# HOWS AND WHYS OF CRI ANALGESIA IN SMALL ANIMALS Luisito S. Pablo, DVM, MS, Diplomate ACVA University of Florida, Gainesville, Florida

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5 Calculation of the fluid rate for a 40-kg dog that will have approximately 3 hours of surgery is shown below: Fluid rate = [60 ml 40 kg] 3 hours = 0.5 ml/kg/hour Drugs needed for this preparation will be calculated given the formula above. Morphine to be added in mg = (0.2 mg/kg/hour 0.5 ml/kg/hour) x 60 ml = 24 mg (2.4 ml) Lidocaine to be added in mg = (3.0 mg/kg/hour 0.5 ml/kg/hour) x 60 ml = 360 mg (18 ml) Ketamine to be added in mg = (0.6 mg/kg/hour 0.5 ml/kg/hour) x 60 ml = 72 mg (0.72 ml) These drugs will be put in a 60-ml syringe and then saline is added to make a total volume of 60 ml. The syringe pump is set at 20 ml/hour (40 kg x 0.5 ml/kg/hour). Table 1: Dosages for Drugs Used in CRI for Pain Control. Drugs Loading dose Infusion rate (IV) Comments (IV) Morphine 0.3 mg/kg slow mg/kg/hour Use higher dose for severe pain. Hydromorphone mg/kg mg/kg/hour Use the lower range of dose in cats. Methadone mg/kg mg/kg/hour Less likely to cause vomiting Fentanyl 5.0 mcg/kg mg/kg/hour ( μg/kg/hour) Relatively expensive Butorphanol mg/kg mg/kg/hour Excellent in cats with mild to moderate pain; more expensive than morphine Lidocaine 1-2 mg/kg mg/kg/hour (20-50 mcg/kg/min) Not recommended for cats Ketamine 0.5 mg/kg mg/kg/hour (2-10 μg/kg/min) Dexmedetomidine 1-2 μg/kg mg/kg/hour ( μg/kg/hour) Use highest infusion rate during painful surgery; use lower dose postop and other painful patients Useful in managing aggressive dog postoperatively and dogs that continue to vocalize despite the use of opioids and acepromazine Reference Gaynor JS, Muir III WW: Handbook of Veterinary Pain Management (ed 2). St. Louis, MO, Mosby Elsevier,

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