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1.

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   

2.
3.

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   

4.

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   

5.

Objective

To determine the effects of two dexmedetomidine continuous rate infusions on the minimum infusion rate of alfaxalone for total intravenous anaesthesia (TIVA), and subsequent haemodynamic and recovery effects in Greyhounds undergoing laparoscopic ovariohysterectomy.

Study design

Prospective, randomized and blinded clinical study.

Animals

Twenty-four female Greyhounds.

Methods

Dogs were premedicated with dexmedetomidine 3 μg kg?1 and methadone 0.3 mg kg?1 intramuscularly. Anaesthesia was induced with IV alfaxalone to effect and maintained with a TIVA mixture of alfaxalone in combination with two different doses of dexmedetomidine (0.5 μg kg?1 hour?1 or 1 μg kg?1 hour?1; groups DEX0.5 and DEX1, respectively). The alfaxalone starting dose rate was 0.07 mg kg?1 minute?1 and was adjusted (± 0.02 mg kg?1 minute?1) every 5 minutes to maintain a suitable depth of anaesthesia. A rescue alfaxalone bolus (0.5 mg kg?1 IV) was administered if dogs moved or swallowed. The number of rescue boluses was recorded. Heart rate, arterial blood pressure and arterial blood gas were monitored. Qualities of sedation, induction and recovery were scored. Differences between groups were tested for statistical significance using a Student’s t test or Mann–Whitney U test as appropriate.

Results

There were no differences between groups in sedation, induction and recovery quality, the median (range) induction dose of alfaxalone [DEX0.5: 2.2 (1.9–2.5) mg kg?1; DEX1: 1.8 (1.2–2.9) mg kg?1], total dose of alfaxalone rescue boluses [DEX0.5: 21.0 (12.5–38.8) mg; DEX1: 22.5 (15.5–30.6) mg] or rate of alfaxalone (DEX0.5: 0.12 ± 0.04 mg kg?1 minute?1; DEX1: 0.12 ± 0.03 mg kg?1 minute?1).

Conclusions and clinical relevance

Co-administration of dexmedetomidine 1 μg kg?1 hour?1 failed to reduce the dose rate of alfaxalone compared with dexmedetomidine 0.5 μg kg?1 hour?1 in Greyhounds undergoing laparoscopic ovariohysterectomy. The authors recommend an alfaxalone starting dose rate of 0.1 mg kg?1 minute?1. Recovery quality was good in the majority of dogs.  相似文献   

6.

Objective

To compare dexmedetomidine–midazolam with alfaxalone–midazolam for sedation in leopard geckos (Eublepharis macularius).

Study design

Prospective, randomized, blinded, complete crossover study.

Animals

Nine healthy adult leopard geckos.

Methods

Geckos were administered a combination of dexmedetomidine (0.1 mg kg?1) and midazolam (1.0 mg kg?1; treatment D–M) or alfaxalone (15 mg kg?1) and midazolam (1.0 mg kg?1; treatment A–M) subcutaneously craniodorsal to a thoracic limb. Heart rate (HR), respiratory rate (fR), righting reflex, palpebral reflex, superficial and deep pain reflexes, jaw tone and escape response were assessed every 5 minutes until reversal. Conditions for intubation and response to needle prick were evaluated. Antagonist drugs [flumazenil (0.05 mg kg?1) ± atipamezole (1.0 mg kg?1)] were administered subcutaneously, craniodorsal to the contralateral thoracic limb, 45 minutes after initial injection, and animals were monitored until recovery.

Results

HR, but not fR, decreased significantly over time in both treatments. HR was significantly lower than baseline at all time points in D–M and for all but the 5 and 10 minute time points in A–M. HR was significantly higher in A–M at all time points after drug administration when compared with D–M. Sedation scores between protocols were similar for most time points. All animals in A–M lost righting reflex compared with seven out of nine (78%) geckos in D–M. Geckos in A–M lost righting reflex for significantly longer time. Mean ± standard deviation time to recovery after antagonist administration was 6.1 ± 2.2 minutes for D–M and 56 ± 29 minutes for A–M, and these times were significantly different.

Conclusions and clinical relevance

Combination D–M or A–M provided sedation of a level expected to allow physical examinations and venipuncture in leopard geckos. A–M provided a faster onset of sedation compared with D–M. Recovery was significantly faster following antagonist reversal of D–M, compared with A–M.  相似文献   

7.
8.

