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Veterinary Sciences Mar 2024The aim of this study was to determine the most appropriate sedation protocol for a standing magnetic resonance imaging (MRI) examination in horses, comparing continuous...
The aim of this study was to determine the most appropriate sedation protocol for a standing magnetic resonance imaging (MRI) examination in horses, comparing continuous rate infusions (CRIs) of detomidine and romifidine combined with a single bolus of morphine. Sixteen horses referred for standing low-field open-magnet MRI were randomly assigned to one of two sedation protocols. The horses were premedicated with 0.03 mg/kg of intramuscular acepromazine, and those animals belonging to Group D received an intravenous (IV) loading dose of detomidine (0.01 mg/kg) 30 min later, while those of Group R received romifidine (0.04 mg/kg). If the horses were inadequately sedated, an additional dose of IV detomidine (0.005 mg/kg) or romifidine (0.02 mg/kg) was administered, according to the animal's group. During the MRI, a single IV bolus of morphine (0.05 mg/kg) was administered, and according to which group it belonged to, the animal started the administration of detomidine (0.01 mg/kg/h) or romifidine (0.02 mg/kg/h). Heart rate (HR), respiratory rate (RR), rectal temperature (RT), depth of sedation, and degree of ataxia were evaluated every 10 min during MRI. Two horses belonging to Group D and four horses from Group R needed additional sedation before entering the MRI unit because they were unsatisfactorily sedated. No side effects were observed following morphine bolus administration. During the MRI procedure, five horses in Group R received an additional IV romifidine bolus (0.01 mg/kg) because the depth of sedation score was 1 and the ataxia score was 0. Any substantial differences were recorded between the two treatments in terms of HR, RR, and RT. In conclusion, at the doses used, a detomidine-morphine combination following a CRI of detomidine appears more suitable than a romifidine-morphine combination following a CRI of romifidine for maintaining an adequate depth of sedation and adequate immobility in horses undergoing standing MRI.
PubMed: 38535858
DOI: 10.3390/vetsci11030124 -
Veterinary Research Forum : An... 2024The aim of this study was to compare the sedative and cardiovascular effects of the combination of acepromazine-clonidine versus acepromazine-xylazine in horses. Four...
The aim of this study was to compare the sedative and cardiovascular effects of the combination of acepromazine-clonidine versus acepromazine-xylazine in horses. Four healthy cross-bred horses were included in the study. They were assigned to two treatments. In treatment I (T1), the animals received xylazine hydrochloride (1.00 mg kg) in combination with acepromazine maleate (0.05 mg kg) intravenously (IV). In treatment II (T2), the animals received intra-gastric administration of clonidine (0.002 mg kg) followed by acepromazine (0.05 mg kg; IV) after 60 min. Head height above the ground (HHAG) and echocardiographic indices were evaluated. In T1, recordings were made 5 min before and 5, 15, 30, 60, and 90 min after drug administration. In T2, recordings were made 5 min before clonidine, 55 min after clonidine administration, and then 5, 15, 30, 60, and 90 min after acepromazine injection. Analyses of the data showed there were not significant differences regarding HHAG and echocardiographic indices between two treatments. For sedation of healthy horses, it was concluded that intra-gastric administration of clonidine and IV administration of acepromazine showed similar sedative and cardiovascular effects compared to IV acepromazine-xylazine administration.
PubMed: 38464604
DOI: 10.30466/vrf.2023.2004451.3910 -
Veterinary Anaesthesia and Analgesia 2024To evaluate the perioperative analgesic effect of the unilateral lumbar erector spinae plane block (ESPB) in dogs undergoing hemilaminectomy.
OBJECTIVE
To evaluate the perioperative analgesic effect of the unilateral lumbar erector spinae plane block (ESPB) in dogs undergoing hemilaminectomy.
STUDY DESIGN
Randomized, blinded clinical study.
ANIMALS
A total of 30 client-owned dogs undergoing thoracolumbar or lumbar hemilaminectomy for intervertebral disc extrusion (IVDE).
