A comparison of propofol, thiopental or ketamine as induction agents in goats

OBJECTIVE: To compare propofol, thiopental and ketamine as induction agents before halothane anaesthesia in goats. STUDY DESIGN: Prospective, randomized cross-over study. Animals Seven healthy adult female goats with mean (+/-SD; range) body mass of 38.9 +/- 3.29 kg; 35-45 kg. METHODS: The seven animals were used on 21 occasions. Each received all three anaesthetics in a randomized cross-over design, with an interval of at least 2 weeks before re-use. Anaesthesia was induced with intravenous (IV) propofol (3 mg kg(-1)), thiopental (8 mg kg(-1), IV) or ketamine (10 mg kg(-1), IV). Following tracheal intubation, anaesthesia was maintained with halothane for 30 minutes. Indirect blood pressure, heart rate, respiratory rate and arterial blood gases were monitored. The quality of induction and recovery, recovery times and incidence of side-effects were recorded. RESULTS: Induction of anaesthesia was smooth and uneventful, and tracheal intubation was easily performed in all but two goats receiving ketamine. Changes in cardiopulmonary variables and acid-base status were similar with all three induction agents and were within clinically acceptable limits. Mean recovery times (time to recovery of swallowing reflex and to standing) were significantly shorter, and side-effects, e.g. apnoea, regurgitation, hypersalivation and tympany, were less common in goats receiving propofol, compared with the other treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Propofol 3 mg kg(-1) IV is superior to thiopental and ketamine as an induction agent before halothane anaesthesia in goats. It provides uneventful recovery which is more rapid than thiopental or ketamine, so reduces anaesthetic risk.     

Effect of propofol at two injection rates or thiopentone on post-intubation apnoea in the dog

Ventilatory effects at induction of anaesthesia were studied following intubation in 66 dogs anaesthetised using thiopentone (10 mg/kg) or propofol (4 mg/kg, injected rapidly or 4 mg/kg, injected slowly). Acepromazine and morphine preanaesthetic medication was administered, and anaesthesia was maintained with halothane in nitrous oxide and oxygen. The time from connection of the breathing system to the first breath was measured. Apnoea was defined as cessation of spontaneous respiration for 15 seconds or longer. Respiratory rate and minute volume were measured for the first five minutes of anaesthesia. Propofol was associated with a greater incidence of apnoea than thiopentone (59 per cent and 64 per cent compared with 32 per cent), but this difference was not statistically significant. Time to first breath was significantly longer with propofol than thiopentone and longest with the slower injection of propofol (P<0.05) (median of four seconds for thiopentone, 19.5 seconds for the propofol rapid injection, and 28.8 seconds for the propofol slow injection). In conclusion, the induction agent and speed of injection affect the incidence and duration of post-intubation apnoea.     

Total intravenous anaesthesia in the horse with propofol

The use of propofol, solubilised in a non-ionic emulsifying agent, for the induction and maintenance of anaesthesia in experimental ponies was assessed. Pilot studies revealed that premedication with xylazine (0.5 mg/kg bodyweight [bwt]) intravenously (iv) followed by propofol (2.0 mg/kg bwt) iv provided a satisfactory smooth induction. Two infusion rates (0.15 mg/kg bwt/min and 0.2 mg/kg bwt/min) were compared for maintenance of anaesthesia. An infusion rate of 0.2 mg/kg/min produced adequate anaesthesia in these ponies. Cardiovascular changes included a decrease in arterial pressure and cardiac output during maintenance. Respiratory depression was manifested by a decrease in rate and an increase in arterial carbon dioxide tension. Recovery after 1 h anaesthesia was rapid and smooth. In conclusion, induction and maintenance of anaesthesia with propofol in premedicated ponies proved a satisfactory technique.     

