Effect of dexmedetomidine constant rate infusion on the bispectral index during alfaxalone anaesthesia in dogs

Navarrete, Rocío; Quirós‐Carmona, Setefilla; Granados, María del Mar; Gómez-Villamandos, R.J.; Domínguez, Juan M.; Fernández-Sarmiento, José Andrés; Muñoz-Rascón, Pilar; Funes, Francisco J.; Morgaz, Juán

doi:10.1111/vaa.12323

“…At present, surgical open reduction is the main method in clinical treatment to promote fracture healing and improve the joint function. However, due to the common peroneal nerve and abundant tissue and blood vessels around the tibiofibula, as well as the large trauma, surgery can easily damage the blood vessels and nerves and induce post-traumatic stress response, accompanied by various postoperative adverse reactions after surgery [ 15 – 17 ]. In addition, patients under general anesthesia experience hemodynamic changes such as increased heart rate and blood pressure due to sympathetic excitation caused by surgical pain and other stimuli as the anesthesia gradually subsides.…”

Section: Discussionmentioning

confidence: 99%

Application of Different Doses of Dexmedetomidine Combined with General Anesthesia in Anesthesia of Patients with Traumatic Tibiofibular Fractures and Its Effect on the Incidence of Adverse Reactions

Zhang

¹

,

Sun

²

,

Cheng

³

et al. 2021

Journal of Healthcare Engineering

View full text Add to dashboard Cite

Objective. To explore the application of different doses of dexmedetomidine combined with general anesthesia in patients with traumatic tibiofibular fractures. Methods. A total of 120 patients with traumatic tibiofibular fractures treated in our hospital (January 2018–January 2021) were selected as the research subjects and equally grouped into group A, group B, group C, and group D according to the dosage of dexmedetomidine. Group B, group C, and group D were pumped with 0.3 μg/kg, 0.5 μg/kg, and 0.8 μg/kg load doses of dexmedetomidine before anesthesia induction, with the same doses for maintenance during surgery. Group A was intravenously pumped with the same amount of normal saline and received tracheal intubation after anesthesia induction, with propofol and remifentanil to maintain general anesthesia during surgery. Results. No notable differences in general data were observed among the groups ( P > 0.05). Ramsay sedation scores of all groups showed a downward trend after drug withdrawal. At 10 min, 30 min, and 60 min, the scores of groups C and D were markedly higher than those of groups A and B ( P < 0.05), and the scores were higher in group D than those in group C ( P < 0.05). The HR changes at each period were close between groups A and B ( P > 0.05). The HRs at T1 and T2 in group C were slightly lower than those in group D ( P > 0.05), and the HRs at T1 in groups A and B were remarkably higher than those in groups C and D, and were higher than those at T0 and T2 ( P < 0.05). The SBP levels of all groups began to rise at T0, peaked at T1, and decreased to a lower level at T2 than that at T0. Moreover, the SBP levels of groups C and D at T1 and T2 were notably lower compared with groups A and B ( P < 0.05). With a lower DBP level in group C than the other three groups at T1, the DBP levels were notably lower in groups C and D than those in groups A and B at T2 ( P < 0.05). With no statistical difference in the MAP levels at T0 among the four groups ( P > 0.05), the MAP levels in group A at T1 and T2 were obviously higher compared with groups C and D ( P < 0.05). The extubation time in group A was notably longer than that that in groups B, C, and D ( P < 0.05), with longer extubation time in group B than that in groups C and D ( P < 0.05). The orientation recovery time in group D was markedly shorter than that in groups A, B, and C ( P < 0.05). The incidence of cognitive dysfunction, chills, and restlessness in groups C and D was notably lower compared with groups A and B ( P < 0.05), with a higher incidence of chills, intraoperative hypotension, and delayed awakening in group D than in group C ( P < 0.05). Conclusion. Dexmedetomidine at doses of 0.5 μg/kg and 0.8 μg/kg has a better effect in the maintenance of general anesthesia for patients with traumatic tibiofibular fractures, with faster orientation recovery, better recovery of postoperative cognitive function, and a lower incidence of adverse reactions. Dexmedetomidine at 0.5 μg/kg is recommended in view of the increased risk of excessive sedation, chills, restlessness, and intraoperative hypotension in patients at 0.8 μg/kg.

