{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T14:48:22Z","timestamp":1774018102176,"version":"3.50.1"},"reference-count":48,"publisher":"American Veterinary Medical Association (AVMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2020,1]]},"abstract":"Abstract<\/jats:title>\n\nOBJECTIVE<\/jats:title>\nTo assess the analgesic efficacy of an IV constant rate infusion (CRI) of a morphine-lidocaine-ketamine (MLK) combination in calves undergoing umbilical herniorrhaphy.<\/jats:p>\n<\/jats:sec>\n\nANIMALS<\/jats:title>\n20 weaned Holstein calves with umbilical hernias.<\/jats:p>\n<\/jats:sec>\n\nPROCEDURES<\/jats:title>\nCalves were randomly assigned to receive a CRI of an MLK solution (0.11 mL\/kg\/h; morphine, 4.8 \u03bcg\/kg\/h; lidocaine, 2.1 mg\/kg\/h; and ketamine, 0.42 mg\/kg\/h) for 24 hours (MLK group) or 2 doses of flunixin meglumine (1.1 mg\/kg, IV, q 24 h) and a CRI of saline (0.9% NaCl) solution (0.11 mL\/kg\/h) for 24 hours (control group). The assigned CRI was begun after anesthesia induction. A pain-scoring system and incisional algometry were used to assess pain, and blood samples were obtained to measure serum cortisol concentration at predetermined times for 120 hours after CRI initiation.<\/jats:p>\n<\/jats:sec>\n\nRESULTS<\/jats:title>\nMean pain scores did not differ significantly between the MLK and control groups at any time. Mean algometry score for the MLK group was significantly greater (calves were less responsive to pressure) than that for the control group at 4 hours after CRI initiation. Mean cortisol concentration decreased over time for both groups and was significantly greater for the MLK group than the control group at 1, 4, and 18 hours after CRI initiation.<\/jats:p>\n<\/jats:sec>\n\nCONCLUSIONS AND CLINICAL RELEVANCE<\/jats:title>\nA CRI of MLK provided adequate postoperative analgesia to calves that underwent umbilical herniorrhaphy. However, the technical support required for CRI administration limits its use to hospital settings. Kinetic analyses of MLK infusions in cattle are necessary to establish optimal dosing protocols and withdrawal intervals.<\/jats:p><\/jats:sec>","DOI":"10.2460\/ajvr.81.1.25","type":"journal-article","created":{"date-parts":[[2019,12,30]],"date-time":"2019-12-30T18:34:24Z","timestamp":1577730864000},"page":"25-32","source":"Crossref","is-referenced-by-count":9,"title":["Analgesic efficacy of an intravenous constant rate infusion of a morphine-lidocaine-ketamine combination in Holstein calves undergoing umbilical herniorrhaphy"],"prefix":"10.2460","volume":"81","author":[{"given":"Amanda K.","family":"Hartnack","sequence":"first","affiliation":[{"name":"1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew J.","family":"Niehaus","sequence":"additional","affiliation":[{"name":"1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey","family":"Lakritz","sequence":"additional","affiliation":[{"name":"1Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johann F.","family":"Coetzee","sequence":"additional","affiliation":[{"name":"2Department of Veterinary Diagnostic and Production Animal Medicine, College of Veterinary Medicine, Iowa State University, Ames, IA 50011."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael D.","family":"Kleinhenz","sequence":"additional","affiliation":[{"name":"3Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA 50011."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1272","reference":[{"key":"ref1","series-title":"J Anim Sci","doi-asserted-by":"publisher","first-page":"955","DOI":"10.2527\/2004.823955x","article-title":"Annual meeting keynote address: animal agriculture and emerging social ethics for animals","volume":"82","author":"Rollin","year":"2004"},{"key":"ref2","series-title":"Pain in animals policy statement","year":"2019"},{"key":"ref3","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"755","DOI":"10.2460\/javma.238.6.755","article-title":"Analgesic drug administration and attitudes about analgesia in cattle among bovine practitioners in the United States","volume":"238","author":"Fajt","year":"2011"},{"key":"ref4","series-title":"Vet Rec","doi-asserted-by":"publisher","first-page":"400","DOI":"10.1136\/vr.104428","article-title":"Clinician attitudes to pain and use of analgesia in cattle: where are we 10 years on?","volume":"181","author":"Remnant","year":"2017"},{"key":"ref5","series-title":"J Dairy