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The Institutional Animal Care and Use Committee (IACUC)
Other Species: Analgesia and Anesthesia formulary
The appropriate use of pain medications (analgesics) and anesthetics is a critical aspect of the
proper care and use of animals in research. Not only are they required by regulatory agencies
when an animal experiences more than momentary pain or discomfort, but minimization of pain
and stress typically results in better, more reproducible results. (Resources to Aid in Recognition
of Pain and Distress; Pain Relief in Animals)
The following is a listing of dosages for many of the more commonly employed analgesics and
anesthetics, and is meant as a guide during protocol preparation. In all cases, animals may
only be utilized with a currently IACUC approved protocol and any changes in the analgesics
or anesthetics must be accompanied by an amendment to the protocol even if the medication
is listed in this formulary.
The formulary is not meant to be an all-inclusive listing. If you would like to use a drug
not included in this listing, please contact a DLAM veterinarian to discuss its use in your
protocol.
Variability amongst models
The doses listed in the formulary were collected from the comparative medicine literature, but
these articles typically evaluate rodent drug doses using the most common strains or stocks
and healthy animals in the case of large animal trials. Moreover, it is well recognized there can
be considerable variation in the effect of drugs across individuals, strains and stocks, as well
as between sexes. Thus, it is critical to evaluate all animals, including strains or models that
you have created, to determine if the doses and/or drugs chosen are appropriate in your study.
If your research focuses on a particular body system, it is also important to consider the effect
of the drug on that system. We encourage you to work with the Division of Laboratory Animal
Medicine (DLAM) veterinarians and/or review the literature for this information. There have
been a considerable number of articles in the comparative medicine literature focusing on
these considerations.
Selecting an appropriate analgesic or anesthetic
In most cases, the formulary includes information regarding the time of onset and duration of
effect. In general, the opiates are shorter-acting than Non-Steroidal Anti-inflammatory Drugs
(NSAIDs) and can be effectively used at the time of the procedure to dampen the induction of
the pain pathways. The pain and discomfort which occurs later is typically attributed to
inflammation, therefore, NSAIDs are used in many post-operative regimens. When using
multiple drugs, it is also critical to consider their potential interactions. For example, certain
opiates can actually antagonize each other’s actions, thus cancelling their beneficial effect.
Additional resources
Currently there are a number of excellent textbooks about laboratory animal anesthesia and
pain management available online through the UNC Library system. A select few are as
follows:
1) http://search.lib.unc.edu/search?R=UNCb6247400 Laboratory animal anesthesia, Flecknell,
P. A. Elsevier/Academic
Press, Amsterdam, Boston, 2009.
2) http://search.lib.unc.edu/search?R=UNCb6554539 Handbook of laboratory animal
science. Volume 1, Essential principles and practices, CRC Press, Boca Raton, FL,
2011
Canine Anesthesia
General anesthesia is accomplished by the blending of three components (Pre-anesthesia,
Induction, and Maintenance). The following anesthetic agents are a general compilation of
accepted agents. Use of these agents in combinations will allow reduction in dosages and potential
risks associated with many subsequent agents. Different disease models may require modification
of their particular anesthetic protocol. Dogs scheduled for general anesthesia should have venous
access, and may require physical examination prior to anesthesia.
Class
Drug
Dose ( mg/kg)
Route
Notes
Pre-anesthetics Sedatives: are used to sedate, provide smooth controlled induction, provide recovery with minimal
excitement phase, reduce dosage (and adverse effects) of induction or maintenance agents and provide analgesia if
indicated. Sedatives, opioids, and anticholinergic agents are commonly used in combination to provide this balanced
anesthesia.
Sedative
Acepromazine
0.1 - 0.2
IM / SC
light sedation, no analgesia, dosages higher than
maximum dosage
given will not increase sedation but only
is 3.0 mg
prolong effect; avoid in seizure prone animals,
will produce vasodilation, decreased systemic
vascular resistance and arterial hypotension
Alpha 2 agonist
Dexmedetomidine
3-9 ug/kg
IM/IV
Note: paradoxical cardiovascular effects; do not
use atropine or epinephrine in the face of
cardiovascular changes; Reverse with
atipamezole 0.2 mg/kg IM or IV; not for use
in dogs less than 2.0 kg; can reduce the need for
induction and maintenance anesthesia 30 - 60%,
consult DLAM for combination protocols. The
dose per kg decreases with the size of the dog
(see charts provided with the drug).
may cause vomiting; any believe label dosage is
too high; reverse with Yohimbine 0.11 mg/kg
IV slowly
Alpha 2 agonist
Xylazine
0.2 - 1.0
IV, IM, SC
Benzodiazepine Midazolam
0.1 - 0.4
IV slowly,
IM
little sedation alone; do not mix in same syringe
Benzodiazepine Diazepam
0.1 - 0.5
IV slowly,
IM
little sedation alone; do not mix in same syringe
due to precipitation
Pre-anesthetic Opioids
Class
Drug
Dose ( mg/kg)
Route
Notes
Opioid
Morphine
0.5 - 2.0
Slow IV,
IM, SC
pure agonist; vomiting and mild respiratory
depression noted
Opioid
Hydromorphone
0.1 - 0.2
IV, IM, SC
pure agonist; vomiting and mild respiratory
depression noted
Opioid
Oxymorphone
0.05 - 0.2
maximum
dosage: 5.0 mg
IV, IM, SC
pure agonist; vomiting and mild respiratory
depression noted, high dosage produces heavy
sedation
Opioid
Butorphanol
0.2 - 0.5
IV, IM, SC
kappa receptor agonist; less vomiting and
respiratory depression than pure agonists
Opioid
Buprenorphine
0.005 - 0.03
IV, IM, SC
partial agonist; less vomiting and respiratory
depression than pure agonists, less intense
sedation and analgesia of other opioids
Dose ( mg/kg)
Route
Notes
Pre-anesthetic Adjuvant
Class
Drug
Anticholinergic
Atropine
0.02 - 0.04
IV, IM, SC
Anticholinergic
Glycopyrolate
0.01 - 0.02
IV, IM, SC
counteract sympatholytic and vagal stimulatory
effects (i.e., bradycardia), indicated in those less
than 6 month old and surgery in and around the
eye, can reduce hyper-salivation, reflex
tachycardia my follow use
Induction: provided to effect (that which allows tracheal intubation). Induction dosages are based on the use of preanesthetics. Consult DLAM for anesthetic consultations.