Propofol anaesthesia in cats

Propofol was administered to 49 cats to induce anaesthesia. The mean dose required was 6.8 mg/kg and this was not affected by prior administration of acepromazine maleate. In 27 cases, propofol was also used as the principal maintenance agent (mean dose rate 0.51 mg/kg/minute). Inductions were very smooth and problem free. Intubation was easily achieved in 15 cats with the aid of local desensitisation by lignocaine spray or neuromuscular relaxation by suxamethonium. Heart rate did not vary significantly during induction or maintenance of anaesthesia but respiratory rates did fall significantly. Recovery from anaesthesia was remarkably smooth in all cases and there was no significant difference in recovery times between the cats in which halothane was the principal maintenance agent and cats which received propofol alone. Side effects were seen during recovery in eight cats and included retching, sneezing and pawing of the face.     

Induction of anaesthesia in dogs and cats with propofol

Propofol was used to induce anaesthesia in 89 dogs and 13 cats of either sex, various breeds and of widely different ages and weights; they varied considerably in physical condition and were anaesthetised for a variety of investigations and surgical procedures. They were premedicated with acepromazine, papaveretum, diazepam, pethidine, atropine and scopolamine in different combinations. After induction with propofol, anaesthesia was maintained with halothane, isoflurane, methoxyflurane and enflurane and, or, nitrous oxide. The mean (+/- sd) induction doses of propofol in unpremedicated and premedicated animals were 5.2 +/- 2.3 mg/kg and 3.6 +/- 1.4 mg/kg respectively for dogs, and 5.0 +/- 2.8 mg/kg and 5.3 +/- 4.3 mg/kg for cats. There were no differences between the sexes. Premedication did not affect recovery times. The incidence of side effects was very low. One dog showed evidence of pain when propofol was injected. No incompatibility was observed between propofol and the premedicants and other anaesthetic agents used.     

Comparative study of propofol or propofol and ketamine for the induction of anaesthesia in dogs

The effects of propofol alone or propofol and ketamine for the induction of anaesthesia in dogs were compared. Thirty healthy dogs were premedicated with acepromazine and pethidine, then randomly allocated to either treatment. Anaesthesia was induced with propofol (4 mg/kg bodyweight intravenously) (group 1), or propofol and ketamine (2 mg/kg bodyweight of each intravenously) (group 2). Anaesthesia was maintained with halothane, delivered in a mixture of oxygen and nitrous oxide (1:2) via a non-rebreathing Bain circuit. Various cardiorespiratory parameters were monitored at two, five, 10, 15, 20, 25 and 30 minutes after induction, and the animals were observed during anaesthesia and recovery, and any adverse effects were recorded. During anaesthesia, the heart rate, but not the systolic arterial pressure, was consistently higher in group 2 (range 95 to 102 beats per minute) than in group 1 (range 73 to 90 beats per minute). Post-induction apnoea was more common in group 2 (11 of 15) than in group 1 (six of 15). Muscle twitching was observed in three dogs in each group. Recovery times were similar in both groups. Propofol followed by ketamine was comparable with propofol alone for the induction of anaesthesia in healthy dogs.     

The effects of halothane and nitrous oxide on the pharmacokinetics of propofol in dogs

The pharmacokinetics of propofol, 6.5 mg/kg, administered as a bolus dose intravenously (i.v.) were studied in six dogs (group 1). The effect of maintaining anaesthesia with halothane and nitrous oxide in oxygen on propofol pharmacokinetics was also investigated in six dogs undergoing routine anaesthesia (group 2). Induction of anaesthesia was rapid in all animals. Post-induction apnoea was a feature in three of the 12 dogs. The blood propofol concentration-time profile was best described by a bi-exponential decline in two dogs in group 1 and in 3 dogs in group 2, and by a tri-exponential decline in four dogs in group 1 and 3 dogs in group 2. The elimination half-life was long in both groups (90.9 min and 75.2 min, respectively), the volume of distribution at steady state large (4889 and 4863 ml/kg) and the clearance rapid (58.6 and 56.3 ml/kg.min). There were no significant differences between the groups, thus indicating that maintenance of anaesthesia with halothane and nitrous oxide had no effect on the pharmacokinetics of propofol in the dog.     

