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Raušer P, Novák L, Pompová A, Fichtel T, Radó M. Influence of fentanyl, medetomidine-fentanyl or acepromazine-fentanyl premedication on oesophageal and rectal temperature in dogs under anaesthesia. Vet Anaesth Analg 2024; 51:357-361. [PMID: 38772852 DOI: 10.1016/j.vaa.2024.04.003] [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] [Received: 07/08/2023] [Revised: 03/29/2024] [Accepted: 04/06/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVE To compare changes in oesophageal (T-Oeso) and rectal (T-Rec) temperature in dogs during general anaesthesia and premedicated with fentanyl, medetomidine-fentanyl or acepromazine-fentanyl. STUDY DESIGN Prospective, randomized, blind clinical study. ANIMALS A total of 120 healthy dogs, aged 2-10 years and weighing 5-20 kg. METHODS Dogs were randomly allocated to one of three groups. Animals of F group were premedicated with fentanyl (0.01 mg kg-1), MF group with medetomidine (0.005 mg kg-1) and fentanyl (0.01 mg kg-1) and AF group with acepromazine (0.01 mg kg-1) and fentanyl (0.01 mg kg-1). Anaesthesia was induced with propofol and maintained with isoflurane in oxygen-air mixture. Fentanyl was administered continuously (0.01 mg kg-1 hour-1). The T-Oeso, T-Rec and ambient temperatures were recorded after induction (T0) and subsequently at 10 minute intervals for 60 minutes (T10-T60). Data were analysed using anova or their non-parametric equivalents (p < 0.05). RESULTS Median T-Oeso was significantly higher in MF group between T0-T20 compared with other groups. Median T-Oeso significantly decreased in F group from 38.0 °C (T0) to 37.4 °C (T30), 37.1 °C (T40), 36.9 °C (T50) and 36.6 °C (T60), in MF group from 38.3 °C (T0) to 37.7 °C (T30), 37.5 °C (T40), 37.2 °C (T50) and 37.1 °C (T60) and in AF group from 37.7 °C (T0) to 37.3 °C (T40), 37.2 °C (T50) and 37.1 °C (T60). The T-Rec significantly decreased in F group from 38.0 °C (T0) to 37.4 °C (T40), 37.2 °C (T50) and 36.9 °C (T60), in MF group from 38.3 °C (T0) to 37.5 °C (T50) and 37.4 °C (T60) and in AF group from 38.2 °C (T0) to 37.6 °C (T40), 37.5 °C (T50) and 37.4 °C (T60). CONCLUSIONS AND CLINICAL RELEVANCE Premedication with fentanyl, medetomidine-fentanyl or acepromazine-fentanyl in the doses used decreased the T-Oeso and T-Rec. The T-Oeso at the beginning of anaesthesia was higher after premedication with medetomidine-fentanyl. However, this difference was not clinically significant.
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Affiliation(s)
- Petr Raušer
- Department of Surgery and Orthopaedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic.
| | - Lukáš Novák
- Department of Surgery and Orthopaedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
| | - Alena Pompová
- Department of Surgery and Orthopaedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
| | - Tomáš Fichtel
- Department of Surgery and Orthopaedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
| | - Michal Radó
- Department of Surgery and Orthopaedics, Small Animal Clinic, Faculty of Veterinary Medicine, University of Veterinary Sciences, Brno, Czech Republic
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Rodríguez-Trujillo R, Batista-Arteaga M, Iusupova K, Rosario-Medina I, Alamo-Santana D. Comparison of Propofol and Alfaxalone as Anesthesic Drugs in Bitches Undergoing Ovariohysterectomies (Healthy Bitches and with Pyometra) and Cesarean Sections. Animals (Basel) 2024; 14:1343. [PMID: 38731346 PMCID: PMC11083245 DOI: 10.3390/ani14091343] [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: 04/18/2024] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
This study evaluated the efficacy and safety of two anesthetic agents, alfaxalone and propofol, on maternal physiological parameters (heart and respiratory rates, blood pressure, and temperature) on either ovariohysterectomies or cesarean sections in bitches. A total of 34 healthy and pyometra-affected females (classified as ASA II), were induced with IV propofol (4 mg/kg), while 35 females, both healthy and pyometra affected, were induced with IV alfaxalone (1 mg/kg). For cesarean sections, females (ASA II) were induced with propofol (n = 14) or alfaxalone (n = 14). Additionally, the neonatal viability and modified Apgar score were recorded at 5, 60, and 120 min post-delivery. There were no significant differences in the physiological parameters when comparing the use of propofol and alfaxalone in bitches undergoing ovariohysterectomies, regardless of their health status, nor when comparing cesarean sections. It was observed that bitches induced with propofol occasionally required an additional dose for maintenance of the anesthesia. Neonatal mortality rates were similar for both groups; however, alfaxalone was associated with higher neonatal viability as indicated by the Apgar scores. The findings suggest that both anesthetic protocols are effective and safe for use in canine reproductive surgeries, with no major differences in basic physiological parameters' alteration or neonatal outcomes between the two agents.