METHODS
Dogs were randomly assigned to receive a unilateral ESPB, performed either with 0.4 mL kg ropivacaine 0.5% [group ROPI (n = 15)] or with saline solution [CNT group (n = 15)]. Dogs were premedicated intravenously (IV) with acepromazine 5 μg kg and methadone 0.2 mg kg, general anaesthesia was induced by administering IV midazolam 0.2 mg kg and propofol to effect and maintained with isoflurane. Fentanyl was administered as rescue analgesia. Bradycardia [heart rate (HR) < 60 beats minute] with hypotension was treated with atropine IV. The Short-Form of the Glasgow Composite Pain Scale was used pre- and postoperatively at 1, 2, 4, 8, 12, 16, 20 and 24 hours after extubation, and methadone 0.2 mg kg was administered IV when pain score was ≥ 5/20. HR and end-tidal concentration of isoflurane (Fe'Iso) were compared between groups with anova combined with a Dunnet's post hoc test. Time to the first rescue methadone and total dose of fentanyl (FEN, μg kg hour) and methadone (MET, mg kg) in the first 24 postoperative hours were compared using unpaired Student's t test. Postoperative pain scores were compared with the Mann-Whitney test and atropine administration with a Fisher's exact test; p < 0.05.
RESULTS
HR, Fe'Iso, FEN, MET and atropine administration were significantly lower in group ROPI compared to CNT. Postoperative analgesic effect was significantly longer, and pain scores were significantly lower in group ROPI for all time points.
CONCLUSIONS AND CLINICAL RELEVANCE
Unilateral ESPB with ropivacaine reduced perioperative opioid consumption and the occurrence of bradycardia in dogs undergoing hemilaminectomy.
Topics: Animals; Dogs; Analgesics; Analgesics, Opioid; Atropine Derivatives; Bradycardia; Dog Diseases; Fentanyl; Isoflurane; Methadone; Nerve Block; Pain, Postoperative; Ropivacaine
PubMed: 38331675
DOI: 10.1016/j.vaa.2023.12.001 -
Frontiers in Veterinary Science 2023Cardiac electrical activity is often altered by administration of anesthetic drugs. While the effects of propofol in this regard have previously been described in dogs,...
Cardiac electrical activity is often altered by administration of anesthetic drugs. While the effects of propofol in this regard have previously been described in dogs, to date, there are no reports of the effect of alfaxalone. This study investigated the impact of both propofol and alfaxalone on the ECG of 60 dogs, after premedication with acepromazine and methadone. Heart rate increased significantly in both groups. The PR and QRS intervals were significantly increased following propofol while with alfaxalone the QRS duration was significantly increased and ST segment depression was observed. The QT and JT interval were significantly shorter following induction with alfaxalone, but, when corrected (c) for heart rate, QTc and JTc in both groups were significantly greater following induction. When comparing the magnitude of change between groups, the change in RR interval was greater in the alfaxalone group. The change in both QT and JT intervals were significantly greater following alfaxalone, but when QTc and JTc intervals were compared, there were no significant differences between the two drugs. The similarly increased QTc produced by both drugs may suggest comparable proarrhythmic effects.
PubMed: 38260194
DOI: 10.3389/fvets.2023.1330111 -
Animals : An Open Access Journal From... Jan 2024Survey data from 42 Australian eastern seaboard veterinary practices involving 506 cases are reported with regard to clinical signs, disease severity, mortality, use of...
Prospective Study of 506 Dogs with Tick Paralysis: Investigating Measures of Severity and Clinical Signs as Predictors of Mortality and Assessing the Benefits of Different Therapeutics.
