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Sarotti D, Franci P, Oricco S, Rabozzi R, Lardone E. Comparison of hemodynamic effects of propofol or alfaxalone during induction in dogs. Front Vet Sci 2024; 11:1442670. [PMID: 39323870 PMCID: PMC11422344 DOI: 10.3389/fvets.2024.1442670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2024] [Accepted: 08/30/2024] [Indexed: 09/27/2024] Open
Abstract
This randomized prospective clinical study aimed to compare the hemodynamic effects of propofol and alfaxalone for the induction of anesthesia in dogs. Thirty-one healthy dogs undergoing various procedures in a private referral center were premedicated with intramuscular acepromazine (0.015 mg/kg) and methadone (0.15 mg/kg). They then received 5 mg/kg of propofol over 30 s for induction, followed by a maintenance dose of 25 mg/kg/h (Group P), or 2 mg/kg of alfaxalone over 30 s for induction, followed by a continuous rate infusion of 10 mg/kg/h (Group A). Heart rate (HR), mean arterial pressure (MAP), and the velocity time integral (VTI) of the aortic blood flow using transthoracic echocardiography were measured before anesthetic induction and every 15 s for 180 s. Dogs not adequately anaesthetized for intubation were excluded from the hemodynamic evaluation. Events of hypotension (any MAP value lower than 60 mmHg) were also recorded. Statistical analyses utilized ANOVA for repeated measures, two-way repeated measures ANOVA, paired t-tests, or Wilcoxon signed rank-test as appropriate. Significance was set at p < 0.05. Two dogs in Group P (2/14) and 3 in Group A (3/17) were excluded from the study because the anesthesia plane was too light to allow intubation. Treatment P resulted in a significant decrease in MAP between 45 and 75 s during the induction period, with no significant variation in HR, VTI, and VTI*HR. In treatment A, HR increases between 60 and 105 s, VTI decreases at 150-180 s. Analysis between groups did not show any difference in MAP (p = 0.12), HR (p = 0.10), VTI (p = 0.22) and VTI*HR (p = 0.74). During induction, hypotension was detected in 3/12 (25%) dogs in Group P and 1/14 (8%) in Group A. In healthy premedicated dogs, propofol and alfaxalone induction produce similar hemodynamic variations. Propofol induction results in a short-term reduction in MAP, whereas alfaxalone induction preserves MAP and cardiac output by significantly increasing heart rate.
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Affiliation(s)
| | - Paolo Franci
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | | | | | - Elena Lardone
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
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2
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Petrucci M, de Brot S, Casoni D. Case report: Side effects of etomidate in propylene glycol in five Göttingen Minipigs. Front Vet Sci 2024; 11:1376604. [PMID: 39055863 PMCID: PMC11270138 DOI: 10.3389/fvets.2024.1376604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024] Open
Abstract
Etomidate, an agonist of the GABA A receptors, is available for clinical use either in combination with 35% propylene glycol or in a lipid emulsion. Its recognized ability to minimally impact the cardiovascular system made etomidate a suitable option for cardiac-compromised patients. Myoclonus and pain at the injection site are recognized side effects of etomidate in propylene glycol, affecting both human and veterinary species. There is no information available concerning potential side effect in minipigs. In the present case series, we report the side effects related to the use of etomidate in 35% propylene glycol in five Ellegaard Göttingen Minipigs that underwent general anesthesia for cardiac magnetic resonance imaging days or weeks after experimentally induced myocardial infarction. Following intravenous injection of etomidate, laryngeal edema and hyperemia were observed in one case. In another case, tachycardia, apnea, and decreased oxygen saturation, accompanied by laryngeal edema and hyperemia, were observed, which resolved spontaneously in a few minutes. In the arterial or venous samples collected shortly after the induction of general anesthesia, hemolysis was macroscopically visible and subsequently confirmed with a hematological exam in all five cases, as well as hemoglobinuria. Necropsies carried out immediately after euthanasia confirmed macroscopic laryngeal edema, marked diffuse lung alveolar and interstitial edema and hyperemia at histology in one animal, and marked acute lung congestion in another animal. These side effects were not observed when etomidate in a lipid emulsion was injected into another 24 animals. The role played by the different formulations (propylene glycol versus lipidic formulation) has not yet been fully elucidated. Based on our observations, we recommend caution in using the formulation of etomidate in 35% propylene glycol in Göttingen Minipigs.
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Affiliation(s)
- Mariafrancesca Petrucci
- Faculty of Medicine, Experimental Surgery Facility (ESF), Experimental Animal Center (EAC), University of Bern, Bern, Switzerland
- Department for BioMedical Research, Faculty of Medicine, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Science (GCB), University of Bern, Bern, Switzerland
| | - Simone de Brot
- COMPATH, Institute of Animal Pathology, University of Bern, Bern, Switzerland
| | - Daniela Casoni
- Faculty of Medicine, Experimental Surgery Facility (ESF), Experimental Animal Center (EAC), University of Bern, Bern, Switzerland
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3
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Casoria V, Greet V, Auckburally A, Murphy S, Flaherty D. Comparison of the effects of propofol and alfaxalone on the electrocardiogram of dogs, with particular reference to QT interval. Front Vet Sci 2024; 10:1330111. [PMID: 38260194 PMCID: PMC10800659 DOI: 10.3389/fvets.2023.1330111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Cardiac electrical activity is often altered by administration of anesthetic drugs. While the effects of propofol in this regard have previously been described in dogs, to date, there are no reports of the effect of alfaxalone. This study investigated the impact of both propofol and alfaxalone on the ECG of 60 dogs, after premedication with acepromazine and methadone. Heart rate increased significantly in both groups. The PR and QRS intervals were significantly increased following propofol while with alfaxalone the QRS duration was significantly increased and ST segment depression was observed. The QT and JT interval were significantly shorter following induction with alfaxalone, but, when corrected (c) for heart rate, QTc and JTc in both groups were significantly greater following induction. When comparing the magnitude of change between groups, the change in RR interval was greater in the alfaxalone group. The change in both QT and JT intervals were significantly greater following alfaxalone, but when QTc and JTc intervals were compared, there were no significant differences between the two drugs. The similarly increased QTc produced by both drugs may suggest comparable proarrhythmic effects.
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Affiliation(s)
- Vincenzo Casoria
- Department of Anaesthesia and Analgesia, Southern Counties Veterinary Specialists, Ringwood, United Kingdom
| | - Victoria Greet
- Department of Cardiology, Southern Counties Veterinary Specialists, Ringwood, United Kingdom
| | - Adam Auckburally
- Department of Anaesthesia and Analgesia, Southern Counties Veterinary Specialists, Ringwood, United Kingdom
| | - Steve Murphy
- Department of Anaesthesia and Analgesia, Southern Counties Veterinary Specialists, Ringwood, United Kingdom
| | - Derek Flaherty
- Department of Anaesthesia and Analgesia, Southern Counties Veterinary Specialists, Ringwood, United Kingdom
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4
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Fernández Castañer J, Quirós Carmona S, Martínez Bernal C, Morgaz Rodríguez J, Navarrete Calvo R, Granados Machuca MDM. Sedation Quality and Cardiorespiratory, Echocardiographic, Radiographic and Electrocardiographic Effects of Intramuscular Alfaxalone and Butorphanol in Spanish Greyhound Dogs. Animals (Basel) 2023; 13:2937. [PMID: 37760337 PMCID: PMC10525580 DOI: 10.3390/ani13182937] [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: 07/19/2023] [Revised: 09/10/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
The quality of sedation and changes in cardiorespiratory variables after the intramuscular administration of alfaxalone and butorphanol in Spanish greyhound dogs were evaluated. Twenty-one adult dogs were included. The dogs received alfaxalone (2 mg/kg) and butorphanol (0.2 mg/kg) intramuscularly. Sedation scoring, cardiorespiratory parameters (including blood gas analysis), echocardiography, thoracic radiography and electrocardiography were performed before sedation and 30 min after drug administration. Moderate sedation was observed, and side effects, such as tremors, nystagmus and auditory hyperesthesia, were noticed. Statistically significant changes in heart rate, invasive blood pressure, pH, arterial saturation of O2 and partial pressure of O2 and CO2 were found. Echocardiographic variables, including end-diastolic volume, left ventricular diameter in diastole, aortic and pulmonic flow, diastolic transmitral flow and left atrial/aortic ratio, and electrocardiography parameters, including PQ interval and QT interval, showed statistically significant changes. In conclusion, the intramuscular administration of alfaxalone and butorphanol to healthy dogs produced moderate sedation with mild cardiorespiratory, echocardiographic and electrocardiographic changes, without alterations in cardiac size on radiographic images.
