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1.
Kirk A. Muñoz Sheilah A. Robertson Deborah V. Wilson 《Veterinary anaesthesia and analgesia》2017,44(4):766-774
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2.
Ana Zapata Francisco G. Laredo Mayte Escobar Amalia Agut Marta Soler Eliseo Belda 《Veterinary anaesthesia and analgesia》2018,45(5):609-617
Objective
To study the effect of alternating the order of midazolam and alfaxalone administration on the incidence of behavioural changes, alfaxalone induction dose and some cardiorespiratory variables in healthy dogs.Study design
Prospective, randomized, controlled, clinical trial.Animals
A total of 33 client-owned dogs undergoing elective procedures.Methods
Following intramuscular acepromazine (0.02 mg kg?1) and morphine (0.4 mg kg?1) premedication, anaesthesia was induced intravenously (IV) with a co-induction of either midazolam (0.25 mg kg?1) prior to alfaxalone (0.5 mg kg?1; group MA), or alfaxalone followed by midazolam at identical doses (group AM). The control group (CA) was administered normal saline IV prior to alfaxalone administration. Additional alfaxalone (0.25 mg kg?1 increments) was administered as required in all groups until orotracheal intubation was possible. Changes in behaviour, quality of induction, ease of intubation and incidence of adverse events at induction were recorded. Heart rate (HR), respiratory rate (fR) and systolic arterial blood pressure (SAP) were measured before treatments (baseline values), 30 minutes after premedication and at 0, 2, 5 and 10 minutes postintubation.Results
The incidence of excitement was higher in group MA compared with groups CA (p = 0.005) and AM (p = 0.013). The mean induction dose of alfaxalone was lower in group AM compared with group CA (p = 0.003). Quality of induction and ease of intubation were similar among groups. Mean HR values decreased after premedication and increased after alfaxalone administration in all groups. Mean SAP values were similar between groups. The number of animals that required manual ventilation was higher in the MA group.Conclusions and clinical relevance
Despite a lower occurrence of adverse events at induction in group AM compared with group MA and a reduction of alfaxalone dose requirement in group AM compared with group CA, the use of an alfaxalone–midazolam co-induction does not seem to produce any cardiovascular or respiratory benefits in healthy dogs. 相似文献3.
PenTing Liao Melissa Sinclair Alexander Valverde Cornelia Mosley Heather Chalmers Shawn Mackenzie Brad Hanna 《Veterinary anaesthesia and analgesia》2017,44(5):1016-1026
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4.
Lauren E. James Catherine JA. Williams Mads F. Bertelsen Tobias Wang 《Veterinary anaesthesia and analgesia》2018,45(3):329-337
Objective
To characterise the minimum dose of intramuscular alfaxalone required to facilitate intubation for mechanical ventilation, and to investigate the impact of cranial versus caudal injection on anaesthetic depth.Study design
Randomised crossover study.Animals
Six healthy juvenile ball pythons (Python regius).Methods
Three dosages (10, 20 and 30 mg kg–1) of alfaxalone were administered to each python in a caudal location with a minimum 2 weeks washout. Induction and recovery were monitored by assessing muscle tone, righting reflex, response to a noxious stimulus and the ability to intubate. A subsequent experiment assessed the influence of injection site by comparing administration of 20 mg kg–1 alfaxalone in a cranial location (1 cm cranial to the heart) with the caudal site. Respiration rate was monitored throughout, and when intubation was possible, snakes were mechanically ventilated.Results
Regardless of dose and injection site, maximum effect was reached within 10.0 ± 2.7 minutes. When administered at the caudal injection site, intubation was only successful after a dosage of 30 mg kg-1, which is higher than in previous reports for other reptiles. However, intubation was possible in all cases after 7.2 ± 1.6 minutes upon cranial administration of 20 mg kg–1, and anaesthetic duration was significantly lengthened (p < 0.001). Both 30 mg kg–1 at the caudal site and 20 mg kg–1 at the cranial site led to apnoea approximately 10 minutes post-injection, at which time the snakes were intubated and mechanically ventilated.Conclusions and clinical relevance
Alfaxalone provided rapid, smooth induction when administered intramuscularly to pythons, and may serve as a useful induction agent prior to provision of volatile anaesthetics. The same dosage injected in the cranial site led to deeper anaesthesia than when injected caudally, suggesting that shunting to the liver and first-pass metabolism of alfaxalone occur when injected caudally, via the renal portal system. 相似文献5.
