1
|
Moretti G, Mattiuzzi I, Garofanini L, Monti E, Serni B, Bufalari A, Nannarone S. Comparison of Butorphanol, Methadone, and Pethidine in Combination with Alfaxalone for Premedication in Isoflurane-Anesthetized Cats Undergoing Ovariectomy. Animals (Basel) 2024; 14:1997. [PMID: 38998109 PMCID: PMC11240537 DOI: 10.3390/ani14131997] [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: 06/08/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/14/2024] Open
Abstract
The aim of this study was to compare three different anesthetic protocols administered intramuscularly (IM) in cats undergoing elective ovariectomy, while evaluating the quality of sedation, antinociceptive, isoflurane-sparing effect, and analgesia in the intra-operative and post-operative phases. A total of 71 female cats were sedated IM with alfaxalone (3 mg/kg) combined with either butorphanol (0.3 mg/kg), methadone (0.3 mg/kg), or pethidine (5 mg/kg). During surgery, vital parameters were constantly monitored; at the end of the procedure, the quality of recovery was assessed through a specific form and each cat was scored for perceived pain using the UNESP-Botucatu scale for 5 days, and rescue analgesia was provided with buprenorphine IM when indicated. Moreover, differences between two different post-operative resting regimens (hospital kennels vs. home) were also assessed. A significant difference emerged for the amount of IM dexmedetomidine required to achieve an adequate level of sedation for intravenous catheterization, highlighting a greater need in the pethidine group (p = 0.021). There was no significant difference between opioid groups for the requirement of intra-operative rescue analgesia, and the clinical parameters were kept within physiological ranges regardless of the opioid used in premedication. Lastly, differences between the UNESP-Botucatu scores were detected from day 3 to day 5 post-operatively, with lower scores in cats with home resting regimens compared to the hospitalized animals, likely due to the presence of an unfamiliar condition and the absence of a cat-friendly environment.
Collapse
Affiliation(s)
- Giulia Moretti
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - Irene Mattiuzzi
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - Lisa Garofanini
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - Eleonora Monti
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - Benedetta Serni
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - Antonello Bufalari
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
- CeRiDA (Research Center on Animal Pain), Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| | - Sara Nannarone
- Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
- CeRiDA (Research Center on Animal Pain), Department of Veterinary Medicine, University of Perugia, Via San Costanzo 4, 06126 Perugia, Italy
| |
Collapse
|
2
|
Guo Y, Mao S, Zhou Z. Effects of intramuscular alfaxalone and dexmedetomidine alone and combined on ocular, electroretinographic, and cardiorespiratory parameters in normal cats. Front Vet Sci 2024; 11:1407928. [PMID: 39021405 PMCID: PMC11251925 DOI: 10.3389/fvets.2024.1407928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/17/2024] [Indexed: 07/20/2024] Open
Abstract
Background This study aimed to determine the effects of intramuscular (IM) administration of alfaxalone with or without dexmedetomidine on short electroretinography (ERG), ocular parameters and cardiorespiratory in healthy cats. Methods Eight healthy female spayed cats were treated with three sedation protocols: IM administration of 5 μg/kg dexmedetomidine (DEX), 5 mg/kg alfaxalone (ALF), and 5 μg/kg dexmedetomidine plus 5 mg/kg alfaxalone (DEX + ALF). The washout period after each treatment was 2 weeks. Physiological parameters, time metrics, intraocular pressure (IOP), Schirmer tear test 1 (STT-1) and a short ERG protocol were recorded. For age data, weight data, time metrics and ERG data, one-way ANOVA with Bonferroni posterior comparisons were performed. For physiological parameters, IOP and STT-1 data, two-way repeated measures ANOVA with Bonferroni posterior comparisons were performed. Statistical significance was set at a p-value <0.05. Results IOPs were increased in all three groups compared to baseline and showed no significant differences among three groups at any time point. STT-1 values were decreased significantly during the process. Significant differences were noticed between a-wave amplitude in the dark-adapted response between DEX and ALF, and a-wave amplitude in light-adapted response between ALF and DEX + ALF. Conclusion This study demonstrates the feasibility of three sedation protocols for short ERG recording in cats. All these treatments resulted in increased IOP values and reduced STT-1 values. But baseline data of ERG was not obtained as a blank control in cats.
Collapse
Affiliation(s)
| | | | - Zhenlei Zhou
- College of Veterinary Medicine, Nanjing Agricultural University, Nanjing, China
| |
Collapse
|
3
|
Shumikhina SI, Kozhukhov SA, Bondar IV. Dose-dependent changes in orientation amplitude maps in the cat visual cortex after propofol bolus injections. IBRO Neurosci Rep 2024; 16:224-240. [PMID: 38352699 PMCID: PMC10862412 DOI: 10.1016/j.ibneur.2023.12.010] [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: 08/21/2023] [Accepted: 12/30/2023] [Indexed: 02/16/2024] Open
Abstract
A general intravenous anesthetic propofol (2,6-diisopropylphenol) is widely used in clinical, veterinary practice and animal experiments. It activates gamma- aminobutyric acid (GABAa) receptors. Though the cerebral cortex is one of the major targets of propofol action, no study of dose dependency of propofol action on cat visual cortex was performed yet. Also, no such investigation was done until now using intrinsic signal optical imaging. Here, we report for the first time on the dependency of optical signal in the visual cortex (area 17/area 18) on the propofol dose. Optical imaging of intrinsic responses to visual stimuli was performed in cats before and after propofol bolus injections at different doses on the background of continuous propofol infusion. Orientation amplitude maps were recorded. We found that amplitude of optical signal significantly decreased after a bolus dose of propofol. The effect was dose- and time-dependent producing stronger suppression of optical signal under the highest bolus propofol doses and short time interval after injection. In each hemisphere, amplitude at cardinal and oblique orientations decreased almost equally. However, surprisingly, amplitude at cardinal orientations in the ipsilateral hemisphere was depressed stronger than in contralateral cortex at most time intervals. As the magnitude of optical signal represents the strength of orientation tuned component, these our data give new insights on the mechanisms of generation of orientation selectivity. Our results also provide new data toward understanding brain dynamics under anesthesia and suggest a recommendation for conducting intrinsic signal optical imaging experiments on cortical functioning under propofol anesthesia.
Collapse
Affiliation(s)
- Svetlana I. Shumikhina
- Functional Neurocytology, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5a Butlerova Street, 117485 Moscow, Russian Federation
| | - Sergei A. Kozhukhov
- Physiology of Sensory Systems, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5a Butlerova Street, 117485 Moscow, Russian Federation
| | - Igor V. Bondar
- Physiology of Sensory Systems, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5a Butlerova Street, 117485 Moscow, Russian Federation
| |
Collapse
|
4
|
Goodwin W, Monteiro BP, Grimm K, Steagall PV. Letter to Editor in response to "Acute kidney injury in 18 cats after subcutaneous meloxicam and an update on non-steroidal anti-inflammatory drug usage in feline patients in Australia". Aust Vet J 2023; 101:411-412. [PMID: 37587769 DOI: 10.1111/avj.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 07/29/2023] [Indexed: 08/18/2023]
Affiliation(s)
- W Goodwin
- Veterinary Anaesthesia and Analgesia Chapter of Australian and New Zealand College of Veterinary Scientists
| | - B P Monteiro
- World Small Animal Veterinary Association Global Pain Council
| | - K Grimm
- American College Veterinary Anesthesia and Analgesia
| | - P V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint Hyacinthe, QC, Canada
- Department of Veterinary Clinical Sciences, Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
5
|
Comparison of alfaxalone and propofol on haematological and serum biochemical variables in cats undergoing radiotherapy with sevoflurane maintenance. Vet Anaesth Analg 2023; 50:146-156. [PMID: 36759290 DOI: 10.1016/j.vaa.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 10/30/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate effects of repeated alfaxalone or propofol administration on haematological and serum biochemical variables in cats undergoing radiotherapy. STUDY DESIGN Prospective, block-randomized, clinical trial. ANIMALS A group of 39 client-owned cats. METHODS After butorphanol (0.2 mg kg-1) and midazolam (0.1 mg kg-1) sedation, cats were randomly assigned to receive either alfaxalone or propofol for induction of anaesthesia and sevoflurane maintenance. Cats were anaesthetized daily with the same induction agent for 10-12 days. Complete blood counts, reticulocytes, Heinz body score and serum biochemistry were performed before the first treatment (T1), at T6, T10 and 3 weeks after the final treatment (T21). Cumulative induction agent dose for each cat at each time point was evaluated for an effect on Heinz body score. Data are shown as mean ± standard deviation; p < 0.05. RESULTS At baseline there were no significant differences in signalment or blood variables between groups. A significant decrease in haematocrit of 2.3% ± 0.77 (p = 0.02) between T1-T6 and T1-T10 [mean 4.1% (± 0.78, p < 0.0001)] was detected, with a significant increase in haematocrit of 2.1% ± 0.80 (p = 0.046) between T6-T21 and 4.0% ± 0.8 (p < 0.001) between T10-T21. Heinz body score significantly increased by 1.86 ± 0.616 (p = 0.013) between T1-T10. In the propofol group, reticulocytes increased significantly between T1-T6 [mean 23,090 μL-1 ± 7670 (p = 0.02)] and T1-T10 [mean 27,440 μL-1 ± 7990 (p = 0.007)]. Mean cumulative dose at T10 was 19.65 mg kg-1 ± 5.3 and 43.4 mg kg-1 ± 14.4 for alfaxalone and propofol, respectively, with no significant effect on Heinz body formation at any time point. CONCLUSIONS AND CLINICAL RELEVANCE Haematocrit decreased in both groups with recovery after 3 weeks. Repeated alfaxalone and propofol administration was not associated with marked haematological or serum biochemistry changes.
