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Blood pressure and electrocardiographic effects of acepromazine in anaesthetized horses
Authors:PJ  Murison  RE Clutton  KJ Blissitt  OD Funnell
Institution:Royal (Dick) School of Veterinary Studies, University of Edinburgh, UK
Abstract:Acepromazine, a phenothiazine tranquilizer, causes hypotension in standing horses ( Parry et al. 1982 ). However, a retrospective study ( Taylor & Young 1993 ) showed that acepromazine pre‐anesthetic medication did not affect arterial blood pressure (MAP) in anaesthetized horses. This study examined the effects of acepromazine on MAP during romifidine–ketamine–halothane anaesthesia in horses anaesthetized for various surgical procedures. Forty‐four horses were allocated by block randomization to groups A and B. Group A received acepromazine 0.05 mg kg?1 IM 30 minutes before induction of anaesthesia, group B did not. All horses received romifidine 0.1 mg kg?1 IV 5 minutes before anaesthesia was induced with diazepam 0.05 mg kg?1 and 2.2 mg kg?1 ketamine IV. The horses' trachea were intubated and horses breathed 50% oxygen and 50% nitrous oxide plus halothane (concentration adjusted as required clinically) from a circle breathing system. Nitrous oxide was discontinued after 10 minutes and analgesics, flunixin 1.1 mg kg?1 and either morphine 0.1 mg kg?1 or butorphanol 0.05 mg kg?1 (matched for horses undergoing the same procedure) administered IV. The facial or dorsal metatarsal artery was catheterized for direct measurement of MAP (every 10 min) and withdrawal of blood for gas analysis (every 30 min). The electrocardiogram (ECG) was monitored continuously with a 10 seconds printout obtained every 10 minutes. Intermittent positive pressure ventilation (IPPV) was instigated if PaCO2 exceeded 9.3 kPa (70 mm Hg). Dobutamine was infused (1.0–5.0 kg?1minute?1) if MAP < 58 mm Hg and was continued until MAP > 70 mm Hg. Mean age, weight and duration of anaesthesia were compared between the groups using a t‐test for independent samples. Gender distribution and numbers of horses requiring IPPV or dobutamine were compared between groups using a chi‐squared test (with Yates correction). To compare MAP over time, the area under the curve (MAPAUC) was calculated and compared between groups using a t‐test. Horses receiving dobutamine were excluded from MAPAUC and MAP comparisons. The ECG printouts were examined for arrhythmias. There were no significant differences between groups (p > 0.05). Group A contained three stallions, 10 geldings and nine mares, aged 6.3 years (range 0.75–18). Group B comprised eight stallions, 11 geldings and three mares aged 7.3(1–16) years. Duration of anaesthesia was group A 97 (50–140) minutes, group B 99 (50–160) minutes. Eight horses in group A and three in group B required IPPV. Nine horses in group A and four in group B received dobutamine. Mean arterial pressure ranged from 60 to 128 mm Hg in group A and 58–96 mm Hg in group B. Mean MAPAUC was 5941 mm Hg minute?1 in group A, in B 6000 mm Hg minute?1. Atrial pre‐mature complexes were recorded from one horse in group B. No other arrhythmias were detected. Although MAP was lower in the acepromazine group, this appeared unlikely to cause a clinical problem. The incidence of arrhythmias was too low to determine the influence of acepromazine in this study.
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