Evaluation of xylazine as a sedative and preanesthetic agent in horses.

Xylazine administered intramuscularly (IM) to horses at the dose level of 2 mg/kg was an effective sedative and preanesthetic for thiamylal sodium narcosis or thiamylal sodium and halothane anesthesia. Evaluation of response of cardiovascular, respiratory, and hepatic function did not indicate serious untoward effects, although cardiac and respiratory rate decreased, calculated vigor of left ventricular contraction decreased, calculated peripheral vascular resistance increased, and transient innocuous cardiac arrhythmias occurred. Effects of the anesthetics used on respiratory function (blood gases and pH), using xylazine as a preanesthetic, were comparable with those observed when promazine was used. The onset of action of xylazine given IM was at least as rapid as that occurring when promazine was given intravenously; e.g., 5 minutes for first observable effects, and 15 to 20 minutes for maximal effect. Recovery, times from anesthesia when using xylazine administered IM as a preanesthetic agent were comparable with those reported after promazine was given intravenously; moreover, horses given xylazine were more calm during recovery and seldom tried to stand before they were able.     

Effect of xylazine on the arrhythmogenic dose of epinephrine in thiamylal/halothane-anesthetized horses.

The effect of xylazine on the arrhythmogenic dose of epinephrine (ADE) was studied in 9 horses. Anesthesia was induced by administration of guaifenesin (50 mg/kg of body weight, IV) followed by thiamylal (4 to 6 mg/kg, IV) and was maintained at 1 minimal alveolar concentration (MAC) of halothane (0.89%). Base apex ECG and facial artery pressure were recorded. Epinephrine was infused in a sequence of arithmetically spaced increasing rates (initial rate 0.25 micrograms/kg/min) for a maximum of 10 minutes. The ADE was defined as the lowest epinephrine infusion rate to the nearest 0.25 micrograms/kg/min at which at least 4 premature ventricular depolarizations occurred in a 15-second period. Xylazine (1.1 mg/kg, IV) was administered after the control ADE was determined. Xylazine did not significantly alter the ADE (control, 1.12 +/- 0.38 micrograms/kg/min; xylazine, 1.21 +/- 0.46 micrograms/kg/min). Blood pressure increased transiently for 8 minutes after xylazine administration. Baseline systolic and diastolic arterial pressures and heart rate were not significantly different from control baseline pressures and heart rate 15 minutes after xylazine administration. Blood pressure and heart rate increased significantly during control and xylazine ADE determinations. Significant differences in pH, PaO2, PaCO2, or base excess were not observed between baseline and ADE in the control or xylazine groups. One horse developed atrial fibrillation, and 2 horses developed ventricular fibrillation during ADE determinations.     

Arrhythmias in dogs associated with epinephrine and thiamylal anesthesia.

Sinus tachycardia bigeminy, ventricular rhythm, ventricular tachycardia, and ventricular fibrillation are produced by relatively small intravenous doses of epinephrine in nonanesthetized dogs and in dogs anesthetized with thiamylal sodium. Origin of the abnormal beat in coupled bigeminal rhythms generated from the bundle o of His or above. Increases in arterial blood pressure may predispose to arrhythmia formation during thiamylal anesthesia.     

Increasing halothane concentration abolishes anesthesia-associated arrhythmias in cats and dogs

Fifteen cats and 6 dogs developed ventricular arrhythmias during halothane anesthesia. Halothane was administered by precision vaporizer, using a semiclosed anesthetic system. Cardiac arrhythmias were diagnosed within 5 to 10 minutes after a surgical plane of anesthesia was achieved. Arrhythmias in 9 of 15 cats and 3 of 6 dogs were converted to sinus rhythm by increasing the inspired halothane concentration. Conversion to sinus rhythm occurred within 4 minutes. Cardiac arrhythmias were reestablished in 8 of 9 cats and 2 of 3 dogs, after decreasing the inspired halothane concentration to its original value. Increasing the inspired halothane concentration can convert anesthetic-associated ventricular arrhythmias to sinus rhythm in dogs and cats.     

