References

Abelson AL, McCobb EC, Shaw S, Armitage-Chan E, Wetmore LA, Karas AZ, Blaze C Use of wound soaker catheters for the administration of local anesthetic for post-operative analgesia: 56 cases. Vet Anaesth Analg. 2009; 36:597-602

Acosta ADP, Gomar C, Natalini CC, Bopp S, Polydoro A, Sala-Blanch X Analgesic effects of epidurally administered levogyral ketamine alone or in combination with morphine on intraoperative and postoperative pain in dogs under-going ovariohysterectomy. Am J Vet Res. 2005; 66:54-61

Borer-Weir K Analgesia.London: Saunders Elsevier; 2014

Cassutto BH, Gfeller RW Use of intravenous lidocaine to prevent reperfusion injury and subsequent multiple organ dysfunction syndrome. J Vet Emerg Crit Care. 2003; 13:137-48

Chew DJ, Buffington CA, Kendall MS, DiBartola SP, Woodworth BE Amitriptyline treatment for severe recurrent idiopathic cystitis in cats. J Am Vet Med Assoc. 1998; 213:(9)1282-6

Coetzee JF, Mosher RA, Kohake LE Pharmacokinetics of oral gabapentin alone or co-administered with meloxicam in ruminant beef calves. Vet J. 2011; 190:98-102

Dugdale A Pain.West Sussex: Blackwell Publishing; 2010

New Zealand: Astra Zeneca Limited; 2013

Epstein ME Adjunctive analgesic use for acute and chronic pain.: Kansas City Proceedings; 2009

Flaherty D Understanding the mechanisms behind acute pain in dogs and cats. The Veterinary Nurse. 2013; 4:609-12

Fu ES, Miguel R, Scharf JE Preemptive ketamine decreases postoperative narcotic requirements in patients undergoing abdominal surgery. Anaesthes Analges. 1997; 84:1086-90

Gaynor JS Control of Cancer Pain in Veterinary Patients. Vet Clin North Am Small Anim Pract. 2008; 38:1429-48

Grubb T What do we really now about the drugs we use to treat chronic pain?. Companion Animal Medicine. 2010a; 25:10-19

Grubb T Chronic Neuropathic Pain in Veterinary Patients. Companion Animal Medicine. 2010b; 25:45-52

Guedes AGP, Matthews NS, Hood DM Effect of ketamine hydrochloride on the analgesic effects of tramadol hydrochloride in horses with signs of chronic laminitis-associated pain. Am J Vet Res. 2012; 73:610-19

Habibian S, Bigham AS, Aali E Comparison of lidocaine, tramadol and lidocaine-tramadol for epidural analgesia in lambs. Res Vet Sci. 2011; 91:434-8

Hamilton SM, Johnston SA, Broadstone RV Evaluation of analgesia provided by the administration of epidural ketamine in dogs with a chemically induced synovitis. Vet Anaesth Analg. 2005; 32:30-9

Holopherne-Doran D Management of chronic pain: advances. European Journal of Companion Animal Practice. 2010; 20:163-8

Jordan DG, Ray JD Management of Chronic Pain in Cats. Today's Veterinary Practice. 2012; 77-82

Kerr C Pain management I: systemic analgesics.Gloucester: BSAVA; 2007

Koenig J, Cote N Equine gastrointestinal motility – ileus and pharmacological modification. Can Vet Journal. 2006; 47:551-9

Kronenberg RH Ketamine as an Analgesic: Parenteral, Oral, Rectal, Subcutaneous, Transdermal and Intranasal Administration. Journal of Pain & Palliative Care Pharmacotherapy. 2002; 16:27-35

Lamont LA Adjunctive Analgesic Therapy in Veterinary Medicine. Vet Clin North Am Small Anim Pract. 2008; 38:1187-203

Lamont LA, Mathews KA Opioids, Nonsteroidal Anti-inflammatories, and Analgesic Adjuvants.Iowa2007

Lascelles BDX, Gaynor JS, Smith ES Amantadine in a multimodal analgesic regimen for alleviation of refractory osteoarthritis pain in dogs. J Vet Intern Med. 2008; 1:53-9

Lorenz ND, Comerford EJ, Iff I Long-term use of gabapentin for musculoskeletal disease and trauma in three cats. J Feline Med Surg. 2012; 15:507-12

McMillan CJ, Livingston A, Clark CR Pharmacokinetics of intravenous tramadol in dogs. The Canadian Journal of Veterinary Research. 2008; 72:325-31

Mealey KL, Peck KE, Bennett BS Systemic absorption of amitriptyline and buspirone after oral and transdermal administration to healthy cats. J Vet Intern Med. 2004; 18:43-6

