Comparison of lidocaine, xylazine, and lidocaine−xylazine for caudal epidural analgesia in cattle

Objective To directly compare the time to onset and duration of analgesia produced by a lidocaine/xylazine combination with that produced by lidocaine and xylazine administered alone in the caudal epidural space of dairy cattle. Design Prospective randomized experimental study. Animals Nine adult (> 4 years of age) dairy cows (520–613 kg). Methods Caudal epidural analgesia was produced in all cows with 2% lidocaine (0.22 mg kg^?1; 5.5 mL 500 kg^?1), 10% xylazine (0.05 mg kg^?1 diluted to 5.5 mL 500 kg^?1 with sterile water), and 2% lidocaine/10% xylazine (0.22 mg kg^?1/0.05 mg kg^?1; total volume of 5.7 mL 500 kg^?1), at no earlier than weekly intervals in a Latin square design. Time to onset, duration and cranial spread of analgesia were recorded, as were degree of sedation, ataxia and ptyalism. Results No significant difference (p > 0.05) was noted for time (mean ± SEM) of onset of analgesia between lidocaine (4.8 ± 1.0 minutes) and the lidocaine/xylazine combination (5.1 ± 0.9 minutes) but onset of analgesia following xylazine was significantly longer (11.7 ± 1.0 minutes) than either of the other two treatments. Lidocaine/xylazine (302.8 ± 11.0 minutes) produced analgesia of significantly longer duration than that of xylazine (252.9 ± 18.9 minutes) and both the lidocaine/xylazine combination and xylazine alone produced analgesia of significantly longer duration than that produced by lidocaine (81.8 ± 11.8 minutes). In all cattle, xylazine, administered either alone or with lidocaine, induced mild to moderate sedation and ataxia and cutaneous analgesia from the coccyx to T13. Mild ataxia was also present in those cattle receiving lidocaine alone. Conclusion The combination of xylazine and lidocaine produces analgesia of quicker onset and longer duration than xylazine administered alone and of longer duration than lidocaine administered alone. Clinical relevance Utilizing this combination, long‐duration obstetrical and surgical procedures could commence relatively soon after epidural injection and could be completed without re‐administration of anesthetic agents.     

Epidural ketamine in the dromedary camel

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.     

Caudal epidural anti‐nociception using lidocaine,bupivacaine or their combination in cows undergoing reproductive procedures

ObjectiveTo evaluate the anti-nociceptive effects of lidocaine, lidocaine-bupivacaine combination or bupivacaine following caudal epidural administration in cows undergoing reproductive procedures.Study designBlinded, randomized experimental study.AnimalsThirty seven healthy Holstein cows (mean weight ± SD, 633 ± 41 kg).MethodsAnimals were allocated randomly to receive one of four treatments: group LID, 0.2 mg kg^?1 lidocaine 2%; group LID-BUP, lidocaine-bupivacaine mixture in a 1:1 volume ratio (0.1 mg kg^?1 and 0.025 mg kg^?1, respectively); group BUP-LD, 0.05 mg kg^?1 bupivacaine 0.5%; and group BUP-HD, 0.06 mg kg^?1 bupivacaine 0.5%. The onset and duration of perineal anti-nociception were determined using superficial and deep pin pricks and the number of cows with complete perineal anti-nociception was recorded. Parameters were compared using anova followed by Duncan's test where relevant.ResultsMean ± SD time to onset of anti-nociception following epidural administration of BUP-LD was significantly longer than for LID-BUP (p < 0.05). The duration (in minutes) of perineal anti-nociception was significantly longer following epidural administration of BUP-HD (247 ± 31) versus LID-BUP (181 ± 33) and LID (127 ± 25) minutes respectively. The % of cows with complete anti-nociception was increased in the group treated with BUP-HD compared to BUP-LD. Severe ataxia or recumbency did not occur in any groups.Conclusions and clinical relevanceEpidurally administered bupivacaine, at a dose of 0.06 mg kg^?1, may provide satisfactory caudal epidural anti-nociception for longer-duration obstetric and surgical procedures.     

Comparison of analgesic efficacy of epidural methadone or ropivacaine/methadone with or without pre‐operative oral tepoxalin in dogs undergoing tuberositas tibiae advancement surgery