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Affiliation(s)
- Julio Fernández Castañer
- Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.F.C.); (C.M.B.)
| | - Setefilla Quirós Carmona
- Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.F.C.); (C.M.B.)
| | - Carmen Martínez Bernal
- Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.F.C.); (C.M.B.)
| | - Juan Morgaz Rodríguez
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.M.R.); (R.N.C.); (M.d.M.G.M.)
| | - Rocío Navarrete Calvo
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.M.R.); (R.N.C.); (M.d.M.G.M.)
| | - María del Mar Granados Machuca
- Department of Animal Medicine and Surgery, School of Veterinary Medicine, University of Córdoba, 14014 Córdoba, Spain; (J.M.R.); (R.N.C.); (M.d.M.G.M.)
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5
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Henze IS, Meira C, Baron Toaldo M, Nolff MC, Steblaj B. Anaesthetic management of three Maine Coon cats undergoing hybrid intervention for treatment of cor triatriatum sinister. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023]
Affiliation(s)
- Inken Sabine Henze
- Section of Anaesthesiology Department of Clinical Diagnostics and Services Vetsuisse Faculty of the University of Zurich Winterthurerstrasse Zurich Switzerland
| | - Carolina Meira
- Section of Anaesthesiology Department of Clinical Diagnostics and Services Vetsuisse Faculty of the University of Zurich Winterthurerstrasse Zurich Switzerland
| | - Marco Baron Toaldo
- Section of Cardiology Clinic for Small Animal Internal Medicine Vetsuisse Faculty of the University of Zurich Winterthurerstrasse Zurich Switzerland
| | - Mirja Christine Nolff
- Clinic for Small Animal Surgery Vetsuisse Faculty of the University of Zurich Winterthurerstrasse Zurich Switzerland
| | - Barbara Steblaj
- Section of Anaesthesiology Department of Clinical Diagnostics and Services Vetsuisse Faculty of the University of Zurich Winterthurerstrasse Zurich Switzerland
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Veen I, Szatmári V, Vries A, Grauw J. Anaesthetic management of a dog with tetralogy of Fallot undergoing placement of a modified Blalock‐Taussig shunt. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Iris Veen
- Department of Clinical Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | - Viktor Szatmári
- Department of Clinical Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | | | - Janny Grauw
- Department of Clinical Sciences Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
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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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8
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de Carellán Mateo AG, Casamián-Sorrosal D. The perioperative management of small animals with previously implanted pacemakers undergoing anaesthesia. Vet Anaesth Analg 2021; 49:7-17. [PMID: 34916163 DOI: 10.1016/j.vaa.2021.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 11/26/2020] [Accepted: 05/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE There is little information in the veterinary literature about the perioperative management of small animal patients with previously implanted pacemakers undergoing elective or emergency non-cardiac procedures. The purpose of this article is to review the current literature with regard to human patients, with previously implanted pacemakers, undergoing general anaesthesia. Using this and the current information on pacemakers and anaesthesia in dogs and cats, we provide recommendations for small animal patients in this situation. DATABASES USED Google Scholar, PubMed and CAB Abstracts using and interlinking and narrowing the search terms: "dog", "cat", "small animals", "anaesthesia", "pacemaker", "perioperative", "transvenous pacing", "temporary pacing". Scientific reports and human and small animal studies from the reference lists of the retrieved papers were reviewed. In addition, related human and veterinary cardiology and anaesthesia textbooks were also included to create a narrative review of the subject. CONCLUSIONS The best perioperative care for these animals comes from a multidisciplinary approach involving the anaesthetist, cardiologist, surgeon and intensive care unit team. When such an approach is not feasible, the anaesthetist should be familiar with pacemaker technology and how to avoid perioperative complications such as electromagnetic interference, lead damage and reprogramming of the device. The preanaesthetic assessment should be thorough. Information regarding the indication for pacemaker placement, complications during the procedure, location, type and programming of the pacemaker should be readily available. The anaesthetic management of these veterinary patients aims to preserve cardiovascular function while avoiding hypotension, and backup pacing should be available during the perioperative period. Further prospective studies are needed to describe the best perioperative care in small animals with a previously implanted pacemaker.
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Affiliation(s)
- Alejandra García de Carellán Mateo
- Anaesthesia and Analgesia Service, Teaching Veterinary Hospital, Department of Animal Medicine and Surgery, School of Veterinary Science, Catholic University of Valencia, Valencia, Spain.
| | - Domingo Casamián-Sorrosal
- Cardiology and Interventional Cardiology Service, Teaching Veterinary Hospital, Department of Animal Medicine and Surgery, School of Veterinary Science, Catholic University of Valencia, Valencia, Spain
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Wolfe KL, Hofmeister EH. Scoping review of quality of anesthetic induction and recovery scales used for dogs. Vet Anaesth Analg 2021; 48:823-840. [PMID: 34483039 DOI: 10.1016/j.vaa.2021.07.001] [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] [Received: 02/05/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare, describe and assess the level of validation of all instruments measuring quality of induction and recovery from anesthesia in dogs. DATABASES USED A search was performed using the electronic database PubMed to find articles containing an induction quality scale, a recovery quality scale or both in dogs. Articles not directly accessible through PubMed were obtained through the Auburn University Library website and Google Scholar. The phrases 'induction scoring systems dogs', 'recovery scoring systems dogs', 'anesthetic induction score dogs', and 'anesthetic recovery score dogs' were used for searches using the 'best match search' function. The time frame searched was from 1980 to May 2020. The search was conducted from March 2020 to May 2020. CONCLUSIONS A thoroughly tested and validated scale for measuring the quality of induction and recovery does not exist in the current veterinary literature. A large disagreement exists between studies on the use of induction and recovery scales, and many have reported inconsistent results with current instruments. It is recommended that an induction and recovery scale intended for wide-scale use be constructed and tested extensively for psychometric validation and reliability.
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Affiliation(s)
- Kathryn L Wolfe
- Department of Animal Sciences, Auburn University, Auburn, AL, USA
| | - Erik H Hofmeister
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
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10
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Foster A, Seo J, Veres‐Nyéki K. Anaesthetic and perioperative management of a dog with biventricular congestive heart failure and advanced second‐degree atrioventricular block. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.94] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Andrew Foster
- Anaesthesia and Analgesia Royal Veterinary College London UK
| | - Joonbum Seo
- Anaesthesia and Analgesia Royal Veterinary College London UK
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11
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Cassady KR, Balko JA, Scharf VF, Briley JD, Slead TS, Graham LF. Anesthesia Case of the Month. J Am Vet Med Assoc 2021; 259:251-254. [PMID: 34242069 DOI: 10.2460/javma.259.3.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Jones TL, Calbay R, da Cunha AF, Hofmeister EH. Descriptive assessment of adverse events associated with midazolam-etomidate versus saline-etomidate in healthy hydromorphone premedicated dogs. J Small Anim Pract 2021; 62:437-441. [PMID: 33565094 DOI: 10.1111/jsap.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/17/2020] [Accepted: 12/29/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To determine the frequency, severity and duration of adverse events including myoclonus, pain on injection, hypersalivation, regurgitation and apnoea after administration of midazolam or saline followed by etomidate in hydromorphone premedicated dogs. MATERIALS AND METHODS Dogs undergoing elective dental prophylaxis or soft tissue surgeries were enrolled in this randomised trial. Dogs were premedicated with hydromorphone 0.1 mg/kg IV. Sixty seconds later, midazolam 0.3 mg/kg or saline at an equivalent volume was administered IV. Sixty seconds after that, etomidate 1.5 mg/kg IV was administered over 60 seconds. Additional doses of 0.5 mg/kg etomidate were administered until endotracheal intubation was successful. Observers were blinded to the treatment. Frequency, duration and a severity score of 0 to 3 were recorded for myoclonus, pain on injection, hypersalivation and regurgitation. Duration of apnoea and frequency of any additional complications was recorded. RESULTS Forty variable breed healthy dogs were enrolled in the study. Myoclonus, pain on injection, regurgitation, hypersalivation, gagging, tachypnoea and pigmenturia occurred, respectively, in 10%, 40%, 0%, 15%, 35%, 25% and 5% of dogs in the saline group and 0%, 65%, 0%, 10%, 45%, 15% and 5% of dogs in the midazolam group. Apnoea occurred for 115 seconds (range 0 to 660 seconds) and 160 seconds (range 0 to 600 seconds) in the saline and midazolam groups, respectively. Two dogs developed pigmenturia. The trial was stopped early due to the occurrence of pigmenturia. CLINICAL SIGNIFICANCE Due to early stopping of the trial, the predefined sample size was not reached. Further investigation is needed to determine if midazolam reduced the incidence of adverse events or improved the induction quality when combined with hydromorphone and etomidate.
