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1.
Bruno H. Pypendop Kristine T. Siao M.G. Ranasinghe Kirby Pasloske 《Veterinary anaesthesia and analgesia》2018,45(3):269-277
Objective
To determine the effective plasma alfaxalone concentration for the production of immobility in cats.Study design
Prospective up-and-down study.Animals
Sixteen 1–2 year old male castrated research cats.Methods
Cats were instrumented with catheters in a jugular and a medial saphenous vein. Alfaxalone was administered via the medial saphenous catheter, using a target-controlled infusion system. The infusion lasted for approximately 32 minutes. A noxious stimulus (tail clamp) was applied 30 minutes after starting the alfaxalone infusion, until the cat moved or 60 seconds had elapsed, whichever occurred first. The target alfaxalone concentration was set at 5 mg L?1 in the first cat and increased or decreased by 1 mg L?1 in subsequent cats, if the previous cat had moved or not moved in response to stimulation, respectively. This was continued until six independent crossovers (different responses in pairs of subsequent cats) had been observed. Blood samples were collected before alfaxalone administration, and 15 and 31 minutes after starting the administration, for the determination of plasma alfaxalone concentration using liquid chromatography/tandem mass spectrometry. The alfaxalone concentration yielding a probability of immobility in 50% (EC50), 95% (EC95) and 99% (EC99) of the population, and their respective 95% Wald confidence intervals were calculated.Results
The EC50, EC95 and EC99 for alfaxalone-induced immobility were 3.7 (2.4–4.9), 6.2 (4.7–) and 7.6 (5.5–) mg L?1, respectively.Conclusions and clinical relevance
The effective plasma alfaxalone concentration for immobility in cats was determined. This value will help in the design of pharmacokinetic-based dosing regimens. 相似文献2.
Bruno H. Pypendop M.G. Ranasinghe Kirby Pasloske 《Veterinary anaesthesia and analgesia》2018,45(4):459-466
Objective
To compare the performance of an alfaxalone constant rate intravenous (IV) infusion versus a 3-step IV infusion, both following a loading dose, for the maintenance of a target plasma alfaxalone concentration of 7.6 mg L–1 (effective plasma alfaxalone concentration for immobility in 99% of the population) in cats.Study design
Prospective randomized crossover study.Animals
A group of six healthy, adult male neutered cats.Methods
Catheters were placed in a jugular vein for blood sampling and in a medial saphenous vein for drug administration. An IV bolus of alfaxalone (2 mg kg–1) was administered, followed by either 0.2 mg kg?1 minute?1 for 240 minutes (single infusion; SI) or 0.4 mg kg?1 minute?1 for 10 minutes, then 0.3 mg kg?1 minute?1 for 30 minutes, and then 0.2 mg kg?1 minute?1 for 200 minutes (3-step infusion; 3-step). Plasma alfaxalone concentration was measured at six time points during the infusions. Measures of performance were calculated for each infusion regimen and compared using the paired Wilcoxon signed-rank test.Results
Median (range) absolute performance error, divergence, median prediction error and wobble were 15 (8–19)%, ?8 (?12 to ?6)% hour?1, ?12 (?19 to ?7)% and 10 (8–19)%, respectively, in the SI treatment, and 6 (2–16)%, 0 (?13 to 2)% hour?1, 1 (?16 to 4)% and 4 (3–6)% respectively, in the 3-step treatment and were significantly smaller in the 3-step treatment than in the SI treatment.Conclusion and clinical relevance
After IV administration of a bolus dose, a 3-step infusion regimen can better maintain stable plasma alfaxalone concentrations close to the target concentration than a single constant rate infusion. 相似文献3.
