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1.
ObjectiveTo compare the effect of alfaxalone and propofol on heart rate (HR) and blood pressure (BP) after fentanyl administration in healthy dogs.Study designProspective, randomised clinical study.AnimalsFifty healthy client owned dogs (ASA I/II) requiring general anaesthesia for elective magnetic resonance imaging for neurological conditions.MethodsAll dogs received fentanyl 7 μg kg−1 IV and were allocated randomly to receive either alfaxalone (n = 25) or propofol (n = 25) to effect until endotracheal (ET) intubation was possible. Heart rate and oscillometric BP were measured before fentanyl (baseline), after fentanyl (Time F) and after ET intubation (Time GA). Post-induction apnoea were recorded. Data were analysed using Fisher’s exact test, Mann Whitney U test and one-way anova for repeated measures as appropriate; p value <0.05 was considered significant.ResultsDogs receiving propofol showed a greater decrease in HR (-14 beat minute−1, range -47 to 10) compared to alfaxalone (1 beat minute−1, range -33 to 26) (p = 0.0116). Blood pressure decreased over the three time periods with no difference between groups. Incidence of post-induction apnoea was not different between groups.ConclusionFollowing fentanyl administration, anaesthetic induction with propofol resulted in a greater negative chronotropic effect while alfaxalone preserved or increased HR.Clinical relevanceFollowing fentanyl administration, HR decreases more frequently when propofol rather than alfaxalone is used as induction agent. However, given the high individual variability and the small change in predicted HR (-7.7 beats per minute after propofol), the clinical impact arising from choosing propofol or alfaxalone is likely to be small in healthy animals. Further studies in dogs with myocardial disease and altered haemodynamics are warranted.  相似文献   

2.
ObjectiveTo compare the physiological parameters, arterial blood gas values, induction quality, and recovery quality after IV injection of alfaxalone or propofol in dogs.Study designProspective, randomized, blinded crossover.AnimalsEight random-source adult female mixed-breed dogs weighing 18.7 ± 4.5 kg.MethodsDogs were assigned to receive up to 8 mg kg?1 propofol or 4 mg kg?1 alfaxalone, administered to effect, at 10% of the calculated dose every 10 seconds. They then received the alternate drug after a 6-day washout. Temperature, pulse rate, respiratory rate, direct blood pressure, and arterial blood gases were measured before induction, immediately post-induction, and at 5-minute intervals until extubation. Quality of induction, recovery, and ataxia were scored by a single blinded investigator. Duration of anesthesia and recovery, and adverse events were recorded.ResultsThe mean doses required for induction were 2.6 ± 0.4 mg kg?1 alfaxalone and 5.2 ± 0.8 mg kg?1 propofol. After alfaxalone, temperature, respiration, and pH were significantly lower, and PaCO2 significantly higher post-induction compared to baseline (p < 0.03). After propofol, pH, PaO2, and SaO2 were significantly lower, and PaCO2, HCO3, and PA-aO2 gradient significantly higher post-induction compared to baseline (p < 0.03). Post-induction and 5-minute physiologic and blood gas values were not significantly different between alfaxalone and propofol. Alfaxalone resulted in significantly longer times to achieve sternal recumbency (p = 0.0003) and standing (p = 0.0004) compared to propofol. Subjective scores for induction, recovery, and ataxia were not significantly different between treatments; however, dogs undergoing alfaxalone anesthesia were more likely to have ≥1 adverse event (p = 0.041). There were no serious adverse events in either treatment.Conclusions and clinical relevanceThere were no clinically significant differences in cardiopulmonary effects between propofol and alfaxalone. A single bolus of propofol resulted in shorter recovery times and fewer adverse events than a single bolus of alfaxalone.  相似文献   

