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Margeti C, Kazakos G, Skampardonis V, Galatos AD, Zacharopoulou T, Tsioli V, Loukopoulos E, Tyrnenopoulou P, Papatsiros VG, Flouraki E. The Effect of a Subsequent Dose of Dexmedetomidine or Other Sedatives following an Initial Dose of Dexmedetomidine on Sedation and Quality of Recovery in Cats: Part I. Vet Sci 2024; 11:186. [PMID: 38787158 PMCID: PMC11126131 DOI: 10.3390/vetsci11050186] [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: 01/31/2024] [Revised: 03/13/2024] [Accepted: 04/20/2024] [Indexed: 05/25/2024] Open
Abstract
Dexmedetomidine is an a2-agonist commonly used in veterinary practice. Occasionally, the administered dose of dexmedetomidine may result in insufficient sedation, and an additional dose or drug may be required. The sedative effects of seven different drugs administered at subsequent time points after an initial, insufficient dose of dexmedetomidine were evaluated. Seven adult cats participated in this crossover, blind, randomised study. The groups consisted of two consecutive doses of dexmedetomidine (15 + 10 μg/kg) (DD) or a dose of dexmedetomidine (15 μg/kg) followed by either NS 0.9% (DC-control group), tramadol 2 mg/kg (DT), butorphanol 0.2 mg/kg (DBT), buprenorphine 20 μg/kg (DBP), ketamine 2 mg/kg (DK), or midazolam 0.1 mg/kg (DM). Sedation was evaluated using the Grint sedation scale. In all groups, atipamezole was administered at the end of the evaluation, and recovery was assessed using the Lozano and Sams recovery scales. The DC and DM groups exhibited minimal sedative effects. The maximum sedative effect was observed in the DD and DK groups, while sedation in the DD and DK groups was significantly higher compared to the DC group. Recovery in all groups was uneventful, except in the DM group, where it was prolonged and difficult, although no statistically significant difference was detected. Therefore, insufficient sedation with dexmedetomidine can be enhanced by a subsequent dose of dexmedetomidine, ketamine, or butorphanol, whereas the addition of midazolam reduces sedation and prolongs recovery.
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Affiliation(s)
- Chrysoula Margeti
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (E.L.); (P.T.)
| | - Georgios Kazakos
- Companion Animal Clinic, School of Veterinary Medicine, Aristotle University of Thessaloniki, 54627 Thessaloniki, Greece;
| | - Vassilis Skampardonis
- Department of Epidemiology, Biostatistics and Animal Health Economics, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece;
| | - Apostolos D. Galatos
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (E.L.); (P.T.)
| | - Theodora Zacharopoulou
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (E.L.); (P.T.)
| | - Vassiliki Tsioli
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (E.L.); (P.T.)
| | - Epameinondas Loukopoulos
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (E.L.); (P.T.)
| | - Panagiota Tyrnenopoulou
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (E.L.); (P.T.)
| | - Vasileios G. Papatsiros
- Clinic of Medicine, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece
| | - Eugenia Flouraki
- Clinic of Surgery, Faculty of Veterinary Medicine, School of Health Sciences, University of Thessaly, Trikalon 224, 43100 Karditsa, Greece; (C.M.); (A.D.G.); (T.Z.); (V.T.); (E.L.); (P.T.)
