Dexmedetomidine low dose followed by constant rate infusion and antagonism by atipamezole in isoflurane-anesthetized cats: an echocardiographic study

Carvalho, Elizabeth Regina; Champion, Tatiana; Ambrosini, F.; Silva, Gabrieli A. da; Freitas, Gabrielle Coelho; Vilani, Ricardo Guilherme D'Otaviano de Castro

doi:10.1016/j.vaa.2018.09.040

Cited by 11 publications

(17 citation statements)

References 28 publications

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“…The authors observed that the combination of drugs made it possible to decrease systolic and diastolic pressures, hypotension, drop in heart rate and bradycardia at different times after pharmacological administration Picollo et al (2012). also found that hemodynamic effects remained even after complete anesthetic recovery Carvalho et al (2019). also observed a decrease in CO in dexmedetomidine infusion in isoflurane-anesthetized cats, the opposite found in this study in DB group.…”

supporting

confidence: 43%

“…In the dexmedetomidine/butorphanol group, this drop was of 50%. Carvalho et al (2019) reported that the administration of dexmedetomidine at the dose of 5 μg kg-1 promotes reduction of heart rate compared from baseline. The intensity of the fall of the HR (47% for XB and 50% for DB) could be explained because of the age of the cats in this study, but it is prove only in dogs that the heart rate varies according to age (Hezzell et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…also observed a decrease in CO in dexmedetomidine infusion in isoflurane-anesthetized cats, the opposite found in this study in DB group. However, we used only one application of dexmedetomidine, whileCarvalho et al (2019) associated inhalation anesthesia (isoflurane) and dexmedetomidine (CRI). On the other hand, comparing the initial dose of dexmedetomidine (5 μg kg-1) used byCarvalho et al.…”

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confidence: 99%

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Echocardiographic assessment of felines sedated with dexmedetomidine or xylazine associated with butorphanol

Megda

Sousa

Miranda

et al. 2022

RSD

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This prospective cohort study aimed to evaluate by echocardiogram the cardiovascular effects of α2 agents associated with butorphanol in cats. A group of 18 mixed-breed cats with a mean weight of 3.65 + 0.7 kg, with an approximate age of 6 months. The cats were assigned in three groups, XB (Xylazine/butorphanol group) sedation with 0.5 mg/kg of xylazine and 0.5 mg/kg of butorphanol IM; DB (Dexmedetomidine/butorphanol group): sedation with 20 µg/kg of dexmedetomidine and 0.5 mg/kg of butorphanol IM; C: control group which received saline solution in volume approximated to those used in the other groups, IM. Echocardiographic variables as ejection fraction (Simpson's method and M-mode) and left ventricular shortening fraction (M-mode), ejection volume, end-systolic volume and cardiac output (Teichholz), tissue Doppler E' and A' wave velocities and cardiac index were evaluated. There was a reduction in echocardiographic variables compared with the control group, being statistically significant for heart rate, ejection fraction (% by Simpson), shortening fraction (% in M-mode) and end-systolic volume in XB and DB groups, and tissue Doppler E' and A' wave velocity (m/s), E'/A' ratio, cardiac output and cardiac index only in XB group. When compared to each other, XB and DB differed significantly in the tissue Doppler E' and A' wave velocity (m/s), and E'/A' ratio. Xylazine was more deleterious than dexmedetomidine in most of the variables evaluated, leading to a significant reduction in cardiac output and cardiac index at the doses used in this study.

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confidence: 43%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Echocardiographic assessment of felines sedated with dexmedetomidine or xylazine associated with butorphanol

Megda

Sousa

Miranda

et al. 2022

RSD

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“…This method has been previously validated in dogs against thermodilution 14 and has been used in multiple studies in cats to evaluate changes in cardiac output. [15][16][17][18][19][20] Because the area of the aortic tract does not change over time, it has been proposed that following changes in VTI should be sufficient to assessing changes in SV. 3 This study aimed to evaluate the accuracy of the ultrasonographic variables CVCCI and inspiratory/minimum and expiratory/maximum diameters of the caudal vena cava to predict fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion.…”

