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Calvo-Santesmases A, Manso-Díaz G, Fores P, López-Sanromán J. Kinematic Patterns in Horses Sedated With Low Doses of Detomidine: An Accelerometric Evaluation. J Equine Vet Sci 2021; 107:103777. [PMID: 34802618 DOI: 10.1016/j.jevs.2021.103777] [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: 07/14/2021] [Revised: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 11/25/2022]
Abstract
Alpha-2-adrenergic drugs, such as detomidine, are commonly used to sedate lame horses during examination. However, the use of these drugs should be minimized, as they have numerous side-effects, like ataxia. Therefore, we wanted to test the effects, on the locomotor pattern, of low doses of detomidine (0.003 mg/kg). Six horses were sedated with 0.003 mg/kg of detomidine and compared with the same horses administered a saline solution. Using a triaxial accelerometer, data of kinetic, coordination and energetic locomotor parameters and the degree of sedation were collected. The effects were monitored for 60 minutes after treatment administration. No effects on coordination parameters were observed, but some kinetic and energetic parameters were significantly altered after detomidine administration compared to the saline group. These results show that administering low doses of detomidine to lame horses can be a useful sedative solution, ensuring a safe examination with lower side-effects.
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Affiliation(s)
- Atocha Calvo-Santesmases
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain.
| | - Gabriel Manso-Díaz
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Paloma Fores
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier López-Sanromán
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Universidad Complutense de Madrid, Madrid, Spain
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Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction. Animals (Basel) 2021; 11:ani11092572. [PMID: 34573538 PMCID: PMC8467133 DOI: 10.3390/ani11092572] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 08/11/2021] [Accepted: 08/30/2021] [Indexed: 12/20/2022] Open
Abstract
Simple Summary When considering sedation or general anaesthesia in horses, a multimodal strategy is commonly preferred over a single drug. This includes the association of alpha-2 adrenoceptor agonists, phenothiazines or opioids, to improve the overall sedative and analgesic effects accordingly. However, the use of opioids alone is limited in horses due to the risk of sympathetic stimulation, central nervous system stimulation, excitement and head jerking. In some countries, butorphanol is currently the only licensed and most used opioid in equine medicine. We aimed to evaluate the pre-anaesthetic association of romifidine with either butorphanol or methadone. The two combinations were administered before induction of general anaesthesia, which included diazepam and ketamine. Evaluations involved the degree of sedation and ataxia, effects on physiological parameters, such as heart and respiratory rates, rectal temperature, quality of induction, ease of intubation and the need for top-up agents before transition to the operating theatre and the institution of a maintenance regimen. Abstract While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the horses had the lowest OS score (no sedation), nor the highest score for ataxia (horse falling). Methadone induced a tendency for minor noise reaction yet minor head lowering scores, the latter being probably the most influencing parameter when scoring OS. Measured physiological parameters decreased in both groups, with greater bradycardia recorded after methadone (p = 0.017), including a higher incidence of atrioventricular blocks that resolved during general anaesthesia. The quality of induction was good–excellent in most of the animals. While comparisons between the degree of antinociception were beyond the scope of this study, analgesic potency might influence the choice when considering opioids as pre-anaesthetic drugs in combination with romifidine before surgery in equines.
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Straticò P, Carluccio A, Varasano V, Guerri G, Suriano R, Robbe D, Cerasoli I, Petrizzi L. Analgesic Effect of Butorphanol during Castration in Donkeys under Total Intravenous Anaesthesia. Animals (Basel) 2021; 11:2346. [PMID: 34438803 PMCID: PMC8388773 DOI: 10.3390/ani11082346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 12/04/2022] Open
Abstract
Pain management is necessary for all surgical procedures. Little scientific evidence about drug efficacy in donkeys is available. The aim of this study was to evaluate the analgesic effect of butorphanol in donkeys undergoing orchiectomy under total intravenous anaesthesia with guaifenesin-ketamine-detomidine. A randomized blinded prospective clinical trial (Protocol n. 2021/0000338), was carried out on 18 clinically healthy donkeys undergoing bilateral orchiectomy. Patients were assigned to Group D (n = 8) or Group DB (n = 10) if receiving intravenous detomidine or detomidine-butorphanol respectively, before induction of general anaesthesia with ketamine-diazepam. Intraoperative muscle relaxation, nystagmus, palpebral reflex, heart and respiratory rate, and non-invasive blood pressure were evaluated every 2 min; time to prepare the patient, duration of surgery and anaesthesia and recovery score were recorded. Group D had significantly longer surgical time, higher heart rate, higher systolic and mean blood pressure (p < 0.05; repeated measure ANOVA), increased muscle rigidity and expression of palpebral reflex (p < 0.05; Mann-Whitney U test) than group DB. Top-ups with thiopental were statistically higher in Group D. Butorphanol and detomidine together produced a more stable anaesthetic plan. The low dosage of opioid and alpha-2-agonists and reduced rescue anaesthesia are responsible for a safer and more superficial anaesthesia, which is mandatory under field conditions.
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Affiliation(s)
- Paola Straticò
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Augusto Carluccio
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Vincenzo Varasano
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Giulia Guerri
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Riccardo Suriano
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Domenico Robbe
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
| | - Ilaria Cerasoli
- Clinica Veterinaria Borghesiana, Via di Vermicino 96, 00133 Roma, Italy;
| | - Lucio Petrizzi
- Faculty of Veterinary Medicine, University of Teramo, Località Piano D’Accio, 64100 Teramo, Italy; (P.S.); (A.C.); (V.V.); (R.S.); (D.R.); (L.P.)