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Imboden TJ, Pownall WR, Rubin S, Spadavecchia C, Schöllhorn B, Rohrbach H. Determination of a safe sedative combination of dexmedetomidine, ketamine and butorphanol for minor procedures in dogs by use of a stepwise optimization method. Acta Vet Scand 2023; 65:41. [PMID: 37737188 PMCID: PMC10515426 DOI: 10.1186/s13028-023-00697-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/10/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND In veterinary practice, most minor procedures such as radiographs, skin biopsies, and wound treatments require sedation. The combination of butorphanol, ketamine, and dexmedetomidine is commonly used, but the ideal dosages for this combination have not been defined. This randomized prospective clinical 3-phases trial initially tested eight clinically relevant combinations of intramuscular administration in 50 dogs (phase 1). The quality of each combination was rated using a purposefully developed negative score (NS; 0-21.5, the lower the NS the better the quality of sedation) to judge the quality of sedation, the occurrence of side effects, and the need for additional anaesthetics. Based on the results of the NS, the eight combinations were divided into "promising" and "unsatisfactory" subgroups. In phase 2, a new combination (N) was calculated and tested in six dogs replacing the worst of the eight initial combinations. This procedure was repeated until the NS could not be improved any further. In phase 3, the best combination was tested in 100 adult dogs undergoing diagnostic or therapeutic procedures. RESULTS The optimal combination established was dexmedetomidine 0.005 mg/kg, ketamine 1 mg/kg, and butorphanol 0.3 mg/kg with a median NS of 1.5 (interquartile range 1.5-2.4). In all 112 dogs receiving this combination, the quality of sedation was satisfactory and no severe side effects were detected. CONCLUSIONS The application of this optimization method allowed the calculation of an optimal drug combination to sedate cardiovascularly healthy dogs. After having being tested in 112 animals, this combination can consequently be considered safe. Therefore, this combination can now be used in daily clinical practice for cardiovascularly healthy adult dogs undergoing minor procedures.
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Affiliation(s)
- Tobias Jonas Imboden
- Border Veterinary Service, Postfach, Fracht West, Zurich Airport, 8058 Switzerland
| | - William Robert Pownall
- Surgery Department, Department of Veterinary Sciences, Vetsuisse Faculty, Small Animal Clinic, University of Bern, Laenggassstrasse 128, Bern, 3012 Switzerland
| | | | - Claudia Spadavecchia
- Anaesthesiology Section, Department of Veterinary Sciences, Vetsuisse Faculty, University of Bern, Laenggassstrasse 124, Bern, 3012 Switzerland
| | - Bernhard Schöllhorn
- Vet Zentrum Berchtesgadener Land, Weitwiesenring 4, 83435 Bad Reichenhall, Deutschland
| | - Helene Rohrbach
- Anaesthesiology Section, Department of Veterinary Sciences, Vetsuisse Faculty, University of Bern, Laenggassstrasse 124, Bern, 3012 Switzerland
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Lazzarini E, Gioeni D, Del Prete G, Brioschi F, Agostinetto G, Carotenuto A. Sedative Effects of Intramuscular Dexmedetomidine and Ketamine at Sub-Anesthetic Dose Alone or in Combination with Methadone in Healthy Dogs. Top Companion Anim Med 2021; 45:100579. [PMID: 34400381 DOI: 10.1016/j.tcam.2021.100579] [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: 10/06/2020] [Revised: 06/18/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
The aim of the present study was to compare sedation quality and cardiorespiratory parameters in healthy dogs after intramuscular injection of dexmedetomidine and ketamine with or without methadone. Forty client-owned dogs were randomly divided into two groups and received IM dexmedetomidine (5 µg kg-1) and ketamine (1 mg kg-1), associated (DKM group) or not (DK group) with methadone (0.2 mg kg-1). Sedation, heart rate (HR), respiratory rate (ƒR), mucous membrane and rectal temperature were recorded at baseline (T0) and after 5 (T5), 10 (T10) and 20 (T20) minutes. From T10, cardiac rhythm was monitored with a continuous lead II electrocardiogram. Ease of venous catheter placement, total propofol dose and any apnea episodes were recorded. Sedation was significantly greater in the DKM group, and a significant increase from T5 to T20 within DKM (P = .0002) and DK (P = .008) was also observed. Within each group, HR was significantly lower at all time points compared to baseline. No significant differences between groups were found in the number of arrhythmogenic events (atrioventricular blocks). In both group ƒR decreased over time. The propofol dose required for anesthesia induction was significantly lower (P = .027) in the DKM group. In conclusion, a good level of sedation was achieved in both groups, although this was greater in DKM. Smooth animal-operator interaction and ease of venous catheter placement showed that DK was a useful sedative protocol in healthy patients.
