In today's VETgirl online veterinary continuing education blog, Dr. Garret Pachtinger, DACVECC reviews the top 3 new analgesia and anesthesia drugs you should know about for your veterinary patients. Veterinary team members understand the importance of analgesia in our patients not only to improve patient care and comfort, but to decrease morbidity and mortality.
More now than ever with the opioid crisis and opioid shortage, veterinary professionals must be alert for newer medications which they can use in their anesthesia and analgesic protocols to improve patient care. In this blog we will review 3 of the newer medications available to veterinary professionals.
1) Recuvyra: Recuvyra is a transdermal fentanyl solution that delivers sustained concentrations of fentanyl for 4 days following a single application. This is available and currently approved for use in the dog only. Recuvyra is a highly concentrated form of fentanyl which is applied to the skin on the dorsal scapular area. Keep in mind, this product is a fentanyl formulation which is a Class II controlled substance. Knowing that it is a long-acting fentanyl product, it's use is not without risk. Dogs that have been treated with Recuvyra should be isolated from children for 72 hours from the time of application. Adults are also advised to avoid contact with the application site for the 72-hour time span. VETgirl's take...understanding the patient population that is likely to receive Recuvyra (e.g. the TPLO or orthopedic fracture repair), many of these patient will recover in the hospital for several days minimizing client exposure during this 72 hour period of time. Please see the full Prescribing Information for more detail. NOTE: This product is no longer available from Elanco. **
2) NOCITA - Nocita is an an extended-release bupivacaine product which has become popular recently with the concern for the opioid shortage. Nocita is a liposome injectable suspension used in the management of post-operative pain in dogs and cats. It is a local anesthetic that is injected directly into the surgical site, providing local pain control only where it is needed. Keep in mind, this medication is not without risk It is not recommended for use in breeding, pregnant or lactating patients. It should not be administered by intravenous or intra-arterial injection. Adverse reactions may include discharge from incision, incisional inflammation and vomiting. Please see the full Prescribing Information for more detail.
3) Remifentanil - Remifentanil is a synthetic opioid with direct action on mu opioid receptors. It has an ultrashort duration of action and elimination independent of hepatic or renal function. The half-life is approximately 6 minutes making Remifentanil an ideal choice for CRI delivery. The down-side? It's fairly expensive ($120/vial) and it must be administered as a constant rate infusion due to its extremely short duration of action. Please see the full Prescribing Information for more detail.
As you would expect, the VETgirl team is very passionate about staying up to date on the veterinary literature and new treatment options that become available for our patients to improve our care, and their quality of life!