buprenorphine and Fever

Leukoencephalopathies have been reported after heroin inhalation or ingestion, and buprenorphine injection, but the physiopathology remains unclear. We report here the first case of leukoencephalopathy caused by buprenorphine ingestion in a 2-year-old child who was admitted for coma and fever. Due to technical problems, the toxicology screen was delayed, and infectious disease was first suspected. A brain MRI found bilateral and symmetric white matter damages in the cerebral hemispheres and the cerebellum. Rapid recovery and positive toxicology screen for buprenorphine on day 4 confirmed the diagnosis of acute intoxication.

Topics: Acute Disease; Analgesics, Opioid; Brain Damage, Chronic; Buprenorphine; Child, Preschool; Coma; Fever; Humans; Leukoencephalopathies; Magnetic Resonance Imaging; Male

To determine the prevalence of postanesthetic hyperthermia [rectal temperature >40 degrees C (104 degrees F)] in a clinical population of cats.. Retrospective study.. One hundred and twenty-five cats with an age range of 2 months to 16.1 years, and weighing 3.9 +/- 1.5 kg.. Data were obtained from the medical records of 125 cats that underwent general anesthesia. Information on perioperative rectal temperatures, breed, sex, weight, surgical procedure, anesthetic time, surgery time, anesthetic and analgesic drugs were retrieved.. Five groups of cats were compared; group 1 (n = 15) received acepromazine and no opioids; group 2 (n = 17) received acepromazine and buprenorphine; group 3 (n = 19) received acepromazine, buprenorphine and ketoprofen; group 4 (n = 45) received acepromazine and hydromorphone and group 5 (n = 29) received acepromazine, hydromorphone and ketoprofen. Data conformed to a split-plot repeated measures analysis of variance and was analyzed using SAS PROC MIXED. Post hoc tests were by means of Bonferroni t-test; < or = 0.05 was considered significant.. Rectal temperature was significantly decreased in all groups at the end of anesthesia. Rectal temperature was significantly elevated at 1, 1.5, 2, 3, 4 and 5 hours after the end of anesthesia in group 4, and at 2, 3 and 4 hours in group 5. Sixty-four percent of cats in group 4 and 69% in group 5 had rectal temperatures >40 degrees C (104 degrees F) at one or more times in the postanesthetic period. The highest temperature recorded was 42.5 degrees C (108.5 degrees F) in one cat in group 4. Mean rectal temperature did not exceed the preoperative temperature at any time during the postanesthetic period in group 1, 2 and 3 animals.. This study indicates an association between hyperthermia and perioperative administration of hydromorphone in cats.. When hydromorphone is used in cats their body temperature should be closely monitored.

Topics: Analgesics, Opioid; Anesthesia Recovery Period; Animals; Body Temperature; Buprenorphine; Cat Diseases; Cats; Female; Fever; Florida; Hydromorphone; Intraoperative Care; Male; Postoperative Care; Prevalence; Records; Retrospective Studies

At first, we investigated whether both beta-endorphin release level in the hypothalamus and body temperature can be altered after intracerebroventricular (i.c.v.) injection of either lipopolysaccharide (LPS), interleukin-1beta (IL-1beta), or prostaglandin E(2) (PGE(2)) in rats. It was found that in the rat, i.c.v. administration of either LPS (0.5 microg in 10 microl), IL-1beta (10 ng in 10 microl), or PGE(2) (200 ng in 10 microl), in addition to producing fever, upregulated the immunoreactivity of beta-endorphin in the preoptic anterior hypothalamus of rat brain. Secondarily, we assessed whether the fever induced by either LPS, IL-1beta, or PGE(2) can be altered by pretreatment with buprenorphine (an opioid receptor antagonist). The results revealed that i.c.v. administration of buprenorphine (1 - 10 microg in 10 microl) alone had an insignificant effect on the body temperature. However, the fever induced by i.c.v. injection of either LPS, IL-1beta, or PGE(2) was significantly attenuated by pretreatment with i.c.v. injection of buprenorphine 1 h before the pyrogen injection in rats. The results suggest that pyrogens enhance beta-endorphin release in the hypothalamus and trigger fever which can be attenuated by buprenorphine, an opioid receptor antagonist.

Topics: Animals; beta-Endorphin; Buprenorphine; Dinoprostone; Fever; Hypothalamus; Immunohistochemistry; Injections, Intraventricular; Interleukin-1; Lipopolysaccharides; Male; Narcotic Antagonists; Pyrogens; Rats; Rats, Sprague-Dawley