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Affiliation(s)
| | | | | | | | - Giulia Agostinetto
- Zooplantlab, Department of Biotechnology and Biosciences, University of Milano Bicocca, Milano, Italy
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Ultrasound-Guided Funicular Block: Ropivacaine Injection into the Tissue around the Spermatic Cord to Improve Analgesia during Orchiectomy in Dogs. Animals (Basel) 2021; 11:ani11051275. [PMID: 33925210 PMCID: PMC8146739 DOI: 10.3390/ani11051275] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/25/2021] [Accepted: 04/26/2021] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Orchiectomy is a common surgical procedure performed on small animals and postoperative analgesia is very important because pain causes various negative effects that prevent patient recovery. Our study aimed to compare the intraoperative ultrasound-guided funicular block with ropivacaine and general anaesthesia using hypnotic and/or analgesic drugs and the postoperative hemodynamic stability and pain scores. This study demonstrated that the use of ultrasound-guided funicular, using ropivacaine, guarantees long-lasting and high-quality analgesic coverage and minimises the post-surgical pain inevitably associated with orchiectomy. This study stemmed from a general trend towards increasing attention on postoperative pain after orchiectomy in dog. Since veterinarians are becoming more focused on relieving surgical pain, anaesthetists are expected to use better protocols that can minimise pain. In fact, acute postsurgical pain is of great interest due to potential risk of becoming chronic if not treated properly. The routine use of the intraoperative ultrasound-guided funicular block with ropivacaine block is considered a useful alternative for pain management for orchiectomy in dogs, which can be performed under sedation or superficial general anaesthesia. In addition, the intraoperative ultrasound-guided funicular block with ropivacaine block ensures satisfactory analgesic coverage that lasts for at least 6 h postoperatively. Abstract Orchiectomy is a common surgical procedure performed on small animals, and it requires postoperative pain management despite its relative simplicity. This study aimed to evaluate the hemodynamic stability, intraoperative administration of additional hypnotic and/or analgesic drugs, and postoperative pain scores following the combination of ultrasound-guided injection of ropivacaine hydrochloride into the spermatic cord and infiltration by the same anaesthetic of the incisional prescrotal line (ROP) or general anaesthesia. Dogs in the ROP group showed greater intraoperative hemodynamic stability and lower pain scores than the control group. The locoregional approach used in this study proved effective in minimising the responses to the surgical stimulus and ensured adequate analgesia intra- and postoperatively. This method, called ultrasound-guided funicular block, allows orchiectomy to be performed under deep sedation without general anaesthesia.
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Chang LJ, Ko JC, Weil AB, Weng HY. Comparison of anesthetic and cardiorespiratory effects of tiletamine-zolazepam-detomidine-butorphanol, tiletamine-zolazepam-xylazine-butorphanol, and ketamine-detomidine-butorphanol in pigs. J Am Vet Med Assoc 2021; 258:883-891. [PMID: 33825528 DOI: 10.2460/javma.258.8.883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate and compare the anesthetic, analgesic, and cardiorespiratory effects of tiletamine-zolazepam-detomidine-butorphanol (TZDB), tiletamine-zolazepam-xylazine-butorphanol (TZXB), and ketamine-detomidine-butorphanol (KDB) in pigs and to assess anesthetic recovery duration and quality following administration of tolazoline as a reversal agent. ANIMALS 11 healthy 2.5-month-old castrated male Landrace mixed-breed pigs. PROCEDURES In a randomized, blinded crossover study design, pigs received the following anesthetic combinations, IM: TZDB (tiletamine-zolazepam [3 mg/kg {1.36 mg/lb}], detomidine [0.18 mg/kg {0.08 mg/lb}], and butorphanol [0.12 mg/kg {0.05 mg/lb}]); TZXB (tiletamine-zolazepam [4 mg/kg {1.8 mg/lb}], xylazine [4 mg/kg], and butorphanol [0.2 mg/kg {0.09 mg/lb}]); and KDB (ketamine [8 mg/kg {3.63 mg/lb}], detomidine [0.18 mg/kg], and butorphanol [0.3 mg/kg {0.14 mg/lb}]). A 7-day washout period was provided between treatments. At 45 minutes of anesthesia, pigs received tolazoline (2 mg/kg [0.9 mg/lb], IM; n = 6) treatment or control (5) treatment with saline (0.9% NaCl) solution. RESULTS All anesthetic combinations induced anesthesia. Endotracheal intubation was completed within 5 minutes after anesthetic administration in all pigs, except in 2 pigs following administration of KDB. Durations (mean ± SD) of endotracheal intubation and lateral recumbency in pigs that did not receive tolazoline were 55.3 ± 4.8 minutes, 83.8 ± 15.8 minutes, and 28.2 ± 4.5 minutes and 112.4 ± 18.7 minutes, 117.2 ± 16.7 minutes, and 79.7 ± 6.0 minutes, respectively, for the TZDB, TZXB, and KDB anesthetic treatments. Tolazoline significantly shortened the duration of anesthetic recovery for all anesthetic treatments without affecting the recovery quality. CONCLUSIONS AND CLINICAL RELEVANCE All 3 anesthetic combinations were suitable for providing anesthesia in pigs. Tolazoline administration shortened the duration of anesthetic recovery without affecting the quality of recovery.
