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Breitenlechner A, Bünger M, Ruczizka UK, Dolezal M, Auer U, Buzanich-Ladinig A. Comparison between Intramuscular and Intranasal Administration of Sedative Drugs Used for Piglet Castration. Animals (Basel) 2024; 14:2325. [PMID: 39199860 PMCID: PMC11350754 DOI: 10.3390/ani14162325] [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: 07/06/2024] [Revised: 08/07/2024] [Accepted: 08/09/2024] [Indexed: 09/01/2024] Open
Abstract
The aim of this study was to test the intranasal administration of different anaesthetics in piglets less than seven days of age undergoing castration for their suitability for providing good-quality sedation and short induction and recovery time with minimal stress. Azaperone alone at a high (5 mg/kg), medium (3 mg/kg) and low dosage (2 mg/kg) and in two combinations with either alfaxalone or midazolam were applied intramuscularly (i.m.) or intranasally (i.n.) to 120 healthy piglets. Compared to intramuscular application, intranasal application showed longer induction times, shorter recovery times and higher scores for defence and vocalisation. In conclusion, the intranasal protocols did not meet the requirements in all groups and their use can therefore not be recommended. A rapid induction phase and good quality of sedation could not be guaranteed.
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Affiliation(s)
- Andreas Breitenlechner
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, University of Veterinary Medicine Vienna, 1210 Vienna, Austria;
| | - Moritz Bünger
- Clinical Centre for Population Medicine in Fish, Pig and Poultry, Clinical Department for Farm Animals and Food System Science, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (M.B.); (U.K.R.); (A.B.-L.)
| | - Ursula Katharina Ruczizka
- Clinical Centre for Population Medicine in Fish, Pig and Poultry, Clinical Department for Farm Animals and Food System Science, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (M.B.); (U.K.R.); (A.B.-L.)
| | - Marlies Dolezal
- Platform for Bioinformatics and Biostatistics, University of Veterinary Medicine Vienna, 1210 Vienna, Austria;
| | - Ulrike Auer
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, University of Veterinary Medicine Vienna, 1210 Vienna, Austria;
| | - Andrea Buzanich-Ladinig
- Clinical Centre for Population Medicine in Fish, Pig and Poultry, Clinical Department for Farm Animals and Food System Science, University of Veterinary Medicine Vienna, 1210 Vienna, Austria; (M.B.); (U.K.R.); (A.B.-L.)
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Costea R, Ene I, Pavel R. Pig Sedation and Anesthesia for Medical Research. Animals (Basel) 2023; 13:3807. [PMID: 38136844 PMCID: PMC10741165 DOI: 10.3390/ani13243807] [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: 11/09/2023] [Revised: 12/06/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
In clinical veterinary practice, proper training and expertise in anesthesia administration and monitoring are essential. Pigs are suitable experimental animals for many surgical techniques because they are similar in size to humans and have a short reproductive cycle. This makes them ideal for research concerning organ transplantation, cardiovascular surgery, and other procedures that require a large animal model. Sedation and premedication should be administered at the lowest dose to be effective with predictable results and reduced adverse effects, to ensure the safety of both the animal and the team involved in the procedure, with a fast onset and optimizing the induction and maintenance of anesthesia. The goal of induction is to achieve a safe and effective level of anesthesia that ensures patient safety and facilitates research. Most of the time, inhalation anesthesia with endotracheal intubation is the ideal choice for maintenance of anesthesia. The difficulties related to endotracheal intubation of pigs can be overcome by knowing the anatomical peculiarities. Effective analgesia tailored to the specific procedure, the pig's condition, and individual responses to medications should complete the maintenance and recovery protocols, reducing perioperative complications.
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Affiliation(s)
- Ruxandra Costea
- Faculty of Veterinary Medicine, University of Agronomic Sciences and Veterinary Medicine, 011464 Bucharest, Romania
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Marion BM, Ghering JM, Dixon BC, Casselman AM, Astleford SM, White CE, Bowling PA. Comparison of Alfaxalone-Midazolam, Tiletamine-Zolazepam, and KetamineAcepromazine Anesthesia during Plethysmography in Cynomolgus Macaques ( Macaca fascicularis) and Rhesus Macaques ( Macaca mulatta). Comp Med 2022; 72:248-256. [PMID: 35772936 PMCID: PMC9413525 DOI: 10.30802/aalas-cm-22-000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Plethysmography is used in nonhuman primates (NHPs) to measure minute volume before aerosol exposure to an agent to calculate total time necessary in the exposure chamber. The consistency of respiratory parameters during the entire exposure time is paramount to ensuring dosing accuracy. Our study sought to validate an alfaxalone-midazolam (AM) anesthetic combination for use in aerosol studies. We hypothesized that AM would provide an adequate duration of anesthesia, achieve and maintain steady state minute volume (SSMV) for 20 min, and have anesthetic quality and side effects comparable to or better than either tiletamine-zolazepam (TZ) and ketamine-acepromazine (KA), the most common anesthetics used for this purpose currently. Two groups of NHPs, one consisting of 15 cynomolgus macaques and one of 15 rhesus macaques, received 3 intramuscular anesthetic combinations (AM, TZ, and KA), no less than one week apart. Anesthetized NHPs were placed in a plethysmograph chamber and their minute volumes were measured every 10 s to determine whether they had achieved SSMV and maintained it for at least 20 consecutive min. Achieving and reliably maintaining an SSMV for at least 20 min facilitates precise aerosol dosing of a challenge agent. Quality of anesthesia, based on the NHP's ability to achieve and maintain SSMV, was higher with AM compared with TZ and KA in both species, and AM had a longer duration of SSMV as compared with TZ and KA in cynomolgus macaques. Average SSMV was larger with AM compared with TZ in cynomolgus macaques, but larger with KA compared with AM in rhesus macaques. Duration of anesthesia was sufficient with all combinations but was longer for TZ than both AM and KA in both species. These results suggest that the AM anesthetic combination would produce the most accurate dosing for an aerosol challenge.
