Cardiopulmonary effects of a two hour medetomidine infusion and its antagonism by atipamezole in horses and ponies

Bettschart‐Wolfensberger, Regula; Bettschart, R.; Vainio, Outi; Marlin, D. J.; Clarke, K.W.

doi:10.1111/j.1467-2995.1999.tb00176.x

Cited by 47 publications

(70 citation statements)

References 20 publications

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“…A significant increase in ½HCO À 3 std B was observed for both alpha 2 -adrenergic agonists. Similar effects on HCO À 3 and BE have been observed after single doses of romifidine (Freeman et al, 2002;Wojtasiak-Wypart et al, 2012) or during medetomidine or detomidine CRI (Daunt et al, 1993;Bettschart-Wolfensberger et al, 1999;Solano et al, 2009) in horses. Unfortunately blood lactate was not measured in the present study.…”

Section: Discussionsupporting

confidence: 55%

“…However pH values remained within physiologically normal limits. An increase in pH has not been reported previously after single doses of the different alpha 2 -adrenergic agonists (Clarke et al, 1991;Bueno et al, 1999;Yamashita et al, 2000;Freeman et al, 2002;Bettschart-Wolfensberger et al, 2005) or during CRI of medetomidine and detomidine (Daunt et al, 1993;Bettschart-Wolfensberger et al, 1999;van Dijk et al, 2003) in horses. Conversely, a decrease in pH in face of an increase in HCO À 3 was reported during a CRI of medetomidine-morphine (Solano et al, 2009).…”

Section: Discussionmentioning

confidence: 74%

“…Concerns regarding alpha 2 -adrenergic agonists mainly reflect their cardiovascular (CV) effects (England and Clarke, 1996;Murrell and Hellebrekers, 2005;Tan and Ho, 2010), and many studies have been designed to examine the CV effects of alpha 2 -adrenergic agonist CRIs in horses (Bettschart-Wolfensberger et al, 1999;Ringer et al, 2013a). However, the use of alpha 2 -adrenergic agonists is also associated with other side effects that might be less obvious, but may have important consequences, especially in critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

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Blood glucose, acid–base and electrolyte changes during loading doses of alpha2-adrenergic agonists followed by constant rate infusions in horses

Ringer¹,

Schwarzwald²,

Portier³

et al. 2013

The Veterinary Journal

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The aim of the present study was to investigate changes in blood glucose concentration ([Glu]B), acid-base status and electrolyte concentrations during constant rate infusions (CRI) of two alpha2-adrenergic agonists in seven horses treated in a blinded, randomised, crossover design with xylazine or romifidine. An intravenous (IV) bolus of xylazine (1mg/kg) or romifidine (80g/kg) was administered followed by an IV CRI of xylazine (0.69mg/kg/h) or romifidine (30g/kg/h) for 2h. Blood samples were collected from the pulmonary artery before and after loading doses, during the CRI, and for 1h after discontinuing drugs. Blood glucose, base excess (BE), pH, partial pressure of carbon dioxide (Pv¯CO2), strong ion difference (SIDest) and bicarbonate concentration ( [Formula: see text] ) increased significantly during the CRI with both alpha2-adrenergic agonists. Chloride concentration ([Cl-]B) and anion-gap (AG) decreased significantly compared to baseline. The decrease in sodium concentration ([Na+]B) was only significant with xylazine. From 1h after starting the CRI onwards, [Glu]B was significantly higher with romifidine compared to xylazine. Except [Glu]B, SIDest, and Pv¯CO2, all variables returned to normal values 1h after discontinuing xylazine. After stopping romifidine, all variables except pH remained altered for at least 1h. It was concluded that loading doses of alpha2-adrenergic agonists followed by CRIs produce [Glu]B, acid-base and electrolyte changes. The clinical significance of the reported changes remains to be investigated and absolute values should be interpreted with caution, as fluid boli were used for cardiac output measurements, but may become important during prolonged infusion and in critically ill patients. a b s t r a c tThe aim of the present study was to investigate changes in blood glucose concentration ([Glu] B ), acidbase status and electrolyte concentrations during constant rate infusions (CRI) of two alpha 2 -adrenergic agonists in seven horses treated in a blinded, randomised, crossover design with xylazine or romifidine.An intravenous (IV) bolus of xylazine (1 mg/kg) or romifidine (80 lg/kg) was administered followed by an IV CRI of xylazine (0.69 mg/kg/h) or romifidine (30 lg/kg/h) for 2 h. Blood samples were collected from the pulmonary artery before and after loading doses, during the CRI, and for 1 h after discontinuing drugs. Blood glucose, base excess (BE), pH, partial pressure of carbon dioxide (P vCO 2 ), strong ion difference (SID est ) and bicarbonate concentration (½HCO It was concluded that loading doses of alpha 2 -adrenergic agonists followed by CRIs produce [Glu] B , acid-base and electrolyte changes. The clinical significance of the reported changes remains to be investigated and absolute values should be interpreted with caution, as fluid boli were used for cardiac output measurements, but may become important during prolonged infusion and in critically ill patients.