Sci","doi-asserted-by":"publisher","first-page":"2118","DOI":"10.3168\/jds.2013-7142","article-title":"Assessing experimental visceral pain in dairy cattle: a pilot, prospective, blinded, randomized, and controlled study focusing on spinal pain proteomics","volume":"97","author":"Rialland","year":"2014"},{"key":"ref6","series-title":"J Dairy Sci","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.3168\/jds.2012-5566","article-title":"The effect of administering ketoprofen on the physiology and behavior of dairy cows following surgery to correct a left displaced abomasum","volume":"96","author":"Newby","year":"2013"},{"key":"ref7","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"418","DOI":"10.2460\/javma.232.3.418","article-title":"Effect of preoperative administration of erythromycin or flunixin meglumine on postoperative abomasal emptying rate in dairy cows undergoing surgical correction of left displacement of the abomasum","volume":"232","author":"Wittek","year":"2008"},{"key":"ref8","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1111\/j.1467-2995.2010.00573.x","article-title":"Effect of sub-anesthetic xylazine and ketamine (\u2018ketamine stun\u2018) administered to calves immediately prior to castration","volume":"37","author":"Coetzee","year":"2010"},{"key":"ref9","series-title":"Can Vet J","first-page":"375","article-title":"The behavioral assessment and alleviation of pain associated with castration in beef calves treated with flunixin meglumine and caudal lidocaine epidural anesthesia with epinephrine","volume":"50","author":"Currah","year":"2009"},{"key":"ref10","series-title":"Am J Vet Res","first-page":"1305","article-title":"Pharmacokinetics and physiologic effects of intramuscularly administered xylazine hydrochloride-ketamine hydrochloride-butorphanol tartrate alone or in combination with orally administered sodium salicylate on biomarkers of pain in Holstein calves following castration and dehorning","volume":"72","author":"Baldridge","year":"2011"},{"key":"ref11","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1046\/j.1467-2987.2003.00127.x","article-title":"Cardiopulmonary effects of combined xylazine-guaiphenesin-ketamine infusion and extradural (inter-coccygeal lidocaine) anaesthesia in calves","volume":"31","author":"Picavet","year":"2004"},{"key":"ref12","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"72","DOI":"10.2460\/javma.2002.221.72","article-title":"Use of low doses of ketamine administered by constant rate infusion as an adjunct for postoperative analgesia in dogs","volume":"221","author":"Wagner","year":"2002"},{"key":"ref13","series-title":"Equine Vet J","first-page":"122","article-title":"Effect of systemic lidocaine on visceral and somatic nociception in conscious horses","volume":"37","author":"Robertson","year":"2005"},{"key":"ref14","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1111\/j.1532-950X.2005.00113.x","article-title":"Intravenous continuous infusion of lidocaine for treatment of equine ileus","volume":"35","author":"Malone","year":"2006"},{"key":"ref15","series-title":"J Dairy Sci","doi-asserted-by":"publisher","first-page":"5194","DOI":"10.3168\/jds.2012-6251","article-title":"The effect of timing of oral meloxicam administration on physiological responses in calves after cautery dehorning with local anesthesia","volume":"96","author":"Allen","year":"2013"},{"key":"ref16","series-title":"Vet J","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1016\/j.tvjl.2010.08.008","article-title":"Pharmacokinetics of oral gabapentin alone or co-administered with meloxicam in ruminant beef calves","volume":"190","author":"Coetzee","year":"2011"},{"key":"ref17","series-title":"Res Vet Sci","doi-asserted-by":"publisher","first-page":"204","DOI":"10.1016\/j.rvsc.2013.01.018","article-title":"A study to compare circulating flunixin, meloxicam and gabapentin concentrations with prostaglandin E2 levels in calves undergoing dehorning","volume":"95","author":"Fraccaro","year":"2013"},{"key":"ref18","series-title":"J Vet Pharmacol Ther","doi-asserted-by":"publisher","first-page":"550","DOI":"10.1111\/jvp.12042","article-title":"The pharmacokinetics and effects of meloxicam, gabapentin, and flunixin in postweaning dairy calves following dehorning with local anesthesia","volume":"36","author":"Glynn","year":"2013"},{"key":"ref19","series-title":"J Anim Sci","doi-asserted-by":"publisher","first-page":"802","DOI":"10.2527\/jas.2008-1752","article-title":"Pain mitigation after