Comparison of quality of recovery from anaesthesia in cats induced with propofol or alfaxalone

Mathis, Alessandra; Pinelas, Rui; Brodbelt, David; Alibhai, Hatim

doi:10.1111/j.1467-2995.2011.00707.x

Cited by 61 publications

(81 citation statements)

References 16 publications

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“…The observed alfaxalone induction doses (1.75 mg/kg -3.00 mg/kg) are similar to those reported in earlier studies in other species such as: sheep Torres et al 2012); dogs (Maddern et al 2010;Suarez et al 2012); and ponies (Klöppel & Leece 2011;Leece et al 2009), but lower than doses reported in cats (Martinez Taboada & Murison 2010;Mathis et al 2012). The reason for the lack of agreement in alfaxalone dose could be the difference in the rate at which alfaxalone was administered.…”

Section: Discussionsupporting

confidence: 87%

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The effects of midazolam and butorphanol, administered alone or combined, on the dose and quality of anaesthetic induction with alfaxalone in goats

Dzikiti¹,

Zeiler²,

Dzikiti³

et al. 2014

J S Afr Vet Assoc

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Goats are rarely anaesthetised; consequently, scant information is available on the efficacy of anaesthetic drugs in this species. Alfaxalone is a relatively new anaesthetic agent, of which the efficacy in goats has not yet been studied. In this study, the sedative and alfaxalone sparing effects of midazolam and butorphanol, administered alone or concomitantly, in goats were assessed. Eight clinically healthy goats, four does and four wethers, were enlisted in a randomised crossover manner to receive intramuscular sedative treatments consisting of saline 0.05 mL/kg, or midazolam 0.30 mg/kg, or butorphanol 0.10 mg/kg, or a combination of midazolam 0.30 mg/kg with butorphanol 0.10 mg/kg before intravenous induction of general anaesthesia with alfaxalone. Following induction, the goats were immediately intubated and the quality of anaesthesia and basic physiological cardiorespiratory and blood-gas parameters were assessed until the goats had recovered from anaesthesia. The degree of sedation, quality of induction and recovery were scored. When compared with saline (3.00 mg/kg), midazolam,administered alone or with butorphanol, caused a statistically significant increased level of sedation and a reduction in the amount of alfaxalone required for induction (2.00 mg/kg and 1.70 mg/kg, respectively). Butorphanol alone (2.30 mg/kg) did not cause significant changes in level of sedation or alfaxalone-induction dose. During induction and recovery, the goats were calm following all treatments, including the control group. Cardiorespiratory and blood-gas parameters were maintained within clinically acceptable limits. The present study showed that midazolam, administered alone or combined with butorphanol, produces a degree of sedation that significantly reduces the dose of alfaxalone required for induction of general anaesthesia in goats, without causing any major adverse cardiorespiratory effects.

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Section: Discussionsupporting

confidence: 87%

“…Brisk palpebral movements and nystagmus have been reported in horses (Goodwin et al 2011). Referred muscle movements have previously been reported in anaesthetised goats and other species, even with other induction agents such as propofol and thiopentone (Benson & Thurmon 1990;Dzikiti et al 2009;Mathis et al 2012). …”

Section: Discussionmentioning

confidence: 91%

The effects of midazolam and butorphanol, administered alone or combined, on the dose and quality of anaesthetic induction with alfaxalone in goats

Dzikiti¹,

Zeiler²,

Dzikiti³

et al. 2014

J S Afr Vet Assoc

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show abstract

“…10,11 However, this low-dose theory may be incorrect as it was higher dosages of alfaxalone that were associated with worse recoveries following IV administration of alfaxalone to cats. 8 The inadequate dosage theory might explain reactivity during the anesthetic period, but would not explain the prolonged excitement and hyper-reactivity during the recovery period. During recovery, the cats moved almost incessantly, at first thrashing in the cage and then pacing once they were more awake.…”

Section: Discussionmentioning

confidence: 99%

Cardiovascular and respiratory effects, and quality of anesthesia produced by alfaxalone administered intramuscularly to cats sedated with dexmedetomidine and hydromorphone