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Troya-Portillo L, López-Sanromán J, Villalba-Orero M, Santiago-Llorente I. Cardiorespiratory, Sedative and Antinociceptive Effects of a Medetomidine Constant Rate Infusion with Morphine, Ketamine or Both. Animals (Basel) 2021; 11:ani11072081. [PMID: 34359209 PMCID: PMC8300393 DOI: 10.3390/ani11072081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary Standing surgery and diagnostic procedures in equine patients under deep sedation reduce the risk associated with general anesthesia. Sedation protocols must be safe, provide a good quality of sedation without producing cardiorespiratory depression and severe ataxia. The use of adrenergic alpha-2 receptors agonist in combination with opioids and/or ketamine can achieve an adequate sedation and provide sufficient analgesia for surgical procedures. Medetomidine and medetomidine with morphine in intravenous constant rate infusion have been evaluated for standing sedation but have not been compared directly. Although ketamine has been combined with other alpha-2 agonists successfully, it has not been evaluated in combination with medetomidine. The objective of this study was to compare four medetomidine-based protocols with the addition of morphine and/or ketamine, including cardiorespiratory, sedative and mechanical antinociceptive variables. All four protocols produced a similar degree of sedation and mechanical antinociception without clinically relevant impact on cardiorespiratory variables. Abstract Standing surgery under sedation reduces anesthetic-related mortality in horses. Medetomidine, alone and combined with morphine in a constant rate infusion (CRI), has been described for standing surgery but their cardiorespiratory, sedative and antinociceptive effects have never been compared. The addition of ketamine could improve analgesia in these procedures with minimal cardiorespiratory consequences. The objectives were to compare the cardiorespiratory effects, quality of sedation, antinociception and ataxia produced by administration of a medetomidine-based CRI with morphine, ketamine or both, in standing horses. A prospective, blind, randomized crossover, experimental design with six healthy adult horses was performed, in which four treatments were administered to all horses with at least two weeks of washout period: medetomidine (M); medetomidine and ketamine (MK); medetomidine and morphine (MMo); and medetomidine, morphine and ketamine (MMoK). Dosages were the same in all treatment groups: medetomidine at 5 µg/kg bwt followed by 5 µg/kg bwt/h, ketamine at 0.4 mg/kg/h and morphine at 50 µg/kg bwt, followed by morphine 30 µg/kg bwt/h. Drug infusions were maintained for 120 min. Cardiorespiratory variables, sedation degree and antinociceptive effects were evaluated during the procedure. All combinations produced similar sedation and antinociceptive effects and no clinically relevant alterations in cardiorespiratory variables occurred. Medetomidine CRI combined with morphine, ketamine or both are suitable and safe protocols for standing sedation in horses and the addition of morphine and/or ketamine did not cause any negative effect but no improving effect on sedation and antinociception was detected.
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Affiliation(s)
- Lucas Troya-Portillo
- Departamento de Medicina y Cirugía Animal, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.L.-S.); (M.V.-O.)
- Correspondence:
| | - Javier López-Sanromán
- Departamento de Medicina y Cirugía Animal, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.L.-S.); (M.V.-O.)
- Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - María Villalba-Orero
- Departamento de Medicina y Cirugía Animal, Universidad Complutense de Madrid, 28040 Madrid, Spain; (J.L.-S.); (M.V.-O.)
| | - Isabel Santiago-Llorente
- Hospital Clínico Veterinario Complutense, Universidad Complutense de Madrid, 28040 Madrid, Spain;
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de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Esteves Trindade PH, Prospero Puoli Filho JN, Luna SPL. Development and validation of the facial scale (FaceSed) to evaluate sedation in horses. PLoS One 2021; 16:e0251909. [PMID: 34061878 PMCID: PMC8168851 DOI: 10.1371/journal.pone.0251909] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 05/05/2021] [Indexed: 01/12/2023] Open
Abstract
Although facial characteristics are used to estimate horse sedation, there are no studies measuring their reliability and validity. This randomised controlled, prospective, horizontal study aimed to validate a facial sedation scale for horses (FaceSed). Seven horses received detomidine infusion i.v. in low or high doses/rates alone (DL 2.5 μg/kg+6.25 μg/kg/h; DH 5 μg/kg+12.5 μg/kg/h) or combined with methadone (DLM and DHM, 0.2 mg/kg+0.05 mg/kg/h) for 120 min, or acepromazine boli i.v. in low (ACPL 0.02 mg/kg) or high doses (ACPH 0.09 mg/kg). Horses' faces were photographed at i) baseline, ii) peak, iii) intermediate, and iv) end of sedation. After randomisation of moments and treatments, photos were sent to four evaluators to assess the FaceSed items (ear position, orbital opening, relaxation of the lower and upper lip) twice, within a one-month interval. The intraclass correlation coefficient of intra- and interobserver reliability of FaceSed scores were good to very good (0.74-0.94) and moderate to very good (0.57-0.87), respectively. Criterion validity based on Spearman correlation between the FaceSed versus the numerical rating scale and head height above the ground were 0.92 and -0.75, respectively. All items and the FaceSed total score showed responsiveness (construct validity). According to the principal component analysis all FaceSed items had load factors >0.50 at the first dimension. The high internal consistency (Cronbach´s α = 0.83) indicated good intercorrelation among items. Item-total Spearman correlation was adequate (rho 0.3-0.73), indicating homogeneity of the scale. All items showed sensitivity (0.82-0.97) to detect sedation, however only orbital opening (0.79) and upper lip relaxation (0.82) were specific to detect absence of sedation. The limitations were that the facial expression was performed using photos, which do not represent the facial movement and the horses were docile, which may have reduced specificity. The FaceSed is a valid and reliable tool to assess tranquilisation and sedation in horses.
