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RAT and MOUSE ANESTHESIA and ANALGESIA Formulary and General Drug Information

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RAT and MOUSE ANESTHESIA and ANALGESIA Formulary and General Drug Information RAT AND MOUSE ANESTHESIA AND ANALGESIA Formulary and General Drug Information Approved: March 2nd, 2016 Definitions General Anesthesia: Loss of consciousness in addition to loss of sensation Analgesia: Loss of sensitivity to pain. **Anesthesia does not necessarily equate with analgesia! ** General anesthesia produces loss of consciousness, so the animal cannot consciously perceive pain, but in unconscious animals, painful stimuli will still be transmitted and processed by the central nervous system. Although the animal does not perceive pain during the surgery, central hypersensitivity can still develop in the spinal cord and brain causing perception of postoperative pain to be heightened. Some anesthetics, such as the alpha‐2 adrenoreceptor agonists (i.e. Xylazine, Dexmedetomidine), do have some analgesic properties. In addition, additional analgesics can be used as part of the anesthetic regimen (i.e. opioids, non‐steroidal anti‐inflammatories). Associated Guidelines and SOPs can be found on the ACC SOP/Guidelines website: http://ors.ubc.ca/contents/animal‐care‐sops‐guidelines Policy 16 Survival Surgery of Rodents SOP ACC‐01‐2015 Rodent Anesthesia SOP ACC‐02‐2014 Rodent Survival Surgery Surgical Class and Analgesia Guidelines TECH 17 Buprenorphine SOP (2014) TECH 19 Metacam SOP (2016) TECH 18 Ketoprofen SOP (2016) TECH 16 Local Anesthetic SOP (2014) Updated Feb. 2016 FORMULARY FOR MICE Local anesthetic/analgesics Lidocaine Dilute to 0.5%, do not Use locally before making surgical Faster onset than hydrochloride (2%) exceed 7 mg/kg total incision bupivacaine but short (<1 dose, SC or intra‐ hour) duration of action incisional Bupivacaine (0.5%) Dilute to 0.25%, do not Use locally before making surgical Slower onset than lidocaine (Marcaine) exceed 8 mg/kg total incision but longer (~ 4‐8 hour) (Recommended) dose, SC or intra‐ duration of action incisional Ketamine combinations Ketamine‐ K:75‐150 mg/kg + May not produce surgical‐plane anesthesia for major procedures. If Dexedetomidine D:~0.5‐1 mg/kg IP or redosing, use 1/3 dose of ketamine alone‐may lose surgical anesthesia. (Recommended) SQ Dexmedetomidine may be reversed with Atipamezole. (in same syringe) Ketamine‐Xylazine K: 75‐150 mg/kg + X: May not produce surgical‐plane anesthesia for major procedure. If 16‐20 mg/kg IP or SQ redosing, use 1/3 dose of ketamine alone‐may lose surgical anesthesia. (in same syringe) Xylazine may be reversed with Atipamezole or Yohimbine. Ketamine‐Xylazine‐ K:75‐100 mg/kg + May not produce surgical‐plane anesthesia for major procedures. If Acepromazine X:16‐20 mg/kg +A: 3 redosing, use 1/3 dose of ketamine alone. Xylazine may be partially (Recommended) mg/kg IP or SQ (in with Atipamezole or Yohimbine. same syringe) Ketamine‐Midazolam K: 75‐100 mg/kg + M: Will not produce surgical‐plane anesthesia for surgical procedures, but 4‐5 mg/kg IP or SQ may be useful for restraint. (in same syringe) Other injectable anesthetics Sodium pentobarbital 50‐90 mg/kg IP Recommended for terminal/acute Consider supplemental (Nembutal) procedures only, with redosing as analgesia (opioid or NSAID) for needed. May occasionally be invasive procedures, especially appropriate for survival procedures. when used on a survival basis. Dilute to 9.1 mg/ml for use (do not For surgery, do not use the use the euthanasia solution). euthanasia solution which is typically 240 mg/ml Opioid analgesia Buprenorphine 0.05‐0.1 mg/kg SC Used pre‐operatively for For major procedures, require (Recommended) preemptive analgesia and post‐ more frequent dosing than 12 operatively every 8‐12 hours hour intervals. Consider multi‐ modal analgesia with a NSAID. High doses of buprenorphine may lead to pica behavior in rats. Non‐steroidal anti‐inflammatory analgesia (NSAID) Note that prolonged use my cause renal, gastrointestinal, or other problems. Avoid using longer than 2 to 3 days. Carprofen 5 mg/kg SC or orally Used pre‐operatively for Depending on the procedure, preemptive analgesia and post‐ may be used as sole analgesic, operatively every 24 hours for 3 or as multi‐modal analgesia with days buprenorphine. Page 2 of 14 Updated Feb. 2016 Meloxicam 5 mg/kg SC or orally Used pre‐operatively for Depending on the procedure, (Recommended) preemptive analgesia and post‐ may be used as sole analgesic, operatively every 24 hours for 3 or as multi‐modal analgesia with days buprenorphine. Recommended to give concurrent SQ fluids. Ketoprofen 5 mg/kg SC Used pre‐operatively for Depending on the procedure, (Recommended) preemptive analgesia and post‐ may be used as sole analgesic, operatively every 24 hours for 3 or as multi‐modal analgesia