Evaluation of the anesthetic efficacy of alfaxalone in oscar fish (Astronotus ocellatus)

Alfaxalone does not have long-term effects on goldfish pyramidal neuron action potential properties or GABAA receptor currents

Anesthetics have varying physiological effects, but most notably alter ion channel kinetics. Alfaxalone is a rapid induction and washout neuroactive anesthetic, which potentiates γ-aminobutyric acid (GABA)-activated GABAA receptor (GABAA-R) currents. This study aims to identify any long-term effects of alfaxalone sedation on pyramidal neuron action potential and GABAA-R properties, to determine if its impact on neuronal function can be reversed in a sufficiently short timeframe to allow for same-day electrophysiological studies in goldfish brain. The goldfish (Carassius auratus) is an anoxia-tolerant vertebrate and is a useful model to study anoxia tolerance mechanisms. The results show that alfaxalone sedation did not significantly impact action potential properties. Additionally, the acute application of alfaxalone onto naive brain slices caused the potentiation of whole-cell GABAA-R current decay time and area under the curve. Following whole-animal sedation with alfaxalone, a 3-h wash of brain slices in alfaxalone-free saline, with saline exchanged every 30 min, was required to remove any potentiating impact of alfaxalone on GABAA-R whole-cell currents. These results demonstrate that alfaxalone is an effective anesthetic for same-day electrophysiological experiments with goldfish brain slices.

Evaluating the Anesthetic and Physiologic Effects of Intramuscular and Intravenous Alfaxalone in Eastern Mud Turtles (Kinosternon subrubrum)

Current sedation protocols for chelonians can pose a challenge to clinicians because of prolonged induction and recovery times, difficulties in gaining venous access, and natural species variation. This study evaluated the sedative and physiologic effects of intramuscular (IM) and intravenous (IV) alfaxalone in six wild-caught adult eastern mud turtles (Kinosternon subrubrum). The turtles received alfaxalone 10 mg/kg IM and IV in a randomized cross-over design. A 10-day washout period occurred between trials. Baseline parameters (heart rate, respiratory rate, temperature, and reflexes) were assessed prior to injection and every 5 min post-injection until recovery. Three venous blood gas samples were also collected and analyzed over the course of each trial (baseline, induction, and recovery). Intravenous alfaxalone resulted in a significantly faster induction (p = 0.016; median: 1.5 min, 25-75%: 1-7.5, minimum-maximum: 1-21) and a shorter total sedation time (p = 0.041; median: 52 min, 25-75%: 34.5-62.5, minimum-maximum: 33-87) when compared with IM alfaxalone (induction, median: 20 min, 25-75%: 15-22.5, minimum-maximum: 15-25; total, median: 70 min, 25-75%: 65-82.5, minimum-maximum: 65-90). Blood gas and physiologic parameters were not significantly different between groups; however, the pH (p = 0.009) and glucose (p = 0.0001) significantly increased, and partial pressure of carbon dioxide (p = 0.024) significantly decreased over time. This study demonstrated that alfaxalone 10 mg/kg IV or IM can be used to provide safe and effective sedation in eastern mud turtles.

Comparison of Alfaxalone and Tricaine Methanesulfonate Immersion Anesthesia And Alfaxalone Residue Clearance In Rainbow Trout (Oncorhynchus Mykiss)

Alfaxalone, a synthetic neuroactive steroid, has been tested as an immersion anesthetic in ornamental fish, but its safety and efficacy in sport fish have not been investigated. In the current study, we compared the physiologic and behavioral effects of alfaxalone with those of tricaine methanesulfonate (MS222) for anesthesia of rainbow trout (Oncorhynchus mykiss) via water immersion. We also analyzed alfaxalone-exposed tissues to determine residue clearance times. Fish were anesthetized for 10 min by immersion in low-dose alfaxalone (Alow; 5 mg/L induction, 1 mg/L maintenance), high-dose alfaxalone (Ahigh; 5 mg/L induction, 2 mg/L maintenance), or MS222 (MS; 150 mg/L induction, 100 mg/L maintenance). Fish received all 3 treatments, separated by a washout period of at least 18 d in a blinded, complete crossover design. We hypothesized that immersion in Alow or Ahigh would provide a stable plane of anesthesia in rainbow trout, with dose-dependent time to recovery, and that opercular rates and depths of anesthesia would be equivalent to that of MS222. The time to anesthesia induction was longer for alfaxalone than MS222 but averaged less than 100 s. The time to recovery from anesthesia was also longer for alfaxalone than MS222, with significantly shorter recovery time for Alow than for Ahigh. All treatments decreased opercular rate and response to noxious stimuli. Alfaxalone residue clearance was greater than 80% from all tissues within 1 h, greater than 99% from muscle within 4 h, and 100% from all tissues within 36 h after exposure. We conclude that alfaxalone immersion at 5 mg/L for induction and 2 mg/L for maintenance provides a safe, viable alternative to MS222 for the anesthesia of rainbow trout.

Fish Sedation and Anesthesia

Veterinarians often need to sedate or anesthetize fish to perform physical examinations or other diagnostic procedures. Sedation may also be required to transport fish. Painful procedures require complete anesthesia with appropriate antinociceptive agents. Regulations and withdrawal times apply to food animal species in many countries. Specific protocols are therefore warranted in commercial fish versus ornamentals. Tonic immobility of elasmobranchs and electric anesthesia should never be used to perform painful procedures. Anesthetic monitoring in fish remains challenging. This review summarizes ornamental fish anesthesia and discusses techniques used in the commercial fish industry and in field conditions.

