Effects of dexmedetomidine and xylazine on cardiovascular function during total intravenous anaesthesia with midazolam and ketamine and recovery quality and duration in horses     

Klaus Hopster  Christina Müller  Charlotte Hopster‐Iversen  Jessica Stahl  Karl Rohn  Sabine Kästner 《Veterinary anaesthesia and analgesia》2014,41(1):25-35

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A comparison of two different ketamine and diazepam combinations with an alphaxalone and medetomidine combination for induction of anaesthesia in sheep     

VP Walsh  M Gieseg  PM Singh  SL Mitchinson 《New Zealand veterinary journal》2013,61(2):136-141

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.  相似文献   

Comparison of three anaesthetic protocols in Bennett’s wallabies (Macropus rufogriseus)     

Tim Bouts  Nicola Harrison  Karla Berry  Polly Taylor  Andrew Routh  Frank Gasthuys 《Veterinary anaesthesia and analgesia》2010,37(3):207-214

ObjectiveInvestigate physiological and sedative/anaesthetic effects of xylazine, medetomidine or dexmedetomidine combined with ketamine in free-ranging Bennett's wallabies.Study designProspective clinical trial.AnimalsTwenty-six adult free-ranging Bennett's wallabies.MethodsAnimals were darted intramuscularly with one of three treatments: xylazine and ketamine, 2.0 and 15.0 mg kg^?1, respectively (XK): medetomidine and ketamine 0.1 and 5.0 mg kg^?1 (MK) and dexmedetomidine and ketamine 0.05 and 5.0 mg kg^?1 (DMK). Body weights were estimated. If the animal was still laterally recumbent after 45 minutes of anaesthesia, then an alpha-2 adrenoceptor antagonist, atipamezole, was administered (XK: 0.4 mg kg^?1, MK: 5 mg kg^?1, DMK: 2.5 mg kg^?1). Heart rate (HR) and respiratory rate (f_R) were recorded at 5-minute intervals and temperature at 10-minute intervals. Venous blood was taken 30 minutes after initial injection. Statistical analysis utilized anova. p < 0.05 was considered significant.ResultsAnimals became recumbent rapidly in all groups. XK animals had muscle twitches, responded to external stimuli, and three animals required additional dosing; this was not observed in the MK and DMK groups. HR (mean ± SD beats minute^?1) in XK (81 ± 4) was significantly higher than MK (74 ± 2) and DMK (67 ± 4). There were no differences in f_R, temperature, blood-gas and biochemical values between groups. More animals in MK (9/10) and DMK (5/6) needed antagonism of anaesthesia compared with XK (1/10). There were no adverse effects after anaesthesia.Conclusion and clinical relevanceCardio-respiratory effects were similar in all groups. There were fewer muscle twitches and reactions to external stimuli in MK and DMK. Duration of anaesthesia was shorter in XK; most animals in MK and DMK needed atipamezole to assist recovery. All three treatments provided satisfactory sedation/anaesthesia and are suitable for use in Bennett's wallabies.  相似文献   

Chemical immobilization of Weddell seals (Leptonychotes weddellii) by ketamine/midazolam combination     

Jo‐Ann E Mellish  Pamela A Tuomi  Allyson G Hindle  Markus Horning 《Veterinary anaesthesia and analgesia》2010,37(2):123-131

ObjectiveTo provide reliable, effective immobilization for Weddell seals under extreme field conditions using an injectable ketamine/midazolam combination.Study designObservational study.AnimalsThirty adult Weddell seals (12 male, 18 female) in Erebus Bay, Antarctica, body mass (mean ± SD) 412 ± 47 kg, aged 9–27 years.MethodsSeals were immobilized with a target dose of 2 mg kg^?1 ketamine hydrochloride and 0.1 mg kg^?1 midazolam hydrochloride (IM), based on visually estimated body mass. When required, maintenance doses were administered at a target of 0.5 mg kg^?1 ketamine hydrochloride and 0.025 mg kg^?1 midazolam hydrochloride (IV).ResultsComplete immobilization was achieved in 33 of 40 injections (14 of which were repeat events on the same individual). Time to immobilization averaged 12 ± 4 minutes, with a duration of initial immobility of 38 ± 19 minutes. Total immobilization time varied by handling protocol, including condition assessment and muscle biopsy (Protocol 1, 60 ± 13 minutes), condition assessment and instrument attachment (Protocol 2, 154 ± 13 minutes), and condition assessment, muscle biopsy and instrument retrieval (Protocol 3, 48 ± 8 minutes). Overall, a total immobilization time of 114 ± 60 minutes was accomplished with 4 ± 4 maintenance doses, and an average recovery time of 36 ± 17 minutes. Most effects of the anesthetic combination were unrelated to mass, age, sex or total body fat. However, leaner seals had longer duration of initial immobility (% and kg total body fat) and recovery times (kg fat). Apnea events were uncommon and treated effectively with doxapram. No animals died.Conclusions and clinical relevanceReliable and effective field immobilization of Weddell seals was accomplished with a low dose of ketamine hydrochloride and midazolam hydrochloride, utilizing IM injection initially and IV maintenance methods.  相似文献   