Collapse
|
6
|
Giannettoni G, Moretti G, Menchetti L, Pepe A, Bellocchi F, Bufalari A, Nannarone S. Sedation quality of alfaxalone associated with butorphanol, methadone or pethidine in cats injected into the supraspinatus or the quadriceps muscle. J Feline Med Surg 2022; 24:e269-e280. [PMID: 35762271 PMCID: PMC10812272 DOI: 10.1177/1098612x221104747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this study was to compare the quality of sedation with three different anaesthetic protocols (alfaxalone combined with butorphanol, methadone or pethidine) administered intramuscularly in cats, and to evaluate the influence of the injection site (between supraspinatus and quadriceps muscles) on the onset and quality of sedation. METHODS A total of 151 cats were selected for this study. Cats were sedated with alfaxalone (3 mg/kg) combined with either butorphanol (0.3 mg/kg; n = 50), methadone (0.3 mg/kg; n = 53) or pethidine (5 mg/kg; n = 48). The combination was injected intramuscularly into the supraspinatus (n = 79) or quadriceps muscle (n = 72). The data included a scoring system for the quality of sedation and physiological parameters, such as heart rate (HR), respiratory rate, body temperature and occurrence of mydriasis, monitored during the first 30 mins of anaesthesia. RESULTS The opioid associated with alfaxalone influenced the overall sedation score, the degree of myorelaxation, the occurrence of mydriasis and HR. The overall sedation score was poorer with butorphanol than with methadone (P = 0.008), and butorphanol induced a lower degree of myorelaxation than methadone (P = 0.013). The injection into the supraspinatus showed better qualitative results for sedation and a faster onset time (in about 3 mins) than that into the quadriceps (P <0.001). HR decreased from baseline (P <0.001) and over time (P <0.001), mainly in cats of the butorphanol-supraspinatus and pethidine-quadriceps groups (P = 0.004). The occurrence of mydriasis was lower after butorphanol than after methadone and pethidine (P = 0.025), while the incidence of side effects did not differ among groups. CONCLUSIONS AND RELEVANCE All three protocols provided a good quality of sedation and allowed performing the scheduled procedure. Moreover, the injection into the supraspinatus muscle showed superior results in all the qualitative scores of sedation and quicker onset time than that into the quadriceps muscle.
Collapse
Affiliation(s)
- Giacomo Giannettoni
- ADVETIA Centre Hospitalier Vétérinaire, Vélizy-Villacoublay, Île-de-France, France
| | - Giulia Moretti
- Department of Veterinary Medicine, Perugia University, Perugia, Italy
| | - Laura Menchetti
- Department of Agricultural and Food Sciences, Alma Mater Studiorum – University of Bologna, Bologna, Italy
| | - Arianna Pepe
- Department of Veterinary Medicine, Perugia University, Perugia, Italy
| | | | | | - Sara Nannarone
- Department of Veterinary Medicine, Perugia University, Perugia, Italy
| |
Collapse
|
7
|
Mastakov A, Henning J, de Gier R, Doneley R. Induction of General Anesthesia With Alfaxalone in the Domestic Chicken. J Avian Med Surg 2021; 35:269-279. [PMID: 34677025 DOI: 10.1647/19-00022] [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: 11/11/2022]
Abstract
Alfaxalone is a safe and effective anesthetic drug for the induction of general anesthesia in many nonavian companion animal species; however, its efficacy has not been fully evaluated in birds. In premedicated trials, the chickens were sedated with butorphanol 2 mg/kg intramuscularly and midazolam 0.5 mg/kg intramuscularly, 15 minutes before intravenous administration of alfaxalone. The chickens were classified as anesthetized if endotracheal intubation was achieved without eliciting a cough reflex, provoking no patient resistance, and with minimal glottis movement within 15 seconds after the administration of alfaxalone. Qualitative and quantitative data were recorded, including duration of anesthesia, quality of induction, quality of recovery, reflexes, time to sternal recumbency, time to standing, and time to normal behaviors. Survival analysis was used to analyze the association between alfaxalone dosage and premedication with time-related variables. Out of the evaluated doses, the lowest intravenous alfaxalone dose required to achieve anesthetic induction and endotracheal intubation in unpremedicated and premedicated chickens was 7.5 and 4 mg/kg, respectively. The duration of anesthesia for all dose rates within the study ranged from 51 seconds to 4 minutes 45 seconds. Premedication generally improved the quality of induction and recovery, but significantly (P < .001) increased the time required for the chickens to stand after being anesthetized and to return to normal behaviors. Most chickens exhibited varying degrees of hyperactivity on anesthetic induction and recovery. No postinduction apnea or deaths of the subject birds occurred during this investigation.
Collapse
Affiliation(s)
- Alexandr Mastakov
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia,
| | - Joerg Henning
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
| | - Rebecca de Gier
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
| | - Robert Doneley
- The University of Queensland-Gatton Campus, The University of Queensland, Gatton QLD 4343, Australia
| |
Collapse
|
8
|
Tamura J, Oyama N, Fukui S, Yamashita K. Comparison of the anesthetic effects between 5 mg/kg of alfaxalone and 10 mg/kg of propofol administered intravenously in cats. J Vet Med Sci 2021; 83:73-77. [PMID: 33431725 PMCID: PMC7870395 DOI: 10.1292/jvms.20-0407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To compare the anesthetic effects after intravenous administration of alfaxalone or propofol without premedication, either alfaxalone (5 mg/kg) or propofol (10
mg/kg) was administered intravenously over 120 sec in 6 cats. Each cat received the alternate treatment at least a 7-day interval. Anesthetic effects (tolerance
of intubation, behavior changes and neurodepressive score) and physiological parameters were evaluated. Both treatments produced a rapid loss of consciousness,
no apnea, and physiological parameters were maintained within clinically acceptable ranges apart from transient hypoxemia. The degree of hypoxemia was greater
after the propofol treatment compared with the alfaxalone treatment. During the recovery period, more adverse events (ataxia, muscular tremors) were observed
after the alfaxalone treatment compared with the propofol treatment.
Collapse
Affiliation(s)
- Jun Tamura
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan.,Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0018, Japan
| | - Norihiko Oyama
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan.,Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0018, Japan
| | - Sho Fukui
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
| | - Kazuto Yamashita
- Departments of Small Animal Clinical Sciences, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
| |
Collapse
|
9
|
Abstract
PRACTICAL RELEVANCE Procedural sedation and analgesia (PSA) describes the process of depressing a patient's conscious state to perform unpleasant, minimally invasive procedures, and is part of the daily routine in feline medicine. Maintaining cardiopulmonary stability is critical while peforming PSA. CLINICAL CHALLENGES Decision-making with respect to drug choice and dosage regimen, taking into consideration the cat's health status, behavior, any concomitant diseases and the need for analgesia, represents an everyday challenge in feline practice. While PSA is commonly perceived to be an uneventful procedure, complications may arise, especially when cats that were meant to be sedated are actually anesthetized. AIMS This clinical article reviews key aspects of PSA in cats while exploring the literature and discussing complications and risk factors. Recommendations are given for patient assessment and preparation, clinical monitoring and fasting protocols, and there is discussion of how PSA protocols may change blood results and diagnostic tests. An overview of, and rationale for, building a PSA protocol, and the advantages and disadvantages of different classes of sedatives and anesthetics, is presented in a clinical context. Finally, injectable drug protocols are reported, supported by an evidence-based approach and clinical experience.
Collapse
Affiliation(s)
- Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Paulo V Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Universite de Montreal, Saint-Hyacinthe, Canada
| |
Collapse
|
10
|
Lagos-Carvajal A, Queiroz-Williams P, Cremer J, Ricco Pereira CH, Nevarez J, da Cunha AF, Liu CC. Effects of a priming dose of alfaxalone on the total anesthetic induction dose for and cardiorespiratory function of sedated healthy cats. Am J Vet Res 2020; 81:850-855. [PMID: 33107747 DOI: 10.2460/ajvr.81.11.850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the effects of a priming dose of alfaxalone on the total anesthetic induction dose for and cardiorespiratory function of sedated healthy cats. ANIMALS 8 healthy adult cats. PROCEDURES For this crossover study, cats were sedated with dexmedetomidine and methadone administered IM. Cats next received a priming induction dose of alfaxalone (0.25 mg/kg, IV) or saline (0.9% NaCl) solution (0.025 mL/kg, IV) over 60 seconds and then an induction dose of alfaxalone (0.5 mg/kg/min, IV) until orotracheal intubation was achieved. Cardiorespiratory variables were recorded at baseline (immediately prior to priming agent administration), immediately after priming agent administration, after orotracheal intubation, and every 2 minutes until extubation. The total induction dose of alfaxalone was compared between the 2 priming agents. RESULTS Mean ± SD total anesthetic induction dose of alfaxalone was significantly lower when cats received a priming dose of alfaxalone (0.98 ± 0.28 mg/kg), compared with when cats received a priming dose of saline solution (1.41 ± 0.17 mg/kg). Mean arterial blood pressure was significantly higher when alfaxalone was used as the priming dose. No cats became apneic or had a hemoglobin oxygen saturation of < 90%. Expired volume per minute was not significantly different between the 2 priming agents. CONCLUSIONS AND CLINICAL RELEVANCE Administration of a priming dose of alfaxalone to healthy sedated cats reduced the total dose of alfaxalone needed to achieve orotracheal intubation, maintained mean arterial blood pressure, and did not adversely impact the measured respiratory variables.