The Use of Alfaxalone in Quaker Parrots (Myiopsitta monachus)

Alfaxalone is a neurosteroid anesthetic that acts on gamma-aminobutyric acid alpha-receptors. The objective of this study was to evaluate the clinical safety and efficacy of alfaxalone (Alfaxan CD). Due to observed hyperexcitability in the subject animals when alfaxalone was the only drug used during the initial trials, premedication with midazolam was also evaluated during the final study. Ten adult Quaker parrots (Myiopsitta monachus) were assigned to 3 groups: 1) low-dose alfaxalone 10 mg/kg (LD), 2) high-dose alfaxalone 25 mg/kg (HD), and 3) alfaxalone 10 mg/ kg with midazolam 1 mg/kg premedication (AM), administered intramuscularly. Induction time, sedation quality, duration of action, and vital parameters, including heart rate, respiratory rate, and temperature, were recorded. All protocols achieved adequate sedation; however, muscle tremors and hyperexcitation were variable. The LD group had a significantly longer mean ± SD induction time (13.5 ± 4.5 minutes) as compared to the HD (6.0 ± 1.3 minutes, P = .002) and AM (6.5 ± 2.9 minutes, P = .006) groups, while recovery time was significantly longer in the HD group (86.2 ± 13.4 minutes) than the LD group (44.4 ± 10.8 minutes, P < .001). Midazolam premedication resulted in reduction of both muscle tremors and hyperexcitation associated with alfaxalone administration, but the recovery time was significantly longer (103.5 ± 15.1 minutes, P < .001) than for the LD group. Alfaxalone as a sole agent resulted in muscle tremors and hyperexcitation during induction, which was attenuated by premedication with midazolam. Further investigation is warranted to characterize the effects of alfaxalone and drugs used to premedicate Quaker parrots.

Immersion anaesthesia in goldfish (Carassius auratus) with three concentrations of alfaxalone

OBJECTIVE

To evaluate the anaesthetic effects of three different alfaxalone doses to induce anaesthesia in goldfish.

STUDY DESIGN

Prospective, randomized, clinical study.

ANIMALS

Thirty goldfish undergoing skin scraping, gill examination and stool collection.

METHODS

Each fish was transferred to an individual 4 L induction tank and randomly allocated into one of three groups (n = 10), in which alfaxalone was administered at concentrations of 6, 7 or 9 mg L^-1. The depth of anaesthesia was evaluated by approach reaction, equilibrium, opercular movement and reaction to tactile stimuli. Sedation, light anaesthesia, surgical anaesthesia and recovery times were recorded. Data were analyzed with analysis of variance. A p value <0.05 was considered significant.

RESULTS

Surgical anaesthesia was achieved in all fish. Goldfish induced with alfaxalone 7 and 9 mg L^-1 showed a mild excitement phase. Time to sedation of the 6 mg L^-1 dose (5.89 ± 0.40 minutes) was significantly longer compared to the 7 mg L^-1 (3.97 ± 0.40 minutes) and 9 mg L^-1 doses (3.94 ± 0.40 minutes). Times to light anaesthesia and surgical anaesthesia of the 9 mg L^-1 dose (7.65 ± 1.04 and 9.60 ± 1.84 minutes, respectively) were significantly faster compared with those of the 6 mg L^-1 dose (13.79 ± 1.04 and 19.75 ± 1.84 minutes, respectively) and the 7 mg L^-1 dose (13.55 ± 1.04 and 21.24 ± 1.84 minutes, respectively). No significant differences were recorded in recovery time. Cessation of opercular movement was recorded in two fish induced with 7 mg L^-1 and in two induced with 9 mg L^-1. No mortality occurred.

CONCLUSIONS

and clinical relevance Alfaxalone is a reliable agent for immersion anaesthesia in goldfish. Immersion in water containing 6 mg alfaxalone L^-1 provided smooth induction of anaesthesia, and no obvious side effects were encountered. Higher doses shortened induction time and caused respiratory depression and excitatory movements.

Microbial integrity of preservative-free alfaxalone in a multiple-use system for two storage conditions and three handling techniques

OBJECTIVE To evaluate the microbial integrity of preservative-free cyclodextrin-based alfaxalone in a multiple-use system. SAMPLE 22 vials of preservative-free alfaxalone. PROCEDURES 2 storage conditions (room temperature, 22°C; refrigerated temperature, 4°C) and 3 handling techniques (closed system transfer device, nonclosed dispensing pin, and manufacturer-supplied vial stopper) comprised 6 treatment groups (3 replicates/group). An aliquot (0.5 mL) was withdrawn from each vial daily for 14 days. Samples were immediately inoculated into tryptic soy broth and incubated at 36°C for 24 hours; samples were subcultured onto 5% Columbia sheep blood agar and incubated for 48 hours. Isolated colonies were evaluated for identification. RESULTS There was no evidence of microbial contamination of vials stored for 7 days in refrigeration and handled with a protected port (closed system transfer device or nonclosed dispensing pin). CONCLUSIONS AND CLINICAL RELEVANCE The US FDA prohibits the use of alfaxalone beyond 6 hours after the vial stopper is broached (punctured), as mandated for a preservative-free injectable medication. Findings for the study reported here supported the use of alfaxalone for 7 days when refrigerated and handled with a single puncture of the stopper by use of a protected port (closed system transfer device or nonclosed dispensing pin). This would appear to be a practical alternative for an injectable anesthetic. It would minimize drug waste and the subsequent environmental impact for disposal of unused drug and allow standardization of storage and handling protocols for alfaxalone use in veterinary practices across the United States.