Clinical review of the pharmacological and anaesthetic effects of alfaxalone in dogs

Bellido, V. Martín; Vettorato, Enzo

doi:10.1111/jsap.13454

Cited by 5 publications

(2 citation statements)

References 77 publications

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“…Alfaxalone was reformulated in 2-hydroxypropyl-b-cyclodextrin, a synthetic carbohydrate molecule not associated with allergic reactions, and is licensed for use in dogs and cats. The pharmacological and anesthetic properties of alfaxalone in dogs have been reviewed ( 18 ), but no studies have evaluated the effects of alfaxalone on the ECG parameters in dogs, and very few studies have assessed the effects on the ECG in humans ( 19 , 20 ). A reformulated version of alfaxalone also using a cyclodextrin excipient, is currently undergoing human trials for re-introduction as an anesthetic agent in this species, so it would be interesting to assess the effects of alfaxalone on the canine ECG with particular reference to the QT interval as a guide to possible effects in humans.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the effects of propofol and alfaxalone on the electrocardiogram of dogs, with particular reference to QT interval

Casoria,

Greet,

Auckburally

et al. 2024

Front. Vet. Sci.

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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.

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Section: Introductionmentioning

confidence: 99%

Comparison of the effects of propofol and alfaxalone on the electrocardiogram of dogs, with particular reference to QT interval

Casoria,

Greet,

Auckburally

et al. 2024

Front. Vet. Sci.

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“…Alfaxalone (3α‐hydroxy‐5α‐pregnane‐11,20‐dione) is a synthetic progesterone analogue widely used in dogs and cats to induce and maintain general anaesthesia (Ferré et al., 2006; Martin Bellido & Vettorato, 2022). The anaesthetic and physiological effects of alfaxalone 1% w/v solution in 2‐hydroxypropyl‐β‐cyclodextrin (HPCD) administered IV have been well‐characterized and shown to produce reliable and repeatable anaesthesia of short duration (Ferré et al., 2006; Keates & Whittem, 2012).…”

Section: Introductionmentioning

confidence: 99%

A dose characterization study evaluating the pharmacodynamics and safety of a concentrated alfaxalone solution (4%) as an intramuscular sedative in dogs

Hoon,

Kat,

Pasloske

et al. 2023

Vet Pharm & Therapeutics

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Alfaxalone is a commonly employed veterinary anaesthetic induction and sedation agent. A 4% w/v preserved, aqueous formulation of alfaxalone ‘RD0387’ (A4%) has recently been developed. To evaluate the sedative effects of A4%, three doses, 5 mg kg−1 (A5); 7.5 mg kg−1 (A7.5) and 10 mg kg−1 (A10) were administered intramuscularly into the epaxial musculature of six healthy adult mixed‐breed dogs in an experimental, randomized, blinded, crossover study. Sedation time variables, quality of sedation (including onset of sedation and recovery), physiological variables, response to cephalic vein catheterization and frequency of undesirable events were recorded. Continuous variables were analysed between treatments (one‐way ANOVA or restricted maximum likelihood modelling) and within treatments compared with baseline (Tukey's test). Categorical data were analysed between treatments (Kruskal‐Wallis' test) and within treatments from baseline (Dunn's test). Significance was set at p < .05. All dogs became sedated (laterally recumbent) and sedation onset was significantly faster in groups A7.5 (9.8 ± 5.3 min) and A10 (9.1 ± 5.6 min) compared to A5 (25.6 ± 16.1 min) (p = .033, p = .027, respectively). Duration of sedation was significantly longer in A10 (168.5 ± 70.6 min) and A7.5 (143.8 ± 58 min) compared to A5 (63.8 ± 28.2 min) (p = .005 and p = .003, respectively). Dogs in A10 had a superior quality of onset of sedation compared to A5 (p = .028). Sedation scores and quality of recovery from sedation were not significantly different between doses. Two dogs (2/6) in A5 were insufficiently sedated for cephalic catheterization. Ataxia was the most frequently observed undesirable event with an overall frequency of 78% (14/18) and 89% (16/18) during sedation onset and recovery, respectively. Overall, A4% administered IM in dogs at 7.5 and 10 mg kg−1 resulted in sufficient sedation for IV catheterization in dogs. To improve the speed and quality of the sedation, it is recommended that future research focuses on combining A4% with other sedative or analgesic drugs.

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Partial intravenous anaesthesia and opioid‐sparing analgesia in a dog undergoing surgical management of insulinoma

Gavet

Ruiz

2022

Vet Record Case Reports

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A 4.5-year-old dog was anaesthetised to undergo a partial pancreatectomy for insulinoma removal, an insulin-secreting pancreatic tumour causing hypoglycaemia. The patient was premedicated with dexmedetomidine (2 μg/kg) and maropitant (1 mg/kg) intravenously. Anaesthesia was induced with alfaxalone (0.5 mg/kg) and diazepam (0.2 mg/kg) intravenously and maintained with a dexmedetomidine constant-rate infusion of 1 μg/kg/h and isoflurane in 70% oxygen. A bilateral transversus abdominis plane block was performed with ropivacaine (0.3% 1 ml/kg) divided into four points. Additional intraoperative analgesia included ketamine, fentanyl and methadone intravenously. Lactated Ringer's solution was administered, and glucose supplementation was adjusted based on glycaemia. Postoperatively, the patient was comfortable and required no analgesia for the 48-hour hospitalisation period, but presented mild hyperglycaemia. This case reports the successful management of an insulinoma with a dexmedetomidine constant-rate infusion and opioid-sparing multimodal analgesia.

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Clinical review of the pharmacological and anaesthetic effects of alfaxalone in dogs

Cited by 5 publications

References 77 publications

Comparison of the effects of propofol and alfaxalone on the electrocardiogram of dogs, with particular reference to QT interval

Comparison of the effects of propofol and alfaxalone on the electrocardiogram of dogs, with particular reference to QT interval

A dose characterization study evaluating the pharmacodynamics and safety of a concentrated alfaxalone solution (4%) as an intramuscular sedative in dogs

Partial intravenous anaesthesia and opioid‐sparing analgesia in a dog undergoing surgical management of insulinoma

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