Long-acting injectable methadone (methadone-fluconazole) provides safe and effective postoperative analgesia in a randomized clinical trial for dogs undergoing soft tissue surgery.

Autor:	Bieberly ZD; Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS., KuKanich B; Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS., KuKanich KS; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Berke KA; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Klocke EE; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Upchurch DA; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Comroe AJ; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Jugan MC; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Mason DE; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Orchard RJ; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Klutzke JB; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Fitzgerald AH; Department of Anatomy and Physiology, College of Veterinary Medicine, Kansas State University, Manhattan, KS., Woodruff K; Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS.
Jazyk:	angličtina
Zdroj:	American journal of veterinary research [Am J Vet Res] 2022 Jun 13; Vol. 83 (8). Date of Electronic Publication: 2022 Jun 13.
DOI:	10.2460/ajvr.22.01.0014
Abstrakt:	Objective: To assess the pharmacokinetics, clinical efficacy, and adverse effects of injectable methadone with the pharmacokinetic enhancer fluconazole (methadone-fluconazole), compared with the standard formulation of injectable methadone, in dogs after ovariohysterectomy. We hypothesized that 2 doses of methadone-fluconazole would provide 24 hours of postoperative analgesia. Animals: 3 purpose-bred dogs (pharmacokinetic preliminary study) and 42 female dogs from local shelters (clinical trial) were included. Procedures: Pharmacokinetics were preliminarily determined. Clinical trial client-owned dogs were blocked by body weight into treatment groups: standard methadone group (methadone standard formulation, 0.5 mg/kg, SC, q 4 h; n = 20) or methadone-fluconazole group (0.5 mg/kg methadone with 2.5 mg/kg fluconazole, SC, repeated once at 6 h; n = 22). All dogs also received acepromazine, propofol, and isoflurane. Surgeries were performed by experienced surgeons, and dogs were monitored perioperatively using the Glasgow Composite Measure Pain Scale-Short Form (CMPS-SF) and sedation scales. Evaluators were masked to treatment. Results: Findings from pharmacokinetic preliminary studies supported that 2 doses of methadone-fluconazole provide 24 hours of drug exposure. The clinical trial had no significant differences in treatment failures or postoperative CMPS-SF scores between treatments. One dog (methadone-fluconazole group) had CMPS-SF > 6 and received rescue analgesia. All dogs had moderate sedation or less by 1 hour (methadone-fluconazole group) or 4 hours (standard methadone group) postoperatively. Sedation was completely resolved in all dogs the day after surgery. Clinical Relevance: Methadone-fluconazole with twice-daily administration was well tolerated and provided effective postoperative analgesia for dogs undergoing ovariohysterectomy. Clinical compliance and postoperative pain control may improve with an effective twice-daily formulation.
Databáze:	MEDLINE
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