Effects of the opioid remifentanil on the arrhythmogenicity of epinephrine in halothane-anesthetized dogs

Opioids may exert a protective effect against ventricular arrhythmias via a vagally mediated mechanism. This study evaluated the effects of the opioid remifentanil on arrhythmogenicity of epinephrine during halothane anesthesia. Eight dogs were assigned to 2 treatments in a randomized crossover design, with 1-week intervals between treatments. Anesthesia was maintained with 1.3% end-tidal halothane in oxygen and mechanical ventilation to maintain eucapnia. A constant rate infusion of remifentanil (0.72 microg/kg/min) was administered throughout the study in the experimental treatment, while control animals received physiologic saline as placebo. The arrhythmogenic dose of epinephrine (ADE), defined as 4 premature ventricular complexes (PVCs) within 15 s, was determined by administering progressively increasing infusion rates of epinephrine (2.5, 5.0, and 10 microg/kg/min), allowing 20 min intervals between each infusion rate. In both treatments, epinephrine infusions induced bradyarrhythmias and atrioventricular conduction disturbances, which were followed by escape beats and PVCs. In the remifentanil treatment, mean +/- s ADE values (11.3 +/- 4.9 microg/kg) did not differ from values observed in control animals (9.9 +/- 6.1 microg/kg). On the basis of the ADE model for assessing the arrhythmogenity of drugs during halothane anesthesia, the present study did not demonstrate a protective effect of remifentanil (0.72 microg/kg/min) against ventricular arrhythmias in dogs.     

Evaluation of the arrhythmogenicity of a low dose of acepromazine: comparison with xylazine.

Alteration in the arrhythmogenic dose of epinephrine (ADE) was determined in 6 healthy dogs under halothane anesthesia following the administration of xylazine at 1.1 mg/kg i.v. and acepromazine at 0.025 mg/kg i.v. The order of treatment was randomly assigned with each dog receiving both treatments and testing was carried out on 2 separate occasions with at least a 1 wk interval. The ADE determinations were made prior to drug administration during halothane anesthesia (CNTL) and then 20 min and 4 h following drug treatment. Epinephrine was infused for 3 min at increasing dose rates (2.5, 5.0, 10.0 micrograms/kg/min) until the arrhythmia criterion (4 or more intermittent or continuous premature ventricular contractions) was reached within the 3 min of infusion or the 1 min following cessation. The interinfusion interval was 20 min. There was a significant difference (P = 0.0001) in the ADE determined following acepromazine administration at 20 min (20.95 micrograms/kg +/- 2.28 SEM) compared to CNTL (6.64 micrograms/kg +/- 1.09), xylazine at 20 min (5.82 micrograms/kg +/- 0.95) and 4 h (6.13 micrograms/kg +/- 1.05), and acepromazine at 4 h (7.32 micrograms/kg +/- 0.34). No other significant differences existed (P < 0.05). In this study we were unable to show any sensitization to epinephrine following xylazine administration during halothane anesthesia, while a protective effect was shown with a low dose of acepromazine.     

Thiamylal-and halothane-sparing effect of diazepam in dogs

The thiamylal- and halothane-sparing effect of diazepam was studied in two experiments using 32 conditioned dogs. Twenty-four dogs received 0.05, 0.1 or 0.2 ml/kg diazepam or 0.9% saline (placebo) prior to the administration of thiamylal sodium i.v. Eight dogs received 0.1 or 0.2 mg/kg diazepam i.v. or placebo prior to or during halothane anesthesia. All three doses of diazepam significantly decreased the amount of thiamylal required to allow orotracheal intubation. The 0.2 mg/kg i.v. dose of diazepam produced the most significant effects. Premedication of dogs with diazepam did not reduce the concentration of halothane required to maintain anesthesia. The administration of 0.1 and 0.2 mg/kg diazepam i.v. during halothane anesthesia decreased the concentration of halothane required to maintain anesthesia. These studies demonstrate that diazepam reduces the amount of thiamylal required for orotracheal intubation, and when given intra-operatively reduces the concentration of halothane required to maintain anesthesia.     