Collapse
|
11
|
General anaesthesia of a black leopard (
Panthera pardus
) with alfaxalone, ketamine and isoflurane. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
12
|
Mahdmina A, Evans A, Yates D, White KL. Comparison of the effects of buprenorphine and methadone in combination with medetomidine followed by intramuscular alfaxalone for anaesthesia of cats undergoing ovariohysterectomy. J Feline Med Surg 2020; 22:77-83. [PMID: 30719951 PMCID: PMC10814567 DOI: 10.1177/1098612x19826357] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The aim of this study was to compare the quality of anaesthesia and analgesia between methadone and buprenorphine in combination with medetomidine after induction with intramuscular (IM) alfaxalone in cats undergoing ovariohysterectomy. METHODS Fifty-one female cats (American Society of Anesthesiologists status I-II), with a median age of 12 months (range 2-60 months), weighing a mean ± SD of 2.5 ± 0.5 kg, were recruited to the study. Cats were randomly allocated to receive medetomidine (600 µg/m2) and buprenorphine (180 µg/m2) (group MB) or medetomidine (500 µg/m2) and methadone (5 mg/m2) (group MM) IM. Anaesthesia was induced 15 mins later using alfaxalone (3 mg/kg) IM. Anaesthesia was maintained with isoflurane in oxygen. All cats received meloxicam preoperatively. Quality of premedication and induction and intraoperative physiological parameters were recorded. Atipamezole (50% of medetomidine dose) was administered at the end of surgery. Cats were assessed postoperatively by the same blinded observer using a simple descriptive scale, numeric rating scale, dynamic interactive visual analogue scale (DIVAS) and UNESP-Botucatu multidimensional composite pain scales, at 10, 20 and 30 mins post-extubation. Parametric and non-parametric data were compared using Student's t-test or Mann-Whitney U-tests, respectively. RESULTS Forty-one cats completed the study. No significant differences were detected between groups before or during anaesthesia. No cats required rescue analgesia. DIVAS scores at 10 mins were significantly less in the MM group compared with the MB. No differences between groups at any other time points were detected using the four metrology instruments. CONCLUSIONS AND RELEVANCE Both protocols provided good anaesthesia conditions for ovariohysterectomy in the cat.
Collapse
Affiliation(s)
| | | | - David Yates
- RSPCA Greater Manchester Animal Hospital, Salford, UK
| | - Kate L White
- School of Veterinary Medicine and Science, University of Nottingham, Loughborough, UK
| |
Collapse
|
13
|
Levine AT, Li B, Barnes P, Lomber SG, Butler BE. Assessment of anesthesia on physiological stability and BOLD signal reliability during visual or acoustic stimulation in the cat. J Neurosci Methods 2020; 334:108603. [PMID: 31982459 DOI: 10.1016/j.jneumeth.2020.108603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 01/21/2020] [Accepted: 01/22/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Neuroimaging methods including fMRI provide powerful tools to observe whole-brain functional networks. This is particularly powerful in animal models, allowing these networks to be probed using complementary methods. However, most animals must be anesthetized for neuroimaging, giving rise to complications resulting from anesthetic effects on the animal's physiological and neurological functions. For example, an established protocol for feline neuroimaging involves co-administration of ketamine and isoflurane - the latter of which is known to suppress cortical function. NEW METHOD Here, we compare this established protocol to alfaxalone, a single-agent anesthetic for functional neuroimaging. We first compare the two in a controlled environment to assess relative safety and to measure physiological stability over an extended time window. We then compare patterns of auditory and visually-evoked activity measured at 7 T to assess mean signal strength and between-subjects signal variability. RESULTS IN COMPARISON WITH EXISTING METHODS We show that alfaxalone results in more stable respiratory rates over the 120 min testing period, with evidence of smaller between-measurements variability within this time window, when compared to ketamine plus isoflurane. Moreover, we demonstrate that both agents evoke similar mean BOLD signals across animals, but that alfaxalone elicits more consistent BOLD activity in response to sound stimuli across all ROIs observed. CONCLUSIONS Alfaxalone is observed to be more physiologically stable, evoking a more consistent BOLD signal across animals than the co-administration of ketamine and isoflurane. Thus, an alfaxalone-based protocol may represent a better approach for neuroimaging in animal models requiring anesthesia.
Collapse
Affiliation(s)
- Alexandra T Levine
- Department of Physiology & Pharmacology, University of Western Ontario, London, Ontario, N6A 5C1, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario, N6A 3K7, Canada
| | - Benson Li
- Department of Psychology, University of Western Ontario, London, Ontario, N6A 5C2, Canada
| | - Paisley Barnes
- Department of Physiology & Pharmacology, University of Western Ontario, London, Ontario, N6A 5C1, Canada
| | - Stephen G Lomber
- Department of Psychology, University of Western Ontario, London, Ontario, N6A 5C2, Canada; Department of Physiology & Pharmacology, University of Western Ontario, London, Ontario, N6A 5C1, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario, N6A 3K7, Canada; National Centre for Audiology, University of Western Ontario, London, Ontario, N6G 1H1, Canada
| | - Blake E Butler
- Department of Psychology, University of Western Ontario, London, Ontario, N6A 5C2, Canada; Brain and Mind Institute, University of Western Ontario, London, Ontario, N6A 3K7, Canada; National Centre for Audiology, University of Western Ontario, London, Ontario, N6G 1H1, Canada.
| |
Collapse
|
14
|
Neilson DM, Viscasillas J, Alibhai HIK, Kenny PJ, Niessen SJM, Sanchis-Mora S. Anaesthetic management and complications during hypophysectomy in 37 cats with acromegaly. J Feline Med Surg 2019; 21:347-352. [PMID: 29848149 PMCID: PMC10814632 DOI: 10.1177/1098612x18778697] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The aim of this study was to describe the anaesthetic management and perianaesthetic complications encountered during hypophysectomy surgery in acromegalic cats. We explored relationships between animal demographic data, the anaesthetic protocol used and presence of perioperative complications. METHODS Cats having undergone hypophysectomy surgery for the treatment of feline acromegaly at a single veterinary referral hospital were identified from hospital records. The anaesthesia records and clinical notes of these animals were retrospectively reviewed. Descriptive statistics were produced and binary logistic regression run to assess for any relationship between patient factors, anaesthetic management and complications during the perioperative period. RESULTS Perianaesthetic complications identified included hypothermia, hypotension, bradycardia and airway obstruction. Mortality at 24 h post-anaesthesia was 8%. The use of alpha (α)2 agonists was associated with a lower incidence of hypotension. Fentanyl infusion was associated with a higher incidence of airway obstruction compared with remifentanil. Subjectively assessed anaesthetic recovery quality had an association with the number of days spent in the intensive care ward postoperatively. CONCLUSIONS AND RELEVANCE The anaesthetic management described seems effective for hypophysectomy surgery in cats. Intraoperative complications were common and, while not apparently associated with 24 h patient outcome, drugs and equipment to manage these complications should be available.
Collapse
Affiliation(s)
| | - Jaime Viscasillas
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Hatim IK Alibhai
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Patrick J Kenny
- Small Animal Specialist Hospital, North Ryde, NSW, Australia
| | - Stijn JM Niessen
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Sandra Sanchis-Mora
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| |
Collapse
|
15
|
Bennett KJ, Seddighi R, Moorhead KA, Messenger K, Cox SK, Sun X, Pasloske K, Pypendop BH, Doherty TJ. Effect of fentanyl on the induction dose and minimum infusion rate of alfaxalone preventing movement in dogs. Vet Anaesth Analg 2019; 46:173-181. [DOI: 10.1016/j.vaa.2018.10.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/25/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022]
|
16
|
Lagos-Carvajal A, Queiroz-Williams P, da Cunha A, Liu CC. Determination of midazolam dose for co-induction with alfaxalone in sedated cats. Vet Anaesth Analg 2019; 46:299-307. [PMID: 30928240 DOI: 10.1016/j.vaa.2019.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 12/23/2018] [Accepted: 01/09/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To investigate the median effective dose 50 (ED50) of midazolam required for endotracheal intubation when used for co-induction of anesthesia with a low dose of alfaxalone in sedated cats. STUDY DESIGN Randomized up-and-down study. ANIMALS A group of 14 mixed-breed cats (eight males, six females), aged 5-12 years and weighing 4.4-6.8 kg. METHODS The cats were randomly assigned in a sequential allocation numbers from one to 14. Cats were sedated with dexmedetomidine (3 μg kg-1) and methadone (0.3 mg kg-1) intramuscularly. After 15 minutes, the quality of sedation was subjectively evaluated. Anesthesia induction was performed by intravenous (IV) administration of alfaxalone (0.25 mg kg-1) over a 60 second interval, followed by another 60 second interval, and then an IV dose of midazolam was administered over a 5 second interval. The initial midazolam dose was 0.3 mg kg-1; then, the midazolam dose was adjusted by ±0.1 mg kg-1 for each consecutive cat based on successful or unsuccessful endotracheal intubation of the previous animal following an up-and-down method. This sequence was followed until six nonsequential crossovers were observed. Crossover was defined as two opposite outcomes in two sequential animals. Data were analyzed using isotonic regression with bootstrapping for determination of midazolam ED50 and logistic regression for correlations (p < 0.05). RESULTS Overall, six independent crossovers were found, and ED50 of midazolam was 0.08 ± 0.04 mg kg-1. Sedation score and successful tracheal intubation had a strong positive correlation (p = 0.02). CONCLUSIONS AND CLINICAL RELEVANCE This study determined that 0.08 ± 0.04 mg kg-1 of midazolam co-administered with 0.25 mg kg-1 of alfaxalone IV allowed smooth endotracheal intubation in half of the cats sedated with methadone and dexmedetomidine at the doses used in this study.
