Strain differences in response to propofol, ketamine and medetomidine in rabbits

Retrospective comparison of the effects of laryngeal mask and endotracheal tube on some cardio-respiratory variables in pet rabbits undergoing anaesthesia for elective gonadectomy

BACKGROUND

Endotracheal intubation in rabbits is challenging and supraglottic airway devices, such as laryngeal masks (LMA), represent an alternative as they are easy to insert, and do not stimulate the larynx requiring therefore a lighter plane of anaesthesia for their insertion and positioning than the endotracheal tubes. We investigated whether, compared to an endotracheal tube, the LMA can reduce the negative effects of general anaesthetics on some cardiovascular and respiratory parameters routinely monitored in rabbits anaesthetized for elective gonadectomy. The records of 21 adult mixed breed pet rabbits were collected retrospectively. Rabbits were divided in two groups based on the type of airway device used. A laryngeal mask secured the airway in group LMA (n = 11), and in group ETT (n = 10) an endotracheal tube was used. The amount of propofol used before successful insertion of the airway device was recorded. A pitot-based spirometer was connected and ventilatory variables were measured immediately after insertion. Pulse rate, non-invasive arterial blood pressure, haemoglobin oxygen saturation, respiratory rate, end-tidal carbon dioxide and volatile anaesthetic consumption were also monitored during the surgical procedure; extubation time was noted as well.

RESULTS

The use of LMA required significantly less propofol (0.8 to 4 mg/kg) for insertion than the ETT (1.2 to 5.6 mg/kg), and the difference was statistically significant (P < 0.01). No differences were observed in ventilatory variables measured immediately after airway positioning. Intraoperatively, there were no differences between groups for respiratory and cardiovascular variables, and amount of isoflurane administered. In all rabbits mean and diastolic blood pressure progressively decreased during surgery. Mean extubation time was shorter in group LMA (6 ± 2 min) than group ETT (8 ± 3 min, P < 0.01).

CONCLUSION

The airway device did not clinically affect the cardiovascular and respiratory variables during anaesthesia. Intraoperative hypoventilation was observed in most rabbits regardless of the device being used; therefore ventilatory support may be required. Rabbits with the laryngeal masks were extubated earlier.

Rabbit Sedation and Anesthesia

With the increasing frequency of rabbits as veterinary patients, the expectation for high-quality, intensive veterinary care, and resultantly an understanding of anesthesia has been increasing. Sedation and general anesthesia are commonly required for many routine and emergency procedures in rabbits, and this results in the need for a strong awareness of anesthetic principles, knowledge of limitations of anesthesia, and maintenance of high standards of anesthesia.

Evaluation of alfaxalone and dexmedetomidine for intramuscular restraint in European hedgehogs (Erinaceus europaeus)

The European hedgehogs may require the use of chemical restraint for clinical examination because of their tendency to roll up as a defensive behaviour. This study evaluated the effects of alfaxalone combined with dexmedetomidine for restraint of hedgehogs undergoing pre-release health checks and atipamezole for recovery.Twenty hedgehogs received alfaxalone 2 mg/kg and dexmedetomidine 0.05 mg/kg intramuscularly in the quadriceps. If the righting reflex was still present, both drugs were administered at half of the initial doses. A semiquantitative scale scored sedation; clinical variables evaluated included pulse rate, respiratory rate, arterial haemoglobin oxygen saturation, end-tidal CO₂ and body temperature.The righting reflex disappeared between 141 and 880 seconds. Overweight animals required one additional injection to achieve adequate relaxation. Pulse rate decreased during the procedure and increased after atipamezole administration. Respiratory rate and end-tidal CO₂ did not change statistically throughout the procedure but one hedgehog showed haemoglobin oxygen saturation lower than 90%. Recovery after atipamezole was smooth and complete. Body temperature decreased over time.The sedation protocol may represent an effective combination to restrain European hedgehogs and atipamezole provides a rapid antagonism. Additional sedatives administration may be required in overweight animals and an external source of oxygen should be available.