Wendy A. Goodwin Kirby Pasloske Helen L. Keates Millaganamada Gedara Ranasinghe Solomon Woldeyohannes Nigel Perkins 《Veterinary anaesthesia and analgesia》2019,46(2):188-199
Objective
To determine the suitability of alfaxalone total intravenous (IV) anaesthesia in horses and concurrently evaluate infusion rates, cardiovascular effects, pharmacokinetics and the quality of the anaesthetic recovery period.Study design
Prospective, experimental study.Animals
Eight Standardbred horses.Methods
Horses were premedicated with IV acepromazine (0.03 mg kg–1) and xylazine (1 mg kg–1) and anaesthesia was induced with guaifenesin (35 mg kg–1) and alfaxalone (1 mg kg–1). Anaesthesia was maintained for 180 minutes using an IV infusion of alfaxalone at a rate determined by a horse’s response to a supramaximal electrical noxious stimulus. Venous blood samples were regularly collected to determine alfaxalone plasma concentrations and for pharmacokinetic analysis. Cardiopulmonary variables were monitored and the quality of the anaesthetic recovery period scored.Results
The median (range) alfaxalone infusion rate was 3.1 (2.4–4.3) mg kg–1 hour–1. The mean ± standard deviation plasma elimination half-life, plasma clearance and volume of distribution for alfaxalone were 41 minutes, 25 ± 6.3 mL minute–1 kg–1 and 1.6 ± 0.5 L kg–1, respectively. During anaesthesia, mean arterial blood pressure was maintained above 70 mmHg in all horses. Cardiac index reached a minimum value (68% of baseline values) immediately after induction of anaesthesia and was maintained between 74% and 90% of baseline values for the remainder of the anaesthetic protocol. Following the cessation of the alfaxalone infusion, six of eight horses exhibited muscle tremors and paddling. All horses stood without incident on the first or second attempt with a median recovery score of 4.5 (good to excellent).Conclusions and clinical relevance
Anaesthesia in horses can be maintained with an infusion of alfaxalone at approximately 3 mg kg–1 hour–1. The alfaxalone infusion rates used resulted in minimal haemodynamic changes and good recovery quality. Mean alfaxalone plasma concentration was stable over the infusion period and clearance rates were similar to previously published single-dose alfaxalone studies in horses. 相似文献4.
Objective
To characterise, as a clinical study, the pharmacokinetics and pharmacodynamics and describe the hypnotic effect of the neurosteroid alfaxalone (3α-hydroxy-5 α-pregnane-11, 20-dione) formulated with 2-hydroxypropyl-β-cyclodextrin in male and female rats.Study design
Prospective, experimental laboratory study.Animals
A total of 12 (six male and six female) adult, aged-matched Sprague Dawley rats.Methods
Surgery and instrumentation was performed under isoflurane anaesthesia in an oxygen/nitrous oxide mixture (1:2) and local anaesthetic infiltration. All animals received a loading dose (1.67 mg kg?1 minute?1) for 2.5 minutes followed by a constant rate infusion (0.75 mg kg?1 minute?1) for 120 minutes of alfaxalone. Isoflurane and nitrous oxide was discontinued 2.5 minutes after the alfaxalone infusion started. Cardiorespiratory variables (heart rate, respiratory rate, arterial blood pressure and end tidal carbon dioxide tension) and clinical signs of anaesthetic depth were evaluated throughout anaesthesia. Carotid artery blood samples were collected at strategic time points for blood gas analysis, haematology, biochemistry, and plasma concentrations of alfaxalone. Plasma samples were assayed using liquid chromatography-mass spectrometry.Results
There were significant differences between the sexes for plasma clearance (p = 0.0008), half-life (p = 0.0268) and mean residence time (p = 0.027). Mean arterial blood pressure was significantly higher in the male rats (p = 0.0255).Conclusions and clinical relevance
This study confirms that alfaxalone solubilised in 2-hydroxypropyl-β-cyclodextrin provides excellent total intravenous anaesthesia in rats. Sex-based differences in pharmacokinetics and pharmacodynamics were demonstrated and must be considered when designing biomedical research models using alfaxalone. 相似文献5.
6.
PenTing Liao Melissa Sinclair Alexander Valverde Cornelia Mosley Heather Chalmers Shawn Mackenzie Brad Hanna 《Veterinary anaesthesia and analgesia》2017,44(5):1016-1026
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7.
Sarah E. Bigby Jennifer E. Carter Sébastien Bauquier Thierry Beths 《Veterinary anaesthesia and analgesia》2017,44(4):905-909
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. 相似文献8.