Objective

To investigate whether an intravenous (IV) lidocaine bolus in calves premedicated with xylazine-butorphanol reduces the amount of ketamine required to allow endotracheal intubation.

Study design

Randomized, prospective clinical study.

Animals

In total, 41 calves scheduled for elective umbilical surgery.

Methods

Calves were randomly assigned to one of two groups (L: lidocaine or S: saline). The calves were administered xylazine (0.07 mg kg?1) and butorphanol (0.1 mg kg?1) intramuscularly and 10 minutes later lidocaine (2 mg kg?1; group L) or saline (group S) IV over 1 minute. After 2 minutes, ketamine (2.5 mg kg?1) was injected IV. If the depth of anaesthesia was insufficient for intubation, additional ketamine (1 mg kg?1) was administered every minute until intubation was successful. The amount of ketamine required for intubation, respiratory rate, pulse rate, arterial pressures, the depth of sedation and conditions of endotracheal intubation after induction of anaesthesia were compared between the two groups.

Results

The calves in group L were sedated more deeply than those in group S; however, neither the median (range) amount of ketamine required for intubation, 3.5 (2.5–4.5) mg kg?1 and 3.5 (2.5–3.5) mg kg?1, respectively, nor the induction quality differed significantly between the groups.

Conclusion and clinical relevance

A bolus of lidocaine (2 mg kg?1) administered 10 minutes after xylazine-butorphanol in calves deepened the degree of sedation but did not decrease the requirement of ketamine for endotracheal intubation. No adverse effects were recorded in the physiological variables measured.  相似文献   

9.

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   

10.

Objective

To compare the effects of thiopentone, propofol and alfaxalone on arytenoid cartilage motion and establish the dose rates to achieve a consistent oral laryngoscopy examination.

Study design

Randomised crossover study.

Animals

Six healthy adult Beagle dogs.

Methods

Each dog was randomly administered three induction agents with a 1-week washout period between treatments. Thiopentone (7.5 mg kg?1), propofol (3 mg kg?1) or alfaxalone (1.5 mg kg?1) was administered over 1 minute for induction of anaesthesia. If the dog was deemed inadequately anaesthetised, then supplemental boluses of 1.8, 0.75 and 0.4 mg kg?1 were administered, respectively. Continual examination of the larynx, using a laryngoscope, commenced once an adequate anaesthetic depth was reached until examination end point. The number of arytenoid motions and vital breaths were counted during three time periods and compared over time and among treatments. Data were analysed using Friedman and Mann–Whitney U tests, Spearman rho and a linear mixed model with post hoc pairwise comparison with Tukey correction.

Results

The median (range) induction and examination times were 2.8 (2.0–3.0), 2.7 (2.0–3.3) and 2.5 (1.7–3.3) minutes (p = 0.727); and 14.1 (8.0–41.8), 5.4 (3.3–14.8) and 8.5 (3.8–31.6) minutes (p = 0.016) for thiopentone, propofol and alfaxalone, respectively. The median dose rates required to achieve an adequate anaesthetic depth were 6.3 (6.0–6.6), 2.4 (2.4–2.4) and 1.2 (1.2–1.2) mg kg?1 minute?1, respectively. There was no significant difference for the total number of arytenoid motions (p = 0.662) or vital breaths (p = 0.789) among induction agents.

Conclusion and clinical relevance

The number of arytenoid motions were similar among the induction agents. However, at the dose rates used in this study, propofol provided adequate conditions for evaluation of the larynx with a shorter examination time which may be advantageous during laryngoscopy in dogs.  相似文献   

11.

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   

12.

Objective

To compare the effects of general anaesthesia using sevoflurane or alfaxalone on the brainstem auditory evoked response (BAER) test in adult healthy cats.

Study design

Prospective, clinical, ‘blinded’, crossover study.

Animals

Ten feral adult healthy cats.

Methods

Premedication consisted of dexmedetomidine (0.01 mg kg–1) intramuscularly (IM). The first general anaesthesia was induced and maintained with sevoflurane (treatment S) for physical examination, BAER test, complete blood tests, thoracic radiographs and abdominal ultrasound. The second general anaesthesia was induced with alfaxalone (treatment A) IM (2 mg kg–1) and maintained with alfaxalone (10 mg kg–1 hour–1) for the BAER test, followed by neutering surgery.The BAER recordings were compared for differences in latencies, amplitudes and waveform morphology. Data were analysed using Student's t test and Wilcoxon rank test for paired samples for parametric and non-parametric data, respectively. Statistical significance was set at p < 0.05.

