Preliminary Results of Behavioral and Cardiopulmonary Effects of a Constant Rate Infusion of Remifentanil–Xylazine for Sedation in Horses

Standing surgical procedures are performed commonly in horses under sedation. The use of a xylazine and remifentanil combination has not been investigated in horses. We proposed to evaluate behavioral and cardiopulmonary effects of an intravenous (IV) infusion of xylazine with remifentanil for sedation in horses. Xylazine (0.8 mg/kg IV) followed in 3 minutes by remifentanil (0.0005 mg/kg IV), and a constant rate infusion of xylazine and remifentanil (0.65 mg/kg/h; 0.0225 mg/kg/h, respectively) was administered in three horses. Heart rate, respiratory rate (RR), arterial blood pressures, quality of sedation, pH, partial pressure of arterial CO₂ (PaCO₂), partial pressure of arterial O₂ (PaO₂), ataxia, sedation, and sedation overall outcome were assessed. Heart rate and RR remained within normal values during sedation without significant changes from baseline. Systolic, mean, and diastolic arterial blood pressures were increased during sedation. There were no significant changes in pH, PaCO₂, and PaO₂. Sedation developed immediately after injection of xylazine in the three horses but did not increase after remifentanil bolus or IV infusion of both drugs. None of the mares had ataxia. Adverse effects during and after sedation were present: excitement, increase in locomotor activity, and decrease in the gastrointestinal motility. The combination of xylazine and remifentanil sedation protocol produces adverse effects. This protocol cannot be recommended for clinical conditions, at the described doses.     

Evaluation of urine specific gravity as a predictor of hypotension during anaesthesia in healthy dogs premedicated with dexmedetomidine

ObjectiveTo investigate the relationship between urine specific gravity (USG) and the risk of arterial hypotension during general anaesthesia (GA) in healthy dogs premedicated with dexmedetomidine and methadone.Study designProspective clinical cohort study.AnimalsA total of 75 healthy client-owned dogs undergoing GA for elective tibial plateau levelling osteotomy.MethodsAfter placing an intravenous catheter, dogs were premedicated with dexmedetomidine (5 μg kg^–1) and methadone (0.3 mg kg^–1) intravenously. After induction of GA with alfaxalone to effect, the bladder was expressed and USG measured. An arterial catheter was placed, and residual blood was used to measure packed cell volume (PCV) and total protein (TP). GA was maintained with isoflurane vaporised in oxygen and a femoral and sciatic nerve block were performed. Arterial blood pressure < 60 mmHg was defined as hypotension and recorded by the anaesthetist. Treatment for hypotension was performed in a stepwise manner following a flow chart. Frequency of hypotension, treatment and response to treatment were recorded. Logistic regression modelling was used to assess the association between USG, TP and PCV and incidence of perioperative hypotension; p < 0.05.ResultsData from 14 dogs were excluded. Of the 61 dogs, 16 (26%) were hypotensive during GA, 15 dogs needed treatment of which 12 were responsive to a decrease in inhalant vaporiser setting. The logistic regression model was not statistically significant (p = 0.8). There was no significant association between USG (p = 0.6), TP (p = 0.4), PCV (p = 0.8) and arterial hypotension during GA.Conclusions and clinical relevanceIn healthy dogs premedicated with dexmedetomidine and methadone and maintained under GA with isoflurane and a femoral and sciatic nerve block, there was no relationship between the specific gravity of urine collected after premedication and intraoperative arterial hypotension.     