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Affiliation(s)
- T L Jones
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, 19555 N 59th Avenue, Glendale, AZ, 85308, USA
| | - R Calbay
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, 19555 N 59th Avenue, Glendale, AZ, 85308, USA
| | - A F da Cunha
- Department of Specialty Medicine, College of Veterinary Medicine, Midwestern University, 19555 N 59th Avenue, Glendale, AZ, 85308, USA
| | - E H Hofmeister
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
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Medina‐Serra R, Palacios C, McMillan M. Alternative anaesthetic management in a reintervention for correction of a left‐to‐right shunting patent ductus arteriosus (PDA) in a dog. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Roger Medina‐Serra
- Royal Veterinary College Department of Veterinary, Clinical Sciences Anaesthesia and Analgesia Hatfield UK
| | | | - Matthew McMillan
- Royal Veterinary College Queen Mother Hosptial for Animals Hatfield UK
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14
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Binetti A, Smets P, Bosmans T, Schauvliege S. Anaesthetic management of a patent ductus arteriosus (PDA) occlusion using an Amplatz canine duct occluder (ACDO) in a dog. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Anna Binetti
- Department of Small Animal MedicineGhent University Faculty of Veterinary MedicineMerelbekeBelgium
| | - Pascale Smets
- Department of Small Animal MedicineGhent University Faculty of Veterinary MedicineMerelbekeBelgium
| | - Tim Bosmans
- Department of Small Animal MedicineGhent University Faculty of Veterinary MedicineMerelbekeBelgium
| | - Stijn Schauvliege
- Department of Surgery and AnaesthesiologyGhent University Faculty of Veterinary MedicineMerelbekeBelgium
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15
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Keating SC, Sage AM, Ambrisko TD, Somrak A, Carroll MQ, Oba PM, Martins B, Swanson KS. The effect of midazolam or lidocaine administration prior to etomidate induction of anesthesia on heart rate, arterial pressure, intraocular pressure and serum cortisol concentration in healthy dogs. Vet Anaesth Analg 2019; 47:160-167. [PMID: 31813669 DOI: 10.1016/j.vaa.2019.09.004] [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: 03/07/2019] [Revised: 08/18/2019] [Accepted: 09/16/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To evaluate selected effects of midazolam or lidocaine administered prior to etomidate for co-induction of anesthesia in healthy dogs. STUDY DESIGN Prospective crossover experimental study. ANIMALS A group of 12 healthy adult female Beagle dogs. METHODS Dogs were premedicated with intravenous (IV) butorphanol (0.3 mg kg-1), and anesthesia was induced with etomidate following midazolam (0.3 mg kg-1), lidocaine (2 mg kg-1) or physiologic saline (1 mL) IV. Heart rate (HR), arterial blood pressure, respiratory rate (fR) and intraocular pressure (IOP) were recorded following butorphanol, after co-induction administration, after etomidate administration and immediately following intubation. Baseline IOP values were also obtained prior to sedation. Etomidate dose requirements and the presence of myoclonus, as well as coughing or gagging during intubation were recorded. Serum cortisol concentrations were measured prior to premedication and 6 hours following etomidate administration. RESULTS Blood pressure, fR and IOP were similar among treatments. Blood pressure decreased in all treatments following etomidate administration and generally returned to sedated values following intubation. HR increased following intubation with midazolam and lidocaine but remained stable in the saline treatment. The dose of etomidate (median, interquartile range, range) required for intubation was lower following midazolam (2.2, 2.1-2.6, 1.7-4.1 mg kg-1) compared with lidocaine (2.7, 2.4-3.6, 2.2-5.1 mg kg-1, p = 0.012) or saline (3.0, 2.8-3.8, 1.9-5.1 mg kg-1, p = 0.015). Coughing or gagging was less frequent with midazolam compared with saline. Myoclonus was not observed. Changes in serum cortisol concentrations were not different among treatments. CONCLUSIONS AND CLINICAL RELEVANCE Midazolam administration reduced etomidate dose requirements and improved intubation conditions compared with lidocaine or saline treatments. Neither co-induction agent caused clinically relevant differences in measured cardiopulmonary function, IOP or cortisol concentrations compared with saline in healthy dogs. Apnea was noted in all treatments following the induction of anesthesia and preoxygenation is recommended.
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Affiliation(s)
- Stephanie Cj Keating
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA.
| | - Adrianna M Sage
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Tamas D Ambrisko
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Amy Somrak
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | | | - Patricia M Oba
- Department of Animal Sciences, University of Illinois, Urbana, IL, USA
| | - Bianca Martins
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA
| | - Kelly S Swanson
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL, USA; Department of Animal Sciences, University of Illinois, Urbana, IL, USA; Division of Nutritional Sciences, University of Illinois, Urbana, IL, USA
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16
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Arenillas M, Caro-Vadillo A, Gómez de Segura IA. Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy. Open Vet J 2019; 9:157-163. [PMID: 31360656 PMCID: PMC6626154 DOI: 10.4314/ovj.v9i2.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 05/09/2019] [Indexed: 11/17/2022] Open
Abstract
The anesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anesthesiologist's main concern is to ensure oxygen delivery and tissue perfusion. Since anesthetic procedures in such patients are rare, there is no previous report about the anesthetic management. A 5.5-year old, 32-kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anesthetized for an ovariohysterectomy to remove an ovarian tumor that was producing high-volume ascites. Methadone (0.3 mg kg-1) was administered intramuscularly (IM) for pre-anesthetic medication, etomidate (1.3 mg kg-1) and midazolam (0.2 mg kg-1) were used for the induction of anesthesia and after endotracheal intubation, anesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5-10 μg kg-1 h-1) and paracetamol (15 mg kg-1) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem, and pimobendan) and continued during the anesthetic procedure. Dobutamine (1.5-5 μg kg-1 minute-1) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg-1) and incisional bupivacaine (2 mg kg-1) were administered at the end of surgery to provide postoperative analgesia. Anesthesia was otherwise uneventful, and recovery was considered excellent.