Lauren E. James Catherine JA. Williams Mads F. Bertelsen Tobias Wang 《Veterinary anaesthesia and analgesia》2018,45(3):329-337
Objective
To characterise the minimum dose of intramuscular alfaxalone required to facilitate intubation for mechanical ventilation, and to investigate the impact of cranial versus caudal injection on anaesthetic depth.Study design
Randomised crossover study.Animals
Six healthy juvenile ball pythons (Python regius).Methods
Three dosages (10, 20 and 30 mg kg–1) of alfaxalone were administered to each python in a caudal location with a minimum 2 weeks washout. Induction and recovery were monitored by assessing muscle tone, righting reflex, response to a noxious stimulus and the ability to intubate. A subsequent experiment assessed the influence of injection site by comparing administration of 20 mg kg–1 alfaxalone in a cranial location (1 cm cranial to the heart) with the caudal site. Respiration rate was monitored throughout, and when intubation was possible, snakes were mechanically ventilated.Results
Regardless of dose and injection site, maximum effect was reached within 10.0 ± 2.7 minutes. When administered at the caudal injection site, intubation was only successful after a dosage of 30 mg kg-1, which is higher than in previous reports for other reptiles. However, intubation was possible in all cases after 7.2 ± 1.6 minutes upon cranial administration of 20 mg kg–1, and anaesthetic duration was significantly lengthened (p < 0.001). Both 30 mg kg–1 at the caudal site and 20 mg kg–1 at the cranial site led to apnoea approximately 10 minutes post-injection, at which time the snakes were intubated and mechanically ventilated.Conclusions and clinical relevance
Alfaxalone provided rapid, smooth induction when administered intramuscularly to pythons, and may serve as a useful induction agent prior to provision of volatile anaesthetics. The same dosage injected in the cranial site led to deeper anaesthesia than when injected caudally, suggesting that shunting to the liver and first-pass metabolism of alfaxalone occur when injected caudally, via the renal portal system. 相似文献9.
Ana Zapata Francisco G. Laredo Mayte Escobar Amalia Agut Marta Soler Eliseo Belda 《Veterinary anaesthesia and analgesia》2018,45(5):609-617
Objective
To study the effect of alternating the order of midazolam and alfaxalone administration on the incidence of behavioural changes, alfaxalone induction dose and some cardiorespiratory variables in healthy dogs.Study design
Prospective, randomized, controlled, clinical trial.Animals
A total of 33 client-owned dogs undergoing elective procedures.Methods
Following intramuscular acepromazine (0.02 mg kg?1) and morphine (0.4 mg kg?1) premedication, anaesthesia was induced intravenously (IV) with a co-induction of either midazolam (0.25 mg kg?1) prior to alfaxalone (0.5 mg kg?1; group MA), or alfaxalone followed by midazolam at identical doses (group AM). The control group (CA) was administered normal saline IV prior to alfaxalone administration. Additional alfaxalone (0.25 mg kg?1 increments) was administered as required in all groups until orotracheal intubation was possible. Changes in behaviour, quality of induction, ease of intubation and incidence of adverse events at induction were recorded. Heart rate (HR), respiratory rate (fR) and systolic arterial blood pressure (SAP) were measured before treatments (baseline values), 30 minutes after premedication and at 0, 2, 5 and 10 minutes postintubation.Results
The incidence of excitement was higher in group MA compared with groups CA (p = 0.005) and AM (p = 0.013). The mean induction dose of alfaxalone was lower in group AM compared with group CA (p = 0.003). Quality of induction and ease of intubation were similar among groups. Mean HR values decreased after premedication and increased after alfaxalone administration in all groups. Mean SAP values were similar between groups. The number of animals that required manual ventilation was higher in the MA group.Conclusions and clinical relevance
Despite a lower occurrence of adverse events at induction in group AM compared with group MA and a reduction of alfaxalone dose requirement in group AM compared with group CA, the use of an alfaxalone–midazolam co-induction does not seem to produce any cardiovascular or respiratory benefits in healthy dogs. 相似文献10.