Anaesthetic regimes for cataract removal in the dog

Dogs scheduled for elective removal of non-diabetic cataracts were assigned to one of four anaesthetic regimes. Thiopentone (Intraval Sodium; RMB Animal Health) or propofol (Rapinovet; Coopers Pitman-Moore) was used as the induction agent and with each agent half the animals were paralysed with vecuronium (Nor-curon; Organon Teknika) and ventilated mechanically, and half breathed spontaneously. Anaesthesia was maintained with halothane (Halothane-M&B; RMB Animal Health) and nitrous oxide (BOC) in oxygen. The use of muscle relaxants significantly improved the eye position and significantly reduced the lowest halothane vaporiser setting used during anaesthesia. Propofol produced a significantly shorter recovery time than thiopentone.     

Speed of induction of anaesthesia in dogs administered halothane, isoflurane, sevoflurane or propofol in a clinical setting

OBJECTIVE: To compare the speed and quality of induction of general anaesthesia using three different inhalant agents and one intravenous agent, in healthy dogs undergoing desexing surgery. MATERIALS AND METHODS: Less excitable dogs were not premedicated; others were premedicated with intramuscular acepromazine and morphine. Anaesthesia induction protocol was randomly assigned, with halothane, isoflurane or sevoflurane delivered by mask, or propofol delivered intravenously. Maximum vaporiser settings were used for inhalant inductions. Induction of anaesthesia was considered complete at the time of endotracheal intubation. Quality of induction was scored by the administering veterinarian. RESULTS: Seventy-one dogs were enrolled. Twenty-four received no premedication and 47 received premedication. Isoflurane inductions were significantly faster than halothane inductions (2.86 +/- 0.25 vs 3.71 +/- 0.22 min; mean +/- SE, P = 0.013). Sevoflurane inductions (3.29 +/- 0.24 min) were not significantly different from either halothane (3.71 +/- 0.22 min, P = 0.202) or isoflurane inductions (2.86 +/- 0.25 min, P = 0.217). Induction with propofol (1.43 +/- 0.13 min) was significantly faster than inhalant induction (P < 0.001 in each case). Premedication decreased the dose requirement and time to induction for dogs induced with propofol, but did not significantly change the time to intubation for inhalant inductions. Dogs administered propofol and/or premedication were significantly more likely to have an excellent quality of induction, but there was no difference between inhalant agents in terms of induction quality. CONCLUSION: Sevoflurane possesses chemical properties that should produce a more rapid induction of anaesthesia in comparison to halothane or isoflurane. However, in clinical practice patient related factors outweigh this improvement.     

In vivo quantification of muscle damage in dogs after general anaesthesia with halothane andpropofol

Muscle damage in dogs anaesthetised with halothane and propofol was quantified by measurement of the area under the curve of plasma creatine kinase (CK) versus time. Plasma CK remained unchanged during anaesthesia for two and a half and five hours. Following halothane anaesthesia of dogs (resting on one side directly on the surgical table or on cushions, and with or without rotation of the body every 30 minutes), plasma CK was elevated in some animals to 10 000 U/litre by the 12th hour (baseline value ≤100 u/litre), whereas it remained almost unchanged in other animals. Plasma CK then returned to reference values on day 2 or 3. The mean equivalent of muscle damaged ranged from 0–6 to 0–9 g/kg bodyweight. No muscle damage could be demonstrated in animals anaesthetised with propofol. It is therefore concluded that plasma CK should not be used as a diagnostic aid following halothane anaesthesia because of false positives due to the halothane anaesthesia itself and that propofol Is best suited for the investigation of muscle damage due to surgical procedures.     

Real time monitoring of propofol blood concentration in ponies anaesthetized with propofol and ketamine