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Affiliation(s)
| | - Miguel Batista-Arteaga
- Unit of Reproduction, Universitary Institute of Biomedical Research and Health, University of Las Palmas de Gran Canaria, Transmontaña s/n, 35413 Arucas, Las Palmas, Spain; (R.R.-T.); (K.I.); (I.R.-M.); (D.A.-S.)
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Miller L, Duncan JC, Handel IG, Shaw DJ, McKenzie HE, Greenhalgh SN. Association between body mass and hypotension in dogs under general anaesthesia. J Small Anim Pract 2023; 64:687-695. [PMID: 37770103 DOI: 10.1111/jsap.13671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 03/19/2023] [Accepted: 08/08/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES To investigate the association between body mass and hypotension during general anaesthesia in dogs undergoing surgical and diagnostic procedures within a referral hospital. MATERIALS AND METHODS Retrospective evaluation of the anaesthetic records of 1789 dogs was performed. Data on signalment, anaesthetic protocol and physiological variables, including mean arterial pressure, were collected. A multivariable generalised linear model was used to identify associations between explanatory variables, including body mass, and hypotension. RESULTS In the population studied, increasing body mass (per 10 kg) was significantly associated with decreasing odds of hypotension (odds ratio 0.68; 95% confidence interval: 0.60 to 0.77). Additional variables associated with a decreased odds of hypotension were pre-anaesthetic medication with alpha-2 agonists (odds ratio 0.63; 95% confidence interval 0.48 to 0.82) and increased body temperature (per 1°C) during general anaesthesia (odds ratio 0.77; 95% confidence interval 0.67 to 0.88). Brachycephaly (odds ratio 1.72; 95% confidence interval 1.25 to 2.38), ASA physical status classification >3 (odds ratio 2.03; 95% confidence interval 1.16 to 3.56), undergoing a surgical procedure (versus diagnostic) (odds ratio 1.57; 95% confidence interval 1.10 to 2.23) and bradycardia (odds ratio 1.37; 95% confidence interval 1.05 to 1.80) were independently associated with increased odds of hypotension. CLINICAL SIGNIFICANCE Dogs of lower body mass and brachycephalic breeds may be at higher risk of hypotension during general anaesthesia or alternatively represent subpopulations in which accurate blood pressure measurement presents a greater challenge. Monitoring blood pressure accurately in these groups requires particular attention and provisions for treating hypotension should be readily accessible.