Trina M. Hancock Nigel A. Caulkett Ed A. Pajor Leanna Grenwich 《Veterinary anaesthesia and analgesia》2018,45(6):858-864
Objective
To determine whether intratesticular injection of an alfaxalone–lidocaine combination can induce anesthesia and provide a rapid recovery in piglets undergoing surgical castration.Study design
Randomized experimental study.Animals
A group of 30 male piglets, aged 2–10 days, weighing 1.3–4.6 kg.Methods
Animals were randomly divided into three equal groups for intratesticular administration of alfaxalone + lidocaine: high dose (group HD; 8 mg kg–1 + 2.5 mg kg–1), medium dose (group MD; 6 mg kg?1 + 2 mg kg?1) and low dose (group LD; 4 mg kg?1 + 1.5 mg kg?1). Induction and recovery times, movement and vocalization were recorded. Pulse rate (PR), oxygen saturation, respiratory rate (fR), rectal temperature, blood pressure and end-tidal carbon dioxide were recorded until recovery.Results
Induction time did not differ significantly among groups (p = 0.19); mean time of 2.2, 3.3 and 3.7 minutes for HD, MD and LD, respectively. Recovery time to sternal recumbency was significantly faster in LD compared with HD and MD (p = 0.005). Time to standing was mean 34.1, 31.6 and 29.6 minutes for HD, MD and LD, respectively (p = 0.58). Incidences of movement and vocalization during the castration procedure were decreased in HD and MD compared with LD, but were not statistically different. There were no differences in the physiologic data among the groups except for PR, which decreased in all three groups (p < 0.05), and fR, which increased in MD and LD (p < 0.05).Conclusions and clinical relevance
The alfaxalone–lidocaine combinations investigated in this study induced deep sedation in all piglets. Physiologic data remained within clinically acceptable ranges, suggesting that this drug combination by intratesticular injection prior to castration in neonatal piglets is well tolerated. The authors recommend the alfaxalone (6 mg kg?1) + lidocaine (2 mg kg?1) dose. 相似文献6.
Eugenio Gaudio Laura Voltan Giulia Maria De Benedictis 《Veterinary anaesthesia and analgesia》2018,45(3):351-356
Objective
To evaluate the clinical effects and quality of sedation, induction, maintenance and recovery in Lemur catta after dexmedetomidine–butorphanol–midazolam sedation and alfaxalone anaesthesia.Study design
Prospective, observational study.Animals
Six male L. catta weighing 3.0 ± 0.6 kg undergoing surgical castration.Methods
Lemurs were sedated with intramuscular dexmedetomidine (0.015 mg kg?1), butorphanol (0.2 mg kg?1) and midazolam (0.2 mg kg?1). Anaesthesia was induced with intravenous alfaxalone 0.5 mg kg?1 over 60 seconds; further boluses were administered until tracheal intubation was feasible and final dose recorded. Alfaxalone continuous infusion was used to maintain anaesthesia. Atipamezole (0.15 mg kg?1) was administered during recovery. The quality of sedation, induction, intubation, maintenance and recovery was assessed using a scoring system. Physiological parameters were recorded during sedation, maintenance and recovery.Results
Sedation was achieved in 13.6 ± 5.6 minutes and no reactions were observed during handling or venepuncture. The mean dose of alfaxalone required for induction and maintenance was 2.09 ± 0.65 and 0.08 ± 0.02 mg kg?1 minute?1, respectively. Quality of induction, intubation and maintenance was good in almost all animals. Mild self-limiting muscle twitching was observed after alfaxalone administration in three animals. Cardiorespiratory function was stable in all animals but one. One lemur showed respiratory depression and required oxygen administration and manual ventilation. The mean maintenance time was 29.2 ± 7.4 minutes. The mean times from the end of alfaxalone administration to extubation, atipamezole administration and full recovery were: 15.3 ± 8.0, 22.2 ± 4.6 and 60.0 ± 8.4 minutes, respectively. Recovery was considered good in all animals.Conclusions and clinical relevance
Dexmedetomidine–butorphanol–midazolam combination provided reliable sedation and adequate muscle relaxation in L. catta. Alfaxalone proved to be a useful drug for induction and maintenance of anaesthesia and might be considered an option for injectable anaesthesia in lemurs. 相似文献7.