ObjectiveTo investigate the clinical efficacy of four analgesia protocols in dogs undergoing tibial tuberosity advancement (TTA).Study designProspective, randomized, blinded study.AnimalsThirty-two client owned dogs undergoing TTA-surgery.MethodsDogs (n= 8 per treatment) received an oral placebo (PM and PRM) or tepoxalin (10 mg kg^?1) tablet (TM and TRM) once daily for 1 week before surgery. Epidural methadone (0.1 mg kg^?1) (PM and TM) or the epidural combination methadone (0.1 mg kg^?1)/ropivacaine 0.75% (1.65 mg kg^?1) (PRM and TRM) was administered after induction of anaesthesia. Intra-operative fentanyl requirements (2 μg kg^?1 IV) and end-tidal isoflurane concentration after 60 minutes of anaesthesia (Fe′ISO₆₀) were recorded. Post-operative analgesia was evaluated hourly from 1 to 8 and at 20 hours post-extubation with a visual analogue scale (VAS) and the University of Melbourne Pain Scale (UMPS). If VAS > 50 and/or UMPS > 10, rescue methadone (0.1 mg kg^?1) was administered IV. Analgesic duration (time from epidural until post-operative rescue analgesia) and time to standing were recorded. Normally distributed variables were analysed with an F-test (α = 0.05) or t-test for pairwise inter-treatment comparisons (Bonferonni adjusted α = 0.0083). Non-normally distributed data were analysed with the Kruskall–Wallis test (α = 0.05 or Bonferonni adjusted α = 0.005 for inter-treatment comparison of post-operative pain scores).ResultsMore intra-operative analgesia interventions were required in PM [2 (0–11)] [median (range)] and TM [2 (1–2)] compared to PRM (0) and TRM (0). Fe′ISO₆₀ was significantly lower in (PRM + TRM) compared to (PM + TM). Analgesic duration was shorter in PM (459 ± 276 minutes) (mean ± SD) and TM (318 ± 152 minutes) compared to TRM (853 ± 288 minutes), but not to PRM (554 ± 234 minutes). Times to standing were longer in the ropivacaine treatments compared to TM.Conclusions and clinical relevanceInclusion of epidural ropivacaine resulted in reduction of Fe′ISO₆₀, avoidance of intra-operative fentanyl administration, a longer duration of post-operative analgesia (in TRM) and a delay in time to standing compared to TM.     

Evaluation of anti-nociceptive effect of epidural tramadol, tramadol-lidocaine and lidocaine in goats

Objective To compare the anti‐nociceptive effect of tramadol, a combination of tramadol‐lidocaine, and lidocaine alone when administered in the epidural space. Study design Experimental randomized cross‐over study. Animals Seven healthy male goats, aged 9–11 months, weight 17.5–25.5 kg. Methods Treatments were lidocaine, 2.86 mg kg^?1, tramadol‐lidocaine (1 mg kg^?1 and 2.46 mg kg^?1, respectively) and tramadol (1 mg kg^?1) given into the epidural space. The volume of all treatments was 0.143 mL kg^?1. Nociception was tested by pin prick and by pressure from a haemostat clamp. Times to the onset and duration of anti‐nociception in the perineal region were recorded. Recumbency and ataxia were noted. Rectal temperature, heart rate and respiratory rate were recorded before and at 15 minute intervals for 2 hours after the administration of each treatment. Statistical comparison used one‐way anova with a post hoc Duncan’s test as a post hoc. Significance was taken as p < 0.05. Results Times (mean ± SD) to onset of and duration of loss of sensation, respectively in minutes were; lidocaine, 3 ± 1 and 85 ± 11), tramadol‐lidocaine 4 ± 1 and 140 ± 2; tramadol 12 ± 1 and 235 ± 18. Onset and duration times were significantly longer with tramadol than the other two treatments. Duration was significantly longer with tramadol‐lidocaine than with lidocaine alone. With lidocaine treatment all goats were severely ataxic or recumbent, after tramadol‐lidocaine mildly ataxic, and after tramadol not ataxic. Rectal temperature, heart and respiratory rates did not differ significantly from baseline after any treatment. Conclusions and clinical relevance The combination of tramadol‐lidocaine given by epidural injection produced an anti‐nociceptive effect in the perineal region, which was rapid in onset and had a longer duration of action than lidocaine alone. This combination might prove useful clinically to provide analgesia in goats for long‐duration obstetrical and surgical procedures but surgical stimuli were not investigated in this study.     

Perineal analgesic actions of epidural clonidine in cattle

Objective To determine the analgesic, sedative, motor, cardiac and respiratory effects of epidural clonidine in cattle. Study design Prospective randomized study. Animal population Six healthy male cattle weighing between 236 and 365 kg. Methods To investigate the effect of epidural clonidine, the animals received 2 and 3 µg kg^?1 of clonidine diluted to 8 mL with 0.9% saline. Two treatments were utilized as controls. The animals from the first control treatment received 2% lidocaine (0.4 mg kg^?1) and those from the second received an equal volume of 0.9% saline. Each animal received each treatment in random order. Evaluations of analgesia, sedation, muscle relaxation, heart rate, respiratory rate and rectal temperature were obtained at 0 (basal), 2, 5, 10, 15 and 30 minutes after epidural injection, and then at 30‐minute intervals until loss of analgesia occurred. All the animals received a standard noxious stimulus consisting of needle insertion into the skin and deep muscle; a 4‐point scale was used to score the response. A second scale was used to score sedation and a third for muscle relaxation. Results Both doses of clonidine were effective in producing analgesia of the tail, perineum, and upper hindlimb. Complete analgesia was present before (mean ± SE = 9 ± 4 vs. 19 ± 9 minutes) and lasted longer (311 ± 33 vs. 192 ± 27 minutes) for the 3 µg kg^?1versus the 2 µg kg^?1 dose, respectively. A dose‐dependent sedative effect of clonidine was also observed, with a peak effect between 60 and 180 minutes. No effects on heart or respiratory rates were observed with either dose of clonidine. Conclusions Epidural administration of 2 and 3 µg kg^?1 of clonidine in cattle in this study provided bilateral perineal analgesia/anesthesia with a dose‐dependent onset and duration of action. Clinical relevance Further studies are required to determine whether the analgesia is sufficient for surgery.     