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Arenillas M, Canfrán S, Aguado D, Gómez de Segura IA. Sedative and analgesic effects of two subanaesthetic doses of ketamine in combination with methadone and a low dose of dexmedetomidine in healthy dogs. Vet Anaesth Analg 2021; 48:545-553. [PMID: 34083140 DOI: 10.1016/j.vaa.2020.11.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 10/06/2020] [Accepted: 11/16/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the sedative, analgesic and recovery characteristics of two subanaesthetic ketamine doses in combination with dexmedetomidine and methadone for intramuscular sedation in healthy Beagles. STUDY DESIGN Randomized, blinded, crossover, experimental study. ANIMALS Six healthy adult Beagles. METHODS Dogs were randomly given three treatments: dexmedetomidine (3 μg kg-1) and methadone (0.3 mg kg-1) combined with ketamine at 1 and 2 mg kg-1 (K1 and K2, respectively) or saline (K0), intramuscularly. Sedation score, response to tail clamping and rectal temperature were recorded at baseline, 5, 15, 25, 35, and 45 minutes posttreatment. Pulse rate (PR), respiratory rate, oxygen haemoglobin saturation and noninvasive blood pressure were also recorded at baseline and every 5 minutes until 45 minutes posttreatment. Onset and duration of recumbency, response to venous catheterization and recovery quality were also assessed. Sedation and physiological variables were compared between treatments and within treatments compared to baseline (analysis of variance). Nonparametric data were analysed with the Friedman and Cochran's Q tests; p < 0.050. RESULTS Increased sedation was found at 15 (K0 and K1), 25 (all treatments) and 35 (K1) minutes compared with baseline. Sedation score, onset (3-12 minutes) and duration of recumbency (29-51 minutes) were similar between treatments. Recovery quality was considered acceptable in all cases. Response to tail clamping was inconsistent within treatments with no differences between them. None of the dogs responded to venous catheterization. There were no differences between treatments in physiological variables, except for PR which was higher in K2 than in K0. Oxygen supplementation was required in five and three dogs administered saline and ketamine, respectively. CONCLUSIONS AND CLINICAL RELEVANCE The addition of 1 or 2 mg kg-1 of ketamine to methadone and dexmedetomidine combination did not enhance sedation or antinociception in healthy dogs. Recovery quality was unaffected.
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Affiliation(s)
- Mario Arenillas
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain.