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Affiliation(s)
| | - Jeanean M Ghering
- Aerobiology, Animal Clinical Pathology, and Telemetry Section, Veterinary Medicine Division, and
| | | | | | | | - Charles E White
- Statistics Section, Veterinary Medicine Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Frederick, Maryland
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Evaluation of alfaxalone and midazolam with or without flumazenil reversal in Egyptian fruit bats (Rousettus aegyptiacus). Vet Anaesth Analg 2020; 48:239-246. [PMID: 33451926 DOI: 10.1016/j.vaa.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate alfaxalone-midazolam anesthesia in Egyptian fruit bats (Rousettus aegyptiacus) and the effect of flumazenil administration on recovery time and quality. STUDY DESIGN Randomized, blinded, crossover and controlled, experimental trial. ANIMALS A total of 10 male Egyptian fruit bats. METHODS Bats were anesthetized with alfaxalone (15 mg kg-1) and midazolam (2 mg kg-1) administered subcutaneously. During anesthesia, vital signs, muscle tone and reflexes were monitored every 10 minutes. Flumazenil (0.3 mg kg-1) or saline at an equal volume was administered subcutaneously 60 minutes after anesthetic administration. Time to induction, time to first movement and recovery time (flying) were measured. Quality of induction, anesthesia and recovery were assessed on a 1-3 scale (1, poor; 2, good; 3, excellent). RESULTS Time to induction was 4.2 ± 1.9 minutes (mean ± standard deviation), with median quality score of 2 (range, 1-3). Anesthesia quality score was 3 (1-3). During anesthesia, heart rate and respiratory frequency decreased significantly and penis relaxation, indicating muscle tone, increased significantly. Administration of flumazenil significantly reduced mean recovery time compared with saline (10 ± 5 versus 45 ± 17 minutes, respectively), and significantly improved the quality of recovery [2.5 (2-3) versus 1 (1-2), respectively]. CONCLUSIONS AND CLINICAL RELEVANCE Alfaxalone-midazolam anesthesia resulted in good induction, muscle relaxation and sufficient anesthesia to perform routine diagnostic and therapeutic procedures for approximately 40 minutes. Reversal of midazolam with flumazenil is recommended, resulting in quicker and better recovery.
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Lervik A, Toverud SF, Krontveit R, Haga HA. A comparison of respiratory function in pigs anaesthetised by propofol or alfaxalone in combination with dexmedetomidine and ketamine. Acta Vet Scand 2020; 62:14. [PMID: 32164761 PMCID: PMC7066810 DOI: 10.1186/s13028-020-0512-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 02/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND General anaesthesia in pigs maintained with intravenous drugs such as propofol may cause respiratory depression. Alfaxalone gives less respiratory depression than propofol in some species. The aim of the investigation was to compare respiratory effects of propofol-ketamine-dexmedetomidine and alfaxalone-ketamine-dexmedetomidine in pigs. Sixteen pigs premedicated with ketamine 15 mg/kg and midazolam 1 mg/kg intramuscularly were anaesthetised with propofol or alfaxalone to allow endotracheal intubation, followed by propofol 8 mg/kg/h or alfaxalone 5 mg/kg/h in combination with ketamine 5 mg/kg/h and dexmedetomidine 4 µg/kg/h given as a continuous infusion for 60 min. The pigs breathed spontaneously with an FIO2 of 0.21. Oxygen saturation (SpO2), end-tidal CO2 concentration (PE'CO2), respiratory rate (fR) and inspired tidal volume (VT) were measured, and statistically compared between treatments. If the SpO2 dropped below 80% or if PE'CO2 increased above 10.0 kPa, the pigs were recorded as failing to complete the study, and time to failure was statistically compared between treatments. RESULTS Alfaxalone treated pigs had significantly higher respiratory rates and lower PE'CO2 than propofol treated pigs, with a fR being 7.3 /min higher (P = 0.01) and PE'CO2 0.8 kPa lower (P = 0.05). SpO2 decreased by 0.6% and fR by 1.0 /min per kg increase in body weight in both treatment groups. Three of eight propofol treated and two of eight alfaxalone treated pigs failed to complete the study, and times to failure were not significantly different between treatments (P = 0.75). CONCLUSIONS No major differences in respiratory variables were found when comparing treatments. Respiratory supportive measures must be available when using both protocols.
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Heng K, Marx JO, Jampachairsi K, Huss MK, Pacharinsak C. Continuous Rate Infusion of Alfaxalone during Ketamine-Xylazine Anesthesia in Rats. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE 2020; 59:170-175. [PMID: 32059754 DOI: 10.30802/aalas-jaalas-19-000122] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Alfaxalone is an injectable anesthetic agent that is used in veterinary medicine for general anesthesia. We evaluated the safety and efficacy of alfaxalone delivered through continuous rate infusion by comparing ketamine-xylazine-alfaxalone (KXA) anesthesia with ketamine-xylazine (KX) anesthesia in Sprague-Dawley rats. Anesthesia was induced in male and female rats by using subcutaneous KX. After induction, rats in the KXA group received alfaxalone (10 mg/kg/h IV) for 35 min, whereas rats in the KX group did not receive alfaxalone. At the end of the trial, alfaxalone was discontinued, and xylazine was reversed in all rats by using atipamezole. Throughout anesthesia, we assessed forepaw withdrawal reflex (FPWR), hindpaw withdrawal reflex (HPWR), response to surgical stimulation, heart rate, respiratory rate, SpO₂, body temperature, and time to standing. KXA produced a reliable surgical plane of anesthesia, as evidenced by the loss of both FPWR and HPWR and lack of response to surgical stimulation in all 16 rats, whereas only 6 of the 16 rats in the KX group lost HPWR. No rat in the KXA group regained a paw withdrawal reflex during alfaxalone administration, whereas 3 of the 12 rats (25%) in the KX group that reached a surgical plane of anesthesia exited that plane within the 35-min timeframe. Neither heart rate, respiratory rate, SpO₂, body temperature, nor time to standing differed between KXA and KX groups; and there were no sex-associated differences in anesthesia response. These results indicate that alfaxalone (10 mg/kg/h IV) delivered through continuous rate infusion, in combination with ketamine and xylazine, provides a safe, prolonged, and reliable surgical plane of anesthesia in rats.