This study examined the pharmacokinetics of propofol by infusion in ponies using an analyser for the rapid measurement of propofol concentrations. The analyser (Pelorus 1000; Sphere Medical Ltd., Cambridge, UK) has a measurement cycle of approximately five minutes. Ten Welsh‐cross ponies (weighing 135–300 kg) undergoing minor procedures were studied after premedication with acepromazine 0.03 mg/kg and detomidine 0.015 mg/kg. Anaesthesia was induced with ketamine 2 mg/kg and diazepam 0.03 mg/kg, and maintained with an infusion of propofol at an initial rate of 0.16 mg/kg/min for the first thirty minutes, after a bolus of 0.3 mg/kg; and ketamine by infusion (20–40 μg/kg/min). Blood samples (<2 mL) were collected prior to, during and after the infusion, and on assuming standing position. Anaesthesia was uneventful; with the duration of infusion 31–89 min. Blood propofol concentrations during the infusion ranged between 1.52 and 7.65 μg/mL; pseudo‐steady state concentrations 3.64–6.78 μg/mL, and concentrations on assuming standing position 0.75–1.40 μg/mL. Propofol clearance and volume of distribution were 31.4 (SD 6.1) mL/min/kg and 220.7 (132.0) mL/kg, respectively. The propofol analyser allows titration of propofol to a given concentration; and may be useful for anaesthesia in animals where kinetics are unknown; in disease states; and where intercurrent therapies affect propofol disposition.     

Propofol Anaesthesia in Cats

Propofol was administered to forty nine cats to induce anaesthesia. The mean dose required was 6.8 mg/kg and this was not affected by prior administration of acepromazine maleate. In 27 cases, propofol was also used as the principal maintenance agent (mean dose rate 0.51 mg/kg/minute). Inductions were very smooth and problem free. Intubation was easily achieved in 15 cats with the aid of local desensitization by lignocaine spray or neuromuscular relaxation by suxamethonium. Heart rate did not vary significantly during induction or maintenance of anaesthesia but respiratory rates did fall significantly.     

A comparison of propofol infusion and propofol/isoflurane anaesthesia in dexmedetomidine premedicated dogs

The effects of propofol infusion were compared with propofol/isoflurane anaesthesia in six beagles premedicated with 10 microg/kg intramuscular (i.m.) dexmedetomidine. The suitability of a cold pressor test (CPT) as a stress stimulus in dogs was also studied. Each dog received isoflurane (end tidal 1.0%, induction with propofol) with and without CPT; propofol (200 microg/kg/min, induction with propofol) with and without CPT; premedication alone with and without CPT in a randomized block study in six separate sessions. Heart rate and arterial blood pressures and gases were monitored. Plasma catecholamine, beta-endorphin and cortisol concentrations were measured. Recovery profile was observed. Blood pressures stayed within normal reference range but the dogs were bradycardic (mean heart rate < 70 bpm). PaCO2 concentration during anaesthesia was higher in the propofol group (mean > 57 mmHg) when compared with isoflurane (mean < 52 mmHg). Recovery times were longer with propofol than when compared with the other treatments. The mean extubation times were 8 +/- 3.4 and 23 +/- 6.3 min after propofol/isoflurane and propofol anaesthesia, respectively. The endocrine stress response was similar in all treatments except for lower adrenaline level after propofol infusion at the end of the recovery period. Cold pressor test produced variable responses and was not a reliable stress stimulus in the present study. Propofol/isoflurane anaesthesia was considered more useful than propofol infusion because of milder degree of respiratory depression and faster recovery.     

Clinical usefulness of propofol as an anesthetic induction agent in dogs and cats

Propofol was used as an induction agent of general anesthesia in 77 dogs and 64 cats, all client owned, for a variety of surgeries/treatments or diagnostic procedures. The mean intravenous doses of propofol required to achieve endotracheal intubation in dogs and cats were 6.5 +/- 1.4 mg/kg and 10.1 +/- 2.8 mg /kg, respectively. Most of the animals could be induced to anesthesia smoothly by the administration of propofol with a high incidence of apnea. Propofol is a clinically valuable anesthetic induction agent in both dogs and cats, however, care must be taken for apnea.     

