Pain management is a crucial component of feline medicine and surgery. This review critically evaluates studies using
buprenorphine in cats and highlights the clinical application of the
opioid in this species. The pharmacokinetic-pharmacodynamic (PK-PD) modeling of IV
buprenorphine has been best described by a combined effect compartmental/receptor association-dissociation model with negative hysteresis. Therefore, plasma concentrations of the
drug are not correlated with
analgesia, and clinicians should not expect to observe
pain relief immediately after
drug administration. In addition, a ceiling effect has not been demonstrated after administration of clinical doses of
buprenorphine in cats; dosages of up to 0.04 mg/kg have been reported. The route of administration influences the onset, duration, and magnitude of antinociception and
analgesia when using this
drug in cats. At clinical dosages, the SC route of administration does not appear to provide adequate antinociception and
analgesia whereas the buccal route has produced inconsistent results. Intravenous or IM administration at a dosage of 0.02-0.04 mg/kg is the preferred for treatment of
pain in the acute setting. A literature search found 14 clinical trials evaluating
buprenorphine sedation,
analgesia, or both in cats. There were 22 original research studies reporting the antinociceptive effects of
buprenorphine by means of thermal threshold, mechanical threshold, or both, minimal alveolar concentration, or PK-PD. Individual variability in response to
buprenorphine administration has been reported, indicating that
buprenorphine may not provide sufficient
analgesia in some cats.
Pain assessment is important when evaluating the efficacy of
buprenorphine and determining whether additional
analgesic treatment is needed.