Romifidine as a premedicant to propofol induction and infusion anaesthesia in the dog

Effect of dexmedetomidine on the minimum infusion rate of propofol preventing movement in dogs

OBJECTIVE

To determine the effect of dexmedetomidine on induction dose and minimum infusion rate of propofol preventing movement (MIR_NM).

STUDY DESIGN

Randomized crossover, unmasked, experimental design.

ANIMALS

Three male and three female healthy Beagle dogs weighing 10.2 ± 2.8 kg.

METHODS

Dogs were studied on three occasions at weekly intervals. Premedications were 0.9% saline (treatment P) or dexmedetomidine (1 μg kg^-1, treatment PLD; 2 μg kg^-1, treatment PHD) intravenously. Anesthesia was induced with propofol (2 mg kg^-1 and then 1 mg kg^-1 every 15 seconds) until intubation. Anesthesia was maintained for 90 minutes in P with propofol (0.5 mg kg^-1 minute^-1) and saline, in PLD with propofol (0.35 mg kg^-1 minute^-1) and dexmedetomidine (1 μg kg^-1 hour^-1), and in PHD with propofol (0.3 mg kg^-1 minute^-1) and dexmedetomidine (2 μg kg^-1 hour^-1). The stimulus (50 V, 50 Hz, 10 ms) was applied to the antebrachium, and propofol infusion was increased or decreased by 0.025 mg kg^-1 minute^-1 based on a positive or negative response, respectively. Data were analyzed using a mixed-model anova and presented as mean ± standard error.

RESULTS

Propofol induction doses were 8.68 ± 0.57 (P), 6.13 ± 0.67 (PLD) and 4.78 ± 0.39 (PHD) mg kg^-1 and differed among treatments (p < 0.05). Propofol MIR_NM values were 0.68 ± 0.13, 0.49 ± 0.16 and 0.26 ± 0.05 mg kg^-1 minute^-1 for P, PLD and PHD, respectively. Propofol MIR_NM decreased 59% in PHD (p < 0.05). Plasma propofol concentrations were 14.04 ± 2.30 (P), 11.30 ± 4.30 (PLD) and 7.96 ± 0.72 (PHD) μg mL^-1 and dexmedetomidine concentrations were 0.68 ± 0.12 (PLD) and 0.89 ± 0.08 (PHD) ng mL^-1 at MIR_NM determination.

CONCLUSIONS AND CLINICAL RELEVANCE

Dexmedetomidine (1 and 2 μg kg^-1) decreased propofol induction dose. Dexmedetomidine (2 μg kg^-1 hour^-1) resulted in a significant decrease in propofol MIR_NM.

Romifidine and low doses of tiletamine-zolazepam in dogs

OBJECTIVE

To evaluate clinical effects of romifidine and low doses of tiletamine-zolazepam (TZ) in dogs.

STUDY DESIGN

Randomized "blinded" cross-over study.

ANIMALS

Six healthy beagle dogs (two males, four females).

METHODS

In separate preliminary experiments dogs received intravenous (IV) tiletamine-zolazepam (TZ) at 1 and 2 mg kg(-1). For the main trial, dogs received romifidine (R) followed 5 minutes later by IV at six dose regimens: R40TZ1, R60TZ1, R80TZ1 (Romifidine at 40, 60, 80 μg kg(-1) and TZ at 1 mg kg(-1)), R40TZ2, R60TZ2 and R80TZ2 (Romifidine at 40, 60, 80 μg kg(-1) and TZ at 2 mg kg(-1)). Dogs underwent endotracheal intubation, but breathed room air. Cardiorespiratory variables were measured and arterial blood analyzed. Quality of sedation, duration of anaesthesia and time to recovery (TR) were recorded. Data were analysed by anova or Friedman test as relevant.

RESULTS

Endotracheal intubation was possible with all romifidine/TZ combinations but not with TZ alone. Mean times (minutes) from TZ injection to return of pedal reflex were 1-3 minutes for TZ alone, and 9-17 minutes for romifidine combinations. In the main trial (romifidine combinations) mean time (minutes) to standing increased with increasing dosage (R40TZ1 13; R80TZ2 32). Five minutes after TZ administration, when compared with baseline arterial blood pressures and arterial carbon dioxide had increased, and respiratory rate, pH and arterial oxygen tensions decreased, these changes becoming statistically significant with the higher dose rates. One dog in R60TZ2 and three dogs in R80TZ2 became hypoxaemic.