Fabio Leonardi Giovanna Lucrezia Costa Claudia Dina Interlandi Jessica Rosa Andrea Ghidelli Marcello Musicò 《Veterinary anaesthesia and analgesia》2019,46(1):79-83
Objective
To evaluate the anaesthetic effects of three different alfaxalone doses to induce anaesthesia in goldfish.Study design
Prospective, randomized, clinical study.Animals
Thirty goldfish undergoing skin scraping, gill examination and stool collection.Methods
Each fish was transferred to an individual 4 L induction tank and randomly allocated into one of three groups (n = 10), in which alfaxalone was administered at concentrations of 6, 7 or 9 mg L–1. The depth of anaesthesia was evaluated by approach reaction, equilibrium, opercular movement and reaction to tactile stimuli. Sedation, light anaesthesia, surgical anaesthesia and recovery times were recorded. Data were analyzed with analysis of variance. A p value <0.05 was considered significant.Results
Surgical anaesthesia was achieved in all fish. Goldfish induced with alfaxalone 7 and 9 mg L–1 showed a mild excitement phase. Time to sedation of the 6 mg L–1 dose (5.89 ± 0.40 minutes) was significantly longer compared to the 7 mg L–1 (3.97 ± 0.40 minutes) and 9 mg L–1 doses (3.94 ± 0.40 minutes). Times to light anaesthesia and surgical anaesthesia of the 9 mg L–1 dose (7.65 ± 1.04 and 9.60 ± 1.84 minutes, respectively) were significantly faster compared with those of the 6 mg L–1 dose (13.79 ± 1.04 and 19.75 ± 1.84 minutes, respectively) and the 7 mg L–1 dose (13.55 ± 1.04 and 21.24 ± 1.84 minutes, respectively). No significant differences were recorded in recovery time. Cessation of opercular movement was recorded in two fish induced with 7 mg L–1 and in two induced with 9 mg L–1. No mortality occurred.Conclusions
and clinical relevance Alfaxalone is a reliable agent for immersion anaesthesia in goldfish. Immersion in water containing 6 mg alfaxalone L–1 provided smooth induction of anaesthesia, and no obvious side effects were encountered. Higher doses shortened induction time and caused respiratory depression and excitatory movements. 相似文献11.
Eugenio Gaudio Laura Voltan Giulia Maria De Benedictis 《Veterinary anaesthesia and analgesia》2018,45(3):351-356
Objective
To evaluate the clinical effects and quality of sedation, induction, maintenance and recovery in Lemur catta after dexmedetomidine–butorphanol–midazolam sedation and alfaxalone anaesthesia.Study design
Prospective, observational study.Animals
Six male L. catta weighing 3.0 ± 0.6 kg undergoing surgical castration.Methods
Lemurs were sedated with intramuscular dexmedetomidine (0.015 mg kg?1), butorphanol (0.2 mg kg?1) and midazolam (0.2 mg kg?1). Anaesthesia was induced with intravenous alfaxalone 0.5 mg kg?1 over 60 seconds; further boluses were administered until tracheal intubation was feasible and final dose recorded. Alfaxalone continuous infusion was used to maintain anaesthesia. Atipamezole (0.15 mg kg?1) was administered during recovery. The quality of sedation, induction, intubation, maintenance and recovery was assessed using a scoring system. Physiological parameters were recorded during sedation, maintenance and recovery.Results
Sedation was achieved in 13.6 ± 5.6 minutes and no reactions were observed during handling or venepuncture. The mean dose of alfaxalone required for induction and maintenance was 2.09 ± 0.65 and 0.08 ± 0.02 mg kg?1 minute?1, respectively. Quality of induction, intubation and maintenance was good in almost all animals. Mild self-limiting muscle twitching was observed after alfaxalone administration in three animals. Cardiorespiratory function was stable in all animals but one. One lemur showed respiratory depression and required oxygen administration and manual ventilation. The mean maintenance time was 29.2 ± 7.4 minutes. The mean times from the end of alfaxalone administration to extubation, atipamezole administration and full recovery were: 15.3 ± 8.0, 22.2 ± 4.6 and 60.0 ± 8.4 minutes, respectively. Recovery was considered good in all animals.Conclusions and clinical relevance
Dexmedetomidine–butorphanol–midazolam combination provided reliable sedation and adequate muscle relaxation in L. catta. Alfaxalone proved to be a useful drug for induction and maintenance of anaesthesia and might be considered an option for injectable anaesthesia in lemurs. 相似文献12.