Preferred
volatile agents
Isoflurane
5.0%
Inhaled
to effect, marked excitement without preanesthetic; consult EH&S policy for proper use
Preferred
volatile agents
Sevoflurane
5.0 - 7.0%
Inhaled
to effect, marked excitement without preanesthetic; consult EH&S policy for proper use
Preferred
injectable agent
Propofol
(propoflo)
2.0 - 4.0
IV slowly
minimal residual sedation, will cause apnea,
vasodilation and hypotension, extravascular
injections are irritating; duration 10 - 20 min.
Use for
terminal
anesthetic
events
Pentobarbital
10 - 30
IV slowly
accumulation of sedative effect is noted with
repeat dosages, low margin of safety, narrow
therapeutic index, longer acting than thiopental;
may cause transient apnea, vasodilation and
hypotension, residual sedation may persist for
hours; euthanasia agent at 4 - 5 times this
recommended dosage, duration 1 - 2 hours
Primarily for
cardiovascular
studies
Etomidate
0.05 – 2.0
IV
adequate pre-anesthesia is essential; can reduce
cortisol production for 6+ hours, give with short
acting glucocorticoid, prolonged administration
is not recommended
Non-preferred
agent
Tiletamine /
Zolazapam
(Telazol )
6.6 - 13.2
IV, IM
not for use in epileptics, can lower seizure
threshold, tachycardia and hypertension have
been noted, longer duration of sedation than
ketamine combinations
Non- preferred
agent
Ketamine /
Benzodiazepine
5 / 0.25
IV, IM
Duration: 20 - 30 minutes. not for use in
epileptics, can lower seizure threshold
Maintenance: anesthesia can be achieved using volatile agents or total intravenous anesthesia (TIVA)
Class
Drug
Dose ( mg/kg)
Route
Notes
Volatile agents
Isoflurane
0.25% - 2.5%
Inhaled
to effect, marked excitement without preanesthetic; consult EH&S policy for proper use
Volatile agents
Sevoflurane
2.0 - 2.4%
Inhaled
to effect, marked excitement without preanesthetic; consult EH&S policy for proper use
Intravenous
Pentobarbital
10 - 30
IV to effect
see above comments
Intravenous
Propofol
(Propoflo)
0.1 - 0.4
mg/kg/min
IV
Continuous
Rate
infusion
(CRI)**
IV repeat
bolus
smoother anesthesia than repeat bolus, can be
diluted in 5% dextrose in water, tolerance noted
in dogs over several days anecdotally
1.0 - 2.0
** Co-administration of the following helps reduce the amount of Propoflo needed. Midazolam (0.35
ug/kg/min); Ketamine (10 - 20 ug/kg/min); Lidocaine (50 ug/kg/min); Morphine (1.0 – 4.0 ug/kg/min);
Dexmedetomidine (0.25 - 0.5ug/kg/min)
Canine Analgesia
Opioid
Dose
(mg/kg)
Route
Interval
Effect
Notes
Opiates: Consider adverse effects - respiratory depression, GI stasis, excitement (typically only at higher doses) and/or
sedation
Buprenorphine
0.006 - 0.02
IV, IM, SC
q 4 - 8 hrs.
onset: ~20 min,
duration: 4.5 - 9
hrs.
25 times as potent as morphine, but
with less maximum analgesic effect;
can be doses sublingually, but will not
be absorbed by GI system, so will lose
effect if swallowed
Butorphanol
0.2 - 0.4
IV, IM, SC
typically
once
short acting: 1 - 2
hrs.; peak plasma
level 45 - 60 min
sedative effect is beneficial for short
procedures or as a pre-anesthetic
medication; also anti-tussive effects
Fentanyl Citrate
0.005 - 0.01
IV, IM, SC
q 2 hrs.
onset is very
quick (2 - 5 min);
duration 20 - 30
min
mu-agonist; useful for intraoperative
analgesia; may require respiratory
support due to suppression, good for
cardiovascular studies as does not
reduce myocardial contractility or
coronary blood flow
0.003 IV
loading dose
followed by
*CRI
*Continuous Rate Infusion
50 mcg/hr
patch for 2025 kg
transdermal
q 72 hrs.
sustained release
for 72 - 108 hrs.
0.5 (range
0.1 - 1.0)
IV, IM, SC
q 4 hrs.
2 - 4 hrs.
Hydromorphone 0.22
IM, SC
q 4 - 6 hrs.
Tramadol
PO
q 6 - 8 hrs.
Morphine
3.0 - 6.0
short elimination half-life (1 - 2 hrs.),
no ceiling effect; when given IV, slow
injection mandatory to hypotension
associated release with histamine
release; vomiting is very common
NSAIDS –do not administer if animal is also on steroids: adverse effects may include blood dyscrasias, interference
with platelet function and the targeting of GI, hepatic and renal tissues following prolonged administration. These effects
are rarely of significance when treating for short periods (2-3 days).
(mg/kg)
Drug
Dose
Route
Interval
Effect
Notes
Carprofen
2.2
4.4
PO, SC
PO, SC
12 hrs.
24 hrs.
half-life: ~ 8 hrs.
synergistic effect with opioids
Firocoxib
5.0
PO
24 hrs.
Ketoprofen
up to 2.0
SC, IM, IV
once
as initial dose followed by oral
administration
Meloxicam
1.0
0.2 initial
load dose
PO
PO, SC, IV
24 hrs.
once
use only up to 5 days
synergistic effect with opioids
0.1
maintenance
PO, SC, IV
24 hrs.
PO
24 hrs.
Other pain medications
Gabapentin
3.0 - 5.0
not considered
effective for
acute pain unless
given preemptively
useful for chronic, neuropathic pain
Local anesthetics - stop nerve transmission by blocking sodium channels; can reduce need for systemic postoperative
analgesics and allow reduced dose of intraoperative anesthesia; epinephrine (vasoconstrictor) can be added (except in
extremities) to reduce risk of systemic absorption
Lidocaine
max dose:
4.0 mg/kg
once
Bupivacaine
max dose:
1.0 mg/kg
once
Ropivacaine
Similar to
bupivacaine
duration of
effect: 60 - 90
minutes
onset: 20 min
duration: 6 - 8 hrs.
if epinepherine included at a
1:200,000 concentration, duration will
be increased by 50%
high doses absorbed systemically can
cause neuro- or cardiotoxicity
similar in effect to bupivacaine but
less cardotoxic. Epinephrine does not
affect absorption.
