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Sedative effects of high dose buprenorphine as a post-operative analgesic in dogs
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|摘要:||Buprenorphine為廣泛應用於獸醫止痛的半合成蒂巴因衍生物，其被歸類為部分致效劑，基於對μ鴉片類受體的高親和力和低內在活性。近年來的研究顯示buprenorphine對於止痛可作為一種完全致效劑且無頂峰效應。然而給予高於臨床建議劑量的buprenorphine可能導致較大的副作用，因此本實驗的目的便是評估高劑量buprenorphine於犬隻的術後鎮靜效果。十五隻自國立中興大學獸醫教學醫院進行去勢的雄性狗被隨機分為buprenorphine 40 (B40組，n=7)或60 μg/kg (B60組，n=8)，結束麻醉並降體溫回復至大於37.8 ℃後，給予靜脈注射分組劑量的buprenorphine作為術後止痛。使用視覺類比量表(VAS)和複合型鎮靜評分系統評估鎮靜分數，於基準值（給藥前）至給藥後12小時記錄測量值、生理參數和疼痛分數。鎮靜效果在給藥後1小時內迅速上升至最大值，其後隨著時間推移而下降，兩組於給藥後4至6小時顯著增加鎮靜程度。B60組相較於B40組呈現較高的鎮靜程度且較長的作用時間，然而兩組之間的差異並不顯著。在整個實驗期間並沒有觀察到對心血管和呼吸系統等有害副作用，也無任何狗需給予救援止痛。根據實驗結果，在給予buprenorphine 40和60 μg/kg後會顯著誘發鎮靜效果，任一劑量的buprenorphine皆足夠提供去勢後長達12小時的止痛。|
Buprenorphine is a semi-synthetic thebaine derivative that broadly employed for analgesia in veterinary medicine. It is classified as partial μ-opioid agonist based on high affinity and low intrinsic activity to the receptor. Recent studies have demonstrated that buprenorphine acts as a full agonist with no ceiling effect on analgesia. However, administration of buprenorphine above the recommended dosage may induce greater adverse reactions. Therefore, the aim of this study is to evaluate the post-operative sedative effects of high dose buprenorphine in dogs. Fifteen male dogs from the NCHU-VMTH for castration were enrolled and randomized to either buprenorphine 40 (B40 group, n = 7) or 60 μg/kg (B60 group, n = 8). After anesthesia and rewarmed body temperature to over 37.8℃, relevant doses of buprenorphine for each group were intravenously administered for post-operative analgesia. Sedation was evaluated using VAS and a multi-dimensional sedation scoring system. Measurements along with vital parameters and pain scores were recorded at baseline (prior to treatment) and up to 12 hours after administration. Sedative effects rapidly elevated to maximum at 1 hour and then fell over time, significant increase in levels of sedation reached 4 to 6 hours after administration of both treatments. B60 group showed promotion of sedative effects and also prolonged the duration of action compared to B40 group; however, the enhancements were not significant among two treatments. No detrimental effects on cardiovascular and respiratory system were observed and none of the dog required rescue analgesia throughout the study. In conclusion, administration of buprenorphine at 40 and 60 μg/kg can significantly induced sedation. Either dose of buprenorphine provides sufficient analgesia for up to 12 hours after castration.
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