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Effects of detomidine or romifidine during maintenance and recovery from isoflurane anaesthesia in horses. Vet Anaesth Analg 2022; 49:624-633. [DOI: 10.1016/j.vaa.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 03/23/2022] [Accepted: 07/12/2022] [Indexed: 11/20/2022]
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Kim A, Sasaki N, Lee I, Lee K, Seo JP. Analgesic and cardiopulmonary effects of premedication with tramadol in calves anesthetized with the infusion of guaifenesin and thiamylal. J Vet Med Sci 2021; 83:1988-1993. [PMID: 34719606 PMCID: PMC8762425 DOI: 10.1292/jvms.21-0196] [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] [Indexed: 11/22/2022] Open
Abstract
This study examined the analgesic and cardiopulmonary effects of intravenous (IV) tramadol during general intravenous anesthesia in calves. Calves were premedicated with diazepam (0.2 mg/kg, IV) with tramadol (2 mg/kg, IV) (group T) or saline (group S). Anesthesia was induced by thiamylal sodium (4 mg/kg, IV) and maintained with an infusion (2 ml/kg/hr) of 5% guaifenesin containing thiamylal sodium (2 mg/ml). Additional thiamylal sodium (1~2 mg/kg, IV) was administered when interference from the calves was observed during surgery. The total counts of additional thiamylal sodium administration, analgesia score using a visual analog scale, recovery time, and cardiopulmonary function in the different groups were assessed and compared. Group T showed significantly fewer counts of additional drug administration and a significantly higher analgesia score. Tramadol may provide adequate analgesia with minimal cardiopulmonary changes in calves during general anesthesia.
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Affiliation(s)
- Ahram Kim
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University
| | - Naoki Sasaki
- Department of Clinical Veterinary Science, Yamaguchi University
| | - Inhyung Lee
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Seoul National University
| | - Kyuyoung Lee
- Center of Animal Disease Modelling and Surveillance, The Department of Medicine and Epidemiology, School of Veterinary Medicine University of California, Davis
| | - Jong-Pil Seo
- College of Veterinary Medicine and Veterinary Medical Research Institute, Jeju National University
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Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021; 11:ani11061777. [PMID: 34198637 PMCID: PMC8232193 DOI: 10.3390/ani11061777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Recovery is the most dangerous phase of general anaesthesia in horses. Numerous publications have reported about this phase, but structured reviews that try to reduce the risk of bias of narrative reviews/expert opinions, focussing on the topic are missing. Therefore, the aim of the present article was to publish the first structured review as a summary of the literature focussing on the recovery phase after general anaesthesia in horses. The objective was to summarise the available literature, taking into account the scientific evidence of the individual studies. A structured approach was followed with two experts in the field independently deciding on article inclusion and its level of scientific evidence. A total number of 444 articles, sorted by topics and classified based on their levels of evidence, were finally included into the present summary. The most important findings were summarised and discussed. The present structured review can be used as a compilation of the publications that, to date, focus on the recovery phase after general anaesthesia in adult horses. This type of review tries to minimise the risk of bias inherent to narrative reviews/expert opinions. Abstract Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords “recovery anaesthesia horse”, entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 “narrative reviews/expert opinions”, 16 “retrospective outcome studies”, 5 “surveys”, 59 “premedication/sedation and induction drugs”, 27 “maintenance with inhalant agents”, 55 “maintenance with total intravenous anaesthesia (TIVA)”, 3 “TIVA versus inhalants”, 56 “maintenance with partial intravenous anaesthesia (PIVA)”, 27 “other drugs used during maintenance”, 18 “drugs before/during recovery”, 18 “recovery systems”, 21 “respiratory system in recovery”, 41 “other factors”, 51 “case series/reports” and 6 “systems to score recoveries”. Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.