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Affiliation(s)
- Kathleen Heng
- Department of Comparative Medicine, Stanford University, Stanford, California
| | - James O Marx
- University Laboratory Animal Resources, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Monika K Huss
- Department of Comparative Medicine, Stanford University, Stanford, California;,
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Oakleaf MH, Mama KR, Mangin LM, Lebsock KJ, Bisazza KT, Hess AM, Easley JT. Comparison of intravenous anesthetic induction doses and physiologic effects of ketamine or alfaxalone in goats undergoing surgery with isoflurane anesthesia. Am J Vet Res 2019; 80:819-824. [PMID: 31449447 DOI: 10.2460/ajvr.80.9.819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare IV doses of alfaxalone and ketamine needed to facilitate orotracheal intubation and assess effects of each treatment on selected physiologic variables in goats undergoing orthopedic surgery with isoflurane anesthesia. ANIMALS 18 healthy adult goats. PROCEDURES Behavior was assessed before and after sedation with midazolam (0.1 mg/kg, IV) for IV catheter placement. Anesthesia was induced with additional midazolam (0.1 mg/kg, IV) and alfaxalone (n = 9) or ketamine (9) at 2 mg/kg, IV, over 30 seconds. An additional dose of alfaxalone or ketamine (1 mg/kg) was given IV if needed for intubation; anesthesia was maintained with isoflurane in oxygen and IV fluids with ketamine (0.5 to 1 mg/kg/h). Direct systolic (SAP), diastolic (DAP), and mean (MAP) arterial blood pressures; heart rate; and respiratory rate were recorded before induction, immediately after intubation, and during surgery. Qualitative anesthetic induction and recovery characteristics were assessed. Variables were compared within and between groups by statistical methods. RESULTS No preinduction variables differed significantly between groups. Postintubation and 30-minute intraoperative SAP, DAP, and MAP were higher for the ketamine group than for the alfaxalone group; within the alfaxalone group, postintubation SAP, MAP, and respiratory rate prior to mechanical ventilation were lower than respective preinduction values. All alfaxalone-group goats were intubated after 1 dose of the induction agent; 5 of 9 ketamine-group goats required an additional (1-mg/kg) dose. Postoperative recovery was good to excellent for all animals. CONCLUSIONS AND CLINICAL RELEVANCE Both drugs were suitable for induction of anesthesia after sedation with midazolam, but most goats required higher doses of ketamine to allow intubation. For situations in which alfaxalone administration is appropriate, the potential for decreased arterial blood pressures and respiratory rate should be considered.
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Abstract
The aim of this experimental study was to evaluate the sedative and cardiorespiratory effects of alfaxalone and midazolam after intramuscular administration in pigs. Fourteen pigs, weighing 18 to 22 kg, aged between 55 and 70 days, American Society of Anaesthesiologists classification 2, affected by congenital reducible umbilical hernia, were included in the study. Alfaxalone (5 mg/kg) and midazolam (0.5 mg/kg) mixed in the same syringe were administered into the neck muscle. Pain on injection, quality of sedation and time to achieve lateral recumbency were recorded. Heart rate (HR), respiratory frequency (fR), and rectal temperature (RT) were recorded at 0 (baseline: before drug administration), 10, 15, and 20 min after the injection. Oxygen saturation of haemoglobin (SpO2), arterial blood pH, arterial oxygen (PaO2) and carbon dioxide (PaCO2) tensions and bicarbonate concentration (HCO3-) were recorded at 10, 15, and 20 min after injection. Continuous data were analysed using a repeated-measure analysis of variance (ANOVA) and aP-value < 0.05 was considered significant. Ten animals out of fourteen showed no pain on injection, whereas the remaining four exhibited mild pain. The time from the end of injection to lateral recumbency was 266 ± 40 s. The quality of sedation ranged between good to very good. No significant changes in the variables monitored were observed between the time points. In conclusion, the intramuscular administration of alfaxalone and midazolam in pigs at the doses used induced reliable and fast sedation, without pain on injection and moderate respiratory effects.
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Tsukamoto Y, Yamada N, Miyoshi K, Yamashita K, Ohsugi T. Anesthetic effect of a mixture of alfaxalone, medetomidine, and butorphanol for inducing surgical anesthesia in ICR, BALB/c, and C57BL/6 mouse strains. J Vet Med Sci 2019; 81:937-945. [PMID: 31080189 PMCID: PMC6612492 DOI: 10.1292/jvms.18-0712] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The anesthetic effects of alfaxalone combined with medetomidine and butorphanol were
investigated for ICR, BALB/c, and C57BL/6 mice. Mice were administered a combination of
0.5 or 0.75 mg/kg medetomidine and 5 mg/kg butorphanol with 30 or 40 mg/kg alfaxalone
(0.5MBA30, 0.75MBA30 and 0.75MBA40, respectively). The drug combinations were administered
subcutaneously and were compared with a widely used combination of 0.3 mg/kg medetomidine,
4 mg/kg midazolam, and 5 mg/kg butorphanol (MMB). All three MBA combinations achieved
surgical anesthesia, although the recovery time was longer with 0.75MBA30 and 0.75MBA40
compared with 0.5MBA30. Furthermore, several mice exhibited a considerable jumping
reaction immediately after injection with 0.75MBA30 and 0.75MBA40. Therefore, 0.5MBA30 may
be suitable for inducing surgical anesthesia in the mouse strains tested. The anesthetic
scores for 0.5MBA30 were improved compared with those of MMB in all three mouse strains;
however, the body temperature drop in C57BL/6 mice was greater with 0.5MBA30. Our results
show that the alfaxalone combination, 0.5MBA30, should allow surgical operations that are
more stable in more strains of mice than MMB, although the combination may cause
hypothermia, especially in C57BL/6 mice.
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Affiliation(s)
- Yoriko Tsukamoto
- Department of Laboratory Animal Science, School of Veterinary Medicine, Rakuno-Gakuen University, 582 Bunkyodai-Midorimachi, Ebetsu, Hokkaido 069-8501, Japan
| | - Norihide Yamada
- Department of Laboratory Animal Science, School of Veterinary Medicine, Rakuno-Gakuen University, 582 Bunkyodai-Midorimachi, Ebetsu, Hokkaido 069-8501, Japan
| | - Kenjiro Miyoshi
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno-Gakuen University, 582 Bunkyodai-Midorimachi, Ebetsu, Hokkaido 069-8501, Japan
| | - Kazuto Yamashita
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno-Gakuen University, 582 Bunkyodai-Midorimachi, Ebetsu, Hokkaido 069-8501, Japan
| | - Takeo Ohsugi
- Department of Laboratory Animal Science, School of Veterinary Medicine, Rakuno-Gakuen University, 582 Bunkyodai-Midorimachi, Ebetsu, Hokkaido 069-8501, Japan
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Lau C, Thakre PP, Bellingham MC. Alfaxalone Causes Reduction of Glycinergic IPSCs, but Not Glutamatergic EPSCs, and Activates a Depolarizing Current in Rat Hypoglossal Motor Neurons. Front Cell Neurosci 2019; 13:100. [PMID: 30967762 PMCID: PMC6440435 DOI: 10.3389/fncel.2019.00100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Accepted: 02/27/2019] [Indexed: 11/20/2022] Open
Abstract
We investigated effects of the neuroactive steroid anesthetic alfaxalone on intrinsic excitability, and on inhibitory and excitatory synaptic transmission to hypoglossal motor neurons (HMNs). Whole cell recordings were made from HMNs in brainstem slices from 7 to 14-day-old Wistar rats. Spontaneous, miniature, and evoked inhibitory post-synaptic currents (IPSCs), and spontaneous and evoked excitatory PSCs (EPSCs) were recorded at –60 mV. Alfaxalone did not alter spontaneous glycinergic IPSC peak amplitude, rise-time or half-width up to 10 μM, but reduced IPSC frequency from 3 μM. Evoked IPSC amplitude was reduced from 30 nM. Evoked IPSC rise-time was prolonged and evoked IPSC decay time was increased only by 10 μM alfaxalone. Alfaxalone also decreased evoked IPSC paired pulse ratio (PPR). Spontaneous glutamatergic EPSC amplitude and frequency were not altered by alfaxalone, and evoked EPSC amplitude and PPR was also unchanged. Alfaxalone did not alter HMN repetitive firing or action potential amplitude. Baseline holding current at −60 mV with a CsCl-based pipette solution was increased in an inward direction; this effect was not seen when tetrodotoxin (TTX) was present. These results suggest that alfaxalone modulates glycine receptors (GlyRs), causing a delayed and prolonged channel opening, as well as causing presynaptic reduction of glycine release, and activates a membrane current, which remains to be identified. Alfaxalone selectively reduces glycinergic inhibitory transmission to rat HMNs via a combination of pre- and post-synaptic mechanisms. The net effect of these responses to alfaxalone is to increase HMN excitability and may therefore underlie neuro-motor excitation during neurosteroid anesthesia.