Cardiopulmonary and isoflurane‐sparing effects of epidural or intravenous infusion of dexmedetomidine in cats undergoing surgery with epidural lidocaine

ObjectiveTo compare the cardiorespiratory, anesthetic-sparing effects and quality of anesthetic recovery after epidural and constant rate intravenous (IV) infusion of dexmedetomidine (DEX) in cats given a low dose of epidural lidocaine under propofol-isoflurane anesthesia and submitted to elective ovariohysterectomy.Study designRandomized, blinded clinical trial.AnimalsTwenty-one adult female cats (mean body weight: 3.1 ± 0.4 kg).MethodsCats received DEX (4 μg kg^?1, IM). Fifteen minutes later, anesthesia was induced with propofol and maintained with isoflurane. Cats were divided into three groups. In GI cats received epidural lidocaine (1 mg kg^?1, n = 7), in GII cats were given epidural lidocaine (1 mg kg^?1) + DEX (4 μg kg^?1, n = 7), and in GIII cats were given epidural lidocaine (1 mg kg^?1) + IV constant rate infusion (CRI) of DEX (0.25 μg kg^?1 minute^?1, n = 7). Variables evaluated included heart rate (HR), respiratory rate (f_R), systemic arterial pressures, rectal temperature (RT), end-tidal CO₂, end-tidal isoflurane concentration (e′ISO), arterial blood gases, and muscle tone. Anesthetic recovery was compared among groups by evaluation of times to recovery, HR, f_R, RT, and degree of analgesia. A paired t-test was used to evaluate pre-medication variables and blood gases within groups. anova was used to compare parametric data, whereas Friedman test was used to compare muscle relaxation.ResultsEpidural and CRI of DEX reduced HR during anesthesia maintenance. Mean ± SD e′ISO ranged from 0.86 ± 0.28% to 1.91 ± 0.63% in GI, from 0.70 ± 0.12% to 0.97 ± 0.20% in GII, and from 0.69 ± 0.12% to 1.17 ± 0.25% in GIII. Cats in GII and GIII had longer recovery periods than in GI.Conclusions and clinical relevanceEpidural and CRI of DEX significantly decreased isoflurane consumption and resulted in recovery of better quality and longer duration, despite bradycardia, without changes in systemic blood pressure.     

Lignocaine versus bupivacaine for flank anaesthesia using multiport catheters via a caudal epidural approach in cattle

Objective To determine the anaesthetic and systemic effects of dorsolumbar epidural anaesthesia using non-stylet multiport catheters via the caudal approach to administer hypertonic 5% lignocaine (HL) or hypertonic 0.5% bupivacaine (HB) to the flank in standing cattle. Materials and methods Six healthy adult cattle weighing 310–455 kg received 0.2 mg/kg HL or 0.025 mg/kg of HB; control animals received 0.9% saline solution. All drugs were injected into the dorsolumbar epidural space via a caudal approach through a non-stylet multiport catheter. Each animal received each treatment at random. Evaluations of anaesthesia, ataxia, heart rate, arterial pressures, respiratory rate and rectal temperature were obtained at 0 (basal), 5, 10, 15, 30, 45, 60, 75, and 90 min after epidural injection and then at 30-min intervals until loss of anaesthesia. All animals received a standard noxious stimulus and a 4-point scale was used to score the response. A second scale was used to score ataxia. Results The duration of anaesthesia in the upper and lower flanks in cattle was 68 ± 12 and 110 ± 15 min (mean ± SD) after dorsolumbar epidural HL or HB, respectively. Both hypertonic local anaesthetics produced a mild ataxia. The systemic changes were within acceptable limits in these clinically healthy cattle. Conclusion In standing cattle the dorsolumbar epidural injection of hypertonic lignocaine provided faster onset of anaesthesia and fewer cardiovascular effects, but had a shorter duration of anaesthesia than hypertonic bupivacaine.     

Minimum infusion rate and hemodynamic effects of propofol, propofol-lidocaine and propofol-lidocaine-ketamine in dogs