References:
Handbook of Laboratory Animal Science, Hau, Jann: Schapi Budd, Group, 2011
Saunders Handbook of Veterinary Drugs: small and large animal, Papich, M.G.,
Elsevier/Saunders, Philadelphia, PA 2011.
Anesthesia and analgesia in laboratory animals (2008). In Faculty Publication
Collection (North Carolina State University), Fish R. E. (Eds.), Amsterdam;
Boston: Academic. Retrieved from http://search.trln.org/search?id=NCSU2166972
North American Companion Animal Formulary. Eds. edited and compiled by Ned F. Kuehn and
Ned F. Kuehn. Port Huron, Mich.: North American Compendiums, 2006.
Plumb, Donald C. Plumb's Veterinary Drug Handbook. Stockholm, Wis.; Ames Iowa:
PharmaVet; Distributed by John Wiley & Sons Inc., 2011.
Small Animal Formulary. Eds. British Small Animal Veterinary Association. and Ian
Ramsey. Quedgeley, Gloucester: British Small Animal Veterinary Association, 2011.
Feline: Analgesia and Anesthesia formulary
The appropriate use of pain medications (analgesics) and anesthetics is a critical aspect of the
proper care and use of animals in research. Not only are they required by regulatory agencies
when an animal experiences more than momentary pain or discomfort, but minimization of pain
and stress typically results in better, more reproducible results. (Resources to Aid in
Recognition of Pain and Distress; Pain Relief in Animals)
The following is a listing of dosages for many of the more commonly employed analgesics and
anesthetics, and is meant as a guide during protocol preparation. In all cases, animals may
only be utilized with a currently IACUC approved protocol and any changes in the analgesics
or anesthetics must be accompanied by an amendment to the protocol even if the medication
is listed in this formulary.
The formulary is not meant to be an all-inclusive listing. If you would like to use a drug
not included in this listing, please contact a DLAM veterinarian to discuss its use in your
protocol.
Variability amongst models
The doses listed in the formulary were collected from the comparative medicine literature, but
these articles typically evaluate rodent drug doses using the most common strains or stocks
and healthy animals in the case of large animal trials. Moreover, it is well recognized there can
be considerable variation in the effect of drugs across individuals, strains and stocks, as well
as between sexes. Thus, it is critical to evaluate all animals, including strains or models that
you have created, to determine if the doses and/or drugs chosen are appropriate in your study.
If your research focuses on a particular body system, it is also important to consider the effect
of the drug on that system. We encourage you to work with the Division of Laboratory Animal
Medicine (DLAM) veterinarians and/or review the literature for this information. There have
been a considerable number of articles in the comparative medicine literature focusing on
these considerations.
Selecting an appropriate analgesic or anesthetic
In most cases, the formulary includes information regarding the time of onset and duration of
effect. In general, the opiates are shorter-acting than Non-Steroidal Anti-inflammatory Drugs
(NSAIDs) and can be effectively used at the time of the procedure to dampen the induction of
the pain pathways. The pain and discomfort which occurs later is typically attributed to
inflammation, therefore, NSAIDs are used in many post-operative regimens. When using
multiple drugs, it is also critical to consider their potential interactions. For example, certain
opiates can actually antagonize each other’s actions, thus cancelling their beneficial effect.
Additional resources
Currently there are a number of excellent textbooks about laboratory animal anesthesia and
pain management available online through the UNC Library system. A select few are as
follows:
1) http://search.lib.unc.edu/search?R=UNCb6247400 Laboratory animal anesthesia, Flecknell,
P. A. Elsevier/Academic
Press, Amsterdam, Boston, 2009.
Feline Anesthetics
Pre-anesthetic agent, induction, followed by inhalation anesthesia and post-operative analgesia.
Anticolinergics
Dosage (mg/kg) and
Route
Duration (in minutes)
Notes
Pre-anesthetic agents
Atropine
0.02 - 0.04 IV, IM, SC
60 - 90
tachycardia may result
Glycopyrrolate
0.01 - 0.02 IM, SC, IV
120 - 240
tachycardia may result
Premedication
Drug
Dosage (mg/kg)
Route
Notes
Acepromazine ±
Morphine
0.04 - 0.1
0.1 - 0.2
IV, IM, SC
IM, SC
Acepromazine ±
Butorphanol
0.04 - 0.1
0.1 - 0.4
IV, IM, SC
IV, IM, SC
Midazolam ±
Ketamine
0.1 - 0.3
5.0
IV, IM, SC
IM
Diazepam ±
Ketamine
0.1 - 0.4
5.0
IV, IM
IM
Midazolam±
Hydromorphone
0.1 - 0.3
0.05 - 0.1
IV, IM
IM, IV, SC
Midazolam ±
Butorphanol
0.1 - 0.3
0.1 - 0.4
IV, IM, SC
IV, IM, SC
Midazolam ±
Buprenorphine
0.1 - 0.3
0.005 - 0.01
IV, IM, SC
IV, IM, SC
Xylazine ±
Butorphanol
0.5 - 1.0
0.1 - 0.4
IV, IM, SC
IV, IM, SC
Medetomidine
0.005 - 0.04
IV, IM
Drug
Dose (mg/kg)
Duration
Notes
Thiopental
15 (to effect - given half
as a rapid bolus and the
remaining to effect)
this is an IV injectable
ultra short acting
barbiturate given as a
1.25% solution
no longer available; in
pre-medicated cats 7.0 mg/kg
may be sufficient for induction,
may
cause transient apnea
Propofol
2.7 - 8.0 (to effect - given
slowly)
rapid induction and rapid
elimination from the
plasma and nonaccumulative
Diazepam +
Ketamine
0.25 + 5.0 (to effect)
Isoflurane
mask or chamber, 3.5 5% for induction and 1.5
- 2.5% for maintenance
4.0 - 4.5% for induction
and 3.0% for maintenance mask/chamber
dexmedetomidine replaces
medetomidine and is about twice
the potency
Medetomidine ±
0.005 - 0.04
IV, IM
dexmedetomidine replaces
Butorphanol
0.1 - 0.4
IV, IM, SC
medetomidine and is about twice
the potency
2) http://search.lib.unc.edu/search?R=UNCb6554539 Handbook of laboratory animal
science. Volume 1, Essential principles and practices, CRC Press, Boca Raton, FL, 20
Induction agents
Sevoflurane
Anesthetic agents
Ketamine
• Administered at 10 to 20 mg/kg IM produces recumbency within 3-5 minutes. Muscle
rigidity and excessive salivation is not uncommon.