Mortality associated with using medetomidine and ketamine for general anesthesia in pregnant and nonpregnant Wistar rats

Medetomidine and ketamine are injectable drugs that can be used in combination to induce general anesthesia in rats. After noticing a high incidence of morbidity and mortality in pregnant Wistar rats given medetomidine and ketamine for anesthesia, the authors further investigated the effects of this combination of anesthetic drugs in both pregnant and nonpregnant Wistar rats. The time to recumbency and the duration of general anesthesia were similar between pregnant and nonpregnant rats. Pregnancy status did not affect the rats' pulse rate, respiratory rate, rectal temperature, oxygen saturation or perfusion index during 2 h of anesthesia. Pregnant rats had significantly lower blood glucose concentrations than nonpregnant rats at all time points, though blood glucose concentrations increased in both groups. The mortality rate was ∼15% both for nonpregnant rats and for pregnant rats. Researchers using medetomidine and ketamine to anesthetize Wistar rats should carefully monitor the rats in order to minimize mortality.

Comparison of S(+)-ketamine and ketamine, with medetomidine, for field anaesthesia in the European brown hare (Lepus europaeus)

OBJECTIVE

To compare anaesthesia and recovery parameters of racemic ketamine or S(+)-ketamine in combination with medetomidine for intramuscular (IM) field anaesthesia in the European brown hare (EBH) (Lepus europaeus).

STUDY DESIGN

Randomized, prospective, blinded clinical trial.

ANIMALS

20 adult EBH (eight male, 12 female), mean ± SD weight 3360 341).

METHODS

Medetomidine (0.2 mg kg(-1) ) and ketamine (30 mg kg(-1) ) (K-M group) or S(+)-ketamine (15 mg kg(-1) ) (S-M group) were administered by IM injection. Time until first effect and loss of righting reflex were recorded. During sedation and anaesthesia heart rate, saturation of arterial haemoglobin, respiratory rate, side stream end tidal CO(2) (Pe'CO(2) ), non invasive blood pressure, body temperature, cardiorespiratory parameters, palpebral reflex, jaw tone and nociception were recorded every 5 minutes. Medetomidine was antagonized with IM atipamezole (1 mg kg(-1) ) 45 minutes after treatment injection. Time until first head lift, standing and total recovery time (T-Recov) were recorded. Incidences of falling and involuntary movements during recovery were counted. Recovery quality was scored by visual analogue scale. Descriptive statistics were used to visualize maintenance data. All other data were included in multiple linear regression models.

RESULTS

Surgical anesthesia was not produced reliably with either protocol. Hypoxaemia occurred in both groups (SpO(2) < 90%). During recovery, falling was noted significantly less often (p < 0.001) in the S-M group (13 ± 7) versus the K-M group (27 ± 13). T-Recov was long, lasting for more than 3 hours in individuals with no significant differences between groups.

CONCLUSION AND CLINICAL RELEVANCE

S(+)-ketamine showed only minor advantages over racemic ketamine. Surgical anaesthesia was not achieved reliably with either protocol. Oxygen supplementation should be considered to prevent hypoxaemia. Further research is needed to develop an injectable field protocol adequate for surgical procedures, but with a rapid smooth recovery.

