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Journal of Acupuncture and Meridian... Jun 2023Cardiorespiratory depression caused by anesthesia decreases the quality and increases the time of postoperative recovery. The acupoint Governor Vessel 26 (GV26) is a...
BACKGROUND
Cardiorespiratory depression caused by anesthesia decreases the quality and increases the time of postoperative recovery. The acupoint Governor Vessel 26 (GV26) is a resuscitation point that can reverse this depression and can be safely used without side effects.
OBJECTIVES
The objective of this study was to evaluate the stimulation and anesthetic recovery time of GV26 in bitches submitted to ovariohysterectomy (OH) under dissociative anesthesia.
METHODS
As pre-anesthetic protocol, acepromazine 0.2% (0.1 mg/kg) and tramadol hydrochloride (2 mg/kg) was used, and induction was performed using midazolam (0.5 mg/kg) and ketamine (10 mg/kg). For the control group, standard procedure was performed for OH, with anesthetic recovery and post-surgical procedures. For the acupuncture group (AP), the stimulation of acupoint GV26 was performed 20 minutes after the anesthetic induction and maintained for 5 minutes. Respiratory rate, amplitude (superficial, normal or deep), type of respiratory movement (abdominal, abdominocostal or thoracoabdominal), heart rate, capillary filling time, temperature, presence or absence of laryngotracheal reflex, presence or absence of interdigital reflexes were assessed immediately before PAM application, and 2 (T1), 5 (T2), 10 (T3), 15 (T4), 20 (T5), 25 (T6) and 30 (T7) minutes after treatment. The results were tabulated and statistically analyzed.
RESULTS
When comparing the AP group with the control group, an improvement in amplitude of the chest cage was observed at all times, where the animals remained in normal or deep respiratory amplitude. The heart rate was significantly higher for the AP group (155.5 ± 34.4 bpm) than the control group at T1 (105.1 ± 15.4 bpm), while recovery time was lower for the AP group (54.1 ± 14.9 min) when compared to control group (79.9 ± 17.9 min).
CONCLUSION
The present paper demonstrated the efficacy of GV26 in maintaining adequate respiratory amplitude and decreasing the anesthetic recovery time.
Topics: Animals; Acupuncture Therapy; Anesthetics; Ketamine; Acepromazine; Acupuncture Points
PubMed: 37381031
DOI: 10.51507/j.jams.2023.16.3.95 -
Veterinary Anaesthesia and Analgesia Jul 2020To evaluate the effects of progressively increasing doses of acepromazine on cardiopulmonary variables and sedation in conscious dogs.
OBJECTIVE
To evaluate the effects of progressively increasing doses of acepromazine on cardiopulmonary variables and sedation in conscious dogs.
STUDY DESIGN
Prospective, experimental study.
ANIMALS
A group of six healthy, adult, mixed-breed dogs weighing 16.5 ± 5.0 kg (mean ± standard deviation).
METHODS
Dogs were instrumented with thermodilution and arterial catheters for evaluation of hemodynamics and arterial blood gases. On a single occasion, acepromazine was administered intravenously to each dog at 10, 15, 25 and 50 μg kg at 20 minute intervals, resulting in cumulative acepromazine doses of 10 μg kg (ACP), 25 μg kg (ACP), 50 μg kg (ACP) and 100 μg kg (ACP). Hemodynamic data and sedation scores were recorded before (baseline) and 20 minutes after each acepromazine dose.
RESULTS
Compared with baseline, all acepromazine doses significantly decreased stroke index (SI), mean arterial pressure (MAP) and arterial oxygen content (CaO) with maximum decreases of 16%, 17% and 21%, respectively. Cardiac index (CI) decreased by up to 19% but not significantly. Decreases of 26-38% were recorded for oxygen delivery index (DOI), with significant differences for ACP and ACP. Systemic vascular resistance index (SVRI) and heart rate did not change significantly. No significant difference was found among acepromazine doses for hemodynamic data. After ACP, mild sedation was observed in five/six dogs and moderate sedation in one/six dogs, whereas after ACP, ACP and ACP, moderate sedation was observed in five/six or six/six dogs.
CONCLUSIONS AND CLINICAL RELEVANCE
In conscious dogs, acepromazine decreased MAP, SI, CaO and DOI, but no significant dose effect was detected. SVRI was not significantly changed, suggesting that the reduction in MAP resulted from decreased CI. The ACP, ACP and ACP doses resulted in moderate sedation in most dogs; ACP resulted in only mild sedation.