band castration of beef calves and its effects on performance, behavior, Escherichia coli, and salivary cortisol","volume":"88","author":"Gonz\u00e1lez","year":"2010"},{"key":"ref20","series-title":"J Dairy Sci","doi-asserted-by":"publisher","first-page":"2450","DOI":"10.3168\/jds.2009-2813","article-title":"The effect of meloxicam on behavior and pain sensitivity of dairy calves following cautery dehorning with a local anesthetic","volume":"93","author":"Heinrich","year":"2010"},{"key":"ref21","series-title":"Can J Comp Med","first-page":"386","article-title":"Cardiopulmonary effects of intramuscular xylazine-ketamine in calves","volume":"46","author":"Rings","year":"1982"},{"key":"ref22","series-title":"J Dairy Sci","doi-asserted-by":"publisher","first-page":"3602","DOI":"10.3168\/jds.2010-3114","article-title":"Noninvasive assessment of autonomic activity for evaluation of pain in calves, using surgical castration as a model","volume":"93","author":"Stewart","year":"2010"},{"key":"ref23","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"17","DOI":"10.2460\/ajvr.81.1.17","article-title":"Pharmacokinetics of an intravenous constant rate infusion of a morphine-lidocaine-ketamine combination in Holstein calves undergoing umbilical herniorrhaphy","volume":"81","author":"Hartnack","year":"2020"},{"key":"ref24","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1111\/j.1467-2995.2004.00126.x","article-title":"Intra-articular lidocaine plus bupivacaine in sheep undergoing stifle arthrotomy","volume":"31","author":"Shafford","year":"2004"},{"key":"ref25","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"418","DOI":"10.2460\/ajvr.70.3.418","article-title":"Comparison of the analgesic properties of transdermally administered fentanyl and intramuscularly administered buprenorphine during and following experimental orthopedic surgery in sheep","volume":"70","author":"Ahern","year":"2009"},{"key":"ref26","series-title":"J Vet Pharmacol Ther","doi-asserted-by":"publisher","first-page":"612","DOI":"10.1111\/jvp.12314","article-title":"The pharmacokinetics of transdermal flunixin meglumine in Holstein calves","volume":"39","author":"Kleinhenz","year":"2016"},{"key":"ref27","series-title":"Vet Rec","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1136\/vr.109.21.464","article-title":"Preliminary observations on the use of a combination of xylazine and ketamine hydrochloride in calves","volume":"109","author":"Waterman","year":"1981"},{"key":"ref28","series-title":"Mod Vet Pract","first-page":"522","article-title":"Anesthesia for cesarean section in large animals","volume":"65","author":"McGrath","year":"1984"},{"key":"ref29","series-title":"Berl Munch Tierarztl Wochenschr","first-page":"465","article-title":"Stress responses in adult cattle due to surgical dehorning using three different types of anaesthesia","volume":"120","author":"Lepkov\u00e1","year":"2007"},{"key":"ref30","series-title":"J Vet Sci","doi-asserted-by":"publisher","first-page":"261","DOI":"10.4142\/jvs.2003.4.3.261","article-title":"Analgesic effect of caudal epidural ketamine in cattle","volume":"4","author":"Lee","year":"2003"},{"key":"ref31","series-title":"Can Vet J","first-page":"155","article-title":"Canadian veterinarians' use of analgesics in cattle, pigs, and horses in 2004 and 2005","volume":"48","author":"Hewson","year":"2007"},{"key":"ref32","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"963","DOI":"10.2460\/ajvr.74.7.963","article-title":"Effect of dexmedetomidine, morphine-lidocaine-ketamine, and dexmedetomidine-morphine-lidocaine-ketamine constant rate infusions on the minimum alveolar concentration of isoflurane and bispectral index in dogs","volume":"74","author":"Ebner","year":"2013"},{"key":"ref33","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.2460\/ajvr.2003.64.1155","article-title":"Effects of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine drug combination on minimum alveolar concentration in dogs anesthetized with isoflurane","volume":"64","author":"Muir WW","year":"2003"},{"key":"ref34","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"1041","DOI":"10.2460\/javma.244.9.1041","article-title":"Postoperative comparison of four perioperative analgesia protocols in dogs undergoing stifle joint surgery","volume":"244","author":"Lewis","year":"2014"},{"key":"ref35","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"289","DOI":"10.1111\/j.1467-2995.2007.00389.x","article-title":"Effects