ObjectiveTo evaluate the effects of a constant rate infusion (CRI) of lidocaine alone or in combination with ketamine on the minimum infusion rate (MIR) of propofol in dogs and to compare the hemodynamic effects produced by propofol, propofol-lidocaine or propofol-lidocaine-ketamine anesthesia.Study designProspective, randomized cross-over experimental design.AnimalsFourteen adult mixed-breed dogs weighing 15.8 ± 3.5 kg.MethodsEight dogs were anesthetized on different occasions to determine the MIR of propofol alone and propofol in combination with lidocaine (loading dose [LD] 1.5 mg kg^?1, CRI 0.25 mg kg^?1 minute^?1) or lidocaine (LD 1.5 mg kg^?1, CRI 0.25 mg kg^?1 minute^?1) and ketamine (LD 1 mg kg^?1, CRI 0.1 mg kg^?1 minute^?1). In six other dogs, the hemodynamic effects and bispectral index (BIS) were investigated. Each animal received each treatment (propofol, propofol-lidocaine or propofol-lidocaine-ketamine) on the basis of the MIR of propofol determined in the first set of experiments.ResultsMean ± SD MIR of propofol was 0.51 ± 0.08 mg kg^?1 minute^?1. Lidocaine-ketamine significantly decreased the MIR of propofol to 0.31 ± 0.07 mg kg^?1 minute^?1 (37 ± 18% reduction), although lidocaine alone did not (0.42 ± 0.08 mg kg^?1 minute^?1, 18 ± 7% reduction). Hemodynamic effects were similar in all treatments. Compared with the conscious state, in all treatments, heart rate, cardiac index, mean arterial blood pressure, stroke index and oxygen delivery index decreased significantly, whereas systemic vascular resistance index increased. Stroke index was lower in dogs treated with propofol-lidocaine-ketamine at 30 minutes compared with propofol alone. The BIS was lower during anesthesia with propofol-lidocaine-ketamine compared to propofol alone.Conclusions and clinical relevanceLidocaine-ketamine, but not lidocaine alone, reduced the MIR of propofol in dogs. Neither lidocaine nor lidocaine in combination with ketamine attenuated cardiovascular depression produced by a continuous rate infusion of propofol.     

Evaluation of the isoflurane‐sparing effects of fentanyl,lidocaine, ketamine,dexmedetomidine, or the combination lidocaine‐ketamine‐dexmedetomidine during ovariohysterectomy in dogs

ObjectiveTo evaluate the isoflurane‐sparing effects of an intravenous (IV) constant rate infusion (CRI) of fentanyl, lidocaine, ketamine, dexmedetomidine, or lidocaine‐ketamine‐dexmedetomidine (LKD) in dogs undergoing ovariohysterectomy.Study designRandomized, prospective, blinded, clinical study.AnimalsFifty four dogs.MethodsAnesthesia was induced with propofol and maintained with isoflurane with one of the following IV treatments: butorphanol/saline (butorphanol 0.4 mg kg^?1, saline 0.9% CRI, CONTROL/BUT); fentanyl (5 μg kg^?1, 10 μg kg^?1 hour^?1, FENT); ketamine (1 mg kg^?1, 40 μg kg^?1 minute^?1, KET), lidocaine (2 mg kg^?1, 100 μg kg^?1 minute^?1, LIDO); dexmedetomidine (1 μg kg^?1, 3 μg kg^?1 hour^?1, DEX); or a LKD combination. Positive pressure ventilation maintained eucapnia. An anesthetist unaware of treatment and end‐tidal isoflurane concentration (Fe′Iso) adjusted vaporizer settings to maintain surgical anesthetic depth. Cardiopulmonary variables and Fe′Iso concentrations were monitored. Data were analyzed using anova (p < 0.05).ResultsAt most time points, heart rate (HR) was lower in FENT than in other groups, except for DEX and LKD. Mean arterial blood pressure (MAP) was lower in FENT and CONTROL/BUT than in DEX. Overall mean ± SD Fe′Iso and % reduced isoflurane requirements were 1.01 ± 0.31/41.6% (range, 0.75 ± 0.31/56.6% to 1.12 ± 0.80/35.3%, FENT), 1.37 ± 0.19/20.8% (1.23 ± 0.14/28.9% to 1.51 ± 0.22/12.7%, KET), 1.34 ± 0.19/22.5% (1.24 ± 0.19/28.3% to 1.44 ± 0.21/16.8%, LIDO), 1.30 ± 0.28/24.8% (1.16 ± 0.18/32.9% to 1.43 ± 0.32/17.3%, DEX), 0.95 ± 0.19/54.9% (0.7 ± 0.16/59.5% to 1.12 ± 0.16/35.3%, LKD) and 1.73 ± 0.18/0.0% (1.64 ± 0.21 to 1.82 ± 0.14, CONTROL/BUT) during surgery. FENT and LKD significantly reduced Fe′Iso.Conclusions and clinical relevanceAt the doses administered, FENT and LKD had greater isoflurane‐sparing effect than LIDO, KET or CONTROL/BUT, but not at all times. Low HR during FENT may limit improvement in MAP expected with reduced Fe′Iso.     

Cardiopulmonary and analgesic effects of caudal epidurally administered ropivacaine in cattle