8.
Setefilla Quirós-Carmona Rocío Navarrete Juan M. Domínguez María del Mar Granados Rafael J. Gómez-Villamandos Pilar Muñoz-Rascón Daniel Aguilar Francisco J. Funes Juan Morgaz 《Veterinary anaesthesia and analgesia》2017,44(2):228-236
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9.
Katherine J. Bennett Reza Seddighi Kaitlin A. Moorhead Kristin Messenger Sherry K. Cox Xiaocun Sun Kirby Pasloske Bruno H. Pypendop Thomas J. Doherty 《Veterinary anaesthesia and analgesia》2019,46(2):173-181
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10.
Daisy Norgate Gert Ter Haar Nicola Kulendra Kata Orsolya Veres-Nyéki 《Veterinary anaesthesia and analgesia》2018,45(6):729-736
Objective
To compare the effect of propofol and alfaxalone on laryngeal motion under a light plane of anaesthesia in nonbrachycephalic and brachycephalic dogs anaesthetized for nonemergency procedures.Study design
Prospective, randomized clinical trial.Animals
A total of 48 client-owned dogs (24 nonbrachycephalic and 24 brachycephalic).Methods
A standardized premedication of methadone (0.2 mg kg?1) and acepromazine (0.01 mg kg?1) was administered intramuscularly. Dogs were randomly assigned to be induced with increments of propofol (1–4 mg kg?1) or alfaxalone (0.5–2 mg kg?1). Laryngeal assessment was performed under a light plane of anaesthesia by a surgeon (GTH) who was unaware of the induction protocol. Laryngeal movement was assessed as either being present when abduction of the laryngeal cartilages upon inspiration was identified, or absent when abduction was not recognized. Simultaneously, a 60-second video was recorded. The same surgeon (GTH) and an additional surgeon (NK) re-evaluated the videos 1 month later. Categorical comparisons were studied using Chi square and Fisher’s exact test where appropriate. Pairwise evaluation of agreement between scorers was undertaken with the kappa statistic (κ).Results
There were no significant differences (p > 0.05) identified between the presence or absence of laryngeal motion between dogs administered propofol or alfaxalone, as well as when analysing nonbrachycephalic and brachycephalic dogs separately. The majority of dogs (>75%) maintained some degree of laryngeal motion with both protocols. Agreement between assessors was excellent (κ = 0.822).Conclusions
Alfaxalone maintained laryngeal motion similarly to propofol in nonbrachycephalic and brachycephalic dogs.Clinical relevance
Both agents would appear appropriate for allowing assessment of laryngeal motion in nonbrachycephalic and brachycephalic dogs. The assessment technique of subjective evaluation of laryngeal motion via peroral laryngoscopy under a light plane of anaesthesia produced consistent results amongst assessors, regardless of the induction agent used. 相似文献11.
Sarah E. Bigby Thierry Beths Sébastien Bauquier Jennifer E. Carter 《Veterinary anaesthesia and analgesia》2017,44(5):1007-1015
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12.
Sarah E. Bigby Jennifer E. Carter Sébastien Bauquier Thierry Beths 《Veterinary anaesthesia and analgesia》2017,44(4):905-909
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13.
Julia Deutsch Colette Jolliffe Emma Archer Elizabeth A. Leece 《Veterinary anaesthesia and analgesia》2017,44(4):794-802
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14.
Josiane Lauper Vincent Marolf Olivier Levionnois Esther Schelling Mireille Meylan Claudia Spadavecchia 《Veterinary anaesthesia and analgesia》2017,44(2):281-286
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15.
Tesh M. Smalle Marthinus J. Hartman Lynette Bester Roxanne K. Buck Geoffrey T. Fosgate Gareth E. Zeiler 《Veterinary anaesthesia and analgesia》2017,44(3):427-434
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16.