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Affiliation(s)
- L Miller
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - J C Duncan
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - I G Handel
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - D J Shaw
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
| | - H E McKenzie
- PDSA, Whitechapel Way, Priorslee, Telford, Shropshire, TF2 9PQ, UK
| | - S N Greenhalgh
- The Royal (Dick) School of Veterinary Studies & The Roslin Institute, The University of Edinburgh, Easter Bush, Midlothian, EH25 9RG, UK
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Henze IS, Navarro Altuna V, Steiger JI, Torgerson PR, Kutter APN. Evaluation of the Analgesic Efficacy of Undiluted Intraperitoneal and Incisional Ropivacaine for Postoperative Analgesia in Dogs after Major Abdominal Surgery. Animals (Basel) 2023; 13:ani13091489. [PMID: 37174527 PMCID: PMC10177421 DOI: 10.3390/ani13091489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 04/24/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Recommendations for intraperitoneal (IP) and incisional (INC) administration of local anaesthetics after visceral surgery exist, but evidence is scarce. This prospective, randomized, blinded, controlled, clinical trial compared postoperative pain in dogs undergoing major abdominal surgery. Sixteen client-owned dogs were anaesthetized with a standardized balanced protocol including opioids and received either 2 mg/kg ropivacaine IP (0.27 mL/kg) and a 1 mg/kg INC splash (0.13 mL/kg) or equal volumes of saline. Influence of the treatment on heart rate (HR) and postoperative pain was assessed using the Short Form of the Glasgow Composite Pain Scale (GCPS-SF), a dynamic interactive visual analogue scale (DIVAS) and mechanical nociceptive threshold testing (MNT). Data was tested with mixed ordinal regression and log linear mixed models for 0.5, 1, 2, 3, 4, 6, 8, 10 and 12 h after extubation. Rescue analgesia was given to 3/8 dogs after ropivacaine and 0/8 dogs after saline. GCPS-SF and MNT were not different between groups. DIVAS was slightly higher after ropivacaine (odds increased by 5.44 (confidence interval (CI) 1.17-9.96, p = 0.012)), and HR after ropivacaine was 0.76 * that after saline (CI 0.61-0.96, p = 0.02) with no effect of time (p = 0.1). Undiluted ropivacaine IP and INC was not beneficial for postoperative analgesia.
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Affiliation(s)
- Inken S Henze
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Victoria Navarro Altuna
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Joëlle I Steiger
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Paul R Torgerson
- Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Annette P N Kutter
- Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
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Conventional and advanced echocardiographic assessment of systolic function in dogs sedated with dexmedetomidine or acepromazine. Res Vet Sci 2021; 141:129-137. [PMID: 34740044 DOI: 10.1016/j.rvsc.2021.09.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/25/2021] [Accepted: 09/26/2021] [Indexed: 01/16/2023]
Abstract
Dexmedetomidine and acepromazine, sedatives commonly used in dogs have opposite vascular effects, resulting in afterload increase and decrease, respectively. This could variably affect systolic myocardial function. Previous echocardiographic studies assessing the cardiovascular effects of these drugs used conventional echocardiography, while advanced techniques such as speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI), which are known to provide a more accurate assessment of systolic function, have been rarely used for this aim. Moreover, in the few studies using advanced techniques, the drugs where combined with opioids. Therefore, the main objective of this prospective study was to assess systolic myocardial function by conventional and advanced echocardiography (STE and TDI), in dogs sedated exclusively with dexmedetomidine or acepromazine not combined with other drugs. Twenty healthy dogs were randomly divided into two groups, Group A (acepromazine, 20 μg/kg IM), and Group D (dexmedetomidine, 5 μg/kg IM), cardiovascular parameters were assessed before sedation (T0), and thirty minutes afterwards (T1). Systolic arterial pressure and heart rate decreased in both groups at T1 as compared to T0. Only one conventional echocardiographic raw variable (left ventricular internal dimension in systole) and three out of five advanced echocardiographic variables (radial TDI systolic velocities at the epicardial region of the left ventricular free wall, longitudinal TDI systolic velocities of the septal mitral valve annulus and the STE-derived left ventricular global strain), were affected in Group D. A systolic impairment was observed in Group D and better estimated by advanced echocardiography. In Group A, only the end diastolic voume index (conventional echocardiography) was decreased. Both protocols seem to induce echocardiographic changes more likely secondary to their vascular action.