ObjectiveTo assess cardiopulmonary and analgesic effects after administration of ropivacaine into the caudal epidural space of cattle.Study designProspective, single-dose trial.AnimalsEight healthy mixed breed cows aged 8 ± 5 years and weighing 507 ± 112 kg.MethodsCaudal epidural anesthesia was produced in cows with 0.75% ropivacaine (0.11 mg kg^?1). Onset time, duration and cranial spread of analgesia were recorded. Heart rate (HR), respiratory rate (f_R), rectal temperature (RT), and mean arterial blood pressure (MAP) were measured prior to epidural administration (T₀) and at 15, 30, 60, 120, 180 and 240 minutes after epidural administration (T₁₅, T₃₀, T₆₀, T₁₂₀, T₁₈₀ and T₂₄₀). Arterial blood acid-base balance (pH, standard bicarbonate and base excess), gas tension (PaO₂, PaCO₂, SaO₂) and electrolytes (Na⁺, K⁺, iCa²⁺,Cl^?) were recorded at T₀, T₃₀, T₆₀, T₁₂₀, T₁₈₀ and T_240. Ataxia was evaluated at T₀, T₃₀, T₆₀, T₁₂₀, T₁₈₀ and T₂₄₀ and at 1 hour intervals thereafter until analgesia was no longer present in each animal.ResultsEpidurally administered ropivacaine induced variable analgesia extending bilaterally from the coccyx to S3. Time to onset of analgesia and mean duration in the perineal area were 15 ± 4 and 359 ± 90 minutes, respectively. Respiratory rate and RT increased from T₁₂₀ to T₂₄₀ when compared to the value at T₀. Ionized calcium and chloride concentrations increased at T₁₈₀ and T₂₄₀ when compared to T₀. The other variables were not significantly different from baseline values (p> 0.05). Four animals were mildly ataxic.Conclusion and clinical relevanceRopivacaine (0.75%, 0.11 mg kg^?1) can be administered by caudal epidural injection to produce prolonged bilateral perineal analgesia with minimal ataxia and cardiopulmonary changes in standing cattle.     

Behavioral responses following eight anesthetic induction protocols in horses

Objective To compare behavioral characteristics of induction and recovery in horses anesthetized with eight anesthetic drug protocols. Study design Randomized prospective experimental study. Animals Eight horses, 5.5 ± 2.4 years (mean ± SD) of age, and weighing 505 ± 31 kg. Methods After xylazine pre‐medication, each of eight horses was anesthetized on four occasions using one of eight different anesthetic induction protocols which incorporated various combinations of ketamine (KET), propofol (PRO), and thiopental (THIO): THIO 8 mg kg^?1; THIO 6 mg kg^?1 + PRO 0.5 mg kg^?1; THIO 4 mg kg^?1 + PRO 1 mg kg^?1; THIO 2 mg kg^?1 + PRO 1.5 mg kg^?1; KET 2 mg kg^?1; KET 1.5 mg kg^?1 + PRO 0.5 mg kg^?1; KET 1 mg kg^?1 + PRO 1 mg kg^?1; KET 0.5 mg kg^?1 + PRO 1.5 mg kg^?1. Quality of induction and recovery were scored from 1 (poor) to 5 (excellent), and time taken to achieve lateral recumbency, first movement, sternal recumbency, and standing were evaluated. Results Time taken to achieve lateral recumbency after drug administration differed significantly (p < 0.0001) among the various combinations, being shortest in horses receiving THIO‐8 (mean ± SD, 0.5 ± 0.3 minutes) and longest in horses receiving KET‐2 (1.4 ± 0.2 minutes). The best scores for induction quality were associated with KET‐1.5 + PRO‐0.5, and the worst scores for induction quality were associated with KET‐2, although the difference was not significant. Time to first movement varied significantly among drug protocols (p = 0.0133), being shortest in horses receiving KET‐2 (12.7 ± 3.6 minutes) and longest in horses receiving THIO‐8 (29.9 ± 1.5 minutes). Horses receiving THIO‐8 made the greatest number of attempts to attain sternal posture (6.5 ± 4.7) and to stand (1.6 ± 0.8). Horses in the THIO‐8 treatment also received the poorest recovery scores (3.3 ± 1.0 and 3.0 ± 0.7 for sternal and standing postures, respectively). The best recovery scores were associated with combinations comprised mainly of propofol. Conclusions Combining propofol with either ketamine or thiopental modifies behaviors associated with use of the individual drugs. Clinical relevance Quality of early anesthesia recovery in horses may be improved by some combinations of propofol with either thiopental or ketamine.     

Evaluation of different doses of propofol in xylazine pre-medicated horses

Objective To characterize responses to different doses of propofol in horses pre‐medicated with xylazine. Animals Six adult horses (five females and one male). Methods Each horse was anaesthetized four times with either ketamine or propofol in random order at 1‐week intervals. Horses were pre‐medicated with xylazine (1.1 mg kg^?1 IV over a minute), and 5 minutes later anaesthesia was induced with either ketamine (2.2 mg kg^?1 IV) or propofol (1, 2 and 4 mg kg^?1 IV; low, medium and high doses, respectively). Data were collected continuously (electrocardiogram) or after xylazine administration and at 5, 10 and 15 minutes after anaesthetic induction (arterial pressure, respiratory rate, pH, PaO₂, PaCO₂ and O₂ saturation). Anaesthetic induction and recovery were qualitatively and quantitatively assessed. Results Differences in the quality of anaesthesia were observed; the low dose of propofol resulted in a poorer anaesthetic induction that was insufficient to allow intubation, whereas the high dose produced an excellent quality of induction, free of excitement. Recorded anaesthesia times were similar between propofol at 2 mg kg^?1 and ketamine with prolonged and shorter recovery times after the high and low dose of propofol, respectively (p < 0.05; ketamine, 38 ± 7 minutes; propofol 1 mg kg^?1, 29 ± 4 minutes; propofol 2 mg kg^?1, 37 ± 5 minutes; propofol 4 mg kg^?1, 50 ± 7 minutes). Times to regain sternal and standing position were longest with the highest dose of propofol (32 ± 5 and 39 ± 7 minutes, respectively). Both ketamine and propofol reversed bradycardia, sinoatrial, and atrioventricular blocks produced by xylazine. There were no significant alterations in blood pressure but respiratory rate, and PaO₂ and O₂ saturation were significantly decreased in all groups (p < 0.05). Conclusion The anaesthetic quality produced by the three propofol doses varied; the most desirable effects, which were comparable to those of ketamine, were produced by 2 mg kg^?1 propofol.     