Atrial Fibrillation Associated with Anesthesia in a Standardbred Gelding

A Standardbred gelding was anesthetized on three occasions over a 3 year period. Anesthesia was induced with xylazine and thiamylal on the first occasion, with xylazine, guaifenesin, and thiamylal on the second, and with acepromazine, guaifenesin, and ketamine on the third. Anesthesia was maintained with halothane during each episode. The horse had atrial fibrillation (AF) after induction of anesthesia on the first two occasions. Because arterial blood pressure remained within normal limits during AF and anesthesia, conversion to normal sinus rhythm with quinidine was not attempted. Reversion to normal sinus rhythm occurred within 12 hours of recovery after each of the first two anesthetic episodes. The gelding remained in normal sinus rhythm throughout the third anesthetic period and recovered uneventfully. Potential causes for AF in anesthetized horses are discussed.     

Effects of two preanesthetic regimens for ophthalmic surgery on intraocular pressure and cardiovascular measurements in dogs

The effects of different preanesthetic medications (acepromazine plus either meperidine or butorphanol) given before the induction of anesthesia with midazolam and ketamine on intraocular pressure, heart rate, and arterial blood pressure were investigated in 20 dogs. Following administration of preanesthetics and induction of anesthesia, dogs were intubated and anesthesia was maintained with halothane for 10 minutes. Intraocular pressure was significantly higher (P <.05) at several evaluations for dogs premedicated with acepromazine/meperidine than for those premedicated with acepromazine/butorphanol. Mean heart rate and diastolic arterial blood pressure were significantly (P <.05) higher 5 minutes after administration of acepromazine/meperidine than after acepromazine/butorphanol. Results of this study suggest that acepromazine/butorphanol is a satisfactory preanesthetic combination to use before induction of anesthesia with midazolam and ketamine for ophthalmic surgery in dogs.     

Romifidine, medetomidine or xylazine before propofol-halothane-N2O anesthesia in dogs.

The objective of this paper was to evaluate romifidine as a premedicant in dogs prior to propofol-halothane-N2O anesthesia, and to compare it with the other alpha2-agonists (medetomidine and xylazine). For this, ten healthy dogs were anesthetized. Each dog received 3 preanesthetic protocols: atropine (10 microg/kg BW, IM), and as a sedative, romifidine (ROM; 40 microg/kg BW, IM), xylazine (XYL; 1 microg/kg, IM), or medetomidine (MED; 20 microg/kg BW, IM). Induction of anesthesia was delivered with propofol 15 min later and maintained with halothane and N2O for one hour in all cases. The following variables were registered before preanesthesia, 10 min after the administration of preanesthesia, and at 5-minute intervals during maintenance: PR, RR, rectal temperature (RT), MAP, SAP, and DAP. During maintenance, arterial oxygen saturation (SpO2), end-tidal CO2 (EtCO2) and percentage of halothane necessary for maintaining anesthesia (%HAL) were also recorded. Induction dose of propofol (DOSE), time to extubation (TE), time to sternal recumbency (TSR) and time to standing (TS) were also registered. The statistical analysis was carried out during the anesthetic period. ANOVA for repeat measures revealed no differences between the 3 groups for PR and RR; however, MAP, SAP and DAP were higher in the MED group; SpO2 was lower in MED and EtCO2 was lower in ROM; %HAL was higher in XYL. No statistical differences were observed in DOSE, TE, TSR or TS. Percentage of halothane was lower in romifidine and medetomidine than in xylazine premedicated dogs also anesthetized with propofol. All the cardiorespiratory variables measured were within normal limits. The studied combination of romifidine, atropine, propofol, halothane and N2O appears to be a safe and effective drug combination for inducing and maintaining general anesthesia in healthy dogs.     

Prevention of thiopental and thiopental/halothane cardiac sensitization to epinephrine in the sheep.

