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Li X, Ye Z, Cui M, Hu A, Li X, Chen Q, Zhao G, Ye F. Dexmedetomidine decreases the 50% effective dose (ED50) of intravenous propofol required to prevent tracheal intubation response in Beagles. J Am Vet Med Assoc 2022; 261:74-79. [PMID: 36315451 DOI: 10.2460/javma.22.01.0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVE To determine the 50% effective dose (ED50) of intravenous propofol required for successfully preventing tracheal intubation response in Beagles co-induced with dexmedetomidine. ANIMALS 36 adult male Beagles. PROCEDURES The dogs were randomly assigned to either group D1, group D2, or group C (received 1 µg/kg, 2 µg/kg dexmedetomidine intravenously, or the same amount of normal saline as dexmedetomidine, 10 mL). The first dog in each group received 6 mg/kg of propofol for induction. The pump speed of propofol was 600 mL/h. The dosage varied with increments or decrements of 0.5 mg/kg based on the Dixon up-and-down method. The duration of eye-opening after propofol administration was recorded. Changes in heart rate (HR) and respiratory rate (RR) were recorded at 5 timepoints: after entering the operation room and prior to propofol administration (T1), 1 and 3 min after propofol administration (T2 and T3), 3 and 5 min after intubation (T4 and T5). RESULTS The required ED50 of propofol that prevented tracheal intubation response in D1, D2, and C groups were 6.4 mg/kg (95% CI, 6.1 to 6.7 mg/kg), 5.8 mg/kg (95% CI, 5.67 to 6 mg/kg), and 8.3 mg/kg (95% CI, 8 to 8.5 mg/kg), respectively. The recovery time of group D2 was significantly longer than that of groups D1 and C (P < .05). The differences in HR among the 3 groups were significant from T2 up to T5 timepoint (P < .05). The differences in RR among the 3 groups were significant at T2 and T3 timepoints (P < .05). CLINICAL RELEVANCE Dexmedetomidine pre-injection reduces the amount of propofol required for endotracheal intubation response in Beagles, thereby reducing the respiratory inhibition induced by propofol.
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Affiliation(s)
- Xiaona Li
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhihui Ye
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Mengxue Cui
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - An Hu
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xiangyu Li
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qicheng Chen
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - GaoFeng Zhao
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Fei Ye
- Department of Anesthesiology, The Second Clinical College of Guangzhou University of Chinese Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
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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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Yang H, Yin Q, Huang L, Zhang M, Zhang X, Sun Q, Liu X, Wang Q, Yang X, Tan L, Ye M, Liu J. The Bioequivalence of Emulsified Isoflurane With a New Formulation of Emulsion: A Single-Center, Single-Dose, Double-Blinded, Randomized, Two-Period Crossover Study. Front Pharmacol 2021; 12:626307. [PMID: 33776768 PMCID: PMC7988084 DOI: 10.3389/fphar.2021.626307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 01/26/2021] [Indexed: 02/05/2023] Open
Abstract
Background: Emulsified isoflurane is a novel intravenous general anesthetic obtained by encapsulating isoflurane molecules into emulsion. The formulation of emulsion has been improved according to the latest regulations of the China Food and Drug Administration. This study was designed to compare the bioequivalence of the new and previous formulation emulsion of isoflurane. Methods: In a single-center, single-dose, double-blinded, randomized, two-period crossover study, healthy volunteers received intravenous injection of 30 mg/kg of isoflurane with either previous formulation of emulsion isoflurane (PFEI) or new formulation of emulsion isoflurane (NFEI). Arterial and venous blood samples were obtained for geometric mean test/reference ratios of Cmax, AUC0-t, and AUC0-∞, as well as their 90% confidence interval (CI90) as the primary outcome. The secondary outcomes were safety measurements such as vital signs, 12-lead electrocardiography, adverse effects, and laboratory tests; and anesthesia efficacy was assessed by Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score, bispectral index (BIS), and loss/recovery of eyelash reflex. Results: 24 subjects were eligible, of which 21 completed the whole experiment (NFEI n = 21, PFEI n = 23). Arterial geometric mean test/reference ratios of Cmax, AUC0-t, and AUC0-∞ were 104.50% (CI90 92.81%–117.65%), 108.23% (94.51%–123.96%), and 106.53% (93.94%∼120.80%), respectively. The most commonly seen adverse effects for NFEI and PFEI were injection pain (38.1% vs. 34.8%), hypotension (19.0% vs. 13.0%), apnea (14.3% vs. 17.4%), and upper airway obstruction (14.3% vs. 13.0%). No severe adverse effect was observed. The effectiveness of general anesthesia was similar between the two formulations. Conclusion: The CI90 of Cmax, AUC0-t, AUC0-∞, NFEI, and PFEI were within the range of 80%–125%, suggesting bioequivalence between NFEI and PFEI. The safety and anesthesia effectiveness were also similar.
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Affiliation(s)
- Hui Yang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qinqin Yin
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Luying Huang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.,Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
| | - Min Zhang
- Clinical Research Center, Yichang Humanwell Pharmaceutical CO., LTD, Yichang, China
| | - Xinxin Zhang
- Clinical Research Center, Yichang Humanwell Pharmaceutical CO., LTD, Yichang, China
| | - Qirong Sun
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xuewei Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Qi Wang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Xi Yang
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Lingcan Tan
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Mao Ye
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
| | - Jin Liu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China
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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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Tanious MK, Beutler SS, Kaye AD, Urman RD. New Hypnotic Drug Development and Pharmacologic Considerations for Clinical Anesthesia. Anesthesiol Clin 2017; 35:e95-e113. [PMID: 28526163 DOI: 10.1016/j.anclin.2017.01.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Since the public demonstration of ether as a novel, viable anesthetic for surgery in 1846, the field of anesthesia has continually sought the ideal anesthetic-rapid onset, potent sedation-hypnosis with a high therapeutic ratio of toxic dose to minimally effective dose, predictable clearance to inactive metabolites, and minimal side effects. This article aims to review current progress of novel induction agent development and provide an update on the most promising drugs poised to enter clinical practice. In addition, the authors describe trends in novel agent development, implications for health care costs, and implications for perioperative care.
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Affiliation(s)
- Mariah Kincaid Tanious
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Sascha S Beutler
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Alan D Kaye
- Department of Anesthesiology and Pain Medicine, Louisiana State University School of Medicine, LSU Health Science Center, 1542 Tulane Avenue, Room 659, New Orleans, LA 70112, USA
| | - Richard D Urman
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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