Survey data from 42 Australian eastern seaboard veterinary practices involving 506 cases are reported with regard to clinical signs, disease severity, mortality, use of pharmaceuticals, and recovery times. New measures of disease severity (visual analogue scales (VAS) and facial expressions) were tested alongside "gold standard" measures (neuromuscular junction (NMJ) scores). Univariable and multivariable logistic regression analyses were conducted to evaluate associations between variables. The VAS scores were progressive, prognostic (especially the respiratory scores) and correlated with the NMJ scores. The presence of inspiratory dyspnoea and crackles on the day of hospitalisation, progressing to expiratory dyspnoea and an expiratory wheeze 24 h later, were highly predictive of mortality. Altered facial features on hospital admission were also highly predictive of mortality. The previously used respiratory score (using various clinical signs) was not predictive of mortality. Older animals had a higher mortality rate, and no gender or breed susceptibility was found. The only pharmaceuticals that were positively associated with mortality were tick antiserum and, in severe cases, antibiotics. The use of many pharmaceutical products (acepromazine, atropine, steroids, antihistamines, antiemetics, diuretics, and S8 anti-anxiety and sedation drugs) had no effect on mortality. More drug classes were used with increasing clinical severity and specific factors (e.g., vomiting/retching, hydration) affected the period of hospitalisation. Geographic variation in respiratory signs and toxicity scores was evident, whereas mortality and disease severity were not different across regions.
PubMed: 38254357
DOI: 10.3390/ani14020188 -
Frontiers in Veterinary Science 2023Propofol is used for anesthetic induction in cats and procedural sedation in countries where alfaxalone is not available. Studies have reported propofol-related effects...
Propofol is used for anesthetic induction in cats and procedural sedation in countries where alfaxalone is not available. Studies have reported propofol-related effects in echocardiography variables in dogs and humans. However, there is a lack of echocardiography studies investigating propofol-related effects on cats. This study aimed to use echocardiography to investigate echocardiographic changes in three protocols using propofol: propofol-slow (2 mg/kg/min, PS); propofol-fast (8 mg/kg/min, PF); propofol-ketamine (S-ketamine 2 mg/kg bolus followed by propofol 2 mg/kg/min; PK) in healthy premedicated (gabapentin-buprenorphine-acepromazine; 200 mg/cat, 0.4, and 0.1 mg/kg, respectively), non-intubated cats. Echocardiographic measurements were obtained at three time points: baseline (before the administration of propofol), end of propofol titration (end-point, T0), and 15 min after T0 (T15). Propofol at a lower rate continued from T0 to T15. Echocardiographic and physiological variables included fractional shortening (FS%), ejection fraction (EF%), HR, BP, and others. Propofol requirements at T0 for PF, PS, and PK groups were 5.0 ± 0.9, 3.8 ± 0.7, and 2.4 ± 0.5 mg/kg, respectively. EF% neither change over time nor between groups. PF and PK showed a reduction in FS% at T0 (47 ± 6 to 34 ± 6 and 42 ± 6 to 36 ± 5, respectively). BP reduced significantly in PF and PS groups (136 ± 26 to 105 ± 13 and 137 ± 22 to 115 ± 15 mmHg, respectively). It is unclear whether changes in echocardiography variables were of clinical relevance related to treatment groups or a result of within-group individual responses.
PubMed: 38152595
DOI: 10.3389/fvets.2023.1272949 -
Schweizer Archiv Fur Tierheilkunde Oct 2023Intraperitoneal administration of local anaesthetics may reduce postoperative pain after ovariohysterectomy in dogs. The aim of this prospective, randomised, blinded,...
Intraperitoneal and incisional ropivacaine did not improve postoperative analgesia after multimodal anaesthesia compared with saline in dogs undergoing ovariohysterectomy.