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Affiliation(s)
- Mario Arenillas
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
| | - Alicia Caro-Vadillo
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
| | - Ignacio A Gómez de Segura
- Department of Animal Medicine and Surgery, Facultad de Veterinaria, Hospital Clínico Veterinario, Universidad Complutense de Madrid, Madrid, Spain
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Pypendop BH, Barter LS, Pascoe PJ, Ranasinghe MG, Pasloske K. Hemodynamic effects of subclinical, clinical and supraclinical plasma alfaxalone concentrations in cats. Vet Anaesth Analg 2019; 46:597-604. [PMID: 31303447 DOI: 10.1016/j.vaa.2019.05.004] [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: 01/08/2019] [Revised: 05/16/2019] [Accepted: 05/18/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To characterize the hemodynamic effects of subclinical, clinical and supraclinical plasma alfaxalone concentrations in cats. STUDY DESIGN Experimental study. ANIMALS A group of six adult healthy male neutered cats. METHODS Cats were anesthetized with desflurane in oxygen for instrumentation. Catheters were placed in a medial saphenous vein for drug administration and in a carotid artery for arterial blood pressure measurement and blood collection. A thermodilution catheter was placed in the pulmonary artery via an introducer placed in a jugular vein for measurement of central venous pressure, pulmonary artery pressure, pulmonary artery occlusion pressure, cardiac output and core body temperature, and for sampling mixed venous blood. A lead II electrocardiogram was connected. Desflurane administration was discontinued and a target-controlled infusion system was used to administer alfaxalone to reach six plasma alfaxalone concentrations ranging from 1.0 to 30.4 mg L-1, with 7.6 mg L-1 considered a clinical concentration for anesthesia. Cardiovascular measurements were recorded, and arterial and mixed-venous blood samples were collected for blood-gas analysis and plasma alfaxalone concentration measurement at each target concentration. Data were analyzed using a repeated-measures analysis of variance and Dunnett's test for comparisons to the lowest target concentration. Significance was set at p < 0.05. RESULTS Mean ± standard deviation plasma alfaxalone concentrations were 0.73 ± 0.32, 1.42 ± 0.41, 3.44 ± 0.40, 6.56 ± 0.43, 18.88 ± 6.81 and 49.47 ± 5.50 mg L-1 for the 1, 1.9, 3.8, 7.6, 15.2, and 30.4 mg L-1 target concentrations, respectively. PaCO2 increased with increasing target plasma alfaxalone concentrations and was 69.4 ± 14.2 mmHg (9.3 ± 1.9 kPa) at the 30.4 mg L-1 target. Some cardiovascular variables were statistically significantly affected by increasing target plasma alfaxalone concentrations. CONCLUSION AND CLINICAL RELEVANCE Within the plasma concentration range studied, alfaxalone caused hypoventilation, but the cardiovascular effects were of small clinical significance.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA.
| | - Linda S Barter
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Peter J Pascoe
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
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Dehuisser V, Bosmans T, Devreese M, Gehring R, Croubels S, Duchateau L, Polis I. Alfaxalone total intravenous anaesthesia in dogs: pharmacokinetics, cardiovascular data and recovery characteristics. Vet Anaesth Analg 2019; 46:605-612. [PMID: 31395484 DOI: 10.1016/j.vaa.2019.04.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 03/14/2019] [Accepted: 04/24/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the cardiovascular effects, pharmacokinetic (PK) data and recovery characteristics of an alfaxalone constant rate infusion (CRI) of different duration in dogs at manufacturer's recommended dose rate. STUDY DESIGN Experimental, prospective, randomized, crossover study. ANIMALS Six intact female Beagles. METHODS Following an intravenous alfaxalone bolus (3 mg kg-1), anaesthesia was maintained using an alfaxalone CRI at 0.15 mg kg-1 minute-1 for 90 (short CRI) or 180 minutes (long CRI). Venous blood samples were collected to determine the PK profile. Cardiovascular variables and recovery characteristics were evaluated. Recovery was scored on a scale ranging from 0, excellent to 4, bad. A mixed-model statistical approach was used to compare the cardiovascular parameters (global α = 0.05). An analysis of variance was performed to compare PK parameters and recovery times between treatments. RESULTS No significant difference was noted between protocols for any PK parameter. Volume of distribution at steady state (935.74 ± 170.25 versus 1119.15 ± 190.65 mL kg-1), elimination half-life (12 ± 2 versus 13 ± 3 minutes), clearance from the central compartment (26.02 ± 4.41 versus 27.74 ± 5.65 mL kg-1 minute-1) and intercompartmental clearance (8.47 ± 4.06 versus 12.58 ± 7.03 mL kg-1 minute-1) were comparable for short CRI and long CRI. Cardiovascular variables remained within physiological limits. Mechanical ventilation was necessary (short CRI: n = 1, long CRI: n = 4). The manufacturer's recommended dose rate resulted in a light plane of anaesthesia. No significant differences in recovery times and scores were observed between treatments. The quality of recovery was scored as very poor with both protocols. CONCLUSIONS AND CLINICAL RELEVANCE PK data were similar between long and short infusions of alfaxalone at the manufacturer's recommended dose, with acceptable cardiovascular conditions. Nevertheless, both protocols resulted in a superficial plane of general anaesthesia with poor recovery characteristics.
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Affiliation(s)
- Virginie Dehuisser
- Department of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
| | - Tim Bosmans
- Department of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Mathias Devreese
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Institute of Computational Comparative Medicine, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Ronette Gehring
- Institute of Computational Comparative Medicine, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Siska Croubels
- Department of Pharmacology, Toxicology and Biochemistry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Luc Duchateau
- Department of Comparative Physiology and Biometry, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Ingeborgh Polis
- Department of Small Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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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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Effect of premedication on dose requirement, cardiovascular effects and recovery quality of alfaxalone total intravenous anaesthesia in dogs. Vet Anaesth Analg 2019; 46:421-428. [PMID: 31178412 DOI: 10.1016/j.vaa.2019.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 01/15/2019] [Accepted: 02/18/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To investigate alfaxalone total intravenous anaesthesia (TIVA) following premedication with methadone combined with acepromazine (ACP) or dexmedetomidine in bitches undergoing ovariohysterectomy. STUDY DESIGN Prospective, blinded, randomized, experimental study. ANIMALS A group of 12 female Beagles. METHODS Dogs were premedicated intravenously with methadone (0.2 mg kg-1) combined with ACP (20 μg kg-1, group AM) or dexmedetomidine (5 μg kg-1, group DM). Anaesthesia was induced with alfaxalone (2 mg kg-1). Anaesthetic maintenance was obtained with an alfaxalone variable rate infusion (VRI) started at 0.15 mg kg-1 minute-1 and adjusted every 5 minutes based on clinical assessment. Mechanical ventilation was initiated when necessary to maintain normocapnia. Anaesthetic monitoring included electrocardiogram, heart rate (HR), invasive diastolic (DAP), systolic (SAP) and mean arterial blood pressure, arterial haemoglobin oxygen saturation, respiratory variables and oesophageal temperature. Data were recorded every 5 minutes. A mixed model statistical approach was used to compare cardiovascular variables within and between groups (α = 0.05). A Wilcoxon rank-sum test was used to compare body temperature, VRI alfaxalone rate, administered rescue analgesia, sedation, induction, intubation, recovery scores and recovery times between treatments. RESULTS Overall HR, SAP and DAP differed between groups (p = 0.001, 0.016, 0.019, respectively). The mean VRI dose rate of alfaxalone differed between groups DM [0.13 (0.11-0.14) mg kg-1 minute-1] and AM [0.18 (0.13-0.19) mg kg-1 minute-1; p = 0.030]. Rescue analgesia was administered more in group AM (p = 0.019). No significant difference in recovery times and scores was observed between protocols. CONCLUSIONS AND CLINICAL RELEVANCE Alfaxalone TIVA following dexmedetomidine/methadone premedication produced a more stable plane of anaesthesia to perform ovariohysterectomy than ACP/methadone. A dose reduction of alfaxalone of 27.7% was obtained in group DM compared with group AM. Recovery quality and recovery times were comparable between both groups.