Katherine J. Bennett Reza Seddighi Kaitlin A. Moorhead Kristin Messenger Sherry K. Cox Xiaocun Sun Kirby Pasloske Bruno H. Pypendop Thomas J. Doherty 《Veterinary anaesthesia and analgesia》2019,46(2):173-181
Objective
To determine the effect of fentanyl on the induction dose and minimum infusion rate of alfaxalone required to prevent movement in response to a noxious stimulus (MIRNM) in dogs.Study design
Experimental crossover design.Animals
A group of six healthy, adult, intact female mixed-breed dogs, weighing 19.7 ± 1.3 kg.Methods
Dogs were randomly administered one of three treatments at weekly intervals: premedication with 0.9% saline (treatment A), fentanyl 5 μg kg–1 (treatment ALF) or fentanyl 10 μg kg–1 (treatment AHF), administered intravenously over 5 minutes. Anesthesia was induced 5 minutes later with incremental doses of alfaxalone to achieve intubation and was maintained for 90 minutes in A with alfaxalone (0.12 mg kg–1 minute–1), in ALF with alfaxalone (0.09 mg kg–1 minute–1) and fentanyl (0.1 μg kg–1 minute–1) and in AHF with alfaxalone (0.06 mg kg–1 minute–1) and fentanyl (0.2 μg kg–1 minute–1). The alfaxalone infusion was increased or decreased by 0.006 mg kg–1 minute–1 based on positive or negative response to antebrachium stimulation (50 V, 50 Hz, 10 ms). Data were analyzed using a mixed-model anova and presented as least squares means ± standard error.Results
Alfaxalone induction doses were 3.50 ± 0.13 (A), 2.17 ± 0.10 (ALF) and 1.67 ± 0.10 mg kg–1 (AHF) and differed among treatments (p < 0.05). Alfaxalone MIRNM was 0.17 ± 0.01 (A), 0.10 ± 0.01 (ALF) and 0.07 ± 0.01 mg kg–1 minute–1 (AHF) and differed among treatments. ALF and AHF decreased the MIRNM by 44 ± 8% and 62 ± 5%, respectively (p < 0.05). Plasma alfaxalone concentrations at MIRNM were 5.82 ± 0.48 (A), 4.40 ± 0.34 (ALF) and 2.28 ± 0.09 μg mL–1 (AHF).Conclusions and clinical relevance
Fentanyl, at the doses studied, significantly decreased the alfaxalone induction dose and MIRNM. 相似文献13.
Dario dOvidio Francesco Marino Emilio Noviello Enrico Lanaro Paolo Monticelli Chiara Adami 《Veterinary anaesthesia and analgesia》2018,45(2):183-189
Objective
To evaluate the efficacy and side effects of alfaxalone administered intramuscularly (IM) as a sedative agent in guinea pigs undergoing survey radiographs.Study design
Prospective clinical trial.Animals
A total of 30 client-owned guinea pigs.Methods
Following baseline assessments, 5 mg kg?1 alfaxalone was administered IM. Heart rate, arterial haemoglobin oxygen saturation, respiratory rate, rectal body temperature, palpebral reflex, response to toe and ear pinch, righting reflex, posture, jaw tone and reaction to manipulation were assessed before and after sedation at 5-minute intervals. The time elapsed from onset of sedation to return of locomotion and coordinated limb movements, the quality of recovery and the occurrence of undesired effects were observed and recorded.Results
The mean ± standard deviation onset of sedation was 2.7 ± 0.6 minutes. The physiological variables remained within normal ranges until completion of the procedure. Palpebral reflex and responsiveness to both ear and toe pinch were maintained during sedation. Neither hypoxaemia nor hypothermia was observed. The duration of sedation was 29.3 ± 3.2 minutes. Sedation and recovery were uneventful, and adverse effects were not observed.Conclusions and clinical relevance
In conclusion, 5 mg kg?1 of IM alfaxalone represents a valuable sedation protocol for healthy guinea pigs undergoing minor noninvasive procedures. Further trials are required to investigate its cardiovascular effects, clinical usefulness in unhealthy patients and its combined use with analgesics for procedures associated with nociception. 相似文献14.