Section: Introductionmentioning

confidence: 99%

Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion

Donati

Tunesi²,

Araos

2022

J Vet Emergen Crit Care

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Objective To evaluate the use of the caudal vena cava collapsibility index (CVCCI) and the inspiratory/minimum and expiratory/maximum diameters of the vena cava to predict fluid responsiveness in hospitalized, critically ill cats with hemodynamic and tissue perfusion abnormalities. Design Diagnostic test study in a prospective cohort of hospitalized cats. Setting Private practice referral hospital. Animals Twenty‐four hospitalized cats with spontaneous breathing and compromised hemodynamics and tissue hypoperfusion. Interventions Ultrasonographic examination before and after fluid expansion with 10 ml/kg of lactated Ringer's solution. Measurements and Main Results Fluid responsiveness was evaluated using the velocity–time integral (VTI) of the subaortic blood flow, by measuring it before and after a fluid load of 10 ml/kg of lactated Ringer's solution. The CVCCI was calculated using the following formula: (maximum diameter – minimum diameter / maximum diameter) × 100. Ten cats were fluid responders (42 %) and 14 were nonresponders (58 %). The area under the receiver operating characteristic curve (AUROC) with their 95% confidence interval for the predictors and the best cutoff values were as follows: CVCCI, AUROC = 0.83 (0.66–1.00) and cutoff = 31%; inspiratory/minimum diameter, AUROC = 0.86 (0.70–1.00) and cutoff = 0.24 cm; expiratory/maximum diameter, AUROC = 0.88 (0.74–1.00) and cutoff = 0.22 cm. A significant lineal correlation was observed between the percentage of increase in VTI after expansion and CVCCI (rs = 0.68, P < 0.001), expiratory/maximum diameter (rs = –0.72, P < 0.001), and inspiratory/minimum diameter (rs = –0.71, P < 0.001). The intraobserver and interobserver variability was low for VTI, and the expiratory/maximum diameter and inspiratory/minimum diameter were high for CVCCI. Conclusions Caudal vena cava measurements could be useful to predict the response to fluids in hospitalized cats with hemodynamic and tissue perfusion alterations. Additional studies are required to draw definitive conclusions about the role of these variables to guide fluid administration in cats.

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“…By activating α -adrenergic receptors, these drugs cause significant vasoconstriction, increasing systemic vascular resistance and inducing reflex bradycardia [ 8 ]. Even lower doses of dexmedetomidine alone (5 μ g.kg−1) were reported to cause a decrease in cardiac output (CO) [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Effect of Dexmedetomidine Low Doses with or without Midazolam in Cats: Clinical, Hemodynamic, Blood Gas Analysis, and Echocardiographic Effects

Castro

Câmara

Barreto

et al. 2022

Anesthesiology Research and Practice

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Objectives. The aim of the study is to compare the sedative, cardiorespiratory, echocardiographic, and blood gas effects of dexmedetomidine and methadone associated or not with midazolam for restraint chemistry in cats. Methods. Eighteen healthy young cats (4.06 ± 0.48 kg) were randomly sedated with two protocols, through the intramuscular route: dexmedetomidine (5 µg.kg−1), methadone (0.3 mg. kg−1) and midazolam (0.3 mg. kg−1) (DMTM, n = 9), or dexmedetomidine (7.5 µg.kg−1) and methadone (0.3 mg. kg−1) (DMT, n = 9). The cardiorespiratory parameters were measured at baseline, 5 and 10 minutes after pharmacological latency. The sedation, analgesia, and muscle relaxation scores were assessed before and 5 minutes after pharmacological latency, while arterial blood gas analysis and echocardiography were assessed before and after 10 or 15 minutes, respectively. Results. There was no difference between the protocols regarding the cardiorespiratory, blood gas, and echocardiographic parameters used. The scores for sedation, analgesia, and muscle relaxation also did not differ between the protocols, with the degree of sedation, analgesia, and myorelaxation considered satisfactory in both groups. A significant decrease in heart rate (HR) was observed after administration of the sedative protocols, reaching a maximum reduction at T10 (46% and 53% reduction in the DMT and DMTM groups, respectively). The reduction in HR had an impact on echocardiographic parameters such as CO, which decreased 53% and 56% in the DMT and DMTM groups, respectively. There was a significant reduction in PaO2, SaO2, ejection fraction, and fractional shortening in both protocols. SpO2 decreased significantly after 5 minutes of sedation in the DMT group, but with a minimum mean SpO2 of 92% in T5. The respiratory rate decreased significantly at 5 and 10 minutes in the DMTM group, while PaCO2 increased in both groups, indicating respiratory depression caused by the drugs. Conclusions and Relevance. The study pointed out that both sedative protocols can be recommended for clinical sedation of young and healthy cats in the doses used. However, both protocols resulted in cardiorespiratory depression in cats and also the particularities of the animals should be evaluated regarding reducing cardiac output by more than 50%.

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Dexmedetomidine low dose followed by constant rate infusion and antagonism by atipamezole in isoflurane-anesthetized cats: an echocardiographic study

Cited by 11 publications

References 28 publications

Echocardiographic assessment of felines sedated with dexmedetomidine or xylazine associated with butorphanol

Echocardiographic assessment of felines sedated with dexmedetomidine or xylazine associated with butorphanol

Caudal vena cava measurements and fluid responsiveness in hospitalized cats with compromised hemodynamics and tissue hypoperfusion

Effect of Dexmedetomidine Low Doses with or without Midazolam in Cats: Clinical, Hemodynamic, Blood Gas Analysis, and Echocardiographic Effects

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