Effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation in dogs

William Jm McFadzean; Edward J Hall; Hugo van Oostrom

doi:10.1016/j.vaa.2017.05.004

Effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation in dogs

William Jm McFadzean^*, Edward J Hall, Hugo van Oostrom

^*Corresponding author for this work

University of Bristol

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: The effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation.

STUDY DESIGN: Prospective, randomized, blinded clinical trial.

ANIMALS: A group of 20 client-owned dogs.

METHODS: Dogs were assigned randomly to be administered intravenous (IV) premedication with either butorphanol (0.4 mg kg-1) or methadone (0.3 mg kg-1). General anaesthesia was induced with propofol to effect and maintained with isoflurane in 100% oxygen. Sedation score 20 minutes after premedication administration and induction dose of propofol were recorded. Heart rate, mean arterial pressure, haemoglobin oxygen saturation, respiratory rate and end-tidal isoflurane concentration were recorded every 5 minutes. Spontaneous lower oesophageal and pyloric sphincter opening, presence of gastro-oesophageal and duodeno-gastric reflux, antral peristaltic contractions and response to endoscopy were recorded as yes or no. Ease of duodenal intubation (EDI) was graded on a scale ranging from 1 (immediate entry with minimal manoeuvring required) to 4 (no entry after 2 minutes). Time (seconds) from the start of pyloric intubation to successfully entering the duodenum was recorded.

RESULTS: Median EDI score [3 ± 1 (butorphanol), 4 ± 1 (methadone), p = 0.035], time [65 ± 36 seconds (butorphanol), 120 ± 38 seconds (methadone), p = 0.028] and number of dogs with spontaneous pyloric sphincter opening [7/10 (butorphanol), 2/10 (methadone), p = 0.035] differed between groups. No other significant differences were found.

CONCLUSIONS AND CLINICAL RELEVANCE: In these clinical cases, duodenal intubation was performed with greater ease, shorter time and more frequent spontaneous opening of the pyloric sphincter after premedication with butorphanol in comparison to methadone. The use of butorphanol facilitated the passage of the endoscope and is therefore recommended for premedication prior to upper gastrointestinal tract endoscopy.

Original language	English
Pages (from-to)	1296-1302
Number of pages	7
Journal	Veterinary Anaesthesia and Analgesia
Volume	44
Issue number	6
DOIs	https://doi.org/10.1016/j.vaa.2017.05.004
Publication status	Published - Nov 2017
Externally published	Yes

Keywords

Anesthesia, General/methods
Animals
Butorphanol
Deep Sedation/methods
Dogs
Duodenoscopy/methods
Female
Hypnotics and Sedatives
Intubation, Intratracheal/methods
Male
Methadone
Preanesthetic Medication/methods

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10.1016/j.vaa.2017.05.004

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@article{55c76fe4036f44359bd4d879562c2dc8,

title = "Effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation in dogs",

abstract = "OBJECTIVE: The effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation.STUDY DESIGN: Prospective, randomized, blinded clinical trial.ANIMALS: A group of 20 client-owned dogs.METHODS: Dogs were assigned randomly to be administered intravenous (IV) premedication with either butorphanol (0.4 mg kg-1) or methadone (0.3 mg kg-1). General anaesthesia was induced with propofol to effect and maintained with isoflurane in 100% oxygen. Sedation score 20 minutes after premedication administration and induction dose of propofol were recorded. Heart rate, mean arterial pressure, haemoglobin oxygen saturation, respiratory rate and end-tidal isoflurane concentration were recorded every 5 minutes. Spontaneous lower oesophageal and pyloric sphincter opening, presence of gastro-oesophageal and duodeno-gastric reflux, antral peristaltic contractions and response to endoscopy were recorded as yes or no. Ease of duodenal intubation (EDI) was graded on a scale ranging from 1 (immediate entry with minimal manoeuvring required) to 4 (no entry after 2 minutes). Time (seconds) from the start of pyloric intubation to successfully entering the duodenum was recorded.RESULTS: Median EDI score [3 ± 1 (butorphanol), 4 ± 1 (methadone), p = 0.035], time [65 ± 36 seconds (butorphanol), 120 ± 38 seconds (methadone), p = 0.028] and number of dogs with spontaneous pyloric sphincter opening [7/10 (butorphanol), 2/10 (methadone), p = 0.035] differed between groups. No other significant differences were found.CONCLUSIONS AND CLINICAL RELEVANCE: In these clinical cases, duodenal intubation was performed with greater ease, shorter time and more frequent spontaneous opening of the pyloric sphincter after premedication with butorphanol in comparison to methadone. The use of butorphanol facilitated the passage of the endoscope and is therefore recommended for premedication prior to upper gastrointestinal tract endoscopy.",

keywords = "Anesthesia, General/methods, Animals, Butorphanol, Deep Sedation/methods, Dogs, Duodenoscopy/methods, Female, Hypnotics and Sedatives, Intubation, Intratracheal/methods, Male, Methadone, Preanesthetic Medication/methods",