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Alonso BB, La Rosa L, Carregaro AB, Gasthuys F, Schauvliege S. Recovery Quality After Romifidine Versus Detomidine Infusion During Isoflurane Anesthesia in Horses. J Equine Vet Sci 2020; 94:103243. [PMID: 33077077 DOI: 10.1016/j.jevs.2020.103243] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 06/07/2020] [Accepted: 08/25/2020] [Indexed: 11/19/2022]
Abstract
To examine the influence of detomidine or romifidine on recovery quality from isoflurane anesthesia, 78 anesthetic records were reviewed, from horses that had received romifidine (group R) during premedication [80-120 μg kg-1 IV], anesthetic maintenance (40 μg kg-1 hour-1 IV), and recovery (20 μg kg-1 IV) or detomidine (group D), at doses of 10-20 μg kg-1 IV, 5 μg kg-1 hour-1 IV, and 2.5 μg kg-1 IV, respectively. Duration of the different recovery phases, the number of attempts to sternal and standing, scores for transition to standing (TrSta), balance and coordination once standing (BC), and final recovery score (FS) were compared between groups using a Mann-Whitney U-test, independent t-test, or chi-squared test, as appropriate (alpha 0.05). Parametric data are represented as the mean ± standard deviation, and nonparametric data as the median (interquartile range). Compared with group D (25 horses), horses in group R (53 horses) needed significantly fewer attempts to achieve sternal recumbency [R 1 (1-1) vs. D 1 (1-2)], remained significantly longer in sternal recumbency [R 10 (3-14,5) vs. D 5 (1-9,5) minutes], needed significantly less attempts to stand [R 1 (1-1) vs. D 2 (1-4)], and a significantly shorter time to stand after making their first attempt [R 0 (0-0) vs. D 3 (0-6) minutes], with significantly better scores for TrSta, BC, and FS in group R. The results suggest that, at the doses used, romifidine provides a better recovery quality.
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Affiliation(s)
- Bruna Bodini Alonso
- Faculty of Veterinary Medicine, Department of Surgery and Anaesthesia of Domestic Animals, University of Ghent, Merelbeke, Belgium.
| | - Lavínia La Rosa
- Faculty of Veterinary Medicine, Department of Surgery and Anaesthesia of Domestic Animals, University of Ghent, Merelbeke, Belgium
| | - Adriano Bonfim Carregaro
- School of Animal Science and Food Engineering, Department of Veterinary Medicine, University of São Paulo, Pirassununga, São Paulo, Brazil
| | - Frank Gasthuys
- Faculty of Veterinary Medicine, Department of Surgery and Anaesthesia of Domestic Animals, University of Ghent, Merelbeke, Belgium
| | - Stijn Schauvliege
- Faculty of Veterinary Medicine, Department of Surgery and Anaesthesia of Domestic Animals, University of Ghent, Merelbeke, Belgium
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Total intravenous anesthesia with alfaxalone, dexmedetomidine and remifentanil in healthy foals undergoing abdominal surgery. Vet Anaesth Analg 2019; 46:315-324. [DOI: 10.1016/j.vaa.2019.01.003] [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: 01/09/2019] [Accepted: 01/09/2019] [Indexed: 11/18/2022]
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Niimura Del Barrio MC, Bennett RC, Hughes JML. Effect of detomidine or romifidine constant rate infusion on plasma lactate concentration and inhalant requirements during isoflurane anaesthesia in horses. Vet Anaesth Analg 2017; 44:473-482. [PMID: 28462846 DOI: 10.1016/j.vaa.2016.01.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 01/15/2016] [Accepted: 01/29/2016] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Influence of detomidine or romifidine constant rate infusion (CRI) on plasma lactate concentration and isoflurane requirements in horses undergoing elective surgery. STUDY DESIGN Prospective, randomised, blinded, clinical trial. ANIMALS A total of 24 adult healthy horses. METHODS All horses were administered intramuscular acepromazine (0.02 mg kg-1) and either intravenous detomidine (0.02 mg kg-1) (group D), romifidine (0.08 mg kg-1) (group R) or xylazine (1.0 mg kg-1) (group C) prior to anaesthesia. Group D was administered detomidine CRI (10 μg kg-1 hour-1) in lactated Ringer's solution (LRS), group R romifidine CRI (40 μg kg-1 hour-1) in LRS and group C an equivalent amount of LRS intraoperatively. Anaesthesia was induced with ketamine and diazepam and maintained with isoflurane in oxygen. Plasma lactate samples were taken prior to anaesthesia (baseline), intraoperatively (three samples at 30 minute intervals) and in recovery (at 10 minutes, once standing and 3 hours after end of anaesthesia). End-tidal isoflurane percentage (Fe'Iso) was analysed by allocating values into three periods: Prep (15 minutes after the start anaesthesia-start surgery); Surgery 1 (start surgery-30 minutes later); and Surgery 2 (end Surgery 1-end anaesthesia). A linear mixed model was used to analyse the data. A value of p<0.05 was considered significant. RESULTS There was a difference in plasma lactate between 'baseline' and 'once standing' in all three groups (p<0.01); values did not differ significantly between groups. In groups D and R, Fe'Iso decreased significantly by 18% (to 1.03%) and by 15% (to 1.07%), respectively, during Surgery 2 compared with group C (1.26%); p<0.006, p<0.02, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Intraoperative detomidine or romifidine CRI in horses did not result in a clinically significant increase in plasma lactate compared with control group. Detomidine and romifidine infusions decreased isoflurane requirements during surgery.
