title: Effects of peri-operative morphine administration during halothane anaesthesia in horses.
abstract: OBJECTIVE
  To study the effects of morphine on haemodynamic variables, blood gas values and the requirement for additional anaesthetic drugs in horses undergoing surgery.
  
  
  METHODS
  Prospective randomized study.
  
  
  METHODS
  Thirty-eight client-owned horses, ASA(American Society of Anesthesiologists) category I or II, undergoing elective surgical procedures, were studied. Horses were divided between two groups, and were paired according to operation, anaesthetist, body position during surgery, mass and breed. Group M+ received morphine by intravenous (IV) injection (0.15 mg kg(-1)) before induction of anaesthesia and then by infusion (0.1 mg kg(-1) hour(-1)) throughout anaesthesia. Group M- received the same anaesthetic technique (pre-anaesthetic medication with romifidine (100 microg kg(-1)) IV; induction with ketamine (2.2 mg kg(-1)) and diazepam (50 microg kg(-1)) IV; maintenance with halothane), except that morphine was excluded. Both groups received flunixin IV (1.1 mg kg(-1)) before surgery. Both groups also received 50% nitrous oxide for the first 10 minutes of anaesthesia. During anaesthesia, end-tidal halothane was maintained at 0.9% (+/-0.1%) in both groups. Heart rate (HR) and respiratory rate (fr), systolic, mean and diastolic arterial pressures were recorded every 5 minutes. Arterial blood samples were analysed every 20 minutes. Additional anaesthetics (ketamine and midazolam) were administered whenever the horse moved. Dobutamine was infused to maintain mean arterial pressure (MAP) > 58 mm Hg, but was discontinued when MAP reached 68 mm Hg. Mechanical ventilation was imposed when PaCO(2) exceeded 9.3 kPa (70 mm Hg).
  
  
  RESULTS
  Haemodynamic data (HR and MAP) and blood gas measurements were analysed using repeated measure analysis using a mixed covariance pattern model (SAS version 8.2). A Student's t-test was used to investigate differences between groups in the doses of additional anaesthetics required. There were no significant differences between M+ or M- groups in MAP (p = 0.65), HR (p = 0.74), PaO2 (p = 0.40) or PaCO2 (p = 0.20). Fewer horses in the M+ group received additional anaesthetics (15.8% compared to 21.1% in M- group), and the mean dose of ketamine required was higher in the M- group (mean +/- SD: M-, 0.93 +/- 0.70; M+, 0.45 +/- 0.17). These differences were not statistically significant (p = 0.28).
  
  
  CONCLUSIONS
  Pre-anaesthetic and peri-operative morphine administration is not associated with significant haemodynamic or ventilatory changes. Horses receiving morphine tended to receive fewer and lower doses of additional anaesthetic drugs, although this was not statistically significant.
authors.affiliation: Department of Veterinary Clinical Studies, Royal (Dick) School of Veterinary Studies, Easter Bush Veterinary Centre, Easter Bush, Roslin, Midlothian EH25 9RG, UK. Louise.Clark@aht.org.uk
authors.forename: Louise
authors.initials: L
authors.lastname: Clark
authors.forename: R Eddie
authors.initials: RE
authors.lastname: Clutton
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Blissitt
authors.forename: Margo E
authors.initials: ME
authors.lastname: Chase-Topping
mesh_terms: D000759:Adjuvants, Anesthesia / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000758:Anesthesia / Q000662:veterinary*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D000818:Animals; D001784:Blood Gas Analysis / Q000662:veterinary; D017558:Elective Surgical Procedures / Q000662:veterinary; D005260:Female; D006221:Halothane / Q000008:administration & dosage; D006439:Hemodynamics / Q000187:drug effects; D006736:Horses / Q000502:physiology* / Q000601:surgery; D007275:Injections, Intravenous / Q000662:veterinary; D007431:Intraoperative Complications / Q000662:veterinary; D008297:Male; D009020:Morphine / Q000008:administration & dosage*; D019990:Perioperative Care / Q000662:veterinary; D011446:Prospective Studies; D016896:Treatment Outcome
chemical_list: D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D009020:Morphine; D006221:Halothane