author = "McFadzean, {William Jm} and Hall, {Edward J} and {van Oostrom}, Hugo",

year = "2017",

month = nov,

doi = "10.1016/j.vaa.2017.05.004",

language = "English",

volume = "44",

pages = "1296--1302",

journal = "Veterinary Anaesthesia and Analgesia",

issn = "1467-2987",

publisher = "Elsevier",

number = "6",

}

TY - JOUR

T1 - Effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation in dogs

AU - McFadzean, William Jm

AU - Hall, Edward J

AU - van Oostrom, Hugo

PY - 2017/11

Y1 - 2017/11

N2 - OBJECTIVE: The effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation.STUDY DESIGN: Prospective, randomized, blinded clinical trial.ANIMALS: A group of 20 client-owned dogs.METHODS: Dogs were assigned randomly to be administered intravenous (IV) premedication with either butorphanol (0.4 mg kg-1) or methadone (0.3 mg kg-1). General anaesthesia was induced with propofol to effect and maintained with isoflurane in 100% oxygen. Sedation score 20 minutes after premedication administration and induction dose of propofol were recorded. Heart rate, mean arterial pressure, haemoglobin oxygen saturation, respiratory rate and end-tidal isoflurane concentration were recorded every 5 minutes. Spontaneous lower oesophageal and pyloric sphincter opening, presence of gastro-oesophageal and duodeno-gastric reflux, antral peristaltic contractions and response to endoscopy were recorded as yes or no. Ease of duodenal intubation (EDI) was graded on a scale ranging from 1 (immediate entry with minimal manoeuvring required) to 4 (no entry after 2 minutes). Time (seconds) from the start of pyloric intubation to successfully entering the duodenum was recorded.RESULTS: Median EDI score [3 ± 1 (butorphanol), 4 ± 1 (methadone), p = 0.035], time [65 ± 36 seconds (butorphanol), 120 ± 38 seconds (methadone), p = 0.028] and number of dogs with spontaneous pyloric sphincter opening [7/10 (butorphanol), 2/10 (methadone), p = 0.035] differed between groups. No other significant differences were found.CONCLUSIONS AND CLINICAL RELEVANCE: In these clinical cases, duodenal intubation was performed with greater ease, shorter time and more frequent spontaneous opening of the pyloric sphincter after premedication with butorphanol in comparison to methadone. The use of butorphanol facilitated the passage of the endoscope and is therefore recommended for premedication prior to upper gastrointestinal tract endoscopy.

AB - OBJECTIVE: The effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation.STUDY DESIGN: Prospective, randomized, blinded clinical trial.ANIMALS: A group of 20 client-owned dogs.METHODS: Dogs were assigned randomly to be administered intravenous (IV) premedication with either butorphanol (0.4 mg kg-1) or methadone (0.3 mg kg-1). General anaesthesia was induced with propofol to effect and maintained with isoflurane in 100% oxygen. Sedation score 20 minutes after premedication administration and induction dose of propofol were recorded. Heart rate, mean arterial pressure, haemoglobin oxygen saturation, respiratory rate and end-tidal isoflurane concentration were recorded every 5 minutes. Spontaneous lower oesophageal and pyloric sphincter opening, presence of gastro-oesophageal and duodeno-gastric reflux, antral peristaltic contractions and response to endoscopy were recorded as yes or no. Ease of duodenal intubation (EDI) was graded on a scale ranging from 1 (immediate entry with minimal manoeuvring required) to 4 (no entry after 2 minutes). Time (seconds) from the start of pyloric intubation to successfully entering the duodenum was recorded.RESULTS: Median EDI score [3 ± 1 (butorphanol), 4 ± 1 (methadone), p = 0.035], time [65 ± 36 seconds (butorphanol), 120 ± 38 seconds (methadone), p = 0.028] and number of dogs with spontaneous pyloric sphincter opening [7/10 (butorphanol), 2/10 (methadone), p = 0.035] differed between groups. No other significant differences were found.CONCLUSIONS AND CLINICAL RELEVANCE: In these clinical cases, duodenal intubation was performed with greater ease, shorter time and more frequent spontaneous opening of the pyloric sphincter after premedication with butorphanol in comparison to methadone. The use of butorphanol facilitated the passage of the endoscope and is therefore recommended for premedication prior to upper gastrointestinal tract endoscopy.

KW - Anesthesia, General/methods

KW - Animals

KW - Butorphanol

KW - Deep Sedation/methods

KW - Dogs

KW - Duodenoscopy/methods

KW - Female

KW - Hypnotics and Sedatives

KW - Intubation, Intratracheal/methods

KW - Male

KW - Methadone

KW - Preanesthetic Medication/methods

U2 - 10.1016/j.vaa.2017.05.004

DO - 10.1016/j.vaa.2017.05.004

M3 - Article

C2 - 29174961

SN - 1467-2987

VL - 44

SP - 1296

EP - 1302

JO - Veterinary Anaesthesia and Analgesia

JF - Veterinary Anaesthesia and Analgesia

IS - 6

ER -

Effect of premedication with butorphanol or methadone on ease of endoscopic duodenal intubation in dogs

Abstract

Keywords

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