CONCLUSIONS AND CLINICAL RELEVANCE

Romifidine improves the quality and lengthens the duration of anaesthesia induced by TZ. The combination provides a suitable protocol for induction of or short-term anaesthesia in healthy dogs. However, the higher doses cause cardiovascular stimulation and respiratory depression, and precautions should be taken accordingly.

Sedative effects of three doses of romifidine in comparison with medetomidine in cats

OBJECTIVE

To compare the sedative effects of three doses of romifidine with one dose of medetomidine.

STUDY DESIGN

Prospective blinded experimental cross-over.

ANIMALS

Five adult Domestic Short Hair cats.

METHODS

Cats were administered romifidine at 80, 120 and 160 μg kg(-1) or medetomidine at 20 μg kg(-1) (M20) intramuscularly (IM). Sedative effects were assessed for 3 hours by summing the scores given to posture, auditory response, resistance to positioning, muscular relaxation, and response to noxious stimuli, giving a total sedation score (TS). The area under the curve (AUC) of TS ≥7 (the score considered as clinically useful sedation) was calculated. Times to stages of sedation were determined. Some physiological parameters were measured. Data to compare treatments were analysed by anova or Kruskal-Wallis test as relevant.

RESULTS

All treatments gave a TS considered clinically useful. There were no significant differences between treatments for times to onset of sedation, maximum TS reached, or AUC. Differences between romifidine treatments for other sedation parameters were not significant but the time to maximum TS and to recovery was shortest in M20. Heart rate (HR) fell significantly with all treatments and, although with M20 it recovered at 65 minutes, it remained significantly depressed for 3 hours after all romifidine treatments. Most cats vomited, and/or hypersalivated after all treatments.

CONCLUSIONS

Doses of 80, 120 and 160 μg kg(-1) romifidine IM produce sedation in cats which is similar to that following medetomidine 20 μg kg(-1) . Recovery from sedation and of physiological parameters was quickest after M20.

CLINICAL RELEVANCE

Doses of romifidine considerably lower than those investigated by previous authors give a clinically useful level of sedation, and their use might result in less side effects and a quicker recovery.

Sedative and analgesic effects of romifidine in camels (Camelus dromedarius)

OBJECTIVE

To evaluate the clinical effectiveness and the sedative and analgesic effects of intravenous (IV) romifidine in camels.

STUDY DESIGN

Randomized prospective study.

ANIMALS

Eighteen healthy adult Dromedary camels.

METHODS

Romifidine was administered IV to camels (n = 6) at three different doses (40, 80 or 120 microg kg(-1)). Time of onset, degree and duration of sedation and analgesia were recorded immediately after drug administration. Heart rate, respiratory rate, ruminal contractions, muscle relaxation, response to auditory and tactile stimulation, distance between ears, distance from lower lip to the ground, and degree of ataxia were also recorded pre-administration and at 5, 15, 30, 45, 60, 90, 120 and 180 minutes post-administration. Plasma glucose, blood urea nitrogen and creatinine were measured.

RESULTS

Romifidine produced dose dependent sedation and analgesia. Significant decreases in heart rate (p < 0.001), ruminal contractions (p < 0.05), distance from lower lip to the ground (p < 0.001), response to auditory and tactile stimuli (p < 0.01), and significant increases in the degree of ataxia (p < 0.01), distance between the ear tips (p < 0.001) and blood glucose (p < 0.01) concentration were recorded after administration of romifidine until recovery. However, no significant changes in rectal temperature and respiratory rate were recorded.

CONCLUSIONS AND CLINICAL RELEVANCE

Intravenous administration of romifidine at three different doses appeared to be an effective sedative and analgesic agent for camels. Bradycardia, ruminal atony, and hyperglycemia were the most important adverse effects after IV administration of romifidine. The IV administration of romifidine at a dose rate of 120 microg kg(-1) caused profound sedation and analgesia. Romifidine could be used for chemical restraint for a variety of diagnostic and minor surgical procedures in camels.