• A wide range of sedatives are combined with ketamine to reduce these side effects and also
to reduce the amount of
ketamine through a synergism
• May cause increased heart rate, cardiac output, and blood pressure
Ketamine-acepromazine
Acepromazine 0.02 - 0.1 mg/kg IM added to ketamine 10 to 20 mg/kg IM, reduces the
muscle rigidity and produces status similar to general anesthesia
Ketamine-medetomidine
Medetomidine at 10 - 50 mcg/kg added to ketamine at 5 mg/kg produces deep sedation
and often recumbency. Butorphanol 0.1-0.4 mg/kg IM can be included in this combination
for better analgesia, sedation and muscle relaxation. (See “kitty magic” below under other
anesthetics). Medetomidine can be substituted by Xylazine 0.5 - 1.0 mg/kg, with shorter
duration of sedation as Xylazine has a shorter half life
Ketamine-Diazepam/Midazolam
This combination will produce less cardiovascular depression than medetomidineketamine Diazepam 0.25 mg/kg and ketamine 5.0 mg/kg given as IV bolus induces
anesthesia in 1-2 minutes Butorphanol 0.1 - 0.4 mg/kg IV can be included in this
combination for better analgesia and muscle relaxation.
Tiletamine and Zolazepam (Telazol)
•
•
•
•
Telazol up to 4.0 mg/kg IV to effect or IM produces deep sedation or light anesthesia
Side effects seen with ketamine-diazepam can be seen (emergence delirium)
Typically used to provide deep sedation in intractable cats
Other sedatives and opioids can be mixed to make the constituent more potent so as
to increase sedation, analgesia and duration of effect, and reduce side effects (e.g.
emergence delirium
•
Can be given IM (9.7 - 11.9 mg/kg) for procedures that require mild levels of analgesia.
IM injection is painful. Duration of anesthesia is 20-30 minutes.
Propofol
• Rapid induction and rapid elimination from the plasma and non-accumulative
• Cats are deficient of glucuronyl transferase, so the phenolic compound is less likely to get
metabolized than in dogs, and it has been shown that repeated dosing is associated with
some side effects ranging from Heinz body formation, delayed recovery, anorexia,
diarrhea, and malaise
• However, a single IV anesthetic induction dose will bear minimal risks
• 6.0 mg/kg IV is administered slowly titrated to effect to induce anesthesia, and in most premedicated cats one third to half of the calculated dose is sufficient to allow ET intubation
Endotracheal intubation
• The laryngeal spasm is easily provoked, so use of Lidocaine spray or short acting
muscle relaxant will facilitate the intubation
• In deep anesthesia laryngeal spasm does not occur, but this is not recommended as a routine
procedure. However, where emergency intubation is required following accidental overdose of
anesthetic, it is never necessary to use Lidocaine spray or muscle relaxant
• Attempts to carry out forceful intubation through tightly apposed vocal folds, even if initially
successful, will result in damage to the mucous membrane with edema and the danger
of post-extubation airway obstruction
• The larynx may also go into spasm after extubation, so endotracheal tubes should, if there
are no surgical contraindications, be removed without any previous deliberate lightening of
anesthesia and after careful aspiration of mucous from the airway
• A standard laryngoscope with an infant size blade is useful to view the laryngeal structure
• A 4.5 - 5.5 mm ET tube is suitable for most adult cats, and use of stylet can facilitate the
intubation
Maintenance
Isoflurane (Aerrane®, Forane®, IsoFlo®, Generics)
• Has replaced halothane both in human and veterinary medicine
• Quicker anesthetic stabilization and more rapid recovery than halothane due to its lower blood
gas solubility
• Isoflurane induces a dose-dependent cardiovascular depression. Induction 3.5% and
maintenance 1.5 - 2.0%
• Isoflurane causes peripheral vasodilation, which is responsible for a low arterial blood
pressure, but tissue looks more bright and pinky indicating better perfusion.
• Isoflurane is less prone to cause arrhythmia compared to halothane
Sevoflurane (Ultane®)
•
•
•
Anesthetic induction, recovery, and intraoperative modulation of anesthetic depths to be
notably faster than Isoflurane.
More expensive than Isoflurane, but it is getting less expensive.
Induces dose-dependent cardiovascular depression to a degree similar to that of
Isoflurane. Induction 4.0 - 4.5% and maintenance 3.0%
Desflurane (Suprane®)
• Lower blood/gas partition coefficient than the inhalants mentioned above, so control of
anesthetic depth is the quick among the volatile agents in clinical use
• The least potent among the volatile anesthetics (MAC = 8~11 %)
• Cardiovascular effects of Desflurane are similar with those of Isoflurane
• Expensive as Sevoflurane, and requires electronically controlled vaporizer which adds to the
inconvenience
Nitrous oxide
• Analgesia from N2O reduces inhalational anesthetic requirement therefore less
cardiovascular depression. It does not provide general anesthesia alone.
• However, the potency of nitrous oxide is only half that of human, so the sparing effect is not
as obvious Maintenance with 50-66% combined with Isoflurane and 33-50% oxygen. At least
30% oxygen should be given with nitrous.
• Use of this agent is not widespread
Total Intra-venous Anesthesia (TIVA)
•
•
•
•
•
•
•
Most commonly employed TIVA is based on propofol combination (±opioids;
benzodiazepines). The loading dose is in the order of 1.0 - 3.0 mg/kg as a bolus, and this
is followed by 2.0 - 6.0 mg/kg/hr
The recovery is very complete even following prolonged use.
It can be used to induce anesthesia with a single bolus dose, and then to maintain
anesthesia using constant rate infusion
These combinations are associated with minimal cardiopulmonary depression. However,
there are two main limitations to continued administration of intravenous anesthetics; the
arterial oxygenation and prolonged recovery.
Arterial oxygenation is always at risk with TIVA, particularly with combination of
Propofol and opioids, and it is recommended the animal still be intubated and put on
100% oxygen.