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Affiliation(s)
- Cora Lau
- Faculty of Medicine, School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Prajwal P Thakre
- Faculty of Medicine, School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Mark C Bellingham
- Faculty of Medicine, School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia
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Hancock TM, Caulkett NA, Pajor EA, Grenwich L. An investigation of the effects of intratesticular alfaxalone and lidocaine during castration in piglets. Vet Anaesth Analg 2018; 45:858-864. [PMID: 30253999 DOI: 10.1016/j.vaa.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 07/06/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To determine whether intratesticular injection of an alfaxalone-lidocaine combination can induce anesthesia and provide a rapid recovery in piglets undergoing surgical castration. STUDY DESIGN Randomized experimental study. ANIMALS A group of 30 male piglets, aged 2-10 days, weighing 1.3-4.6 kg. METHODS Animals were randomly divided into three equal groups for intratesticular administration of alfaxalone + lidocaine: high dose (group HD; 8 mg kg-1 + 2.5 mg kg-1), medium dose (group MD; 6 mg kg-1 + 2 mg kg-1) and low dose (group LD; 4 mg kg-1 + 1.5 mg kg-1). Induction and recovery times, movement and vocalization were recorded. Pulse rate (PR), oxygen saturation, respiratory rate (fR), rectal temperature, blood pressure and end-tidal carbon dioxide were recorded until recovery. RESULTS Induction time did not differ significantly among groups (p = 0.19); mean time of 2.2, 3.3 and 3.7 minutes for HD, MD and LD, respectively. Recovery time to sternal recumbency was significantly faster in LD compared with HD and MD (p = 0.005). Time to standing was mean 34.1, 31.6 and 29.6 minutes for HD, MD and LD, respectively (p = 0.58). Incidences of movement and vocalization during the castration procedure were decreased in HD and MD compared with LD, but were not statistically different. There were no differences in the physiologic data among the groups except for PR, which decreased in all three groups (p < 0.05), and fR, which increased in MD and LD (p < 0.05). CONCLUSIONS AND CLINICAL RELEVANCE The alfaxalone-lidocaine combinations investigated in this study induced deep sedation in all piglets. Physiologic data remained within clinically acceptable ranges, suggesting that this drug combination by intratesticular injection prior to castration in neonatal piglets is well tolerated. The authors recommend the alfaxalone (6 mg kg-1) + lidocaine (2 mg kg-1) dose.
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Affiliation(s)
- Trina M Hancock
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Nigel A Caulkett
- Department of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada.
| | - Ed A Pajor
- Department of Production Animal Health, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB, Canada
| | - Leanna Grenwich
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, AB, Canada
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Dehuisser V, Bosmans T, Kitshoff A, Duchateau L, de Rooster H, Polis I. Cardiovascular effects, induction and recovery characteristics and alfaxalone dose assessment in alfaxalone versus alfaxalone-fentanyl total intravenous anaesthesia in dogs. Vet Anaesth Analg 2017; 44:1276-1286. [DOI: 10.1016/j.vaa.2017.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/07/2017] [Accepted: 04/10/2017] [Indexed: 11/30/2022]
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Aoki M, Wakuno A, Kushiro A, Mae N, Kakizaki M, Nagata SI, Ohta M. Evaluation of total intravenous anesthesia with propofol-guaifenesin-medetomidine and alfaxalone-guaifenesin-medetomidine in Thoroughbred horses undergoing castration. J Vet Med Sci 2017; 79:2011-2018. [PMID: 29057764 PMCID: PMC5745181 DOI: 10.1292/jvms.16-0658] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Anesthetic and cardiorespiratory effects of total intravenous anesthesia (TIVA) technique
using propofol-guaifenesin-medetomidine (PGM) and alfaxalone-guaifenesin-medetomidine
(AGM) were preliminarily evaluated in Thoroughbred horses undergoing castration. Twelve
male Thoroughbred horses were assigned randomly into two groups. After premedication with
intravenous (IV) administrations of medetomidine (5.0 µg/kg) and
butorphanol (0.02 mg/kg), anesthesia was induced with guaifenesin (10 mg/kg IV), followed
by either propofol (2.0 mg/kg IV) (group PGM: n=6) or alfaxalone (1.0 mg/kg IV) (group
AGM: n=6). Surgical anesthesia was maintained for 60 min at a constant infusion of either
propofol (3.0 mg/kg/hr) (group PGM) or alfaxalone (1.5 mg/kg/hr) (group AGM), in
combination with guaifenesin (80 mg/kg/hr) and medetomidine (3.0
µg/kg/hr). Responses to surgical stimuli, cardiorespiratory values, and
induction and recovery characteristics were recorded throughout anesthesia. During
anesthesia induction, one horse paddled in group PGM. All horses from group AGM were
maintained at adequate anesthetic depth for castration. In group PGM, 3 horses showed
increased cremaster muscle tension and one showed slight movement requiring additional IV
propofol to maintain surgical anesthesia. No horse exhibited apnea, although arterial
oxygen tension decreased in group AGM to less than 60 mmHg. Recovery quality was good to
excellent in both groups. In conclusion, TIVA using PGM and AGM infusion was available for
60 min anesthesia in Thoroughbred horses. TIVA techniques using PGM and AGM infusion
provided clinically acceptable general anesthesia with mild cardiorespiratory depression.
