eISSN :
1943-5681
Publisher :
American Veterinary Medical Association, United States - Illinois
Marhofer P, Brummett CM. Safety and efficiency of dexme-detomidine as adjuvant to local anesthetics. Curr Opin An-aesthesiol 2016;29:632–637.
Abdallah FW, Brull R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systematic review and meta-analysis. Br J Anaesth 2013;110:915–925.
Vorobeichik L, Brull R, Abdallah FW. Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks: a systematic review and meta-analysis of randomized controlled trials. Br J Anaesth 2017;118:167–181.
Brummett CM, Norat MA, Palmisano JM, et al. Perineural administration of dexmedetomidine in combination with bu-pivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat. Anesthesiology 2008;109:502–511.
Akhondzadeh R, Rashidi M, Gousheh M, et al. The effect of adding dexmedetomidine as an adjuvant to lidocaine in fore-arm fracture surgeries by supraclavicular block procedure under ultrasound-guided. Anesth Pain Med 2018;8:e74355.
Fritsch G, Danninger T, Allerberger K, et al. Dexmedetomi-dine added to ropivacaine extends the duration of intersca-lene brachial plexus blocks for elective shoulder surgery when compared with ropivacaine alone: a single-center, prospective, triple-blind, randomized controlled trial. Reg Anesth Pain Med 2014;39:37–47.
Keplinger M, Marhofer P, Kettner SC, et al. A pharmacody-namic evaluation of dexmedetomidine as an additive drug to ropivacaine for peripheral nerve blockade: a randomised, triple-blind, controlled study in volunteers. Eur J Anaesthe-siol 2015;32:790–796.
Bisui B, Samanta S, Ghoshmaulik S, et al. Effect of locally ad-ministered dexmedetomidine as adjuvant to levobupivacaine in supraclavicular brachial plexus block: double-blind controlled study. Anesth Essays Res 2017;11:981–986.
Jung HS, Seo KH, Kang JH, et al. Optimal dose of perineu-ral dexmedetomidine for interscalene brachial plexus block to control postoperative pain in patients undergo-ing arthroscopic shoulder surgery: a prospective, double-blind, randomized controlled study. Medicine (Baltimore) 2018;97:e0440.
Abdallah FW, Dwyer T, Chan VW, et al. IV and perineural dexmedetomidine similarly prolong the duration of analgesia after interscalene brachial plexus block: a randomized, three-arm, triple-masked, placebo-controlled trial. Anesthesiology 2016;124:683–695.
Bartel AK, Campoy L, Martin-Flores M, et al. Comparison of bupivacaine and dexmedetomidine femoral and sciatic nerve blocks with bupivacaine and buprenorphine epidural injection for stifle arthroplasty in dogs. Vet Anaesth Analg 2016;43:435–443.
Trein TA, Floriano BP, Wagatsuma JT, et al. Effects of dexme-detomidine combined with ropivacaine on sciatic and femoral nerve blockade in dogs. Vet Anaesth Analg 2017;44:144– 153.
Campoy L, Bezuidenhout AJ, Gleed RD, et al. Ultrasound-guided approach for axillary brachial plexus, femoral nerve, and sciatic nerve blocks in dogs. Vet Anaesth Analg 2010;37:144–153.
Hofmeister EH, Chandler MJ, Read MR. Effects of aceproma-zine, hydromorphone, or an acepromazine-hydromor-phone combination on the degree of sedation in clinically normal dogs (Erratum published in J Am Vet Med Assoc 2011;238:182). J Am Vet Med Assoc 2010;237:1155–1159.
Szerkus O, Struck-Lewicka W, Kordalewska M, et al. HPLC-MS/MS method for dexmedetomidine quantification with design of experiments approach: application to pediatric pharmacokinetic study. Bioanalysis 2017;9:395–406.
US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Re-search, Center for Veterinary Medicine. Guidance for indus-try: bioanalytical method validation. Available at: academy. gmp-compliance.org/guidemgr/files/4252FNL.PDF. Ac-cessed Aug 9, 2020.
Kirksey MA, Haskins SC, Cheng J, et al. Local anesthetic peripheral nerve block adjuvants for prolongation of analgesia: a systematic qualitative review. PLoS One 2015;10:e0137312.
Lin YN, Li Q, Yang RM, et al. Addition of dexmedetomidine to ropivacaine improves cervical plexus block. Acta Anaes-thesiol Taiwan 2013;51:63–66.
Rancourt MP, Albert NT, Côté M, et al. Posterior tibial nerve sensory blockade duration prolonged by adding dexmedeto-midine to ropivacaine. Anesth Analg 2012;115:958–962.
Bloor BC, Ward DS, Belleville JP, et al. Effects of intravenous dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology 1992;77:1134–1142.
Ebert TJ, Hall JE, Barney JA, et al. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 2000;93:382–394.
Andersen JH, Grevstad U, Siegel H, et al. Does dexmedetomi-dine have a perineural mechanism of action when used as an adjuvant to ropivacaine?: a paired, blinded, randomized trial in healthy volunteers. Anesthesiology 2017;126:66–73.
Yoshitomi T, Kohjitani A, Maeda S, et al. Dexmedetomidine enhances the local anesthetic action of lidocaine via an al-pha-2A adrenoceptor. Anesth Analg 2008;107:96–101.
Kosugi T, Mizuta K, Fujita T, et al. High concentrations of dexmedetomidine inhibit compound action potentials in frog sciatic nerves without alpha(2) adrenoceptor activation. Br J Pharmacol 2010;160:1662–1676.
Brummett CM, Hong EK, Janda AM, et al. Perineural dex-medetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current. Anesthesiology 2011;115:836–843.