Tight anesthetic depth control is more difficult with TIVA so abrupt awakening during
anesthesia is more likely if one is not familiar with the technique and animal’s physiologic
reflexes unique to that (inhalant anesthetic provides advantage in this respect since
monitoring anesthetic concentration in breathing gases allows better anesthetic depth
control)
However, prolonged CRI propofol has increased likelihood of toxicity
Perioperative pain management
•
Traditionally use of opioids in cats within the perioperative period has not been as
•
•
•
•
widespread as in dogs. However, with more research and better pharmacologic
understanding, veterinarians have increased in prescribing opioids in cats
The CNS excitement can be minimized with concurrent administration of sedatives,
but other side effects such as respiratory depression, vomiting and dysphoria are
still possible
Behavioral changes associated with pain include decreased appetite, aggression,
indifference to the surrounding, and avoiding human contacts (see Pain notes)
In addition to opioids, α2-adrenergic agonists, local anesthetics, and nonsteroidal antiinflammatory drugs (NSAIDs) can be used to provide analgesia. Since cat is more
susceptible to develop NSAID-related toxicity, careful selection of
dosing and choice of drugs is necessary to avoid complications
Recovery
•
•
•
Cats are prone to develop hypothermia during recovery due to their small size
and this can significantly prolong the recovery and increase oxygen demand of
the muscle tissues.
Forced warm air blanket, circulating warm water blanket are very effective to
keep the body temperature, but other means such as hot rice socks, used
warm fluid bags, hair dryer and infrared lamps are useful external heat source
If animals pre-treated with reversible agents, recovery can be expedited by
reversing the drugs with specific antagonists.
Atipamezole and naloxone are two primary examples and they are best used titrated
to effect. Close observation should continue to avoid the animal relapsing into
sedation which may expose the animal to potential danger of aspiration or airway
obstruction
Analgesics
Agent
Dosage and Route
Duration
Notes
Buprenorphine
0.01 - 0.03 mg/kg
6 - 12 hours
good analgesia, there is a ceiling
effect
2 - 4 hours
moderate analgesia, may cause
some dysphoria
3 - 4 hours
good analgesia; lower dose
recommended
SC, IM, IV
Butorphanol
0.1 - 0.5 mg/kg
SC, IM, IV
Oxymorphone
0.05 - 0.1 mg/kg
SC, IM
Ketoprofen
2.0 mg/kg SC initial dose,
then 1.0 mg/kg q 24 hours
for subsequent doses
24 hours
good analgesia
Fentanyl
25µg patch applied to
clipped skin > 2.5kg. If
<2.5kg remove half the
backing (don’t cut patch)
several days
delay of 4 - 12 hours after applying
before effect takes place; If
inadequate pain control after 24
hours another analgesic may be
given, or another patch applied
Acetaminophen
NEVER
TOXIC
Non-Steroidal-Anti-inflammatory Drugs (NSAIDS)
There are few long term studies. NSAIS are extra label except meloxicam (one time use
injectable). The effect lasts about 24 hours.
Potential adverse affects: decreased platelet function (bleeding), gastrointestinal problems,
renal effects and may displace other drugs.
•
•
•
Ketoprofen: 2.0 mg/kg subcutaneously or 1.0 mg/kg orally
Carprofen: 1.0 – 4.0 mg/kg PO,SC
Meloxicam: 0.1 - 0.3 mg/kg SC,PO
Local anesthetics
Lidocaine and bupivacaine are used as local anesthetics. They have a narrower margin of
safety than in some other species. Lidocaine has potential CNS toxicity in cats and doses of
1 to 2.5mg/kg have been reported used in cats. Duration is for 1 to 2 hours. Doses of
bupivacaine less than 2mg/kg infiltrated SC are generally safe. Bupivacaine local blocks last
up to 3 - 12 hours.
Sedation
Diazepam 1.0 mg/kg IM, PO or IV
Acepromazine 0.05 - 0.1 mg/kg IM or IV; moderate sedation no analgesia, good relaxation
duration 60-120 minutes
Other Anesthetics
Pentobarbital: 25 – 30 mg/kg IV to effect for anesthesia
A combination of Dexmedetomidine, opioid and ketamine (called kitty magic, DKT or Triple combination)
Dexmedetomidine
mild/pre-anesthetic:
dose dependent
+ Butorphanol
0.004 - 0.006 mg/kg IM
+ Ketamine
+ 0.08 - 0.125 mg/kg IM
(induction; a.k.a. “kitty magic”)
+ 0.8 - 1.25 mg/kg IM
Profound/surgical:
0.025-0.0375 mg/kg IM
+ 0.4-0.6 mg/kg IM
+ 5.0 -7.5 mg/kg IM
“Kitty Magic” is a combination of equal volumes of Dexmedetomidine opioid and ketamine.
Concentrations used for these volumes are Butorphanol 10 mg/ml (or other opiates
Hydromorphine 2 mg/ml, Morphine 15mg/ml, or buprenorphine 0.3 mg/ml) Ketamine 100mg/ml
and Dexameetomidine 0.5 mg/ml.
In a 5.0 kg cat these agents are combined and administered IM: for surgical or painful
procedures
0.2cc Dexdomitor
0.2cc Ketamine
0.2cc Buprenorphine (or other opioid)
This combination provides 30 minutes of profound sedation and analgesia typically sufficient
to perform castration or other moderately painful procedures. Occasionally small amounts of
inhalant anesthesia by mask are required.
For simple non painful procedures in a 5.0 kg cat the dose can be reduced to
0.1cc Dexdomitor
0.1cc Ketamine
0.1ccTorbugesic
For invasive surgical procedures in a 5.0 kg cat such as ovariohysterectomy the dose of each
can be increased to 0.3 ml
Feline anesthesia and analgesia formulary: adopted from Dr. Lyon Lee, DVM, PhD, DACVA,
College of Veterinary Medicine, Oklahoma State University, Canine & Feline Anesthesia,
Veterinary Surgery I, VMED 7412.
Guinea Pig: Analgesia and Anesthesia formulary
The appropriate use of pain medications (analgesics) and anesthetics is a critical aspect of the
proper care and use of animals in research. Not only are they required by regulatory agencies
when an animal experiences more than momentary pain or discomfort, but minimization of
pain and stress typically results in better, more reproducible results. (Resources to Aid in
Recognition of Pain and Distress; Pain Relief in Animals)
The following is a listing of dosages for many of the more commonly employed analgesics
and anesthetics, and is meant as a guide during protocol preparation. In all cases, animals
may only be utilized with a currently IACUC approved protocol and any changes in the
analgesics or anesthetics must be accompanied by an amendment to the protocol even if the
medication is listed in this formulary.
The formulary is not meant to be an all-inclusive listing. If you would like to use a drug
not included in this listing, please contact a DLAM veterinarian to discuss its use in your
protocol.