However, inspired air should be supplemented with oxygen to prevent hypoxemia during
anesthesia.
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Affiliation(s)
- Motoki Aoki
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Ai Wakuno
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Asuka Kushiro
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Naomi Mae
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Masashi Kakizaki
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | | | - Minoru Ohta
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
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The use of alfaxalone for premedication, induction and maintenance of anaesthesia in pigs: a pilot study. Vet Anaesth Analg 2017; 44:905-909. [PMID: 28716685 DOI: 10.1016/j.vaa.2016.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 05/28/2016] [Accepted: 06/21/2016] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The evaluation of alfaxalone as a premedication agent and intravenous anaesthetic in pigs. STUDY DESIGN Prospective, clinical trial. ANIMALS Nine healthy, 6-8-week-old female Landrace pigs weighing 22.2 ± 1.0 kg, undergoing epidural catheter placement. METHODS All pigs were premedicated with 4 mg kg-1 alfaxalone, 40 μg kg-1 medetomidine and 0.4 mg kg-1 butorphanol administered in the cervical musculature. Sedation was subjectively scored by the same observer from 1 (no sedation) to 10 (profound sedation) prior to induction of anaesthesia with alfaxalone intravenously to effect. All pigs were maintained on alfaxalone infusions with the rate of administration adjusted to maintain appropriate anaesthetic depth. Quality of induction was scored from 1 (poor) to 3 (smooth) and basic cardiorespiratory variables were recorded every 5 minutes during anaesthesia. Results are reported as mean ± standard deviation or median (range) as appropriate. RESULTS Sedation scores were 9 (7-10). Inductions were smooth in all pigs and cardiovascular variables remained within normal limits for the duration of anaesthesia. The induction dose of alfaxalone was 0.9 (0.0-2.3) mg kg-1. Three pigs did not require additional alfaxalone after premedication to facilitate intubation. CONCLUSIONS AND CLINICAL RELEVANCE Intramuscular alfaxalone in combination with medetomidine and butorphanol produced moderate to deep sedation in pigs. Alfaxalone produced satisfactory induction and maintenance of anaesthesia with minimal cardiovascular side effects. Appropriate monitoring of pigs premedicated with this protocol is required as some pigs may become anaesthetized after intramuscular administration of this combination of drugs.
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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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del Álamo AM, Mandsager RE, Riebold TW, Payton ME. Evaluation of intravenous administration of alfaxalone, propofol, and ketamine-diazepam for anesthesia in alpacas. Vet Anaesth Analg 2014; 42:72-82. [PMID: 24834969 DOI: 10.1111/vaa.12170] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Accepted: 11/07/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate the effects of induction of anesthesia with alfaxalone in alpacas. STUDY DESIGN Prospective, randomized, crossover design. ANIMALS Five healthy alpacas (96.7 ± 19.9 kg, 9.6 ± 3.1 years old). METHODS The alpacas were anesthetized on three occasions with alfaxalone, propofol, or ketamine-diazepam by intravenous injection. Quality of induction and intubation was assessed using a simple descriptive scale, and quality of recovery was scored: 1 (very poor)-5 (excellent). The auricular artery was catheterized for measurement of systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures and collection of blood. Variables measured were hemoglobin oxygen saturation (SpO2 ), respiratory rate, and end-tidal carbon dioxide partial pressure (Pe'CO2 ), and ECG. Repeated measures anova was used to assess effects of drug and time. Significance was set at p < 0.05. RESULTS Mean dose of alfaxalone sufficient to allow intubation was 2.1 mg kg(-1) . Induction was excellent with all protocols. Heart rate (HR), SAP and MAP were significantly higher following alfaxalone compared to ketamine-diazepam. Blood lactate concentration when standing following alfaxalone was higher compared to minutes 1 and 6, and to propofol (p < 0.05). All alpacas required oxygen supplementation and mechanical ventilation to treat SpO2 < 90% or Pe'CO2 > 60 mmHg. Time from induction to standing was longer with alfaxalone (34.1 ± 3.2 minutes) than propofol (19.0 ±4.3 minutes) or ketamine-diazepam (24.9 ±1.7 minutes). Recovery quality median scores were clinically and statistically different: 2 (alfaxalone), 4 (ketamine-diazepam), and 5 (propofol). Tremors, paddling, rolling, seizure-like activity and thrashing characterized recovery from alfaxalone. CONCLUSION Recovery quality was worst with alfaxalone. HR, SAP, MAP were increased at minute 1 in all protocols. Transient hypercapnia and hypoxia was observed with all protocols. CLINICAL RELEVANCE All protocols were adequate for induction of anesthesia. Alfaxalone alone in unpremedicated alpacas is not recommended.
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Affiliation(s)
- Ana M del Álamo
- College of Veterinary Medicine, Oregon State University, Veterinary Teaching Hospital, Corvallis, OR, USA
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Comparison of three different sedative-anaesthetic protocols (ketamine, ketamine-medetomidine and alphaxalone) in common marmosets (Callithrix jacchus). BMC Vet Res 2013; 9:113. [PMID: 23758836 PMCID: PMC3686586 DOI: 10.1186/1746-6148-9-113] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 06/03/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Handling of common marmoset (Callithrix jacchus) usually requires chemical restraint. Ketamine has been associated with muscle damage in primates, while common marmosets, compared to other primates, additionally display an exceptional high sensitivity to ketamine-associated side-effects. Notably, muscle twitching movements of limbs and hands, and a marked increase in salivation are observed. We investigated two alternative intramuscular (i.m.) immobilisation protocols against ketamine (50 mg/kg; protocol 1) in a double-blind randomised crossover study in ten healthy adult common marmosets for use as a safe reliable, short-term immobilisation and sedation. These protocols comprised: alphaxalone (12 mg/kg; protocol 2) and 25 mg/kg ketamine combined with 0.50 mg/kg medetomidine (reversal with 2.5 mg/kg atipamezole; protocol 3A). Following completion and unblinding, the project was extended with an additional protocol (3B), comprising 25 mg/kg ketamine combined with 0.05 mg/kg medetomidine (reversal with 0.25 mg/kg atipamezole, twice with 35 min interval). RESULTS All protocols in this study provided rapid onset (induction times <5 min) of immobilisation and sedation. Duration of immobilisation was 31.23 ± 22.39 min, 53.72 ± 13.08 min, 19.73 ± 5.74 min, and 22.78 ± 22.37 min for protocol 1, 2, 3A, and 3B, respectively. Recovery times were 135.84 ± 39.19 min, 55.79 ± 11.02 min, 405.46 ± 29.81 min, and 291.91 ± 80.34 min, respectively. Regarding the quality, and reliability (judged by pedal withdrawal reflex, palpebral reflex and muscle tension) of all protocols, protocol 2 was the most optimal. Monitored vital parameters were within clinically acceptable limits during all protocols and there were no fatalities. Indication of muscle damage as assessed by AST, LDH and CK values was most prominent elevated in protocol 1, 3A, and 3B. CONCLUSIONS We conclude that intramuscular administration of 12 mg/kg alphaxalone to common marmosets is preferred over other protocols studied. Protocol 2 resulted in at least comparable immobilisation quality with acceptable and less frequent side effects and superior recovery quality. In all protocols, supportive therapy, such as external heat support, remains mandatory. Notably, an unacceptable long recovery period in both ketamine/medetomidine protocols (subsequently reversed with atipamezole) was observed, showing that α-2 adrenoreceptor agonists in the used dose and dosing regime is not the first choice for sedation in common marmosets in a standard research setting.
