Peer-reviewed veterinary case report
Pain on injection with alfaxalone versus two propofol types in dogs
By Michou, Joanne N et al.·Published in Veterinary anaesthesia and analgesia·2012·Department of Clinical Veterinary Medicine, United Kingdom·View original on PubMed →
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Original publication title: Comparison of pain on injection during induction of anaesthesia with alfaxalone and two formulations of propofol in dogs.
- Species:
- dog
Plain-English summary
A group of 30 dogs needing anesthesia for radiotherapy were given three different drugs to see which caused the least pain during injection. The results showed that one formulation of propofol caused pain in about 20% of the dogs, while the other formulation caused pain in only 3.3%. The study found that the propofol that was lipid-based led to more severe reactions, including some dogs experiencing facial swelling and skin issues. Because of these concerns, the study was stopped early, and it was concluded that the other formulations were better tolerated.
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Abstract
OBJECTIVE: To compare the incidence of pain during injection of three intravenous induction agents in dogs. STUDY DESIGN: Prospective, crossover, randomized, blinded, clinical study. ANIMALS: Thirty dogs requiring anaesthesia for radiotherapy. METHODS: Dogs were anaesthetized on three occasions at weekly intervals. An IV cephalic catheter was placed, flushed with saline and alfentanil 0.01 mg kg(-1) and atropine 0.02 mg kg(-1) administered. After 30 seconds either: propofol lipid macroemulsion (Drug(P) ), propofol lipid-free microemulsion (Drug(PC) ) or alfaxalone (Drug(A)) was administered over 60 seconds. Each induction agent was administered once to each dog. Induction was recorded by video and reviewed by an assessor, unaware of treatment. Catheter placement (number of attempts, site, size and recent vein use) were recorded. Behavioural changes associated with pain or excitation, were recorded. Severity of pain on injection was recorded (mild, moderate or severe pain). Incidence of pain was analysed using logistic regression, excitation using McNemar's test (p < 0.05) and association of pain with induction agent and catheter placement using the Akaike Information Criterion (AIC). RESULTS: No dogs reacted to saline or Drug(A,) thus Drug(A) was excluded from analysis. Pain on injection occurred in six dogs (20%) with Drug(PC) and one dog (3.3%) with Drug(P). Pain was severe in four dogs with Drug(PC). Drug(P) resulted in a trend for reduced risk of pain compared to Drug(PC) (p = 0.076, odds ratio [confidence intervals] 0.14 [0.027-0.86]). Both propofol formulations resulted in greater risk of excitation than Drug(A) (p = 0.0003, odds ratio 4.5 [1.86-10.90]). Induction agent was associated with pain, whilst catheter placement was not. One dog developed facial oedema and one other dog skin necrosis adjacent to the catheter site following Drug(PC.) The study was terminated early due to ethical concerns about the severity of reactions with Drug(PC). conclusions and clinical relevance: Drug(PC) was associated with clinically relevant moderate to severe pain behaviour whilst Drug(A) and Drug(P) were not.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/22414225/