| | - Susana Canfrán
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Delia Aguado
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Ignacio A Gómez de Segura
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
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Effects of intramuscular vatinoxan (MK-467), co-administered with medetomidine and butorphanol, on cardiopulmonary and anaesthetic effects of intravenous ketamine in dogs. Vet Anaesth Analg 2020; 47:604-613. [PMID: 32682664 DOI: 10.1016/j.vaa.2020.05.008] [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: 09/02/2019] [Revised: 04/21/2020] [Accepted: 05/08/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To investigate the impact of intramuscular (IM) co-administration of the peripheral α2-adrenoceptor agonist vatinoxan (MK-467) with medetomidine and butorphanol prior to intravenous (IV) ketamine on the cardiopulmonary and anaesthetic effects in dogs, followed by atipamezole reversal. STUDY DESIGN Randomized, masked crossover study. ANIMALS A total of eight purpose-bred Beagle dogs aged 3 years. METHODS Each dog was instrumented and administered two treatments 2 weeks apart: medetomidine (20 μg kg-1) and butorphanol (100 μg kg-1) premedication with vatinoxan (500 μg kg-1; treatment MVB) or without vatinoxan (treatment MB) IM 20 minutes before IV ketamine (4 mg kg-1). Atipamezole (100 μg kg-1) was administered IM 60 minutes after ketamine. Heart rate (HR), mean arterial (MAP) and central venous (CVP) pressures and cardiac output (CO) were measured; cardiac (CI) and systemic vascular resistance (SVRI) indices were calculated before and 10 minutes after MVB or MB, and 10, 25, 40, 55, 70 and 100 minutes after ketamine. Data were analysed with repeated measures analysis of covariance models. A p-value <0.05 was considered statistically significant. Sedation, induction, intubation and recovery scores were assessed. RESULTS At most time points, HR and CI were significantly higher, and SVRI and CVP significantly lower with MVB than with MB. With both treatments, SVRI and MAP decreased after ketamine, whereas HR and CI increased. MAP was significantly lower with MVB than with MB; mild hypotension (57-59 mmHg) was recorded in two dogs with MVB prior to atipamezole administration. Sedation, induction, intubation and recovery scores were not different between treatments, but intolerance to the endotracheal tube was observed earlier with MVB. CONCLUSIONS AND CLINICAL RELEVANCE Haemodynamic performance was improved by vatinoxan co-administration with medetomidine-butorphanol, before and after ketamine administration. However, vatinoxan was associated with mild hypotension after ketamine with the dose used in this study. Vatinoxan shortened the duration of anaesthesia.
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Raisi A, Norouzian H, Rostami M. Influence of tramadol on anesthesia times, analgesia and electrocardiogram associated with injection anesthesia in common buzzards ( Buteo buteo). VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2019; 10:51-57. [PMID: 31183016 PMCID: PMC6522193 DOI: 10.30466/vrf.2019.34308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Accepted: 01/09/2018] [Indexed: 11/29/2022]
Abstract
A balanced anesthesia protocol is called perfect when it has fast induction, excellent recovery, the least effect on the cardiopulmonary system and sufficient analgesia. Many of anesthetic combinations have an analgesic effect without opioids. However, at the end of anesthesia, analgesia decreases or is incomplete. The purpose of this study was to evaluate anesthesia times, electrocardiogram (ECG) and analgesic effect of tramadol when administrated with ketamine, ketamine-diazepam, ketamine-midazolam, and ketamine-xylazine and selected a balanced anesthesia protocol in buzzards. Ten adult common buzzards (Buteo buteo) received seven different anesthetic protocols (with or without tramadol). In each protocol, anesthesia times, electrocardiograph parameters and analgesic effect were recorded. Excluding ketamine-tramadol, all protocols produced deep anesthesia in all buzzards. Among of all protocols, no significant differences regarding the amplitude and duration of waves (P, QRS and T) was found. By adding tramadol to anesthetic protocols, response duration to thermal sense increased up 3 hr after recovery. Tramadol did not make considerable effects on anesthesia times and ECG and made analgesic effect up to 3 hr when used with ketamine-benzodiazpins or ketamine-xylazine. Therefore, tramadol can be used with injectable anesthetics to make suitably balanced anesthesia in buzzards.
