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Kästner SB, Amon T, Tünsmeyer J, Noll M, Söbbeler FJ, Laakso S, Saloranta L, Huhtinen M. Anaesthetic-sparing effect of the anxiolytic drug tasipimidine in Beagle dogs. Vet Anaesth Analg 2024; 51:244-252. [PMID: 38555213 DOI: 10.1016/j.vaa.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 12/03/2023] [Accepted: 02/05/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVE To evaluate the effect of oral tasipimidine on dog handling, ease of catheter placement and propofol and isoflurane requirements for anaesthesia. STUDY DESIGN Placebo-controlled, randomized, blinded, experimental trial. ANIMALS A group of seven adult Beagle dogs weighing (mean ± standard deviation) 13.1 ± 2.7 kg with a mean age of 18.6 ± 1 months. METHODS The dogs underwent four treatments before induction of anaesthesia with propofol. PP: placebo orally (PO) 60 minutes before induction of anaesthesia followed by placebo (NaCl 0.9%) intravenously (IV). TP: tasipimidine 30 μg kg-1 (PO) 60 minutes before induction of anaesthesia followed by placebo (NaCl 0.9%) IV. TMP: tasipimidine 30 μg kg-1 PO 60 minutes before induction of anaesthesia followed by methadone 0.2 mg kg-1 IV. TMPD: tasipimidine 30 μg kg-1 PO 60 minutes before induction of anaesthesia followed by methadone 0.2 mg kg-1 and dexmedetomidine 1 μg kg-1 IV followed by a dexmedetomidine constant rate infusion of 1 μg kg-1 hour-1. Sedation, response to catheter placement, intubation quality, time to loss of consciousness, time to intubation, required dose of propofol and minimum alveolar isoflurane concentration preventing motor movement (MACNM) were determined. A mixed-model analysis or the Friedman and Mann-Whitney test were used; p-value < 0.05. RESULTS Response to catheter placement did not differ between treatments. Tasipimidine alone reduced the propofol dose by 30%. Addition of methadone or methadone and dexmedetomidine reduced the propofol dose by 48% and 50%, respectively. Isoflurane MACNM was reduced by 19% in tasipimidine-medicated dogs, whereas in combination with methadone or methadone and dexmedetomidine, isoflurane MACNM was reduced by 35%. CONCLUSIONS AND CLINICAL RELEVANCE An anxiolytic dose of tasipimidine induced mild signs of sedation in dogs and reduced propofol and isoflurane requirements to induce and maintain anaesthesia, which needs to be considered in an anaesthetic plan.
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Affiliation(s)
- Sabine Br Kästner
- Small Animal Clinic, University of Veterinary Medicine Hannover, Hannover, Germany.
| | - Thomas Amon
- Small Animal Clinic, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Julia Tünsmeyer
- Small Animal Clinic, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Mike Noll
- Evidensia Small Animal Clinic, Norderstedt, Germany
| | - Franz-Josef Söbbeler
- Small Animal Clinic, University of Veterinary Medicine Hannover, Hannover, Germany
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Trenholme HN, Sakai DM, Craig HA, Torpy FJ, Reed RA, Martin-Flores M. Evaluation of a rapid sequence induction technique in dogs with or without rocuronium. Vet Anaesth Analg 2024; 51:52-59. [PMID: 38071121 DOI: 10.1016/j.vaa.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/12/2023] [Accepted: 11/12/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVE To determine, using a rapid sequence induction (RSI) technique, whether rocuronium improves the quality and speed of endotracheal intubation in healthy dogs. STUDY DESIGN Randomized, crossover, experimental study. ANIMALS Six adult intact male Beagles (12.3 ± 0.4 kg). METHODS Dogs were premedicated with intravenous acepromazine (0.03 mg kg-1) and hydromorphone (0.1 mg kg-1). Ten minutes later, anesthesia was induced with intravenous propofol (2 mg kg-1 over 5 seconds), followed by saline (0.06 mL kg-1, CT group) or rocuronium (0.6 mg kg-1, RT group), with orotracheal intubation attempted after 45 seconds. Intubation time (IT) and conditions (IC) were assessed. PaO2, PaCO2, arterial blood pH and serum cortisol were obtained before and after RSI. After endotracheal intubation, saline (0.04 mL kg-1) or sugammadex (4 mg kg-1) were administered intravenously in CT or RT groups, respectively. Spontaneous ventilation restoration was noted. RESULTS The IT was 54.3 ± 6.9 (mean ± SD) and 57.8 ± 5.2 seconds for CT and RT, respectively (p = 0.385). All laryngoscopies indicated good IC in both treatment groups. Heart rate was lower in CT group than in RT group (66 ± 16 versus 103 ± 39 beats minute-1, p = 0.016). PaCO2, pH, PaO2 and cortisol did not differ between treatments. Compared with baseline, PaCO2 increased from 47.7 ± 6.2 to 58.8 ± 5.8 (p < 0.001) and pH decreased from 7.35 ± 0.04 to 7.28 ± 0.04 (p = 0.003), independent of treatment. Dogs in both treatment groups returned to spontaneous ventilation within 30 seconds of RSI. CONCLUSIONS AND CLINICAL RELEVANCE RSI resulted in respiratory acidosis without hypoxemia or increased cortisol. Rocuronium did not improve IT or IC. Spontaneous ventilation was observed immediately after administering saline or sugammadex. The co-administration of rocuronium showed no clinical benefits over propofol alone in RSI in healthy dogs.