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Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 74%

Section: Introductionmentioning

confidence: 99%

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Blood glucose, acid–base and electrolyte changes during loading doses of alpha2-adrenergic agonists followed by constant rate infusions in horses

Ringer¹,

Schwarzwald²,

Portier³

et al. 2013

The Veterinary Journal

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“…The cardiovascular effects of medetomidine are dose‐dependent and similar to the effects observed with detomidine, but of shorter duration (Yamashita et al ., ). Used as a constant rate infusion for sedation in horses, medetomidine provided continuous sedation without bradycardia or reduction in cardiac output (Bettschart‐Wolfensberger et al ., ,b).…”

Section: Introductionmentioning

confidence: 99%

Pharmacokinetics and pharmacodynamics of intravenous dexmedetomidine in the horse

Rezende

Grimsrud

Stanley

et al. 2014

Vet Pharm & Therapeutics

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The aim of the study was to describe the pharmacokinetics and selected pharmacodynamics of intravenous dexmedetomidine in horses. Eight adult horses received 5 μg/kg dexmedetomidine IV. Blood samples were collected before and for 10 h after drug administration to determine dexmedetomidine plasma concentrations. Pharmacokinetic parameters were calculated using noncompartmental analysis. Data from one outlier were excluded from the statistical summary. Behavioral and physiological responses were recorded before and for 6 h after dexmedetomidine administration. Dexmedetomidine concentrations decreased rapidly (elimination half-life of 8.03 ± 0.84 min). Time of last detection varied from 30 to 60 min. Bradycardia was noted at 4 and 10 min after drug administration (26 ± 8 and 29 ± 8 beats/min respectively). Head height decreased by 70% at 4 and 10 min and gradually returned to baseline. Ability to ambulate was decreased for 60 min following drug administration, and mechanical nociceptive threshold was increased during 30 min. Blood glucose peaked at 30 min (134 ± 24 mg/dL) and borborygmi were decreased for the first hour after dexmedetomidine administration. Dexmedetomidine was quickly eliminated as indicated by the rapid decrease in plasma concentrations. Physiological, behavioral, and analgesic effects observed after dexmedetomidine administration were of short duration.

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“…cardiopulmonary effects compared with a bolus administration in conscious ponies [24]. Although cardiac output and peripheral resistance were not measured in this study, medetomidine CRI at a rate of 0.05 mg/kg/min did not appear to affect cardiovascular functions adversely.…”

Section: Tablementioning

confidence: 72%

Effects of Medetomidine Constant Rate Infusion on Sevoflurane Requirement, Cardiopulmonary Function, and Recovery Quality in Thoroughbred Racehorses Undergoing Arthroscopic Surgery

Tokushige

Ohta

Okano

et al. 2015

Journal of Equine Veterinary Science

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Cardiopulmonary effects of a two hour medetomidine infusion and its antagonism by atipamezole in horses and ponies

Cited by 47 publications

References 20 publications

Blood glucose, acid–base and electrolyte changes during loading doses of alpha2-adrenergic agonists followed by constant rate infusions in horses

Blood glucose, acid–base and electrolyte changes during loading doses of alpha2-adrenergic agonists followed by constant rate infusions in horses

Pharmacokinetics and pharmacodynamics of intravenous dexmedetomidine in the horse

Effects of Medetomidine Constant Rate Infusion on Sevoflurane Requirement, Cardiopulmonary Function, and Recovery Quality in Thoroughbred Racehorses Undergoing Arthroscopic Surgery

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