Jill K Maney H Edward Durham Kathleen P Goucher Erika L Little 《Veterinary anaesthesia and analgesia》2018,45(4):539-544
Objective
To compare the induction and recovery characteristics and selected cardiopulmonary variables of midazolam–alfaxalone or midazolam–ketamine in donkeys sedated with xylazine.Study design
Randomized, blinded, crossover experimental trial.Animals
A group of seven adult male castrated donkeys weighing 164 ± 14 kg.Methods
Donkeys were randomly administered midazolam (0.05 mg kg?1) and alfaxalone (1 mg kg?1) or midazolam (0.05 mg kg?1) and ketamine (2.2 mg kg?1) intravenously following sedation with xylazine, with ≥ 7 days between treatments. Donkeys were not endotracheally intubated and breathed room air. Time to lateral recumbency, first movement, sternal recumbency and standing were recorded. Induction and recovery were assigned scores between 1 (very poor) and 5 (excellent). Heart rate (HR), respiratory rate (fR), invasive arterial blood pressures and arterial blood gases were measured before induction and every 5 minutes following induction until first movement.Results
Time to lateral recumbency (mean ± standard deviation) was shorter after alfaxalone (29 ± 10 seconds) compared with ketamine (51 ± 9 seconds; p = 0.01). Time to first movement was the same between treatments (27 versus 23 minutes). Time to standing was longer with alfaxalone (58 ± 15 minutes) compared with ketamine (33 ± 8 minutes; p = 0.01). Recovery score [median (range)] was of lower quality with alfaxalone [3 (2–5)] compared with ketamine [5 (3–5); p = 0.03]. There were no differences in HR, fR or arterial pressures between treatments. No clinically important differences in blood gases were identified between treatments. Five of seven donkeys administered alfaxalone became hypoxemic (PaO2 <60 mmHg; 8.0 kPa) and all donkeys administered ketamine became hypoxemic (p = 0.13).Conclusions and clinical relevance
Both midazolam–alfaxalone and midazolam–ketamine produced acceptable anesthetic induction and recovery in donkeys after xylazine sedation. Hypoxemia occurred with both treatments. 相似文献15.
Julia Deutsch Colette Jolliffe Emma Archer Elizabeth A. Leece 《Veterinary anaesthesia and analgesia》2017,44(4):794-802
Objective
To assess quality of sedation following intramuscular (IM) injection of two doses of alfaxalone in combination with butorphanol in cats.Study design
Prospective, randomized, ‘blinded’ clinical study.Animals
A total of 38 cats undergoing diagnostic imaging or noninvasive procedures.Methods
Cats were allocated randomly to be administered butorphanol 0.2 mg kg?1 combined with alfaxalone 2 mg kg?1 (group AB2) or 5 mg kg?1 (group AB5) IM. If sedation was inadequate, alfaxalone 2 mg kg?1 IM was administered and cats were excluded from further analysis. Temperament [1 (friendly) to 5 (aggressive)], response to injection, sedation score at 2, 6, 8, 15, 20, 30, 40, 50 and 60 minutes, overall sedation quality scored after data collection [1 (excellent) to 4 (inadequate)] and recovery quality were assessed. Heart rate (HR), respiratory rate (fR) and arterial haemoglobin saturation (SpO2) were recorded every 5 minutes. Groups were compared using t tests and Mann–Whitney U tests. Sedation was analysed using two-way anova, and additional alfaxalone using Fisher's exact test (p < 0.05).Results
Groups were similar for sex, age, body mass and response to injection. Temperament score was lower in group AB2 [2 (1–3)] compared to AB5 [3 (1–5)] (p = 0.006). Group AB5 had better sedation at 6, 8, 20 and 30 minutes and overall sedation quality was better in AB5 [1 (1–3)], compared to AB2 [3 (1–4)] (p = 0.0001). Additional alfaxalone was required for 11 cats in AB2 and two in AB5 (p = 0.005). Recovery quality, HR, fR and SpO2 were similar. Seven cats required oxygen supplementation. Complete recovery times were shorter in AB2 (81.8 ± 24.3 versus 126.6 ± 33.3 minutes; p = 0.009). Twitching was the most common adverse event.Conclusions and clinical relevance
In combination with butorphanol, IM alfaxalone at 5 mg kg?1 provided better quality sedation than 2 mg kg?1. Monitoring of SpO2 is recommended. 相似文献16.
