Veterinary Anesthesia & Analgesia Support Group
Practical Information for the Compassionate Veterinary Practitioner
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  Preanesthetic/Procedural Sedation Videos
  Nalbuphine + (Dex)Medetomidine + Midazolam
  Comparison to Butorphanol + (Dex)Medetomidine + Midazolam

Prior to premeds

10 to 15 minutes post IM premeds


IV catheter placement in butorphanol kitten

IV catheter placement in nalbuphine kitten


IT block on premeds alone

IT block on premeds alone


Post neuter at 1 hour post premeds


Same drug doses but we switched the 2 opioids

40 minutes post IM injection

The black kitten received the nalbuphine in this sequence


1 hour post IM injection

The kittens in this sequence are 13 week old males. Both received 0.015 mg/kg medetomidine and 0.2 mg/kg midazolam. One received 0.2 mg/kg butorphanol and one received 0.2 mg/kg nalbuphine. The medications were combined and given IM in the epaxial musculature.

On day 1 they were both neutered. Intratesticular blocks using 1 mg/kg each of lidocaine and bupivacaine were administered after premeds to assess patient response to IT local anesthesia. Ketamine 5 mg/kg and diazepam 0.25 mg/kg was drawn up and given IV to effect. The kittens were intubated and placed on oxygen. The neuters were completed without additional inhalant anesthetic agents. The intensity of the sedative/analgesic medications was similar at 10 minutes post-injection although the nalbuphine kitten appeared to have a slightly less intense total effect. The nalbuphine kitten recovered to purposeful movement about 10 minutes more quickly than the butorphanol kitten. No antagonists were administered.

On day 2, the exact same sedative/analgesic drugs and doses were administered but the opioids were switched. As the day before, the intensity of the sedative/analgesic effect was similar at 10 minutes post IM injection. Likewise, the nalbuphine kitten recovered to purposeful movement 10 to 15 minutes before the butorphanol kitten. No antagonists were administered.

Nalbuphine is primarily a kappa agonists as is butorphanol. Like butorphanol, nalbuphine exerts an antagonist effect at the mu receptor. Nalbuphine is NOT a scheduled drug which simplifies records keeping. Nalbuphine is also much less expensive; about 1/7th the cost of butorphanol. Both opioids possess mild analgesic properties of short duration. 

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Last modified: April 5, 2011 .