Comparison of sedation quality and safety of detomidine and romifidine as a continuous rate infusion for standing elective laparoscopic ovariectomy in mares

Abstract

Objective To compare efficacy and safety of a continuous rate infusion of detomidine hydrochloride and romifidine hydrochloride for standing elective bilateral laparoscopic ovariectomy in mares. Study Design Blinded, randomized prospective clinical study. Animals Eighteen healthy mares presenting for elective bilateral ovariectomy Methods Mares were randomly assigned to one of two sedation protocols. Prior to surgery, baseline head height, heart rate, respiratory rate, and postural sway were recorded. An IV loading dose of α2‐agonist (46 μg/kg romifidine or 13.9 μg/kg detomidine) was administered. Standing sedation was maintained with a continuous rate infusion of the respective α2‐agonist (126 μg/kg/h romifidine or 37.8 μg/kg/h detomidine). Intraoperative measurements included respiratory rate, heart rate, head height, postural sway, and response to surgical stimulus. Postoperatively, fecal output was recorded, and pain scoring was performed using composite pain score and visual analog scales. Results Three of 18 horses required additional α‐2 agonists: one detomidine and two romifidine and butorphanol. Head height during surgery was lower (p < .001) in mares receiving detomidine. Postural sway around the vertical axis was greater in mares sedated with detomidine rather than romifidine (p = .013). No differences were detected in intraoperative heart rate, postoperative pain scores or postoperative fecal output between sedation techniques. Conclusion Comparable scores for surgical stimulation and sedation were measured in both sedation groups. No differences in postoperative analgesia or manure production were identified. Clinical Significance Romifidine appears suitable as an alternative to detomidine and may limit ataxia and head drop in sedated horses.

Standing surgery among equine board certified surgeons: Survey regarding current use and trends

“…In addition, using sedatives with multimodal analgesia or locoregional anaesthesia is reported to facilitate standing procedures by reducing the nociceptive stimulation and the risks of undesired patient reactions 23 . Unfortunately, there is still a paucity of scientific data regarding the exact morbidity/mortality rate for specific standing procedures and there is little scientific evidence regarding the use of one sedation protocol over another 23,36 …”

“…23 Unfortunately, there is still a paucity of scientific data regarding the exact morbidity/mortality rate for specific standing procedures and there is little scientific evidence regarding the use of one sedation protocol over another. 23,36 The study presents several limitations intrinsic to study design, including subjectivity associated with the questions and answers included in the survey. Also, the survey asked respondents to include some information based on their memory or perception (i.e., monthly caseload, percentage of surgeries performed standing) which may have affected the accuracy of the results.…”

Guanabenz in the horse – A preliminary report on clinical effects and comparison to clonidine and other alpha-2 adrenergic agonists

“…Daunt and Steffey (2002) reviewed alpha-2 adrenergic agonists effects in horses and noted head droop among them. For example, Lawless et al (2021) studied head height as a means of gauging comparative sedative effects of detomidine and romifidine during laparoscopic ovariectomy. In a similar study that measured head droop (Queiroz-Neto et al 1998), amitraz produced a dose-dependent response.…”

Comparison of Detomidine or Romifidine in Combination with Morphine for Standing Magnetic Resonance Imaging in Horses

“…Alpha-2 adrenoreceptor agonists are the most commonly used drugs in horses for standing sedation. For standing procedures requiring long-term chemical restraint, as is the case for MRI, a CRI of these drugs is often administered [ 4 , 14 , 15 ].…”

“…Many studies have compared these two drugs using bolus administration and a CRI, in both experimental and clinical studies, showing them to be potent analgesics and sedatives [ 13 , 15 , 16 ]. However, to the authors’ knowledge, the feasibility of either of these protocols in standing sedation for MRI has not been investigated yet.…”