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Affiliation(s)
- H Nicole Trenholme
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Daniel M Sakai
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA.
| | - Hannah A Craig
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Frederick J Torpy
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Rachel A Reed
- Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA, USA
| | - Manuel Martin-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
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Heart rate, arterial pressure and propofol-sparing effects of guaifenesin in dogs. Vet Anaesth Analg 2023; 50:50-56. [PMID: 36344374 DOI: 10.1016/j.vaa.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the heart rate (HR) and systemic arterial pressure (sAP) effects, and propofol induction dose requirements in healthy dogs administered propofol with or without guaifenesin for the induction of anesthesia. STUDY DESIGN Prospective blinded crossover experimental study. ANIMALS A total of 10 healthy adult female Beagle dogs. METHODS Dogs were premedicated with intravenous (IV) butorphanol (0.4 mg kg-1) and administered guaifenesin 5% at 50 mg kg-1 (treatment G50), 100 mg kg-1 (treatment G100) or saline (treatment saline) IV prior to anesthetic induction with propofol. HR, invasive sAP and respiratory rate (fR) were recorded after butorphanol administration, after guaifenesin administration and after propofol and endotracheal intubation. Propofol doses for intubation were recorded. Repeated measures analysis of variance (anova) was used to determine differences in propofol dose requirements among treatments, and differences in cardiopulmonary values over time and among treatments with p < 0.05 considered statistically significant. RESULTS Propofol doses (mean ± standard deviation) for treatments saline, G50 and G100 were 3.3 ± 1.0, 2.7 ± 0.7 and 2.1 ± 0.8 mg kg-1, respectively. Propofol administered was significantly lower in treatment G100 than in treatment saline (p = 0.04). In treatments G50 and G100, HR increased following induction of anesthesia and intubation compared with baseline measurements. HR was higher in treatment G100 than in treatments G50 and saline following induction of anesthesia. In all treatments, sAP decreased following intubation compared with baseline values. There were no significant differences in sAP among treatments. fR was lower following intubation than baseline and post co-induction values and did not differ significantly among treatments. CONCLUSIONS AND CLINICAL RELEVANCE When administered as a co-induction agent in dogs, guaifenesin reduced propofol requirements for tracheal intubation. HR increased and sAP and fR decreased, but mean values remained clinically acceptable.
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Effects of intravenous acepromazine and butorphanol on propofol dosage for induction of anesthesia in healthy Beagle dogs. Vet Anaesth Analg 2022; 49:354-363. [DOI: 10.1016/j.vaa.2022.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 11/21/2022]
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Walters K, Lehnus K, Liu NC, Bigby SE. Determining an optimum propofol infusion rate for induction of anaesthesia in healthy dogs: a randomized clinical trial. Vet Anaesth Analg 2022; 49:243-250. [DOI: 10.1016/j.vaa.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/26/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
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Martín Bellido V, Vettorato E. Clinical review of the pharmacological and anaesthetic effects of alfaxalone in dogs. J Small Anim Pract 2021; 63:341-361. [PMID: 34893985 DOI: 10.1111/jsap.13454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/11/2021] [Accepted: 11/16/2021] [Indexed: 01/02/2023]
Abstract
This clinical review summarises the pharmacological and anaesthetic properties of alfaxalone in the dog. Available pharmacokinetic-pharmacodynamic data and factors affecting the induction dose have been reported. Furthermore, quality of induction and recovery after alfaxalone administration, the use of alfaxalone for total intravenous anaesthesia, and its effects on the cardio-respiratory system, on laryngeal motion, on intraocular pressure and tear production have been evaluated. Finally, the use of alfaxalone in dogs undergoing caesarean section and the effect of intramuscular alfaxalone administration have been considered.