show abstract

“…In non-sedated healthy dogs, the median (range) induction dose of alfaxalone used in both clinical and experimental studies was 3 (2 to 4.74) mg/kg (Ferre et al 2006, Muir et al 2008, Pasloske et al 2009, Keates & Whittem 2012, Morgaz Rodríguez et al 2012, Maney et al 2013, Costa et al 2014, Quiros-Carmona et al 2014, Bauer & Ambros 2016, Navarrete et al 2016, Bennett et al 2017, Hasiuk et al 2018, Pattanapon et al 2018, Bennett et al 2019, Dehuisser et al 2019a, Hampton et al 2019a,b, Bini et al 2020.…”

Section: Factors Affecting the Induction Dosementioning

confidence: 99%

“…When an alfa-2 agonist was combined with (Maddern et al 2010, Herbert et al 2013, Pinelas et al 2014, Bauer & Ambros 2016, Dehuisser et al 2017, Quiros-Carmona et al 2017, White & Yates 2017, Bigby et al 2017a,b, Dehuisser et al 2019b, or without an opioid (Maddern et al 2010, Quiros-Carmona et al 2014, Navarrete et al 2016, Bennett et al 2017, doses from 0.6 to 3.39 mg/kg were necessary to achieve endotracheal intubation. However, no differences were found comparing dexmedetomidine (10 μg/kg) and acepromazine (0.02 mg/kg) (Herbert et al 2013), or dexmedetomidine (5 μg/kg) and acepromazine (0.05 mg/kg), both combined with methadone (0.5 mg/kg) (Bigby et al 2017a), despite higher sedation scores were obtained in the dexmedetomidine groups.…”

Section: Factors Affecting the Induction Dosementioning

confidence: 99%

See 1 more Smart Citation

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

Bellido¹,

Vettorato²

2021

J of Small Animal Practice

View full text Add to dashboard Cite

This clinical review summarises the pharmacological and anaesthetic properties of alfaxalone in the dog. Available pharmacokinetic‐pharmacodynamic data and factors affecting the induction dose have been reported. Furthermore, quality of induction and recovery after alfaxalone administration, the use of alfaxalone for total intravenous anaesthesia, and its effects on the cardio‐respiratory system, on laryngeal motion, on intraocular pressure and tear production have been evaluated. Finally, the use of alfaxalone in dogs undergoing caesarean section and the effect of intramuscular alfaxalone administration have been considered.

show abstract

“…Since inhaling anesthetic agent would suppress the brain electrical activities resulting in intermittent iEEG recording, the continuous infusion of intravenous dexmedetomidine (0.3-0.7 µg/kg/hr) combined weak general anesthesia (maintained with 0.4-0.8% isoflurane) were used. This approach did not affect spontaneous interictal epileptiform activity, did not stimulate any additional motor activity, and also facilitated continuous iEEG recording [60][61][62][63] .…”

Section: Transcutaneous and Subcutaneous Stimulation-induced Intracramentioning

confidence: 99%

Analyzing the advantages of subcutaneous over transcutaneous electrical stimulation for activating brainwaves

Kang

¹

,

Lee

²

,

Kim

³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Transcranial electrical stimulation (TES) is a widely accepted neuromodulation modality for treating brain disorders. However, its clinical efficacy is fundamentally limited due to the current shunting effect of the scalp and safety issues. A newer electrical stimulation technique called subcutaneous electrical stimulation (SES) promises to overcome the limitations of TES by applying currents directly at the site of the disorder through the skull. While SES seems promising, the electrophysiological effect of SES compared to TES is still unknown, thus limiting its broader application. Here we comprehensively analyze the SES and TES to demonstrate the effectiveness and advantages of SES. Beagles were bilaterally implanted with subdural strips for intracranial electroencephalography and electric field recording. For the intracerebral electric field prediction, we designed a 3D electromagnetic simulation framework and simulated TES and SES. In the beagle model, SES induces three to four-fold larger cerebral electric fields compared to TES, and significant changes in power ratio of brainwaves were observed only in SES. Our prediction framework suggests that the field penetration of SES would be several-fold larger than TES in human brains. These results demonstrate that the SES would significantly enhance the neuromodulatory effects compared to conventional TES and overcome the TES limitations.

show abstract

Effect of dexmedetomidine constant rate infusion on the bispectral index during alfaxalone anaesthesia in dogs

Cited by 8 publications

References 40 publications

Application of Different Doses of Dexmedetomidine Combined with General Anesthesia in Anesthesia of Patients with Traumatic Tibiofibular Fractures and Its Effect on the Incidence of Adverse Reactions

Application of Different Doses of Dexmedetomidine Combined with General Anesthesia in Anesthesia of Patients with Traumatic Tibiofibular Fractures and Its Effect on the Incidence of Adverse Reactions

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

Analyzing the advantages of subcutaneous over transcutaneous electrical stimulation for activating brainwaves

Contact Info

Product

Resources

About