Medetomidine continuous rate intravenous infusion in horses in which surgical anaesthesia is maintained with isoflurane and intravenous infusions of lidocaine and ketamine

Kempchen, S.; Kuhn, M.; Spadavecchia, Claudia; Levionnois, Olivier (2012). Medetomidine continuous rate intravenous infusion in horses in which surgical anaesthesia is maintained with isoflurane and intravenous infusions of lidocaine and ketamine. Veterinary anaesthesia and analgesia, 39(3), pp. 245-55. Oxford: Blackwell Science 10.1111/j.1467-2995.2011.00701.x

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OBJECTIVE: To evaluate medetomidine as a continuous rate infusion (CRI) in horses in which anaesthesia is maintained with isoflurane and CRIs of ketamine and lidocaine. STUDY DESIGN: Prospective, randomized, blinded clinical trial. ANIMALS: Forty horses undergoing elective surgery. METHODS: After sedation and induction, anaesthesia was maintained with isoflurane. Mechanical ventilation was employed. All horses received lidocaine (1.5 mg kg(-1) initially, then 2 mg kg(-1) hour(-1)) and ketamine (2 mg kg(-1) hour(-1)), both CRIs reducing to 1.5 mg kg(-1) hour(-1) after 50 minutes. Horses in group MILK received a medetomidine CRI of 3.6 mug kg(-1) hour(-1), reducing after 50 minutes to 2.75 mug kg(-1) hour(-1), and horses in group ILK an equal volume of saline. Mean arterial pressure (MAP) was maintained above 70 mmHg using dobutamine. End-tidal concentration of isoflurane (FE'ISO) was adjusted as necessary to maintain surgical anaesthesia. Group ILK received medetomidine (3 mug kg(-1) ) at the end of the procedure. Recovery was evaluated. Differences between groups were analysed using Mann-Whitney, Chi-Square and anova tests as relevant. Significance was taken as p < 0.05. RESULTS: FE'ISO required to maintain surgical anaesthesia in group MILK decreased with time, becoming significantly less than that in group ILK by 45 minutes. After 60 minutes, median (IQR) FE'ISO in MILK was 0.65 (0.4-1.0) %, and in ILK was 1 (0.62-1.2) %. Physiological parameters did not differ between groups, but group MILK required less dobutamine to support MAP. Total recovery times were similar and recovery quality good in both groups. CONCLUSION AND CLINICAL RELEVANCE: A CRI of medetomidine given to horses which were also receiving CRIs of lidocaine and ketamine reduced the concentration of isoflurane necessary to maintain satisfactory anaesthesia for surgery, and reduced the dobutamine required to maintain MAP. No further sedation was required to provide a calm recovery.

Item Type:

Journal Article (Original Article)

Division/Institute:

05 Veterinary Medicine > Department of Clinical Veterinary Medicine (DKV) > DKV - Anaesthesiology

UniBE Contributor:

Spadavecchia, Claudia and Levionnois, Olivier

ISSN:

1467-2987

Publisher:

Blackwell Science

Language:

English

Submitter:

Andrea Stettler

Date Deposited:

15 Nov 2013 12:18

Last Modified:

04 May 2014 23:27

Publisher DOI:

10.1111/j.1467-2995.2011.00701.x

PubMed ID:

22405503

Additional Information:

Notes: Kempchen, Stephanie Kuhn, Mathias Spadavecchia, Claudia Levionnois, Olivier L England Veterinary anaesthesia and analgesia Vet Anaesth Analg. 2012 Mar;39(3):245-55. doi: 10.1111/j.1467-2995.2011.00701.x. Epub 2012 Mar 8. Edition: 2012/03/13 Date: Mar

URI:

https://boris.unibe.ch/id/eprint/38983

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