Disposition of propofol after medetomidine premedication in beagle dogs

Propofol by infusion was administered to 6 adult beagle dogs on 2 separate occasions. The dogs received either no premedication or 20 μg/kg im medetomidine 15 min before induction of anaesthesia, with propofol given at 7 mg/kg/min to permit tracheal intubation. After tracheal intubation the infusion rate was maintained for 120 min at 0.4 mg/kg/min in the non-premedicated, and 0.2 mg/kg/min in the premedicated dogs. The latter group received atipamezole 50 μg/kg im immediately at the end of the infusion. After induction of anaesthesia, a 7F balloon catheter designed for thermal dilution measurement of cardiac output was inserted via the right jugular vein. Blood propofol concentrations were measured by HPLC with fluorescence detection and kinetic variables calculated using non-compartmental moment analysis. The induction dose of propofol was 7.00 (sem 0.55) mg/kg in non-premedicated compared with 3.09 (0.25) mg/kg in premedicated dogs. There were differences in systemic clearance and mean residence time (MRT_iv); 47.5 (6.2) ml/kg/min vs 29.0 (4.4) ml/kg/min (non-premedicated vs premedicated) and 132.3 (5.2) min vs 152.4 (3.1) min (P < 0.02 and P < 0.001, respectively). Cardiorespiratory effects were similar in the 2 groups although heart rate was lower in the premedicated dogs. Venous admixture was high (20–45%) but similar in the 2 groups.     

PROPOFOL INFUSION ANAESTHESIA IN DOGS

Studies were carried out on 40 dogs premedicated with acepromazine (0.05 mg kg^-1), and atropine (0.02 mg kg^-1) to determine the minimum infusion rate of propofol needed to maintain anaesthesia and to compare the quality of the anaesthesia with that produced by halothane/nitrous oxide/oxygen. An infusion rate of 0.4 mg kg^-1 min^-1 of propofol produced surgical anaesthesia in dogs breathing oxygen or oxygen-enriched air. Cardiovascular and respiratory effects were similar to those in dogs anaesthetized with halothane/nitrous oxide and with both anaesthetic regimes myocardial oxygen consumption appeared to increase with increasing duration of anaesthesia. Propofol infusion was associated with a 16 per cent incidence of vomiting in the recovery period. Maintenance of anaesthesia in healthy dogs by the continuous infusion of propofol appeared to be safe but less satisfactory than the use of halothane/nitrous oxide.     

Effects of propofol-sevoflurane anesthesia on the maternal and fetal hemodynamics blood gases, and uterine activity in pregnant goats

To determine the effects of propofol and sevoflurane on hemodynamics, acid-base balance and uterine activity in pregnant animals, a prospective experimental study was designed by use of ten pregnant goats. Propofol was intravenously administered at a bolus dose of 5 mg/kg and then infused a rate of 0.3 mg/kg/min for 5 min. Following the induction, the animals were incrementally inhaled 2.7 and 4.1% of end-tidal concentration of sevoflurane each for 30 min, and then recovered. The maternal and fetal heart rate (HR), arterial blood pressure (BP) and acid-base balance, the intrauterine pressure (IUP), and the uterine blood flow (UBF) were measured. Following the pre-anesthetic data, the parameters were measured 7 times throughout the anesthetic and recovering periods. The propofol infusion induced 1.37 times of HR increase and produced decrease in PO(2) and a relevant metabolic acidemia in the mother, with no effect in the fetus. Sevoflurane reduced BP in the fetus from 30 (2.7%) to 60 (4.1%) min of inhalation. The uterine contractions disappeared throughout sevoflurane inhalation, and then recurred within 15 min after the cessation of sevoflurane. Propofol injection increases HR, and induces a moderate hypoxemia and metabolic acidemia associated with the suppressed ventilation for pregnant goats, with less effect on the fetal hemodinamics. Sevoflurane causes minimal change in maternal hemodynamics, but induces significant hypotension in the fetus and reduction of uterine activity. These data may be useful in making anesthetic choices combined with analgesia for Caesarian section in goats.     