3.
ObjectiveTo determine if body condition score (BCS) influences the sedative effect of intramuscular (IM) premedication or the dose of intravenous (IV) propofol required to achieve endotracheal intubation in dogs.Study designProspective clinical study.AnimalsForty–six client–owned dogs undergoing general anaesthesia.MethodsDogs were allocated to groups according to their BCS (BCS, 1 [emaciated] to 9 [obese]): Normal–weight Group (NG, n = 25) if BCS 4–5 or Over–weight Group (OG, n = 21) if BCS over 6. Dogs were scored for sedation prior to IM injection of medetomidine (5 μg kg?1) and butorphanol (0.2 mg kg?1) and twenty minutes later anaesthesia was induced by a slow infusion of propofol at 1.5 mg kg?1 minute?1 until endotracheal intubation could be achieved. The total dose of propofol administered was recorded. Data were tested for normality then analyzed using Student t–tests, Mann–Whitney U tests, chi–square tests or linear regression as appropriate.ResultsMean ( ± SD) propofol requirement in NG was 2.24 ± 0.53 mg kg?1 and in OG was 1.83 ± 0.36 mg kg?1. The difference between the groups was statistically significant (p = 0.005). The degree of sedation was not different between the groups (p = 0.7). Post–induction apnoea occurred in 11 of 25 animals in the NG and three of 21 in OG (p = 0.052).ConclusionsOverweight dogs required a lower IV propofol dose per kg of total body mass to allow tracheal intubation than did normal body condition score animals suggesting that IV anaesthetic doses should be calculated according to lean body mass. The lower dose per kg of total body mass may have resulted in less post–induction apnoea in overweight/obese dogs. The effect of IM premedication was not significantly affected by the BCS.Clinical relevanceInduction of general anaesthesia with propofol in overweight dogs may be expected at lower doses than normal–weight animals.  相似文献   

4.
ObjectiveTo assess the cardiorespiratory and hypnotic-sparing effects of ketamine co-induction with target-controlled infusion of propofol in dogs.Study designProspective, randomized, blinded clinical study.AnimalsNinety healthy dogs (ASA grades I/II). Mean body mass 30.5 ± SD 8.6 kg and mean age 4.2 ± 2.6 years.MethodsAll dogs received pre-anaesthetic medication with acepromazine (0.03 mg kg?1) and morphine (0.2 mg kg?1) administered intramuscularly 30 minutes prior to induction of anaesthesia. Heart rate and respiratory rate were recorded prior to pre-medication. Animals were allocated into three different groups: Group 1 (control) received 0.9% NaCl, group 2, 0.25 mg kg?1 ketamine and group 3, 0.5 mg kg?1 ketamine, intravenously 1 minute prior to induction of anaesthesia, which was accomplished using a propofol target-controlled infusion system. The target propofol concentration was gradually increased until endotracheal intubation was possible and the target concentration at intubation was recorded. Heart rate, respiratory rate and noninvasive blood pressure were recorded immediately prior to induction, at successful intubation and at 3 and 5 minutes post-intubation. The quality of induction was graded according to the amount of muscle twitching and paddling observed. Data were analysed using a combination of chi-squared tests, Fisher's exact tests, Kruskal–Wallis, and anova with significance assumed at p< 0.05.ResultsThere were no significant differences between groups in the blood propofol targets required to achieve endotracheal intubation, nor with respect to heart rate, noninvasive blood pressure or quality of induction. Compared with the other groups, the incidence of post-induction apnoea was significantly higher in group 3, but despite this dogs in this group had higher respiratory rates overall.Conclusions and clinical relevanceUnder the conditions of this study, ketamine does not seem to be a useful agent for co-induction of anaesthesia with propofol in dogs.  相似文献   

5.

Objectives

To compare propofol and alfaxalone, with or without midazolam, for induction of anesthesia in fentanyl-sedated dogs, and to assess recovery from total intravenous anesthesia (TIVA).

Study design

Prospective, incomplete, Latin-square study.

Animals

Ten dogs weighing 24.5 ± 3.1 kg (mean ± standard deviation).

Methods

Dogs were randomly assigned to four treatments: treatment P-M, propofol (1 mg kg?1) and midazolam (0.3 mg kg?1); treatment P-S, propofol and saline; treatment A-M, alfaxalone (0.5 mg kg?1) and midazolam; treatment A-S, alfaxalone and saline, administered intravenously (IV) 10 minutes after fentanyl (7 μg kg?1) IV. Additional propofol or alfaxalone were administered as necessary for endotracheal intubation. TIVA was maintained for 35–55 minutes by infusions of propofol or alfaxalone. Scores were assigned for quality of sedation, induction, extubation and recovery. The drug doses required for intubation and TIVA, times from sedation to end of TIVA, end anesthesia to extubation and to standing were recorded. Analysis included a general linear mixed model with post hoc analysis (p < 0.05).

Results

Significant differences were detected in the quality of induction, better in A-M than A-S and P-S, and in P-M than P-S; in total intubation dose, lower in P-M (1.5 mg kg?1) than P-S (2.1 mg kg?1), and A-M (0.62 mg kg?1) than A-S (0.98 mg kg?1); and lower TIVA rate in P-M (268 μg kg?1 minute?1) than P-S (310 μg kg?1 minute?1). TIVA rate was similar in A-M and A-S (83 and 87 μg kg?1 minute?1, respectively). Time to standing was longer after alfaxalone than propofol, but was not influenced by midazolam.