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Affiliation(s)
- M C Niimura Del Barrio
- Veterinary Clinical Studies, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland.
| | - Rachel C Bennett
- Veterinary Clinical Studies, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - J M Lynne Hughes
- Veterinary Clinical Studies, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
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Gozalo-Marcilla M, Gasthuys F, Schauvliege S. Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 2: opioids and alpha-2 adrenoceptor agonists. Vet Anaesth Analg 2015; 42:1-16. [DOI: 10.1111/vaa.12196] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/13/2013] [Indexed: 01/04/2023]
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Pöppel N, Hopster K, Geburek F, Kästner S. Influence of ketamine or xylazine supplementation on isoflurane anaesthetized horses- a controlled clinical trial. Vet Anaesth Analg 2015; 42:30-8. [DOI: 10.1111/vaa.12176] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2013] [Accepted: 10/06/2013] [Indexed: 11/26/2022]
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Valverde A. Balanced Anesthesia and Constant-Rate Infusions in Horses. Vet Clin North Am Equine Pract 2013; 29:89-122. [DOI: 10.1016/j.cveq.2012.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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GOZALO-MARCILLA M, HOPSTER K, GASTHUYS F, HATZ L, KRAJEWSKI AE, SCHAUVLIEGE S. Effects of a constant-rate infusion of dexmedetomidine on the minimal alveolar concentration of sevoflurane in ponies. Equine Vet J 2012; 45:204-8. [DOI: 10.1111/j.2042-3306.2012.00613.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hubbell JAE, Aarnes TK, Lerche P, Bednarski RM. Evaluation of a midazolam-ketamine-xylazine infusion for total intravenous anesthesia in horses. Am J Vet Res 2012; 73:470-5. [DOI: 10.2460/ajvr.73.4.470] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Marcilla MG, Schauvliege S, Segaert S, Duchateau L, Gasthuys F. Influence of a constant rate infusion of dexmedetomidine on cardiopulmonary function and recovery quality in isoflurane anaesthetized horses. Vet Anaesth Analg 2012; 39:49-58. [DOI: 10.1111/j.1467-2995.2011.00672.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Schauvliege S, Marcilla MG, Verryken K, Duchateau L, Devisscher L, Gasthuys F. Effects of a constant rate infusion of detomidine on cardiovascular function, isoflurane requirements and recovery quality in horses. Vet Anaesth Analg 2011; 38:544-54. [DOI: 10.1111/j.1467-2995.2011.00659.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Wagner AE, Mama KR, Steffey EP, Ferreira TH, Rezende ML. Comparison of the cardiovascular effects of equipotent anesthetic doses of sevoflurane alone and sevoflurane plus an intravenous infusion of lidocaine in horses. Am J Vet Res 2011; 72:452-60. [DOI: 10.2460/ajvr.72.4.452] [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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Marcilla MG, Schauvliege S, Duchateau L, Gasthuys F. Cardiopulmonary effects of two constant rate infusions of dexmedetomidine in isoflurane anaesthetized ponies. Vet Anaesth Analg 2010; 37:311-21. [DOI: 10.1111/j.1467-2995.2010.00537.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Muir WW. Anaesthesia and pain management in horses. EQUINE VET EDUC 2010. [DOI: 10.1111/j.2042-3292.2005.tb01823.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
General anesthesia of horses entails considerable risk of morbidity and mortality. A large-scale, multicenter study reported that the death rate from non-colic-related anesthetics was 0.9%, while the perianesthetic mortality rate at a single, busy equine surgical practice was somewhat more favorable, at 0.12%. While any perianesthetic death is devastating, mortality figures alone do not reflect the overall morbidity of equine anesthesia in terms of nonterminal events or injuries related to recovery. In some circumstances, recognition of perianesthetic complications may allow appropriate intervention to prevent the complication from worsening or progressing to mortality. This article describes some of the complications that may occur during and after general anesthesia of horses, and suggests ways to prevent or mitigate them.