Pharmacokinetics and pharmacodynamics of intravenous medetomidine in the horse

ObjectiveTo describe the pharmacodynamics and pharmacokinetics following an intravenous (IV) bolus dose of medetomidine in the horse.Study designProspective experimental trial.AnimalsEight, mature healthy horses age 11.7 ± 4.6 (mean ± SD) years, weighing 557 ± 54 kg.MethodsMedetomidine (10 μg kg^?1) was administered IV. Blood was sampled at fixed time points from before drug administration to 48 hours post administration. Behavioral, physiological and biochemical data were obtained at predetermined time points from 0 minutes to 24 hours post administration. An algometer was also used to measure threshold responses to noxious stimuli. Medetomidine concentrations were determined by liquid chromatography-Mass Spectrometry and used for calculation of pharmacokinetic parameters using noncompartmental and compartmental analysis.ResultsPharmacokinetic analysis estimated that medetomidine peaked (8.86 ± 3.87 ng mL^?1) at 6.4 ± 2.7 minutes following administration and was last detected at 165 ± 77 minutes post administration. Medetomidine had a clearance of 39.6 ± 14.6 mL kg^?1 minute^?1 and a volume of distribution of 1854 ± 565 mL kg^?1. The elimination half-life was 29.1 ± 12.5 minutes. Glucose concentration reached a maximum of 176 ± 46 mg dL^?1 approximately 1 hour post administration. Decreased heart rate, respiratory rate, borborygmi, packed cell volume, and total protein concentration were observed following administration. Horses lowered their heads from 107 ± 12 to 20 ± 10 cm within 10 minutes of drug administration and gradually returned to normal. Horse mobility decreased after drug administration. An increased mechanical threshold was present from 10 to 45 minutes and horses were less responsive to sound.Conclusion and clinical relevance Behavioral and physiological effects following intravenous administration positively correlate with pharmacokinetic profiles from plasma medetomidine concentrations. Glucose concentration gradually transiently increased following medetomidine administration. The analgesic effect of the drug appeared to have a very short duration.     

Effect of medetomidine-butorphanol and dexmedetomidine-butorphanol combinations on intraocular pressure in healthy dogs

ObjectiveTo assess the effects of intravenous (IV) medetomidine-butorphanol and IV dexmedetomidine-butorphanol on intraocular pressure (IOP).Study designProspective, randomized, blinded clinical study.AnimalsForty healthy dogs. Mean ± SD body mass 37.6 ± 6.6 kg and age 1.9 ± 1.3 years.MethodsDogs were allocated randomly to receive an IV combination of dexmedetomidine, 0.3 mg m^?2, combined with butorphanol, 6 mg m^?2, (group DEX) or medetomidine 0.3 mg m^?2, combined with butorphanol 6 mg m^?2, (group MED). IOP and pulse (PR) and respiratory (f_R) rates were measured prior to (baseline) and at 10 (T10), 20 (T20), 30 (T30) and 40 (T40) minutes after drug administration. Oxygen saturation of hemoglobin (SpO₂) was monitored following sedation. Data were analyzed by anova followed by Dunnett's tests for multiple comparisons. Changes were considered significant when p < 0.05.ResultsFollowing drug administration, PR and f_R were decreased significantly at all time points but did not differ significantly between groups. Baseline IOP in mmHg was 14 ± 2 for DEX and 13 ± 2 for MED. With both treatments, at T10, IOP increased significantly (p < 0.001), reaching 20 ± 3 and 17 ± 2 for DEX and MED respectively. This value for DEX was significantly higher than for MED. There were no significant differences in IOP values between groups at any other time points. At T30 and T40, IOP in both groups was below baseline (DEX, 12 ± 2 and 11 ± 2: MED 12 ± 2 and 11 ± 2) and this was statistically significant, for DEX.Conclusions and clinical relevanceAt the documented doses, both sedative combinations induced a transient increase and subsequent decrease of IOP relative to baseline, which must be taken into consideration when planning sedation of animals in which marked changes in IOP would be undesirable.     