Epidural ketamine in the dromedary camel     

Azari O  Molaei MM  Emadi L  Sakhaee E  Esmaeili M 《Veterinary anaesthesia and analgesia》2012,39(3):291-295

ObjectiveTo evaluate the clinical and physiological effects of epidural injection of ketamine in camels.Study designRandomized prospective study.AnimalsTen healthy immature male dromedary camels.MethodsKetamine was administered epidurally at doses of 1 and 2 mg kg^?1 (five animals in each treatment). The drug was injected into the first intercoccygeal epidural space. Anti-nociception, sedation, ataxia, and effect on cardiopulmonary, rectal temperature and some selected haematological parameters were recorded at different intervals before (baseline) and after the drug administration. Data were analyzed by anova or U Mann–Whitney tests, as relevant and significance was taken as p < 0.05.ResultsEpidural ketamine at the 2 mg kg^?1 dose produced complete anti-nociception in the tail, anus and perineum, whilst the 1 mg kg^?1 dose produced complete anti-nociception only in the tail. Epidural ketamine resulted in mild to moderate sedation at the 1 mg kg^?1 dose and deep sedation at the 2 mg kg^?1 dose. Ataxia was observed in all test subjects and was severe, resulting in recumbency, in the 2 mg kg^?1 group. Respiratory rate and rectal temperature did not change significantly after injection of either treatment. Following epidural injection of 2 mg kg^?1 of ketamine, heart rate increased significantly from the pre-injection baseline of 55 ± 2 to 76 ± 4 (mean ± SD) beats minute^?1, but after the lower dose changes were not significant. The only significant changes in measured haematologic parameters were decreases in total erythrocyte count at 45 minutes and total leukocyte count from 45–75 minutes, in the 2 mg kg^?1 group.ConclusionEpidural ketamine injection was associated with caudal anti-nociception, sedation and ataxia in the dromedary camels; the intensity and duration of which was dose dependant.Clinical relevanceNeither of the doses of epidural ketamine injection in our study was applicable for standing surgical procedures in dromedary camels.  相似文献   

Alfaxalone compared with ketamine for induction of anaesthesia in horses following xylazine and guaifenesin     

Helen L Keates  Andrew W van Eps  Martin RB Pearson 《Veterinary anaesthesia and analgesia》2012,39(6):591-598

ObjectiveTo compare anaesthesia induced with either alfaxalone or ketamine in horses following premedication with xylazine and guaifenesin.Study designRandomized blinded cross-over experimental study.AnimalsSix adult horses, five Standardbreds and one Thoroughbred; two mares and four geldings.MethodsEach 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 (PaO₂) and carbon dioxide (PaO₂), 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).ResultsThere 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, PaO₂ or PaCO₂ although for both regimens, PaO₂ decreased with respect to before premedication values. There was no difference between treatments in effect on blood pressure.Conclusions and clinical relevanceBoth 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.  相似文献   

Propofol–medetomidine–ketamine total intravenous anaesthesia in thiafentanil–medetomidine-immobilized impala (Aepyceros melampus)     

Roxanne K. Buck  Leith R.C. Meyer  George F. Stegmann  Sabine B.R. Kästner  Maya Kummrow  Christina Gerlach  Geoffrey T. Fosgate  Gareth E. Zeiler 《Veterinary anaesthesia and analgesia》2017,44(1):138-143

Objective

To characterize a propofol–medetomidine-ketamine total intravenous anaesthetic in impala (Aepyceros melampus).

Study design

Prospective clinical study.

Animals

Ten adult female impala.

Materials and methods

Impala were immobilized at 1253 m above sea level with 2.0 mg thiafentanil and 2.2 mg medetomidine via projectile darts. Propofol was given to effect (0.5 mg kg^?1 boluses) to allow endotracheal intubation, following which oxygen was supplemented at 2 L minute^?1. Anaesthesia was maintained with a constant-rate infusion of medetomidine and ketamine at 5 μg kg^?1 hour^?1 and 1.5 mg kg^?1 hour^?1, respectively, and propofol to effect (initially 0.2 mg kg^?1 minute^?1) for 120 minutes. The propofol infusion was titrated according to reaction to nociceptive stimuli every 15 minutes. Cardiopulmonary parameters were monitored continuously and arterial blood gas samples were analysed intermittently. After 120 minutes' maintenance, the thiafentanil and medetomidine were antagonized using naltrexone (10:1 thiafentanil) and atipamezole (5:1 medetomidine), respectively.

Results

All impala were successfully immobilized. The median dose [interquartile range (IQR)] of propofol required for intubation was 2.7 (1.9–3.3) mg kg^?1. The propofol–medetomidine–ketamine combination abolished voluntary movement and ensured anaesthesia for the 120 minute period. Propofol titration showed a generally downward trend. Median (IQR) heart rate [57 (53–61) beats minute^?1], respiratory rate [10 (9–12) breaths minute^?1] and mean arterial blood pressure [101 (98–106) mmHg] were well maintained. Arterial blood gas analysis indicated hypoxaemia, hyper- capnia and acidaemia. Butorphanol (0.12 mg kg^?1) was an essential rescue drug to counteract thiafentanil-induced respiratory depression. All impala regurgitated frequently during the maintenance period. Recovery was calm and rapid in all animals. Median (IQR) time to standing from antagonist administration was 4.4 (3.2–5.6) minutes.