Brighton T. Dzikiti Patience S. Ndawana Loveness N. Dzikiti Frik G. Stegmann 《Veterinary anaesthesia and analgesia》2018,45(3):285-294
Objective
To determine the minimum infusion rate (MIR) of alfaxalone required to prevent purposeful movement in response to standardized stimulation while co-administered with lidocaine at three different doses by constant infusion rate infusion (CRI) in goats.Study design
Prospective, blinded, randomized crossover, experimental.Animals
A total of eight healthy goats: four does and four wethers.Methods
Anaesthetic induction was with lidocaine at 1 mg kg?1 [low dose of lidocaine (L-Lid)], 2 mg kg?1 [moderate dose (M-Lid)] or 4 mg kg?1 [high dose (H-Lid)] and alfaxalone at 2 mg kg?1. Anaesthetic maintenance was with alfaxalone initially at 9.6 mg kg?1 hour?1 combined with one of three lidocaine treatments: 3 mg kg?1 hour?1 (L-Lid), 6 mg kg?1 hour?1 (M-Lid) or 12 mg kg?1 hour?1 (H-Lid). The MIR of alfaxalone was determined by testing for responses to a stimulation in the form of clamping on a digit with a Vulsellum forceps every 30 minutes during lidocaine CRI. Basic cardiopulmonary parameters were measured.Results
The alfaxalone MIRs were 8.64 (6.72–10.56), 6.72 (6.72–8.64) and 6.72 (6.72–6.72) mg kg?1 hour?1 during L-Lid, M-Lid and H-Lid, respectively, without any significant differences among treatments. Compared to the initial rate of 9.6 mg kg?1 hour?1, these reductions in MIR are equivalent to 10, 30 and 30%, respectively. Significant increases in heart rate (HR) and arterial carbon dioxide partial pressure (PaCO2) and decreases in arterial haemoglobin saturation (SaO2), arterial oxygen partial pressure (PaO2) and respiratory frequency (fR) immediately after induction were observed during all lidocaine treatments.Conclusions and clinical relevance
Lidocaine reduces the alfaxalone MIR by up to 30% with a tendency towards a plateauing in this effect at high CRIs. Immediate oxygen supplementation might be required to prevent hypoxaemia. 相似文献17.
Daisy Norgate Gert Ter Haar Nicola Kulendra Kata Orsolya Veres-Nyéki 《Veterinary anaesthesia and analgesia》2018,45(6):729-736
Objective
To compare the effect of propofol and alfaxalone on laryngeal motion under a light plane of anaesthesia in nonbrachycephalic and brachycephalic dogs anaesthetized for nonemergency procedures.Study design
Prospective, randomized clinical trial.Animals
A total of 48 client-owned dogs (24 nonbrachycephalic and 24 brachycephalic).Methods
A standardized premedication of methadone (0.2 mg kg?1) and acepromazine (0.01 mg kg?1) was administered intramuscularly. Dogs were randomly assigned to be induced with increments of propofol (1–4 mg kg?1) or alfaxalone (0.5–2 mg kg?1). Laryngeal assessment was performed under a light plane of anaesthesia by a surgeon (GTH) who was unaware of the induction protocol. Laryngeal movement was assessed as either being present when abduction of the laryngeal cartilages upon inspiration was identified, or absent when abduction was not recognized. Simultaneously, a 60-second video was recorded. The same surgeon (GTH) and an additional surgeon (NK) re-evaluated the videos 1 month later. Categorical comparisons were studied using Chi square and Fisher’s exact test where appropriate. Pairwise evaluation of agreement between scorers was undertaken with the kappa statistic (κ).Results
There were no significant differences (p > 0.05) identified between the presence or absence of laryngeal motion between dogs administered propofol or alfaxalone, as well as when analysing nonbrachycephalic and brachycephalic dogs separately. The majority of dogs (>75%) maintained some degree of laryngeal motion with both protocols. Agreement between assessors was excellent (κ = 0.822).Conclusions
Alfaxalone maintained laryngeal motion similarly to propofol in nonbrachycephalic and brachycephalic dogs.Clinical relevance
Both agents would appear appropriate for allowing assessment of laryngeal motion in nonbrachycephalic and brachycephalic dogs. The assessment technique of subjective evaluation of laryngeal motion via peroral laryngoscopy under a light plane of anaesthesia produced consistent results amongst assessors, regardless of the induction agent used. 相似文献18.