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Affiliation(s)
- Alice Rodrigues de Oliveira
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Midlothian, United Kingdom
| | - Simone Katja Ringer
- Department of Clinical Diagnostics and Services, Section Anaesthesiology, Vetsuisse Faculty, University of Zürich, Zürich, Switzerland
| | - Stijn Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Mariana Werneck Fonseca
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Pedro Henrique Esteves Trindade
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - José Nicolau Prospero Puoli Filho
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
| | - Stelio Pacca Loureiro Luna
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, São Paulo, Brazil
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Lawless SP, Moorman VJ, Hendrickson DA, Mama KR. Comparison of sedation quality and safety of detomidine and romifidine as a continuous rate infusion for standing elective laparoscopic ovariectomy in mares. Vet Surg 2021; 50:990-998. [PMID: 33797093 DOI: 10.1111/vsu.13627] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 02/11/2021] [Accepted: 03/18/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To compare efficacy and safety of a continuous rate infusion of detomidine hydrochloride and romifidine hydrochloride for standing elective bilateral laparoscopic ovariectomy in mares. STUDY DESIGN Blinded, randomized prospective clinical study. ANIMALS Eighteen healthy mares presenting for elective bilateral ovariectomy METHODS: Mares were randomly assigned to one of two sedation protocols. Prior to surgery, baseline head height, heart rate, respiratory rate, and postural sway were recorded. An IV loading dose of α2-agonist (46 μg/kg romifidine or 13.9 μg/kg detomidine) was administered. Standing sedation was maintained with a continuous rate infusion of the respective α2-agonist (126 μg/kg/h romifidine or 37.8 μg/kg/h detomidine). Intraoperative measurements included respiratory rate, heart rate, head height, postural sway, and response to surgical stimulus. Postoperatively, fecal output was recorded, and pain scoring was performed using composite pain score and visual analog scales. RESULTS Three of 18 horses required additional α-2 agonists: one detomidine and two romifidine and butorphanol. Head height during surgery was lower (p < .001) in mares receiving detomidine. Postural sway around the vertical axis was greater in mares sedated with detomidine rather than romifidine (p = .013). No differences were detected in intraoperative heart rate, postoperative pain scores or postoperative fecal output between sedation techniques. CONCLUSION Comparable scores for surgical stimulation and sedation were measured in both sedation groups. No differences in postoperative analgesia or manure production were identified. CLINICAL SIGNIFICANCE Romifidine appears suitable as an alternative to detomidine and may limit ataxia and head drop in sedated horses.
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Affiliation(s)
- Shauna P Lawless
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Valerie J Moorman
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Dean A Hendrickson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Khursheed R Mama
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA
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de Oliveira AR, Gozalo-Marcilla M, Ringer SK, Schauvliege S, Fonseca MW, Trindade PHE, Puoli Filho JNP, Luna SPL. Development, Validation, and Reliability of a Sedation Scale in Horses (EquiSed). Front Vet Sci 2021; 8:611729. [PMID: 33665216 PMCID: PMC7921322 DOI: 10.3389/fvets.2021.611729] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/15/2021] [Indexed: 12/11/2022] Open
Abstract
The lack of standardization of sedation scales in horses limits the reproducibility between different studies. This prospective, randomized, blinded, horizontal and controlled trial aimed to validate a scale for sedation in horses (EquiSed). Seven horses were treated with intravenous detomidine in low/high doses alone (DL 2.5 μg/kg + 6.25 μg/kg/h; DH 5 μg/kg +12.5 μg/kg/h) or associated with methadone (DLM and DHM, 0.2 mg/kg + 0.05 mg/kg/h) and with low (ACPL 0.02 mg/kg) or high (ACPH 0.09 mg/kg) doses of acepromazine alone. Horses were filmed at (i) baseline (ii) peak, (iii) intermediate, and (iv) end of sedation immediately before auditory, visual and pressure stimuli were applied and postural instability evaluated for another study. Videos were randomized and blindly evaluated by four evaluators in two phases with 1-month interval. Intra- and interobserver reliability of the sum of EquiSed (Intraclass correlation coefficient) ranged between 0.84-0.94 and 0.45-0.88, respectively. The criterion validity was endorsed by the high Spearman correlation between the EquiSed and visual analog (0.77), numerical rating (0.76), and simple descriptive scales (0.70), and average correlation with head height above the ground (HHAG) (-0.52). The Friedman test confirmed the EquiSed responsiveness over time. The principal component analysis showed that all items of the scale had a load factor ≥ 0.50. The item-total Spearman correlation for all items ranged from 0.3 to 0.5, and the internal consistency was good (Cronbach's α = 0.73). The area under the curve of EquiSed HHAG as a predictive diagnostic measure was 0.88. The sensitivity of the EquiSed calculated according to the cut-off point (score 7 of the sum of the EquiSed) determined by the receiver operating characteristic curve, was 96% and specificity was 83%. EquiSed has good intra- and interobserver reliabilities and is valid to evaluate tranquilization and sedation in horses.