Collapse
Affiliation(s)
- Angie Lagos-Carvajal
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Patricia Queiroz-Williams
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA.
| | - Anderson da Cunha
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| | - Chin-Chi Liu
- Department of Veterinary Clinical Sciences, School of Veterinary Medicine, Louisiana State University, Baton Rouge, LA, USA
| |
Collapse
|
17
|
CARDIOVASCULAR EFFECTS OF ALFAXALONE AND PROPOFOL IN THE BULLFROG,LITHOBATES CATESBEIANUS. J Zoo Wildl Med 2018. [DOI: 10.1638/2017-0152r.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
18
|
Oliveira RLS, Moreira CMR, Barcellos MCB, Silva CPP, Teixeira JGC, Souza HJM. Effect of administration rate on propofol requirement in cats. J Feline Med Surg 2018; 20:91-94. [PMID: 29172963 PMCID: PMC11129270 DOI: 10.1177/1098612x17695891] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
Objectives The objective of this study was to determine the effect of administration rate on propofol dose for induction of anesthesia and the effect of methadone on this dose. Methods This was a prospective, randomized, blinded clinical study. Forty male cats (mean ± SD age 1.5 ± 0.8 years) were admitted for orchiectomy. Cats were randomly allocated to receive acepromazine (0.05 mg/kg) with either methadone (MET; 0.3 mg/kg) or saline (SAL; 0.03 ml/kg). Each premedication group then received anesthetic induction with propofol at 5 (F) or 1.5 mg/kg/min (S), resulting in the following four groups: MET-F, SAL-F, MET-S and SAL-S. Sedation scores were assigned at 15 and 30 mins after premedication using a simple descriptive scale (SDS) and a visual analog scale (VAS). After assignment of sedation scores, respiratory frequency ( fR) was recorded, and anesthetic induction began and was continued until cats lost their palpebral reflexes and jaw tone, and the eye globe rotated ventromedially. The time for induction and the total amount of propofol needed was recorded, and intubation was then performed. After intubation, fR was also recorded. Results SDS and VAS sedation scores were low at 15 and 30 mins after premedication. There was no significant difference in sedation scores by time or between the groups at any time on any scale. The amount of propofol needed to achieve anesthetic induction was 5.3 ± 1.1 mg/kg in group MET-F, which was statistically lower when compared with the other three groups, which demonstrated no difference among them. Conclusions and relevance Premedication with acepromazine and methadone was not able to produce adequate sedation in healthy cats. The slow induction rate is not adequate for use in cats considering that all of the animals demonstrated excitement during anesthetic induction. The fast administration rate was able to produce adequate induction of anesthesia and reduce the amount of propofol needed to achieve intubation only when using methadone.
Collapse
Affiliation(s)
- Renato LS Oliveira
- Department of Medicine and Surgery, Veterinary Institute, UFRRJ, Seropédica, Rio de Janeiro, Brazil
| | | | | | | | | | | |
Collapse
|
19
|
Perrin KL, Bertelsen MF. Intravenous Alfaxalone and Propofol Anesthesia in the Bearded Dragon (Pogona vitticeps). ACTA ACUST UNITED AC 2017. [DOI: 10.5818/16-01-071.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Kathryn L. Perrin
- Center for Zoo and Wild Animal Health, Copenhagen Zoo, 2000 Frederiksberg, Denmark
| | - Mads F. Bertelsen
- Center for Zoo and Wild Animal Health, Copenhagen Zoo, 2000 Frederiksberg, Denmark
| |
Collapse
|
20
|
Taylor SD, Baird AN, Weil AB, Ruple A. Evaluation of three intravenous injectable anaesthesia protocols in healthy adult male alpacas. Vet Rec 2017; 181:322. [PMID: 28847875 DOI: 10.1136/vr.104085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 07/13/2017] [Accepted: 07/24/2017] [Indexed: 11/04/2022]
Abstract
Few studies have investigated the effects of intravenous injectable anaesthesia in alpacas. The objective of this study was to evaluate three intravenous injectable anaesthesia protocols in healthy adult alpacas exposed to noxious stimulation. A prospective randomised crossover study was done using six healthy adult male alpacas. Cardiopulmonary variables including heart rate, respiratory rate, mean arterial pressure, end-tidal pCO2 and haemoglobin oxygen saturation were collected immediately after and every two minutes following induction of each of three anaesthesia protocols in six male castrated alpacas. A hoof tester was used to apply consistent pressure every two minutes after induction and the response was recorded. Time from induction to muscle contraction and leg withdrawal were recorded, as well as time from induction to extubation, sternal recumbency and standing. There was no significant difference in duration of anaesthesia or cardiopulmonary variables among the three anaesthesia protocols. Total duration of anaesthesia was approximately 20 minutes for each protocol. Hypoxaemia and mild hypercarbia were common among all protocols. Induction and recovery scores were excellent.
Collapse
Affiliation(s)
- Sandra D Taylor
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Aubrey N Baird
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Ann B Weil
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | - Audrey Ruple
- Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| |
Collapse
|
21
|
Bigby SE, Beths T, Bauquier S, Carter JE. Postinduction apnoea in dogs premedicated with acepromazine or dexmedetomidine and anaesthetized with alfaxalone or propofol. Vet Anaesth Analg 2017; 44:1007-1015. [PMID: 28927811 DOI: 10.1016/j.vaa.2016.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 09/20/2016] [Accepted: 10/20/2016] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To compare incidence and duration of postinduction apnoea in dogs after premedication with methadone and acepromazine (MA) or methadone and dexmedetomidine (MD) followed by induction with propofol (P) or alfaxalone (A). STUDY DESIGN Prospective, randomized clinical trial. ANIMALS A total of 32 American Society of Anesthesiologists class I dogs (15 females, 17 males), aged between 4 months and 4 years, weighing between 3 and 46 kg. METHODS Dogs were randomly allocated to be administered MA+P, MA+A, MD+P or MD+A (methadone 0.5 mg kg-1 and acepromazine 0.05 mg kg-1 or dexmedetomidine 5 μg kg-1). Induction agents were administered intravenously via syringe driver (P at 4 mg kg-1 minute-1 or A at 2 mg kg-1 minute-1) until successful endotracheal intubation and the endotracheal tube connected to a circle system with oxygen flow at 2 L minute-1. Oxygen saturation of haemoglobin (SpO2), end tidal partial pressure of carbon dioxide and respiratory rate were monitored continuously. If apnoea (≥ 30 seconds without breathing) occurred, the duration until first spontaneous breath was measured. If SpO2 decreased below 90% the experiment was stopped and manual ventilation initiated. Data were analysed with general linear models with significance set at p ≤ 0.05. RESULTS There was no statistical difference in the incidence (11 of 16 dogs in A groups and 12 of 16 dogs in P groups), or mean ± standard deviation duration (A groups 125 ± 113 seconds, P groups 119 ± 109 seconds) of apnoea. The SpO2 of one dog in the MD+P group decreased below 90% during the apnoeic period. CONCLUSIONS AND CLINICAL RELEVANCE Propofol and alfaxalone both cause postinduction apnoea and the incidence and duration of apnoea is not influenced by the use of acepromazine or dexmedetomidine in premedication. Monitoring of respiration is recommended when using these premedication and induction agent combinations.
Collapse
Affiliation(s)
- Sarah E Bigby
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Australia.
| | - Thierry Beths
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Australia
| | - Sébastien Bauquier
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Australia
| | - Jennifer E Carter
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, Australia
| |
Collapse
|
22
|
Khenissi L, Nikolayenkova-Topie O, Broussaud S, Touzot-Jourde G. Comparison of intramuscular alfaxalone and ketamine combined with dexmedetomidine and butorphanol for castration in cats. J Feline Med Surg 2017; 19:791-797. [PMID: 27401921 PMCID: PMC11104125 DOI: 10.1177/1098612x16657951] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives Cardiorespiratory parameters and anaesthesia quality in cats anaesthetised with either intramuscular (IM) alfaxalone or ketamine both combined with dexmedetomidine and butorphanol for castration were evaluated. Methods Thirty-two client-owned cats were randomly assigned to receive either alfaxalone (A; 3 mg/kg IM) or ketamine (K; 5 mg/kg IM), combined with dexmedetomidine (10 μg/kg) and butorphanol (0.2 mg/kg). Heart rate (HR), respiratory rate (RR) and rectal temperature (T°) were recorded prior to drug administration. Pulse rate (PR) and RR were recorded 10 (T10) and 15 (T15) mins after injection (T0). Cardiorespiratory values (PR, RR, SPO2, blood pressure, PE'CO2) were recorded every 5 mins for the duration of the procedure. Pain at injection, intubation and recovery were evaluated with simple descriptive scores. Feasibility of anaesthesia was evaluated by the number of top-ups of anaesthetic needed. Cat attitude, ability to walk and presence of ataxia were assessed several times after extubation (Texmin) and the time between injection and extubation recorded. Pain was assessed at Tex120 and Tex240 with the 4Avet-pain score. Results The RR was significantly lower in group K at T10 (RRK = 28 ±13.35 breaths per minute [brpm], RRA= 43.24 ±7.04 brpm) and T15 (RRK = 28 ±11.53 brpm vs RRA = 43 ±12.18 brpm). Time to extubation was significantly longer in group A (TA = 62 ±14.6 mins, TK = 45.13 ± 7.38 mins). Cats in group K needed more top-ups, were more ataxic at Tex120, had a worse recovery score at Tex60 and were less willing to walk at Tex30. Conclusions and relevance Cats receiving alfaxalone had a longer but better quality recovery. Cardiorespiratory parameters were stable and within clinically acceptable values following IM injection of either alfaxalone or ketamine in healthy cats. Intramuscular alfaxalone is a suitable alternative to ketamine for short procedures requiring anaesthesia when used in combination with dexmedetomidine and butorphanol.