Jill K Maney H Edward Durham Kathleen P Goucher Erika L Little 《Veterinary anaesthesia and analgesia》2018,45(4):539-544
Objective
To compare the induction and recovery characteristics and selected cardiopulmonary variables of midazolam–alfaxalone or midazolam–ketamine in donkeys sedated with xylazine.Study design
Randomized, blinded, crossover experimental trial.Animals
A group of seven adult male castrated donkeys weighing 164 ± 14 kg.Methods
Donkeys were randomly administered midazolam (0.05 mg kg?1) and alfaxalone (1 mg kg?1) or midazolam (0.05 mg kg?1) and ketamine (2.2 mg kg?1) intravenously following sedation with xylazine, with ≥ 7 days between treatments. Donkeys were not endotracheally intubated and breathed room air. Time to lateral recumbency, first movement, sternal recumbency and standing were recorded. Induction and recovery were assigned scores between 1 (very poor) and 5 (excellent). Heart rate (HR), respiratory rate (fR), invasive arterial blood pressures and arterial blood gases were measured before induction and every 5 minutes following induction until first movement.Results
Time to lateral recumbency (mean ± standard deviation) was shorter after alfaxalone (29 ± 10 seconds) compared with ketamine (51 ± 9 seconds; p = 0.01). Time to first movement was the same between treatments (27 versus 23 minutes). Time to standing was longer with alfaxalone (58 ± 15 minutes) compared with ketamine (33 ± 8 minutes; p = 0.01). Recovery score [median (range)] was of lower quality with alfaxalone [3 (2–5)] compared with ketamine [5 (3–5); p = 0.03]. There were no differences in HR, fR or arterial pressures between treatments. No clinically important differences in blood gases were identified between treatments. Five of seven donkeys administered alfaxalone became hypoxemic (PaO2 <60 mmHg; 8.0 kPa) and all donkeys administered ketamine became hypoxemic (p = 0.13).Conclusions and clinical relevance
Both midazolam–alfaxalone and midazolam–ketamine produced acceptable anesthetic induction and recovery in donkeys after xylazine sedation. Hypoxemia occurred with both treatments. 相似文献17.
Wendy A. Goodwin Kirby Pasloske Helen L. Keates Millaganamada Gedara Ranasinghe Solomon Woldeyohannes Nigel Perkins 《Veterinary anaesthesia and analgesia》2019,46(2):188-199
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18.
Bruno H. Pypendop M.G. Ranasinghe Kirby Pasloske 《Veterinary anaesthesia and analgesia》2018,45(4):459-466
Objective
To compare the performance of an alfaxalone constant rate intravenous (IV) infusion versus a 3-step IV infusion, both following a loading dose, for the maintenance of a target plasma alfaxalone concentration of 7.6 mg L–1 (effective plasma alfaxalone concentration for immobility in 99% of the population) in cats.Study design
Prospective randomized crossover study.Animals
A group of six healthy, adult male neutered cats.Methods
Catheters were placed in a jugular vein for blood sampling and in a medial saphenous vein for drug administration. An IV bolus of alfaxalone (2 mg kg–1) was administered, followed by either 0.2 mg kg?1 minute?1 for 240 minutes (single infusion; SI) or 0.4 mg kg?1 minute?1 for 10 minutes, then 0.3 mg kg?1 minute?1 for 30 minutes, and then 0.2 mg kg?1 minute?1 for 200 minutes (3-step infusion; 3-step). Plasma alfaxalone concentration was measured at six time points during the infusions. Measures of performance were calculated for each infusion regimen and compared using the paired Wilcoxon signed-rank test.Results
Median (range) absolute performance error, divergence, median prediction error and wobble were 15 (8–19)%, ?8 (?12 to ?6)% hour?1, ?12 (?19 to ?7)% and 10 (8–19)%, respectively, in the SI treatment, and 6 (2–16)%, 0 (?13 to 2)% hour?1, 1 (?16 to 4)% and 4 (3–6)% respectively, in the 3-step treatment and were significantly smaller in the 3-step treatment than in the SI treatment.Conclusion and clinical relevance
After IV administration of a bolus dose, a 3-step infusion regimen can better maintain stable plasma alfaxalone concentrations close to the target concentration than a single constant rate infusion. 相似文献19.
Melissa D. Smith Michele Barletta Kathryn A. Diehl Erik H. Hofmeister Samuel P. Franklin 《Veterinary anaesthesia and analgesia》2019,46(1):36-42