Topics: Acepromazine; Animals; Conscious Sedation; Dogs; Dose-Response Relationship, Drug; Female; Hemodynamics; Hypnotics and Sedatives; Male; Prospective Studies; Respiration
PubMed: 32362549
DOI: 10.1016/j.vaa.2020.02.007 -
Tierarztliche Praxis. Ausgabe G,... Apr 2019In 2018, no new active pharmaceutical ingredients were released on the German market for horses or food-producing animals. One established veterinary active... (Review)
Review
In 2018, no new active pharmaceutical ingredients were released on the German market for horses or food-producing animals. One established veterinary active pharmaceutical ingredient became available for an additional species: the inhalant anesthetic Isoflurane (Isofluran Baxter vet) from the group of halogenated hydrocarbon compounds was additionally authorized for pigs (piglets). With Acepromazine, Mepivacaine and Oxyclozanide, three temporarily non-available active ingredients were reapproved in new drugs. Additionally, one drug with a new combination of active ingredients and one drug with a new pharmaceutical form were launched on the market for horses and food-producing animals.
Topics: Acepromazine; Anesthetics, Inhalation; Anesthetics, Local; Animals; Animals, Domestic; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antiplatyhelmintic Agents; Bees; Dopamine Antagonists; Drug Therapy; Germany; Horses; Isoflurane; Meloxicam; Mepivacaine; Oxalic Acid; Oxyclozanide; Swine; Thiamphenicol; Veterinary Drugs
PubMed: 30999352
DOI: 10.1055/a-0858-7380 -
BMC Veterinary Research Jul 2020To evaluate the effect on arterial blood pressure (ABP) of labetalol infusion as treatment for perioperative non nociceptive acute hypertension in dogs. The clinical...
BACKGROUND
To evaluate the effect on arterial blood pressure (ABP) of labetalol infusion as treatment for perioperative non nociceptive acute hypertension in dogs. The clinical records of dogs receiving intra or postoperative labetalol infusion were retrospectively reviewed. Invasive systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressure and heart rate (HR) before labetalol infusion (T0) and 15, 30, 45 and 60 min (T1, T2, T3 and T4 respectively) after infusion were retrieved. The dose rate of labetalol infusion and use of concurrently administered drugs that could have potentially affected ABP and/or HR were also recorded. ANOVA for repeated measures and Dunnett's multiple comparison test were used to determine the effect of labetalol on ABP and HR. Differences were considered significant when p < 0.05.
RESULTS
A total of 20 dogs met the inclusion criteria, and hypertension was documented after craniotomy (12/20), adrenalectomy (4/20) and other procedures (4/20). Five dogs received labetalol intraoperatively, 14 postoperatively, and 1 during the surgical procedure and recovery. Median infusion duration and rate were 463 (60-2120) minutes and 1.1 (0.2-3.4) mg/kg/h respectively. Median loading dose was 0.2 (0.2-0.4) mg/kg. Labetalol produced a significant decrease in SAP and DAP at all time points compared to T0 (p < 0.05), while the effect was not significant at T1 for MAP (p = 0.0519). Median maximum MAP decrease was 31 (20-90) mmHg. Heart rate did not increase significantly during treatment (p = 0.2454). Acepromazine given before or during labetalol treatment did not reduce significantly ABP (p = 0.735).
CONCLUSIONS
Labetalol produced a reliable and titratable decrease in ABP with non significant increase in HR.
Topics: Adrenalectomy; Animals; Antihypertensive Agents; Craniotomy; Dogs; Heart Rate; Hypertension; Intraoperative Complications; Labetalol; Retrospective Studies
PubMed: 32709242
DOI: 10.1186/s12917-020-02475-4 -
Veterinary Anaesthesia and Analgesia Jan 2022To evaluate the anesthetic effects of two drug combinations with local anesthesia, with or without postoperative antagonists, for orchiectomy in cats.
Effects of dissociative anesthesia opioid-free protocols combined with local anesthesia, with or without flumazenil or atipamezole postoperatively, for orchiectomy in cats.
OBJECTIVE
To evaluate the anesthetic effects of two drug combinations with local anesthesia, with or without postoperative antagonists, for orchiectomy in cats.
STUDY DESIGN
Prospective, randomized blinded clinical study.
ANIMALS
A total of 64 healthy cats.
