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A clinical comparison of two anaesthetic protocols using lidocaine or medetomidine in horses


Ringer, Simone K; Kalchofner Guerrero, Karin S; Boller, Jolanda; Fürst, Anton; Bettschart-Wolfensberger, Regula (2007). A clinical comparison of two anaesthetic protocols using lidocaine or medetomidine in horses. Veterinary Anaesthesia and Analgesia, 34(4):257-268.

Abstract

Objective: To compare the effects of two balanced anaesthetic protocols on end-tidal isoflurane (Fe′ISO), cardiopulmonary performance and quality of recovery in horses.
Design: Prospective blinded randomized clinical study.
Animals: Sixty-nine client-owned horses, American Society of Anesthesiologists category I and II, undergoing elective surgery.
Methods: The horses were premedicated with acepromazine (0.03 mg kg−1) IM 30–60 minutes before induction of anaesthesia and were randomly assigned to one of two treatments: in group L (37 horses) xylazine (1 mg kg−1) and in group M (31 horses) medetomidine (7 μg kg−1) was administered IV for sedation. Anaesthesia was induced 5 minutes later with ketamine (2.2 mg kg−1) and diazepam (0.02 mg kg−1) IV and maintained with isoflurane in oxygen/air (initial FIO2 0.40–0.50) and a constant rate infusion (CRI) of either lidocaine (2 mg kg−1/15 minutes loading dose followed by 50 μg kg−1 minute−1) (group L) or medetomidine (3.5 μg kg−1 hour−1) (group M). If horses showed movement or nystagmus, additional thiopental or ketamine was administered. Heart rate, mean arterial pressure (MAP), Fe′ISO and arterial blood gases were measured. Cardiac output was measured with the lithium dilution method in 10 (group L) and 11 (group M) horses every 45 minutes. Recovery was scored.
Results: Heart rate and the cardiac index (CI) were significantly higher in group L with changes over time. In group M, MAP was significantly higher during the first 50 minutes. Group L needed more additional ketamine and thiopental to maintain a surgical plane of anaesthesia and Fe′ISO was significantly higher from 70 minutes. Recovery was longer in group M and of better quality. The significance level was set at p < 0.05.
Conclusions and clinical relevance: In group M, maintenance of stable anaesthetic depth was easier and lower Fe′ISO was required to maintain a surgical plane of anaesthesia. Recoveries were longer but of better quality. The CI was higher in group L but cardiovascular function was generally well maintained in both groups.

Abstract

Objective: To compare the effects of two balanced anaesthetic protocols on end-tidal isoflurane (Fe′ISO), cardiopulmonary performance and quality of recovery in horses.
Design: Prospective blinded randomized clinical study.
Animals: Sixty-nine client-owned horses, American Society of Anesthesiologists category I and II, undergoing elective surgery.
Methods: The horses were premedicated with acepromazine (0.03 mg kg−1) IM 30–60 minutes before induction of anaesthesia and were randomly assigned to one of two treatments: in group L (37 horses) xylazine (1 mg kg−1) and in group M (31 horses) medetomidine (7 μg kg−1) was administered IV for sedation. Anaesthesia was induced 5 minutes later with ketamine (2.2 mg kg−1) and diazepam (0.02 mg kg−1) IV and maintained with isoflurane in oxygen/air (initial FIO2 0.40–0.50) and a constant rate infusion (CRI) of either lidocaine (2 mg kg−1/15 minutes loading dose followed by 50 μg kg−1 minute−1) (group L) or medetomidine (3.5 μg kg−1 hour−1) (group M). If horses showed movement or nystagmus, additional thiopental or ketamine was administered. Heart rate, mean arterial pressure (MAP), Fe′ISO and arterial blood gases were measured. Cardiac output was measured with the lithium dilution method in 10 (group L) and 11 (group M) horses every 45 minutes. Recovery was scored.
Results: Heart rate and the cardiac index (CI) were significantly higher in group L with changes over time. In group M, MAP was significantly higher during the first 50 minutes. Group L needed more additional ketamine and thiopental to maintain a surgical plane of anaesthesia and Fe′ISO was significantly higher from 70 minutes. Recovery was longer in group M and of better quality. The significance level was set at p < 0.05.
Conclusions and clinical relevance: In group M, maintenance of stable anaesthetic depth was easier and lower Fe′ISO was required to maintain a surgical plane of anaesthesia. Recoveries were longer but of better quality. The CI was higher in group L but cardiovascular function was generally well maintained in both groups.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:05 Vetsuisse Faculty > Veterinary Clinic > Equine Department
Dewey Decimal Classification:570 Life sciences; biology
630 Agriculture
Language:English
Date:2007
Deposited On:24 Jul 2012 15:31
Last Modified:08 Dec 2017 16:51
Publisher:Wiley-Blackwell
ISSN:1467-2987
Free access at:PubMed ID. An embargo period may apply.
Publisher DOI:https://doi.org/10.1111/j.1467-2995.2006.00321.x
PubMed ID:17567378

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