Variability amongst models
The doses listed in the formulary were collected from the comparative medicine literature, but
these articles typically evaluate rodent drug doses using the most common strains or stocks
and healthy animals in the case of large animal trials. Moreover, it is well recognized there
can be considerable variation in the effect of drugs across individuals, strains and stocks, as
well as between sexes. Thus, it is critical to evaluate all animals, including strains or models
that you have created, to determine if the doses and/or drugs chosen are appropriate in your
study.
If your research focuses on a particular body system, it is also important to consider the
effect of the drug on that system. We encourage you to work with the Division of Laboratory
Animal Medicine (DLAM) veterinarians and/or review the literature for this information. There
have been a considerable number of articles in the comparative medicine literature focusing
on these considerations.
Selecting an appropriate analgesic or anesthetic
In most cases, the formulary includes information regarding the time of onset and duration of
effect. In general, the opiates are shorter-acting than Non-Steroidal Anti-inflammatory Drugs
(NSAIDs) and can be effectively used at the time of the procedure to dampen the induction of
the pain pathways. The pain and discomfort which occurs later is typically attributed to
inflammation, therefore, NSAIDs are used in many post-operative regimens. When using
multiple drugs, it is also critical to consider their potential interactions. For example, certain
opiates can actually antagonize each other’s actions, thus cancelling their beneficial effect.
Additional resources
Currently there are a number of excellent textbooks about laboratory animal anesthesia and
pain management available online through the UNC Library system. A select few are as
follows:
1) http://search.lib.unc.edu/search?R=UNCb6247400 Laboratory animal anesthesia, Flecknell,
P. A. Elsevier/Academic
Press, Amsterdam, Boston, 2009.
2) http://search.lib.unc.edu/search?R=UNCb6554539 Handbook of laboratory animal
science. Volume 1, Essential principles and practices, CRC Press, Boca Raton, FL,
2011.
Guinea Pig
Note: guinea pigs responses to many injectable anesthetics are highly variable. Atropine (0.05 mg/kg SC) is
recommended as pre-anesthetic to decrease bronchial and salivary secretions.
Anesthetics
Drug name
Dose (mg/kg)
Route
Frequency
Duration
Notes
Ketamine +
Acepromazine
100
5.0
IM
once
45 - 120 min
Ketamine +
Diazepam
Ketamine +
Xylazine
100
5.0
40
5.0
IM
once
30 - 45 min
IP, IM
once
30 min
Xylazine can be
reversed with
Yohimbine
Ketamine +
Xylazine +
Acepromazine
40
5.0 - 10
1.5
IM
once
30 - 45 min
Xylazine can be
reversed with
Yohimbine
Pentobarbital
37
IP
once
60 - 90 min
Urethane
1500
IV, IP
once
5 - 8 hours
Isoflurane
0.25 - 4.0% to
effect, by
vaporizer/mask
continuous/inhalation
anesthesia may
produce hypotension,
may irritate face
area/cause tearing
Sevoflurane
0.25 - 5.0% to
effect, by
vaporizer/mask
continuous/inhalation
anesthesia may
produce hypotension,
may irritate face
area/cause tearing
for non-survival
procedures only
Analgesics
Drug name
Dose (mg/kg)
Route
Frequency
Buprenorphine
0.05 - 0.1
SC
every 6 - 12 hours
Butorphanol
0.2 - 2.0
SC, IM, IP
every 2 - 4 hours
Carprofen
4.0
SC
every 24 hours
Flunixin
Meglumine
Ketoprofen
2.5
SC
every 12 hours
1.0
SC, IM
every 12 hours
References:
Flecknell, P., Laboratory Animal
Anesthesia, 3rd. ed, 2009. Longley, L.A.,
Anesthesia of Exotic Pets, 2008.
Duration
Notes
use with caution in
hypotensive animals
use with caution in
hypotensive animals
use with caution in
hypotensive animals
Rabbit: Analgesia and Anesthesia formulary
The appropriate use of pain medications (analgesics) and anesthetics is a critical aspect of the
proper care and use of animals in research. Not only are they required by regulatory agencies
when an animal experiences more than momentary pain or discomfort, but minimization of pain
and stress typically results in better, more reproducible results. (Resources to Aid in
Recognition of Pain and Distress; Pain Relief in Animals)
The following is a listing of dosages for many of the more commonly employed analgesics and
anesthetics, and is meant as a guide during protocol preparation. In all cases, animals may
only be utilized with a currently IACUC approved protocol and any changes in the analgesics or
anesthetics must be accompanied by an amendment to the protocol even if the medication is
listed in this formulary.
The formulary is not meant to be an all-inclusive listing. If you would like to use a drug not
included in this listing, please contact a DLAM veterinarian to discuss its use in your
protocol.
Variability amongst models
The doses listed in the formulary were collected from the comparative medicine literature, but
these articles typically evaluate rodent drug doses using the most common strains or stocks
and healthy animals in the case of large animal trials. Moreover, it is well recognized there can
be considerable variation in the effect of drugs across individuals, strains and stocks, as well
as between sexes. Thus, it is critical to evaluate all animals, including strains or models that
you have created, to determine if the doses and/or drugs chosen are appropriate in your study.
If your research focuses on a particular body system, it is also important to consider the
effect of the drug on that system. We encourage you to work with the Division of Laboratory
Animal Medicine (DLAM) veterinarians and/or review the literature for this information.
There have been a considerable number of articles in the comparative medicine literature
focusing on these considerations.
Selecting an appropriate analgesic or anesthetic
In most cases, the formulary includes information regarding the time of onset and duration of
effect. In general, the opiates are shorter-acting than Non-Steroidal Anti-inflammatory Drugs
(NSAIDs) and can be effectively used at the time of the procedure to dampen the induction of
the pain pathways. The pain and discomfort which occurs later is typically attributed to
inflammation, therefore, NSAIDs are used in many post-operative regimens. When using
multiple drugs, it is also critical to consider their potential interactions. For example, certain
opiates can actually antagonize each other’s actions, thus cancelling their beneficial effect.
Additional resources
Currently there are a number of excellent textbooks about laboratory animal anesthesia and
pain management available online through the UNC Library system. A select few are as
follows:
1) http://search.lib.unc.edu/search?R=UNCb6247400 Laboratory animal anesthesia,
Flecknell, P. A. Elsevier/Academic Press, Amsterdam, Boston, 2009.
2) http://search.lib.unc.edu/search?R=UNCb6554539 Handbook of laboratory animal
science. Volume 1, Essential principles and practices, CRC Press, Boca Raton, FL,
2011.