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Affiliation(s)
- Abbas Raisi
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Lorestan University, Khorramabad, Iran
| | - Hassan Norouzian
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Lorestan University, Khorramabad, Iran
| | - Milad Rostami
- Student of Veterinary Medicine, Faculty of Veterinary Medicine, Lorestan University, Khorramabad, Iran
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Griffin B, Bushby PA, McCobb E, White SC, Rigdon-Brestle YK, Appel LD, Makolinski KV, Wilford CL, Bohling MW, Eddlestone SM, Farrell KA, Ferguson N, Harrison K, Howe LM, Isaza NM, Levy JK, Looney A, Moyer MR, Robertson SA, Tyson K. The Association of Shelter Veterinarians' 2016 Veterinary Medical Care Guidelines for Spay-Neuter Programs. J Am Vet Med Assoc 2017; 249:165-88. [PMID: 27379593 DOI: 10.2460/javma.249.2.165] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As community efforts to reduce the overpopulation and euthanasia of unwanted and unowned cats and dogs have increased, many veterinarians have increasingly focused their clinical efforts on the provision of spay-neuter services. Because of the wide range of geographic and demographic needs, a wide variety of spay-neuter programs have been developed to increase delivery of services to targeted populations of animals, including stationary and mobile clinics, MASH-style operations, shelter services, community cat programs, and services provided through private practitioners. In an effort to promote consistent, high-quality care across the broad range of these programs, the Association of Shelter Veterinarians convened a task force of veterinarians to develop veterinary medical care guidelines for spay-neuter programs. These guidelines consist of recommendations for general patient care and clinical procedures, preoperative care, anesthetic management, surgical procedures, postoperative care, and operations management. They were based on current principles of anesthesiology, critical care medicine, infection control, and surgical practice, as determined from published evidence and expert opinion. They represent acceptable practices that are attainable in spay-neuter programs regardless of location, facility, or type of program. The Association of Shelter Veterinarians envisions that these guidelines will be used by the profession to maintain consistent veterinary medical care in all settings where spay-neuter services are provided and to promote these services as a means of reducing sheltering and euthanasia of cats and dogs.
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Kushnir Y, Toledano N, Cohen L, Bdolah-Abram T, Shilo-Benjamini Y. Intratesticular and incisional line infiltration with ropivacaine for castration in medetomidine–butorphanol–midazolam sedated dogs. Vet Anaesth Analg 2017; 44:346-355. [DOI: 10.1016/j.vaa.2016.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 02/22/2016] [Accepted: 03/06/2016] [Indexed: 11/29/2022]
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Santos M, Bertrán de Lis BT, Tendillo FJ. Effects of intramuscular dexmedetomidine in combination with ketamine or alfaxalone in swine. Vet Anaesth Analg 2015; 43:81-5. [PMID: 25819017 DOI: 10.1111/vaa.12259] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/02/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate and compare the use of intramuscular (IM) premedication with dexmedetomidine in combination with ketamine or alfaxalone in pigs. STUDY DESIGN Prospective, randomized, 'blinded' trial. ANIMALS Fourteen healthy 2-month-old Landrace × Large White pigs weighing 21.5 ± 0.6 kg. METHODS Animals were distributed randomly into two groups: group KD (n = 7) was given 10 mg kg(-1) IM ketamine + 10 μg kg(-1) IM dexmedetomidine; and group AD (n = 7) was given 5 mg kg(-1) IM alfaxalone + 10 μg kg(-1) IM dexmedetomidine mixed in the same syringe. Pain on injection, degree of sedation and quality of induction were scored. The time from induction of anaesthesia to recumbency was recorded. Once pigs were recumbent, reflexes were evaluated. Pulse and respiratory rates, end-tidal carbon dioxide and arterial oxygen saturation were recorded at 5 and 10 minutes after drug administration. Data were compared using a two-way anova or a t-test for unpaired data as relevant. Data are presented as the mean ± standard deviation (range). RESULTS Two animals in both groups showed slight pain on drug injection. The time to lateral recumbency in group KD [187 ± 34 seconds (153-230)] was similar to group AD [206 ± 36 seconds (150-248)]. In group AD, sedation was deeper, and the quality of anaesthetic induction was smoother. When moved for anaesthesia, five pigs in group KD vocalized. There were no differences between groups in pulse rates, arterial oxygen saturation and end-tidal carbon dioxide; however, the respiratory rate at 10 minutes was significantly higher in group KD than in group AD. CONCLUSIONS AND CLINICAL RELEVANCE IM dexmedetomidine in combination with ketamine in pigs induced moderate to deep sedation and fair to smooth induction of anaesthesia. When dexmedetomidine was combined with alfaxalone, sedation was deeper, and induction was of a better quality.