The cardiopulmonary effects of anesthetic induction with isoflurane,ketamine‐diazepam or propofol‐diazepam in the hypovolemic dog

ObjectiveTo evaluate and compare the cardiopulmonary effects of induction of anesthesia with isoflurane (Iso), ketamine–diazepam (KD), or propofol–diazepam (PD) in hypovolemic dogs.Study designProspective randomized cross–over trial.AnimalsSix healthy intact, mixed breed, female dogs weighing 20.7 ± 4.2 kg and aged 22 ± 2 months.MethodsDogs had 30 mL kg^?1 of blood removed at a rate of 1.5 mL kg^?1 minute^?1 under isoflurane anesthesia. Following a 30–minute recovery period, anesthesia was reinduced. Dogs were assigned to one of three treatments: isoflurane via facemask using 0.5% incremental increases in the delivered concentration every 30 seconds, 1.25 mg kg^?1 ketamine and 0.0625 mg kg^?1 diazepam intravenously (IV) with doses repeated every 30 seconds as required, and 2 mg kg^?1 propofol and 0.2 mg kg^?1 diazepam IV followed by 1 mg kg^?1 propofol increments IV every 30 seconds as required. Following endotracheal intubation all dogs received 1.7% end–tidal isoflurane in oxygen. Cardiopulmonary variables were recorded at baseline (before induction) and at 5 or 10 minute intervals following endotracheal intubation.ResultsInduction time was longer in Iso (4.98 ± 0.47 minutes) compared to KD (3.10 ± 0.47 minutes) or PD (3.22 ± 0.45 minutes). To produce anesthesia, KD received 4.9 ± 2.3 mg kg^?1 ketamine and 0.24 ± 0.1 mg kg^?1 diazepam, while PD received 2.2 ± 0.4 mg kg^?1 propofol and 0.2 mg kg^?1 diazepam. End–tidal isoflurane concentration immediately following intubation was 1.7 ± 0.4% in Iso. Arterial blood pressure and heart rate were significantly higher in KD and PD compared to Iso and in KD compared to PD. Arterial carbon dioxide partial pressure was significantly higher in PD compared to KD and Iso immediately after induction.Conclusions and clinical relevanceIn hypovolemic dogs, KD or PD, as used in this study to induce anesthesia, resulted in less hemodynamic depression compared to isoflurane.     

Evaluation of analgesic and physiologic effects of epidural morphine administered at a thoracic or lumbar level in dogs undergoing thoracotomy

ObjectiveTo evaluate the analgesic and physiological effects of epidural morphine administered at the sixth and seventh lumbar or the fifth and sixth thoracic vertebrae in dogs undergoing thoracotomy.Study designProspective, randomized, blinded trial.AnimalsFourteen mixed-breed dogs, weighing 8.6 ± 1.4 kg.MethodsThe animals received acepromazine (0.1 mg kg^?1) IM and anesthesia was induced with propofol (4 mg kg^?1) IV. The lumbosacral space was punctured and an epidural catheter was inserted up to the region between the sixth and seventh lumbar vertebrae (L, n = 6) or up to the fifth or sixth intercostal space (T, n = 8). The dogs were allowed to recover and after radiographic confirmation of correct catheter position, anesthesia was reinduced with propofol IV and maintained with 1.7% isoflurane. Following stabilization of monitored parameters, animals received morphine (0.1 mg kg^?1) diluted in 0.9% NaCl to a final volume of 0.25 mL kg^?1 via the epidural catheter, and after 40 minutes, thoracotomy was initiated. Heart rate and rhythm, systolic, mean and diastolic arterial pressures, respiratory rate, arterial hemoglobin oxygen saturation, partial pressure of expired CO₂ and body temperature were measured immediately before the epidural administration of morphine (0 minute) and every 10 minutes during the anesthetic period. The Melbourne pain scale and the visual analog scale were used to assess post-operative pain. The evaluation began 3 hours after the epidural administration of morphine and occurred each hour until rescue analgesia.ResultsThere were no important variations in the physiological parameters during the anesthetic period. The post-operative analgesic period differed between the groups, being longer in T (9.9 ± 1.6 hours) compared with L (5.8 ± 0.8 hours).ConclusionsThe use of morphine, at a volume of 0.25 mL kg^?1, administered epidurally over the thoracic vertebrae provided longer lasting analgesia than when deposited over the lumbar vertebrae.Clinical relevanceThe deposition of epidural morphine provided longer lasting analgesia when administered near to the innervation of the injured tissue without increasing side effects.     

