Page 54 - BSAVA Guide to Pain Management in Small Animal Practice

5 | Pharmacological treatment of pain

VetBooks.ir Intravenous infusions continued

individual drugs can e titrated to effect, and one or more of the infusions can e
discontinued as the patient improves, or if it e periences side effects caused y one
of the drugs.

Drug Loading dose (i.v.) Maintenance dose (i.v.)
MLK: Dog: Add to ml saline
Morphine .1 . mg kg .1 mg kg h • mg morphine
• mg lidocaine
Lidocaine 1 mg kg mg kg h • 1 mg ketamine
Ketamine . mg kg .6 mg kg h
• Remove appropriate volume from saline
Cats: leave out bag rst
lidocaine
• Infuse at 1 ml kg h during surgery
• Post-surgery adjust up or down
depending on patient comfort
• Sedation is common
FLK: Dog: Add to ml saline
Fentanyl . g kg i.v. g kg h . mg • 7 g .7 mg fentanyl
Lidocaine 1 mg kg i.v. kg/h) • mg lidocaine
• 1 mg ketamine
Ketamine . mg kg i.v. mg kg h
Cats: leave out .6 mg kg h • Remove appropriate volume from saline
bag rst
lidocaine
• Infuse at 1 ml kg h during surgery
• Post-surgery adjust up or down
depending on patient comfort
• Sedation is common. Be aware of the
potential for respiratory depression

Individual drugs those licensed, but the authors have found
igure . provides an explanation of drug them to be e ective. Since absorption from the
classes, suggested doses and particular subcutis is slow and variable, yielding low
adverse e ects for each drug. All of the drugs plasma levels, intravenous or intramuscular
discussed below are Schedule Controlled administration is recommended (Ingvast-
Drugs in the UK (must be stored in a locked Larsson et al., 1 . nset of action is 1 1
cabinet and detailed records of supply and use minutes by intravenous or intramuscular
must be kept), except buprenorphine (Schedule in ection. uration of action is 4 hours in dogs
, butorphanol and codeine. and up to 6 hours in cats. ethadone can be
used by intravenous infusion at the same dose
Methadone: Methadone is licensed in several rates as morphine. It can be used to supple-
countries as an analgesic in cats (i.m.) and dogs ment analgesia during general anaesthesia by
(i.v., i.m. and s.c.). It is a full MOP agonist and also intravenous or intramuscular injection or
an N-methyl- -aspartate (NMDA) receptor intravenous infusion. Intravenous boluses
antagonist. It is unlikely to cause vomiting or during general anaesthesia may cause apnoea
histamine release and is the opioid most and marked bradycardia, this may be prevented
commonly used by the authors. The doses by in ecting very slowly over at least minutes
recommended in igure . are lower than or by using the intramuscular route instead.

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