Differences in hepatic cytochrome P450 activity correlate with the strain-specific biotransformation of medetomidine in AX/JU and IIIVO/JU inbred rabbits

Medetomidine is an alpha(2)-adrenoceptor agonist with sedative and analgesic properties. Previously we demonstrated significant differences in the response to medetomidine between two inbred rabbit strains, denoted IIIVO/JU and AX/JU. The aim of the present study was twofold: first, to compare the hepatic CYP450 enzyme activities between these rabbit strains [n = 13(male male,7 female female)/strain]. To this end, liver microsomes were incubated with known fluorescent substrates for the major drug-metabolizing CYP450 isoforms. A comparison of the obtained results indicated significant gender differences as well as differences between the two rabbit inbred strains. Secondly, the biotransformation rate of medetomidine in liver microsomes of both rabbit strains was determined using liquid chromatography coupled to tandem mass spectrometry. The rate of hydroxymedetomidine and medetomidine carboxylic acid formation was found to be significantly higher in the AX/JU strain. Specific CYP2D and CYP2E inhibitors could decrease the formation of both metabolites. Significant correlations were found between the rate of biotransformation of medetomidine and the activities of CYP2D and CYP2E, as well as between CYP450 enzyme activities and the anaesthetic response to medetomidine.

A comparison of ketamine-midazolam and ketamine-medetomidine combinations for induction of anaesthesia in rabbits

OBJECTIVE

To compare ketamine-midazolam (KMZ) and ketamine-medetomidine (KMT) anaesthesia in rabbits using anaesthetic induction, maintenance and recovery data.

STUDY DESIGN

Randomized, prospective, blinded clinical trial.

ANIMALS

Fifty rabbits (25 male, 25 female) of different breeds undergoing ovariohysterectomy or castration. Rabbits were 12.7 +/- 9.8 months old with body mass 2.24 +/- 0.61 kg.

STUDY DESIGN

Randomized, prospective, blinded clinical trial.

METHODS

Ketamine (15 mg kg(-1)) and midazolam (3 mg kg(-1)) or medetomidine (0.25 mg kg(-1)) were administered by intramuscular (IM) injection. Ten minutes after IM injection, blind intubation of the trachea was attempted. The time taken, the number of attempts and a subjective score of the ease of intubation were recorded. Isoflurane (range 0-3.6%) in 100% oxygen was delivered via a Jackson Rees modification of an Ayre's T-piece non-rebreathing system. Carprofen (3 mg kg(-1)) and dextrose saline (5 mL kg(-1) hour(-1)) were administered intravenously (IV). During surgery heart rate (HR), respiratory rate (RR) and arterial oxygen saturation of haemoglobin (SpO(2)) were monitored. Times to extubation and first head lift were recorded. Group KMT received atipamezole (0.5 mg kg(-1)) IM 30 minutes after discontinuation of isoflurane. Activity was scored at 30, 60 and 120 minutes after volatile agent discontinuation. Mean time to loss of righting reflex (LRR), body mass, RR and vaporizer setting were compared using a two-tailed t-test. Median values for all other data were compared using a Mann-Whitney test.

RESULTS

Mean time to LRR (+/-SD) was significantly shorter with KMT (1.64 +/- 0.55 minutes) compared with KMZ (2.28 +/- 0.66 minutes). Intubation was not possible in seven rabbits (three with KMT, four with KMZ) and three with KMT developed laryngospasm. Mean HR, SpO(2) and vaporizer settings were all significantly lower in group KMT.

CONCLUSION AND CLINICAL RELEVANCE

KMT has a faster onset of action and a greater isoflurane-sparing effect when compared with KMZ. Rabbits with KMT were more prone to laryngospasm and had significantly lower HR.

Peri-operative body temperatures in isoflurane-anaesthetized rabbits following ketamine-midazolam or ketamine-medetomidine

OBJECTIVE

To investigate alterations in peri-operative body temperatures and oesophageal-skin temperatures in isoflurane-anaesthetized rabbits following either ketamine-midazolam or ketamine-medetomidine induction of anaesthesia.

ANIMAL POPULATION

Fifty client-owned rabbits, (25 male, 25 female) of different breeds anaesthetized for elective neutering (age range: 3-42 months; mass range: 1.15-4.3 kg).

STUDY DESIGN

Randomized, blinded clinical study.