METHODS
Cats were assigned to four equal groups: ketamine (5 mg kg) and dexmedetomidine (10 μg kg) were administered intramuscularly (IM), followed postoperatively with intravenous (IV) saline (5 mL; group KDS) or atipamezole (50 μg kg; group KDA); and ketamine (14 mg kg) with midazolam (0.5 mg kg) and acepromazine (0.1 mg kg) IM, with postoperative IV saline (5 mL; group KMAS) or flumazenil (0.1 mg kg; group KMAF). Lidocaine (2 mg kg) was divided between subcutaneous and intratesticular injection. Physiologic variables were recorded at time points during anesthesia. Ketamine rescue dose was recorded. The degree of sedation and the quality of recovery were evaluated postoperatively.
RESULTS
Time to loss of pedal reflex was longer in groups KMAS and KMAF than in groups KDS and KDA (p = 0.010). Total rescue dose of ketamine was higher in KMAS and KMAF than in KDS and KDA (p = 0.003). Heart rate (HR) during anesthesia was higher in KMAS and KMAF than in KDS and KDA (p = 0.001). Times to head up (p = 0.0005) and to sternal recumbency (p = 0.0003) were shorter in KDA than in KDS, KMAS and KMAF. Lower sedation scores were assigned sooner to KDA than KDS, KMAS and KMAF (p < 0.001). Recovery quality scores were good in all groups.
CONCLUSIONS AND CLINICAL RELEVANCE
Both anesthetic protocols allowed the performance of orchiectomy. Groups KMAS and KMAF required higher rescue doses of ketamine before injecting lidocaine. HR and oscillometric systolic pressure were minimally changed in groups KD and tachycardia was recorded in groups KMA. Only atipamezole shortened the anesthetic recovery.
Topics: Analgesics, Opioid; Anesthesia, Local; Animals; Cats; Dexmedetomidine; Flumazenil; Imidazoles; Male; Orchiectomy; Prospective Studies
PubMed: 34656443
DOI: 10.1016/j.vaa.2021.09.003 -
Veterinary Anaesthesia and Analgesia Nov 2020To evaluate the feasibility of gastroduodenoscopy in dogs premedicated with acepromazine in combination with butorphanol or methadone. (Comparative Study)
Comparative Study
OBJECTIVE
To evaluate the feasibility of gastroduodenoscopy in dogs premedicated with acepromazine in combination with butorphanol or methadone.
STUDY DESIGN
Prospective, randomized, double-blinded clinical trial.
ANIMALS
A group of 40 client-owned dogs.
METHODS
Dogs were randomly allocated to one of two groups and give intramuscular acepromazine 0.02 mg kg combined with either butorphanol 0.3 mg kg (group ACEBUT) or methadone 0.2 mg kg (group ACEMET). General anaesthesia was induced with propofol and ketamine and maintained with sevoflurane (2.3%) in oxygen. Cardiopulmonary variables were recorded at 5 minute intervals during anaesthesia. Feasibility of the entire gastroduodenoscopy was evaluated with a visual analogue scale (VAS) from 0 (best) to 100 (worst) (primary outcome of the study). Lower oesophageal sphincter dilatation and duodenal intubation were scored. Pylorus diameter was measured with standard endoscopic inflatable balloons. Overall cardiovascular stability was assessed during anaesthesia, using a VAS (0-100), as was the presence of fluid in the oesophagus, regurgitation, need for mechanical ventilation, and intraoperative and postoperative rescue analgesia (secondary outcomes of the study). Differences between treatments were analysed with Mann-Whitney U, Student t test, Fisher exact test or mixed model analysis of variance as appropriate. Subsequently, feasibility VAS of the gastroduodenoscopy was assessed for noninferiority between groups. The noninferiority margin was set as -10.
RESULTS
All gastroduodenoscopies were successfully completed in both groups using an endoscope tip diameter of 12.8 mm in all but one dog. Feasibility of gastroduodenoscopy was evaluated as 2.9 ± 5.6 in group ACEBUT and 5.1 ± 5.8 in group ACEMET. No significant differences between groups were detected in any measured or assessed variables, and noninferiority was confirmed.
CONCLUSION AND CLINICAL RELEVANCE
In our study population, the effects of methadone and butorphanol when combined with acepromazine were comparable.
Topics: Acepromazine; Analgesics; Anesthesia, General; Anesthetics, Combined; Animals; Butorphanol; Dogs; Double-Blind Method; Endoscopy, Gastrointestinal; Feasibility Studies; Hypnotics and Sedatives; Methadone; Premedication; Prospective Studies
PubMed: 33041210
DOI: 10.1016/j.vaa.2020.03.008 -
Veterinary Anaesthesia and Analgesia Jul 2017To evaluate the onset and duration of hematological changes and the use of Doppler ultrasound (spleen) in dogs sedated with acepromazine or xylazine.