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Xueyuan H, Li L, Yujie Y, Wenshuai Y, Huayun Z, Wei G, Honggang F. Comparison of behavioral and cardiopulmonary parameters during immobilization using dexmedetomidine, tiletamine and zolazepam with or without buprenorphine in Siberian tigers (Panthera tigris). J Vet Behav 2021. [DOI: 10.1016/j.jveb.2021.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cazlan CE, Hay Kraus BL. Effects of 2% lidocaine hydrochloride solution as a coinduction agent with propofol on cardiopulmonary variables and administered propofol doses in healthy dogs premedicated with hydromorphone hydrochloride and acepromazine maleate. J Am Vet Med Assoc 2020; 256:93-101. [PMID: 31841086 DOI: 10.2460/javma.256.1.93] [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 evaluate the effects of lidocaine as a coinduction agent with propofol on cardiopulmonary variables and administered propofol doses in healthy dogs premedicated with hydromorphone hydrochloride and acepromazine maleate and anesthetized with isoflurane. ANIMALS 40 client-owned dogs (American Society of Anesthesiologists physical status classification I or II and age ≥ 6 months) scheduled to undergo anesthesia for elective procedures. PROCEDURES In a randomized, blinded, controlled clinical trial, dogs received 2% lidocaine hydrochloride solution (2.0 mg/kg [0.9 mg/lb], IV; n = 20) or buffered crystalloid solution (0.1 mL/kg [0.05 mL/lb], IV; 20; control treatment) after premedication with acepromazine (0.005 mg/kg [0.002 mg/lb], IM) and hydromorphone (0.1 mg/kg, IM). Anesthesia was induced with propofol (1 mg/kg [0.45 mg/lb], IV, with additional doses administered as needed) and maintained with isoflurane. Sedation was assessed, and anesthetic and cardiopulmonary variables were measured at various points; values were compared between treatment groups. RESULTS Propofol doses, total sedation scores, and anesthetic and most cardiopulmonary measurements did not differ significantly between treatment groups over the monitoring period; only oxygen saturation as measured by pulse oximetry differed significantly (lower in the lidocaine group). Mean ± SD propofol dose required for endotracheal intubation was 1.30 ± 0.68 mg/kg (0.59 ± 0.31 mg/lb) and 1.41 ± 0.40 mg/kg (0.64 ± 0.18 mg/lb) for the lidocaine and control groups, respectively. CONCLUSIONS AND CLINICAL RELEVANCE No propofol-sparing effect was observed with administration of lidocaine as a coinduction agent for the premedicated dogs of this study. Mean propofol doses required for endotracheal intubation were considerably lower than currently recommended doses for premedicated dogs. (J Am Vet Med Assoc 2020;256:93-101).
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Kanda T, Mizoguchi Y, Furumoto K, Shimizu Y, Maeta N, Furukawa T. Effect of Intramuscular Medetomidine Administration on Tear Flow in Rats. Vet Sci 2020; 7:vetsci7020042. [PMID: 32294903 PMCID: PMC7356148 DOI: 10.3390/vetsci7020042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/09/2020] [Accepted: 04/10/2020] [Indexed: 01/30/2023] Open
Abstract
Medetomidine has been reported to decrease tear flow significantly in dogs, cats, and pigs when used as a sedative or analgesic; however, there are no such reports when it comes to rats. The present study aimed to investigate the effect of medetomidine on tear flow in rats. Medetomidine in doses of 50, 100, or 200 µg/kg or a physiological saline solution as the control, were administered intramuscularly to male Slc:Wistar/ST rats. After the administration of medetomidine, tear flow in both eyes was measured using a phenol red thread tear test. The area under the curve (AUC) of phenol red thread test values from baseline to 8 h was calculated. Data were plotted against the dose of medetomidine and simple linear regression analysis was performed. The effect of the drug on phenol red thread test values was considered dose-related when linear analysis yielded a significant relationship. In all medetomidine-treated groups, tear flow decreased significantly in both eyes after administration, while no significant changes were observed in either eye in the control group. The AUC values from baseline to 8 h after administration in groups treated with 100 and 200 µg/kg of medetomidine were significantly lower in both the left and right eyes compared to the control group. The linear regression of the AUC values was significant for both eyes. Our results indicated that the intramuscular administration of medetomidine in rats decreased tear flow significantly in a dose-dependent manner.
