Buprenorphine analgesia reduces survival with ALM resuscitation in a rat model of uncontrolled hemorrhage: concerns for trauma-related research

Letson, Hayley, and Dobson, Geoffrey (2020) Buprenorphine analgesia reduces survival with ALM resuscitation in a rat model of uncontrolled hemorrhage: concerns for trauma-related research. Shock. (In Press)

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Abstract

The effect of analgesia on physiological systems has received little attention in trauma research. Our aim was to examine the effect of two different analgesics, buprenorphine and carprofen, on adenosine, lidocaine, and magnesium (ALM) resuscitation in a rat model of laparotomy and non-compressible hemorrhage. Male Sprague-Dawley rats were randomly assigned to Saline Carprieve, ALM Carprieve, Saline Buprenorphine, or ALM Buprenorphine (all n=10). Anesthetized animals underwent surgical placement of chronic catheters and laparotomy, then hemorrhage was induced by liver resection (60% left lateral lobe). After 15 min, animals received 0.7 mL/kg 3% NaCl�ALM bolus, and after 60 min, 4 h 0.5 mL/kg/h 0.9% NaCl�ALM drip with 72 h monitoring. Carprieve groups received 5 mg/kg s.c. every 24 h and Buprenorphine groups received 0.05 mg/kg Temgesic every 6 to 12 h. Survival, hemodynamics, blood chemistry, and hematology were measured. ALM Carprieve led to 100% survival compared to 40% survival in ALM Buprenorphine group (P=0.004). In Saline-treated rats, buprenorphine reduced median survival time by 91% (22 h to 2 h). Recovery of mean arterial pressure (MAP) at 60 min was lower in the buprenorphine versus Carprieve groups (83% vs. 101% for ALM and 62% vs. 95% for Saline groups). Buprenorphine was also associated with higher blood lactates and potassium. No analgesic-related differences were found in total white cells, lymphocytes, platelet count, hyperthermia, weight loss, or pica. We conclude that reduced survival and MAP recovery appears to a buprenorphine effect on cardiovascular function. Until the underlying mechanisms can be elucidated, buprenorphine should be used with caution in small and possibly large models of trauma and shock.

Item ID: 63865
Item Type: Article (Research - C1)
ISSN: 1540-0514
Keywords: ALM, analgesia, buprenorphine, Carprieve, carprofen, non-steroidal anti-inflammatory drug, rodent, Temgesic
Copyright Information: Copyright © 2020 by the Shock Society
Funders: USSOCOM
Projects and Grants: W81XWH-USSOCOM-BAA-15-1
Date Deposited: 21 Aug 2020 05:48
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1116 Medical Physiology > 111699 Medical Physiology not elsewhere classified @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110305 Emergency Medicine @ 40%
11 MEDICAL AND HEALTH SCIENCES > 1199 Other Medical and Health Sciences > 119999 Medical and Health Sciences not elsewhere classified @ 20%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920118 Surgical Methods and Procedures @ 20%
92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified @ 80%
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