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Blissitt KJ, Raisis AL, Adams VJ, Rogers KH, Henley WE, Young LE. The effects of halothane and isoflurane on cardiovascular function in dorsally recumbent horses undergoing surgery. Vet Anaesth Analg 2008; 35:208-19. [DOI: 10.1111/j.1467-2995.2007.00376.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wagner AE, Miyake Y. Cardiac output and other hemodynamic variables in anesthetized dogs undergoing laparotomy because of abdominal neoplasia. J Am Vet Med Assoc 2008; 232:547-52. [DOI: 10.2460/javma.232.4.547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ringer SK, Kalchofner K, Boller J, Fürst A, Bettschart-Wolfensberger R. A clinical comparison of two anaesthetic protocols using lidocaine or medetomidine in horses. Vet Anaesth Analg 2007; 34:257-68. [PMID: 17567378 DOI: 10.1111/j.1467-2995.2006.00321.x] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the effects of two balanced anaesthetic protocols on end-tidal isoflurane (Fe'ISO), cardiopulmonary performance and quality of recovery in horses. DESIGN Prospective blinded randomized clinical study. ANIMALS Sixty-nine client-owned horses, American Society of Anesthesiologists category I and II, undergoing elective surgery. METHODS The horses were premedicated with acepromazine (0.03 mg kg(-1)) IM 30-60 minutes before induction of anaesthesia and were randomly assigned to one of two treatments: in group L (37 horses) xylazine (1 mg kg(-1)) and in group M (31 horses) medetomidine (7 microg kg(-1)) was administered IV for sedation. Anaesthesia was induced 5 minutes later with ketamine (2.2 mg kg(-1)) and diazepam (0.02 mg kg(-1)) IV and maintained with isoflurane in oxygen/air (initial FIO2 0.40-0.50) and a constant rate infusion (CRI) of either lidocaine (2 mg kg(-1)/15 minutes loading dose followed by 50 microg kg(-1) minute(-1)) (group L) or medetomidine (3.5 microg kg(-1) hour(-1)) (group M). If horses showed movement or nystagmus, additional thiopental or ketamine was administered. Heart rate, mean arterial pressure (MAP), Fe'ISO and arterial blood gases were measured. Cardiac output was measured with the lithium dilution method in 10 (group L) and 11 (group M) horses every 45 minutes. Recovery was scored. RESULTS Heart rate and the cardiac index (CI) were significantly higher in group L with changes over time. In group M, MAP was significantly higher during the first 50 minutes. Group L needed more additional ketamine and thiopental to maintain a surgical plane of anaesthesia and Fe'ISO was significantly higher from 70 minutes. Recovery was longer in group M and of better quality. The significance level was set at p < 0.05. CONCLUSIONS AND CLINICAL RELEVANCE In group M, maintenance of stable anaesthetic depth was easier and lower Fe'ISO was required to maintain a surgical plane of anaesthesia. Recoveries were longer but of better quality. The CI was higher in group L but cardiovascular function was generally well maintained in both groups.
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Affiliation(s)
- Simone K Ringer
- Equine Hospital, VETSUISSE Faculty, University of Zürich, Zürich, Switzerland.