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Affiliation(s)
- Alice Rodrigues de Oliveira
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and The Roslin Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Simone Katja Ringer
- Section Anaesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zürich, Zurich, Switzerland
| | - Stijn Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Mariana Werneck Fonseca
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Pedro Henrique Esteves Trindade
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - José Nicolau Prospero Puoli Filho
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Stelio Pacca Loureiro Luna
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University Universidade Estadual Paulista (UNESP), Botucatu, Brazil
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Campoy L, Sedgwick SR. Standing Sedation and Iocoregional Analgesia in Equine Dental Surgery. Vet Clin North Am Equine Pract 2021; 36:477-499. [PMID: 33189231 DOI: 10.1016/j.cveq.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Procedural sedation has become popular for describing a semiconscious state that allows patients to be comfortable during certain surgical or diagnostic procedures. Sedation may be enhanced by locoregional anesthetic techniques to produce sufficient analgesia and muscle relaxation for surgery to occur. Sedation and local anesthesia for standing diagnostic and surgical procedures on the horse's head circumvents the potential complications of general anesthesia (particularly, complications related to recovery). However, the implementation of a locoregional anesthetic technique requires a thorough understanding of the anatomy to maximize success and minimize possible complications.
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Affiliation(s)
- Luis Campoy
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Mailbox 32, Ithaca, NY 14853, USA
| | - Samantha R Sedgwick
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Mailbox 32, Ithaca, NY 14853, USA.
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Delli-Rocili MM, Cribb NC, Trout DR, Thomason JJ, Valverde A. Effectiveness of a paraverterbral nerve block versus local portal blocks for laparoscopic closure of the nephrosplenic space: A pilot study. Vet Surg 2020; 49:1007-1014. [PMID: 32463519 DOI: 10.1111/vsu.13452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/22/2020] [Accepted: 05/02/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the effectiveness of a paravertebral nerve block vs local portal blocks for laparoscopic closure of the nephrosplenic space in standing sedated research horses. STUDY DESIGN Randomized clinical trial. ANIMALS Twelve horses were randomly allocated to two groups (n = 6 per group), paravertebral block of nerves T18 , L1 , and L2 or local blocks of the three laparoscopic portals. METHODS Horses were sedated with dexmedetomidine (4 μg/kg IV and constant rate infusion [CRI] of 2.5 μg/kg/h) and morphine (50 μg/kg IV and CRI of 30 μg/kg/h). According to group allocation, 20 mL of either lidocaine or saline was injected into each paravertebral nerve site or into each local portal site to facilitate laparoscopy for closure of the nephrosplenic space. The overall quality of sedation, analgesia, behavior exhibited during surgery, and ease to perform the surgery were blindly scored by using a visual analog scale (VAS). RESULTS Time to complete local anesthesia was similar for both blocks, and there was no difference in VAS scores between groups. Total duration of surgery was also similar between the paravertebral (79 ± 16 min) and local portal blocks (85 ± 25 min) groups. CONCLUSION The paravertebral nerve block and the local portal blocks provided similar conditions during surgery and can be used interchangeably for closure of the nephrosplenic space. CLINICAL SIGNIFICANCE The paravertebral nerve block can be readily performed and may be useful in surgical procedures.
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Affiliation(s)
- Massimo M Delli-Rocili
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Nicola C Cribb
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Donald R Trout
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Jeffrey J Thomason
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Alexander Valverde
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
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Kallmyr A, Giving EM, Moen LO, Øverlie M, Holm T, David F. Complete resection of the alar folds in eight standing horses with a bipolar dividing and vessel-sealing device. Vet Surg 2020; 49:521-528. [PMID: 32027042 PMCID: PMC7155021 DOI: 10.1111/vsu.13383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/25/2019] [Accepted: 12/26/2019] [Indexed: 12/02/2022]
Abstract
Objective To describe a resection technique of the alar folds in the standing horse. Study design Retrospective case study. Animals Eight Standardbred racing trotters. Methods Horses in which alar fold collapse had been diagnosed between 2017 and 2018 were included in this study. All horses underwent alar fold resection under standing sedation and regional anesthesia with a bipolar electrosurgical open sealer/divider device (LigaSure). Intraoperative and postoperative complications were recorded. A Wilcoxon signed‐rank test was used to compare differences in median prize money earning pre‐surgery and post‐surgery (P < .05). Results The surgical procedure was short (20‐30 min), with minimal (1/8) to no (7/8) bleeding and was well tolerated in all cases. Complete resection of the alar folds along with 3 to 5 cm of the ventral conchal cartilage was achieved. No complications were observed post‐surgery with satisfactory second intention healing, allowing return to training/racing within 3 to 6 weeks post‐surgery in all cases. Median earnings post‐surgery increased (P = .03) compared with pre‐surgery. Conclusion Alar fold resection with bipolar electrosurgical energy offered a good alternative to the traditional surgical approaches performed under general anesthesia. The surgery significantly improved race earnings and performance while avoiding the risk associated with general anesthesia and offered a short and complication‐free rehabilitation period. Clinical impact This study describes a surgical technique offering a novel approach to resection of the alar folds in the standing horse.
