Buprenorphine in Cats: Is it an effective postoperative analgesic?

Evaluation of the perioperative

analgesic efficacy of buprenorphine,

compared with butorphanol, in cats

Leon N. Warne, DVM; Thierry Beths, DMV, PhD; Merete Holm, DVM;

Jennifer E. Carter, DVM; Sébastien H. Bauquier, DMV

J Am Vet Med Assoc 2014;245:195–202

Summary

In this study the authors compared the analgesic efficacy of buprenorphine vs. butorphanol for cats undergoing ovariohysterectomy.  Cats were divided into 2 groups: one group was premedicated with buprenorphine in combination with medetomidine, and the other group premedicated with butorphanol and medetomidine prior to general anesthesia. A “validated multidimensional composite pain scale” was used to evaluate pain in all cats, and rescue analgesia (methadone and meloxicam) was administered if the score went above a predetermined level (>9 of 28 indicating moderate to severe pain).

The authors hypothesized that buprenorphine would provide superior postoperative analgesia to cats undergoing ovariohysterectomy.

In phase 1 of the study only a premedication dose of the buprenorphine or butorphanol was given. This phase of the study had to be stopped after 10 cats since 9 of them required rescue analgesia immediately postoperatively.

In phase 2 of the study the experimental methods were the same as phase 1 except a second dose of buprenorphine or butorphanol was given during incision closure. In this phase of the study all cats receiving butophanol required rescue analgesia, whereas none of the cats receiving buprenorphine required rescue analgesia.

Commentary

Two key points can be taken from this study:

• Buprenorphine was clearly more efficacious than butorphanol in providing postoperative analgesia.
• After premedicating with buprenorphine, a second dose was required prior to anesthetic recovery (during incision closure) to provide sufficient analgesia.

This is a very practical and well-designed study that has important clinical implications. Buprenorphine appears to be an effective postoperative analgesic for cats and should be considered as a useful element of the veterinary surgeon’s postoperative care in cats. Butorphanol was not an effective analgesic in the study and although possibly useful in other clinical situations, cannot be recommended for cats undergoing ovariohysterectomy or other surgeries with similar pain levels.


What is your experience with buprenorphine in cats as an analgesic?