Results

General anaesthesia was uneventful; normal BAER comprising five peaks could be identified in both treatments. Mean ± SD latencies were 1.05 ± 0.09, 1.83 ± 0.11, 2.52 ± 0.19, 3.43 ± 0.17 and 4.39 ± 0.15 ms and 1.03 ± 0.04, 1.81 ± 0.73, 2.53 ± 0.15, 3.37 ± 0.13 and 4.33 ± 0.13 ms in treatments S and A, respectively. Median (interquartile range) amplitudes were 2.83 (0.67), 1.27 (0.41), 0.30 (0.40), 1.05 (0.82), 0.61 (0.38) microvolts and 2.84 (1.21), 1.49 (1.18), 0.26 (0.32), 0.91 (0.50) and 0.92 (0.64) microvolts in treatments S and A, respectively. There were no statistically significant differences in mean latencies or median amplitudes between both the anaesthetics.

Conclusions and clinical relevance

This study demonstrates that there were no statistically significant differences between both the anaesthetics on the BAER test in adult healthy cats. Moreover, two possible anaesthetic protocols are described for cats undergoing this electrodiagnostic test.  相似文献   

13.

Objective

We investigated the plasma concentrations and cardiovascular effects of intramuscularly (IM) administered medetomidine, administered alone or with three different doses of MK-467.

Study design

Prospective, randomized, open, crossover trial.

Animals

Eight purpose-bred healthy Beagle dogs.

Methods

Each dog was administered four treatments: medetomidine 20 μg kg–1 IM alone or mixed in the same syringe with MK-467 (200 μg kg–1, 400 μg kg–1 or 600 μg kg–1). Instrumentation was performed under standardized anaesthesia. The dogs were allowed to recover before measurement of baseline values. Composite sedation scores, cardiovascular variables, i.e., heart rate (HR), cardiac output (CO), mean arterial and central venous blood pressures (MAP and CVP) and arterial blood gases were recorded at baseline and for 60 minutes after treatment. Drug concentrations in venous plasma were analysed. Generalized linear mixed models for repeated measures with post hoc Bonferroni correction were used with statistical significance level set at α = 0.05.

Results

All treatments initially demonstrated the effects of medetomidine: HR and CO decreased and CVP increased. MAP transiently increased and then significantly decreased from baseline with the two highest MK-467 doses. The cardiovascular effects of medetomidine disappeared more rapidly with MK-467 than with medetomidine alone. With medetomidine alone, sedation scores remained high until the end of the 60 minute follow-up. Maximum concentrations of medetomidine were more rapidly achieved and were higher with MK-467.

Conclusions and clinical relevance

Initial haemodynamic effects of medetomidine were not prevented by MK-467, but these effects were attenuated and their duration shortened by MK-467, independently of dose. Absorption of medetomidine was accelerated by MK-467, when administered concomitantly IM, resulting in faster sedation; addition of MK-467 shortened the sedative effect of medetomidine.  相似文献   

14.

Objective

To evaluate whether intratesticular and incisional ropivacaine infiltration produces sufficient intra- and postoperative analgesia for castrating dogs under sedation.

Study design

Randomized, blinded, controlled clinical study.

Animals

Twenty-three healthy dogs weighing 5.8–35.6 kg admitted for castration.

Methods

Dogs were sedated with medetomidine (0.01 mg kg?1), butorphanol (0.2 mg kg?1) and midazolam (0.2 mg kg?1) intramuscularly, and were randomly assigned to group R, 0.2–0.4 mL kg?1 of ropivacaine 0.5%, or group S, an equivalent volume of saline injected intratesticularly and along the incision line. If persistent motion was observed during surgery, sedation was considered to be insufficient and general anaesthesia was induced. Carprofen 2.2 mg kg?1 was administered postoperatively. Pain was evaluated in all dogs before sedation and postoperatively following atipamezole administration at 1, 2, 4, 8 and 24 hours using an interactive visual analogue scale (IVAS; 0–100), the Glasgow composite pain scale-short form (CMPS-SF; 0–24), and a mechanical algometer. Methadone 0.3 mg kg?1 was administered intravenously to dogs if IVAS >30 or CMPS-SF >4.