Sedative and cardiorespiratory effects of three doses of romifidine in comparison with medetomidine in five cats

This study was designed to compare the effects of three doses of romifidine (200, 400 and 600 microg/kg) with medetomidine (80 microg/kg) administered intramuscularly to five cats. The quality of sedation and the cardiovascular and respiratory effects of each treatment were evaluated, and the onset and duration of the sedation, and the cats' recovery times, were measured. Cardiorespiratory variables were also analysed. The dose of 200 microg/kg romifidine was clinically superior to the other doses of romifidine, providing moderate sedation, with minor cardiorespiratory and other adverse effects. However none of the doses of romifidine induced as deep and reliable sedation as the dose of medetomidine.

Comparison of Romifidine and Medetomidine Pre-medication in Propofol?Isoflurane Anaesthetised Dogs

The objective of this paper was to evaluate romifidine as a pre-medicant in dogs prior to propofol-isoflurane anaesthesia, and to compare it with medetomidine. For this, eight healthy dogs were anaesthetised. Each dog received three pre-anaesthetic protocols: R40 (romifidine, 40 microg/kg, IV), R80 (romifidine, 80 microg/kg, IV) or MED (medetomidine, 10 microg/kg, IV). Induction of anaesthesia was delivered with propofol and maintained with isoflurane. The following variables were studied before sedative administration and 10 min after sedative administration: heart rate (HR), mean arterial pressure (MAP), systolic arterial pressure (SAP) and diastolic arterial pressure (DAP) and respiratory rate (RR). During maintenance, the following variables were recorded at 5-min intervals: HR, MAP, SAD, DAP, arterial oxygen saturation (SpO(2)), end-tidal CO(2)(EtCO(2)), end-tidal concentration of isoflurane (EtISO) required for maintenance of anaesthesia and tidal volume (TV). Time to extubation, time to sternal recumbency and time to standing were also registered. HR and RR experimented a significantly decreased during sedation in all protocols respect to baseline values. Mean HR, MAP, SAP, DAP, SpO(2), EtCO(2), and TV during anaesthesia were similar for the three protocols. End tidal of isoflurane concentration was statistically similar for all protocols. Recovery time for R40 was significantly shorter than in R80 and MED. The studied combination of romifidine, propofol and isoflurane appears to be an effective drug combination for inducing and maintaining general anaesthesia in healthy dogs.

Romifidine-Ketamine Anaesthesia in Atropine and Triflupromazine Pre-medicated Buffalo Calves

The study was conducted on 10 buffalo calves with a weight of 98.5 +/- 3.9 kg and age 9.7 +/- 1.3 months. Ten trials of two treatments were carried out using a randomized block design. Atropine at the dose of 0.02 mg/kg bodyweight was administered in both the groups. The animals of group I received romifidine at the dose of 10 microg/kg i.v., 10 min after atropine administration, whereas, animals of group II received triflupromazine at the dose of 0.3 mg/kg i.m. and 10 min later romifidine at the dose of 10 microg/kg i.v. immediately followed by ketamine at the dose of 5 mg/kg i.v. The onset of action of romifidine in group I occurred within 2 min and the animals remained under mild sedation for 31 +/- 4.8 min. In group II, the triflupromazine-romifidine-ketamine combination induced anaesthesia for 14 +/- 2.3 min. Hypothermia, significant bradycardia and respiratory depression was noticed in both groups at different time intervals.

Sedative, analgesic and cardiorespiratory effects of romifidine in cats

OBJECTIVE

To evaluate the sedative, analgesic, and cardiorespiratory effects of intramascular (IM) romifidine in cats.

STUDY DESIGN

Prospective, randomized experimental trial.

ANIMALS

Ten healthy adult cats.

METHODS

Romifidine (100, 200, and 400 microg kg(-1)) or xylazine (1 mg kg(-1)) was given IM in a cross-over study design. Heart rate (HR), respiratory rate (RR), rectal temperature (RT), hemoglobin saturation, oscillometric arterial pressure, and scores for sedation, muscle relaxation, position, auditory response, and analgesia were determined before and after drug administration. Time to recumbency, duration of recumbency, and time to recover from sedation were determined. Subjective evaluation and cardiorespiratory variables were recorded before and at regular intervals for 60 minutes after drug administration.