Collapse
Affiliation(s)
- Latifa Khenissi
- Department of Anaesthesia, Langford Veterinary Services, University of Bristol, Langford, UK
| | | | - Ségolène Broussaud
- Anaesthesia and Critical Care Service, Oniris Teaching Hospital, Nantes, France
| | | |
Collapse
|
23
|
Deutsch J, Jolliffe C, Archer E, Leece EA. Intramuscular injection of alfaxalone in combination with butorphanol for sedation in cats. Vet Anaesth Analg 2017; 44:794-802. [DOI: 10.1016/j.vaa.2016.05.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 05/10/2016] [Accepted: 05/18/2016] [Indexed: 11/24/2022]
|
24
|
Bigby SE, Beths T, Bauquier S, Carter JE. Effect of rate of administration of propofol or alfaxalone on induction dose requirements and occurrence of apnea in dogs. Vet Anaesth Analg 2017; 44:1267-1275. [PMID: 29146451 DOI: 10.1016/j.vaa.2017.03.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 02/06/2017] [Accepted: 03/21/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate the effect of rate of administration of propofol or alfaxalone on induction dose requirements and incidence of postinduction apnea (PIA) in dogs following premedication with methadone and dexmedetomidine. STUDY DESIGN Prospective, randomized clinical trial. ANIMALS Thirty-two healthy American Society of Anesthesiologists class I client-owned dogs (seven females, 25 males), aged between 5 and 54 months, weighing between 2.0 and 48.2 kg. METHODS Dogs were premedicated intramuscularly with 0.5 mg kg-1 methadone and 5 μg kg-1 dexmedetomidine. Thirty minutes after premedication, dogs were preoxygenated for 5 minutes before the induction agent was administered intravenously via a syringe driver until orotracheal intubation was achieved. Dogs were randomized to receive alfaxalone 0.5 mg kg-1 minute-1 (A-Slow), alfaxalone 2 mg kg-1 minute-1 (A-Fast), propofol 1 mg kg-1 minute-1 (P-Slow), or propofol 4 mg kg-1 minute-1 (P-Fast). Oxygen saturation of hemoglobin (SpO2), end-tidal carbon dioxide and respiratory rate were monitored. If PIA (≥30 seconds without a breath) occurred, the time to the first spontaneous breath was measured. If SpO2 decreased below 90%, the experiment was stopped and manual ventilation initiated. RESULTS The mean±standard deviation induction doses of alfaxalone and propofol were lower in the A-Slow [A-Slow 0.9±0.3 mg kg-1, A-Fast 2.2±0.5 mg kg-1 (p≤0.001)] and P-Slow [P-Slow 1.8±0.6 mg kg-1, P-Fast 4.1±0.7 mg kg-1 (p≤0.001)] groups, respectively. The incidence of PIA was 25% for the A-Slow and P-Slow groups and 100% for the A-Fast and P-Fast groups (p = 0.007). CONCLUSIONS AND CLINICAL RELEVANCE Both propofol and alfaxalone following methadone and dexmedetomidine premedication caused PIA. Induction dose requirement and incidence of PIA were affected by the rate of administration of both drugs. When possible, propofol and alfaxalone doses should be reduced and administered slowly to reduce PIA.
Collapse
Affiliation(s)
- Sarah E Bigby
- Department of Veterinary Medicine, University of Cambridge, Cambridge, England, UK.
| | - Thierry Beths
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC, Australia
| | - Sébastien Bauquier
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC, Australia
| | - Jennifer E Carter
- Faculty of Veterinary and Agricultural Sciences, University of Melbourne, Werribee, VIC, Australia
| |
Collapse
|
25
|
Bellini L, Mollo A, Contiero B, Busetto R. Intraoperative end-tidal concentration of isoflurane in cats undergoing ovariectomy that received tramadol, buprenorphine or a combination of both. J Feline Med Surg 2017; 19:110-116. [PMID: 26581470 PMCID: PMC10816558 DOI: 10.1177/1098612x15615655] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives The aim of the study was to evaluate the end-tidal concentration of isoflurane required to maintain heart and respiratory rate within ± 20% of basal measurement in cats undergoing ovariectomy that received buprenorphine, tramadol or a combination of both. Methods Thirty cats, divided into three groups, were enrolled in a simple operator-blinded, randomised study. Cats received acepromazine (0.03 mg/kg) and one of the following treatments: buprenorphine (0.02 mg/kg), tramadol (2 mg/kg) or a combination of both. Anaesthesia was induced with propofol and maintained with isoflurane titrated in order to maintain heart and respiratory rate within the target values recorded before premedication. Results Groups were similar for age, weight, dose of propofol administered, sedation and recovery scores. Cats receiving tramadol with buprenorphine were extubated earlier after isoflurane discontinuation. No statistical differences were detected in end-tidal fraction of isoflurane between buprenorphine alone or with tramadol. In cats that received tramadol or buprenorphine alone, ovarian pedicle traction caused a statistical increase in end-tidal isoflurane concentration compared with that measured during incision and suture of the skin. In cats that received the combination of tramadol plus buprenorphine no differences among surgical time points were observed. Conclusions and relevance Tramadol added to buprenorphine did not provide any advantage in decreasing the end-tidal fraction of isoflurane compared with buprenorphine alone, although it is speculated there may be an infra-additive interaction between tramadol and buprenorphine in cats.
Collapse
Affiliation(s)
- Luca Bellini
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Antonio Mollo
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Barbara Contiero
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| | - Roberto Busetto
- Department of Animal Medicine, Production and Health, University of Padua, Legnaro, Italy
| |
Collapse
|
26
|
Bauquier SH, Warne LN, Carter JE, Whittem T, Beths T. Influence of two administration rates of alfaxalone at induction on its relative potency in cats: a pilot study. J Feline Med Surg 2017; 19:231-234. [PMID: 26377702 PMCID: PMC10816553 DOI: 10.1177/1098612x15606494] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
Objectives The aim of the study was to evaluate, in a controlled, randomised, masked clinical trial, the influence of administration rate of alfaxalone at induction on its relative potency in cats and to report the incidence of cardiorespiratory adverse effects. Methods Twelve healthy female domestic cats admitted for ovariohysterectomy were premedicated with buprenorphine 20 µg/kg intramuscularly and alfaxalone 3.0 mg/kg subcutaneously. Sedation scores were established (using a published scale ranging from 1 [no sedation] to 5 [profound sedation]) prior to anaesthesia induction with alfaxalone intravenously at 2 mg/kg/min (group A2; n = 6) or 0.5 mg/kg/min (group A0.5; n = 6) to effect until orotracheal intubation was achieved. Sedation scores and alfaxalone induction doses were compared between the groups, using a Mann-Whitney exact test. Results are reported as median and range. Presence of apnoea (no breathing for more than 30 s) or hypotension (mean arterial blood pressure <60 mmHg) within 5 mins postintubation was also reported. Results Although sedation scores (1.5 [range 1.0-3.0] and 2.5 [range 1.0-3.0] for A2 and A0.5, respectively) were not significantly different ( P = 0.32), cats in group A2 required significantly more alfaxalone (4.3 mg/kg [range 3.4-7.0 mg/kg]) than group A0.5 (2.1 mg/kg [range 1.5-2.5 mg/kg]) ( P = 0.002). Two cats in each group presented postinduction apnoea, and two cats in group A2 and three cats in group A0.5 presented postinduction hypotension. Conclusions and relevance The use of a slower induction infusion rate resulted in an increase in the alfaxalone relative potency without obvious cardiorespiratory benefit.
Collapse
Affiliation(s)
- Sébastien H Bauquier
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC, Australia
| | - Leon N Warne
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC, Australia
| | - Jennifer E Carter
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC, Australia
| | - Ted Whittem
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC, Australia
| | - Thierry Beths
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC, Australia
| |
Collapse
|
27
|
Chiu KW, Robson S, Devi JL, Woodward A, Whittem T. The cardiopulmonary effects and quality of anesthesia after induction with alfaxalone in 2-hydroxypropyl-β
-cyclodextrin in dogs and cats: a systematic review. J Vet Pharmacol Ther 2016; 39:525-538. [DOI: 10.1111/jvp.12312] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/20/2016] [Indexed: 11/30/2022]
Affiliation(s)
- K. W. Chiu
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - S. Robson
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - J. L. Devi
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - A. Woodward
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| | - T. Whittem
- Translational Research and Animal Clinical Trials Study (TRACTS) Group; Faculty of Veterinary and Agricultural Sciences; University of Melbourne; Werribee Vic. Australia
| |
Collapse
|
28
|
Campagna I, Schwarz A, Keller S, Bettschart-Wolfensberger R, Mosing M. Comparison of the effects of propofol or alfaxalone for anaesthesia induction and maintenance on respiration in cats. Vet Anaesth Analg 2015; 42:484-92. [DOI: 10.1111/vaa.12231] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 06/24/2014] [Indexed: 12/01/2022]
|
29
|
de Vries M, Putter G. Perioperative anaesthetic care of the cat undergoing dental and oral procedures: key considerations. J Feline Med Surg 2015; 17:23-36. [PMID: 25527491 DOI: 10.1177/1098612x14560096] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
CLINICAL CHALLENGES Anaesthesia for dental and oral procedures in cats can be challenging and many factors need to be taken into consideration. Often it is older patients requiring these procedures and, while old age itself is not a contraindication for general anaesthesia, older patients tend to have limited homeostatic reserves and are, therefore, more prone to anaesthesia-induced insults of vital organs. Most sedative and anaesthetic agents have cardiovascular side effects, which may result in detrimental consequences in older patients in which organ reserves are likely reduced. AIMS The need for good patient assessment and management during the entire perianaesthetic period cannot be overemphasised. This article describes how both anaesthetic protocol and intravenous fluid therapy should be tailored to the individual cat's needs. Application of a multimodal analgesic protocol (the combination of different analgesic agents) and a balanced anaesthetic technique incorporating local nerve blocks is highly recommended and a particular focus of the review. The use of local anaesthetic agents for the latter not only provides optimal pre-emptive analgesia, but also reduces the amount of anaesthetic agents needed to maintain an adequate level of anaesthesia and, therefore, limits their side effects. Other key aspects of perianaesthetic care of the feline dental and oral patient include airway protection, monitoring and maintenance of body temperature, eye protection, and analgesia extending well into the post-anaesthetic period. EVIDENCE BASE The authors draw on their clinical experience and the referenced literature to provide a practical overview of this critical but often-overlooked aspect of feline dentistry.