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Affiliation(s)
- Teppei Kanda
- Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoino-oka, Imabari, Ehime 794-8555, Japan
- Department of Comparative Animal Science, College of Life Science, Kurashiki University of Science and the Arts, 2640 Nishinoura, Tsurajima-cho, Kurashiki, Okayama 712-8505, Japan
- Correspondence:
| | - Yuka Mizoguchi
- Department of Comparative Animal Science, College of Life Science, Kurashiki University of Science and the Arts, 2640 Nishinoura, Tsurajima-cho, Kurashiki, Okayama 712-8505, Japan
| | - Kayo Furumoto
- Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoino-oka, Imabari, Ehime 794-8555, Japan
- Department of Comparative Animal Science, College of Life Science, Kurashiki University of Science and the Arts, 2640 Nishinoura, Tsurajima-cho, Kurashiki, Okayama 712-8505, Japan
| | - Yuki Shimizu
- Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoino-oka, Imabari, Ehime 794-8555, Japan
- Department of Comparative Animal Science, College of Life Science, Kurashiki University of Science and the Arts, 2640 Nishinoura, Tsurajima-cho, Kurashiki, Okayama 712-8505, Japan
| | - Noritaka Maeta
- Faculty of Veterinary Medicine, Okayama University of Science, 1-3 Ikoino-oka, Imabari, Ehime 794-8555, Japan
- Department of Comparative Animal Science, College of Life Science, Kurashiki University of Science and the Arts, 2640 Nishinoura, Tsurajima-cho, Kurashiki, Okayama 712-8505, Japan
| | - Toshinori Furukawa
- Department of Animal Pharmaceutical Science, School of Pharmaceutical Science, Kyushu University of Health and Welfare, 1714-1 Yoshino-cho, Nobeoka, Miyazaki 882-8508, Japan
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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.
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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
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Wagner MC, Hecker KG, Pang DSJ. Sedation levels in dogs: a validation study. BMC Vet Res 2017; 13:110. [PMID: 28420386 PMCID: PMC5395740 DOI: 10.1186/s12917-017-1027-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 04/07/2017] [Indexed: 11/18/2022] Open
Abstract
Background The aim of this study was to assess validation evidence for a sedation scale for dogs. We hypothesized that the chosen sedation scale would be unreliable when used by different raters and show poor discrimination between sedation protocols. A sedation scale (range 0–21) was used to score 62 dogs scheduled to receive sedation at two veterinary clinics in a prospective trial. Scores recorded by a single observer were used to assess internal consistency and construct validity of the scores. To assess inter-rater reliability, video-recordings of sedation assessment were randomized and blinded for viewing by 5 raters untrained in the scale. Videos were also edited to allow assessment of inter-rater reliability of an abbreviated scale (range 0–12) by 5 different raters. Results Both sedation scales exhibited excellent internal consistency and very good inter-rater reliability (full scale, intraclass correlation coefficient [ICCsingle] = 0.95; abbreviated scale, ICCsingle = 0.94). The full scale discriminated between the most common protocols: dexmedetomidine-hydromorphone (median [range] of sedation score, 11 [1–18], n = 20) and acepromazine-hydromorphone (5 [0–15], n = 36, p = 0.02). Conclusions The hypothesis was rejected. Full and abbreviated scales showed excellent internal consistency and very good reliability between multiple untrained raters. The full scale differentiated between levels of sedation. Electronic supplementary material The online version of this article (doi:10.1186/s12917-017-1027-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marika C Wagner
- Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Kent G Hecker
- Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Daniel S J Pang
- Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada. .,Départment de sciences cliniques, Faculté de medicine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, J2S 7C6, Canada. .,Groupe de recherche en pharmacologie animale du Québec (GREPAQ), Faculté de medicine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada.