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Affiliation(s)
- V Martín Bellido
- Dick White Referrals, Station Farm - London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - E Vettorato
- Dick White Referrals, Station Farm - London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
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Reabel SN, Queiroz-Williams P, Cremer J, Hampton CE, Liu CC, da Cunha A, Nevarez JG. Assessment of intramuscular administration of three doses of alfaxalone combined with hydromorphone and dexmedetomidine for endoscopic-guided orotracheal intubation in domestic rabbits (Oryctolagus cuniculus). J Am Vet Med Assoc 2021; 259:1148-1153. [PMID: 34727075 DOI: 10.2460/javma.20.07.0402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the dose of alfaxalone for IM administration combined with dexmedetomidine and hydromorphone that would allow endoscopic-guided orotracheal intubation in rabbits without causing a decrease in respiratory rate or apnea. ANIMALS 15 sexually intact (9 females and 6 males) healthy Miniature Lop rabbits weighing a mean ± SD of 2.3 ± 0.3 kg and ranging in age from 4 to 9 months. PROCEDURES In a randomized, controlled clinical trial, rabbits received 0.1 mg of hydro-morphone/kg and 0.005 mg of dexmedetomidine/kg, plus alfaxalone at either 2 mg/kg (5 rabbits), 5 mg/kg (5 rabbits), or 7 mg/kg (5 rabbits). Drugs were mixed in a single syringe and administered IM. Semiquantitative rating scales were used to evaluate quality of anesthesia and intubation. Orotracheal intubation was attempted with endoscopy and confirmed by capnography. RESULTS The number of successful intubations was 0, 3, and 4 in rabbits receiving 2, 5, and 7 mg of alfaxalone/kg, respectively. Median (range) anesthesia quality scores (scale, 0 to 12; 12 = deepest anesthesia) were 3 (2 to 5), 6 (5 to 6), and 6 (4 to 9) for rabbits receiving 2, 5, and 7 mg of alfaxalone/kg, respectively. The median (range) intubation quality scores (scale, 0 to 3 [ie, intubation not possible to easiest intubation]) were 0 (0 to 0), 2 (0 to 3), and 2 (0 to 3) for rabbits receiving 2, 5, and 7 mg of alfaxalone/kg, respectively. None of the rabbits experienced a decrease in respiratory rate or apnea. CONCLUSIONS AND CLINICAL RELEVANCE Increasing doses of alfaxalone combined with hydromorphone and dexmedetomidine increased the success rate of endoscopic-guided orotracheal intubation. Increasing the dose of alfaxalone had no effect on respiratory rate.
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Mastakov A, Henning J, de Gier R, Doneley R. Induction of General Anesthesia With Alfaxalone in the Domestic Chicken. J Avian Med Surg 2021; 35:269-279. [PMID: 34677025 DOI: 10.1647/19-00022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Alfaxalone is a safe and effective anesthetic drug for the induction of general anesthesia in many nonavian companion animal species; however, its efficacy has not been fully evaluated in birds. In premedicated trials, the chickens were sedated with butorphanol 2 mg/kg intramuscularly and midazolam 0.5 mg/kg intramuscularly, 15 minutes before intravenous administration of alfaxalone. The chickens were classified as anesthetized if endotracheal intubation was achieved without eliciting a cough reflex, provoking no patient resistance, and with minimal glottis movement within 15 seconds after the administration of alfaxalone. Qualitative and quantitative data were recorded, including duration of anesthesia, quality of induction, quality of recovery, reflexes, time to sternal recumbency, time to standing, and time to normal behaviors. Survival analysis was used to analyze the association between alfaxalone dosage and premedication with time-related variables. Out of the evaluated doses, the lowest intravenous alfaxalone dose required to achieve anesthetic induction and endotracheal intubation in unpremedicated and premedicated chickens was 7.5 and 4 mg/kg, respectively. The duration of anesthesia for all dose rates within the study ranged from 51 seconds to 4 minutes 45 seconds. Premedication generally improved the quality of induction and recovery, but significantly (P < .001) increased the time required for the chickens to stand after being anesthetized and to return to normal behaviors. Most chickens exhibited varying degrees of hyperactivity on anesthetic induction and recovery. No postinduction apnea or deaths of the subject birds occurred during this investigation.