Conclusions and clinical relevance

Addition of midazolam reduced the induction doses of propofol and alfaxalone and improved the quality of induction in fentanyl-sedated dogs. The dose rate of propofol for TIVA was decreased.  相似文献   

6.

Objective

To compare incidence and duration of postinduction apnoea in dogs after premedication with methadone and acepromazine (MA) or methadone and dexmedetomidine (MD) followed by induction with propofol (P) or alfaxalone (A).

Study design

Prospective, randomized clinical trial.

Animals

A total of 32 American Society of Anesthesiologists class I dogs (15 females, 17 males), aged between 4 months and 4 years, weighing between 3 and 46 kg.

Methods

Dogs were randomly allocated to be administered MA+P, MA+A, MD+P or MD+A (methadone 0.5 mg kg?1 and acepromazine 0.05 mg kg?1 or dexmedetomidine 5 μg kg?1). Induction agents were administered intravenously via syringe driver (P at 4 mg kg?1 minute?1 or A at 2 mg kg?1 minute?1) until successful endotracheal intubation and the endotracheal tube connected to a circle system with oxygen flow at 2 L minute?1. Oxygen saturation of haemoglobin (SpO2), end tidal partial pressure of carbon dioxide and respiratory rate were monitored continuously. If apnoea (≥ 30 seconds without breathing) occurred, the duration until first spontaneous breath was measured. If SpO2 decreased below 90% the experiment was stopped and manual ventilation initiated. Data were analysed with general linear models with significance set at p ≤ 0.05.

Results

There was no statistical difference in the incidence (11 of 16 dogs in A groups and 12 of 16 dogs in P groups), or mean ± standard deviation duration (A groups 125 ± 113 seconds, P groups 119 ± 109 seconds) of apnoea. The SpO2 of one dog in the MD+P group decreased below 90% during the apnoeic period.

Conclusions and clinical relevance

Propofol and alfaxalone both cause postinduction apnoea and the incidence and duration of apnoea is not influenced by the use of acepromazine or dexmedetomidine in premedication. Monitoring of respiration is recommended when using these premedication and induction agent combinations.  相似文献   

7.
ObjectiveTo document the effects of two doses of dexmedetomidine on the induction characteristics and dose requirements of alfaxalone.Study designRandomized controlled clinical trial.AnimalsSixty one client owned dogs, status ASA I-II.MethodsDogs were allocated randomly into three groups, receiving as pre-anaesthetic medication, no dexmedetomidine (D0), 1 μg kg?1 dexmedetomidine (D1) intramuscularly (IM) or 3 μg kg?1 dexmedetomidine IM (D3). All dogs also received 0.2 mg kg?1 methadone IM. Level of sedation was assessed prior to induction of anaesthesia. Induction of general anaesthesia was performed with alfaxalone administered intravenously to effect at a rate of 1 mg kg?1 minute?1; the required dose to achieve tracheal intubation was recorded. Anaesthesia was maintained with isoflurane in oxygen. Cardiopulmonary parameters were recorded throughout the anaesthetic period. Quality of intubation, induction and recovery of anaesthesia were recorded. Quantitative data were compared with one-way anova or Kruskal-Wallis test. Repeated measures were log-transformed and analysed with repeated measures anova (p < 0.05).ResultsTreatment groups were similar for categorical data, with exception of sedation level (p < 0.001). The doses (mean ± SD) of alfaxalone required for intubation were D0 1.68 ± 0.24, D1 1.60 ± 0.36 and D3 1.41 ± 0.43, the difference between D0 and D3 being statistically significant (p = 0.036). Heart and respiratory rates during the anaesthetic period were significantly different over time and between groups (p < 0.001); systolic arterial blood pressure was significantly different over time (p < 0.001) but not between groups (p = 0.833). Induction quality and recovery scores were similar between groups (p = 1.000 and p = 0.414, respectively).Conclusions and clinical relevanceThe administration of alfaxalone resulted in a good quality anaesthetic induction which was not affected by the dose of dexmedetomidine. Dexmedetomidine at 3 μg kg?1 IM combined with methadone provides good sedation and enables a reduction of alfaxalone requirements.  相似文献   