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Durongphongtorn S, McDonell WN, Kerr CL, Neto FJT, Mirakhur KK. Comparison of hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of anesthesia with isoflurane and halothane in horses undergoing arthroscopic surgery. Am J Vet Res 2006; 67:32-42. [PMID: 16426209 DOI: 10.2460/ajvr.67.1.32] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of halothane and isoflurane in horses undergoing arthroscopic surgery. ANIMALS 8 healthy adult horses. PROCEDURE Anesthesia was maintained with isoflurane or halothane (crossover study). At 6 intervals during anesthesia and surgery, cardiopulmonary variables and related derived values were recorded. Recovery from anesthesia was assessed; gastrointestinal tract motility was subjectively monitored for 72 hours after anesthesia. Horses were administered chromium, and fecal chromium concentration was used to assess intestinal transit time. Venous blood samples were collected for clinicopathologic analyses before and 2, 24, and 48 hours after anesthesia. RESULTS Compared with halothane-anesthetized horses, cardiac index, oxygen delivery, and heart rate were higher and systemic vascular resistance was lower in isoflurane-anesthetized horses. Mean arterial blood pressure and the dobutamine dose required to maintain blood pressure were similar for both treatments. Duration and quality of recovery from anesthesia did not differ between treatments, although the recovery periods were somewhat shorter with isoflurane. After isoflurane anesthesia, gastrointestinal motility normalized earlier and intestinal transit time of chromium was shorter than that detected after halothane anesthesia. Compared with isoflurane, halothane was associated with increases in serum aspartate transaminase and glutamate dehydrogenase activities, but there were no other important differences in clinicopathologic variables between treatments. CONCLUSIONS AND CLINICAL RELEVANCE Compared with halothane, isoflurane appears to be associated with better hemodynamic stability during anesthesia, less hepatic and muscle damage, and more rapid return of normal intestinal motility after anesthesia in horses undergoing arthroscopic procedures.
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Affiliation(s)
- Sumit Durongphongtorn
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON, Canada
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Haga HA, Lykkjen S, Revold T, Ranheim B. Effect of intratesticular injection of lidocaine on cardiovascular responses to castration in isoflurane-anesthetized stallions. Am J Vet Res 2006; 67:403-8. [PMID: 16506900 DOI: 10.2460/ajvr.67.3.403] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the effect of intratesticular administration of lidocaine on cardiovascular responses and cremaster muscle tension during castration of isoflurane-anesthetized stallions. ANIMALS 28 healthy stallions (mean +/- SD age, 4.2 +/- 2.8 years) with no testicular abnormalities that were scheduled for castration. PROCEDURE Each horse was given acepromazine (20 microg/kg, IM), romifidine (50 microg/kg, IV), and butorphanol (20 microg/kg, IV). Anesthesia was induced with ketamine (2.5 mg/kg, IV) and midazolam (50 microg/kg, IV) and maintained with isoflurane (1.7% end-tidal concentration). After 10 minutes at a stable anesthetic plane, a needle was placed in each testicle and either no fluid or 15 mL of 2% lidocaine was injected; 10 minutes after needle placement, surgery was commenced. Pulse rate and arterial blood pressures were measured invasively at intervals from 5 minutes prior to castration (baseline) until 5 minutes after the left spermatic cord was clamped. The surgeon subjectively scored the degree of cremaster muscle tension. In 2 horses, lidocaine labeled with radioactive carbon (C(14)) was used and testicular autoradiograms were obtained. RESULTS Compared with baseline values, castration significantly increased blood pressure measurements; intratesticular injection of lidocaine decreased this blood pressure response and cremaster muscle tension. In 2 horses, autoradiography revealed diffuse distribution of lidocaine into the spermatic cord but poor distribution into the cremaster muscle. CONCLUSIONS AND CLINICAL RELEVANCE In isoflurane-anesthetized stallions, intratesticular injection of lidocaine prior to castration appeared to decrease intraoperative blood pressure responses and cremaster muscle tension and may be a beneficial supplement to isoflurane anesthesia.
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Affiliation(s)
- Henning A Haga
- Department of Companion Animal Clinical Sciences, Norwegian School of Veterinary Science, PO Box 8146 Dep, N-0033 Oslo, Norway
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Raisis AL. Skeletal muscle blood flow in anaesthetized horses. Part II: effects of anaesthetics and vasoactive agents. Vet Anaesth Analg 2005; 32:331-7. [PMID: 16297042 DOI: 10.1111/j.1467-2995.2005.00192.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE This review aims at evaluating studies investigating the effects of anaesthesia on skeletal muscle blood flow and associated cardiovascular function in anaesthetized horses and discusses how the results of these studies contribute to our understanding of the pathogenesis and prevention of post-anaesthetic myopathy. DATABASE USED Pubmed & personal files. CONCLUSION There is little published information on the effects of anaesthesia on skeletal muscle blood flow in horses. Available reports predominantly refer to halothane and isoflurane. The effects of vasoactive drugs have mainly been studied in halothane-anaesthetized horses. The results of these studies support the importance of cardiac output in the maintenance of adequate arterial blood pressure, perfusion pressure and muscle blood flow. Adequate perfusion pressure appears to be important for overcoming the detrimental effects of high intra-compartmental pressure in dependent muscles and hydrostatic pressure in nondependent muscles.