The effects of epinephrine (5 microgram/kg of body weight) on ten unanesthetized sheep were experimentally tested: all sheep displayed serious arrhythmias. Sheep anesthetized with thiopental and thiopental/halothane combination displayed cardiac arrhythmias of the order of 10% and 20% respectively. Challenge injections of epinephrine (5 microgram/kg of body weight) to ten sheep anesthetized with thiopental, and to the same number of animals after 45 minutes of anesthesia with thiopental/halothane, produced serious arrhythmias. However, following preanesthetic treatment with acepromazine maleate (0.5 mg/kg) to 15 sheep, serious arrhythmias were prevented in all of them when they were given arrhythmic doses of epinephrine.     

Clinical comparison of xylazine and medetomidine for premedication of horses

OBJECTIVE: To compare the analgesic and cardiopulmonary effects of medetomidine and xylazine when used for premedication of horses undergoing general anesthesia. DESIGN: Randomized clinical trial. ANIMALS: 40 horses. PROCEDURE: Twenty horses were premedicated with medetomidine (10 microg/kg [4.5 microg/lb], i.m.) and the other 20 were premedicated with xylazine (2 mg/kg [0.9 mg/kg], i.m.). Horses were then anesthetized with a combination of guaifenesin and ketamine; anesthesia was maintained with halothane. Additional doses of medetomidine or xylazine were given if horses were not sufficiently sedated at the time of anesthetic induction. After induction of anesthesia, sodium pentothal was administered as necessary to prevent limb movements. Hypotension was treated with dobutamine; hypoventilation and hypoxemia were treated with intermittent positive-pressure ventilation. The quality of anesthetic induction, maintenance, and recovery and the quality of the transition to inhalation anesthesia were scored. RESULTS: Scores for the quality of the transition to inhalation anesthesia were significantly higher for horses premedicated with medetomidine than for horses premedicated with xylazine. However, other scores, recovery times, and numbers of attempts needed to achieve sternal recumbency and to stand were not significantly different between groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that medetomidine is suitable for premedication of horses undergoing general anesthesia. Analgesic and cardiopulmonary effects of medetomidine were similar to those of xylazine, except that the transition to inhalation anesthesia was smoother when horses were premedicated with medetomidine, rather than xylazine.     

Influence of nifedipine on xylazine-induced acute pressor response in halothane-anesthetized dogs

Effects and interaction of nifedipine (Ca channel blocker) and xylazine (mixed alpha agonist) during halothane anesthesia were examined in 6 dogs. After achievement of steady-state halothane (1.35%) anesthesia, blood pressure (BP) and heart rate (HR) were recorded in these dogs during 3-minute saline or nifedipine (20 micrograms/kg) infusion periods. Seven minutes after the end of saline or nifedipine infusion, xylazine (1.1 mg/kg of body weight) was infused over a 2-minute period. After saline pretreatment, xylazine administration increased diastolic BP (33.67 +/- 3.91 mm of Hg) and decreased HR. Nifedipine infusion induced a transient reduction in BP, accompanied by a more persistent increase in HR. Compared with saline pretreatment, nifedipine pretreatment significantly decreased the acute increase in diastolic BP (33.67 +/- 3.91 vs 14.00 +/- 2.94 mm of Hg) which occurred during xylazine injection. After saline and nifedipine infusions, xylazine administration decreased HR 30 +/- 15.02 and 36.5 +/- 10.36 beats/min, respectively. A pronounced sinus arrhythmia and/or 2nd-degree atrioventricular block developed in all dogs during xylazine injection after saline infusion. Arrhythmias were not observed in the dogs after nifedipine infusion. Nifedipine's Ca blocking action depressed xylazine-induced acute vasoconstriction and concomitant increase in diastolic BP. Because alpha 2-, but not alpha 1-adrenoceptor-mediated vasoconstriction is Ca-dependent, these results indicate that a portion of the acute pressor response induced by IV xylazine in halothane-anesthetized dogs may be alpha 2-mediated. Seemingly, nifedipine-induced hypotension and damping of xylazine-induced increases in BP attenuated xylazine's actions on cardiac rate and rhythm.     