Minghella E, Auckburally A A preventive multimodal analgesic strategy for bilateral rostral mandibulectomy in a horse. Equine Vet Ed. 2014; 26:66-71

Muir WW NMDA Receptor Antagonists and Pain: Ketamine. Vet Clin North Am Equine Pract. 2010; 26:565-78

Murrell J, Flaherty D Extensing postoperative opioid analgesia in dogs 1. Oral drug administration. In Practice. 2014; 36:277-83

Nolan AM Pharmacology of Analgesic Drugs.London: WBSaunders; 2000

Peck TE, Hill S, Williams M Core drugs in anaesthetic practice – Analgesics.Cambridge: Cambridge University Press; 2008

Plumb DC Gabapentin, 7th edition. Iowa: Blackwell; 2011

Pypendop BH, Ilkiw JE The effects of intravenous lidocaine administration on the minimum alveolar concentration of isoflurane in cats. Vet Anaesth Analges. 2005; 100:97-101

Riedesel DH Anesthetics.Iowa: Wiley-Blackwell; 2008

Robertson SA Managing Pain in Feline Patients. Vet Clin North Am Small Anim Pract. 2008; 38:1267-90

Robertson SA, Taylor PM Pain management in cats – past, present and future. Part 2. Treatment of pain — clinical pharmacology. J Feline Med Surg. 2004; 6:321-33

Shilo Y, Britzi M, Eytan B Pharmacokinetics of tramadol in horses after intravenous, intramuscular and oral administration. J Vet Pharmacol Ther. 2008; 31:60-5

Slingby LS, Waterman-Pearson AE The post-operative analgesic effects of ketamine after canine ovariohysterectomy – a comparison between pre- or postoperative administration. Res Vet Sci. 2000; 69:147-52

Steagall PVM, Monteiro-Steagall BP Multimodal analgesia for perioperative pain in three cats. J Feline Med Surg. 2013; 15:737-43

Teppema LJ, Nieuwenhujis D, Olievier C, Dahan A Respiratory depression by tramadol in the cat. Anesthesiology. 2003; 98:420-7

Terry RL, McDonnell SM, Eps AWV Pharmacokinetic profile and behavioural effects of gabapentin in the horse. J Vet Pharmacol Ther. 2010; 33:485-94

Valtolina C, Robben JH, Uilenreef J Clinical evaluation of the efficacy and safety of a constant rate infusion of dexmedetomidine for postoperative pain management in dogs. Vet Anaesth Analg. 2009; 36:295-307

Wagner AE, Walton JA, Hellyer PW, Gaynor JS, Mama KR Use of low doses of ketamine administered by constant rate infusion as an adjunct for postoperative analgesia in dogs. J Am Vet Med Assoc. 2002; 221:72-5

Wagner AE, Mich PM, Uhrig SR, Hellyer PW Clinical evaluation of perioperative administration of gabapentin as an adjunct for postoperative analgesia in dogs undergoing amputation of a forelimb. J Am Vet Med Assoc. 2010; 236:751-6

Zaccuro L, Driessen B, Scandella M Continuous perineural block of the palmar nerves: A new technique for pain relief in the distal equine forelimb. Clinical Techniques in Equine Practice. 2007; 6:(2)154-64

Zech DF, Grond S, Lynch J, Hertel D, Lehmann KA Validation of World Health Organization Guidelines for cancer pain relief: a 10-year prospective study. Pain. 1995; 63:65-76

Adjunctive analgesics

02 October 2014
15 mins read
Volume 5 · Issue 8

Abstract

Adjunctive analgesics are drugs that have primary therapeutic indications other than providing analgesia. They are commonly co-administered with traditional analgesics in order to provide ‘multimodal analgesia’ when traditional analgesics alone may not provide adequate analgesia. This article will review the current adjunctive analgesics used in veterinary patients including their pharmacological properties, route of administration and some species specific applications.

Most veterinary patients experiencing acute pain may be managed with opioids, nonsteroidal anti-inflammatories (NSAIDs) and loco-regional anaesthetic techniques. These so called ‘traditional analgesics’ share one similarity, which is the management of pain being their primary indication (Lamont, 2008).

Adjunctive analgesics (also called analgesic adjuvants), are drugs that come from different pharmacological classes and have primary indications other than pain (Shaffran, 2005; Lamont and Mathews, 2007). They have the potential to improve comfort without adverse effects such as sedation, dysphoria, gastrointestinal tract dysfunction, respiratory depression, or renal toxicity associated with traditional analgesics (Wagner et al, 2002; Lamont, 2008; Wagner et al, 2010). They may also facilitate a reduction in the dose of other, concurrently administered, analgesics which may also reduce the incidence of adverse effects.

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