OBJECTIVE
To evaluate the onset and duration of hematological changes and the use of Doppler ultrasound (spleen) in dogs sedated with acepromazine or xylazine.
STUDY DESIGN
Clinical study.
ANIMALS
A total of 24 mixed breed dogs aged 1-4 years and weighing 15-25 kg.
METHODS
Dogs were randomly distributed into two groups: acepromazine group (AG) which were administered acepromazine (0.05 mg kg) intramuscularly and xylazine group (XG) administered xylazine (0.5 mg kg) intramuscularly. Sonographic evaluations (morphologic and hemodynamic splenic vascularization) and hematologic tests were performed before drug administration (baseline) and 5, 15, 30, 60, 120, 240, 360, 480 and 720 minutes after drug administration.
RESULTS
A significant reduction occurred in erythrogram variables in AG at 15-720 minutes corresponding with a significant enlargement of the spleen. In XG, a significant reduction was observed in the erythrogram variables at 30-60 minutes without a significant enlargement of the spleen. Hilar diameter did not change over time in either group. Flow alterations were found only in the splenic artery in AG, with a decreased final diastolic velocity observed at 60-120 minutes.
CONCLUSIONS
Administration of acepromazine resulted in decreased red blood cell count, hemoglobin, packed cell volume and an increased diameter of the spleen. Xylazine administration resulted in similar hematologic changes but of smaller magnitude and duration and without splenic changes. The absence of significant changes in the Doppler flow parameters of the splenic artery and vein and the hilar diameter suggests that the splenomegaly that was observed in AG was not due to splenic vasodilation. No splenic sequestration occurred after xylazine administration.
CLINICAL RELEVANCE
The results indicate that acepromazine decreases the erythrocyte concentrations by splenic erythrocyte sequestration and concomitant splenomegaly. Xylazine can cause slight hematologic changes, but without splenic changes.
Topics: Acepromazine; Animals; Deep Sedation; Dogs; Erythrocyte Count; Female; Hematocrit; Hemoglobins; Hypnotics and Sedatives; Injections, Intramuscular; Male; Spleen; Ultrasonography, Doppler; Xylazine
PubMed: 28756914
DOI: 10.1016/j.vaa.2016.11.012 -
Journal of the American Veterinary... Sep 2023To evaluate the efficacy and safety of bromelain to control pain and inflammation in cats undergoing ovariohysterectomy.
OBJECTIVE
To evaluate the efficacy and safety of bromelain to control pain and inflammation in cats undergoing ovariohysterectomy.
ANIMALS
30 client-owned cats undergoing ovariohysterectomy.
PROCEDURES
In a randomized, blinded clinical study, cats were assigned to receive either oral bromelain suspension (40 mg/kg [18 mg/lb]; BG, n = 15) or placebo solution (0.1 mL/kg [0.045 mL/lb]; PG, 15), which were administered 90 minutes before and 12 hours after surgery. The anesthetic protocol included acepromazine, meperidine, propofol, and isoflurane. Pain and sedation were assessed at various time points up to 24 hours post-extubation using the UNESP-Botucatu multidimensional composite pain scale, the Glasgow feline composite measure pain scale, and a descriptive numerical scale. Surgical wound inflammation was measured at the same time points, using a numeric rating scale. Morphine was administered as rescue analgesia. Laboratory data (urea, creatinine, gamma-glutamyl transferase, alkaline phosphatase, the prothrombin time, and the fecal occult blood) were analyzed preoperatively and 24 hours after surgery.
RESULTS
Pain/inflammation scores, and analgesic requirements did not differ between groups. Shorter recovery time and lower sedation scores were recorded during the first hour post-extubation in the BG than the PG. Postoperatively, serum creatinine and gamma-glutamyl transferase were lower in the BG compared to PG. Compared to baseline values, all biochemistry variables decreased at 24 hours in the BG. The prothrombin time and fecal occult blood did not differ between groups or over time.
CLINICAL RELEVANCE
Bromelain did not provide significant analgesic and anti-inflammatory benefits over placebo in cats undergoing ovariohysterectomy.
Topics: Female; Cats; Animals; Ovariectomy; Bromelains; Pain, Postoperative; Hysterectomy; Analgesics; Anti-Inflammatory Agents; Inflammation; Transferases; Cat Diseases
PubMed: 37085147
DOI: 10.2460/javma.23.02.0117 -
Veterinary Anaesthesia and Analgesia Sep 2023To compare pain perception between gonadectomized and intact dogs.
OBJECTIVE
To compare pain perception between gonadectomized and intact dogs.