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Affiliation(s)
- Alexandr Mastakov
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia,
| | - Joerg Henning
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
| | - Rebecca de Gier
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
| | - Robert Doneley
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
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Tamura J, Oyama N, Fukui S, Yamashita K. Comparison of the anesthetic effects between 5 mg/kg of alfaxalone and 10 mg/kg of propofol administered intravenously in cats. J Vet Med Sci 2021; 83:73-77. [PMID: 33431725 PMCID: PMC7870395 DOI: 10.1292/jvms.20-0407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To compare the anesthetic effects after intravenous administration of alfaxalone or propofol without premedication, either alfaxalone (5 mg/kg) or propofol (10
mg/kg) was administered intravenously over 120 sec in 6 cats. Each cat received the alternate treatment at least a 7-day interval. Anesthetic effects (tolerance
of intubation, behavior changes and neurodepressive score) and physiological parameters were evaluated. Both treatments produced a rapid loss of consciousness,
no apnea, and physiological parameters were maintained within clinically acceptable ranges apart from transient hypoxemia. The degree of hypoxemia was greater
after the propofol treatment compared with the alfaxalone treatment. During the recovery period, more adverse events (ataxia, muscular tremors) were observed
after the alfaxalone treatment compared with the propofol treatment.
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Affiliation(s)
- Jun Tamura
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan.,Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0018, Japan
| | - Norihiko Oyama
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan.,Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0018, Japan
| | - Sho Fukui
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
| | - Kazuto Yamashita
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
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Dose requirement and cardiopulmonary effects of diluted and undiluted propofol for induction of anaesthesia in dogs. Vet Anaesth Analg 2020; 48:247-251. [PMID: 33423952 DOI: 10.1016/j.vaa.2020.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 10/08/2020] [Accepted: 10/23/2020] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To compare the dose, cardiopulmonary effects and quality of anaesthetic induction in dogs using propofol (10 mg mL-1) and diluted propofol (5 mg mL-1). STUDY DESIGN Randomized, blinded, clinical study. ANIMALS A total of 28 client-owned dogs (12 males/16 females). METHODS Following intramuscular acepromazine (0.02 mg kg-1) and methadone (0.2 mg kg-1), propofol (UP, 10 mg mL-1) or diluted propofol (DP, 5 mg mL-1) was administered intravenously (0.2 mL kg-1 minute-1) by an anaesthetist unaware of the allocated group to achieve tracheal intubation. Sedation, intubation and induction quality were scored from 0 to 3. Pre- and post-induction pulse rate (PR), respiratory rate (fR) and systolic (SAP), mean (MAP) and diastolic (DAP) arterial blood pressure were compared. Time to first breath and induction dose were recorded. Data were analysed for normality and Mann-Whitney U or Student t tests were performed where appropriate. Significance was set at p < 0.05. Data are presented as mean ± standard deviation or median (range). RESULTS The propofol dose administered to achieve induction was lower in the DP group (2.62 ± 0.48 mg kg-1) than in the UP group (3.48 ± 1.17 mg kg-1) (p = 0.021). No difference was observed in pre- and post-induction PR, SAP, MAP, DAP and fR between groups. The differences between post-induction and pre-induction values of these variables were also similar between groups. Time to first breath did not differ between groups. Sedation scores were similar between groups. Quality of tracheal intubation was marginally better with UP 0 (0-1) than with DP 1 (0-2) (p = 0.036), but overall quality of induction was similar between groups [UP 0 (0-1) and DP 0 (0-1), p = 0.549]. CONCLUSION AND CLINICAL RELEVANCE Diluting propofol reduced the dose to induce anaesthesia without significantly altering the cardiopulmonary variables.