Ryan S. Bailey Linda S. Barter Bruno H. Pypendop 《Veterinary anaesthesia and analgesia》2017,44(4):876-882
Objective
To characterize the pharmacokinetics of dexmedetomidine when administered as a short intravenous (IV) infusion to isoflurane-anesthetized rabbits.Study design
Experimental study.Animals
A total of six healthy adult female New Zealand White rabbits.Methods
Rabbits were anesthetized with isoflurane in oxygen. Following determination of isoflurane minimum alveolar concentration (MAC), the anesthetic dose was reduced to 0.7 × MAC, and dexmedetomidine hydrochloride (20 μg kg?1) was infused IV over 5 minutes. Arterial blood samples were obtained immediately before and at 1, 2, 5, 6, 7, 10, 15, 30, 60, 90, 120, 240 and 360 minutes following termination of the infusion. Samples were transferred into tubes containing ethylenediaminetetraacetic acid and centrifuged immediately. The plasma was harvested and stored at –80 °C until analyzed. Concentrations of dexmedetomidine in plasma were determined by liquid chromatography mass spectrometry. Compartment models were fitted to the time and concentration data using nonlinear regression.Results
A three-compartment model best fit the data set. Median volume of distribution at steady state and terminal half-life were 3169 mL kg?1 (range, 2182–3859 mL kg?1) and 80 minutes (range, 72–88 minutes), respectively.Conclusions and clinical relevance
The pharmacokinetics of dexmedetomidine in isoflurane-anesthetized, healthy, New Zealand White rabbits were characterized in this study. Data from this study can be used to determine dosing regimens for dexmedetomidine in isoflurane-anesthetized rabbits. 相似文献19.
Jill K. Maney 《Veterinary anaesthesia and analgesia》2017,44(5):1184-1188
Objective
To describe the sedative and physiologic effects of two doses of alfaxalone administered intramuscularly in dogs.Study design
Randomized, blinded, crossover experimental trial.Animals
Ten adult mixed-breed dogs.Methods
Dogs were assigned randomly to be administered one of three intramuscular injections [saline 0.1 mL kg?1 (S), alfaxalone 1 mg kg?1 (A1) or alfaxalone 2 mg kg?1 (A2)] on three occasions. Heart rate (HR), respiratory rate (fR) and sedation score were assessed before injection (T0) and at 5 (T5), 10 (T10), 15 (T15), 20 (T20), 30 (T30), 45 (T45) and 60 (T60) minutes postinjection. Rectal temperature was determined at T0 and T60. Adverse events occurring between the time of injection and T60 were recorded.Results
Sedation scores were higher in group A2 at T15 and T30 compared with group S. There were no additional differences between groups in sedation score. The A2 group had higher sedation scores at T15, T20 and T30 compared with T0. The A1 group had higher sedation scores at T10 and T30 compared with T0. Temperature was lower in groups A1 and A2 compared with S at T60, but was not clinically significant. There were no differences between or within groups in HR or fR. Adverse effects were observed in both A1 and A2 groups. These included ataxia (17/20), auditory hyperesthesia (5/20), visual disturbance (5/20), pacing (4/20) and tremor (3/20).Conclusions and clinical relevance
While alfaxalone at 2 mg kg?1 intramuscularly resulted in greater median sedation scores compared with saline, the range was high and adverse effects frequent. Neither protocol alone can be recommended for providing sedation in healthy dogs. 相似文献20.
Trina M. Hancock Nigel A. Caulkett Ed A. Pajor Leanna Grenwich 《Veterinary anaesthesia and analgesia》2018,45(6):858-864