RESULTS

Bradycardia developed in all cats that were given romifidine or xylazine. No other significant differences in physiologic parameters were observed from baseline values or between treatments. Increasing the dose of romifidine did not result in increased sedation or muscle relaxation. Cats given xylazine showed higher sedation and muscle relaxation scores over time. Analgesia scores were significantly higher after administration of romifidine (400 microg kg(-1)) and xylazine (1 mg kg(-1)) than after romifidine at 100 or 200 microg kg(-1). Duration of lateral recumbency was not significantly different between treatments; however, cats took longer to recover after administration of 400 micro g kg(-1) romifidine.

CONCLUSIONS AND CLINICAL RELEVANCE

Bradycardia is the most important adverse effect after IM administration of romifidine at doses ranging from 100 to 400 microg kg(-1) or 1 mg kg(-1) of xylazine in cats. The sedative effects of romifidine at 200 microg kg(-1) are comparable to those of 1 mg kg(-1) of xylazine, although muscle relaxation and analgesia were significantly less with romifidine than with xylazine.

Analgesic, sedative and haemodynamic effects of spinally administered romifidine in female goats

The present study was designed to evaluate the analgesic, sedative and haemodynamic effects of spinally administered romifidine in goats. Ten female healthy goats weighing 14-18 kg were randomly divided into two groups, I and II, of five animals each. Romifidine was administered spinally at rates of 50 and 75 microg/kg body weight in the animals of groups I and II, respectively, into the lumbosacral space. The treatments were compared based on their effects on analgesia, sedation, ataxia, heart rate, respiratory rate, rectal temperature, mean arterial pressure, central venous pressure, electrocardiogram and haemato-biochemical parameters. The objective parameters were analysed statistically using paired t-test and Duncan's multiple range test. Depth of analgesia was measured by recording the response to pin prick at different regions and was graded on a scale from 0 to 3. Moderate to complete analgesia was recorded at perineum and flank in both groups. Sedation was moderate in both groups. Ataxia was observed in all the animals but it was more pronounced in group II. Heart rate decreased significantly (P < 0.01) in both groups. A decrease in respiration rate was also recorded in both groups but it was more significant (P < 0.01) and for longer duration in group II as compared to group I. A slight increase in rectal temperature was also observed in both groups. Mean arterial pressure decreased and central venous pressure increased significantly (P < 0.01) in both groups but changes were more pronounced in group II. Electrocardiogram changes in group I included bradycardia, increased QT interval and increased or biphasic T wave but in animals of group II, in addition to these changes, occasional sinus dysrhythmia, increased PR interval and second-degree heart block were also recorded. Haemoglobin and packed cell volume decreased non-significantly in both groups. A significant (P < 0.01) increase in blood glucose and non-significant changes in plasma proteins, urea nitrogen and creatinine were recorded in both groups. The results of the study revealed that romifidine at the rate of 50 microg/kg could produce moderate to complete analgesia of perineum and flank after spinal administration into the lumbosacral space in goats. The analgesia could not be enhanced further by increasing the dose of romifidine up to 75 microg/kg, however, ataxia and cardiopulmonary and haemodynamic side-effects became more apparent.

Effects of sevoflurane, isoflurane and halotane anaesthesia on fluorescein angiographic phases of dogs: a comparative study

A fluorescein angiography method was developed to compare the onset and the total duration of the fluorangiographic phases between three anaesthetic protocols in six healthy mixed-breed dogs. The animals were anaesthetized three times. Each dog received, as pre-anaesthetic protocol, atropine (10 micrograms/kg intramuscularly), and as a sedative, romifidine (80 micrograms/kg intravenously). Fifteen minutes later, induction of anaesthesia was delivered with propofol (1 mg/kg intravenously) and maintained either with sevoflurane (SEVO group), isoflurane (ISO group) or halothane (HAL group) for 30 min in all cases. Some angiographic, cardiovascular and respiratory variables were registered during the procedure. Recovery times were also registered. Angiographic variables recorded were: onset of the arterial phase (TA), onset of the arteriovenous phase (TAV), onset of the venous phase (TV), complete arterial phase duration (I1), complete arteriovenous phase duration (I2) and I1 plus I2 (I3). Mean heart rate, mean arterial pressure, systolic arterial pressure, diastolic arterial pressure, respiratory rate, tidal volume, arterial oxygen saturation and end-tidal CO2 during SEVO and ISO anaesthesia, were similar in dogs. Minute ventilation and rectal temperature were higher in dogs with SEVO than ISO. HAL produced higher arterial pressures and a lower arterial oxygen saturation than ISO and SEVO. Mean respiratory rate, rectal temperature and minute ventilation were higher in HAL. Pulse rate, end-tidal CO2 and tidal volume were similar in the dogs of the three groups. No differences in recovery times were found. The fluorescein angiographic times were within the normal range. There were no significant differences between protocols in I1, I2 or I3. HAL produced a significant increase of all temporal variables (TA, TAV and TV) when compared with ISO; TA was higher in HAL than SEVO-treated dogs. All protocols appear to be safe and effective for inducing and maintaining general anaesthesia in healthy dogs for performing fluorescein angiography.