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Affiliation(s)
- Anthea L Raisis
- Division of Veterinary and Biomedical Sciences, Murdoch University, Perth, WA, Australia.
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Raisis AL, Blissitt KJ, Henley W, Rogers K, Adams V, Young LE. The effects of halothane and isoflurane on cardiovascular function in laterally recumbent horses. Br J Anaesth 2005; 95:317-25. [PMID: 15980042 DOI: 10.1093/bja/aei180] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Experimental studies in adult horses have shown that general anaesthesia maintained with isoflurane is associated with less depression of cardiovascular function compared with halothane anaesthesia. Adverse effects of intermittent positive-pressure ventilation (IPPV) have also been demonstrated. Nevertheless, the haemodynamic effects of these agents and the effects of differing modes of ventilation have not been assessed during clinical anaesthesia in horses undergoing surgery. METHODS The haemodynamic effects of isoflurane or halothane anaesthesia during spontaneous or IPPV were studied non-invasively in 32 laterally recumbent horses undergoing elective surgery. Indices of cardiac function and measurements of femoral arterial blood flow and resistance were recorded using transoesophageal and transcutaneous Doppler echocardiography, respectively. Arterial pressure was measured directly using a facial artery catheter. RESULTS Cardiac index (CI) was significantly higher during isoflurane anaesthesia than during halothane anaesthesia and was also higher during spontaneous ventilation with isoflurane. CI decreased significantly over time and an inverse relationship was observed between CI and mean arterial pressure (MAP). Horses with higher MAP had a significantly lower CI. During isoflurane anaesthesia, femoral arterial blood flow was significantly higher in both pelvic limbs compared with halothane anaesthesia, and flow in the lower limb was significantly higher during spontaneous ventilation than during IPPV. No significant change in femoral blood flow was observed over time. CONCLUSION The effects of anaesthetics and mode of ventilation on cardiovascular function recorded under surgical conditions in horses are similar to those reported under experimental conditions. However, in contrast with previous experimental studies, CI progressively decreased over time regardless of agent used or mode of ventilation employed.
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Affiliation(s)
- A L Raisis
- Department of Equine Clinical Studies, Animal Health Trust, Lanwades Park, Newmarket, Suffolk, UK
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Mama KR, Wagner AE, Steffey EP, Kollias-Baker C, Hellyer PW, Golden AE, Brevard LF. Evaluation of xylazine and ketamine for total intravenous anesthesia in horses. Am J Vet Res 2005; 66:1002-7. [PMID: 16008223 DOI: 10.2460/ajvr.2005.66.1002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the use of xylazine and ketamine for total i.v. anesthesia in horses. ANIMALS 8 horses. PROCEDURE Anesthetic induction was performed on 4 occasions in each horse with xylazine (0.75 mg/kg, i.v.), guaifenesin (75 mg/kg, i.v.), and ketamine (2 mg/kg, i.v.). Intravenous infusions of xylazine and ketamine were then started by use of 1 of 6 treatments as follows for which 35, 90, 120, and 150 represent infusion dosages (microg/kg/min) and X and K represent xylazine and ketamine, respectively: X35 + K90 with 100% inspired oxygen (O2), X35 + K120-(O2), X35 + K150-(O2), X70 + K90-(O2), K150-(O2), and X35 + K120 with a 21% fraction of inspired oxygen (ie, air). Cardiopulmonary measurements were performed. Response to a noxious electrical stimulus was observed at 20, 40, and 60 minutes after induction. Times to achieve sternal recumbency and standing were recorded. Quality of sedation, induction, and recovery to sternal recumbency and standing were subjectively evaluated. RESULTS Heart rate and cardiac index were higher and total peripheral resistance lower in K150-(O2) and X35 + K120-air groups. The mean arterial pressure was highest in the X35 + K120-air group and lowest in the K150-(O2) group (125 +/- 6 vs 85 +/- 8 at 20 minutes, respectively). Mean Pa(O2) was lowest in the X35 + K120-air group. Times to sternal recumbency and standing were shortest for horses receiving K150-(O2) (23 +/- 6 minutes and 33 +/- 8 minutes, respectively) and longest for those receiving X70 + K90-(O2) (58 +/- 28 minutes and 69 +/- 27 minutes, respectively). CONCLUSIONS AND CLINICAL RELEVANCE Infusions of xylazine and ketamine may be used with oxygen supplementation to maintain 60 minutes of anesthesia in healthy adult horses.