The pharmacokinetics of ketamine after a continuous infusion under halothane anaesthesia in horses

The pharmacodynamics and pharmacokinetics of ketamine, when administered by infusion as an adjunct to halothane anaesthesia in horses, were investigated in 5 equine patients presented for routine castration. Anaesthesia was induced with detomidine, 20 μg/kg, followed by ketamine, 2.2 mg/kg bwt, the trachea intubated and the horses allowed to breathe halothane in oxygen. Five minutes later, a constant rate infusion of ketamine, 40 μg/kg min, was commenced and the halothane vaporiser concentration adjusted to maintain a light plane of anaesthesia. The mean infusion duration was 62 min (range 40–103). The ketamine was switched off approximately 15 min before the halothane. Plasma ketamine and norketamine levels, determined by high performance liquid chromatography, ranged from 0.74–2.04 μg/ml and 0.15–0.75 μg/ml, respectively, during the infusion period. The harmonic mean elimination half-life of ketamine was 46.1 min, mean volume of distribution at steady state (Vdss) was 1365 (271) ml/kg, mean body clearance (Cl) was 32.3 (9.1) ml/min.kg, and average mean residence time for the infusion (MRTinf) was 105.9 (20.4) min, respectively. Following termination of halothane, mean times to sternal recumbency and standing were 21.1 (6.9) and 41.6 (17.0) min, respectively. Surgical conditions were considered highly satisfactory, and physiological parameters were well preserved in most animals.     

Anesthesia in Sheep With Propofol or With Xylazine-Ketamine Followed by Halothane

Objective- This study evaluates the clinical usefulness and anesthetic effect of propofol, and compares these effects with those of xylazine-ketamine-halothane anesthesia in sheep.
Study Design- Prospective, randomized, clinical trial. Animals or Sample Population- Fourteen healthy adult male sheep.
Methods- Sheep were randomly assigned to two different drug regimens: (1) Bolus injection of propofol (3 mg/kg, intravenously [IV]) followed by continuous intravenous infusion and (2) xylazine (0.11 mg/kg, IV) and ketamine (2.2 mg/kg, IV) for induction followed by halothane anesthesia. Heart rate, respiratory rate, and arterial blood pressures were monitored during anesthesia. Venous blood samples were collected for blood gas analysis. Quality of induction and recovery were also recorded.
Results- The average dose of propofol used to induce and maintain anesthesia was 6.63 ±2.06 mg/kg and 29.3 ±11.7 mg/kg/hr (0.49 ±0.20 mg/kg/min), respectively. The duration of propofol anesthesia was 45.3 ±13.2 minutes and recovery to standing occurred in 14.7 ±5.7 minutes. Sheep receiving xylazine-ketamine-halothane were anesthetized for 35.9 ±4.0 minutes and recovery to standing occurred within 28.5 ±7.5 minutes. Sheep anesthetized with propofol had a significantly higher heart rate, diastolic blood pressure and Pvo₂, and a lower Pvco₂ at 30 minutes and lower BE at 15 and 30 minutes than sheep anesthetized with xylazine-ketamine-halothane.
Conclusions- Propofol anesthesia was characterized by a smooth induction, effective surgical anesthesia and rapid recovery which was comparable to anesthesia with xylazine-ketamine-halothane.
Clinical Relevance- Propofol may be indicated in situations when it is desirable to maintain anesthesia with an intravenous infusion followed by a rapid recovery in healthy sheep.     

Propofol-halothane-nitrous oxide/oxygen anaesthesia for mega-voltage radiotherapy in dogs

Observations were made on 49 dogs aged 3–13 years, of ASA Grades I and 11, during 83 periods of mega-voltage radiotherapy. The dogs weighed 5.847.0 kg and the total duration of anaesthesia ranged from 12–52 min (mean ± sem, 22 ± 8). No premedication was given. Anaesthesia was induced with iv propofol and, following endotracheal intubation, maintained with halothane/nitrous oxide/oxygen and intermittent injections of propofol. The dose of propofol needed to induce jaw relaxation sufficient for intubation was 3.5–10.8 mgkg bwt (5.67 ± 0.15) administered over 7–137 s (36 ± 2). On 91 occasions in 54 periods of anaesthesia, supplementary doses of propofol ranging from 0.2–4.9 mg/kg bwt (1.42 ± 0.14) were needed during positioning for irradiation. The times elapsing from extubation to swallowing, response to voice, spontaneous head lifting and walking were 3, 6, 7 and 13 min, respectively. A 12% incidence of tonic-clonic movements indicated that the method of anaesthesia cannot be regarded as entirely satisfactory for mega-voltage radiotherapy.