Alteration in the arrhythmogenic dose of epinephrine (ADE) following xylazine administration to halothane-anesthetized dogs

The arrhythmogenic dose of epinephrine (ADE) was determined in six dogs during halothane (1.35%) anesthesia before and after xylazine administration (1.1 mg/kg, i.v. bolus; 1.1 mg/kg/hr, i.v. infusion). The arrhythmogenic dose was determined by constant infusion of freshly mixed epinephrine (100 microgram/ml). The ADE was defined as the total dose of epinephrine which produced four or more intermittent or continuous premature ventricular contractions within a 15-sec period. Total dose was calculated as a function of infusion rate and time to arrhythmia. Following xylazine administration, ADE significantly decreased from 6.28 +/- 0.522 to 4.17 +/- 0.679 micrograms/kg. At the end of i.v. xylazine bolus administration, heart rate significantly decreased (115 +/- 4 to 99 +/- 4.9 b.p.m.), and mean arterial pressure significantly increased (83 +/- 4.0 to 122 +/- 3.4 mm Hg). Heart rate measured immediately prior to epinephrine-induced arrhythmia formation was significantly increased following xylazine administration (177 +/- 8 vs 78 +/- 3 b.p.m.). Mean arterial blood pressure was unchanged. Apparently, xylazine, a mixed alpha agonist, potentiated halothane-induced myocardial sensitization to ventricular arrhythmogenesis and was associated with a significant increase in heart rate, but not blood pressure, during subsequent epinephrine infusions.     

Tourniquet-induced hypertension in a horse

Arterial hypertension developed in a horse anesthetized for arthroscopy and lavage of an inflamed right carpal joint. Anesthesia was induced with xylazine HCl, butorphanol, guaifenesin, and thiamylal Na and was maintained with halothane in oxygen. Arterial hypertension and tachycardia developed within 15 minutes after a pneumatic tourniquet was placed 8 to 10 cm proximal to the right carpus and inflated to 800 mm of Hg. The surgical procedure was expedited, halothane was discontinued and anesthesia was maintained with guaifenesin to facilitate bandaging. Heart rate decreased from 72 to 42 beats/min after the tourniquet cuff was deflated. Mean arterial pressure decreased from 260 mm of Hg to 128 mm of Hg. Differential diagnosis for a rapidly increasing arterial pressure during halothane anesthesia include inadequate plane of anesthesia, signs of pain, hypercapnia, hypoxemia, and/or hyperthermia.     

Hemodynamic effects of carbon dioxide during intermittent positive-pressure ventilation in horses

The hemodynamic effects of high arterial carbon dioxide pressure (PaCO2) during anesthesia in horses were studied. Eight horses were anesthetized with xylazine, guaifenesin, and thiamylal, and were maintained with halothane in oxygen (end-tidal halothane concentration = 1.15%). Baseline data were collected while the horses were breathing spontaneously; then the horses were subjected to intermittent positive-pressure ventilation, and data were collected during normocapnia (PaCO2, 35 to 45 mm of Hg), moderate hypercapnia (PaCO2, 60 to 70 mm of Hg), and severe hypercapnia (PaCO2, 75 to 85 mm of Hg). Hypercapnia was induced by adding carbon dioxide to the inspired gas mixture. Moderate and severe hypercapnia were associated with significant (P less than 0.05) increases in aortic blood pressure, left ventricular systolic pressure, cardiac output, stroke volume, maximal rate of increase and decrease in left ventricular pressure (positive and negative dP/dtmax, respectively), and median arterial blood flow, and decreased time constant for ventricular relaxation. These hemodynamic changes were accompanied by increased plasma epinephrine and norepinephrine concentrations. Administration of the beta-blocking drug, propranolol hydrochloride, markedly depressed the response to hypercapnia. This study confirmed that in horses, hypercapnia is associated with augmentation of cardiovascular function.     