Results

There was no significant difference between groups for the number of dogs administered general anaesthesia. The time from the beginning of surgery to induction of general anaesthesia was significantly shorter [median (range)] in group S [6 (3–25) minutes] than in group R [56 (36–76) minutes]. At 8 hours IVAS was significantly higher in group S (14 ± 10) than in group R (6 ± 4).

Conclusions and clinical relevance

Intratesticular and incisional ropivacaine infiltration delayed the time to anaesthesia induction, and provided analgesia after castration performed under deep sedation in dogs. Intratesticular local anaesthesia can be an important part of the anaesthetic plan for castration.  相似文献   

15.

Objective

To investigate the sedative effects in dogs of tiletamine–zolazepam–acepromazine (TZA) or ketamine–flunitrazepam (KF) administered orally and to evaluate the effectiveness of encapsulated TZA for capturing free-roaming dogs.

Study design

Experimental study followed by a field trial.

Animals

Six research dogs and 27 free-roaming dogs.

Methods

In a pilot study, six research dogs were administered liquid TZA (20 mg kg?1 tiletamine–zolazepam and 2 mg kg?1 acepromazine) or liquid KF (50 mg kg?1 ketamine and 2 mg kg?1 flunitrazepam) orally: treatment 1, forcefully squirting liquid medication into the mouth; treatment 2, encapsulating liquid medication for administration in canned food; treatment 3, administering liquid medication mixed with gravy. Sedation was scored. A follow-up field trial attempted capture of 27 free-roaming dogs.

Results

In the pilot study, the median time (range) to lateral recumbency (% dogs) after TZA administration was: treatment 1, 47.5 (35–80) minutes (67%); treatment 2, 30 (15–65) minutes (83%); and treatment 3, 75 (45–110) minutes (100%). No dogs in KF treatment 2 or 3 achieved lateral recumbency. Based on these results, 20 free-roaming dogs were offered encapsulated TZA in canned food: TZ (20 mg kg?1) and acepromazine (2 mg kg?1). Of these, no further drugs to four dogs (one dog captured), 10 dogs were administered a second dose within 30 minutes (five dogs captured) and six dogs were administered TZ (5 mg kg?1) and xylazine (1.1–2.2 mg kg?1) intramuscularly by blow dart (six dogs captured). Seven dogs were initially offered twice the TZA dose (five dogs captured). In total, 63% free-roaming dogs were captured after administration of encapsulated TZA in canned food.

Conclusions and clinical relevance

Oral administration of encapsulated TZA in canned dog food can aid in the capture of free-roaming dogs, but additional drugs may be required. The sedation onset time and medication palatability influenced the capture rate.  相似文献   

16.

Objective

To determine the cardiovascular and acid-base effects of 6% hydroxyethyl starch (HES) 130/0.4 and 0.9% sodium chloride (NaCl) administered to anaesthetized greyhounds with haemorrhagic shock.

Study design

Prospective, experimental, complete randomized block design.

Animals

Twelve healthy adult greyhounds.

Methods

After 60 minutes of isoflurane anaesthesia, 48 mL kg?1 of blood was removed to induce hypotension. Dogs were randomized to receive either 20 mL kg?1 of HES 130/0.4 or 80 mL kg?1 of 0.9% NaCl over 20 minutes. Haemoglobin, arterial and central venous blood gas and electrolytes, lactate, mean arterial pressure (MAP) and cardiac index were measured at: T0, 60 minutes after induction of anaesthesia, immediately prior to blood removal; T1, immediately after blood removal; T2, immediately after fluid administration; and T3, 40 minutes after fluid administration. Oxygen extraction ratio (O2ER) was calculated at each sample time.

Results

O2ER increased at T1 and decreased at T2 and T3, with no difference between the two groups. Dogs administered HES 130/0.4 had higher lactate at T2 [mean (95% confidence interval) 1.3 (0.8–1.9) mmol L?1] than dogs administered 0.9% NaCl [0.8 (0.5–1.1) mmol L?1]; p = 0.045. Dogs administered HES 130/0.4 had a higher MAP at T3 [88 (74–102) mmHg] than dogs administered 0.9% NaCl [69 (60–79) mmHg]; p = 0.019. Dogs administered 0.9% NaCl were more acidaemic at T2 and T3, including higher hydrogen ion, lower bicarbonate, lower base excess and higher chloride concentrations.