Intraperitoneal administration of local anaesthetics may reduce postoperative pain after ovariohysterectomy in dogs. The aim of this prospective, randomised, blinded, placebo-controlled clinical trial was to compare postoperative analgesia and opioid requirements after intraperitoneal and incisional administration of ropivacaine versus 0,9 % NaCl (saline). Forty-three client-owned dogs were enrolled in the study and anaesthetised using a standardized protocol that included premedication with acepromazine (0,03-0,05 mg/kg) and dexmedetomidine (0,01 mg/kg) intramuscularly. Anaesthesia was induced with propofol titrated to effect and ketamine (1 mg/kg) intravenously and maintained with isoflurane in oxygen. The analgesic regimen included carprofen (4 mg/kg) subcutaneously and morphine (0,2 mg/kg) intravenously. Depending on group assignment, each dog received either an intraperitoneal and incisional splash with ropivacaine (2 mg/kg and 1 mg/kg, respectively) (group R), or an equal volume of saline (group S). Buprenorphine (0,02 mg/kg) was administered intramuscularly once the uterus was removed. Sedation and pain were assessed 0,5, 1, 2, 4, 6 and 8 hours after extubation using a sedation scale, the short form of the Glasgow Composite Pain Scale (CMPS-SF) and a dynamic interactive visual analogue scale (DIVAS). Postoperatively, buprenorphine (0,01 mg/kg) was administered intravenously if dogs scored 6/24 on CMPS-SF. The ordinal mixed model showed no difference in pain scores between groups. Fisher's exact test showed no significant difference in postoperative buprenorphine requirements between group S (3/22 dogs) and group R (1/21 dogs) at the doses used. In addition, lower sedation scores were associated with higher DIVAS scores. In this multimodal analgesic protocol, ropivacaine could not improve analgesia compared to saline.
Topics: Animals; Dogs; Female; Analgesia; Analgesics; Analgesics, Opioid; Anesthesia; Buprenorphine; Dog Diseases; Hysterectomy; Ovariectomy; Pain, Postoperative; Prospective Studies; Ropivacaine
PubMed: 37822246
DOI: 10.17236/sat00405 -
Frontiers in Veterinary Science 2023Epidural anesthesia is commonly administered as part of balanced anesthesia for perioperative analgesia. The main goal of this randomized clinical trial was to compare...
Epidural anesthesia is commonly administered as part of balanced anesthesia for perioperative analgesia. The main goal of this randomized clinical trial was to compare the efficacy of two epidural approaches in dogs undergoing surgery for a perineal hernia. A secondary aim was to compare motor blockade. Intact ASA 1 and 2 male dogs, weighing ≤25 kg with no previous surgery for perineal hernia were enrolled. After premedication with IM acepromazine 0.02 mg/kg and butorphanol 0.3 mg/kg, general anesthesia was induced with propofol and maintained with sevoflurane in oxygen. Dogs were randomly allocated to receive either a lumbosacral (LS, = 30) or a sacrococcygeal (SC, = 26) epidural injection with ropivacaine 1% (0.2 mL/kg) under computed tomography guidance. Successful analgesia was defined as no need of intraoperative rescue analgesia (fentanyl 3 μg/kg IV). Clinical failure was defined as the need of more than two boluses of fentanyl/h each dog received meloxicam 0.2 mg/kg IV at the end of the surgery. The Glasgow Composite Pain Scale short form (GCPS-SF), tactile sensitivity, pressure pain thresholds and motor blockade were assessed at 4, 6, 8, and 24 h after the epidural injection. Methadone (0.2 mg/kg, IV) was administered if the GCPS-SF was ≥6/24 points. Differences between groups were analyzed with the Mann-Whitney test, Student's -test or Fisher's Exact test, as appropriate. Success rate was assessed for non-inferiority between groups. The non-inferiority margin was set at -10%. Epidural analgesia was successful in 24 dogs in group LS and 17 dogs in group SC ( = 0.243), resulting in success rates of 80 and 65% in LS and SC groups, respectively. The non-inferiority of group SC versus group LS was confirmed. Clinical failure was recorded in two dogs in group LS and one dog in group SC. No significant differences between groups were detected in the GCPS-SF score, tactile sensitivity, pressure pain thresholds, need of post-operative methadone, or motor blockade. Both epidural techniques are valuable analgesic options for perineal hernia repair in dogs.
PubMed: 37808102
DOI: 10.3389/fvets.2023.1163025 -
The Journal of Veterinary Medical... Nov 2023The aim of this study was to compare the intra and postoperative analgesic effects of sacrococcygeal epidural levobupivacaine with those of lumbosacral levobupivacaine...