Comparison of analgesia provided by lidocaine, lidocaine-morphine or lidocaine-tramadol delivered epidurally in dogs following orchiectomy

ObjectiveTo evaluate and compare the postoperative analgesia provided by epidural lidocaine, lidocaine/morphine or lidocaine/tramadol in dogs following elective orchiectomy.Study designProspective experimental trial.AnimalsThirty-six mongrel dogs aged 2-8 years old, weighing 6.6-22 kg.MethodsThe dogs received 6.0 mg kg^?1 of lidocaine combined with 1.0 mg kg^?1 of tramadol, 0.1 mg kg^?1 of morphine or 0.01 mL kg^?1 of 0.9% NaCl epidurally. Analgesia was assessed at 4, 8, 12, 18 and 24 hours (T4, T8, T12 and T24) after the offset of lidocaine using a scale composed of physiologic and behavioral parameters. Rescue analgesia with morphine (0.2 mg kg^?1, IM) was performed if the evaluation score exceeded 10 during the postoperative period. The scores over time were analyzed using the Friedman’s two-way analysis of variance and the comparison between groups was made by the Kruskal-Wallis test with statistical significances accepted if p = 0.05.ResultsThere were no differences in the pain scores between the morphine and tramadol groups over time and no rescue analgesia was administered. In the NaCl group, rescue analgesia was needed at T4, T8 and T12. Within this group, the final evaluation times (T18 and T24) had lower pain scores than at T4, T8 and T12.Conclusions and clinical relevanceEpidural lidocaine/tramadol provided an analgesic effect comparable to that of epidural lidocaine/morphine during the first 12 hours after surgical castration without substantial side effects, suggesting that tramadol may be an effective postoperative analgesic in dogs submitted to this surgical procedure.     

A comparison of the analgesic effects of caudal epidural methadone and lidocaine in the horse

Objective To evaluate and compare the effects of caudal epidural administration of methadone (METH) and lidocaine (LIDO) on tolerance to thermal stimulation over the dermatomes of the perineal, sacral, lumbar and thoracic regions in the horse. Study design A blinded, randomized, prospective, experimental cross‐over study. Animals Seven healthy horses, 15.7 ± 4.9 years (mean ± SD) of age, weighing 536 ± 37 kg. Methods The horses were randomly assigned to receive two treatments (group M: METH, 0.1 mg kg^?1 or group L: LIDO, 0.35 mg kg^?1) at intervals of at least 28 days. An 18‐gauge 80‐mm Tuohy epidural needle was placed in the first intercoccygeal space (Co1–Co2) in awake standing horses restrained in stocks. Analgesia was assessed by use of a probe maintained at a constant 62 °C by circulating hot water. The maximum stimulation time was 30 seconds. Bilateral stimulation was performed at five defined points. Before drug administration, baseline values of response time to thermal stimuli were obtained. Time to response was then measured 15 and 60 minutes after METH or LIDO administration and then hourly until the response returned to baseline at all stimulation points on two further assessments. Development of any ataxia and/or sedation was recorded. Positive pain responses were defined as purposeful avoidance movements of the head, neck, trunk, limbs and tail. Absence of attempts to kick, bite and turning of the head toward the stimulation site were used to indicate analgesia. Results Caudal epidural administration of METH and LIDO significantly increased reaction time to thermal stimulation (one‐sample t‐test; p = 0.05). Analgesia in the perineal region was present 15 minutes after both METH and LIDO administration and progressed from caudal to cranial dermatones with time. The duration of a significant increase in reaction time was 5 hours after METH injection compared to 3 hours following LIDO. All horses defaecated and urinated normally, and no excitement, sedation or ataxia were observed after METH administration. The horses were unable to defaecate normally and were moderately to severely ataxic with hindlimb weakness after LIDO. Conclusions Caudal epidural administration of methadone has considerable potential in the management of perineal, lumbo‐sacral and thoracic pain in horses. Regional differences exist in the onset, duration and intensity of the pain relief. Clinical relevance Epidural methadone administration provides analgesia with no measured side effects in these healthy adult horses.     

A comparison of sedative effects of xylazine alone or combined with levomethadone or ketamine in calves prior to disbudding