8.
ObjectiveTo compare the dose, cardiopulmonary effects and quality of anaesthetic induction in dogs using propofol (10 mg mL–1) and diluted propofol (5 mg mL–1).Study designRandomized, blinded, clinical study.AnimalsA total of 28 client-owned dogs (12 males/16 females).MethodsFollowing intramuscular acepromazine (0.02 mg kg–1) and methadone (0.2 mg kg–1), propofol (UP, 10 mg mL–1) or diluted propofol (DP, 5 mg mL–1) was administered intravenously (0.2 mL kg–1 minute–1) by an anaesthetist unaware of the allocated group to achieve tracheal intubation. Sedation, intubation and induction quality were scored from 0 to 3. Pre- and post-induction pulse rate (PR), respiratory rate (fR) and systolic (SAP), mean (MAP) and diastolic (DAP) arterial blood pressure were compared. Time to first breath and induction dose were recorded. Data were analysed for normality and Mann–Whitney U or Student t tests were performed where appropriate. Significance was set at p < 0.05. Data are presented as mean ± standard deviation or median (range).ResultsThe propofol dose administered to achieve induction was lower in the DP group (2.62 ± 0.48 mg kg–1) than in the UP group (3.48 ± 1.17 mg kg–1) (p = 0.021). No difference was observed in pre- and post-induction PR, SAP, MAP, DAP and fR between groups. The differences between post-induction and pre-induction values of these variables were also similar between groups. Time to first breath did not differ between groups. Sedation scores were similar between groups. Quality of tracheal intubation was marginally better with UP 0 (0–1) than with DP 1 (0–2) (p = 0.036), but overall quality of induction was similar between groups [UP 0 (0–1) and DP 0 (0–1), p = 0.549].Conclusion and clinical relevanceDiluting propofol reduced the dose to induce anaesthesia without significantly altering the cardiopulmonary variables.  相似文献   

9.
ObjectiveTo compare anaesthetic induction in healthy dogs using propofol or ketofol (a propofol-ketamine mixture).Study designProspective, randomized, controlled, ‘blinded’ study.AnimalsSeventy healthy dogs (33 males and 37 females), aged 6–157 months and weighing 4–48 kg.MethodsFollowing premedication, either propofol (10 mg mL?1) or ketofol (9 mg propofol and 9 mg ketamine mL?1) was titrated intravenously until laryngoscopy and tracheal intubation were possible. Pulse rate (PR), respiratory rate (fR) and arterial blood pressure (ABP) were compared to post-premedication values and time to first breath (TTFB) recorded. Sedation quality, tracheal intubation and anaesthetic induction were scored by an observer who was unaware of treatment group. Mann–Whitney or t-tests were performed and significance set at p = 0.05.ResultsInduction mixture volume (mean ± SD) was lower for ketofol (0.2 ± 0.1 mL kg?1) than propofol (0.4 ± 0.1 mL kg?1) (p < 0.001). PR increased following ketofol (by 35 ± 20 beats minute?1) but not consistently following propofol (4 ± 16 beats minute?1) (p < 0.001). Ketofol administration was associated with a higher mean arterial blood pressure (MAP) (82 ± 10 mmHg) than propofol (77 ± 11) (p = 0.05). TTFB was similar, but ketofol use resulted in a greater decrease in fR (median (range): ketofol -32 (-158 to 0) propofol -24 (-187 to 2) breaths minute?1) (p < 0.001). Sedation was similar between groups. Tracheal intubation and induction qualities were better with ketofol than propofol (p = 0.04 and 0.02 respectively).Conclusion and clinical relevanceInduction of anaesthesia with ketofol resulted in higher PR and MAP than when propofol was used, but lower fR. Quality of induction and tracheal intubation were consistently good with ketofol, but more variable when using propofol.  相似文献   

10.
ObjectiveTo determine the effects of graded doses of propofol on cardiovascular parameters and intraocular pressures (IOP) in normal dogs.Study designProspective, randomized, modified Latin square, cross-over experimental study.AnimalsEleven adult random-source dogs weighing 20.2 ± 5.7 kg.MethodsThere were three treatment groups: propofol 8 mg kg?1 intravenous (IV) until loss of jaw tone (Group P), propofol until loss of jaw tone +20% (Group P20), and propofol until loss of jaw tone +50% (Group P50). Atracurium 0.1 mg kg?1 IV was administered in all treatments immediately after the propofol. All dogs received the three treatments in a randomized order, with at least a one week interval between treatments. Direct arterial blood pressure and IOP by applanation tonometry were obtained at baseline, after 5 minutes of pre-oxygenation (before induction), before, and after intubation. Blood gas samples were obtained at baseline, after pre-oxygenation, and before intubation.ResultsThere was no significant difference in IOP readings at any time point among groups. The IOP was significantly higher before intubation versus before induction in all three groups. There was a significantly smaller change in systolic, mean (MAP), and diastolic (DAP) arterial pressures in the P50 group compared with the P group after intubation. There was a significantly smaller change in MAP and DAP in the P50 group compared with the P20 group after intubation. The increase in CO2 from before induction to before intubation was significantly greater in the P50 group than in the P or P20 groups.Conclusions and clinical relevanceGraded doses of propofol did not affect the increase in IOP observed with propofol induction in normal dogs. Higher doses of propofol are of no apparent additional benefit in animals who cannot tolerate an abrupt increase in IOP but may be of benefit in dogs who cannot tolerate an abrupt increase in blood pressure accompanying orotracheal intubation.  相似文献   