Grubb

Greene

Perez

2013

Journal of Feline Medicine and Surgery

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The cardiovascular and respiratory effects, and the quality of anesthesia of alfaxalone administered intramuscularly (IM) to cats sedated with dexmedetomidine and hydromorphone were evaluated. Twelve healthy adult cats were anesthetized, with six cats receiving dexmedetomidine (0.01 mg/kg IM) followed by alfaxalone (5 mg/kg IM; group DA) and six receiving dexmedetomidine (0.01 mg/kg IM) plus hydromorphone (0.1 mg/kg IM) followed by alfaxalone (5 mg/kg IM; group DHA). Cardiorespiratory (pulse rate, blood pressure, respiratory rate, saturation of oxygen with hemoglobin, end tidal carbon dioxide partial pressure) and bispectral index (BIS) data were collected every 10 mins for 90 mins starting immediately after intubation. The quality of anesthesia was scored by a blinded researcher at induction and at 5 and 60 mins after extubation. Recovery scores ranged from 1 (prolonged struggling) to 4 (no struggling). There were no clinically significant (P >0.05) differences in any data between groups or over time. Physiologic parameters were within normal limits for cats at all times. BIS values were consistent with light anesthesia in both groups. However, recovery was prolonged and marked with excitement, ataxia and hyper-reactivity in all cats. Thus, although cardiovascular and respiratory parameters are stable following IM injection of alfaxalone to cats sedated with dexmedetomidine and hydromorphone, recovery is extremely poor and this route of administration is not recommended for anesthesia in cats.

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“…Goodwin et al [29] reported unacceptable recoveries in horses recovering from 3-h general anesthesia with an infusion of alfaxalone of 3 mg/kg/h. Others reported that alfaxalone induced central nervous system excitation and that induction of anesthesia with alfaxalone was associated with poor recovery [30, 31]. In the current study, the adverse effects of alfaxalone might remain in the attempt to stand because the plasma alfaxalone concentration after standing in Group AM was 0.32 ± 0.07 µg/mL.…”

Section: Discussionmentioning

confidence: 57%

Clinical evaluation of constant rate infusion of alfaxalone–medetomidine combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery

et al. 2018

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BackgroundAlfaxalone has a number of pharmacological properties which are desirable for constant rate infusion (CRI). Previously, the co-administration of alfaxalone and medetomidine is shown to be suitable for short-term anesthesia in horses. However, the use of alfaxalone–medetomidine CRI with inhalational anesthesia under surgical procedures have not been investigated in clinical cases. The aim of the present study was to evaluate the clinical efficacy of alfaxalone–medetomidine CRI in sevoflurane-anesthetized Thoroughbred racehorses undergoing arthroscopic surgery. Sevoflurane requirement, cardiovascular function, and induction/recovery quality were compared between horses maintained with sevoflurane in combination with medetomidine CRI (3 µg/kg/h) (Group M; n = 25) and those maintained with sevoflurane in combination with alfaxalone–medetomidine CRI (0.5 mg/kg/h and 3 µg/kg/h, respectively) (Group AM; n = 25).ResultsThe mean end-tidal sevoflurane concentrations were significantly lower in Group AM (1.8 ± 0.2%) than in Group M (2.4 ± 0.1%). The mean dobutamine infusion rate required for maintaining mean arterial blood pressure within the target values (60–80 mmHg) was significantly lower in Group AM (0.53 ± 0.20 µg/kg/min) than in Group M (0.85 ± 0.32 µg/kg/min). Induction and recovery scores were not significantly different between two groups. However, excitatory response during recovery were observed in five horses in Group AM. The mean plasma alfaxalone concentrations were stable throughout the maintenance period (0.77 ± 0.12 to 0.85 ± 0.13 µg/mL), and decreased significantly immediately after standing (0.32 ± 0.07 µg/mL).ConclusionsAlfaxalone–medetomidine CRI reduced sevoflurane requirement by approximately 26% with good maintenance of cardiopulmonary function in Thoroughbred racehorses undergoing arthroscopic surgery. Sevoflurane in combination with alfaxalone–medetomidine CRI may be a clinically effective anesthetic technique for Thoroughbred racehorses. However, 20% of horses administered alfaxalone showed remarkable excitatory response during recovery. Greater attention to excitatory response may be advisable if alfaxalone is used for induction or maintenance of anesthesia. A larger study is needed to explore the clinical relevance of these findings.

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Comparison of quality of recovery from anaesthesia in cats induced with propofol or alfaxalone

Cited by 61 publications

References 16 publications

The effects of midazolam and butorphanol, administered alone or combined, on the dose and quality of anaesthetic induction with alfaxalone in goats

The effects of midazolam and butorphanol, administered alone or combined, on the dose and quality of anaesthetic induction with alfaxalone in goats

Cardiovascular and respiratory effects, and quality of anesthesia produced by alfaxalone administered intramuscularly to cats sedated with dexmedetomidine and hydromorphone

Clinical evaluation of constant rate infusion of alfaxalone–medetomidine combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery

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