Evidence map›Paper›PMID 30735096›Full record

ArticleJournal of feline medicine and surgery2020

Use of nalbuphine as a substitute for butorphanol in combination with dexmedetomidine and tiletamine/zolazepam: a randomized non-inferiority trial.

Rachael E Kreisler, Heather N Cornell, Veronica A Smith, Samantha E Kelsey, Erik H Hofmeister

Open access · greenAbstract readRandomized Controlled Trial, Veterinary
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of feline medicine and surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Different Doses of Nalbuphine Combined with Dexmedetomidine in Laparoscopic Oophorocystectomy.Medical science monitor : international medical journal of experimental and clinical research · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Rachael E KreislerDepartment of Pathology and Population Medicine, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.ORCID 0000-0002-5562-5521
Heather N CornellDepartment of Pathology and Population Medicine, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Veronica A SmithCollege of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Samantha E KelseyCollege of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Erik H HofmeisterDepartment of Surgery, Animal Health Institute, College of Veterinary Medicine, Midwestern University, Glendale, AZ, USA.
Midwestern University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe goal of this study was to determine whether a drug combination using nalbuphine with dexmedetomidine and tiletamine/zolazepam is non-inferior to one that uses butorphanol.

methodsAll healthy cats presenting solely for gonadectomy to two trap-neuter-return mobile clinic days were randomly assigned to induction with a combination of tiletamine/zolazepam 3 mg/kg, dexmedetomidine 7.5 µg/kg and either butorphanol or nalbuphine at 0.15 mg/kg. All participants were blinded to the identity of the combinations. The primary endpoint was clinician satisfaction, comprised of the mean of four satisfaction ratings on a 7-point Likert scale (highly dissatisfied through to highly satisfied) recorded for induction, maintenance of anesthesia, surgery and recovery. Exploratory endpoints included each individual score, number of injections, duration of induction, duration of recovery and need for reversal agent. To assess non-inferiority for the primary endpoint and individual scores, the difference and 95% confidence intervals (CIs) of the difference between the mean clinical scores for the nalbuphine and butorphanol-based combinations were calculated and compared with a prespecified non-inferiority margin of 20% (1.4 points).

resultsSeventy-two cats were enrolled, 36 in each group. The mean ± SD composite score for the combination with nalbuphine was 6.06 ± 0.59 (95% CI 5.86-6.25) points, while the combination with butorphanol was 6.22 ± 0.62 (95% CI 6.01-6.43). The difference between mean scores was 0.17 (-0.12 to 0.45), which did not exceed the prespecified boundary of 1.4, establishing the non-inferiority of nalbuphine. No individual clinical score for nalbuphine was inferior to butorphanol, and there were no significant differences for any secondary endpoints. CONCLUSIONS AND RELEVANCE: The clinical experience of the nalbuphine-based combination was non-inferior to the butorphanol-based combination. Nalbuphine is an effective substitute for butorphanol, providing another option if butorphanol is unavailable due to shortage, controlled status or cost, without requiring a change in anesthetic workflow.

Indexed as

Central Nervous System DepressantsDexmedetomidineNalbuphineTiletamineZolazepamAnimalsCastrationCatsDrug CombinationsCentral Nervous System DepressantsDexmedetomidineDrug CombinationsNalbuphineTiletaminetiletamine, zolazepam drug combinationZolazepamanesthetic protocolbutorphanolclinical satisfaction scorecontrolled substancedrug substitutionfield medicineNalbuphinenon-inferiority

Identifiers

PMID30735096
PMCPMC10814574
OpenAlexW2912853429

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.