Comparison of premedication with buprenorphine or methadone with meloxicam for postoperative analgesia in dogs undergoing orthopaedic surgery.

J Small Anim Pract. 2013 Jul 13;
Hunt JR, Attenburrow PM, Slingsby LS, Murrell JC

To determine whether methadone, administered before orthopaedic surgery, results in improved postoperative analgesia compared to buprenorphine.Thirty-eight dogs undergoing orthopaedic surgeries (the majority being tibial tuberosity advancement or elbow arthrotomy) were premedicated with 0?·?03?mg/kg acepromazine and either 20?µg/kg buprenorphine or 0?·?5?mg/kg methadone, intramuscularly, allocated randomly. Anaesthesia was induced with propofol intravenously to effect and maintained with isoflurane in oxygen. 0?·?2?mg/kg meloxicam was administered at anaesthetic induction. Sedation was assessed by means of a dynamic interactive visual analogue and simple descriptive scales and pain by dynamic interactive visual analogue and the short form Glasgow composite pain scales, by a single observer blinded to treatment group at intervals for 8?hours following premedication.Sedation scores were higher than baseline in both groups following premedication until the end of the assessment period (P?=?0?·?0001), with no differences between groups. Pain scores were lower overall in dogs premedicated with methadone (dynamic interactive visual analogue scale P?=?0?·?048; short form Glasgow composite pain scale P?=?0?·?0045), and these dogs required less additional analgesia (42%, compared to 79% premedicated with buprenorphine, P?=?0?·?045).At the doses investigated, methadone produced superior analgesia to buprenorphine for 8?hours postoperatively in dogs undergoing orthopaedic surgery.
HubMed – Methadone

Retention of Participants in Medication Assisted Programs in Low and Middle-Income Countries: An International Systematic Review.

Addiction. 2013 Jul 17;
Feelemyer J, Jarlais DD, Arasteh K, Abdul-Quader AS, Hagan H

Medication assisted treatment (MAT) is a key component in overdose prevention, reducing illicit opiate use and risk of blood borne virus infection. By retaining participants in MAT programs for longer periods of time, more noticeable and permanent changes in drug use, risk behavior, and quality of life can be achieved. Many studies have documented retention in MAT programs in high-income countries, using a 50% average 12-month follow-up retention rate as a marker for a successful MAT program. This study contributes to a systematic understanding of how successful programs have been in retaining participants in low and middle-income countries (LMIC) over time.Using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines we conducted a systematic literature search to identify MAT program studies that documented changes in retention over time for participants in buprenorphine and methadone programs in LMIC. Retention was measured for participants by length of follow-up, type of MAT, and treatment dosage.There were 58 MAT program studies with 27,047 participants eligible for inclusion in the review. Overall average retention after 12 months was 54.3% (95% CI: 46.2%, 63.7%). Overall average retention was moderately good for both buprenorphine (48.3%, 95% CI: 22.1%, 74.6%) and methadone (56.6%, 95% CI: 45.9%, 67.3%), after 12 months of treatment. Among programs using methadone there was no statistically significant difference in average retention by dosage level, and the 10 highest and lowest dosage programs obtained similar average retention levels after 12 months.Medication Assisted Treatment programs in Low and Middle Income Countries achieve an average 50% retention rate after 12 months with wide variation across programmes but little difference between those using buprenorphine versus methadone.
HubMed – Methadone

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