Collapse
|
30
|
Diao HX, Jiang S, Gao PY, Liu HY, Li JN, Fan HG. Comparison of the effects of propofol and emulsified isoflurane alone or combined with dexmedetomidine on induction of anesthesia in dogs. Vet Anaesth Analg 2015; 43:145-52. [PMID: 26136171 DOI: 10.1111/vaa.12287] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 03/19/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the respective effects of propofol and emulsified isoflurane administered alone and in combination with dexmedetomidine on the quality of induction of anesthesia, physiological variables and recovery in dogs. STUDY DESIGN Prospective, randomized, experimental trial. ANIMALS Thirty-six adult mixed-breed dogs. METHODS Animals were randomly assigned to one of four induction protocols: propofol alone (group P); emulsified isoflurane alone (group EI); both propofol and dexmedetomidine (group PD), or both emulsified isoflurane and dexmedetomidine (group EID). Pulse rate (PR), respiratory rate (fR ), non-invasive arterial blood pressure and arterial blood gases were measured at baseline, before induction, immediately after intubation (time 0), and at 5 minute intervals until the dog began to swallow and the trachea was extubated. The quality of induction and recovery, and degree of ataxia were scored by a single investigator unaware of group assignment. The durations of anesthesia and recovery, and the incidence of adverse events were recorded. RESULTS There were no clinically significant differences among the groups in induction quality. Systolic arterial pressure was lower in EID compared with P at 5 minutes. PR and fR were lower in PD and EID compared with P after induction. The PaCO2 at 5 minutes was higher than at baseline in group P. Ataxia score was lower in EID than in P. Time from induction to extubation and time from extubation to sternal recumbency were lower in EID compared with PD. CONCLUSIONS AND CLINICAL RELEVANCE There were no clinically significant differences among the groups in induction quality. In PD and EID, but not in P, PR and fR were decreased after induction. The EID combination resulted in smooth and rapid induction and recovery and thus may be useful clinically for induction of anesthesia.
Collapse
Affiliation(s)
- Hong-Xiu Diao
- Department of Veterinary Surgery, College of Veterinary Medicine, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Sheng Jiang
- Department of Veterinary Surgery, College of Veterinary Medicine, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Pei-Yuan Gao
- Department of Veterinary Surgery, College of Veterinary Medicine, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Hai-Yu Liu
- Department of Veterinary Surgery, College of Veterinary Medicine, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Jian-Nan Li
- Department of Veterinary Surgery, College of Veterinary Medicine, Northeast Agricultural University, Harbin, Heilongjiang, China
| | - Hong-Gang Fan
- Department of Veterinary Surgery, College of Veterinary Medicine, Northeast Agricultural University, Harbin, Heilongjiang, China
| |
Collapse
|
31
|
Tamura J, Ishizuka T, Fukui S, Oyama N, Kawase K, Itami T, Miyoshi K, Sano T, Pasloske K, Yamashita K. Sedative effects of intramuscular alfaxalone administered to cats. J Vet Med Sci 2015; 77:897-904. [PMID: 25786416 PMCID: PMC4565810 DOI: 10.1292/jvms.14-0200] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The sedative effects of intramuscular (IM) alfaxalone in 2-hydroxypropyl-beta-cyclodextrin (alfaxalone-HPCD) were evaluated in cats. The cats were treated with alfaxalone-HPCD in five occasions with a minimum 14-day interval between treatments: an IM injection of 1.0 mg/kg (IM1), 2.5 mg/kg (IM2.5), 5 mg/kg (IM5) or 10 mg/kg (IM10), or an intravenous injection of 5 mg/kg (IV5). The sedative effects were evaluated subjectively using a composite measurement scoring system (a maximum score of 16). Cardio-respiratory variables were measured non-invasively. The median sedation scores peaked at 10 min (score 9), 15 min (score 14), 10 min (score 16), 10 to 20 min (score 16) and 2 to 5 min (score 16) after the IM1, IM2.5, IM5, IM10 and IV5 treatments, respectively. The IM5 treatment produced longer lasting sedation, compared to the IV5 treatment. Durations of maintenance of lateral recumbency after the IM10 treatment (115 ± 22 min) were longer than those after the IM2.5 (40 ± 15 min), IM5 (76 ± 21 min) and IV5 treatments (50 ± 5 min). Cardio-respiratory variables remained within clinically acceptable ranges, except for each one cat that showed hypotension (<60 mmHg) after the IM10 and IV5 treatments. Tremors, ataxia and opisthotonus-like posture were observed during the early recovery period after the IM2.5, IM5, IM10 and IV5 treatments. In conclusion, IM alfaxalone-HPCD produced dose-dependent and clinically relevant sedative effect at 2.5 to 10 mg/kg in healthy cats. Hypotension may occur at higher IM doses of alfaxalone-HPCD.
Collapse
Affiliation(s)
- Jun Tamura
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
|
33
|
Warne LN, Beths T, Whittem T, Carter JE, Bauquier SH. A review of the pharmacology and clinical application of alfaxalone in cats. Vet J 2014; 203:141-8. [PMID: 25582797 DOI: 10.1016/j.tvjl.2014.12.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 11/03/2014] [Accepted: 12/14/2014] [Indexed: 10/24/2022]
Abstract
Alfaxalone-2-hydroxpropyl-β-cyclodextrin (alfaxalone-HPCD) was first marketed for veterinary use in Australia in 2001 and has since progressively became available throughout the world, including the USA, where in 2012 Food and Drug Administration (FDA) registration was granted. Despite the growing body of published works and increasing global availability of alfaxalone-HPCD, the accumulating evidence for its use in cats has not been thoroughly reviewed. The purpose of this review is: (1) to detail the pharmacokinetic properties of alfaxalone-HPCD in cats; (2) to assess the pharmacodynamic properties of alfaxalone-HPCD, including its cardiovascular, respiratory, central nervous system, neuromuscular, hepatic, renal, haematological, blood-biochemical, analgesic and endocrine effects; and (3) to consider the clinical application of alfaxalone-HPCD for sedation, induction and maintenance of anaesthesia in cats. Based on the published literature, alfaxalone-HPCD provides a good alternative to the existing intravenous anaesthetic options for healthy cats.
Collapse
Affiliation(s)
- Leon N Warne
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic 3030, Australia
| | - Thierry Beths
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic 3030, Australia
| | - Ted Whittem
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic 3030, Australia
| | - Jennifer E Carter
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic 3030, Australia
| | - Sébastien H Bauquier
- Translational Research and Clinical Trials (TRACTs), Veterinary Hospital, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, Vic 3030, Australia.
| |
Collapse
|
34
|
Tamura J, Ishizuka T, Fukui S, Oyama N, Kawase K, Miyoshi K, Sano T, Pasloske K, Yamashita K. The pharmacological effects of the anesthetic alfaxalone after intramuscular administration to dogs. J Vet Med Sci 2014; 77:289-96. [PMID: 25428797 PMCID: PMC4383774 DOI: 10.1292/jvms.14-0368] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
The pharmacological effects of the anesthetic alfaxalone were evaluated after
intramuscular (IM) administration to 6 healthy beagle dogs. The dogs received three IM
doses each of alfaxalone at increasing dose rates of 5 mg/kg (IM5), 7.5 mg/kg (IM7.5) and
10 mg/kg (IM10) every other day. Anesthetic effect was subjectively
evaluated by using an ordinal scoring system to determine the degree of neuro-depression
and the quality of anesthetic induction and recovery from anesthesia. Cardiorespiratory
variables were measured using noninvasive methods. Alfaxalone administered IM produced
dose-dependent neuro-depression and lateral recumbency (i.e., 36 ± 28 min, 87 ± 26 min and
115 ± 29 min after the IM5, IM7.5 and IM10 treatments, respectively). The endotracheal
tube was tolerated in all dogs for 46 ± 20 and 58 ± 21 min after the IM7.5 and IM10
treatments, respectively. It was not possible to place endotracheal tubes in 5 of the
6 dogs after the IM5 treatment. Most cardiorespiratory variables remained
within clinically acceptable ranges, but hypoxemia was observed by pulse oximetry for 5 to
10 min in 2 dogs receiving the IM10 treatment. Dose-dependent decreases in rectal
temperature, respiratory rate and arterial blood pressure also occurred. The quality of
recovery was considered satisfactory in all dogs receiving each treatment; all the dog
exhibited transient muscular tremors and staggering gait. In conclusion, IM alfaxalone
produced a dose-dependent anesthetic effect with relatively mild cardiorespiratory
depression in dogs. However, hypoxemia may occur at higher IM doses of alfaxalone.