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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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Liu C, Lin T, Zhou Z. Dexmedetomidine combined with etomidate or emulsified isoflurane for induction reduced cardiopulmonary response in dogs. PLoS One 2018; 13:e0208625. [PMID: 30532170 PMCID: PMC6285997 DOI: 10.1371/journal.pone.0208625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 11/20/2018] [Indexed: 11/18/2022] Open
Abstract
To investigate the effects of etomidate, emulsified isoflurane, and their combination with dexmedetomidine on physiological parameters, electrocardiogram (ECG) results, and the quality of induction and recovery during isoflurane maintenance anaesthesia. 5 mixed-breed dogs received each of four treatments: etomidate (E group); emulsified isoflurane (EI group); both dexmedetomidine and etomidate (DE group); or both dexmedetomidine and emulsified isoflurane (DEI group). All drugs were IV injection administered for induction, followed by 1.5 MAC (minimal alveolar concentration) of isoflurane to maintain anaesthesia. Rectal temperature (RT), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), and ECG were measured at baseline, 0, 5, 10, 20, 40, and 60 minutes after intubation. The quality of induction and recovery was evaluated for all dogs. All the anaesthetic procedures provided good conditions for induction of anaesthesia. The quality of induction and recovery in the E group was worse than other groups. The decrease of RR in the E and DE groups was stronger than that in the EI and DEI groups. The dogs in the E group had the most significant prolongation of the Q-T interval and changes in the S-T segment. Deviation and extension of the S-T segment were noted in the El group. The dogs in the DE and DEI groups had fewer changes in the ECG results than those in the E and EI groups. The addition of dexmedetomidine caused less effect on cardiopulmonary parameters and the ECG results than either etomidate or emulsified isoflurane alone. Thus, etomidate or emulsified isoflurane in combination with dexmedetomidine may be useful clinically for the induction of anaesthesia.
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Affiliation(s)
- Chao Liu
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, China
| | - Tingting Lin
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, China
| | - Zhenlei Zhou
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, Jiangsu, China
- * E-mail:
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Italiano M, Robinson R. Effect of benzodiazepines on the dose of alfaxalone needed for endotracheal intubation in healthy dogs. Vet Anaesth Analg 2018; 45:720-728. [DOI: 10.1016/j.vaa.2018.06.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 04/08/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022]
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Pharmacokinetics of intramuscular alfaxalone and its echocardiographic, cardiopulmonary and sedative effects in healthy dogs. PLoS One 2018; 13:e0204553. [PMID: 30248146 PMCID: PMC6152991 DOI: 10.1371/journal.pone.0204553] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 08/17/2018] [Indexed: 11/19/2022] Open
Abstract
The pharmacokinetics and the effects of a single intramuscular (IM) dose of alfaxalone on sedation and cardiopulmonary and echocardiographic variables was studied in dogs. Twelve healthy adult Beagles (3 females, 9 males) were used in this prospective controlled cross-over trial. Echocardiography was performed with and without 4 mg kg-1 alfaxalone IM with a week wash-out interval. Sedation (19-point scale; 0 = no sedation), cardiopulmonary parameters, blood gas analysis and plasma concentration of alfaxalone were assessed every 5 minutes following the injection (T0). The influence of the alfaxalone plasma concentration and time on physiological variables was tested using a linear model whereas echocardiographic measurements were compared between conscious and alfaxalone-administered dogs using paired t-tests. Compared to baseline, alfaxalone administration was followed by an increase in heart rate (HR) from T5 to T30 and a decrease in mean arterial pressure (MAP) at T10, T25 and T30, in stroke volume (SV; 15 ± 5 to 11 ± 3 ml; P<0.0001), and end-diastolic volume (EDV; 24.7 ± 5.7 to 19.4 ± 4.9 ml). Cardiac output (CO) and blood gas analysis did not change significantly throughout. Mean plasma half-life was 29 ± 8 minutes, volume of distribution was 1.94 ± 0.63 L kg-1, and plasma clearance was 47.7 ± 14.1 ml kg-1 minute-1. Moderate to deep sedation was observed from T5 to T35. Ten dogs showed paddling, trembling, nystagmus and strong reaction to sound during the procedure. Although there were no significant changes in CO and oxygenation, the impact of HR, MAP, SV, EDV alterations requires further investigations in dogs with cardiac disease.
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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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Sedative and physiologic effects of low-dose intramuscular alfaxalone in dogs. Vet Anaesth Analg 2017; 44:1184-1188. [DOI: 10.1016/j.vaa.2016.11.013] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 11/24/2016] [Indexed: 11/23/2022]
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Liao P, Sinclair M, Valverde A, Mosley C, Chalmers H, Mackenzie S, Hanna B. Induction dose and recovery quality of propofol and alfaxalone with or without midazolam coinduction followed by total intravenous anesthesia in dogs. Vet Anaesth Analg 2017; 44:1016-1026. [DOI: 10.1016/j.vaa.2017.02.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 10/19/2022]
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Bennett RC, Salla KM, Raekallio MR, Scheinin M, Vainio OM. Effects of the α2-adrenoceptor agonist medetomidine on the distribution and clearance of alfaxalone during coadministration by constant rate infusion in dogs. Am J Vet Res 2017; 78:956-964. [DOI: 10.2460/ajvr.78.8.956] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Deutsch J, Ekiri A, de Vries A. Alfaxalone for maintenance of anaesthesia in ponies undergoing field castration: continuous infusion compared with intravenous boluses. Vet Anaesth Analg 2017; 44:832-840. [PMID: 28687474 DOI: 10.1016/j.vaa.2016.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/23/2016] [Accepted: 06/16/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To compare alfaxalone as continuous intravenous (IV) infusion with intermittent IV injections for maintenance of anaesthesia in ponies undergoing castration. STUDY DESIGN Prospective, randomized, 'blinded' clinical study. ANIMALS A group of 33 entire male Welsh ponies undergoing field castration. METHODS After preanaesthetic medication with IV detomidine (10 μg kg-1) and butorphanol (0.05 mg kg-1), anaesthesia was induced with IV diazepam (0.05 mg kg-1) followed by alfaxalone (1 mg kg-1). After random allocation, anaesthesia was maintained with either IV alfaxalone 2 mg kg-1 hour-1 (group A; n = 16) or saline administered at equal volume (group S; n = 17). When necessary, additional alfaxalone (0.2 mg kg-1) was administered IV. Ponies were breathing room air. Using simple descriptive scales, surgical conditions and anaesthesia recovery were scored. Total amount of alfaxalone, ponies requiring additional alfaxalone and time to administration, time from induction to end of infusion and end of infusion to standing were noted. Indirect arterial blood pressure, pulse and respiratory rates, end-expiratory carbon dioxide partial pressure and arterial haemoglobin oxygen saturation were recorded every 5 minutes. Data were analysed using Student t, Mann-Whitney U and chi-square tests, where appropriate (p < 0.05). RESULTS Total amount of alfaxalone administered after induction of anaesthesia (0.75 ± 0.27 versus 0.17 ± 0.23 mg kg-1; p < 0.0001) and time to standing (14.8 ± 4 versus 11.6 ± 4 minutes; p = 0.044) were higher in group A compared to group S. Ponies requiring additional alfaxalone boluses [four (group A) versus seven (group S)] and other measured variables were similar between groups; five ponies required oxygen supplementation [three (group A) versus two (group S)]. CONCLUSION AND CLINICAL RELEVANCE Continuous IV infusion and intermittent administration of alfaxalone provided similar anaesthesia quality and surgical conditions in ponies undergoing field castration. Less alfaxalone is required when used intermittently.