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Affiliation(s)
| | | | | | | | - Therese Holm
- Evidensia Lørenskog Dyreklinikk, Lørenskog, Norway
| | - Florent David
- Equine Veterinary Medical Center, a member of Qatar Foundation, Doha, Qatar.,College of Health & Life Science, Hamad Bin Khalifa University, Doha, Qatar
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Matthews N, van Loon JPAM. Anesthesia, Sedation, and Pain Management of Donkeys and Mules. Vet Clin North Am Equine Pract 2019; 35:515-527. [PMID: 31587973 DOI: 10.1016/j.cveq.2019.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The number of donkeys in the world may not be increasing but awareness of their use and concern for welfare and pain recognition and treatment are receiving increasing veterinary interest. Therefore, accurate information about anesthesia and analgesia in donkeys and mules is important to more equine practitioners. This review highlights the current knowledge on various anesthetic and analgesic approaches in donkey and mules. The authors emphasize that there is still much information that is not available about donkeys and mules; in many circumstances, the clinician must use available equine information to treat the patient, while monitoring for differences in response.
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Affiliation(s)
| | - Johannes P A M van Loon
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan, Utrecht 3584 CM, The Netherlands
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Diez Bernal S, Studer N, Thormann W, Spadavecchia C, Levionnois O. Pharmacokinetic-pharmacodynamic modelling of the antinociceptive effect of a romifidine infusion in standing horses. Vet Anaesth Analg 2019; 47:129-136. [PMID: 31810766 DOI: 10.1016/j.vaa.2019.06.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/16/2019] [Accepted: 06/18/2019] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To evaluate the effect of a romifidine infusion on antinociception and sedation, and to investigate its relationship with plasma concentration. STUDY DESIGN Prospective, experimental, nonrandomized trial. ANIMALS A total of 10 healthy adult warmblood horses. METHODS Romifidine (loading dose: 0.08 mg kg-1, infusion: 0.03 mg kg-1 hour-1) was administered intravenously over 120 minutes. Romifidine plasma concentrations were determined by capillary electrophoresis. Sedation quality and nociceptive thresholds were evaluated at regular time points before, during and after romifidine administration. The nociceptive withdrawal reflex was elicited by electrical stimulation at the thoracic limb using a dedicated threshold tracking algorithm and recorded by electromyography at the deltoid muscle. A pharmacokinetic-pharmacodynamic model was established and correlation between romifidine plasma concentration and main output variables tested. RESULTS A two compartmental model best described the romifidine pharmacokinetic profile. The nociceptive thresholds increased compared with baseline in all horses from 10 to 146 minutes after romifidine administration (p < 0.001). Peak effect reached 5.7 ± 2.3 times the baseline threshold (mean ± standard deviation). The effect/concentration relationship followed a counter-clockwise hysteresis loop. The mean plasma concentration was weakly correlated to nociceptive thresholds (p < 0.0071, r = 0.392). The sedative effects were significant until 160 minutes but variable, not correlated to plasma concentration (p = 0.067), and weakly correlated to nociceptive thresholds (p < 0.0001, r = 0.33). CONCLUSIONS AND CLINICAL RELEVANCE Romifidine elicited a marked antinociceptive effect. Romifidine-induced antinociception appeared with a delayed onset and lasted longer than sedation after discontinuing its administration.
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Affiliation(s)
- Sabina Diez Bernal
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland.
| | - Nicole Studer
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Wolfgang Thormann
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Claudia Spadavecchia
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Olivier Levionnois
- Department of Anaesthesiology and Pain Therapy, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Hollis AR, Pascal M, Van Dijk J, Jolliffe C, Kaartinen J. Behavioural and cardiovascular effects of medetomidine constant rate infusion compared with detomidine for standing sedation in horses. Vet Anaesth Analg 2019; 47:76-81. [PMID: 31619335 DOI: 10.1016/j.vaa.2019.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/20/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the efficacy of a medetomidine constant rate infusion (CRI) with a detomidine CRI for standing sedation in horses undergoing high dose rate brachytherapy. STUDY DESIGN Randomized, controlled, crossover, blinded clinical trial. ANIMALS A total of 50 horses with owner consent, excluding stallions. METHODS Each horse was sedated with intravenous acepromazine (0.02 mg kg-1), followed by an α2-adrenoceptor agonist 30 minutes later and then by butorphanol (0.1 mg kg-1) 5 minutes later. A CRI of the same α2-adrenoceptor agonist was started 10 minutes after butorphanol administration and maintained for the treatment duration. Treatments were given 1 week apart. Each horse was sedated with detomidine (bolus dose, 10 μg kg-1; CRI, 6 μg kg-1 hour-1) or medetomidine (bolus dose, 5 μg kg-1; CRI, 3.5 μg kg-1 hour-1). If sedation was inadequate, a quarter of the initial bolus of the α2-adrenoceptor agonist was administered. Heart rate (HR) was measured via electrocardiography, and sedation and behaviour evaluated using a previously published scale. Between treatments, behaviour scores were compared using a Wilcoxon signed-rank test, frequencies of arrhythmias with chi-square tests, and HR with two-tailed paired t tests. A p value <0.05 indicated statistical significance. RESULTS Total treatment time for medetomidine was longer than that for detomidine (p = 0.04), and ear movements during medetomidine sedation were more numerous than those during detomidine sedation (p = 0.03), suggesting there may be a subtle difference in the depth of sedation. No significant differences in HR were found between treatments (p ≥ 0.09). Several horses had arrhythmias, with no difference in their frequency between the two infusions. CONCLUSIONS AND CLINICAL RELEVANCE Medetomidine at this dose rate may produce less sedation than detomidine. Further studies are required to evaluate any clinical advantages to either drug, or whether a different CRI may be more appropriate.