Conclusion

and clinical relevance The effect of 20 mL kg?1 of HES 130/0.4 on shock, as measured by O2ER, was no different than that of 80 mL kg?1 of 0.9% NaCl in dogs under general anaesthesia. Acidaemia in the NaCl group is likely attributable to hyperchloraemic metabolic acidosis from the larger volume administered.  相似文献   

17.

Objective

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

Study design

Prospective, randomized clinical trial.

Animals

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

Methods

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

Results

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

Conclusions and clinical relevance

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

18.

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   

19.

Objective

To determine the intubation dose and select physiologic effects of alfaxalone alone or in combination with midazolam or ketamine in dogs.

Study design

Prospective, clinical study.

Animals

Fifty-three healthy client-owned dogs [mean ± standard deviation (SD)] 5.1 ± 1.8 years, 27 ± 15.4 kg, scheduled for elective orthopedic surgery.

Methods

After premedication with acepromazine (0.02 mg kg–1) and hydromorphone (0.1 mg kg–1) intramuscularly, alfaxalone (0.25 mg kg–1) was administered intravenously over 15 seconds followed immediately by 0.9% saline (AS), midazolam (0.3 mg kg–1; AM), ketamine (1 mg kg–1; AK1), or ketamine (2 mg kg–1; AK2). Additional alfaxalone (0.25 mg kg–1 increments) was administered as required to permit endotracheal intubation. The incidence of apnea and the time from intubation until spontaneous movement were recorded. Heart rate (HR) and blood pressure were recorded 15 minutes after premedication, after intubation and 2, 5, 10 and 15 minutes thereafter. Blood was collected for measurement of serum glucose and insulin concentrations before induction, after intubation and at 2, 5, 10 and 50 minutes. Data were analyzed by split-plot anova with Bonferroni adjustment for the number of group comparisons.

Results

Mean ± SD alfaxalone mg kg–1 doses required for endotracheal intubation were AS (1.0 ± 0.4), AM (0.4 ± 0.2), AK1 (0.5 ± 0.3) and AK2 (0.5 ± 0.4) (p = 0.0005). Differences in cardiopulmonary variables among groups were minor; HR decreased in AS, while in other groups, HR increased transiently postintubation. Incidence of apnea in AS was 54% with no significant difference among groups. Midazolam significantly prolonged time from intubation until spontaneous movement (p < 0.002).

Conclusions and clinical relevance

Midazolam and ketamine reduced the alfaxalone dose required for endotracheal intubation. Serum glucose and insulin concentrations were not influenced by administration of alfaxalone alone or when administered with midazolam or ketamine.  相似文献   

20.

Objective

To compare the effects of two balanced anaesthetic protocols (isoflurane–dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses.

Study design

Prospective, blinded, randomized clinical study.

Animals

Sixty healthy adult warm blood horses undergoing elective surgery.

Methods

Thirty horses each were sedated with dexmedetomidine 3.5 μg kg?1 (group DEX) or medetomidine 7 μg kg?1 (group MED) intravenously. After assessing and supplementing sedation if necessary, anaesthesia was induced with ketamine/diazepam and maintained with isoflurane in oxygen/air and dexmedetomidine 1.75 μg kg?1 hour?1 or medetomidine 3.5 μg kg?1 hour?1. Ringer's lactate (7–10 mL kg?1 hour?1) and dobutamine were administered to maintain normotension. Controlled mechanical ventilation maintained end-tidal expired carbon dioxide pressures at 40–50 mmHg (5.3–6.7 kPa). Heart rate, invasive arterial blood pressure, inspired and expired gas composition and arterial blood gases were measured. Dexmedetomidine 1 μg kg?1 or medetomidine 2 μg kg?1 was administered for timed and scored recovery phase. Data were analysed using two-way repeated-measures analysis of variance and chi-square test. Significance was considered when p  0.05.

Results

In group DEX, significantly more horses (n = 18) did not fulfil the sedation criteria prior to induction and received one or more supplemental doses, whereas in group MED only two horses needed one additional bolus. Median (range) total sedation doses were dexmedetomidine 4 (4–9) μg kg?1 or medetomidine 7 (7–9) μg kg?1. During general anaesthesia, cardiopulmonary parameters did not differ significantly between groups. Recovery scores in group DEX were significantly better than in group MED.

Conclusions and clinical relevance

Horses administered dexmedetomidine required more than 50% of the medetomidine dose to reach equivalent sedation. During isoflurane anaesthesia, cardiopulmonary function was comparable between the two groups. Recovery scores following dexmedetomidine were better compared to medetomidine.  相似文献   

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