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Affiliation(s)
| | - Abel Ekiri
- College of Public Health and Health Profession, University of Florida, Gainesville, FL, USA
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Muñoz KA, Robertson SA, Wilson DV. Alfaxalone alone or combined with midazolam or ketamine in dogs: intubation dose and select physiologic effects. Vet Anaesth Analg 2017; 44:766-774. [PMID: 28756063 DOI: 10.1016/j.vaa.2017.01.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/25/2017] [Accepted: 01/26/2017] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine the intubation dose and select physiologic effects of alfaxalone alone or in combination with midazolam or ketamine in dogs. STUDY DESIGN Prospective, clinical study. ANIMALS Fifty-three healthy client-owned dogs [mean±standard deviation (SD)] 5.1±1.8 years, 27±15.4 kg, scheduled for elective orthopedic surgery. METHODS After premedication with acepromazine (0.02 mg kg-1) and hydromorphone (0.1 mg kg-1) intramuscularly, alfaxalone (0.25 mg kg-1) was administered intravenously over 15 seconds followed immediately by 0.9% saline (AS), midazolam (0.3 mg kg-1; AM), ketamine (1 mg kg-1; AK1), or ketamine (2 mg kg-1; AK2). Additional alfaxalone (0.25 mg kg-1 increments) was administered as required to permit endotracheal intubation. The incidence of apnea and the time from intubation until spontaneous movement were recorded. Heart rate (HR) and blood pressure were recorded 15 minutes after premedication, after intubation and 2, 5, 10 and 15 minutes thereafter. Blood was collected for measurement of serum glucose and insulin concentrations before induction, after intubation and at 2, 5, 10 and 50 minutes. Data were analyzed by split-plot anova with Bonferroni adjustment for the number of group comparisons. RESULTS Mean±SD alfaxalone mg kg-1 doses required for endotracheal intubation were AS (1.0±0.4), AM (0.4±0.2), AK1 (0.5±0.3) and AK2 (0.5±0.4) (p=0.0005). Differences in cardiopulmonary variables among groups were minor; HR decreased in AS, while in other groups, HR increased transiently postintubation. Incidence of apnea in AS was 54% with no significant difference among groups. Midazolam significantly prolonged time from intubation until spontaneous movement (p<0.002). CONCLUSIONS AND CLINICAL RELEVANCE Midazolam and ketamine reduced the alfaxalone dose required for endotracheal intubation. Serum glucose and insulin concentrations were not influenced by administration of alfaxalone alone or when administered with midazolam or ketamine.
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Affiliation(s)
- Kirk A Muñoz
- Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA.
| | - Sheilah A Robertson
- Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
| | - Deborah V Wilson
- Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, USA
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Chiu KW, Robson S, Devi JL, Woodward A, Whittem T. The cardiopulmonary effects and quality of anesthesia after induction with alfaxalone in 2-hydroxypropyl-β
-cyclodextrin in dogs and cats: a systematic review. J Vet Pharmacol Ther 2016; 39:525-538. [DOI: 10.1111/jvp.12312] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- K. W. Chiu
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - S. Robson
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - J. L. Devi
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - A. Woodward
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - T. Whittem
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
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Conde Ruiz C, Del Carro AP, Rosset E, Guyot E, Maroiller L, Buff S, Portier K. Alfaxalone for total intravenous anaesthesia in bitches undergoing elective caesarean section and its effects on puppies: a randomized clinical trial. Vet Anaesth Analg 2015; 43:281-90. [PMID: 26451686 DOI: 10.1111/vaa.12298] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 02/27/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the effects and reliability of alfaxalone constant rate infusion (CRI) in comparison to isoflurane to maintain anaesthesia in bitches undergoing elective caesarean section. STUDY DESIGN Prospective, randomized, 'blinded' clinical trial. ANIMALS Twenty-two client-owned bitches and 94 puppies. METHODS Bitches were randomly assigned to receive an alfaxalone CRI [0.2 mg kg(-1) minute(-1) intravenously (IV), and once the last puppy was delivered, the dose was halved; n = 11] or 2% (vaporizer dial setting) isoflurane (n = 11) for maintenance of anaesthesia. All dogs were induced with alfaxalone (3 mg kg(-1) ) IV. Additional alfaxalone (0.3 mg kg(-1) IV) was administered if the depth of anaesthesia was inadequate and the total dose was calculated. Bitches were mechanically ventilated. Analgesia was administered after the delivery of puppies. Physiological variables were recorded every 5 minutes. The bitches' recovery times were also recorded. Quality of induction and recovery were evaluated. Puppies' vigour was evaluated with a modified Apgar score at 5 and 60 minutes after birth. Puppies' survival rates at 24 and 48 hours and at 15 days were recorded. Data were analysed using an anova, Student's t-test or Wilcoxon rank-sum test. RESULTS The rescue dose of alfaxalone was higher (p = 0.01); bitches' recoveries were longer (p < 0.001) and puppies' Apgar scores were significantly lower at 5 and 60 minutes (p < 0.001 and p = 0.003, respectively) with alfaxalone than with isoflurane. However, no significant differences were found for puppies' survival between groups. CONCLUSIONS AND CLINICAL RELEVANCE Alfaxalone CRI seems to be a possible protocol for puppies and bitches undergoing elective caesarean sections. However, bitches recovered more slowly and puppy Apgar scores were lower in comparison to isoflurane.
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Affiliation(s)
- Clara Conde Ruiz
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Andrea P Del Carro
- Section of Biotechnology and Theriogenology, CERREC & CRB-ANIM, Université de Lyon, VetAgro Sup 1, Marcy l'Etoile, France
| | - Emilie Rosset
- Section of Biotechnology and Theriogenology, CERREC & CRB-ANIM, Université de Lyon, VetAgro Sup 1, Marcy l'Etoile, France
| | - Emilie Guyot
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Laura Maroiller
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France
| | - Samuel Buff
- Section of Biotechnology and Theriogenology, CERREC & CRB-ANIM, Université de Lyon, VetAgro Sup 1, Marcy l'Etoile, France
| | - Karine Portier
- Section of Anaesthesiology, Université de Lyon, VetAgro Sup, Marcy l'Etoile, France.,INSERM, UMR-1060, CarMeN, Lyon, France
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Kutter APN, Bettschart-Wolfensberger R, Schwarzwald CC, Portier KG, Ringer SK. Evaluation of the non-calibrated pulse contour cardiac output monitor FloTrac/Vigileo against thermodilution in standing horses. Vet Anaesth Analg 2015; 43:153-62. [PMID: 26095722 DOI: 10.1111/vaa.12281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 02/10/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the non-calibrated, minimally invasive cardiac output (CO) monitor FloTrac/Vigileo (FloTrac) against thermodilution (TD) CO in standing horses. STUDY DESIGN Prospective, experimental trial. ANIMALS Nine adult horses weighing a median (range) of 535 (470-602) kg. METHODS Catheters were placed in the right atrium, pulmonary artery and carotid artery under local anaesthesia. CO was measured 147 times by TD and FloTrac and indexed to body weight. Changes in CO were achieved with romifidine or xylazine and dobutamine constant rate infusions. Bland-Altman analysis, concordance and polar plot analysis were used to assess agreement and ability to track changes in CO. RESULTS Mean ± standard deviation COTD of 48 ± 16 mL kg(-1) minute(-1) (range: 19-93 mL kg(-1) minute(-1) ) and mean COF loTrac of 9 ± 3 mL kg(-1) minute(-1) (range: 5-21 mL kg(-1) minute(-1) ) were measured. Low agreement with a large mean bias of 39 mL kg(-1) minute(-1) and wide limits of agreement of 8-70 mL kg(-1) minute(-1) were found. The percentage error of 108% and precision of TD of ± 18% resulted in an estimated precision of FloTrac of ± 106%. Comparison of changes in COF loTrac with changes in COTD gave a concordance rate of 52% in the four-quadrant plot, and a mean polar angle of -11° with radial limits of agreement of ± 61 ° in the polar plot. Mean arterial pressure (MAP) and COF loTrac were positively correlated (r = 0.5, p < 0.0001). No correlation of MAP with COTD was observed. CONCLUSIONS AND CLINICAL RELEVANCE The FloTrac system, originally designed for use in humans, neither measured absolute CO in standing horses accurately nor tracked relative changes in CO measured by TD correctly. The false dependence of COF loTrac on arterial blood pressure further discourages the use of this technique in horses.