Sedative effects of propofol in horses

Objective  We hypothesized that propofol can produce rapidly-reversible, dose-dependent standing sedation in horses.
Study design  Prospective randomized, blinded, experimental trial.
Animals  Twelve healthy horses aged 12 ± 6 years (mean ± SD), weighing 565 ± 20 kg, and with an equal distribution of mares and geldings.
Methods  Propofol was administered as an intravenous bolus at one of three randomized doses (0.20, 0.35 and 0.50 mg kg⁻¹). Cardiovascular and behavioral measurements were made by a single investigator, who was blinded to treatment dose, at 3 minute intervals until subjective behavior scores returned to pre-sedation baseline values. Continuous data were analyzed over time using repeated-measures anova and noncontinuous data were analyzed using Friedman tests.
Results  There were no significant propofol dose or temporal effects on heart rate, respiratory rate, vertical head height, or jugular venous blood gases (pH_v, P_vO₂, P_vCO₂). The 0.35 mg kg⁻¹ dose caused mild sedation lasting up to 6 minutes. The 0.50 mg kg⁻¹ dose increased sedation depth and duration, but with increased ataxia and apparent muscle weakness.
Conclusions and clinical relevance  Intravenous 0.35 mg kg⁻¹ propofol provided brief, mild sedation in horses. Caution is warranted at higher doses due to increased risk of ataxia.     

Effect of detomidine on visceral and somatic nociception and duodenal motility in conscious adult horses

ObjectiveTo evaluate the effects of detomidine on visceral and somatic nociception, heart and respiratory rates, sedation, and duodenal motility and to correlate these effects with serum detomidine concentrations.Study designNonrandomized, experimental trial.AnimalsFive adult horses, each with a permanent gastric cannula weighing 534 ± 46 kg.MethodsVisceral nociception was evaluated by colorectal (CRD) and duodenal distension (DD). The duodenal balloon was used to assess motility. Somatic nociception was assessed via thermal threshold (TT). Nose–to–ground (NTG) height was used as a measure of sedation. Serum was collected for pharmacokinetic analysis. Detomidine (10 or 20 μg kg^?1) was administered intravenously. Data were analyzed by means of a three–factor anova with fixed factors of treatment and time and random factor of horse. When a significant time × treatment interaction was detected, differences were compared with a simple t–test or Bonferroni t–test. Significance was set at p < 0.05.ResultsDetomidine produced a significant, dose–dependent decrease in NTG height, heart rate, and skin temperature and a significant, nondose–dependent decrease in respiratory rate. Colorectal distension threshold was significantly increased with 10 μg kg^?1 for 15 minutes and for at least 165 minutes with 20 μg kg^?1. Duodenal distension threshold was significantly increased at 15 minutes for the 20 μg kg^?1 dose. A significant change in TT was not observed at either dose. A marked, immediate decrease in amplitude of duodenal contractions followed detomidine administration at both doses for 50 minutes.Conclusions and clinical relevanceDetomidine caused a longer period of visceral anti–nociception as determined by CRD but a shorter period of anti–nociception as determined by DD than has been previously reported. The lack of somatic anti–nociception as determined by TT testing may be related to the marked decrease in skin temperature, likely caused by peripheral vasoconstriction and the low temperature cut–off of the testing device.     

EFFECTS OF SEDATION WITH MIDAZOLAM AND BUTORPHANOL ON RESISTIVE AND PULSATILITY INDICES IN HEALTHY DOGS

Resistive index (RI) and pulsatility index (PI) are indirect measurements of blood flow resistance that may be measured by pulsed wave Doppler ultrasonography. Chemical restrain may potentially alter the indices although it is required to perform ultrasonography in some patients. The purpose of this study was to describe values for both intrarenal and ocular RI and PI within the same subject in clinically normal dogs sedated with a midazolam and butorphanol combination and evaluate if there are any significant changes between sedated and nonsedated dogs. Fifteen healthy Beagle dogs were studied by Duplex Doppler interrogation in interlobar or arcuate arteries of the kidney and long posterior ciliary artery. Pulse rate and systolic blood pressure were also determined. All measurements were recorded before and after the administration of a sedative combination of midazolam (0.2 mg/kg) and butorphanol (0.2 mg/kg). Mean comparison tests (paired t-tests or Wilcoxon's rank-sum test) were used to determine if any significant differences existed between right and left renal values or right and left ocular values. A correlation study (Pearson or Spearman) was applied between RI, PI, and systolic pressure, and pulse rate. RI and PI were significantly higher in sedated Beagles than in unsedated Beagles. There was neither correlation between index and systolic blood pressure nor pulse rate. In conclusion, provided that normal RI and PI increase in sedated animals, then reference ranges should be higher when sedated--healthy or ill--animals are evaluated.     