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Murphy LA, Barletta M, Graham LF, Reichl LJ, Duxbury MM, Quandt JE. Effects of acepromazine and trazodone on anesthetic induction dose of propofol and cardiovascular variables in dogs undergoing general anesthesia for orthopedic surgery. J Am Vet Med Assoc 2017; 250:408-416. [DOI: 10.2460/javma.250.4.408] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Algren DA, Ashworth A. Acute acepromazine overdose: clinical effects and toxicokinetic evaluation. J Med Toxicol 2015; 11:121-3. [PMID: 25059809 DOI: 10.1007/s13181-014-0416-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Acepromazine is a phenothiazine that is used exclusively in veterinary medicine for multiple purposes. Human overdoses are rarely reported and toxicokinetic data has never been reported. We present a case of intentional acepromazine overdose resulting in central nervous system and cardiovascular toxicity with confirmatory toxicokinetic data. CASE REPORT A 54-year-old woman intentionally ingested 950 mg of her dog's acepromazine. Within 3 h of ingestion, she developed central nervous system and respiratory depression along with hypotension requiring non-invasive ventilation and vasopressors. Clinical toxicity resolved over the following 8 h. Serial plasma acepromazine levels were determined using gas chromatography/mass spectrometry. The initial acepromazine level (1-h post-ingestion) was 63 ng/ml. Follow-up levels at 8-, 10.5-, and 13.5-h post-ingestion were 8.9 ng/ml, 7.6 ng/ml, and 6.3 ng/ml, respectively. DISCUSSION Human acepromazine toxicity is rarely reported but results in clinical toxicity (central nervous system depression, respiratory depression, hypotension) are similar to other phenothiazines. Compared to other phenothiazines, it appears to have a short elimination half-life that may account for the brief duration of clinical toxicity with relatively rapid improvement. No significant human cardiac toxicity has been reported. Treatment is supportive. CONCLUSION This case highlights the unique toxicity of acepromazine in demonstrating rapid improvement of severe toxicity within 8 h consistent with a short elimination half-life.
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Affiliation(s)
- D Adam Algren
- Division of Clinical Pharmacology/Medical Toxicology, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO, 64108, USA,
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Koh RB, Isaza N, Xie H, Cooke K, Robertson SA. Effects of maropitant, acepromazine, and electroacupuncture on vomiting associated with administration of morphine in dogs. J Am Vet Med Assoc 2015; 244:820-9. [PMID: 24649993 DOI: 10.2460/javma.244.7.820] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate effects of maropitant, acepromazine, and electroacupuncture on morphine-related signs of nausea and vomiting in dogs and assess sedative effects of the treatments. DESIGN Randomized controlled clinical trial. ANIMALS 222 dogs. PROCEDURES Dogs received 1 of 6 treatments: injection of saline (0.9% NaCl) solution, maropitant citrate, or acepromazine maleate or electroacupuncture treatment at 1 acupoint, 5 acupoints, or a sham acupoint. Morphine was administered after 20 minutes of electroacupuncture treatment or 20 minutes after injectable treatment. Vomiting and retching events and signs of nausea and sedation were recorded. RESULTS Incidence of vomiting and retching was significantly lower in the maropitant (14/37 [37.8%]) group than in the saline solution (28/37 [75.7%]) and sham-acupoint electroacupuncture (32/37 [86.5%]) groups. The number of vomiting and retching events in the maropitant (21), acepromazine (38), 1-acupoint (35), and 5-acupoint (34) groups was significantly lower than in the saline solution (88) and sham-acupoint electroacupuncture (109) groups. Incidence of signs of nausea was significantly lower in the acepromazine group (3/37 [8.1%]) than in the sham-acupoint group (15/37 [40.5%]). Mean nausea scores for the saline solution, maropitant, and sham-acupoint electroacupuncture groups increased significantly after morphine administration, whereas those for the acepromazine, 1-acupoint electroacupuncture, and 5-acupoint electroacupuncture groups did not. Mean sedation scores after morphine administration were significantly higher in dogs that received acepromazine than in dogs that received saline solution, maropitant, and sham-acupoint electroacupuncture treatment. CONCLUSIONS AND CLINICAL RELEVANCE Maropitant treatment was associated with a lower incidence of vomiting and retching, compared with control treatments, and acepromazine and electroacupuncture appeared to prevent an increase in severity of nausea following morphine administration in dogs.