The aim of this study was to compare the intra and postoperative analgesic effects of sacrococcygeal epidural levobupivacaine with those of lumbosacral levobupivacaine in feline ovariohysterectomy. Thirty-six cats were premedicated with intramuscular acepromazine (0.05 mg/kg) and meperidine (6 mg/kg). Anesthesia was induced with intravenous propofol and maintained with isoflurane in oxygen. The cats were randomly assigned one of the three treatments receiving 0.33% levobupivacaine (0.3 mL/kg) into the sacrococcygeal (S-C group, n=12) or lumbosacral (L-S group, n=12) epidural space, or the same volume of 0.9% saline solution into one of the epidural approaches (Control group, n=12). Intraoperatively, cardiorespiratory variables, end-tidal isoflurane concentration (FE´ISO), and fentanyl requirements were recorded. Postoperative pain was assessed by the UNESP (Universidade Estadual Paulista)-Botucatu multidimensional composite pain scale and the Glasgow feline composite measure pain scale up to 8 hr post-extubation. Morphine was administered as rescue analgesia. Overall FE´ISO and fentanyl requirements were lower in the L-S and S-C compared to the Control (P=0.002-0.048, respectively). There was no significant difference in the cardiorespiratory variables during anesthesia, postoperative pain and rescue analgesia among groups. The time to standing after anesthesia was prolonged in the L-S and S-C groups than in the Control (P<0.001). Lumbosacral and sacrococcygeal epidural levobupivacaine resulted in similar decreases in isoflurane requirements and intraoperative fentanyl supplementation in the cats, with no postoperative benefits.
Topics: Animals; Cats; Analgesics; Cat Diseases; Fentanyl; Isoflurane; Levobupivacaine; Pain, Postoperative
PubMed: 37793832
DOI: 10.1292/jvms.23-0114 -
American Journal of Veterinary Research Nov 2023To elucidate the cardiovascular effects of escalating doses of phenylephrine and norepinephrine in dogs receiving acepromazine and isoflurane.
OBJECTIVE
To elucidate the cardiovascular effects of escalating doses of phenylephrine and norepinephrine in dogs receiving acepromazine and isoflurane.
ANIMALS
8 beagles aged 1 to 2 years (7.4 to 11.2 kg).
METHODS
All dogs received acepromazine 0.01 mg/kg, propofol 4 to 5 mg/kg, and isoflurane and were mechanically ventilated. Mean arterial pressure (MAP) from a femoral artery catheter and continuous electrocardiogram were recorded. Cardiac output (CO) was measured with transpulmonary thermodilution. Systemic vascular resistance (SVR), global end-diastolic volume (GEDV), and global ejection fraction (GEF) were subsequently calculated. Phenylephrine and norepinephrine were infused in random order at 0.07, 0.3, 0.7, and 1.0 μg/kg/min. All variables were measured after 15 minutes of each infusion rate. The effects of dose, agent, and their interaction on the change of each variable were evaluated with mixed-effect models. A P < .05 was used for significance.
RESULTS
Atrial premature complexes occurred in 3 dogs during norepinephrine infusion at doses of 0.3, 0.7, and 1 μg/kg/min; no dysrhythmias were seen with phenylephrine administration. MAP increased during dose escalation (P < .0001) within each agent and did not differ between agents (P = .6). The decrease in HR was greater for phenylephrine (P < .0001). Phenylephrine decreased CO and GEF and increased GEDV and SVR (all P < .03). Norepinephrine decreased the SVR and increased CO, GEDV, and GEF (all P < .03).
CLINICAL RELEVANCE
Our results confirm that phenylephrine increases arterial pressures mainly through vasoconstriction in acepromazine-premedicated dogs while norepinephrine, historically considered a vasopressor, does so primarily through an increase in inotropism.
Topics: Animals; Dogs; Acepromazine; Isoflurane; Norepinephrine; Phenylephrine; Blood Pressure
PubMed: 37657733
DOI: 10.2460/ajvr.23.06.0147