STUDY DESIGN
Blinded, prospective, cohort study.
ANIMALS
A group of 74 client-owned dogs.
METHODS
Dogs were divided into four groups: group 1-female/neutered (F/N), group 2-female/intact (F/I), group 3-male/neutered (M/N) and group 4-male/intact (M/I). Premedication consisted of intramuscularly administered acepromazine (0.05 mg kg) and morphine (0.2 mg kg), and subcutaneously administered carprofen (4 mg kg). Anaesthesia was induced with propofol (1 mg kg intravenously and supplementary doses to effect) and maintained with isoflurane in 100% oxygen. Intraoperative analgesia was achieved with fentanyl infusion (0.1 μg kg minute). Pain assessments [using the University of Melbourne Pain Scale (UMPS) and an algometer at the incision site (IS), parallel to the incision site (NIS), and on the contralateral healthy limb] were performed preoperatively, and at 1, 2, 4, 6, 9 and 20 hours after extubation. The time-standardised area under the curve (AUCst) for measurements was calculated and compared by performing a one-way multivariate analysis of variance (manova). Statistical significance was set at p < 0.05.
RESULTS
Postoperatively, F/N exhibited higher pain than F/I, with estimated marginal means (95% confidence intervals) AUCstIS 909 (672-1146) versus AUCstIS 1385 (1094-1675) (p = 0.014), AUCstNIS 1122 (823-1420) versus AUCstNIS 1668 (1302-2033) (p = 0.024) and AUCstUMPS 5.30 (4.58-6.02) versus AUCstUMPS 4.1 (3.2-5.0) (p = 0.041). Similarly, M/N showed higher pain than M/I with AUCstIS 686 (384-987) versus AUCstIS 1107 (871-1345) (p = 0.031) and AUCstNIS 856 (476-1235) versus AUCstNIS 1407 (1109-1706) (p = 0.026), and AUCstUMPS 6.0 (5.1-6.9) versus AUCstUMPS 4.4 (3.7-5.2) (p = 0.008).
CONCLUSIONS AND CLINICAL RELEVANCE
Gonadectomy affects pain sensitivity in dogs undergoing stifle surgery. Neutering status should be taken into consideration when planning individualized anaesthetic/analgesic protocols.
Topics: Dogs; Female; Male; Animals; Pain, Postoperative; Orthopedics; Stifle; Pain Measurement; Prospective Studies; Cohort Studies; Castration; Dog Diseases
PubMed: 37295978
DOI: 10.1016/j.vaa.2023.05.002 -
Research in Veterinary Science Dec 2021Dexmedetomidine and acepromazine, sedatives commonly used in dogs have opposite vascular effects, resulting in afterload increase and decrease, respectively. This could...
Dexmedetomidine and acepromazine, sedatives commonly used in dogs have opposite vascular effects, resulting in afterload increase and decrease, respectively. This could variably affect systolic myocardial function. Previous echocardiographic studies assessing the cardiovascular effects of these drugs used conventional echocardiography, while advanced techniques such as speckle tracking echocardiography (STE) and tissue Doppler imaging (TDI), which are known to provide a more accurate assessment of systolic function, have been rarely used for this aim. Moreover, in the few studies using advanced techniques, the drugs where combined with opioids. Therefore, the main objective of this prospective study was to assess systolic myocardial function by conventional and advanced echocardiography (STE and TDI), in dogs sedated exclusively with dexmedetomidine or acepromazine not combined with other drugs. Twenty healthy dogs were randomly divided into two groups, Group A (acepromazine, 20 μg/kg IM), and Group D (dexmedetomidine, 5 μg/kg IM), cardiovascular parameters were assessed before sedation (T0), and thirty minutes afterwards (T1). Systolic arterial pressure and heart rate decreased in both groups at T1 as compared to T0. Only one conventional echocardiographic raw variable (left ventricular internal dimension in systole) and three out of five advanced echocardiographic variables (radial TDI systolic velocities at the epicardial region of the left ventricular free wall, longitudinal TDI systolic velocities of the septal mitral valve annulus and the STE-derived left ventricular global strain), were affected in Group D. A systolic impairment was observed in Group D and better estimated by advanced echocardiography. In Group A, only the end diastolic voume index (conventional echocardiography) was decreased. Both protocols seem to induce echocardiographic changes more likely secondary to their vascular action.
Topics: Acepromazine; Animals; Dexmedetomidine; Dogs; Echocardiography; Prospective Studies; Systole; Ventricular Function, Left
PubMed: 34740044
DOI: 10.1016/j.rvsc.2021.09.014