METHODS

Pre-anaesthetic rectal temperature was measured. A 24 SWG catheter was placed in a marginal ear vein after local anaesthesia. Ketamine (15 mg kg(-1)) with medetomidine (0.25 mg kg(-1)) (group KMT) or with midazolam (3 mg kg(-1)) (group KMZ) was injected intramuscularly (IM). Following endotracheal intubation anaesthesia was maintained with isoflurane in oxygen. Carprofen (3 mg kg(-1)) and glucose saline (5 mL kg(-1) hour(-1)) were administered through the intravenous catheter. Room temperature and humidity, skin temperature (from tip of pinna) and oesophageal temperature were measured during anaesthesia. Ovariohysterectomy or castration was performed. Rectal temperature was taken when isoflurane was discontinued (time zero) and 30, 60 and 120 minutes thereafter. Atipamezole (0.5 mg kg(-1)) was administered IM to rabbits in group KMT at zero plus 30 minutes. Mass, averaged room temperature and duration of anaesthesia data were compared using a two-tailed t-test. Age, averaged room humidity, rectal temperature decrease, oesophageal temperature decrease and oesophageal-skin difference data were compared using a Kruskal-Wallis test. p < 0.05 was considered significant.

RESULTS

The averaged oesophageal-skin temperature difference was significantly greater in group KMT [median 9.85 degrees C (range 6.42-13.85 degrees C)] than in group KMZ [4.38 degrees C (2.83-10.43 degrees C)]. Rectal temperature decreased over the anaesthetic period was not significantly different between the two groups; however, oesophageal temperature decrease was significantly less in group KMT [1.1 degrees C (-0.1-+2.7 degrees C)] than in group KMZ [1.4 degrees C (0.6-3.1 degrees C)].

CONCLUSIONS

Oesophageal-skin temperature difference is larger in rabbits anaesthetized with ketamine-medetomidine combination than ketamine-midazolam.

CLINICAL RELEVANCE

The oesophageal temperature in rabbits anaesthetized with ketamine-medetomidine and isoflurane decreases significantly less than in animals anaesthetized with ketamine-midazolam and isoflurane, during anaesthesia.

Comparative study of three intramuscular anaesthetic combinations (medetomidine/ketamine, medetomidine/fentanyl/midazolam and xylazine/ketamine) in rabbits

OBJECTIVE

To compare the quality of surgical anaesthesia and cardiorespiratory effects of three intramuscular (IM) anaesthetic combinations in rabbits.

STUDY DESIGN

Prospective randomized cross-over experimental study.

ANIMALS

Nineteen adult female chinchilla mixed-bred rabbits weighing 3.9 +/- 0.8 kg.

METHODS

Rabbits were given one of three IM anaesthetic combinations: 0.25 mg kg(-1) medetomidine and 35.0 mg kg(-1) ketamine (M-K), 0.20 mg kg(-1) medetomidine and 0.02 mg kg(-1) fentanyl and 1.0 mg kg(-1) midazolam (M-F-Mz) and 4.0 mg kg(-1) xylazine and 50 mg kg(-1) ketamine (X-K). The effects of anaesthesia on nociceptive reflexes, circulatory and respiratory function were recorded. Statistical analyses involved repeated measures anova with paired Student's t-test applied post hoc. P-values <0.05 were considered as significant.