Conclusions and clinical relevance

A propofol–medetomidine–ketamine combination could provide adequate anaesthesia for invasive procedures in impala. The propofol infusion should begin at 0.2 mg kg^?1 minute^?1 and be titrated to clinical effect. Oxygen supplementation and airway protection with a cuffed endotracheal tube are essential.  相似文献   

Magnetic resonance imaging of two suspected cases of global brain ischemia   总被引：1，自引：0，他引：1  

Gregory L. Panarello  DVM    Curtis W. Dewey  DVM  MS  DACVIM  DACVS    Georgina Barone  DVM    Joseph D. Stefanacci  VMD  DACVR 《Journal of Veterinary Emergency and Critical Care》2004,14(4):269-277

Objective: To describe the clinical findings and magnetic resonance imaging (MRI) characteristics of two animals with suspected global brain ischemia (GBI). Series summary: Two brachycephalic animals (Persian cat and Boston terrier) presented for altered mentation, blindness, ataxia, and seizures after being anesthetized. Common to both anesthetic protocols was ketamine. Clinically, the neurological deficits developed rapidly and did not progress after the initial 24 hours. MRI findings were most consistent with GBI. MRI, including pre‐ and post‐T1 weighted, T2 weighted, and fluid‐attenuated inversion recovery (FLAIR) studies, was used to image these animals. Abnormalities were seen post‐T1, T2, and FLAIR. Both animals improved neurologically with supportive care over several weeks, but both remained blind. New information: The use of MRI for diagnosing GBI.  相似文献   

Assessment and management of acute pain in cats     

Sheilah A. Robertson  BVMS  PhD  DACVA 《Journal of Veterinary Emergency and Critical Care》2005,15(4):261-272

Abstract: Cats are popular pets, but until recently, their peri-operative and traumatic pain had been seriously underestimated and under-treated. The lack of treatment stems from difficulty in recognizing pain, lack of licensed analgesic drugs, fear of toxic side effects, and lack of information specific to cats. Fortunately, in the last decade, many advances have been made in feline analgesia. It is now obvious that because of the cat's unique metabolism, species-specific studies are essential. Opioids are the mainstay of any analgesic protocol for acute pain and can be used with few side effects. Other drugs that can be utilized include the α₂-agonists, local anesthetics, and non-steroidal anti-inflammatory drugs. Pain assessment in cats is challenging and developing, and validating pain scoring systems remains an important goal. The information in this article will help the critical care and emergency clinician formulate a safe and effective analgesic plan for feline patients.  相似文献   

Effect of intravenous lidocaine and ketamine on the minimum alveolar concentration of isoflurane in goats     

Doherty T  Redua MA  Queiroz-Castro P  Egger C  Cox SK  Rohrbach BW 《Veterinary anaesthesia and analgesia》2007,34(2):125-131

OBJECTIVE: To evaluate the effects of i.v. lidocaine (L) and ketamine (K), alone and in combination (LK), on the minimum alveolar concentration (MAC) of isoflurane (ISO) in goats. STUDY DESIGN: Randomized crossover design. ANIMALS: Eight, adult mixed breed castrated male goats, aged 1-2 years weighing 24-51 kg. METHODS: Anesthesia was induced with ISO that was delivered via a mask. The tracheas were intubated and the animals ventilated to maintain an end-tidal carbon dioxide partial pressure between 25 and 30 mmHg (3.3-4 kPa). Baseline MAC (MAC(B)) that prevented purposeful movement in response to clamping a claw was determined in triplicate. After MAC(B) determination, each goat received one of the following treatments, which were administered as a loading (LD) dose followed by a constant rate infusion, IV: L (2.5 mg kg(-1); 100 microg kg(-1) minute(-1)), K (1.5 mg kg(-1); 50 microg kg(-1) minute(-1)), L and K combination or saline, and the MAC (MAC(T)) was re-determined in triplicate. Plasma concentrations of L and K were measured around each MAC point and the values averaged. RESULTS: The least-squares mean MAC(B) for all treatments was 1.13 +/- 0.03%. L, K, and LK reduced (p < 0.05) MAC(B) by 18.3%, 49.6% and 69.4%, respectively. Plasma concentrations for L, K, and LK were 1617 +/- 385, 1535 +/- 251 and 1865 +/- 317/1467 +/- 185 ng mL(-1), respectively. No change (p > 0.05) occurred with saline. CONCLUSION: Lidocaine and K caused significant decreases in the MAC of ISO. The combination (LK) had an additive effect. However, the plasma L concentrations were less than predicted, as was the MAC reduction with L. CLINICAL RELEVANCE: The use of L, K and the combination, at the doses studied, will allow a clinically important reduction in the concentration of ISO required to maintain general anesthesia in goats.  相似文献