Collapse
Affiliation(s)
- Jun Tamura
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8501, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Kalchofner Guerrero KS, Reichler IM, Schwarz A, Jud RS, Hässig M, Bettschart-Wolfensberger R. Alfaxalone or ketamine-medetomidine in cats undergoing ovariohysterectomy: a comparison of intra-operative parameters and post-operative pain. Vet Anaesth Analg 2014; 41:644-53. [DOI: 10.1111/vaa.12157] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 07/26/2013] [Indexed: 11/29/2022]
|
36
|
Minimum infusion rate of alfaxalone for total intravenous anaesthesia after sedation with acepromazine or medetomidine in cats undergoing ovariohysterectomy. Vet Anaesth Analg 2014; 41:480-90. [DOI: 10.1111/vaa.12144] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Accepted: 03/05/2013] [Indexed: 11/26/2022]
|
37
|
Beths T, Touzot-Jourde G, Musk G, Pasloske K. Clinical evaluation of alfaxalone to induce and maintain anaesthesia in cats undergoing neutering procedures. J Feline Med Surg 2014; 16:609-15. [PMID: 24305470 PMCID: PMC11164152 DOI: 10.1177/1098612x13514420] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
This study looked at the use and efficacy of alfaxalone for total intravenous anaesthesia (TIVA) in cats. Following intramuscular medetomidine (20 μg/kg) and morphine (0.3 mg/kg) premedication, anaesthesia was induced and maintained with intravenous alfaxalone. Patients were breathing 100% oxygen. Heart rate (HR), respiratory rate (RR), end-tidal carbon dioxide, oxygen saturation of haemoglobin and indirect arterial blood pressure via Doppler (DAP) were recorded every 5 mins. Thirty-four cats (10 males and 24 females), between the age of 6 and 18 months, and weighing between 1.8 and 5.3 kg, and undergoing neutering procedures were included in this study. The results are presented as median (min, max) values. The time to first spontaneous movement (TS) was >30 mins in 19 cats, of which 12 received atipamezole for reversal of the effects of medetomidine. The TS was 53 (43, 130) mins in these 12 cats and 50 (40, 72) mins in the other seven cats. The body temperature in those 19 cats was significantly lower than the other cats (P = 0.05). The alfaxalone induction dose and maintenance infusion rate were1.7 (0.7, 3.0) mg/kg and 0.18 (0.06, 0.25) mg/kg/min, respectively. The HR, RR and DAP were 145 (68, 235) beats/min, 17 (5, 40) breaths/min and 110 (58, 210) mmHg, respectively. Apnoea was not observed in any cat. In conclusion, alfaxalone TIVA in combination with medetomidine and morphine premedication was effective in feral and domestic cats for the performance of neutering surgery; low body temperature might have resulted in longer recoveries in some cats.
Collapse
Affiliation(s)
- Thierry Beths
- Faculty of Veterinary Science, Melbourne University Veterinary Hospital, Werribee, VIC, Australia
| | | | - Gabrielle Musk
- College of Veterinary Medicine, Murdoch University, Murdoch, WA, Australia
| | - Kirby Pasloske
- Research and Development, Jurox Pty Ltd, Rutherford, NSW, Australia
| |
Collapse
|
38
|
Minter LJ, Bailey KM, Harms CA, Lewbart GA, Posner LP. The efficacy of alfaxalone for immersion anesthesia in koi carp (Cyprinus carpio). Vet Anaesth Analg 2014; 41:398-405. [DOI: 10.1111/vaa.12113] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 11/08/2012] [Indexed: 11/29/2022]
|
39
|
del Álamo AM, Mandsager RE, Riebold TW, Payton ME. Evaluation of intravenous administration of alfaxalone, propofol, and ketamine-diazepam for anesthesia in alpacas. Vet Anaesth Analg 2014; 42:72-82. [PMID: 24834969 DOI: 10.1111/vaa.12170] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 11/07/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effects of induction of anesthesia with alfaxalone in alpacas. STUDY DESIGN Prospective, randomized, crossover design. ANIMALS Five healthy alpacas (96.7 ± 19.9 kg, 9.6 ± 3.1 years old). METHODS The alpacas were anesthetized on three occasions with alfaxalone, propofol, or ketamine-diazepam by intravenous injection. Quality of induction and intubation was assessed using a simple descriptive scale, and quality of recovery was scored: 1 (very poor)-5 (excellent). The auricular artery was catheterized for measurement of systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures and collection of blood. Variables measured were hemoglobin oxygen saturation (SpO2 ), respiratory rate, and end-tidal carbon dioxide partial pressure (Pe'CO2 ), and ECG. Repeated measures anova was used to assess effects of drug and time. Significance was set at p < 0.05. RESULTS Mean dose of alfaxalone sufficient to allow intubation was 2.1 mg kg(-1) . Induction was excellent with all protocols. Heart rate (HR), SAP and MAP were significantly higher following alfaxalone compared to ketamine-diazepam. Blood lactate concentration when standing following alfaxalone was higher compared to minutes 1 and 6, and to propofol (p < 0.05). All alpacas required oxygen supplementation and mechanical ventilation to treat SpO2 < 90% or Pe'CO2 > 60 mmHg. Time from induction to standing was longer with alfaxalone (34.1 ± 3.2 minutes) than propofol (19.0 ±4.3 minutes) or ketamine-diazepam (24.9 ±1.7 minutes). Recovery quality median scores were clinically and statistically different: 2 (alfaxalone), 4 (ketamine-diazepam), and 5 (propofol). Tremors, paddling, rolling, seizure-like activity and thrashing characterized recovery from alfaxalone. CONCLUSION Recovery quality was worst with alfaxalone. HR, SAP, MAP were increased at minute 1 in all protocols. Transient hypercapnia and hypoxia was observed with all protocols. CLINICAL RELEVANCE All protocols were adequate for induction of anesthesia. Alfaxalone alone in unpremedicated alpacas is not recommended.
Collapse
Affiliation(s)
- Ana M del Álamo
- College of Veterinary Medicine, Oregon State University, Veterinary Teaching Hospital, Corvallis, OR, USA
| | | | | | | |
Collapse
|
40
|
Dzikiti TB, Zeiler GE, Dzikiti LN, Garcia ER. The effects of midazolam and butorphanol, administered alone or combined, on the dose and quality of anaesthetic induction with alfaxalone in goats. J S Afr Vet Assoc 2014; 85:1047. [DOI: 10.4102/jsava.v85i1.1047] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 10/15/2013] [Accepted: 10/25/2013] [Indexed: 11/01/2022] Open
Abstract
Goats are rarely anaesthetised; consequently, scant information is available on the efficacy of anaesthetic drugs in this species. Alfaxalone is a relatively new anaesthetic agent, of which the efficacy in goats has not yet been studied. In this study, the sedative and alfaxalonesparing effects of midazolam and butorphanol, administered alone or concomitantly, in goats were assessed. Eight clinically healthy goats, four does and four wethers, were enlisted in a randomised crossover manner to receive intramuscular sedative treatments consisting of saline 0.05 mL/kg, or midazolam 0.30 mg/kg, or butorphanol 0.10 mg/kg, or a combination ofmidazolam 0.30 mg/kg with butorphanol 0.10 mg/kg before intravenous induction of general anaesthesia with alfaxalone. Following induction, the goats were immediately intubated and the quality of anaesthesia and basic physiological cardiorespiratory and blood-gas parameters were assessed until the goats had recovered from anaesthesia. The degree of sedation, quality of induction and recovery were scored. When compared with saline (3.00 mg/kg), midazolam,administered alone or with butorphanol, caused a statistically significant increased level of sedation and a reduction in the amount of alfaxalone required for induction (2.00 mg/kg and 1.70 mg/kg, respectively). Butorphanol alone (2.30 mg/kg) did not cause significant changes in level of sedation or alfaxalone-induction dose. During induction and recovery, the goats were calm following all treatments, including the control group. Cardiorespiratory and blood gasparameters were maintained within clinically acceptable limits. The present study showed that midazolam, administered alone or combined with butorphanol, produces a degree of sedation that significantly reduces the dose of alfaxalone required for induction of general anaesthesia in goats, without causing any major adverse cardiorespiratory effects.
Collapse
|
41
|
Carter J, Story DA. Veterinary and human anaesthesia: an overview of some parallels and contrasts. Anaesth Intensive Care 2014; 41:710-8. [PMID: 24180711 DOI: 10.1177/0310057x1304100605] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The history of human and veterinary anaesthesia is both intertwined and parallel. Physicians and anaesthetists often first experimented on animals and developments from human anaesthesia have been incorporated into veterinary medicine. Within veterinary medicine, anaesthesia is a specialty discipline as it is in human medicine. Veterinary anaesthetists undertake additional training and rigorous examinations for a diploma or fellowship. In contrast to human anaesthesia in Australia and New Zealand, veterinary anaesthesia is often performed by non-specialists and by veterinary nurses. Veterinary anaesthesia uses many of the same drugs for premedication, induction and maintenance of anaesthesia as human anaesthesia. However, there are species specific effects of some of the drugs used that differ from the effects in humans. Furthermore, some agents, particularly alpha-2 adrenoreceptor agonists and ketamine, are used very widely in veterinary practice. Also in contrast to most human anaesthesia, in large animal and exotic animal practice the patients can present a physical danger to the anaesthetist. The most notable contrast between human and veterinary anaesthesia is in the reported perioperative complication and mortality rates, with a species dependent perianaesthetic mortality of up to 2% in dogs, cats and horses and greater than 2% in guinea pigs and birds, which is up to 100-fold higher than in human anaesthesia.