11.
ObjectivePropofol may cause adverse effects (e.g. apnoea, hypotension) at induction of anaesthesia. Co-induction of anaesthesia may reduce propofol requirements. The effect of fentanyl or midazolam on propofol dose requirements and cardiorespiratory parameters was studied.Study designRandomized, controlled, blinded clinical study.AnimalsSixty-six client owned dogs (35 male, 31 female, ASA I-II, age 6–120 months, body mass 4.7–48.0 kg) were selected.MethodsPre-medication with acepromazine (0.025 mg kg−1) and morphine (0.25 mg kg−1) was administered by intramuscular injection. After 30 minutes group fentanyl-propofol (FP) received fentanyl (2 μg kg−1), group midazolam-propofol (MP) midazolam (0.2 mg kg−1) injected over 30 seconds via a cephalic catheter and in a third group, control-propofol (CP), the IV catheter was flushed with an equivalent volume of heparinized saline. Anaesthesia was induced 2 minutes later, with propofol (4 mg kg−1minute−1) administered to effect. After endotracheal intubation anaesthesia was maintained with a standardized anaesthetic protocol. Pulse rate, respiratory rate (RR) and mean arterial pressure (MAP) were recorded before the co-induction agent, before induction, and 0, 2 and 5 minutes after intubation. Apnoea ≥30 seconds was recorded and treated. Sedation after pre-medication, activity after the co-induction agent, quality of anaesthetic induction and endotracheal intubation were scored.ResultsPropofol dose requirement was significantly reduced in FP [2.90 mg kg−1(0.57)] compared to CP [3.51 mg kg−1 (0.74)] and MP [3.58 mg kg−1(0.49)]. Mean pulse rate was higher in MP than in CP or FP (p = 0.003). No statistically significant difference was found between groups in mean RR, MAP or incidence of apnoea. Activity score was significantly higher (i.e. more excited) (p = 0.0001), and quality of induction score was significantly poorer (p = 0.0001) in MP compared to CP or FP. Intubation score was similar in all groups.Conclusions and clinical relevanceFentanyl decreased propofol requirement but did not significantly alter cardiovascular parameters. Midazolam did not reduce propofol requirements and caused excitement in some animals.  相似文献   

12.
ObjectiveTo determine an optimum infusion rate of propofol that permitted rapid tracheal intubation while minimizing the duration of postinduction apnoea.Study designProspective, randomized, blinded clinical trial.AnimalsA total of 60 client-owned dogs presented for elective neutering and radiography.MethodsDogs were randomly allocated to one of five groups (groups A–E) to have propofol at an infusion rate of 0.5, 1, 2, 3, or 4 mg kg–1 minute–1, respectively, following intramuscular premedication with methadone 0.5 mg kg–1 and dexmedetomidine 5 μg kg–1. Propofol administration was stopped when adequate conditions for tracheal intubation were identified. Time to tracheal intubation and duration of apnoea were recorded. If oxygen haemoglobin saturation decreased to < 90%, manual ventilation was initiated. A one-way analysis of covariance was conducted to compare the effect of propofol infusion rate on duration of apnoea and intubation time whilst controlling for covariates, followed by post hoc tests. The significance level was set at p < 0.05.ResultsPropofol infusion rate had a significant effect on duration of apnoea (p = 0.004) and intubation time (p < 0.001) after controlling for bodyweight and sedation scores, respectively. The adjusted means (± standard error) of duration of apnoea were significantly shorter in groups A and B (49 ± 39 and 67 ± 37 seconds, respectively) than in groups C, D and E (207 ± 34, 192 ± 36 and 196 ± 34 seconds, respectively). Group B (115 ± 10 seconds) had a significantly shorter intubation time than group A (201 ± 10 seconds, p < 0.001).Conclusions and clinical relevanceAn infusion rate of 1.0 mg kg–1 minute–1 (group B) appears to offer the optimal compromise between speed of induction and duration of postinduction apnoea.  相似文献   