Cardiovascular effects of romifidine in dogs

OBJECTIVE

To characterize the cardiovascular effects of romifidine at doses ranging from 5 to 100 microg/kg of body weight, IV.

ANIMALS

25 clinically normal male Beagles.

PROCEDURE

Romifidine was administered IV at a dose of 5, 10, 25, 50, or 100 microg/kg (n = 5/group). Heart rate, arterial pressure, central venous pressure, mean pulmonary arterial pressure, pulmonary capillary wedge pressure, body temperature, cardiac output, and PCV were measured immediately prior to and at selected times after romifidine administration. Cardiac index, stroke index, rate-pressure product, systemic and pulmonary vascular resistance indices, and left and right ventricular stroke work indices were calculated. Degree of sedation was assessed by an observer who was blinded to the dose administered.

RESULTS

Romifidine induced a decrease in heart rate, pulmonary arterial pressure, rate-pressure product, cardiac index, and right ventricular stroke work index and an increase in central venous pressure, pulmonary capillary wedge pressure, and systemic vascular resistance index. In dogs given romifidine at a dose of 25, 50, or 100 microg/kg, an initial increase followed by a prolonged decrease in arterial pressure was observed. Arterial pressure immediately decreased in dogs given romifidine at a dose of 5 or 10 microg/kg.

CONCLUSIONS AND CLINICAL RELEVANCE

Results suggest that IV administration of romifidine induces dose-dependent cardiovascular changes in dogs. However, the 2 lowest doses (5 and 10 microg/kg) induced less cardiovascular depression, and doses > or = 25 microg/kg induced similar cardiovascular changes, suggesting that there may be a ceiling on the cardiovascular effects of romifidine.

Effect of romifidine and romifidine-butorphanol for sedation in dogs

The sedative and physiological effects of intravenous romifidine at 120 micrograms/kg were compared with intravenous romifidine (120 micrograms/kg) followed immediately by intravenous butorphanol (0.1 mg/kg) in 18 clinically normal adult beagles in a blinded randomised change-over study. Following the injection of romifidine alone the dogs became recumbent and there was an increase in a subjective score awarded to the degree of sedation. Heart rate and respiratory rate decreased and minor bradyarrhythmias were noted. The romifidine-butorphanol combination produced a significant decrease in the time to the onset of sedation and increase in the sedative effect and duration of action compared with romifidine alone. With the exception of a further decrease in heart rate and respiratory rate, there were no additional side effects following the use of the romifidine-butorphanol combination. The marked sedative effect associated with this combination would appear to be useful in the clinical situation where an increased degree of sedation is required.

Dose-sparing effects of romifidine premedication for thiopentone and halothane anaesthesia in the dog

Two intravenous doses of romlfidine (40 and 80 micrograms/kg) and a placebo were compared as premedicants for anaesthesia induced with thiopentone and maintained using halothane in oxygen. Romifidine significantly and linearly reduced the induction dose of thiopentone; placebo-treated dogs required 15.1 +/- 3.6 mg/kg, while dogs treated with 40 micrograms/kg and 80 micrograms/kg romifidine required 6.5 +/- 1.6 and 3.9 +/- 0.3 mg/kg thiopentone, respectively. Romifidine also significantly and linearly reduced the end tidal halothane concentration necessary to maintain a predetermined level of anaesthesia; placebo-treated dogs required 1.6 +/- 0.3 per cent halothane, while dogs treated with 40 micrograms/kg and 80 micrograms/kg romifidine required 1.3 +/- 0.4 and 0.8 +/- 0.2 per cent, respectively. Romifidine produced a significant shortening in the recovery from anaesthesia, and the higher dose of romifidine significantly improved the overall quality of anaesthesia.