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Cazlan CE, Hay Kraus BL. Effects of 2% lidocaine hydrochloride solution as a coinduction agent with propofol on cardiopulmonary variables and administered propofol doses in healthy dogs premedicated with hydromorphone hydrochloride and acepromazine maleate. J Am Vet Med Assoc 2020; 256:93-101. [PMID: 31841086 DOI: 10.2460/javma.256.1.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effects of lidocaine as a coinduction agent with propofol on cardiopulmonary variables and administered propofol doses in healthy dogs premedicated with hydromorphone hydrochloride and acepromazine maleate and anesthetized with isoflurane. ANIMALS 40 client-owned dogs (American Society of Anesthesiologists physical status classification I or II and age ≥ 6 months) scheduled to undergo anesthesia for elective procedures. PROCEDURES In a randomized, blinded, controlled clinical trial, dogs received 2% lidocaine hydrochloride solution (2.0 mg/kg [0.9 mg/lb], IV; n = 20) or buffered crystalloid solution (0.1 mL/kg [0.05 mL/lb], IV; 20; control treatment) after premedication with acepromazine (0.005 mg/kg [0.002 mg/lb], IM) and hydromorphone (0.1 mg/kg, IM). Anesthesia was induced with propofol (1 mg/kg [0.45 mg/lb], IV, with additional doses administered as needed) and maintained with isoflurane. Sedation was assessed, and anesthetic and cardiopulmonary variables were measured at various points; values were compared between treatment groups. RESULTS Propofol doses, total sedation scores, and anesthetic and most cardiopulmonary measurements did not differ significantly between treatment groups over the monitoring period; only oxygen saturation as measured by pulse oximetry differed significantly (lower in the lidocaine group). Mean ± SD propofol dose required for endotracheal intubation was 1.30 ± 0.68 mg/kg (0.59 ± 0.31 mg/lb) and 1.41 ± 0.40 mg/kg (0.64 ± 0.18 mg/lb) for the lidocaine and control groups, respectively. CONCLUSIONS AND CLINICAL RELEVANCE No propofol-sparing effect was observed with administration of lidocaine as a coinduction agent for the premedicated dogs of this study. Mean propofol doses required for endotracheal intubation were considerably lower than currently recommended doses for premedicated dogs. (J Am Vet Med Assoc 2020;256:93-101).
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Bustamante R, Gómez de Segura IA, Canfrán S, Aguado D. Effects of ketamine or midazolam continuous rate infusions on alfaxalone total intravenous anaesthesia requirements and recovery quality in healthy dogs: a randomized clinical trial. Vet Anaesth Analg 2020; 47:437-446. [PMID: 32340894 DOI: 10.1016/j.vaa.2019.10.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/18/2019] [Accepted: 10/06/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the alfaxalone dose reduction during total intravenous anaesthesia (TIVA) when combined with ketamine or midazolam constant rate infusions and to assess recovery quality in healthy dogs. STUDY DESIGN Prospective, blinded clinical study. ANIMALS A group of 33 healthy, client-owned dogs subjected to dental procedures. METHODS After premedication with intramuscular acepromazine 0.05 mg kg-1 and methadone 0.3 mg kg-1, anaesthetic induction started with intravenous alfaxalone 0.5 mg kg-1 followed by either lactated Ringer's solution (0.04 mL kg-1, group A), ketamine (2 mg kg-1, group AK) or midazolam (0.2 mg kg-1, group AM) and completed with alfaxalone until endotracheal intubation was achieved. Anaesthesia was maintained with alfaxalone (6 mg kg-1 hour-1), adjusted (±20%) every 5 minutes to maintain a suitable level of anaesthesia. Ketamine (0.6 mg kg-1 hour-1) or midazolam (0.4 mg kg-1 hour-1) were employed for anaesthetic maintenance in groups AK and AM, respectively. Physiological variables were monitored during anaesthesia. Times from alfaxalone discontinuation to extubation, sternal recumbency and standing position were calculated. Recovery quality and incidence of adverse events were recorded. Groups were compared using parametric analysis of variance and nonparametric (Kruskal-Wallis, Chi-square, Fisher's exact) tests as appropriate, p < 0.05. RESULTS Midazolam significantly reduced alfaxalone induction and maintenance doses (46%; p = 0.034 and 32%, p = 0.012, respectively), whereas ketamine only reduced the alfaxalone induction dose (30%; p = 0.010). Recovery quality was unacceptable in nine dogs in group A, three dogs in group AK and three dogs in group AM. CONCLUSIONS AND CLINICAL RELEVANCE Midazolam, but not ketamine, reduced the alfaxalone infusion rate, and both co-adjuvant drugs reduced the alfaxalone induction dose. Alfaxalone TIVA allowed anaesthetic maintenance for dental procedures in dogs, but the quality of anaesthetic recovery remained unacceptable irrespective of its combination with ketamine or midazolam.