13.
ObjectiveTo evaluate the effects of the co-administration of midazolam on the dose requirement for propofol anesthesia induction, heart rate (HR), systolic arterial pressure (SAP) and the incidence of excitement.Study designProspective, randomized, controlled and blinded clinical study, with owner consent.AnimalsSeventeen healthy, client owned dogs weighing 28 ± 18 kg and aged 4.9 ± 3.9 years old.MethodsDogs were sedated with acepromazine 0.025 mg kg?1 and morphine 0.25 mg kg?1 intramuscularly (IM), 30 minutes prior to induction of anesthesia. Patients were randomly allocated to receive midazolam (MP; 0.2 mg kg?1) or sterile normal saline (CP; 0.04 mL kg?1) intravenously (IV) over 15 seconds. Propofol was administered IV immediately following test drug and delivered at 3 mg kg?1 minute?1 until intubation was possible. Scoring of pre-induction sedation, ease of intubation, quality of induction, and presence or absence of excitement following co-induction agent, was recorded. HR, SAP and respiratory rate (fR) were obtained immediately prior to, immediately following, and 5 minutes following induction of anesthesia.ResultsThere were no significant differences between groups with regard to weight, age, gender, or sedation. Excitement occurred in 5/9 dogs following midazolam administration, with none noted in the control group. The dose of propofol administered to the midazolam group was significantly less than in the control group. Differences in HR were not significant between groups. SAP was significantly lower in the midazolam group compared with baseline values 5 minutes after its administration. However, values remained clinically acceptable.Conclusions and clinical relevanceThe co-administration of midazolam with propofol decreased the total dose of propofol needed for induction of anesthesia in sedated healthy dogs, caused some excitement and a clinically unimportant decrease in SAP.  相似文献   

14.
ObjectiveTo compare the effects of propofol and alfaxalone on respiration in cats.Study designRandomized, ‘blinded’, prospective clinical trial.AnimalsTwenty cats undergoing ovariohysterectomy.MethodsAfter premedication with medetomidine 0.01 mg kg−1 intramuscularly and meloxicam 0.3 mg kg−1 subcutaneously, the cats were assigned randomly into two groups: group A (n = 10) were administered alfaxalone 5 mg kg−1 minute−1 followed by 10 mg kg−1 hour−1 intravenously (IV) and group P (n = 10) were administered propofol 6 mg kg−1 minute−1 followed by 12 mg kg−1hour−1 IV for induction and maintenance of anaesthesia, respectively. After endotracheal intubation, the tube was connected to a non-rebreathing system delivering 100% oxygen. The anaesthetic maintenance drug rate was adjusted (± 0.5 mg kg−1 hour−1) every 5 minutes according to a scoring sheet based on physiologic variables and clinical signs. If apnoea > 30 seconds, end-tidal carbon dioxide (Pe′CO2) > 7.3 kPa (55 mmHg) or arterial haemoglobin oxygen saturation (SpO2) < 90% occurred, manual ventilation was provided. Methadone was administered postoperatively. Data were analyzed using independent-samples t-tests, Fisher's exact test, linear mixed-effects models and binomial test.ResultsManual ventilation was required in two and eight of the cats in group A and P, respectively (p = 0.02). Two cats in both groups showed apnoea. Pe′CO2 > 7.3 kPa was recorded in zero versus four and SpO2 < 90% in zero versus six cats in groups A and P respectively. Induction and maintenance dose rates (mean ± SD) were 11.6 ± 0.3 mg kg−1 and 10.7 ± 0.8 mg kg−1 hour−1 for alfaxalone and 11.7 ± 2.7 mg kg−1 and 12.4 ± 0.5 mg kg−1 hour−1 for propofol.Conclusion and clinical relevanceAlfaxalone had less adverse influence on respiration than propofol in cats premedicated with medetomidine. Alfaxalone might be better than propofol for induction and maintenance of anaesthesia when artificial ventilation cannot be provided.  相似文献   