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Affiliation(s)
| | | | - Jan Van Dijk
- Animal Health Trust, Lanwades Park, Kentford, UK
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Gozalo-Marcilla M, Luna SP, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S. Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses. Vet Anaesth Analg 2019; 46:325-334. [PMID: 30935776 DOI: 10.1016/j.vaa.2019.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 12/12/2018] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the required rate of a detomidine infusion (loading dose 5 μg kg-1; initial rate 12.5 μg kg-1 hour-1) added to a constant infusion of methadone (0.2 mg kg-1; 0.05 mg kg-1 hour-1) for sedation in standing horses and ponies undergoing elective surgeries with appropriate local anaesthetic techniques. STUDY DESIGN Prospective, clinical study. ANIMALS Adult, healthy, client-owned, non-food-producing horses or ponies sedated for elective standing surgeries longer than 45 minutes. METHODS At baseline (in the stables before administration of sedative agents), at 10 minutes after sedation and every 5 minutes thereafter, ataxia, sedation and surgical condition were evaluated; each scored 0-3. These scores were used to adjust the detomidine administration rate using the Ghent Sedation Algorithm. A 10 cm visual analogue scale (VAS) was used by the main surgeon at the end of the procedure to evaluate the surgical conditions. Heart rate, systolic arterial pressure and respiratory frequency were also recorded at each time point. For statistical analysis, anova for normal, Kruskal-Wallis H-test for non-normal variables, and Mann-Whitney U test for VAS were used. RESULTS From the 42 horses/ponies included in this study, 28 underwent dental procedures and 14 other types of procedures. Overall, dental procedures required higher mean detomidine rates compared with other types of surgeries (16.9 ± 4.5 versus 9.0 ± 1.9 μg kg-1 hour-1) (p < 0.001). Dental procedures were assigned similar VAS scores, median (range), of 7.8 (5.8-10) with other procedures, 8.7 (2.8-10). Cardiovascular changes were not clinically significant. No signs or behavioural changes of abdominal pain were observed postoperatively. CONCLUSIONS AND CLINICAL RELEVANCE Satisfactory surgical conditions were achieved using a combination of detomidine and methadone infusions with locoregional anaesthesia, with no adverse effects. Dental procedures required higher detomidine dose rates compared with other surgeries.
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Affiliation(s)
- Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK.
| | - Stelio Pl Luna
- School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Frank Gasthuys
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Elke Pollaris
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lieven Vlaminck
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Ann Martens
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Stijn Schauvliege
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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How to score sedation and adjust the administration rate of sedatives in horses: a literature review and introduction of the Ghent Sedation Algorithm. Vet Anaesth Analg 2018; 46:4-13. [PMID: 30528671 DOI: 10.1016/j.vaa.2018.08.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/20/2018] [Accepted: 08/23/2018] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To summarize the different methods used to assess sedation and/or adjust the dose or administration rate of alpha-2 agonists in horses and to propose an algorithm to adjust the administration rate of a constant rate infusion of an alpha-2 agonist in horses. DATABASES USED PubMed and Web of Science; search terms: horse, sedation and score. CONCLUSIONS Most authors distinguish between sedation depth, sedation quality and degree of ataxia. These three features are evaluated using scoring systems similar to those classically used to assess pain, i.e. simple descriptive scales, numerical rating scales (NRS), visual analogue scales and/or multifactorial sedation scales. In addition, head height above the ground is often used as a measure of the depth of sedation. Very few authors have described how to adjust the administration rate or dose of alpha-2 agonists. Based on the available literature, the Ghent Sedation Algorithm was developed, which assigns scores (NRS) for degree of ataxia, sedation depth and surgical conditions, and uses these to prescribe changes in the administration rate of constant rate infusions of alpha-2 agonists. Studies are needed to validate this algorithm.
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Müller TM, Hopster K, Bienert-Zeit A, Rohn K, Kästner SBR. Effect of butorphanol, midazolam or ketamine on romifidine based sedation in horses during standing cheek tooth removal. BMC Vet Res 2017; 13:381. [PMID: 29212478 PMCID: PMC5719754 DOI: 10.1186/s12917-017-1299-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 11/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on romifidine based sedation in horses during cheek tooth removal. METHODS Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with romifidine (same dose) and butorphanol (0.02 mg/kg; CRI 0.04 mg/kg/h). Group RM received romifidine (same dose) and midazolam (0.02 mg/kg; CRI 0.06 mg/kg/h) whereas group RK was administered romifidine (same dose) and ketamine (0.5 mg/kg; CRI 1.2 mg/kg/h). If sedation was not adequate a top up bolus of romifidine (0.01 mg/kg) was administered. The quality of sedation and the conditions for tooth extraction, the level of ataxia, chewing, head and tongue movement were evaluated by using a scoring system. The investigator was blinded to the applied sedation protocol. Furthermore, serum cortisol concentrations before, during and after the procedure were analyzed to gain more information about the stress level of the horses. RESULTS Horses in group RM showed significantly less chewing and tongue activity compared to horses sedated with romifidine alone or with butorphanol additionally, but also significantly higher levels of ataxia. The quality of sedation was significantly better if romifidine was administered in combination with ketamine compared to romifidine alone. Furthermore, horses of group RK needed less additional romifidine boli compared to all other groups. Blood cortisol concentrations during surgery in groups RB and RM remained unchanged. Horses of group R showed higher cortisol concentrations during sedation compared to horses of groups RB and RM. CONCLUSION Romifidine alone at an initial bolus dose of 0.03 mg/kg followed by a constant rate infusion of 0.05 mg/kg/h was insufficient to obtain an adequate level of sedation and led to increased stress levels, whereas the addition of butorphanol inhibited the stress response. The combination of romifidine with either midazolam or ketamine improved sedation quality and surgical conditions.