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Affiliation(s)
- Ronald B Koh
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610
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Ferreira JP, Dzikit TB, Zeiler GE, Buck R, Nevill B, Gummow B, Bester L. Anaesthetic induction and recovery characteristics of a diazepam-ketamine combination compared with propofol in dogs. J S Afr Vet Assoc 2015; 86:1258. [PMID: 26244579 PMCID: PMC6138176 DOI: 10.4102/jsava.v86i1.1258] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Revised: 03/18/2015] [Accepted: 03/26/2015] [Indexed: 11/18/2022] Open
Abstract
Induction of anaesthesia occasionally has been associated with undesirable behaviour in dogs. High quality of induction of anaesthesia with propofol has been well described while in contrast variable induction and recovery quality has been associated with diazepam-ketamine. In this study, anaesthetic induction and recovery characteristics of diazepam-ketamine combination with propofol alone were compared in dogs undergoing elective orchidectomy. Thirty-six healthy adult male dogs were used. After habitus scoring (simple descriptive scale [SDS]), the dogs were sedated with morphine and acepromazine. Forty minutes later a premedication score (SDS) was allocated and general anaesthesia was induced using a combination of diazepam-ketamine (Group D/K) or propofol (Group P) and maintained with isoflurane. Scores for the quality of induction, intubation and degree of myoclonus were allocated (SDS). Orchidectomy was performed after which recovery from anaesthesia was scored (SDS) and times to extubation and standing were recorded. Data were analysed using descriptive statistics and Kappa Reliability and Kendall Tau B tests. Both groups were associated with acceptable quality of induction and recovery from anaesthesia. Group P, however, was associated with a poorer quality of induction (p = 0.014), prolonged induction period (p = 0.0018) and more pronounced myoclonus (p = 0.003), but had better quality of recovery (p = 0.000002) and shorter recovery times (p = 0.035) compared with Group D/K. Diazepam-ketamine and propofol are associated with acceptable induction and recovery from anaesthesia. Propofol had inferior anaesthetic induction characteristics, but superior and quicker recovery from anaesthesia compared with diazepam-ketamine.
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Affiliation(s)
- Jacques P Ferreira
- Department of Companion Animal Clinical Studies, University of Pretoria.
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Salla K, Bennett RC, Restitutti F, Junnila J, Raekallio M, Vainio O. A comparison in dogs of medetomidine, with or without MK-467, and the combination acepromazine-butorphanol as premedication prior to anaesthesia induced by propofol and maintained with isoflurane. Vet Anaesth Analg 2014; 41:163-73. [DOI: 10.1111/vaa.12094] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Accepted: 03/13/2013] [Indexed: 12/12/2022]
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Mama KR, Gaynor JS, Harvey RC, Robertson SA, Koenig RL, Cozzi EM. Multicenter clinical evaluation of a multi-dose formulation of propofol in the dog. BMC Vet Res 2013; 9:261. [PMID: 24359719 PMCID: PMC3901023 DOI: 10.1186/1746-6148-9-261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Accepted: 12/16/2013] [Indexed: 12/02/2022] Open
Abstract
Background Propofol is a widely used injectable anesthetic agent for induction and short-term maintenance in dogs. A multi-dose formulation of propofol (MDP) has been developed which includes 2% benzyl alcohol as a preservative. In order to document the use of the product under clinical conditions, MDP was tested in a prospective clinical trial conducted at six sites within the United States. One hundred thirty-eight healthy, client-owned dogs were assigned to one of six treatment groups based on premedicants (none, acepromazine/buprenorphine, midazolam/buprenorphine, medetomidine/buprenorphine) and maintenance agents (MDP, inhaled anesthetic). Anesthesia was induced by the intravenous administration of MDP given to effect. Physiological indices including heart rate, respiratory rate and blood pressure were monitored prior to and during anesthesia induction, maintenance and recovery. Adverse events, defined for severity by pre-established limits of these physiological values, as well as side effects, defined as any observation outside the normal range, were noted. Results The mean intubation dose was 7.6 ± 2.1 mg/kg for MDP alone and 4.7 ± 1.3, 4.0 ± 1.0 mg/kg and 3.2 ± 1.4 mg/kg when buprenorphine was used in combination with midazolam, acepromazine and medetomidine, respectively. Of the 32 adverse events, apnea (12 incidents), bradycardia (9 incidents) and hypotension (7 incidents) were most frequently recorded. Emesis, cyanosis and second degree heart block were each noted once and successfully resolved. The cause of a single death 2 days post-anesthesia was assessed as a surgical complication. Conclusions MDP was found to be acceptable for use in healthy dogs for induction and short term maintenance of anesthesia when used alone and in combination with premedicants and inhaled anesthetics.