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Affiliation(s)
- Annette P N Kutter
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Colin C Schwarzwald
- Clinic for Equine Internal Medicine, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Karine G Portier
- Section of Anaesthesiology, VetAgro Sup (Veterinary Campus), University of Lyon, Marcy L'Étoile, France.,INSERM (Institut National de la Santé et de la Recherche Médicale), UMR-1060, CarMeN (Cardiovasculaire, Métabolisme, Diabétologie et Nutrition), Lyon, France
| | - Simone K Ringer
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Raisis AL, Smart L, Drynan E, Hosgood G. Cardiovascular function during maintenance of anaesthesia with isoflurane or alfaxalone infusion in greyhounds experiencing blood loss. Vet Anaesth Analg 2015; 42:133-41. [DOI: 10.1111/vaa.12190] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Accepted: 01/02/2014] [Indexed: 11/30/2022]
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d'Ovidio D, Spadavecchia C, Angeli G, Adami C. Etomidate anaesthesia by immersion in oriental fire-bellied toads (Bombina orientalis). Lab Anim 2015; 49:319-26. [PMID: 25673664 DOI: 10.1177/0023677215571655] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of the present study was to evaluate the efficacy and the safety of etomidate anaesthesia by immersion technique in Bombina orientalis. The study comprised two phases. The first phase was carried out to identify the etomidate concentration capable of producing anaesthetic induction, as well as surgical anaesthesia, in the toads. The second phase was aimed at testing that concentration in eight additional animals. Etomidate administered via immersion at a concentration of 37.5 mg/L produced effective anaesthesia in oriental fire-bellied toads. The average duration of surgical anaesthesia was 20 min. All the toads enrolled in the study survived the anaesthesia and long-term complications did not occur. However, undesired side-effects, namely itching, myoclonus and prolonged recovery, were noticed during the perianaesthetic period. The authors concluded that etomidate anaesthesia by immersion, at a concentration of 37.5 mg/L, is suitable in oriental fire-bellied toads and produces anaesthesia of a depth and duration that is sufficient to allow the completion of various experimental procedures, without resulting in lethal complications. However, the occurrence of undesired side-effects opens a debate on the safety of this anaesthetic technique, and imposes the need for further investigation prior to proposing the latter for routine laboratory practice.
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Affiliation(s)
- D d'Ovidio
- Freelance Veterinarian, Arzano, Naples, Italy
| | - C Spadavecchia
- Department of Veterinary Clinical Science, Anaesthesiology and Pain Therapy Division, Vetsuisse Faculty of the University of Berne, Berne, Switzerland
| | - G Angeli
- Department of Veterinary Medicine, University of Perugia, Perugia, Italy
| | - C Adami
- Department of Veterinary Clinical Science, Anaesthesiology and Pain Therapy Division, Vetsuisse Faculty of the University of Berne, Berne, Switzerland
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Morgaz J, Granados MDM, Muñoz-Rascón P, Dominguez JM, Fernández-Sarmiento JA, Gómez-Villamandos RJ, Navarrete R. Comparison of thermodilution, lithium dilution, and pulse contour analysis for the measurement of cardiac output in 3 different hemodynamic states in dogs. J Vet Emerg Crit Care (San Antonio) 2014; 24:562-70. [PMID: 25142925 DOI: 10.1111/vec.12219] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2013] [Accepted: 07/14/2014] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To (1) evaluate lithium dilution (LiDCO) and transpulmonary thermodilution (PiCCOTD ) in relation to traditional thermodilution (PAC-TD) for determining cardiac output (CO) in 3 different hemodynamic states in dogs and to (2) compare the continuous CO values obtained using power analysis (PulseCO) with continuous PiCCO (PiCCOc). DESIGN Prospective randomized study. SETTING University research laboratory. ANIMALS Fourteen healthy Beagles. INTERVENTIONS CO was measured using PAC-TD, LiDCO, and PiCCOTD in 3 different hemodynamic states induced in random order and defined on the basis of the mean arterial pressure (MAP). Normodynamic state was defined as the baseline MAP and 1 MAC sevoflurane. The hypodynamic state was induced with a deep level of sevoflurane anesthesia. The hyperdynamic state was induced with noradrenaline. After these measurements were obtained in each hemodynamic state, CO was monitored continuously for 30 min using PulseCO and PiCCOc. Agreement was assessed using Bland-Altman analysis and intraclass correlation coefficients, and a trend score was determined for the continuous CO measurements. MEASUREMENTS AND MAIN RESULTS There was good agreement among the 3 modalities of CO measurement in each hemodynamic state. The mean CIPAC-TD /CIPICCOTD bias was -0.04 ± 1.19 L/min/m(2) (limits of agreement, -2.37/1.93 L/min/m(2) ), and the mean CIPAC-TD /CILiDCO bias was -0.11 ± 1.55 L/min/m(2) (limits of agreement, -3.04/2.93 L/min/m(2) ). The mean CIPulseCO -CIPiCCOc bias was -0.04 ± 1.91 L/min/m(2) (limits of agreement, -1.95/1.87 L/min/m(2) ), which suggested good agreement. The CIPulseCO -CIPiCCOc trend score, calculated from 252 paired comparisons, was 93.3% positive after zone exclusion (∆CI < 15%). CONCLUSIONS Both LiDCO and PiCCOTD agreed well with PAC-TD for the measurement of CO under different hemodynamic conditions. Moreover, PiCCOc appears to be an accurate method for monitoring continuous CO in dogs as its performance for measurement was similar to that of PulseCO.
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Affiliation(s)
- Juan Morgaz
- Department of Animal Medicine and Surgery, University of Córdoba, Córdoba, Spain
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Seo JI, Han SH, Choi R, Han J, Lee L, Hyun C. Cardiopulmonary and anesthetic effects of the combination of butorphanol, midazolam and alfaxalone in Beagle dogs. Vet Anaesth Analg 2014; 42:304-8. [PMID: 25112420 DOI: 10.1111/vaa.12223] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 07/17/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the physiological variables, arterial blood gas values, induction of anesthesia quality, and recovery quality using the combination of butorphanol, midazolam and alfaxalone in dogs. ANIMALS Ten healthy adult Beagle dogs weighing 8.3 ± 3.1 kg. METHODS Rectal temperature (T), pulse rate (PR), respiratory rate (f(R)), mean arterial pressure (MAP), and arterial blood gases were measured and recorded prior to intravenous (IV) administration of butorphanol, prior to administration of both midazolam and alfaxalone IV 10 minutes later, then every 5 minutes for 20 minutes. M-mode echocardiographic left ventricular (LV) indices were measured before and 5 minutes after administration of alfaxalone. Qualitative scores for induction of anesthesia and recovery were allocated, duration of anesthesia and recovery were calculated, and adverse events were recorded. RESULTS Scores for induction and recovery quality were excellent. No significant adverse events were observed. Mean ± SD time from induction to extubation and to standing (full recovery) was 29 ± 6 and 36 ± 8 minutes, respectively. There were statistically significant changes in PR, f(R) and MAP after drug administration. Transient hypercarbia developed after alfaxalone injection. The echocardiographic LV indices were reduced after alfaxalone injection, although those changes were not statistically significant. CONCLUSIONS AND CLINICAL RELEVANCE The combination of butorphanol, midazolam and alfaxalone provided excellent quality of induction of anesthesia and exerted minimal cardiopulmonary effects in healthy dogs.
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Affiliation(s)
- Jeong-Im Seo
- Section of Small Animal Internal Medicine, College of Veterinary Medicine, Kangwon National University, Chuncheon, Korea
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Pinelas R, Alibhai HIK, Mathis A, Jimenez Lozano A, Brodbelt DC. Effects of different doses of dexmedetomidine on anaesthetic induction with alfaxalone – a clinical trial. Vet Anaesth Analg 2014; 41:378-85. [DOI: 10.1111/vaa.12121] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2013] [Accepted: 04/05/2013] [Indexed: 12/25/2022]
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Sanchis-Mora S, Viscasillas J, Mathis A, Palacios C, Brodbelt DC, Alibhai HI. Anaesthetic management and complications of pacemaker implantation in dogs. Vet Rec 2014; 175:303. [PMID: 24958554 DOI: 10.1136/vr.102246] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The aim of this study was to report the anaesthetic management and peri-anaesthetic complications of 57 dogs undergoing pacemaker implantation at a referral institution over 10 years (2002-2012). The median duration of the procedure was 135 minutes (range 25-260 minutes). Patients were classified as American Society of Anaesthesiologist (ASA) III (42 cases) and ASA IV (15 cases). Forty-three patients had third-degree atrioventricular block, and 14 patients had sick sinus syndrome. The anaesthetic protocol most frequently chosen was pethidine (41 cases), etomidate-midazolam (43 cases) and isoflurane in oxygen for maintenance (57 cases). Transthoracic external pacing was used (43 cases) until the internal pacing lead was implanted. Atracurium was administered (48 cases) and intermittent positive pressure ventilation was applied in 52 cases. Complications observed included hypothermia (19 cases) and hypotension (5 cases). Three patients died (5.8%, 95% CI 1.1% to 14.6%) within the first 48 hours after termination of anaesthesia. The outcome for this procedure in sick animals appeared generally good though a number of complications were documented.