RESULTS

Reflex loss was most rapid and complete in M-K recipients, whereas animals receiving M-F-Mz showed the longest tolerance of endotracheal intubation (78.1 +/- 36.5 minutes). Loss of righting reflex was significantly most rapid (p < 0.05) in the X-K group (114.7 +/- 24.0 minutes). Surgical anaesthesia was achieved in 16 of 19 animals receiving M-K, in 14 animals receiving M-F-Mz, and in seven animals with X-K, but only for a short period (7.1 +/- 11.6 minutes). This was significantly (p < 0.001) shorter than with M-K (38.7 +/- 30.0 minutes) and M-F-Mz (31.6 +/- 26.6 minutes). Heart rates were greatest in X-K recipients; lowest HR were seen in animals receiving M-F-Mz. Mean arterial blood pressure was significantly higher (about 88 mmHg) during the first hour in the M-K group. During recovery, the greatest hypotension was encountered in the X-K group; minimum values were 53 +/- 12 mmHg. Six of 19 animals in the M-F-Mz group showed a short period of apnoea (30 seconds) immediately after endotracheal intubation. Respiratory frequency was significantly lower in this group (p < 0.001). Highest values for arterial carbon dioxide partial pressures (PaCO(2)) (6.90 +/- 0.87 kPa; 52.5 +/- 6.5 mmHg) occurred after induction of anaesthesia in group M-F-Mz animals. There was a marked decrease in PaO(2) in all three groups (the minimum value 5.28 +/- 0.65 kPa [39.7 +/- 4.9 mmHg] was observed with M-K immediately after injection). Arterial PO(2) was between 26.0 and 43.0 kPa (196 and 324 mmHg) in all groups during O(2) delivery and decreased - but not <7.98 kPa - on its withdrawal. Immediately after drug injection, pH(a) values fell in all groups, with lowest values after 30 minutes (7.23 +/- 0.03 with M-K, 7.28 +/- 0.05 with M-F-Mz, and 7.36 +/- 0.04 with X-K). The X-K animals showed significantly (p < 0.001) higher pH values than medetomidine recipients. During 1 hour of anaesthesia pH values in the medetomidine groups remained below those of the X-K group.

CONCLUSIONS

Surgical anaesthesia was induced in most animals receiving medetomidine-based combinations. Arterial blood pressure was maintained at baseline values for about 1 hour after M-K. Transient apnoea occurred with M-F-Mz and mandates respiratory function monitoring. Oxygen enrichment of inspired gases is necessary with all three combinations. Endotracheal intubation is essential in rabbits receiving M-F-Mz.

CLINICAL RELEVANCE

The quality of surgical anaesthesia was greatest with M-K. All combinations allowed recoveries of similar duration. It is theoretically possible to antagonize each component of the M-F-Mz combination.

The use of a medetomidine, butorphanol and atropine combination to enable blood sampling in young pigs

AIM

To determine the suitability of a reversible, injectable anaesthetic combination including medetomidine, butorphanol and atropine to produce the degree of immobilisation required to allow blood sampling in young pigs.

METHODS

Twenty 6-week-old crossbred, intact male pigs were sedated with an intramuscular (I/M) injection of 80 microg/kg medetomidine, 200 microg/kg butorphanol and 25 microg/kg atropine. Heart and respiratory rates and rectal temperatures were monitored. Excessive salivation, gagging, laryngeal reflex, presence of pedal reflex and deep and surface analgesia were noted. Time of injection and the time when pigs reached mild and full sedation were also recorded.

RESULTS

Mild sedation was produced in 90% of pigs after 5.6 (SEM 0.96) min (n = 18; median 5, range 2-16 min), and full sedation (lateral recumbency and loss of jaw tone) in 60% of pigs after 12.5 (SEM 2.14) min (n = 12; median 10, range 5-28 min). The depth and duration of sedation were very variable and most animals were easily aroused. Ninety percent of the animals required the administration of halothane by mask to allow blood sampling, but the amount of halothane required was small. Heart and respiratory rates decreased (p < 0.001) but remained within the normal range. Rectal temperature was above normal at the time of sedation and at the time of blood sampling when the ambient temperature was 29 degrees C but not when the ambient temperature was reduced to 25 degrees C.

CONCLUSIONS

The combination of medetomidine, butorphanol and atropine at these doses produced sedation of variable depth and duration that was insufficient on its own to allow blood sampling in the majority of pigs. Hyperthermia can occur in temperature-controlled environments when using medetomidine, butorphanol and atropine in pigs. Reduction of stress and a quieter environment may improve the effects of the anaesthetic combination.