Rabbit Anesthesia
Drug
Dose (mg/kg)/Route
Frequency
Notes
Inhalation anesthesia
Isoflurane
1.0 - 3.0% inhalant
to effect, (up to
5.0% for induction)
as needed
mask or chamber induction without injected presedation may result in breath holding and injury
Sevoflurane
up to 8.0%
as needed
mask or chamber induction without injected presedation may result in breath holding and injury
Injectable anesthesia
KetamineXylazine
35 - 50 + 5.0 - 10
SC
may not produce surgical-plane anesthesia for
major procedures, if re-dosing use ketamine alone;
may be partially reversed with Atipamezole (1.0
mg/kg IM) or Yohimbine (0.2 mg/kg IV)
KetamineDexmedetomidine
35 - 50 + ~0.5
SC
may not produce surgical-plane anesthesia for
major procedures, if re-dosing use ketamine alone;
may be partially reversed with Atipamezole (1.0
mg/kg IM) or Yohimbine (0.2 mg/kg IV), can
cause bradycardia and apnea
KetamineXylazineAcepromazine
35 - 40 + 3.0 - 5.0 +
0.75 - 1.0
SC (in same syringe)
may not produce surgical-plane anesthesia for
major procedures, if re-dosing, use ketamine alone;
may be partially reversed with Atipamezole (1.0
mg/kg IM) or Yohimbine (0.2 mg/kg IV)
KetamineAcepromazine
50 + 1.0
IM
safe sedation, add more ketamine IV if needed to
top off for surgical anesthesia
Pentobarbital
(Nembutal)
20 – 160
IV
recommended
for terminal
procedures
only
apnea is common at anesthetic doses
Propofol
12 – 26
IV
continuous IV
only useful IV; respiratory depression upon
induction is common, tissue necrosis if given
extra-vascular, can be used for induction and
intubation followed by gas anesthesia
Local anesthesia
Lidocaine HCl
Bupivicaine
dilute to 0.5%, do
not exceed 7.0
mg/kg total dose, SC
or intra-incisional
dilute to 0.25%, do
not exceed 8.0
mg/kg total dose, SC
or intra-incisional
faster onset but shorter duration (<1 hour)
slower onset but longer duration (4 - 8 hours)
Rabbit Analgesia
Buprenorphine
0.02 - 0.1
SC, IP, IM
q 6 - 12 hours
Carprofen
4.0 - 5.0
SC
2.0 - 5.0
SC
0.01 - 0.3
Prescription-onlymedication
IM, SC
q 12 - 24 hours
Ketoprofen
Meloxicam
okay for routine use up to 72 hours, then consult
with veterinary staff before additional use; can
cause GI stasis
q 12 - 24 hours
q 24 hours for
4 days
Pre-anesthetics
Glycopyrrolate
0.01 IV
0.1 IM, SC
References:
Laboratory Animal Anesthesia, 3rd edition, P.
Flexnell, pp 204 - 212. Anesthesia of Exotic Pets, LA
Longley, pp 36 - 58.
anticholinergic
Swine: Analgesia and Anesthesia formulary
The appropriate use of pain medications (analgesics) and anesthetics is a critical aspect of the
proper care and use of animals in research. Not only are they required by regulatory agencies
when an animal experiences more than momentary pain or discomfort, but minimization of pain
and stress typically results in better, more reproducible results. (Resources to Aid in
Recognition of Pain and Distress; Pain Relief in Animals)
The following is a listing of dosages for many of the more commonly employed analgesics and
anesthetics, and is meant as a guide during protocol preparation. In all cases, animals may
only be utilized with a currently IACUC approved protocol and any changes in the analgesics
or anesthetics must be accompanied by an amendment to the protocol even if the medication
is listed in this formulary.
The formulary is not meant to be an all-inclusive listing. If you would like to use a drug
not included in this listing, please contact a DLAM veterinarian to discuss its use in your
protocol.
Variability amongst models
The doses listed in the formulary were collected from the comparative medicine literature, but
these articles typically evaluate rodent drug doses using the most common strains or stocks
and healthy animals in the case of large animal trials. Moreover, it is well recognized there can
be considerable variation in the effect of drugs across individuals, strains and stocks, as well
as between sexes. Thus, it is critical to evaluate all animals, including strains or models that
you have created, to determine if the doses and/or drugs chosen are appropriate in your study.
If your research focuses on a particular body system, it is also important to consider the effect
of the drug on that system. We encourage you to work with the Division of Laboratory Animal
Medicine (DLAM) veterinarians and/or review the literature for this information. There have
been a considerable number of articles in the comparative medicine literature focusing on
these considerations.
Selecting an appropriate analgesic or anesthetic
In most cases, the formulary includes information regarding the time of onset and duration of
effect. In general, the opiates are shorter-acting than Non-Steroidal Anti-inflammatory Drugs
(NSAIDs) and can be effectively used at the time of the procedure to dampen the induction of
the pain pathways. The pain and discomfort which occurs later is typically attributed to
inflammation, therefore, NSAIDs are used in many post-operative regimens. When using
multiple drugs, it is also critical to consider their potential interactions. For example, certain
opiates can actually antagonize each other’s actions, thus cancelling their beneficial effect.
Additional resources
Currently there are a number of excellent textbooks about laboratory animal anesthesia and
pain management available online through the UNC Library system. A select few are as
follows:
1) http://search.lib.unc.edu/search?R=UNCb6247400 Laboratory animal anesthesia, Flecknell,
P. A. Elsevier/Academic
Press, Amsterdam, Boston, 2009.
2) http://search.lib.unc.edu/search?R=UNCb6554539 Handbook of laboratory animal
science. Volume 1, Essential principles and practices, CRC Press, Boca Raton, FL,
2011.
Swine
Note that all of these doses are approximations and must be titrated to the animal’s strain, age, sex and individual
responses. Significant departures from these doses should be discussed with a veterinarian. Doses will also vary
depending on what other drugs are being administered concurrently.