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Affiliation(s)
- S Sanchis-Mora
- Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, Hatfield AL9 7TA, UK
| | - J Viscasillas
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK
| | - A Mathis
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK
| | - C Palacios
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK
| | - D C Brodbelt
- Department of Production and Population Health, Royal Veterinary College, Hatfield, UK
| | - H I Alibhai
- Department of Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK
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Quirós Carmona S, Navarrete-Calvo R, Granados MM, Domínguez JM, Morgaz J, Fernández-Sarmiento JA, Muñoz-Rascón P, Gómez-Villamandos RJ. Cardiorespiratory and anaesthetic effects of two continuous rate infusions of dexmedetomidine in alfaxalone anaesthetized dogs. Res Vet Sci 2014; 97:132-9. [PMID: 24768518 DOI: 10.1016/j.rvsc.2014.03.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Revised: 02/24/2014] [Accepted: 03/28/2014] [Indexed: 12/26/2022]
Abstract
Six Beagles were used in this prospective randomised crossover experimental study. Dexmedetomidine was administered at 0, 1 or 2 μg/kg IV for group C, LDA and HDA, respectively. Animals were induced and maintained with alfaxalone at 0.07 mg/kg/min with a CRI dexmedetomidine dose of 0, 0.5 or 1 μg/kg/h for group C, LDA and HDA, respectively. Cardiorespiratory variables, arterial blood gases and depth of anaesthesia were recorded. The recovery times and quality of recovery were scored. Group HDA produced a greater increase in the depth of anaesthesia than LDA. However, with both protocols, CI was halved compared to normal values in dogs. The use of oxygen before and during the anaesthetic maintenance is advisable, mainly if dexmedetomidine is going to be use as a pre-medicant and maintenance agent. The quality of recovery was better in groups receiving dexmedetomidine, without causing an increase in recovery time.
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Affiliation(s)
- S Quirós Carmona
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain.
| | - R Navarrete-Calvo
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain
| | - M M Granados
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain
| | - J M Domínguez
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain
| | - J Morgaz
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain
| | | | - P Muñoz-Rascón
- Department of Animal Medicine and Surgery, University of Cordoba, Cordoba, Spain
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Dzikiti TB, Zeiler GE, Dzikiti LN, Garcia ER. The effects of midazolam and butorphanol, administered alone or combined, on the dose and quality of anaesthetic induction with alfaxalone in goats. J S Afr Vet Assoc 2014; 85:1047. [DOI: 10.4102/jsava.v85i1.1047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 10/15/2013] [Accepted: 10/25/2013] [Indexed: 11/01/2022] Open
Abstract
Goats are rarely anaesthetised; consequently, scant information is available on the efficacy of anaesthetic drugs in this species. Alfaxalone is a relatively new anaesthetic agent, of which the efficacy in goats has not yet been studied. In this study, the sedative and alfaxalonesparing effects of midazolam and butorphanol, administered alone or concomitantly, in goats were assessed. Eight clinically healthy goats, four does and four wethers, were enlisted in a randomised crossover manner to receive intramuscular sedative treatments consisting of saline 0.05 mL/kg, or midazolam 0.30 mg/kg, or butorphanol 0.10 mg/kg, or a combination ofmidazolam 0.30 mg/kg with butorphanol 0.10 mg/kg before intravenous induction of general anaesthesia with alfaxalone. Following induction, the goats were immediately intubated and the quality of anaesthesia and basic physiological cardiorespiratory and blood-gas parameters were assessed until the goats had recovered from anaesthesia. The degree of sedation, quality of induction and recovery were scored. When compared with saline (3.00 mg/kg), midazolam,administered alone or with butorphanol, caused a statistically significant increased level of sedation and a reduction in the amount of alfaxalone required for induction (2.00 mg/kg and 1.70 mg/kg, respectively). Butorphanol alone (2.30 mg/kg) did not cause significant changes in level of sedation or alfaxalone-induction dose. During induction and recovery, the goats were calm following all treatments, including the control group. Cardiorespiratory and blood gasparameters were maintained within clinically acceptable limits. The present study showed that midazolam, administered alone or combined with butorphanol, produces a degree of sedation that significantly reduces the dose of alfaxalone required for induction of general anaesthesia in goats, without causing any major adverse cardiorespiratory effects.
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Navarrete-Calvo R, Gómez-Villamandos RJ, Morgaz J, Manuel Domínguez J, Fernández-Sarmiento A, Muñoz-Rascón P, López Villalba I, Del Mar Granados M. Cardiorespiratory, anaesthetic and recovery effects of morphine combined with medetomidine and alfaxalone in rabbits. Vet Rec 2014; 174:95. [DOI: 10.1136/vr.101293] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- R. Navarrete-Calvo
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
| | - R. J. Gómez-Villamandos
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
| | - J. Morgaz
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
| | - J. Manuel Domínguez
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
| | - A. Fernández-Sarmiento
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
| | - P. Muñoz-Rascón
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
| | - I. López Villalba
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
| | - M. Del Mar Granados
- Department of Animal Medicine and Surgery; Scholl of Veterinary Medicine; University of Córdoba; Córdoba Spain
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Ramos RV, Monteiro-Steagall BP, Steagall PVM. Management and complications of anaesthesia during balloon valvuloplasty for pulmonic stenosis in dogs: 39 cases (2000 to 2012). J Small Anim Pract 2014; 55:207-12. [DOI: 10.1111/jsap.12182] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. V. Ramos
- Department of Clinical Studies, Ontario Veterinary College; University of Guelph; Ontario Canada
| | - B. P. Monteiro-Steagall
- Département de Biomédecine Vétérinaire, Faculté de Médecine Vétérinaire; Université de Montreal; QC Canada
| | - P. V. M. Steagall
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire; Universite de Montreal; QC Canada
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Hasiuk MMM, Forde N, Cooke A, Ramey K, Pang DSJ. A comparison of alfaxalone and propofol on intraocular pressure in healthy dogs. Vet Ophthalmol 2013; 17:411-6. [DOI: 10.1111/vop.12119] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Michelle M. M. Hasiuk
- Veterinary Clinical and Diagnostic Sciences; Faculty of Veterinary Medicine; University of Calgary; Calgary Alberta Canada T2N 4Z6
| | - Nessa Forde
- Western Veterinary Specialist and Emergency Centre; Calgary Alberta Canada T2N 4Z6
| | - Amy Cooke
- Western Veterinary Specialist and Emergency Centre; Calgary Alberta Canada T2N 4Z6
| | - Kelli Ramey
- Western Veterinary Specialist and Emergency Centre; Calgary Alberta Canada T2N 4Z6
| | - Daniel S. J. Pang
- Veterinary Clinical and Diagnostic Sciences; Faculty of Veterinary Medicine; University of Calgary; Calgary Alberta Canada T2N 4Z6
- Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada T2N 4Z6
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The effects on cardio-respiratory and acid–base variables of a constant rate infusion of alfaxalone–HPCD in sheep. Vet J 2013; 196:209-12. [DOI: 10.1016/j.tvjl.2012.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 09/12/2012] [Accepted: 09/17/2012] [Indexed: 11/18/2022]
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