This ppt describes on neuroleptanalgesia which is used for the chemical restraint of large animals. It also contains various combinations of neuroleptanalgesics. Neuroleptanalgesia is a combination of neurolept/ tranquiliser and an opiod analgesic.

1. Dr. Arya Mohan
19-MVM-13
NEUROLEPTANALGESIA
VPT 603 CNS PHARMACOLOGY

2.  Analgesia: - absence of pain
 Tranquilisation: - state of behavioral change where in
anxiety is relieved & patient is relaxed, although
aware of its surroundings
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ANALGESICS
NEUROLEPT/
TRANQUILISER
NEUROLEPTANALGESICS

3. NEUROLEPTANALGESIA
 A state of CNS depression & analgesia
 Characterised by profound sedation, immobilisation,
intense analgesia without loss of consciousness
 Introduced by De Castro & Mundeleer (1959) as
"anesthcsie sans barbituriques"
 Became popular in Europe as "an alternative to
general anesthesia" (Nilsson & Janssen, 1961)
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4.  Body becomes flaccid
 Slowing down of bodily functions such as respiration
 Also has adrenergic blocking, antiemetic,
antifibrillatic & anticonvulsant activities
 Similar to but not equal to a light plane of anesthesia
 1960’s- Phenoperidine & Haloperidol
 Early 1980’s- replaced by Fentanyl & Droperidol
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Effects show marked variation, so data on one
animal cannot be transposed on other animals

5. ADVANTAGES
 Produce more deeper & more reliable sedation
 Produce more reliable analgesia & less marked
respiratory depression
 Neuroleptic component abolishes the emetic effect
and lessens the bradycardia & bradyarrhythmia
produced by opioid analgesics (dogs)
 Produce a stage of immobilisation suitable for
chemical restraint of wild & exotic animals
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6. INDICATIONS
 In minor surgical procedures
 In diagnostic procedures
 Adjunct to local anesthetic
 Used as premedication
 Chemical restraint of wild & ferocious animals
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NEUROLEPTANALGESICS

8. FENTANYL & DROPERIDOL
 Fentanyl- potent opioid agonist
 Droperidol- butyrephenone neuroleptic sedative
 In a ratio 1:50- INNOVAR- VET
 Droperidol potentiates the analgesic effect of Fentanyl
 Droperidol is a potent D₂ receptor antagonist with Histamine
& 5HT antagonist activity
 Possess central antiemetic action, reduce motor tone &
causes tranquilisation & sedation
 Fentanyl acts at μ opioid receptors & produce analgesia
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9.  Combined effect in dogs include a decreased heart
rate secondary to increased vagal tone & decrease in
arterial BP
 In cats heart rate is increased with decrease in BP
PHARMACOKINETICS
 Onset of action within 30-40 min
 Remain sedated for hours
 Metabolised in liver
 Eliminated in urine
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10. SIDE EFFECTS
 Are dose dependent- overdosage
 Bradycardia, respiratory depression, salivation, nystagmus &
defecation
 Wood chest syndrome in dogs & humans after rapid i/v
 Thoracic musculature is rigid & interferes with normal
ventilatory function
 Attributed to Fentanyl & is reversed by Naloxone
 CNS stimulation, ataxia & abnormal behavior in pigs
 Irritation & pain at site of injection
 Overdosage- profound respiratory & CNS depression
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11. CONTRAINDICATIONS
 Not used in food animals
 Perivascular injection avoided- tissue irritation
 Not recommended in cats, horses & ruminants – CNS
stimulation
 Should not be used along with barbiturates in C-section-
hazardous to neonates
 Administration of Atropine prior can prevent bradycardia
& salivation
 Approved for use only in dogs
@0.1-0.15 ml/Kg im & 0.04-0.08ml/Kg iv
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0.4mg Fentanyl &
20mg Droperidol in
each ml

12. ETORPHINE &
ACEPROMAZINE
 Used for immobilisation of various domestic & exotic
species
 Etorphine- Opioid agonist
 Acepromazine- phenothiazine tranquiliser
 Acepromazine is a potent dopamine receptor antagonist
with some histamine, serotonin, muscarinic & α
adrenergic receptor blocking actions
 Etorphine is an opioid agonist widely used to
immobilize large domestic & wild animals such as
elephants 10/28/202012

13.  Recommended in domestic animals such as horses,
pigs, cattle & sheep
 Combination causes marked & persistent
tachycardia, transient rise in BP, increased muscle
tone & mydriasis
 Highly toxic to humans- should wear gloves
 Immobilisation should not be used without
availability of an opioid antagonist Naloxone
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14. Highly potent neuroleptanalgesic supplied
along with antagonist Diprenorphine
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Contain 2.45mg/ml Etorphine with
Acepromazine 10mg/ml in IMMOBILON
& 3mg/ml Diprenorphine in REVIVON

15. FENTANYL & FLUANISONE
 Recommended in dogs, primates & rabbits
 Fluanisone- butyrephenone derivative
 Fentanyl @ 0.325mg/ml & Fluanisone @ 10mg/ml
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16. Other Combinations
COMBINATION SPECIES
ETORPHINE &
METHOTRIMEPRAZINE
Dogs
BUTORPHANOL & MEDETOMIDINE Dogs & Cats
BUTORPHANOL & XYLAZINE Horses
BUTORPHANOL & DETOMIDINE Horses
BUTORPHANOL & ACEPROMAZINE Horses
METHADONE & ACEPROMAZINE Horses
METHADONE & XYLAZINE Horses
MORPHINE & XYLAZINE Horses
PETHIDINE & ACEPROMAZINE Dogs & Horses
BUPRENORPHINE &
ACEPROMAZINE
Dogs & Cats
OXYMORPHONE & ACEPROMAZINE Dogs & Cats 10/28/2020
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CNS PHARMACOLOGY

17. NEUROLEPTANESTHESIA
 Concurrent administration of 65-70% N₂O to
neuroleptanalgesics
 State of amnesia is produced
 Patient completely detached from environment
 Loss of consciousness
 Loss of ability to obey commands & communicate
 Inability to move or change position
 Fentanyl + Droperidol + N₂O
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