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Affiliation(s)
- Martín Santos
- Medical and Surgical Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Blanca T Bertrán de Lis
- Medical and Surgical Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Francisco J Tendillo
- Medical and Surgical Research Unit, Instituto de Investigación Sanitaria Puerta de Hierro-Majadahonda, Madrid, Spain
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Krimins RA, Ko JC, Weil AB, Payton ME. Evaluation of anesthetic, analgesic, and cardiorespiratory effects in dogs after intramuscular administration of dexmedetomidine-butorphanol-tiletamine-zolazepam or dexmedetomidine-tramadol-ketamine drug combinations. Am J Vet Res 2013; 73:1707-14. [PMID: 23106454 DOI: 10.2460/ajvr.73.11.1707] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare anesthetic, analgesic, and cardiorespiratory effects in dogs after IM administration of dexmedetomidine (7.5 μg/kg)-butorphanol (0.15 mg/kg)-tiletamine-zolazepam (3.0 mg/kg; DBTZ) or dexmedetomidine (15.0 μg/kg)-tramadol (3.0 mg/kg)-ketamine (3.0 mg/kg; DTrK) combinations. ANIMALS 6 healthy adult mixed-breed dogs. PROCEDURES Each dog received DBTZ and DTrK in a randomized, crossover-design study with a 5-day interval between treatments. Cardiorespiratory variables and duration and quality of sedation-anesthesia (assessed via auditory stimulation and sedation-anesthesia scoring) and analgesia (assessed via algometry and electrical nerve stimulation) were evaluated at predetermined intervals. RESULTS DBTZ or DTrK induced general anesthesia sufficient for endotracheal intubation ≤ 7 minutes after injection. Anesthetic quality and time from drug administration to standing recovery (131.5 vs 109.5 minutes after injection of DBTZ and DTrK, respectively) were similar between treatments. Duration of analgesia was significantly longer with DBTZ treatment, compared with DTrK treatment. Analgesic effects were significantly greater with DBTZ treatment than with DTrK treatment at several time points. Transient hypertension (mean arterial blood pressure > 135 mm Hg), bradycardia (heart rate < 60 beats/min), and hypoxemia (oxygen saturation < 90% via pulse oximetry) were detected during both treatments. Tidal volume decreased significantly from baseline with both treatments and was significantly lower after DBTZ administration, compared with DTrK, at several time points. CONCLUSIONS AND CLINICAL RELEVANCE DBTZ or DTrK rapidly induced short-term anesthesia and analgesia in healthy dogs. Further research is needed to assess efficacy of these drug combinations for surgical anesthesia. Supplemental 100% oxygen should be provided when DBTZ or DTrK are used.
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Affiliation(s)
- Rebecca A Krimins
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN 47907, USA
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Ko JC, Barletta M, Sen I, Weil AB, Krimins RA, Payton ME, Constable P. Influence of ketamine on the cardiopulmonary effects of intramuscular administration of dexmedetomidine-buprenorphine with subsequent reversal with atipamezole in dogs. J Am Vet Med Assoc 2013; 242:339-45. [DOI: 10.2460/javma.242.3.339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Krimins RA, Ko JC, Weil AB, Payton ME, Constable PD. Hemodynamic effects in dogs after intramuscular administration of a combination of dexmedetomidine-butorphanol-tiletamine-zolazepam or dexmedetomidine-butorphanol-ketamine. Am J Vet Res 2012; 73:1363-70. [DOI: 10.2460/ajvr.73.9.1363] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ko JC, Austin BR, Barletta M, Weil AB, Krimins RA, Payton ME. Evaluation of dexmedetomidine and ketamine in combination with various opioids as injectable anesthetic combinations for castration in cats. J Am Vet Med Assoc 2011; 239:1453-62. [DOI: 10.2460/javma.239.11.1453] [Citation(s) in RCA: 21] [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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