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Affiliation(s)
- Rocío Bustamante
- Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Ignacio A Gómez de Segura
- Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Susana Canfrán
- Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Delia Aguado
- Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain.
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Miller C, Hughes E, Gurney M. Co-induction of anaesthesia with alfaxalone and midazolam in dogs: a randomized, blinded clinical trial. Vet Anaesth Analg 2019; 46:613-619. [PMID: 31285156 DOI: 10.1016/j.vaa.2019.03.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 02/13/2019] [Accepted: 03/01/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To qualitatively assess the co-induction of anaesthesia with midazolam and alfaxalone and to determine cardiovascular or respiratory alterations compared with alfaxalone alone. STUDY DESIGN A randomized, blinded, clinical trial. ANIMALS A total of 29 American Society of Anesthesiologists grade I or II, client-owned dogs undergoing elective orthopaedic or soft tissue surgery. METHODS All dogs received 0.02 mg kg-1 acepromazine and 0.3 mg kg-1 methadone intramuscularly 30 minutes prior to anaesthesia. Measurements of heart rate (HR), respiratory frequency and blood pressure (BP) were assessed pre-induction and at 0, 2 and 5 minutes post-induction. Anaesthesia was induced with 0.5 mg kg-1 alfaxalone followed by either 0.4 mg kg-1 midazolam intravenously (group M) or an equal volume of saline (group S). Conditions were assessed for intubation and further boluses of 0.25 mg kg-1 alfaxalone were given as required. Response to co-induction, ease of intubation and quality of induction were scored, and total dose of alfaxalone required for intubation was recorded. Repeated measures one-way analysis of variance with post hoc Tukey's test was used to assess within group changes over time and Student t tests were used to compare between groups. Incidence of apnoea was assessed using a Fisher's exact test. Data are shown as mean ± standard deviation. RESULTS Group M included 14 dogs and group S 15 dogs. There was a significant difference in the total dose of alfaxalone required for intubation, 0.65 ± 0.20 mg kg-1 group M and 0.94 ± 0.26 mg kg-1 group S (p = 0.002). Apnoea occurred significantly more frequently in group M (p = 0.007). There were no clinically significant differences in HR or BP at the measured time points between groups. CONCLUSIONS AND CLINICAL RELEVANCE Co-induction with midazolam had significant alfaxalone-sparing effects with no clinically detectable cardiovascular changes. Apnoea is common after co-induction.
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Affiliation(s)
- Chris Miller
- Northwest Veterinary Specialists, Sutton Weaver, Cheshire, United Kingdom.
| | - Ellen Hughes
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - Matt Gurney
- Northwest Veterinary Specialists, Sutton Weaver, Cheshire, United Kingdom
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14
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Bennett KJ, Seddighi R, Moorhead KA, Messenger K, Cox SK, Sun X, Pasloske K, Pypendop BH, Doherty TJ. Effect of fentanyl on the induction dose and minimum infusion rate of alfaxalone preventing movement in dogs. Vet Anaesth Analg 2019; 46:173-181. [DOI: 10.1016/j.vaa.2018.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022]
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15
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Zapata A, Laredo FG, Escobar M, Agut A, Soler M, Belda E. Effects of midazolam before or after alfaxalone for co-induction of anaesthesia in healthy dogs. Vet Anaesth Analg 2018; 45:609-617. [DOI: 10.1016/j.vaa.2018.04.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 03/02/2018] [Accepted: 04/06/2018] [Indexed: 11/16/2022]
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16
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A question of time. Vet Anaesth Analg 2018; 45:401-404. [DOI: 10.1016/j.vaa.2018.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/25/2018] [Accepted: 05/25/2018] [Indexed: 11/17/2022]
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