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Lau C, Ranasinghe MG, Shiels I, Keates H, Pasloske K, Bellingham MC. Plasma pharmacokinetics of alfaxalone after a single intraperitoneal or intravenous injection of Alfaxan®
in rats. J Vet Pharmacol Ther 2013; 36:516-20. [DOI: 10.1111/jvp.12055] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 03/26/2013] [Indexed: 11/28/2022]
Affiliation(s)
- C. Lau
- School of Biomedical Sciences, University of Queensland; Brisbane Qld Australia
| | | | - I. Shiels
- School of Veterinary Science, University of Queensland; Gatton Qld Australia
| | - H. Keates
- School of Veterinary Science, University of Queensland; Gatton Qld Australia
| | | | - M. C. Bellingham
- School of Biomedical Sciences, University of Queensland; Brisbane Qld Australia
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Santos González M, Bertrán de Lis BT, Tendillo Cortijo FJ. Effects of intramuscular alfaxalone alone or in combination with diazepam in swine. Vet Anaesth Analg 2013; 40:399-402. [PMID: 23495812 DOI: 10.1111/vaa.12033] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 11/20/2012] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To describe the use of intramuscular (IM) premedication with alfaxalone alone or in combination with diazepam in pigs. STUDY DESIGN Randomised-controlled trial. ANIMALS Twelve healthy 2 month-old Landrace x Large White pigs weighing 21.3 ± 2.4 kg. METHODS Animals were distributed randomly into two groups: group A (n = 6) 5 mg kg(-1) of IM alfaxalone; and group AD (n = 6) 5 mg kg(-1) of IM alfaxalone + 0.5 mg kg(-1) of IM diazepam mixed in the same syringe. The total volume of injectate was standardized at 14 mL by dilution in 0.9% sodium chloride. Pain on injection, the degree of sedation and the quality of and time to induction of recumbency were evaluated. Once pigs were recumbent, reflexes were evaluated. Pulse and respiratory rates and arterial oxygen saturation were recorded at 5 and 10 minutes after drug administration. Pigs were then moved to another room for subsequent anaesthesia. RESULTS Two animals of group A and one of group AD showed slight pain on drug injection. Time to lateral recumbency (in seconds) was shorter in group AD (mean 203 ± SD 45 range 140-260) than group A (302 ± 75, range 220-420; p < 0.05). In group AD sedation was deeper, and on recumbency there was better muscle relaxation. When moved for anaesthesia, two pigs in Group A showed slight resistance but did not vocalize. There were no differences in physiologic measurements between groups, although in both groups, respiratory rate was significantly lower at ten compared with five minutes post drug injection. There was no apneoa. CONCLUSIONS AND CLINICAL RELEVANCE IM administration of alfaxalone combined with diazepam resulted in a rapid onset of recumbency and deep sedation, with minimal side effects. The combination might be useful for premedication, but volume of injectate will limit its use to small pigs.
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Affiliation(s)
- Martín Santos González
- Medical and Surgical Research Unit, Hospital Universitario Puerta de Hierro Majadahonda, Madrid, Spain.
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Keates HL, van Eps AW, Pearson MRB. Alfaxalone compared with ketamine for induction of anaesthesia in horses following xylazine and guaifenesin. Vet Anaesth Analg 2012; 39:591-8. [PMID: 22823480 DOI: 10.1111/j.1467-2995.2012.00756.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To compare anaesthesia induced with either alfaxalone or ketamine in horses following premedication with xylazine and guaifenesin. STUDY DESIGN Randomized blinded cross-over experimental study. ANIMALS Six adult horses, five Standardbreds and one Thoroughbred; two mares and four geldings. METHODS Each horse received, on separate occasions, induction of anaesthesia with either ketamine 2.2 mg kg(-1) or alfaxalone 1 mg kg(-1) . Premedication was with xylazine 0.5 mg kg(-1) and guaifenesin 35 mg kg(-1) . Incidence of tremors/shaking after induction, recovery and ataxia on recovery were scored. Time to recovery was recorded. Partial pressure of arterial blood oxygen (PaO(2) ) and carbon dioxide (PaO(2) ), arterial blood pressures, heart rate (HR) and respiratory rates were recorded before premedication and at intervals during anaesthesia. Data were analyzed using Wilcoxon matched pairs signed rank test and are expressed as median (range). RESULTS There was no difference in the quality of recovery or in ataxia scores. Horses receiving alfaxalone exhibited a higher incidence of tremors/shaking on induction compared with those receiving ketamine (five and one of six horses respectively). Horses recovered to standing similarly [28 (24-47) minutes for alfaxalone; 22 (18-35) for ketamine] but took longer to recover adequately to return to the paddock after alfaxalone [44 (38-67) minutes] compared with ketamine [35 (30-47)]. There was no statistical difference between treatments in effect on HR, PaO(2) or PaCO(2) although for both regimens, PaO(2) decreased with respect to before premedication values. There was no difference between treatments in effect on blood pressure. CONCLUSIONS AND CLINICAL RELEVANCE Both alfaxalone and ketamine were effective at inducing anaesthesia, although at induction there were more muscle tremors after alfaxalone. As there were no differences between treatments in relation to cardiopulmonary responses or quality of recovery, and only minor differences in recovery times, both agents appear suitable for this purpose following the premedication regimen used in this study.