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Affiliation(s)
- Theresa Maria Müller
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
| | - Klaus Hopster
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
| | - Astrid Bienert-Zeit
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
| | - Karl Rohn
- Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
| | - Sabine B R Kästner
- Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany
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Medeiros LQ, Gozalo-Marcilla M, Taylor PM, Campagnol D, de Oliveira FA, Watanabe MJ, de Araujo Aguiar AJ. Sedative and cardiopulmonary effects of dexmedetomidine infusions randomly receiving, or not, butorphanol in standing horses. Vet Rec 2017; 181:402. [PMID: 28822974 DOI: 10.1136/vr.104359] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 06/22/2017] [Accepted: 07/24/2017] [Indexed: 11/04/2022]
Abstract
Dexmedetomidine (DEX) alone, or combined with butorphanol (BUT), may be administered by constant rate infusions (CRIs) in standing horses. This blinded, randomised, crossover study in six healthy adult horses aimed to determine the sedative and cardiopulmonary effects of DEX (dexmedetomidine (3.5 µg/kg+5 µg/kg/hour CRI) and DEX/BUT (dexmedetomidine (3.5 µg/kg+3.5 µg/kg/hour CRI) and butorphanol (20 µg/kg+24 µg/kg/hour CRI)). Head height above ground (HHAG), ataxia, responses to tactile/auditory stimuli and cardiopulmonary variables were recorded before, at 5/15/30/60/90 minutes and after CRIs terminated (15/30/60 minutes). Repeated measures analysis of variance with Tukey-Kramer test were used for cardiopulmonary values (mean±SD) and HHAG reduction (per cent), and Friedman's and Dunn's for non-parametric data (P<0.05). Maximum HHAG reductions of 54 per cent (DEX) and 58 per cent (DEX/BUT) occurred at 15 minutes, with ataxia for 15 minutes in both treatments. Responses to stimuli were reduced for 30 minutes in both treatments, and auditory up to 60 minutes in DEX. Cardiopulmonary effects typical of α2-agonists were observed, with no differences between treatments. At the doses and rates reported here, both regimens provided clinically sufficient sedation for only 30 minutes.
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Affiliation(s)
- Luíza Quintão Medeiros
- Graduate Program in Anaesthesiology, Medical School of Botucatu, UNESP-Univ Estadual Paulista, Botucatu-SP, Brazil
| | - Miguel Gozalo-Marcilla
- Department of Veterinary Surgery and Anaestesiology, Faculty of Veterinary Medicine and Animal Science, UNESP - Univ Estadual Paulista, Botucatu-SP, Brazil
| | | | - Daniela Campagnol
- Graduate Program in Anaesthesiology, Medical School of Botucatu, UNESP-Univ Estadual Paulista, Botucatu-SP, Brazil
| | - Flávia Augusta de Oliveira
- Graduate Program in Anaesthesiology, Medical School of Botucatu, UNESP-Univ Estadual Paulista, Botucatu-SP, Brazil
| | - Marcos Jun Watanabe
- Department of Veterinary Surgery and Anaestesiology, Faculty of Veterinary Medicine and Animal Science, UNESP - Univ Estadual Paulista, Botucatu-SP, Brazil
| | - Antonio José de Araujo Aguiar
- Department of Veterinary Surgery and Anaestesiology, Faculty of Veterinary Medicine and Animal Science, UNESP - Univ Estadual Paulista, Botucatu-SP, Brazil
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Moine S, Flammer SA, de Jesus Maia-Nussbaumer P, Klopfenstein Bregger MD, Gerber V. Evaluation of the effects of performance dentistry on equine rideability: a randomized, blinded, controlled trial. Vet Q 2017; 37:195-199. [DOI: 10.1080/01652176.2017.1329598] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Sébastien Moine
- Department of Veterinary Clinical Sciences, Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Shannon Axiak Flammer
- Department of Veterinary Clinical Sciences, Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Päivi de Jesus Maia-Nussbaumer
- Department of Veterinary Clinical Sciences, Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Micaël D. Klopfenstein Bregger
- Department of Veterinary Clinical Sciences, Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
| | - Vincent Gerber
- Department of Veterinary Clinical Sciences, Swiss Institute of Equine Medicine, University of Bern and Agroscope, Bern, Switzerland
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Hermans H, Veraa S, Wolschrijn CF, van Loon JPAM. Local anaesthetic techniques for the equine head, towards guided techniques and new applications. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H. Hermans
- Department of Equine SciencesFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
| | - S. Veraa
- Division of Diagnostic ImagingFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
| | - C. F. Wolschrijn
- Department of Pathobiology Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | - J. P. A. M. van Loon
- Department of Equine SciencesFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
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Gozalo-Marcilla M, Luna SP, Crosignani N, Filho JNP, Possebon FS, Pelligand L, Taylor PM. Sedative and antinociceptive effects of different combinations of detomidine and methadone in standing horses. Vet Anaesth Analg 2017; 44:1116-1127. [PMID: 29050998 DOI: 10.1016/j.vaa.2017.03.