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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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Haga HA, Dolvik NI. Electroencephalographic and cardiovascular variables as nociceptive indicators in isoflurane-anaesthetized horses. Vet Anaesth Analg 2005; 32:128-35. [PMID: 15877659 DOI: 10.1111/j.1467-2995.2005.00194.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate Fourier-transformed electroencephalographic (EEG) variables, mean arterial blood pressure (MAP) and pulse rate as nociceptive indicators in isoflurane-anaesthetized horses. ANIMALS Five standardbred and three Norwegian cold-blooded trotter stallions undergoing castration, aged 2-4 years, mass 378-538 kg. MATERIALS AND METHODS All horses received intravenous (IV) detomidine (10 microg kg(-1) IV) and butorphanol (0.01 mg kg(-1) IV). Additional detomidine (4 microg kg(-1) IV) was administered in the induction area. Anaesthesia was induced with ketamine (2.5 mg kg(-1) IV) and diazepam (40 microg kg(-1) IV), and maintained for 30 minutes with isoflurane (end-tidal concentration of 1.4%) vaporized in oxygen. The electroencephalogram, MAP and pulse rate were recorded for 15 minutes, beginning 5 minutes before skin incision. Differences between the mean values of recordings taken before, and during surgery were calculated and tested for significant differences using a two-sided Student's t-test. RESULTS A significant rise in MAP and a fall in pulse rate were found. No significant change was found in any EEG variable. CONCLUSION/CLINICAL relevance Of the variables evaluated, MAP seems to be the most sensitive and reliable indicator of nociception in isoflurane-anaesthetized horses.
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Affiliation(s)
- Henning A Haga
- Department of Companion Animal Clinical Sciences, The Norwegian School of Veterinary Science, Oslo.
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Van Dijk P, Lankveld DPK, Rijkenhuizen ABM, Jonker FH. Hormonal, metabolic and physiological effects of laparoscopic surgery using a detomidine-buprenorphine combination in standing horses. Vet Anaesth Analg 2003; 30:71-79. [DOI: 10.1046/j.1467-2995.2003.00097.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2001] [Accepted: 08/07/2001] [Indexed: 11/20/2022]
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Lee YHL, Clarke KW, Alibhai HIK, Song DY. The effects of ephedrine on intramuscular blood flow and other cardiopulmonary parameters in halothane-anesthetized ponies. Vet Anaesth Analg 2002; 29:171-181. [DOI: 10.1046/j.1467-2995.2002.00095.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2001] [Accepted: 05/16/2002] [Indexed: 11/20/2022]
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Abstract
Administration of alpha-2 agonists to horses produces a variety of behavioral effects (sedation, somnolence, analgesia), and physiological effects. One of the most significant beneficial effects of administering alpha-2 agonists is the degree of analgesia they provide. Alpha-2 agonists have been the mainstay of analgesia for colic pain in horses since their introduction to clinical veterinary medicine. The increased potency of the more recently introduced alpha-2 agonists allows the provision of analgesia for conditions not previously relieved by other drugs. Unfortunately, there are significant side effects associated with alpha-2 agonist administration. Studies are underway to identify the physiologic effects associated with the stimulation of each alpha-2 receptor subtype, in hopes of developing subtype-specific alpha-2 agonists and antagonists.
