Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horses

Abstract Background Atlantoaxial (AA) cerebrospinal fluid (CSF) collection in standing horses utilizes the controlled narcotic morphine, thereby limiting feasibility in field practice settings. Objectives To compare AA CSF collection time and reaction scores in horses sedated with morphine‐containin...

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Main Authors: Gemma Cock, Zachary Blakeney, Jorge A. Hernandez, Sally DeNotta
Format: Article
Language:English
Published: Wiley 2022-09-01
Series:Journal of Veterinary Internal Medicine
Subjects:
Online Access:https://doi.org/10.1111/jvim.16450
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author Gemma Cock
Zachary Blakeney
Jorge A. Hernandez
Sally DeNotta
author_facet Gemma Cock
Zachary Blakeney
Jorge A. Hernandez
Sally DeNotta
author_sort Gemma Cock
collection DOAJ
description Abstract Background Atlantoaxial (AA) cerebrospinal fluid (CSF) collection in standing horses utilizes the controlled narcotic morphine, thereby limiting feasibility in field practice settings. Objectives To compare AA CSF collection time and reaction scores in horses sedated with morphine‐containing and opioid‐free sedation protocols: detomidine + morphine (DM), detomidine + xylazine (DX), detomidine + detomidine (DD), detomidine alone (D0); To develop a novel method for assessing sedation in standing horses using open‐source motion‐tracking software. Animals Six healthy adult horses. Methods Randomized crossover. Atlantoaxial CSF collections were performed weekly for 4 weeks. Horses received sedation protocols in random order. Procedure time and procedure reaction scores were compared between groups using Friedman test. Associations between procedure reaction scores and motion tracking variables (total distance and farthest excursion traveled by horse's head) were examined using scatter diagrams and linear regression. Results Procedure times were lower in horses sedated with DX (median: 36 seconds; range: 28 − 188), compared to D0 (121; 35 − 196; P = 0.04). Procedure reaction scores were lower in horses sedated with DX (median 1.0, range 1.0 to 2.0), or DM (1.8; 1.3 − 3.0) compared to DO (3.0; 2.3 − 3.0; P = .03). Reactions to dura mater puncture were recorded in 3 of 6 horses in D0 and DD groups, and 0 of 6 horses in DX and DM groups. Positive associations were observed between reaction score vs total distance or farthest excursion distance from baseline. Conclusions and Clinical Importance Both opioid‐free and morphine‐containing sedation protocols are acceptable for AA CSF collection. Motion‐tracking software represents a novel method for assessing sedation in standing horses.
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spelling doaj.art-fa305a193540406e81dcf8bf193ee59f2022-12-22T03:21:32ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762022-09-013651812181910.1111/jvim.16450Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horsesGemma Cock0Zachary Blakeney1Jorge A. Hernandez2Sally DeNotta3Large Animal Clinical Sciences University of Florida College of Veterinary Medicine Gainesville Florida USALarge Animal Clinical Sciences University of Florida College of Veterinary Medicine Gainesville Florida USALarge Animal Clinical Sciences University of Florida College of Veterinary Medicine Gainesville Florida USALarge Animal Clinical Sciences University of Florida College of Veterinary Medicine Gainesville Florida USAAbstract Background Atlantoaxial (AA) cerebrospinal fluid (CSF) collection in standing horses utilizes the controlled narcotic morphine, thereby limiting feasibility in field practice settings. Objectives To compare AA CSF collection time and reaction scores in horses sedated with morphine‐containing and opioid‐free sedation protocols: detomidine + morphine (DM), detomidine + xylazine (DX), detomidine + detomidine (DD), detomidine alone (D0); To develop a novel method for assessing sedation in standing horses using open‐source motion‐tracking software. Animals Six healthy adult horses. Methods Randomized crossover. Atlantoaxial CSF collections were performed weekly for 4 weeks. Horses received sedation protocols in random order. Procedure time and procedure reaction scores were compared between groups using Friedman test. Associations between procedure reaction scores and motion tracking variables (total distance and farthest excursion traveled by horse's head) were examined using scatter diagrams and linear regression. Results Procedure times were lower in horses sedated with DX (median: 36 seconds; range: 28 − 188), compared to D0 (121; 35 − 196; P = 0.04). Procedure reaction scores were lower in horses sedated with DX (median 1.0, range 1.0 to 2.0), or DM (1.8; 1.3 − 3.0) compared to DO (3.0; 2.3 − 3.0; P = .03). Reactions to dura mater puncture were recorded in 3 of 6 horses in D0 and DD groups, and 0 of 6 horses in DX and DM groups. Positive associations were observed between reaction score vs total distance or farthest excursion distance from baseline. Conclusions and Clinical Importance Both opioid‐free and morphine‐containing sedation protocols are acceptable for AA CSF collection. Motion‐tracking software represents a novel method for assessing sedation in standing horses.https://doi.org/10.1111/jvim.16450cerebrospinal fluidCSFequine neurologyequine sedationneurology diagnostics
spellingShingle Gemma Cock
Zachary Blakeney
Jorge A. Hernandez
Sally DeNotta
Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horses
Journal of Veterinary Internal Medicine
cerebrospinal fluid
CSF
equine neurology
equine sedation
neurology diagnostics
title Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horses
title_full Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horses
title_fullStr Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horses
title_full_unstemmed Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horses
title_short Opioid‐free sedation for atlantoaxial cerebrospinal fluid collection in adult horses
title_sort opioid free sedation for atlantoaxial cerebrospinal fluid collection in adult horses
topic cerebrospinal fluid
CSF
equine neurology
equine sedation
neurology diagnostics
url https://doi.org/10.1111/jvim.16450
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AT sallydenotta opioidfreesedationforatlantoaxialcerebrospinalfluidcollectioninadulthorses