Drug
Dose (mg/kg) and Route
Frequency
Notes
Recommended:
Isoflurane
1.0 - 3.0% inhalant to
effect (up to 5.0% for
induction)
whenever general
anesthesia is required
concurrent preemptive analgesia is
recommended for survival surgery;
must use precision vaporizer, mask
induction is possible with very
small pigs
Recommended:
Sevoflurane
1.0 - 3.0% inhalant to
effect (up to 8.0% for
induction)
whenever general
anesthesia is required
concurrent preemptive analgesia is
recommended for survival surgery;
must use precision vaporizer, mask
induction is possible with very
small pigs
Nitrous oxide (N2O)
up to 60% with oxygen
whenever deep sedation
or general anesthesia is
required
not acceptable for surgery as sole
agent - usually used with inhalant
anesthetic to potentiate effect and
lower required dose
Inhalation anesthetics
Dissociative (Ketamine and/or Telazol®) combinations
Recommended:
Ketamine-Xylazine
15 - 20 + 1.1 - 2.2 IM (in
same syringe)
prior to general
anesthesia
can result in large volumes consider
using Telazol® or Telazol®
combination as an alternative
Recommended:
Telazol® alone (combo
of tiletamine and
zolazepam in a vial
reconstituted with 5 ml
sterile water, contains 50
mg/ml of each; dose listed
is based on 100mg/ml of
combined active
ingredients)
Ketamine
6.0 - 8.0
IM (= 0.06 - 0.08 ml/kg)
for sedation or preanesthesia
Telazol® must be stored
refrigerated once reconstituted
11 - 33
IM, SC
any time sedation is
required
not typically used as sole agent in
swine
Telazol®-KetamineXylazine (TKX)
~ 1 ml/50 lbs. BW
IM
for sedation or preanesthesia
Telazol® must be stored
refrigerated once reconstituted:
to mix: reconstitute Telazol® with
2.5 ml, large animal Xylazine
(100mg/ml) and 2.5 ml ketamine
(100mg/ml) instead of water.
Xylazine - Telazol®
2.2 - 8.8 + 2.0 - 8.8
for sedation or preanesthesia
Telazol® must be stored
refrigerated once reconstituted: to
mix: reconstitute Telazol® with 5
ml. of ‘large animal Xylazine
(100mg/ml) instead of water
Ketamine-Diazepam
(continuous infusion)
~ 0.2 + ~ 0.0005
mg/kg/hr
sedation for imaging or
other prolonged
procedures – not adequate
anesthesia for surgical
procedures
not adequate anesthesia for surgical
procedures
~1.0
SC, IM
any time medetomidine
more specific for medetomidine
or Xylazine has been used than for Xylazine (as a general rule,
atipamezole is dosed at the same
volume as medetomidine, though
they are manufactured at different
concentrations)
Reversal agents
Atipamezole
Other injectable anesthetics and tranquilizers
Pentobarbital (Nembutal)
20 - 60 IV single or
intermittent bolus, or
2.0 - 20 mg/kg/hour IV
continuous infusion
recommended for
terminal/acute procedures
only, with booster doses
as needed
consider supplemental analgesia
(opioid or NSAID) for invasive
procedures
Propofol
16 - 22
IV
as induction agent, prior
to general anesthesia with
pentobarbital or inhalant
respiratory depression upon
induction is possible
Acepromazine
0.08 - 1.1
IM, SC
may be used whenever
ketamine combinations
are used
usually only used in conjunction
with anesthetics such as ketamine:
acepromazine is a tranquilizer and
does not confer analgesia
Drug
Dose (mg/kg) and Route
Frequency
Notes
Recommended:
Buprenorphine
0.005 - 0.1
SC (usually use 0.05 - 0.1
for major surgery)
used pre-operatively for
preemptive analgesia and
post-operatively every 4 12 hours
when used as sole analgesic, typical
regimen is: once at time of
procedure, second dose will be
administered 4 - 6 hours
later; additional doses every 8 - 12
hours as needed, consider multimodal analgesia with NSAID and
local analgesic
Butorphanol
0.1 - 0.5
SC
used pre-operatively for
preemptive analgesia and
post-operatively every 46 hours
for major procedures, require more
frequent dosing than 12 hour
intervals; consider multi-modal
analgesia with a NSAID
Oxymorphone
0.01 - 0.2
IM or SC
used pre-operatively for
preemptive analgesia and
post-operatively every 3 4 hours, or for ‘rescue
analgesia’ when
buprenorphine is not
potent enough
more potent but shorter duration
than buprenorphine or butorphanol
Opioid analgesia
Fentanyl patch
50 µg/hr
place patch 24 hours in
advance of surgery and
maintain for up to 3 days
when severe post-surgical pain is
anticipated
Non-steroidal anti-inflammatory analgesia (NSAID) -- prolonged use my cause renal, gastrointestinal, or other
problems
Recommended:
Carprofen
2.0 - 4.0
SC, PO
used pre-operatively for
preemptive analgesia and
post-operatively once or
twice every 24 hours for
up to 4 days
depending on the procedure, may be
used as sole analgesic, or as multimodal analgesia with buprenorphine
Meloxicam
0.2 - 0.4
PO, IM, SC
used pre-operatively for
preemptive analgesia and
post-operatively every 24
hours for up to 4 days
depending on the procedure, may be
used as sole analgesic, or as multimodal analgesia with buprenorphine
Ketoprofen
~1.0 - 3.0
SC, IM
used pre-operatively for
depending on the procedure, may be
preemptive analgesia and used as sole analgesic, or as multipost-operatively every 24 modal analgesia with buprenorphine
hours for up to 4 days
Ketorolac
0.5 - 1.0 mg/kg
SC, IM, PO
used pre-operatively for
preemptive analgesia and
post-operatively once or
twice every 24 hours for
up to 4 days
depending on the procedure, may be
used as sole analgesic, or as multimodal analgesia with buprenorphine
Aspirin
10 - 20 mg
PO
consult veterinarian
every 4 - 12 hours
enteric coated are best
consult veterinarian
consult veterinarians
Flunixin
Local anesthetic/analgesics--lidocaine and bupivacaine may be combined in one syringe for rapid onset and
long duration analgesia
Lidocaine HCl
may dilute to 0.5 -1%
(=10mg/ml), may be
mixed in same syringe
with bupivacaine,
SC, intra-incisional
use locally before making faster onset than bupivacaine but
surgical incision
short (<1 hour) duration of action
Bupivacaine
may dilute to 0.25 - 0.5%, use locally before making slower onset than lidocaine but
may be mixed in same
surgical incision
longer (~4 - 8 hours) duration of
syringe with lidocaine,
action
SC, intra-incisional
References
Compiled with reference to UCSF, Dartmouth, ISU, Case Western Reserve Universities and
M. Swindle Sinclair
Research Technical Bulletin “Anesthesia and Analgesia in Swine”