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Affiliation(s)
- Helen L Keates
- School of Veterinary Science, The University of Queensland, Gatton Campus, Qld, Australia.
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Granados MM, Domínguez JM, Fernández-Sarmiento A, Funes FJ, Morgaz J, Navarrete R, Carrillo JM, Rubio M, Muñoz-Rascón P, Gómez de Segura IA, Gómez-Villamandos R. Anaesthetic and cardiorespiratory effects of a constant-rate infusion of alfaxalone in desflurane-anaesthetised sheep. Vet Rec 2012; 171:125. [PMID: 22791525 DOI: 10.1136/vr.100487] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A prospective, randomised, blinded controlled study was performed to determine the anaesthetic and cardiorespiratory effects of a constant-rate infusion (CRI) of alfaxalone in 12 sheep anaesthetised with desflurane, and undergoing experimental orthopaedic surgery. Sheep were sedated with dexmedetomidine (4 μg/kg, intravenously) and butorphanol (0.3 mg/kg, intravenously). Anaesthesia was induced with alfaxalone (1 mg/kg/minute to effect, intravenously) and maintained with desflurane in oxygen and alfaxalone 0.07 mg/kg/minute or saline for 150 minutes (range 150-166 minutes). The anaesthetic induction dose of alfaxalone, the desflurane expiratory fraction required for anaesthetic maintenance, cardiorespiratory measurements and blood-gases were recorded at predetermined intervals. Quality of sedation, anaesthetic induction and recovery were assessed. The alfaxalone induction dose was 1.7 mg/kg (1.2 to 2.6 mg/kg). The desflurane expiratory fraction was lower (22 per cent) in sheep receiving alfaxalone CRI (P=0). Also, heart rate (P=0), cardiac index (P=0.002), stroke index (P=0) and contractility (P=0) were higher, and systemic vascular resistance (P=0.002) was lower. Although respiratory rate tended to be higher with alfaxalone, there was no difference in PCO2 between the groups. Recovery times were significantly longer in sheep given alfaxalone (25.4 v 9.5 minutes) but recovery quality was similar. Alfaxalone reduced requirements of desflurane and maintained similar cardiorespiratory function, but recovery time was more prolonged.
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Affiliation(s)
- M M Granados
- Department of Animal Medicine and Surgery, Anaesthesia Unit, Veterinary Faculty, University of Córdoba, Córdoba, Spain.
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22
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Walsh VP, Gieseg M, Singh PM, Mitchinson SL, Chambers JP. A comparison of two different ketamine and diazepam combinations with an alphaxalone and medetomidine combination for induction of anaesthesia in sheep. N Z Vet J 2012; 60:136-41. [PMID: 22352931 DOI: 10.1080/00480169.2011.645769] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
AIMS To investigate the perceived adverse effects of a particular batch of ketamine during induction of anaesthesia in sheep and to assess if any adverse effects would make intubation more difficult for the veterinary students. METHODS Thirty adult sheep (mean bodyweight 74.5 (SD 9.4) kg) were randomly assigned to one of six groups of five sheep. Sheep in Groups A and B received I/V 0.5 mg/kg diazepam and 10 mg/kg ketamine (Ketamine Injection; Parnell Laboratories NZ Ltd, of the suspect batch); those in Groups C and D received I/V 0.5 mg/kg diazepam and 10 mg/kg ketamine (Ketalar; Hospira NZ Ltd.), and those in Groups E and F received I/V 2 μg/kg medetomidine and 2 mg/kg alphaxalone. In Groups A, C and E, intubation was by an experienced anaesthetist, and in Groups B, D and F intubation was by a veterinary student. Time from injection to successful intubation, the ease of intubation, saturation of haemoglobin with oxygen (SpO₂) and partial pressure of oxygen in arterial blood (PaO₂) were measured before the sheep were connected to an anaesthetic machine and allowed to breath oxygen. Times to extubation, holding its head up and standing, maximum and minimum heart rates, respiratory rates, maximal end tidal CO₂, and the quality of recovery were then recorded. RESULTS There were no measurable differences in outcomes between sheep in Groups A and B compared with C and D. Time to intubation was slightly shorter for the experienced anaesthetist than the student, but the difference was not significant. The sheep in Groups E and F took less time to recover than those in Groups A-D (p<0.05), but there were no significant differences between the groups in either the ease of induction or quality of recovery. Most sheep in Groups E and F showed minor excitatory effects, mainly at induction, which did not interfere with induction. Respiratory rates were lower in Groups E and F than Groups A-D (p<0.01), but SpO₂ was higher in Groups E and F than A and B (p<0.05). CONCLUSIONS The clinical impression that the batch of Parnell ketamine produced unexpected effects was shown to be incorrect. All the combinations produced anaesthesia that allowed intubation by the veterinary student. CLINICAL RELEVANCE All the drug combinations produced satisfactory anaesthesia in sheep, but the alphaxaloneand medetomidine combination resulted in faster recovery.
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Affiliation(s)
- V P Walsh
- Institute of Veterinary, Animal and Biomedical Sciences, Massey University, Private Bag 11222, Palmerston North, New Zealand
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Rodríguez JM, Muñoz-Rascón P, Navarrete-Calvo R, Gómez-Villamandos RJ, Domínguez Pérez JM, Fernández Sarmiento JA, Quirós Carmona S, Granados Machuca MM. Comparison of the cardiopulmonary parameters after induction of anaesthesia with alphaxalone or etomidate in dogs. Vet Anaesth Analg 2012; 39:357-65. [PMID: 22405410 DOI: 10.1111/j.1467-2995.2011.00695.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare the cardiorespiratory effects and quality of induction of and recovery from anaesthesia following etomidate or alphaxalone-HPCD IV. STUDY DESIGN Randomized 'blinded' cross-over study. Twenty-four hours was allowed between phases. ANIMALS Eight healthy adult Beagles (four male, four female). METHODS Dogs were anaesthetized with sevoflurane for instrumentation, then allowed to awake. They then received etomidate (treatment E) or alphaxalone-HPCD (treatment A) intravenously to effect. Heart rate (HR), body temperature, invasive arterial pressures (AP), systemic vascular resistance index (SVRI), stroke volume index, cardiac index (CI), contractility, respiratory rate, central venous pressure, and capnometry were obtained before anaesthetic induction (baseline), 30 seconds and 1 minute after induction, after intubation, one minute after intubation, and for every 5 minutes afterwards until the dog began to swallow and the trachea was extubated. Arterial bloods were taken for analyses before induction, after intubation and every 10 minutes thereafter. The dogs breathed room air. The quality of induction of and recovery from anaesthesia were scored categorically. Statistical analyses used anova for repeated measures, paired t-tests or Wilcoxon signed rank-test as relevant. Significance was set at p < 0.05. RESULTS The induction doses required were (mean ± SD) 2.91 ± 0.41 mg kg(-1) and 4.15 ± 0.7 mg kg(-1) for treatment E and A respectively. No significant changes in cardiovascular parameters were observed with treatment E. Treatment A resulted in statistically significant increases in HR and CI and reductions of APs and SVRI. Time to extubation was longer with treatment A (25 ± 7 minutes) than with treatment E (17 ± 4 minutes). Dogs became hypoxic with both treatments. The quality of induction and recovery were excellent with treatment A, but significantly less satisfactory with treatment E (recovery score, treatment E median 1, range 0-2; treatment A median 0, range 0-1). CONCLUSIONS AND CLINICAL RELEVANCE Alphaxalone-HPCD caused significant tachycardia and increase in CI, and statistically (but not clinically) significant decreases in APs and SVRI. Etomidate caused no statistically significant cardiovascular changes. Quality of recovery was better with alfaxalone-HPCD. Both agents caused short-lived hypoxia, and oxygen supplementation is advisable.