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 03/05/2017] [Accepted: 03/06/2017] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate intravenous (IV) detomidine with methadone in horses to identify a combination which provides sedation and antinociception without adverse effects. STUDY DESIGN Randomized, placebo-controlled, blinded, crossover. ANIMALS A group of eight adult healthy horses aged (mean ± standard deviation) 7 ± 2 years and 372 ± 27 kg. METHODS A total of six treatments were administered IV: saline (SAL); detomidine (5 μg kg-1; DET); methadone (0.2 mg kg-1; MET) alone or combined with detomidine [2.5 (MLD), 5 (MMD) or 10 (MHD) μg kg-1]. Thermal, mechanical and electrical nociceptive thresholds were measured, and sedation, head height above ground (HHAG), cardiopulmonary variables and intestinal motility were evaluated at 5, 15, 30, 45, 60, 75, 90, 120 and 180 minutes. Normal data were analyzed by mixed-model analysis of variance and non-normal by Kruskal-Wallis (p < 0.05). RESULTS Nociceptive thresholds in horses administered methadone with the higher doses of detomidine (MMD, MHD) were increased above baseline to a greater degree and for longer duration (MMD: 15-30 minutes, MHD: 30-60 minutes) than in horses administered low dose with methadone or detomidine alone (MLD, DET: 5-15 minutes). No increases in nociceptive thresholds were recorded in SAL or MET. Compared with baseline, HHAG was lower for 30 minutes in MMD and DET, and for 45 minutes in MHD. No significant sedation was observed in SAL, MET or MLD. Intestinal motility was reduced for 75 minutes in MHD and for 30 minutes in all other treatments. CONCLUSIONS Methadone (0.2 mg kg-1) potentiated the antinociception produced by detomidine (5 μg kg-1), with minimal sedative effects. CLINICAL RELEVANCE Detomidine (5 μg kg-1) with methadone (0.2 mg kg-1) produced antinociception without the adverse effects of higher doses of detomidine.
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Affiliation(s)
- Miguel Gozalo-Marcilla
- Department of Veterinary Surgery and Anaesthesiology, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil.
| | - Stelio Pl Luna
- Department of Veterinary Surgery and Anaesthesiology, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Nadia Crosignani
- Department of Veterinary Surgery and Anaesthesiology, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - José Np Puoli Filho
- Department of Animal Production, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Fábio S Possebon
- Department of Veterinary Hygiene and Public Health, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Ludovic Pelligand
- Departments of Clinical Services and Sciences and Comparative Biomedical Sciences, Royal Veterinary College, Hatfield, UK
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van Loon JPAM, Van Dierendonck MC. Monitoring equine head-related pain with the Equine Utrecht University scale for facial assessment of pain (EQUUS-FAP). Vet J 2017; 220:88-90. [PMID: 28190503 DOI: 10.1016/j.tvjl.2017.01.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 11/24/2022]
Abstract
This study validates a recently described pain scale, the Equine Utrecht University scale for facial assessment of pain (EQUUS-FAP), in horses with acute or postoperative pain originating from the head, including dental pain, ocular pain, or trauma to the skull. This cohort study of 23 horses with head-related pain and 23 normal, healthy controls revealed significant differences in EQUUS-FAP scores between control horses and horses with acute or postoperative pain (P <0.001). Moreover, pain scores after surgery decreased significantly over time (P <0.001). The scale showed good inter-observer reliability (intra-class correlation coefficient = 0.92), sensitivity (80%), specificity (78%), and positive (80%) and negative predictive values (78%).
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Affiliation(s)
- Johannes P A M van Loon
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, NL-3584 CM Utrecht, The Netherlands.
| | - Machteld C Van Dierendonck
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 114, NL-3584 CM Utrecht, The Netherlands; Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium; Department of Veterinary Sciences Antwerp University, Universiteitsplein 1, 2610 Wilrijk - Antwerp, Belgium
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The use of low doses of acepromazine as an aid for lameness diagnosis in horses: An accelerometric evaluation. Vet Comp Orthop Traumatol 2015. [PMID: 26219640 DOI: 10.3415/vcot-14-11-0177] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of the present study was to quantify by accelerometry the trotting pattern of adult horses sedated with two different doses of acepromazine, in order to assess the use of this drug in equine lameness evaluations. METHODS Seven mature horses were used and three treatments were administered to each horse: saline solution, acepromazine (0.01 mg/kg), and acepromazine (0.02 mg/kg). The portable gait analyzer used consisted of three orthogonal accelerometers that measure accelerations along the dorsoventral, longitudinal, and lateral axes. Baseline values were obtained and after treatment, accelerometric recordings were repeated every five minutes during the first 20 minutes after the injection and then every 10 minutes thereafter for two hours. Ground-to-lip distance was also measured. RESULTS Administration of acepromazine decreased some of the variables investigated and differences between doses were observed. Speed, stride frequency, and stride length were significantly reduced following treatments. For coordination parameters, no significant differences among values were observed. Energetic variables suffered only weak reductions whereas ground-to-lip distance values were significantly decreased up to 120 minutes after treatment. CLINICAL SIGNIFICANCE Acepromazine produces significant alterations in the gait pattern with differences between doses, but it does not affect coordination variables in normal unexcited horses, and at a dose of 0.01 mg/kg may be the tranquilizer of choice for evaluating lameness in this setting.
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Wright S. Highlights of recent clinically relevant papers. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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