Behavioral and Cardiopulmonary Effects of a Constant Rate Infusion of Remifentanil–Xylazine for Sedation in Horses

Xylazine and remifentanil in constant rate infusion (CRI) could be used for sedation in horses without adverse effects. The objective was to evaluate behavioral and cardiopulmonary effects of an intravenous (IV) infusion of xylazine and remifentanil for sedation in horses. Xylazine (0.8 mg/kg IV) followed after 3 minutes by a CRI of xylazine and remifentanil (0.65 mg/kg/h and 6 μg/kg/h, respectively) was administered in 10 healthy horses for 60 minutes. Sedation, ataxia, and cardiopulmonary, hematological, and blood gases variables were evaluated. Heart rate decreased significantly during the first 25 minutes after CRI of xylazine and remifentanil, whereas the respiratory rate showed a significant decrease at 20 minutes and remained significantly low until the endpoint. There were no statistically significant fluctuations in blood arterial pressure, blood pH, partial pressure of arterial carbon dioxide, lactate, creatinine, calcium, chlorine, and sodium, compared with baseline values. Blood partial pressure of arterial oxygen and bicarbonate values were significantly higher compared with baseline values, whereas potassium decreased. Sedation and ataxia developed immediately after the administration of xylazine in all horses. All horses recovered successfully within 10 minutes after interruption of the CRI of xylazine and remifentanil, with no ataxia. No adverse effects were observed. The use of a combination of xylazine and remifentanil as sedation protocol has no adverse effects at the described dosage.     

S‐(+)‐Linalool from Lippia alba: sedative and anesthetic for silver catfish (Rhamdia quelen)

ObjectiveThe present study describes the isolation of linalool from the essential oil of Lippia alba (Mill.) N. E. Brown, and its anesthetic effect in silver catfish (Rhamdia quelen) in comparison with essential oil. The potentiation of depressant effects of linalool with a benzodiazepine (BDZ) and the involvement of GABAergic system in its antagonism by flumazenil were also evaluated.Study designProspective experimental study.AnimalsJuvenile silver catfish unknown sex weighing mean 9.24 ± 2.83 g (n = 6 for each experimental group per experiment).MethodsColumn chromatography was used for the isolation of S-(+)-linalool. Fish (n = 6 for each concentration) were transferred to aquaria with linalool (30, 60, and 180 μL L^?1) or EO of L. alba (50, 100, and 300 μL L^?1) to determine the induction time for anesthesia. After induction, the animals were transferred to anesthetic-free aquaria to assess their recovery time. To observe the potentiation, fish were exposed to linalool (30, 60, and 180 μL L^?1) in the presence or absence of BDZ (diazepam 150 μm). In another experiment, fish exposed to linalool (30 and 180 μL L^?1) or BDZ were transferred to an anesthetic-free aquaria containing flumazenil (5 μm) or water to assess recovery time.ResultsLinalool had a similar sedation profile to the essential oil at a proportional concentration in silver catfish. However, the anesthesia profile was different. Potentiation of linalool effect occurred only when tested at low concentration. Fish exposed to BDZ showed faster anesthesia recovery in water with flumazenil, but the same did not occur with linalool.Conclusions and clinical relevanceThe use of linalool as a sedative and anesthetic for silver catfish was effective at 30 and 180 μL L^?1, respectively. The mechanism of action seems not to involve the benzodiazepine site of the GABAergic system.