Pharmacokinetics of buprenorphine following constant rate infusion for postoperative analgesia in dogs undergoing ovariectomy

Objective To investigate the pharmacokinetics of buprenorphine and its main active metabolite, norbuprenorphine, after administration of an intravenous loading dose followed by constant rate infusion (CRI) in dogs. Study design Prospective, clinical study. Animals A total of seven healthy dogs undergoing elective ovariectomy. Methods Buprenorphine was administered as a loading dose (intravenous bolus of 15 µg kg-1) followed by CRI (2.5 µg kg-1 hour-1 for 6 hours). Moreover, intraoperative analgesia was supplemented by an intramuscular carprofen (4 mg kg-1) injection, administered prior to surgery, and by lidocaine, administrated through subcutaneous infiltration and through a splash on the ovarian vascular pedicle during surgery. Pain and sedation were scored for all animals throughout the 24hour study period and rescue analgesia was administered when a visual analogue scale score was > 40 mm. Blood samples were collected from a jugular catheter at regular intervals, and plasma concentrations of buprenorphine and norbuprenorphine were determined by a validated liquid chromatographyetandem mass spectrometry method. Results Buprenorphine showed a twocompartment kinetic profile. Maximum concentration was 23.92 ± 8.64 ng mL-1 at 1 minute (maximum time); elimination half-life was 41.87 ± 17.35 minutes; area under the curve was 486.68 ± 125.66 minutes ng-1 mL-1; clearance was 33.61 ± 13.01 mL minute-1 kg-1, and volume of distribution at steady state was 1.77 ± 0.50 L kg-1. In no case was rescue analgesia required. Norbuprenorphine resulted below the lower limit of quantification in almost all samples. Conclusions and clinical relevance The results suggest that a buprenorphine CRI can be a useful tool for providing analgesia in postoperative patients, considering its minor side effects and the advantages of a CRI compared to frequent boluses. The negligible contribution of norbuprenorphine to the therapeutic effect was confirmed.