15.
ObjectiveTo evaluate the clinical efficacy and cardiorespiratory effects of alfaxalone as an anaesthetic induction agent in dogs with moderate to severe systemic disease.Study designRandomized prospective clinical study.AnimalsForty dogs of physical status ASA III-V referred for various surgical procedures.MethodsDogs were pre-medicated with intramuscular methadone (0.2 mg kg?1) and allocated randomly to one of two treatment groups for induction of anaesthesia: alfaxalone (ALF) 1–2 mg kg?1 administered intravenously (IV) over 60 seconds or fentanyl 5 μg kg?1 with diazepam 0.2 mg kg?1± propofol 1–2 mg kg?1 (FDP) IV to allow endotracheal intubation. Anaesthesia was maintained with isoflurane in oxygen and fentanyl infusion following both treatments. All dogs were mechanically ventilated to maintain normocapnia. Systolic blood pressure (SAP) was measured by Doppler ultrasound before and immediately after anaesthetic induction, but before isoflurane administration. Parameters recorded every 5 minutes throughout subsequent anaesthesia were heart and respiratory rates, end-tidal partial pressure of carbon dioxide and isoflurane, oxygen saturation of haemoglobin and invasive systolic, diastolic and mean arterial blood pressure. Quality of anaesthetic induction and recovery were recorded. Continuous variables were assessed for normality and analyzed with the Mann Whitney U test. Repeated measures were log transformed and analyzed with repeated measures anova (p < 0.05).ResultsTreatment groups were similar for continuous and categorical data. Anaesthetic induction quality was good following both treatments. Pre-induction and post-induction systolic blood pressure did not differ between treatments and there was no significant change after induction. The parameters measured throughout the subsequent anaesthetic procedures did not differ between treatments. Quality of recovery was very, quite or moderately smooth.Conclusions and clinical relevanceInduction of anaesthesia with alfaxalone resulted in similar cardiorespiratory effects when compared to the fentanyl-diazepam-propofol combination and is a clinically acceptable induction agent in sick dogs.  相似文献   

16.
ObjectiveTo compare the effects of intravenous (IV) lidocaine and fentanyl on the cough reflex and autonomic response during endotracheal intubation in dogs.Study designRandomized, blinded, superiority clinical trial.AnimalsA total of 46 client-owned dogs undergoing magnetic resonance imaging.MethodsAfter intramuscular methadone (0.2 mg kg–1), dogs were randomized to be administered either IV lidocaine (2 mg kg–1; group L) or fentanyl (7 μg kg–1; group F). After 5 minutes, alfaxalone was administered until endotracheal intubation was possible (1 mg kg–1 IV over 40 seconds followed by 0.4 mg kg–1 increments to effect). Total dose of alfaxalone was recorded and cough reflex at endotracheal intubation was scored. Heart rate (HR) was continuously recorded, Doppler systolic arterial blood pressure (SAP) was measured every 20 seconds. Vasovagal tonus index (VVTI) and changes (Δ) in HR, SAP and VVTI between pre-intubation and intubation were calculated. Groups were compared using univariate and multivariate analysis. Statistical significance was set as p < 0.05.ResultsGroup F included 22 dogs and group L 24 dogs. The mean (± standard deviation) alfaxalone dose was 1.1 (± 0.2) and 1.35 (± 0.3) mg kg–1 in groups F and L, respectively (p = 0.0008). At intubation, cough was more likely in group L (odds ratio = 11.3; 95% confidence intervals, 2.1 – 94.2; p = 0.01) and HR increased in 87.5% and 54.5% of groups L and F, respectively (p = 0.02). The median (range) ΔHR between pre-intubation and intubation was higher (13.1%; – 4.3 to + 55.1) in group L (p = 0.0021). Between groups, SAP and VVTI were similar.Conclusion and clinical relevanceAt the stated doses, whilst reducing the alfaxalone dose, fentanyl is superior to lidocaine in suppressing the cough reflex and blunting the increase in HR at endotracheal intubation in dogs premedicated with methadone.  相似文献   

17.
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18.
ObjectiveTo investigate the cardiorespiratory, nociceptive and endocrine effects of the combination of propofol and remifentanil, in dogs sedated with acepromazine.Study designProspective randomized, blinded, cross-over experimental trial.AnimalsTwelve healthy adult female cross-breed dogs, mean weight 18.4 ± 2.3 kg.MethodsDogs were sedated with intravenous (IV) acepromazine (0.05 mg kg?1) followed by induction of anesthesia with IV propofol (5 mg kg?1). Anesthesia was maintained with IV propofol (0.2 mg kg?1 minute?1) and remifentanil, infused as follows: R1, 0.125 μg kg?1 minute?1; R2, 0.25 μg kg?1 minute?1; and R3, 0.5 μg kg?1 minute?1. The same dogs were administered each dose of remifentanil at 1-week intervals. Heart rate (HR), mean arterial pressure (MAP), respiratory rate (fR), end tidal CO2 (Pe′CO2), arterial hemoglobin O2 saturation, blood gases, and rectal temperature were measured before induction, and 5, 15, 30, 45, 60, 75, 90, and 120 minutes after beginning the infusion. Nociceptive response was investigated by electrical stimulus (50 V, 5 Hz and 10 ms). Blood samples were collected for plasma cortisol measurements. Statistical analysis was performed by anova (p < 0.05).ResultsIn all treatments, HR decreased during anesthesia with increasing doses of remifentanil, and increased significantly immediately after the end of infusion. MAP remained stable during anesthesia (72–98 mmHg). Antinociception was proportional to the remifentanil infusion dose, and was considered satisfactory only with R2 and R3. Plasma cortisol concentration decreased during anesthesia in all treatments. Recovery was smooth and fast in all dogs.Conclusions and clinical relevanceInfusion of 0.25–0.5 μg kg?1 minute?1 remifentanil combined with 0.2 mg kg?1 minute?1 propofol produced little effect on arterial blood pressure and led to a good recovery. The analgesia produced was sufficient to control the nociceptive response applied by electrical stimulation, suggesting that it may be appropriate for performing surgery.  相似文献   