Collapse
Affiliation(s)
- J Carter
- Faculty of Veterinary Science and Melbourne Medical School, the University of Melbourne, Melbourne, Victoria
| | | |
Collapse
|
42
|
Gieseg MA, Hon H, Bridges J, Walsh V. A comparison of anaesthetic recoveries in cats following induction with either alfaxalone or ketamine and diazepam. N Z Vet J 2013; 62:103-9. [DOI: 10.1080/00480169.2013.840234] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
43
|
Khor KH, Shiels IA, Campbell FE, Greer RM, Rose A, Mills PC. Evaluation of a technique to measure heart rate variability in anaesthetised cats. Vet J 2013; 199:229-35. [PMID: 24321367 DOI: 10.1016/j.tvjl.2013.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 11/06/2013] [Accepted: 11/09/2013] [Indexed: 12/01/2022]
Abstract
Analysis of heart rate (HR) and heart rate variability (HRV) are powerful tools to investigate cardiac diseases, but current methods, including 24-h Holter monitoring, can be cumbersome and may be compromised by movement artefact. A commercially available data capture and analysis system was used in anaesthetised healthy cats to measure HR and HRV during pharmacological manipulation of HR. Seven healthy cats were subjected to a randomised crossover study design with a 7 day washout period between two treatment groups, placebo and atenolol (1mg/kg, IV), with the efficacy of atenolol to inhibit β1 adrenoreceptors challenged by epinephrine. Statistical significance for the epinephrine challenge was set at P<0.0027 (Holm-Bonferroni correction), whereas a level of significance of P<0.05 was set for other variables. Analysis of the continuous electrocardiography (ECG) recordings showed that epinephrine challenge increased HR in the placebo group (P=0.0003) but not in the atenolol group. The change in HR was greater in the placebo group than in the atenolol group (P=0.0004). Therefore, compared to cats pre-treated with placebo, pre-treatment with atenolol significantly antagonised the tachycardia while not significantly affecting HRV. The increased HR in the placebo group following epinephrine challenge was consistent with a shift of the sympathovagal balance towards a predominantly sympathetic tone. However, the small (but not significant at the critical value) decrease in the normalised high-frequency component (HFnorm) in both groups of cats suggested that epinephrine induced a parasympathetic withdrawal in addition to sympathetic enhancement (increased normalised low frequency component or LFnorm). In conclusion, this model is a highly sensitive and repeatable model to investigate HRV in anaesthetised cats that would be useful in the laboratory setting for short-term investigation of cardiovascular disease and subtle responses to pharmacological agents in this species.
Collapse
Affiliation(s)
- Kuan Hua Khor
- School of Veterinary Science, The University of Queensland, Gatton Campus, QLD 4343, Australia; Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Ian A Shiels
- School of Veterinary Science, The University of Queensland, Gatton Campus, QLD 4343, Australia
| | - Fiona E Campbell
- School of Veterinary Science, The University of Queensland, Gatton Campus, QLD 4343, Australia
| | - Ristan M Greer
- School of Veterinary Science, The University of Queensland, Gatton Campus, QLD 4343, Australia
| | - Annie Rose
- School of Veterinary Science, The University of Queensland, Gatton Campus, QLD 4343, Australia
| | - Paul C Mills
- School of Veterinary Science, The University of Queensland, Gatton Campus, QLD 4343, Australia.
| |
Collapse
|
44
|
EFFICACY OF ALFAXALONE FOR INTRAVASCULAR ANESTHESIA AND EUTHANASIA IN BLUE CRABS (CALLINECTES SAPIDUS). J Zoo Wildl Med 2013; 44:694-9. [DOI: 10.1638/2012-0285r1.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
45
|
|
46
|
Maney JK, Shepard MK, Braun C, Cremer J, Hofmeister EH. A comparison of cardiopulmonary and anesthetic effects of an induction dose of alfaxalone or propofol in dogs. Vet Anaesth Analg 2013; 40:237-44. [DOI: 10.1111/vaa.12006] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 01/20/2012] [Indexed: 11/26/2022]
|
47
|
Grubb TL, Greene SA, Perez TE. Cardiovascular and respiratory effects, and quality of anesthesia produced by alfaxalone administered intramuscularly to cats sedated with dexmedetomidine and hydromorphone. J Feline Med Surg 2013; 15:858-65. [DOI: 10.1177/1098612x13478265] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The cardiovascular and respiratory effects, and the quality of anesthesia of alfaxalone administered intramuscularly (IM) to cats sedated with dexmedetomidine and hydromorphone were evaluated. Twelve healthy adult cats were anesthetized, with six cats receiving dexmedetomidine (0.01 mg/kg IM) followed by alfaxalone (5 mg/kg IM; group DA) and six receiving dexmedetomidine (0.01 mg/kg IM) plus hydromorphone (0.1 mg/kg IM) followed by alfaxalone (5 mg/kg IM; group DHA). Cardiorespiratory (pulse rate, blood pressure, respiratory rate, saturation of oxygen with hemoglobin, end tidal carbon dioxide partial pressure) and bispectral index (BIS) data were collected every 10 mins for 90 mins starting immediately after intubation. The quality of anesthesia was scored by a blinded researcher at induction and at 5 and 60 mins after extubation. Recovery scores ranged from 1 (prolonged struggling) to 4 (no struggling). There were no clinically significant ( P >0.05) differences in any data between groups or over time. Physiologic parameters were within normal limits for cats at all times. BIS values were consistent with light anesthesia in both groups. However, recovery was prolonged and marked with excitement, ataxia and hyper-reactivity in all cats. Thus, although cardiovascular and respiratory parameters are stable following IM injection of alfaxalone to cats sedated with dexmedetomidine and hydromorphone, recovery is extremely poor and this route of administration is not recommended for anesthesia in cats.
Collapse
Affiliation(s)
- Tamara L Grubb
- Veterinary Clinical Sciences Department, Washington State University, Pullman, WA, USA
| | - Stephen A Greene
- Veterinary Clinical Sciences Department, Washington State University, Pullman, WA, USA
| | - Tania E Perez
- Veterinary Clinical Sciences Department, Washington State University, Pullman, WA, USA
| |
Collapse
|
48
|
O'Hagan BJ, Pasloske K, McKinnon C, Perkins NR, Whittem T. Clinical evaluation of alfaxalone as an anaesthetic induction agent in cats less than 12 weeks of age. Aust Vet J 2012; 90:395-401. [DOI: 10.1111/j.1751-0813.2012.00983.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2012] [Indexed: 11/27/2022]
Affiliation(s)
- BJ O'Hagan
- Jurox Pty Ltd; 85 Gardiner Road; Rutherford; New South Wales; 2320; Australia
| | - K Pasloske
- Jurox Pty Ltd; 85 Gardiner Road; Rutherford; New South Wales; 2320; Australia
| | - C McKinnon
- RSPCA 6/10 Burlington Place; Rutherford; New South Wales; 2320; Australia
| | - NR Perkins
- AusVet Animal Health Services; 1a/109 Herries Street; Toowoomba; Queensland; 2350; Australia
| | - T Whittem
- Jurox Pty Ltd; 85 Gardiner Road; Rutherford; New South Wales; 2320; Australia
| |
Collapse
|
49
|
Nelissen P, Corletto F, Aprea F, White RAS. Effect of Three Anesthetic Induction Protocols on Laryngeal Motion during Laryngoscopy in Normal Cats. Vet Surg 2012; 41:876-83. [DOI: 10.1111/j.1532-950x.2012.01030.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
50
|
Granados MM, Domínguez JM, Fernández-Sarmiento A, Funes FJ, Morgaz J, Navarrete R, Carrillo JM, Rubio M, Muñoz-Rascón P, Gómez de Segura IA, Gómez-Villamandos R. Anaesthetic and cardiorespiratory effects of a constant-rate infusion of alfaxalone in desflurane-anaesthetised sheep. Vet Rec 2012; 171:125. [PMID: 22791525 DOI: 10.1136/vr.100487] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A prospective, randomised, blinded controlled study was performed to determine the anaesthetic and cardiorespiratory effects of a constant-rate infusion (CRI) of alfaxalone in 12 sheep anaesthetised with desflurane, and undergoing experimental orthopaedic surgery. Sheep were sedated with dexmedetomidine (4 μg/kg, intravenously) and butorphanol (0.3 mg/kg, intravenously). Anaesthesia was induced with alfaxalone (1 mg/kg/minute to effect, intravenously) and maintained with desflurane in oxygen and alfaxalone 0.07 mg/kg/minute or saline for 150 minutes (range 150-166 minutes). The anaesthetic induction dose of alfaxalone, the desflurane expiratory fraction required for anaesthetic maintenance, cardiorespiratory measurements and blood-gases were recorded at predetermined intervals. Quality of sedation, anaesthetic induction and recovery were assessed. The alfaxalone induction dose was 1.7 mg/kg (1.2 to 2.6 mg/kg). The desflurane expiratory fraction was lower (22 per cent) in sheep receiving alfaxalone CRI (P=0). Also, heart rate (P=0), cardiac index (P=0.002), stroke index (P=0) and contractility (P=0) were higher, and systemic vascular resistance (P=0.002) was lower. Although respiratory rate tended to be higher with alfaxalone, there was no difference in PCO2 between the groups. Recovery times were significantly longer in sheep given alfaxalone (25.4 v 9.5 minutes) but recovery quality was similar. Alfaxalone reduced requirements of desflurane and maintained similar cardiorespiratory function, but recovery time was more prolonged.
Collapse
Affiliation(s)
- M M Granados
- Department of Animal Medicine and Surgery, Anaesthesia Unit, Veterinary Faculty, University of Córdoba, Córdoba, Spain.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|