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Affiliation(s)
- David A Daunt
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA
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Wilson DV, Bohart GV, Evans AT, Robertson S, Rondenay Y. Retrospective analysis of detomidine infusion for standing chemical restraint in 51 horses. Vet Anaesth Analg 2002; 29:54-57. [DOI: 10.1046/j.1467-2987.2001.00047.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/1999] [Accepted: 12/18/2000] [Indexed: 11/20/2022]
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Taylor PM, Kirby JJ, Shrimpton DJ, Johnson CB. Cardiovascular effects of surgical castration during anaesthesia maintained with halothane or infusion of detomidine, ketamine and guaifenesin in ponies. Equine Vet J 1998; 30:304-9. [PMID: 9705113 DOI: 10.1111/j.2042-3306.1998.tb04102.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Sixteen colts were premedicated with acepromazine and anaesthesia was induced with detomidine and ketamine. Ponies were randomly allocated to receive halothane (HAL) or infusion of detomidine, ketamine and guaiphenesin (DKG) to maintain anaesthesia. Heart and respiratory rate, ECG, mean arterial blood pressure (MABP), cardiac index (CI), blood gases and plasma cortisol, ketamine and guaiphenesin were measured. Surgical castration took place between 45 and 75 min and anaesthesia lasted 90 min. MABP with DKG was significantly higher than with HAL, and, with HAL, MABP increased from pre-surgery (64 +/- 6 mmHg) to mid-surgery (80 +/- 5 mmHg) but did not change with DKG. At 30 min, CI was similar in both groups (57 +/- 7 ml/kg bwt/min); it decreased during surgery with HAL and remained low, but it increased slightly with DKG, and was higher than with HAL at 60 and 90 min. Plasma cortisol decreased in both groups until 40 min then increased with HAL only during surgery. Ketamine concentration reached a plateau (1.3-1.8 microg/ml) between 20 and 90 min and guaiphenesin concentration between 60 and 90 min (99-101 microg/ml). Recovery was generally smooth in both groups. This study demonstrated that during HAL the increase in blood pressure associated with surgical stimulus is accompanied by decreased CI; this did not occur during DKG which is likely to lead to better tissue perfusion than HAL. The adrenocortical activity seen during HAL was absent during DKG which may result from pituitary depression, analgesic effects of total intravenous anaesthesia (TIVA) or better perfusion.
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Affiliation(s)
- P M Taylor
- Department of Clinical Veterinary Medicine, University of Cambridge, UK
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Wagner AE, Dunlop CI, Wertz EM, Chapman PL, Baxter GM, Klopp LS. Hemodynamic responses of horses to anesthesia and surgery, before and after administration of a low dose of endotoxin. Vet Surg 1995; 24:78-85. [PMID: 7701776 DOI: 10.1111/j.1532-950x.1995.tb01300.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Seven horses, which were part of an investigation of the effect of endotoxin administration on vascular reactivity, were anesthetized on two separate occasions for surgical excision of 4-cm sections of palmar digital artery and vein. On the first occasion, the horses were given an infusion of 1 L 0.9% NaCl solution intravenously (i.v.) just before induction of anesthesia (control); on the second occasion, the horses received an infusion of 1 L 0.9% NaCl containing Escherichia coli endotoxin, 0.1 microgram/kg (endotoxin). On both occasions, anesthesia was induced with xylazine, guaifenesin, and ketamine, and maintained with halothane in oxygen. Hemodynamic measurements were made with the horses under anesthesia immediately before beginning surgery (period 1), during skin incision (period 2), during dissection and excision of the vessels (period 3), during skin suturing (period 4), and after completion of surgery during bandaging (period 5). Hemoglobin concentration and mixed venous oxygen content were greater at all periods in horses that received endotoxin. Otherwise, there were no significant differences in hemodynamic parameters between control horses and horses administered endotoxin before beginning surgery (period 1). During surgery and bandaging, horses administered endotoxin had significantly higher heart rate (periods 3, 4, and 5), cardiac index (periods 3, 4, and 5), and oxygen delivery (periods 2, 3, 4, and 5) than did control horses, and mean arterial blood pressure (period 2) and systemic vascular resistance (periods 2, 3, 4, and 5) were less than in control horses. Compared with period 1, surgical stimulation in control horses was associated with increased mean arterial blood pressure and systemic vascular resistance (periods 2, 3, 4, and 5), but cardiac index and oxygen delivery were decreased (periods 3, 4, and 5).(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A E Wagner
- Department of Clinical Sciences, Colorado State University, Fort Collins 80523
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Taylor P, Young S. Does the induction agent affect the course of halothane anaesthesia in horses? ACTA ACUST UNITED AC 1993. [DOI: 10.1111/j.1467-2995.1993.tb00122.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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