Hemodynamic effects of high-frequency oscillatory ventilation in halothane-anesthetized dogs

Hemodynamic effects of spontaneous ventilation, intermittent positive-pressure ventilation (IPPV), and high-frequency oscillatory ventilation (HFOV) were compared in 6 dogs during halothane anesthesia. Anesthesia was induced with IV thiamylal Na and was maintained with halothane (end-tidal concentration, 1.09%). During placement of catheters, dogs breathed spontaneously through a conventional semiclosed anesthesia circuit. Data were collected, and dogs were mechanically ventilated, using IPPV or HFOV in random order. Ventilation was adjusted to maintain PaCO2 between 38 and 43 mm of Hg during IPPV and HFOV. Cardiac index, aortic blood pressure, and maximum rate of increase of left ventricular pressure were significantly (P less than 0.05) less during HFOV than during spontaneous ventilation, whereas right atrial and pulmonary artery pressure were significantly greater during HFOV than during spontaneous ventilation. During IPPV, only the maximum rate of increase of left ventricular pressure was significantly less than that during spontaneous ventilation.     

Retrospective Assessment of Dobutamine Therapy for Hypotension in Anesthetized Horses

Dobutamine was infused (1.7 micrograms/kg/minute) into 200 anesthetized horses as treatment for hypotension. The horses had been premedicated with xylazine, and anesthesia was induced with guaifenesin and ketamine and maintained with halothane. One hundred fifty-seven horses (79%) responded with an average increase in systolic blood pressure of at least 10 mm Hg within 10 minutes. A cardiac arrhythmia developed in 56 horses (28%) after dobutamine administration: 34 with sinus bradycardia, 18 with atrioventricular block, 2 with premature atrial contractions, and 2 with atrioventricular dissociation. Dobutamine intravenous infusion was effective treatment for hypotension in horses anesthetized with halothane.     

Metabolic and hormonal changes associated with arthroscopic surgery in the horse

The effect of general anaesthesia and arthroscopic surgery on blood glucose and lactate, plasma non-esterified fatty acids, insulin, beta-endorphin and cortisol was investigated in seven horses. Animals were premedicated with xylazine and anaesthesia was induced with guaifenesin and sodium thiamylal and maintained with halothane vaporised in oxygen. Blood samples were collected in the pre-, intra- and post operative period. Induction of anaesthesia was associated with a transient hyperglycaemia and a significant rise in plasma insulin levels. Plasma insulin values fell during surgery but showed a significant increase post operatively. Surgery stimulated a small but significant rise in plasma beta-endorphin and cortisol values but these had returned to baseline values in the early post operative period. No changes in blood lactate were recorded.     

Halothane-catecholamine arrhythmias in swine (Sus scrofa)

The arrhythmogenic dose of epinephrine (ADE) was determined in 6 pigs during steady-state anesthesia (1.5% halothane in O2) and steady-state anesthesia plus xylazine (1.1 mg X kg-1 X hr-1; IV infusion) and after either prazosin (alpha 1) or metoprolol (beta 1) adrenergic blockade during halothane-xylazine (H-X) anesthesia. A constant infusion (1, 2, 3, 5, and 10 micrograms X kg-1 X min-1) of freshly mixed epinephrine (100 micrograms X ml-1 in saline solution) was used to determine ADE. The ADE was defined as the total dose of epinephrine which produced 4 or more continuous or intermittent, premature, ventricular contractions within a 15-s period. The mean epinephrine total dose values during 1.5% halothane anesthesia, H-X anesthesia alone, or H-X anesthesia after either prazosin (0.1 mg X kg-1) or metoprolol (0.5 mg X kg-1) adrenergic blockade were 3.60 +/- 0.844, 2.68 +/- 0.402, 11.85 +/- 3.804, and 5.17 +/- 0.587 micrograms X kg-1, respectively. Xylazine administration did not significantly decrease ADE, although mean arterial pressure significantly increased. Prazosin administration significantly increased ADE and was associated with an increased heart rate and a decreased mean arterial pressure. We conclude that alpha 1-blockade with prazosin is more protective to epinephrine-induced arrhythmias in H-X-anesthetized pigs than is beta 1-blockade with metoprolol.