ObjectiveTo compare the sedative effects of intramuscular xylazine alone or combined with levomethadone or ketamine in calves before cautery disbudding.Study designRandomized, blinded, clinical trial.AnimalsA total of 28 dairy calves, aged 21 ± 5 days and weighing 61.0 ± 9.3 kg (mean ± standard deviation).MethodsCalves were randomly allocated to three groups: xylazine (0.1 mg kg^–1) and levomethadone (0.05 mg kg^–1; group XL), xylazine (0.1 mg kg^–1) and ketamine (1 mg kg^–1; group XK) and xylazine alone (0.2 mg kg^–1; group X). Local anaesthesia (procaine hydrochloride) and meloxicam were administered subcutaneously 15 minutes after sedation and 15 minutes before disbudding. The calves’ responses to the administration of local anaesthesia and disbudding were recorded. Sedation was assessed at baseline and at intervals up to 240 minutes postsedation. Times of recumbency, first head lift and first standing were recorded. Drug plasma concentrations were measured.ResultsData were obtained from 27 animals. All protocols resulted in sedation sufficient to administer local anaesthesia and to perform disbudding. Sedation scores significantly correlated with drug plasma concentrations (p ≤ 0.002). Times to recumbency did not differ among protocols (2.8 ± 0.3, 3.1 ± 1.1 and 2.1 ± 0.8 minutes for groups XL, XK and X, respectively), whereas interval from drug(s) administration until first head lift was significantly shorter in group XK than X (47.3 ± 14.1, 34.4 ± 5.3 and 62.6 ± 31.9 minutes for groups XL, XK and X, respectively). The area under the time-sedation curve was significantly greater in group X than XK or XL (754 ± 215, 665 ± 118 and 1005 ± 258 minutes for groups XL, XK and X, respectively).Conclusions and clinical relevanceLevomethadone or ketamine with a low dose of xylazine produced short but sufficient sedation for local anaesthesia and disbudding with minimum resistance.     

Epidural administration of tiletamine/zolazepam in horses

Objectives To evaluate the analgesic, physiologic, and behavioral effects of the epidural administration of tiletamine/zolazepam in horses. Study design Prospective, double‐blind, randomized experimental study. Animals Five adult, healthy horses aged 10–16 years and weighing (mean ± SD) 400 ± 98 kg. Methods The horses were sedated with 1.0 mg kg^?1 intravenous (IV) xylazine, and an epidural catheter was placed into the first intercoccygeal intervertebral space. After a 48‐hour resting period, epidural tiletamine/zolazepam, 0.5 mg kg^?1 (treatment I) or 1.0 mg kg^?1 (treatment II), diluted up to 5 mL in sterile water, was administered with a 1‐week interval between the treatments. Heart rate, respiratory rate, arterial blood pressure, and sedation were evaluated. In order to evaluate the respiratory effects, blood from the carotid artery was withdrawn at time 0 (baseline), and then after 60 and 240 minutes. Analgesia was evaluated by applying a noxious stimulus with blunt‐tipped forceps on the perineal region, and graded as complete, moderate, or absent. Data were collected before tiletamine/zolazepam administration and at 15‐minute intervals for 120 minutes, and 4 hours after tiletamine/zolazepam administration. Data were analyzed with anova and Bonferroni's test with p < 0.05. Results The results showed no significant difference between treatments in cardiovascular and respiratory measurements. Sedation was observed with both doses, and it was significantly different from baseline at 60, 75, and 90 minutes in treatment II. Moderate analgesia and locomotor ataxia were observed with both the treatments. Conclusions and clinical relevance The results suggest that caudal epidural 0.5 and 1.0 mg kg^?1 tiletamine/zolazepam increases the threshold to pressure stimulation in the perineal region in horses. The use of epidural tiletamine/zolazepam could be indicated for short‐term moderate epidural analgesia. There are no studies examining spinal toxicity of Telazol, and further studies are necessary before recommending clinical use of this technique.     

Comparative analgesic and sedative effects of tramadol,tramadol‐lidocaine and lidocaine for caudal epidural analgesia in donkeys (Equus asinus)

ObjectiveTo compare anti-nociceptive and sedative effects of tramadol, a combination of tramadol-lidocaine, and lidocaine alone for perineal analgesia in donkeys.Study designExperimental ‘blinded’ randomized cross-over study.AnimalsSix healthy adult donkeys.MethodsTreatments were tramadol (TR) (1.0 mg kg⁻¹), tramadol-lidocaine (TRLD) (0.5 and 0.2 mg kg⁻¹ respectively) and lidocaine (LD) (0.4 mg kg⁻¹) given into the epidural space. The volume of all treatments was 0.02 mL kg⁻¹. Nociception was tested at the perineal region by pin prick, followed, if no reaction, by pressure from a haemostat clamp. Times to onset, degree and duration of anti-nociception of the perineal region were recorded. Response was tested immediately after drug administration and at: 2, 5, 10, 15, 30, 45, and 60 minutes post-administration and then at 30 minute intervals thereafter until a response re-occurred. Physiologic data and degree of sedation and ataxia were recorded pre-administration and at intervals for 240 minutes post-administration. Results were analyzed using anova, Kruskal–Wallis tests, and Wilks’ Lambda test as relevant. Significance was taken as p < 0.05.ResultsTimes (minutes, mean ± SD) to onset and duration of anti-nociception, respectively were; TR 13 ± 1.6 and 220 ± 4.6; TRLD 6 ± 0.8 and 180 ± 8.5; LD 4 ± 1.4 and 75 ± 4. Onset and duration times were significantly longer with TR than the other two treatments. TR never produced complete anti-nociception, whereas the TRLD and LD induced complete anti-nociceptive effects. Duration was significantly longer with TRLD than with LD alone. Epidural injections of TR and TRLD induced mild sedation.Conclusions and clinical relevanceEpidural combination of TRLD produced an anti-nociceptive effect in the perineum, which was rapid in onset and had a longer duration of action than LD alone. An epidural single dose of TRLD combination would appear to provide an acceptable analgesic effect in the perineal region of donkeys.