of intravenous lidocaine, ketamine, and the combination on the minimum alveolar concentration of sevoflurane in dogs","volume":"35","author":"Wilson","year":"2008"},{"key":"ref36","series-title":"Am J Vet Res","first-page":"1802","article-title":"Effects of ketamine infusion on halothane minimal alveolar concentration in horses","volume":"53","author":"Muir WW","year":"1992"},{"key":"ref37","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1111\/vaa.12102","article-title":"Cardiovascular effects of a continuous rate infusion of lidocaine in calves anesthetized with xylazine, midazolam, ketamine and isoflurane","volume":"41","author":"Ara\u00fajo","year":"2014"},{"key":"ref38","series-title":"Equine Vet J","first-page":"559","article-title":"Effect of a constant rate infusion of lidocaine on the quality of recovery from sevoflurane or isoflurane general anaesthesia in horses","volume":"37","author":"Valverde","year":"2005"},{"key":"ref39","series-title":"J Am Vet Med Assoc","first-page":"761","article-title":"Medial condylar fractures of the third metatarsal bone in horses","volume":"185","author":"Richardson","year":"1984"},{"key":"ref40","series-title":"J Am Vet Med Assoc","doi-asserted-by":"publisher","first-page":"711","DOI":"10.2460\/javma.229.5.711","article-title":"Comparison of recoveries from anesthesia of horses placed on a rapidly inflating-deflating air pillow or the floor of a padded stall","volume":"229","author":"Ray-Miller","year":"2006"},{"key":"ref41","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"451","DOI":"10.1111\/j.1467-2995.2011.00636.x","article-title":"Evaluation of the isoflurane-sparing effects of lidocaine infusion during umbilical surgery in calves","volume":"38","author":"Vesal","year":"2011"},{"key":"ref42","series-title":"Physiol Behav","doi-asserted-by":"publisher","first-page":"411","DOI":"10.1016\/j.physbeh.2004.08.027","article-title":"Effects of acute stressors on nociception, adrenocortical responses and behavior of dairy cows","volume":"83","author":"Herskin","year":"2004"},{"key":"ref43","series-title":"J Anim Sci","doi-asserted-by":"publisher","first-page":"240","DOI":"10.2527\/jas.2005-346","article-title":"Effects of social isolation and restraint on adrenocortical responses and hypoalgesia in loose-housed dairy cows","volume":"85","author":"Herskin","year":"2007"},{"key":"ref44","series-title":"Vet Clin North Am Food Anim Pract","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1016\/j.cvfa.2012.11.002","article-title":"Assessment and management of pain associated with castration in cattle","volume":"29","author":"Coetzee","year":"2013"},{"key":"ref45","series-title":"Vet Clin North Am Food Anim Pract","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.cvfa.2012.11.012","article-title":"Assessment and management of pain associated with lameness in cattle","volume":"29","author":"Shearer","year":"2013"},{"key":"ref46","series-title":"Vet Clin North Am Food Anim Pract","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.cvfa.2012.11.007","article-title":"Behavioral responses of cattle to pain and implications for diagnosis, management, and animal welfare","volume":"29","author":"Millman","year":"2013"},{"key":"ref47","series-title":"Vet Clin North Am Food Anim Pract","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1016\/j.cvfa.2012.11.004","article-title":"Assessment and management of pain in small ruminants and camelids","volume":"29","author":"Plummer","year":"2013"},{"key":"ref48","series-title":"BMC Vet Res","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1186\/s12917-014-0200-0","article-title":"Validation of the UNESP-Botucatu unidimensional composite pain scale for assessing postoperative pain in cattle","volume":"10","author":"de Oliveira","year":"2014"}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/81\/1\/ajvr.81.1.25.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/81\/1\/ajvr.81.1.25.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/81\/1\/ajvr.81.1.25.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T20:44:38Z","timestamp":1696538678000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/81\/1\/ajvr.81.1.25.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":48,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.2460\/ajvr.81.1.25","relation":{},"ISSN":["0002-9645"],"issn-type":[{"value":"0002-9645","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}