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Affiliation(s)
- Khursheed R Mama
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
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Carter JE, Lewis C, Beths T. Onset and quality of sedation after intramuscular administration of dexmedetomidine and hydromorphone in various muscle groups in dogs. J Am Vet Med Assoc 2013; 243:1569-72. [DOI: 10.2460/javma.243.11.1569] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Boveri S, Brearley JC, Dugdale AHA. The effect of body condition on propofol requirement in dogs. Vet Anaesth Analg 2013; 40:449-54. [DOI: 10.1111/vaa.12034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 12/12/2012] [Indexed: 11/27/2022]
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Hunt JR, Grint NJ, Taylor PM, Murrell JC. Sedative and analgesic effects of buprenorphine, combined with either acepromazine or dexmedetomidine, for premedication prior to elective surgery in cats and dogs. Vet Anaesth Analg 2012; 40:297-307. [PMID: 23279623 DOI: 10.1111/vaa.12003] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 07/19/2012] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the sedative and analgesic effects of intramuscular buprenorphine with either dexmedetomidine or acepromazine, administered as premedication to cats and dogs undergoing elective surgery. STUDY DESIGN Prospective, randomized, blinded clinical study. ANIMALS Forty dogs and 48 cats. METHODS Animals were assigned to one of four groups, according to anaesthetic premedication and induction agent: buprenorphine 20 μg kg(-1) with either dexmedetomidine (dex) 250 μg m(-2) or acepromazine (acp) 0.03 mg kg(-1), followed by alfaxalone (ALF) or propofol (PRO). Meloxicam was administered preoperatively to all animals and anaesthesia was always maintained using isoflurane. Physiological measures and assessments of pain, sedation and mechanical nociceptive threshold (MNT) were made before and after premedication, intraoperatively, and for up to 24 hours after premedication. Data were analyzed with one-way, two-way and mixed between-within subjects anova, Kruskall-Wallis analyses and Chi squared tests. Results were deemed significant if p ≤ 0.05, except where multiple comparisons were performed (p ≤ 0.005). RESULTS Cats premedicated with dex were more sedated than cats premedicated with acp (p < 0.001) and ALF doses were lower in dex cats (1.2 ± 1.0 mg kg(-1) ) than acp cats (2.5 ± 1.9 mg kg(-1)) (p = 0.041). There were no differences in sedation in dogs however PRO doses were lower in dex dogs (1.5 ± 0.8 mg kg(-1) ) compared to acp dogs (3.3 ± 1.1 mg kg(-1) ) (p < 0.001). There were no differences between groups with respect to pain scores or MNT for cats or dogs. CONCLUSION Choice of dex or acp, when given with buprenorphine, caused minor, clinically detectable, differences in various characteristics of anaesthesia, but not in the level of analgesia. CLINICAL RELEVANCE A combination of buprenorphine with either acp or dex, followed by either PRO or ALF, and then isoflurane, accompanied by an NSAID, was suitable for anaesthesia in dogs and cats undergoing elective surgery. Choice of sedative agent may influence dose of anaesthetic induction agent.
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Affiliation(s)
- James R Hunt
- Morley Veterinary Centre, Taunton, Somerset, UK.
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