Evaluation of total intravenous anesthesia with propofol or ketamine-medetomidine-propofol combination in horses

Abstract

Objective—To compare the anesthetic and cardiorespiratory effects of total IV anesthesia with propofol (P-TIVA) or a ketamine-medetomidine-propofol combination (KMP-TIVA) in horses. Design—Randomized experimental trial. Animals—12 horses. Procedure—Horses received medetomidine (0.005 mg/kg [0.002 mg/lb], IV). Anesthesia was induced with midazolam (0.04 mg/kg [0.018 mg/lb], IV) and ketamine (2.5 mg/kg [1.14 mg/lb], IV). All horses received a loading dose of propofol (0.5 mg/kg [0.23 mg/lb], IV), and 6 horses underwent P-TIVA (propofol infusion). Six horses underwent KMP-TIVA (ketamine [1 mg/kg/h {0.45 mg/lb/h}] and medetomidine [0.00125 mg/kg/h {0.0006 mg/lb/h}] infusion; the rate of propofol infusion was adjusted to maintain anesthesia). Arterial blood pressure and heart rate were monitored. Qualities of anesthetic induction, transition to TIVA, and maintenance of and recovery from anesthesia were evaluated. Results—Administration of KMP IV provided satisfactory anesthesia in horses. Compared with the P-TIVA group, the propofol infusion rate was significantly less in horses undergoing KMP-TIVA (0.14 ± 0.02 mg/kg/min [0.064 ± 0.009 mg/lb/min] vs 0.22 ± 0.03 mg/kg/min [0.1 ± 0.014 mg/lb/min]). In the KMP-TIVA and P-TIVA groups, anesthesia time was 115 ± 17 minutes and 112 ± 11 minutes, respectively, and heart rate and arterial blood pressure were maintained within acceptable limits. There was no significant difference in time to standing after cessation of anesthesia between groups. Recovery from KMP-TIVA and P-TIVA was considered good and satisfactory, respectively. Conclusions and Clinical Relevance—In horses, KMP-TIVA and P-TIVA provided clinically useful anesthesia; the ketamine-medetomidine infusion provided a sparing effect on propofol requirement for maintaining anesthesia.

Clinical Evaluation of Total Intravenous Anesthesia Using a Combination of Propofol and Medetomidine following Anesthesia Induction with Medetomidine, Guaifenesin and Propofol for Castration in Thoroughbred Horses

“…Guaifenesin, a central muscle relaxant, administered during induction in this study could have influenced the recovery time. Meanwhile, it has been suggested that the recovery time from propofol anesthesia is longer in Thoroughbred and other horses of similar weight than in ponies [24]. Therefore, in these horses, appropriate monitoring of the depth of anesthesia is crucial to prevent overdose administration of propofol, which results in the delay of recovery.…”

“…In humans, TIVA with propofol and ketamine has become a popular means of anesthesia and has been reported to provide a good maintenance state without remarkable cardiorespiratory depression [12]. Propofol has also been used for horses as TIVA in combination with ketamine and is known to provide sufficient anesthesia [10,20,24,25].…”

Evaluation of the effects of intravenous anaesthesia using a combination of ketamine - medetomidine in Sahel goats

“…Medetomidine that was used in the present study is a more potent sedative than detomidine and coupled with lack of surgery in this study these prolonged the anaesthesia in the goats. These two are responsible for the prolonged anaesthesia observed in the goats (Umar et al, 2006). In conclusion, ketamine and medetomidine combination used for total intravenous anaesthesia produced effective anaesthesia in goats.…”

“…Medetomidine is an alpha 2 agonist which produces sedation, analgesia and muscle relaxation in veterinary practice. Medetomidine is an effective sedative in small animal practice (Sinclair, 2003) and horses (Umar et al, 2006;Yamashita et al, 2007). Indeed, ketamine and medetomidine combinations have been found to provide excellent immobilization and muscle relaxation in a wide range of species of animals while the ability to reverse the sedative effect of alpha 2 adrenoreceptor agonist has proved to be particularly useful (Hall et al, 2001).…”

“…Advantages of intravenous anaesthesia include rapid and smooth induction of anaesthesia, little equipment requirements (needles, syringes, catheters), easy administration of drugs and achievement of balanced anaesthesia (Yamashita et al, 2007). Intravenous anaesthesia is indicated mostly for major surgery such as orthopaedic surgeries in animals including limb amputation, management, arthroscopy, obstetrical procedures like ceasarian section and orchidectomy in large animals (Hall et al, 2001;Umar et al, 2006;Kilic, 2008). Ketamine has analgesic effect which is partly mediated by N-Methyl-D-aspartate antagonistic activity in cats, dogs, rabbits and other small animals (Gaynor, 2002).…”