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Klöppel H, Leece EA. Comparison of ketamine and alfaxalone for induction and maintenance of anaesthesia in ponies undergoing castration. Vet Anaesth Analg 2011; 38:37-43. [PMID: 21214708 DOI: 10.1111/j.1467-2995.2010.00584.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare alfaxalone with ketamine for total intravenous anaesthesia in ponies undergoing castration. STUDY DESIGN Prospective, randomised, blinded clinical study. ANIMALS Forty-two, 12-month-old Welsh Mountain ponies. METHODS Ponies were assigned randomly to receive ketamine or alfaxalone. After administration of romifidine 100 μg kg(-1) and butorphanol 50 μg kg(-1) intravenously (IV), sedation and response to tactile stimulation were scored. If sedation was insufficient, romifidine 30 μg kg(-1) was administered IV. Anaesthesia was induced with ketamine 2.2 mg kg(-1) or alfaxalone 1 mg kg(-1) , both in combination with diazepam 20 μg kg(-1) IV. Time from end of injection to lateral recumbency was recorded. Simple descriptive scores were used to score quality of induction, surgical conditions and recovery. Ketamine 0.5 mg kg(-1) or alfaxalone 0.2 mg kg(-1) were administered if movement was observed. Times to first head lift, sternal recumbency and standing, and number of attempts needed were recorded. All scores were performed by the same observer, unaware of treatment. Normally distributed data were compared using t-test and non-normally distributed data with Mann-Whitney test. Level of significance was set at p<0.05. RESULTS Three ponies needed additional sedation. Mean induction times were 30 ± 6 and 18 ± 4 seconds following ketamine and alfaxalone respectively (p<0.0001). Additional doses were required by four ponies given ketamine and seven given alfaxalone. Sedation, induction and surgical scores were similar for both groups. Recovery scores (scale of 1-4 with 1 best) differed statistically between groups [ketamine group, median 1 (1-2); alfaxalone group 1.5 (1-4) (p=0.04)]. No differences in anaesthesia time or times taken from end of surgery to head lift, sternal recumbency and standing were detected. CONCLUSION AND CLINICAL RELEVANCE Induction times following alfaxalone were shorter than following ketamine. Both anaesthetic agents provided acceptable quality of anaesthesia for castration.
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Affiliation(s)
- Heide Klöppel
- Animal Health Trust, Suffolk, UK Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
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Andaluz A, Felez-Ocaña N, Santos L, Fresno L, García F. The effects on cardio-respiratory and acid-base variables of the anaesthetic alfaxalone in a 2-hydroxypropyl-β-cyclodextrin (HPCD) formulation in sheep. Vet J 2011; 191:389-92. [PMID: 21543243 DOI: 10.1016/j.tvjl.2011.03.017] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 03/23/2011] [Accepted: 03/26/2011] [Indexed: 11/18/2022]
Abstract
The objective of this study was to determine the pharmacodynamic effects in sheep of the anaesthetic alfaxalone in a 2-hydroxypropyl-β-cyclodextrin formulation. Seven Ripollesa sheep, weighing 43.0±6.6 kg, were used in the study. Twenty-four hours after instrumentation, the sheep were anesthetised with alfaxalone (2 mg/kg bodyweight IV) in cyclodextrin. Heart rate, arterial blood pressure, respiratory rate and arterial blood gases were recorded. Alfaxalone administration resulted in minimal cardio-respiratory depression. Time to standing from anaesthesia was 22.0±10.6 min. Apnoea was not observed in any of the sheep. Significant differences from baseline were not observed in respiratory rate or arterial blood pressure. Heart rate increased significantly (P<0.05) immediately after administration, returning to control values at 20 min. The calculated haemoglobin saturation (SO2) decreased significantly during the first 15 min after alfaxalone administration. The arterial pH decreased significantly during the first 30 min of the study, although no significant differences from basal values were observed in the arterial partial pressure of carbon dioxide (PaCO2). The results showed that alfaxalone in 2-hydroxypropyl-β-cyclodextrin administered as an IV bolus at 2 mg/kg produced minimal adverse effects and an uneventful recovery from anaesthesia in sheep.
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Affiliation(s)
- A Andaluz
- Department of Animal Medicine and Surgery, Faculty of Veterinary Medicine, Autonomous University of Barcelona (U.A.B), 08193 Bellaterra, Barcelona, Spain.
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Marsh MK, McLeod SR, Hansen A, Maloney SK. Induction of anaesthesia in wild rabbits using a new alfaxalone formulation. Vet Rec 2009; 164:122-3. [DOI: 10.1136/vr.164.4.122] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- M. K. Marsh
- Vertebrate Pest Research Unit; New South Wales Department of Primary Industries; Forest Road Orange NSW 2800 Australia
| | - S. R. McLeod
- Vertebrate Pest Research Unit; New South Wales Department of Primary Industries; Forest Road Orange NSW 2800 Australia
| | - A. Hansen
- Vertebrate Pest Research Unit; New South Wales Department of Primary Industries; Forest Road Orange NSW 2800 Australia
| | - S. K. Maloney
- School of Biomedical, Biomolecular and Chemical Science; University of Western Australia; Crawley WA 6009 Australia
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WHITTEM T. KN01 Anaesthesia and analgesia at the central GABA Areceptor. J Vet Pharmacol Ther 2006. [DOI: 10.1111/j.1365-2885.2006.00759_1.x] [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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