with days buprenorphine. Recommended to give concurrent SQ fluids. Inhalation anesthetics Isoflurane 1‐3% inhalant to effect Survival surgery requires concurrent preemptive analgesia. (Recommended) (up to 5% for Must use precision vaporizer induction). Recommended dilutions for mice and small rats to get accurate volumes: NOTE: some drugs are sensitive to light. Store diluted preparations away from light. Diluted drugs should be discarded 30 days after dilution. Ketamine (100 mg/ml): Dilute to 50 mg/ml. Draw 1 ml of Ketamine (100 mg/ml) into a sterile syringe and dispense into a sterile multi‐dose vial. To this, add 1 ml of sterile, pyrogen‐free water or sterile 0.9% NaCl. Label the vial with Ketamine 50 mg/kg, the date prepared and the expiry date. Dexmedetomidine (0.5 mg/kg): Dilute to 0.25 mg/kg. Draw 1 ml of Dexmedetomidine (0.5 mg/ml) into a sterile syringe and dispense into a sterile multi‐dose vial. To this, add 1 ml of sterile, pyrogen‐ free water or sterile 0.9% NaCl. Label the vial with Dexmedetomidine 0.25 mg/kg, the date prepared and the expiry date. Xylazine (20 mg/ml): Dilute to 2 mg/ml. Draw 1 ml of Xylazine (20 mg/ml) into a sterile syringe and dispense into a sterile multi‐dose vial. To this, add 9 ml of sterile, pyrogen‐free water or sterile 0.9% NaCl. Label the vial with Xylazine 2 mg/ml, the date prepared and the expiry date. Acepromazine (10 mg/ml): Dilute to 1 mg/ml. Draw 1 ml of Acepromazine (10 mg/ml) into a sterile syringe and dispense into a sterile multi‐dose vial. To this, add 9 ml of sterile, pyrogen‐free water or sterile 0.9% NaCl. Label the vial with Acepromazine 1 mg/ml, the date prepared and the expiry date. Midazolam (5 mg/ml): Dilute to 1 mg/ml. Draw 1 ml of Midazolam (5 mg/ml) into a sterile syringe and dispense into a sterile multi‐dose vial. To this, add 4 ml of sterile, pyrogen‐free water or sterile 0.9% NaCl. Label the vial with Midazolam 1 mg/ml, the date prepared and the expiry date. Sodium Pentobarbital (54.7 mg/ml): Dilute to 9.1 mg/ml. Draw 1 ml of Sodium Pentobarbital (54.7 mg/ml) into a sterile syringe and dispense into a sterile multi‐dose vial. To this, add 5 ml of sterile, pyrogen‐free water or sterile 0.9% NaCl. Label the vial with Sodium Pentobarbital 9.1 mg/kg, the date prepared and the expiry date. Page 3 of 14 Updated Feb. 2016 FORMULARY FOR RATS Local anesthetic/analgesics Lidocaine hydrochloride Dilute to 0.5%, do not Use locally before making surgical Faster onset than bupivacaine (2%) exceed 7 mg/kg total incision but short (<1 hour) duration of dose, SC or intra‐ action incisional Bupivacaine (0.5%) Dilute to 0.25%, do not Use locally before making surgical Slower onset than lidocaine (Marcaine) exceed 8 mg/kg total incision but longer (~ 4‐8 hour) (Recommended) dose, SC or intra‐ duration of action incisional Ketamine combinations Ketamine‐ K: 75‐90 mg/kg + D: May not produce surgical‐plane anesthesia for major procedures. If Dexedetomidine 0.5‐0.75 mg/kg IP or redosing, use 1/3 dose of ketamine alone‐may lose surgical (Recommended) SQ (in same syringe) anesthesia. Dexmedetomidine may be reversed with Atipamezole. Ketamine‐Xylazine K: 75‐90 mg/kg + X: 5‐ May not produce surgical‐plane anesthesia for major procedures, 10 mg/kg IP or SQ (in though more reliable than in mice. If redosing, use 1/3 dose of same syringe) ketamine alone‐may lose surgical anesthesia. Xylazine may be reversed with Atipamezole or Yohimbine. Ketamine‐Xylazine‐ K: 75 ‐90 mg/kg + X: 5‐ May not produce surgical‐plane anesthesia for major procedures. If Acepromazine 10 mg/kg +A: 1–2 redosing, use 1/3 dose of ketamine alone. Xylazine may be reversed mg/kg IP or SQ with Atipamezole or Yohimbine. (in same syringe) Ketamine‐Midazolam K: 75‐90 mg/kg + M: 4‐ Will not produce surgical‐plane anesthesia for surgical procedures, 5 mg/kg IP or SQ but may be useful for restraint. (in same syringe) Other injectable anesthetics Sodium pentobarbital 40 ‐60 mg/kg IP Recommended for terminal/acute Consider supplemental procedures only, with booster analgesia (opioid or NSAID) for doses as needed. May occasionally invasive procedures, especially be appropriate for survival when used on a survival basis. procedures. Dilute to 9.1 mg/ml for *For surgery, do not use the use (do not use the euthanasia euthanasia solution which is solution). typically 240 mg/ml Opioid analgesia Buprenorphine 0.01 ‐ 0.05 mg/kg SC or Used pre‐operatively for For major procedures, require (Recommended) IP preemptive analgesia and post‐ more frequent dosing than 12 operatively every 8‐12 hour hour intervals. Consider multi‐ modal analgesia with a NSAID. High doses of buprenorphine may lead to pica behavior in rats. Non‐steroidal anti‐inflammatory analgesia (NSAID) Note that prolonged use my cause renal, gastrointestinal, or other problems. Avoid using for longer than 2 to 3 days.
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