19.
ObjectiveTo determine in dogs the effects of medetomidine and butorphanol, alone and in combination, on the induction dose of alfaxalone and to describe the induction and intubation conditions.Study designProspective, randomized, blinded clinical trial.AnimalsEighty-five client-owned dogs (ASA 1 or 2).MethodsSubjects were block randomized to treatment group according to temperament. The treatment groups were: medetomidine 4 μg kg?1 (M), butorphanol 0.1 mg kg?1 (B), or a combination of both (MB), all administered intramuscularly. After 30 minutes, a sedation score was assigned, and alfaxalone 0.5 mg kg?1 was administered intravenously over 60 seconds by an observer who was unaware of treatment group. Tracheal intubation conditions were assessed and, if tracheal intubation was not possible after 20 seconds, further boluses of 0.2 mg kg?1 were given every 20 seconds until intubation was achieved. Induction dose and adverse events (sneezing, twitching, paddling, excitement, apnoea and cyanosis) were recorded; induction quality and intubation conditions were scored and recorded.ResultsThe mean dose of alfaxalone required for induction was similar for groups M and B: 1.2 ± 0.4 mg kg?1. The mean dose requirement for group MB (0.8 ± 0.3 mg kg?1) was lower than groups M and B (p < 0.0001). Induction dose was not influenced by temperament or level of sedation. Induction and intubation scores did not differ between treatment groups. Adverse events were noted in 16 dogs; there was no association with treatment group, temperament or level of sedation.Conclusions and clinical relevanceMedetomidine and butorphanol administered in combination reduce the anaesthetic induction dose of alfaxalone compared to either agent alone. This difference should be taken into account when using this combination of drugs in a clinical setting.  相似文献   

20.
ObjectiveTo assess the effects of varying the sequence of midazolam and propofol administration on the quality of induction, cardiorespiratory parameters and propofol requirements in dogs.Study designRandomized, controlled, clinical study.AnimalsThirty‐three client owned dogs (ASA I‐III, 0.5–10 years, 5–30 kg).MethodsDogs were premedicated with acepromazine (0.02 mg kg?1) and morphine (0.4 mg kg?1) intramuscularly. After 30 minutes, group midazolam‐propofol (MP) received midazolam (0.25 mg kg?1) intravenously (IV) before propofol (1 mg kg?1) IV, group propofol‐midazolam (PM) received propofol before midazolam IV at the same doses, and control group (CP) received saline IV, instead of midazolam, before propofol. Supplementary boluses of propofol (0.5 mg kg?1) were administered to effect to all groups until orotracheal intubation was completed. Behaviour after midazolam administration, quality of sedation and induction, and ease of intubation were scored. Heart rate (HR), respiratory rate, and systolic arterial blood pressure were recorded before premedication, post‐premedication, after midazolam or saline administration, and at 0, 2, 5, and 10 minutes post‐intubation. End‐tidal CO2 and arterial oxygen haemoglobin saturation were recorded at 2, 5 and 10 minutes post‐intubation.ResultsQuality of sedation and induction, and ease of intubation were similar in all groups. Incidence of excitement was higher in the MP compared to CP (p = 0.014) and PM (p = 0.026) groups. Propofol requirements were decreased in MP and PM groups with respect to CP (p < 0.001), and in PM compared to MP (p = 0.022). The HR decreased after premedication in all groups, and increased after midazolam and subsequent times in MP (p = 0.019) and PM (p = 0.001) groups. Incidence of apnoea and paddling was higher in CP (p = 0.005) and MP (p = 0.031) groups than in PM.Conclusions and clinical relevanceAdministration of midazolam before propofol reduced propofol requirements although caused mild excitement in some dogs. Administration of propofol before midazolam resulted in less excitatory phenomena and greater reduction of propofol requirements.  相似文献   

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