The Effects of Mepivacaine Hydrochloride on Antimicrobial Activity and Mechanical Nociceptive Threshold During Amikacin Sulfate Regional Limb Perfusion in the Horse

Aimée C. Colbath, Luke Anthony Wittenburg, Jenifer R. Gold, C. Wayne McIlwraith, Valerie J. Moorman

Research output: Contribution to journalArticle

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Abstract

Objective: To determine the effect of intravenous regional limb perfusion (IVRLP) with a combination of mepivacaine hydrochloride and amikacin sulfate on synovial fluid amikacin sulfate concentration, antimicrobial activity, and mechanical nociceptive threshold (MNT). Study Design: Experimental study. Animals: Healthy adult horses (n=9). Methods: One IVRLP treatment was randomly administered by cephalic vein of each limb: amikacin alone (1 g amikacin in 60 mL saline) or amikacin with mepivacaine (1 g amikacin and 500 mg mepivacaine in 60 mL saline). Opposite treatments were repeated after a 24 hour wash-out period. Amikacin concentration and antimicrobial activity were determined for synovial fluid from middle carpal joints at tourniquet removal and 30 minutes following. Zone of inhibition was determined for Staphylococcus aureus and Escherichia coli. MNT was determined at 3 dorsal metacarpal locations prior to and after sedation, after Esmarch tourniquet application, and 30 minutes after IVRLP prior to and after tourniquet removal. Results: Two limbs from each treatment group were removed because of undetectable amikacin concentrations for a total of 14 data sets analyzed. Synovial fluid amikacin concentrations and zone of inhibition were not significantly different between treatments at any time point. MNT were significantly increased 30 minutes after IVRLP prior to and following tourniquet removal using amikacin and mepivacaine (median, range; 40.0 µg/mL, 38.7–40.0 and 40.0, 25.8–40.0, respectively) compared to amikacin alone (19.5 µg/mL, 18.7–25.6 and 15.3, 13.2–20.5, respectively). Conclusion: Addition of mepivacaine to amikacin for IVRLP in the horse as a means of providing analgesia without decreasing antimicrobial activity.

Original languageEnglish (US)
Pages (from-to)798-803
Number of pages6
JournalVeterinary Surgery
Volume45
Issue number6
DOIs
StatePublished - Aug 1 2016
Externally publishedYes

Fingerprint

Mepivacaine
amikacin
Amikacin
limbs (animal)
Horses
sulfates
Extremities
Perfusion
anti-infective agents
horses
tourniquets
Tourniquets
synovial fluid
Synovial Fluid
Carpal Joints
metacarpus
Metacarpal Bones
sedation
Therapeutics
analgesia

ASJC Scopus subject areas

  • veterinary(all)

Cite this

The Effects of Mepivacaine Hydrochloride on Antimicrobial Activity and Mechanical Nociceptive Threshold During Amikacin Sulfate Regional Limb Perfusion in the Horse. / Colbath, Aimée C.; Wittenburg, Luke Anthony; Gold, Jenifer R.; McIlwraith, C. Wayne; Moorman, Valerie J.

In: Veterinary Surgery, Vol. 45, No. 6, 01.08.2016, p. 798-803.

Research output: Contribution to journalArticle

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abstract = "Objective: To determine the effect of intravenous regional limb perfusion (IVRLP) with a combination of mepivacaine hydrochloride and amikacin sulfate on synovial fluid amikacin sulfate concentration, antimicrobial activity, and mechanical nociceptive threshold (MNT). Study Design: Experimental study. Animals: Healthy adult horses (n=9). Methods: One IVRLP treatment was randomly administered by cephalic vein of each limb: amikacin alone (1 g amikacin in 60 mL saline) or amikacin with mepivacaine (1 g amikacin and 500 mg mepivacaine in 60 mL saline). Opposite treatments were repeated after a 24 hour wash-out period. Amikacin concentration and antimicrobial activity were determined for synovial fluid from middle carpal joints at tourniquet removal and 30 minutes following. Zone of inhibition was determined for Staphylococcus aureus and Escherichia coli. MNT was determined at 3 dorsal metacarpal locations prior to and after sedation, after Esmarch tourniquet application, and 30 minutes after IVRLP prior to and after tourniquet removal. Results: Two limbs from each treatment group were removed because of undetectable amikacin concentrations for a total of 14 data sets analyzed. Synovial fluid amikacin concentrations and zone of inhibition were not significantly different between treatments at any time point. MNT were significantly increased 30 minutes after IVRLP prior to and following tourniquet removal using amikacin and mepivacaine (median, range; 40.0 µg/mL, 38.7–40.0 and 40.0, 25.8–40.0, respectively) compared to amikacin alone (19.5 µg/mL, 18.7–25.6 and 15.3, 13.2–20.5, respectively). Conclusion: Addition of mepivacaine to amikacin for IVRLP in the horse as a means of providing analgesia without decreasing antimicrobial activity.",
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AU - Gold, Jenifer R.

AU - McIlwraith, C. Wayne

AU - Moorman, Valerie J.

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