Hemodynamic, respiratory and sedative effects of progressively increasing doses of acepromazine in conscious dogs

Rangel, Julia P.P.; Monteiro, Eduardo Raposo; Bitti, Flavia S.; S.N., Juarez; Campagnol, Daniela

doi:10.1016/j.vaa.2020.02.007

Cited by 19 publications

(10 citation statements)

References 8 publications

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“…7 However, in a recent study in awake dogs, the reduction in blood pressure after administration of acepromazine occurred owing to a decrease in stroke volume and cardiac output and not as a result of vasodilation. 20 An unexpected finding in our study was that a greater number of cats presented hypotension at T1 in acepromazine–butorphanol groups than in acepromazine–nalbuphine groups (36–45% vs 0–8%, respectively), and an overall significant difference between groups was detected. This might indicate that acepromazine–butorphanol results in greater prevalence of hypotension than acepromazine–nalbuphine.…”

Section: Discussionmentioning

confidence: 49%

Sedative effects of acepromazine in combination with nalbuphine or butorphanol, intramuscularly or intravenously, in healthy cats: a randomized, blinded clinical trial

Costa

Monteiro

Marques

et al. 2020

Journal of Feline Medicine and Surgery

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Objectives The aim of this study was to compare the sedative effects in cats administered acepromazine–nalbuphine and acepromazine–butorphanol, intramuscularly (IM) and intravenously (IV), and the occurrence of adverse cardiorespiratory effects. Methods Forty-six cats were randomly divided into four groups and administered acepromazine (0.05 mg/kg) combined with nalbuphine (0.5 mg/kg) or butorphanol (0.4 mg/kg), IV (ACP-NALIV and ACP-BUTIV groups, respectively) or IM (ACP-NALIM and ACP-BUTIM groups, respectively). Sedation scores, ease of intravenous catheter placement (simple descriptive scale [SDS] scores), physiologic variables, venous blood gases and the propofol dose required for anesthetic induction were recorded. Results Mild sedation was observed in all groups approximately 30 mins after treatment administration (timepoint T1, prior to propofol administration). Sedation scores at T1 increased above baseline in all groups ( P <0.05), but no significant difference was observed among groups. Dynamic interactive visual analogue scale sedation scores (range 0–100 mm) recorded at T1 were (median [interquartile range]): ACP-NALIM, 12 (10–12); ACP-NALIV, 11 (6–16); ACP-BUTIM, 11 (7–14); and ACP-BUTIV, 12 (7–19). Overall, SDS scores did not change from baseline at T1 and there was no significant difference among groups. The propofol dose did not differ among groups. Blood gases remained within the reference intervals for cats. Significant decreases from baseline were detected for all groups in systolic arterial pressure (SAP). Mean ± SD values at T1 were (mmHg): ACP-NALIM, 108 ± 13; ACP-NALIV, 102 ± 10; ACP-BUTIM, 97 ± 13; and ACP-BUTIV, 98 ± 21. Arterial hypotension (SAP <90 mmHg) was recorded at T1 in 0/11, 1/13, 4/11 and 5/11 cats in groups ACP-NALIM, ACP-NALIV, ACP-BUTIM and ACP-BUTIV, respectively, and was further exacerbated after the induction of anesthesia with propofol. Conclusions and relevance In healthy cats administered acepromazine–nalbuphine and acepromazine–butorphanol, IM and IV, the degree of sedation was mild regardless of the protocol and the route of administration. The main adverse effect observed was a reduction in arterial blood pressure.

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Section: Discussionmentioning

confidence: 49%

Sedative effects of acepromazine in combination with nalbuphine or butorphanol, intramuscularly or intravenously, in healthy cats: a randomized, blinded clinical trial

Costa

Monteiro

Marques

et al. 2020

Journal of Feline Medicine and Surgery

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“…Also, it has to be considered that an increase in azaperone dose might lead to the manifestation or worsening of some of its side effects, such as excessive sedation, seizures and catalepsy (The European Agency for the Evaluation of Medicinal Products 1998). A recent study in conscious dogs highlighted how acepromazine, another dopaminergic drug, leads to a decrease in blood pressure through cardiac output impairment rather than a drop in systemic vascular resistance (Rangel et al 2020 ). Azaperone’s effects on cardiac output and systemic vascular resistance in antelopes are not known yet, and therefore further research is necessary to clarify azaperone’s possible dose-dependent adverse and opioid-sparing effects.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of two different etorphine doses combined with azaperone in blesbok (Damaliscus pygargus phillipsi) immobilisation

Gaudio

Laubscher

Meyer

et al. 2021

Journal of the South African Veterinary Association

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Chemical immobilisation is essential for veterinarians to perform medical procedures in wild African ungulates. Potent opioids combined with neuroleptic drugs are most often used for this purpose. The present study aimed at comparing the quality of immobilisation and effects on physiological variables between a high (high etorphine-azaperone [HE]: 0.09 mg kg–1) and low etorphine dose (low etorphine-azaperone [LE]: 0.05 mg kg–1), both combined with azaperone (0.35 mg kg–1), in 12 adult female boma-acclimatised blesbok. It was hypothesised that a reduction in etorphine’s dose in combination with azaperone would result in less cardiorespiratory impairment but likely worsen the quality of immobilisation. Both treatments resulted in rapid induction and recovery times. Overall inter-treatment differences occurred in pulse rate (HE and LE: 52 ± 15 and 44 ± 11 beats minute–1, p 0.0001), respiratory rate (HE and LE: 15 ± 4 and 17 ± 4 breaths minute–1, p 0.006), partial pressure of exhaled carbon dioxide (HE and LE: 62.0 ± 5.0 and 60.0 ± 5.6 millimetre of mercury [mmHg], p 0.028) and arterial carbon dioxide (HE and LE: 58.0 ± 4.5 and 55.0 ± 3.9 mmHg, p 0.002). Both HE and LE led to bradycardia, hypertension and marked hypoxia to a similar extent. Furthermore, quality of induction, immobilisation and recovery were similar in both treatments. The role of azaperone in the development of cardiorespiratory compromise and gas exchange impairment that occurred when these combinations were used is still unclear. Further studies are recommended to elucidate drug- and dose-specific physiological effects in immobilised antelope.

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“…These results were unexpected as the combination of ACP, a well-known sedative and anxiolytic drug, with an opioid should be advantageous thanks to the induced neuroleptanalgesia [12]. In addition, an intraoperative increase in MAP was unpredicted as the mechanism of action of acepromazine consists of blunting increase in blood pressure due to blockade of vascular alpha-1 adrenergic receptors causing a reduction in systemic vascular resistance and a consequent fall in blood pressure [13,14]. Therefore, in this study, one can assume that the addition of ACP couldn't demonstrate any additional value compared to the administration of morphine alone.…”

Section: Discussionmentioning

confidence: 99%

Performance of the Parasympathetic Tone Activity (PTA) index to assess the intraoperative nociception using different premedication drugs in anaesthetised dogs

Mansour

Hachem

Jamous

et al. 2020

International Journal of Veterinary Science and Medicine

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The dynamic variations of the Parasympathetic Tone Activity (PTA) index were evaluated to assess nociception in dogs undergoing anaesthetic protocols with different premedication drugs. Sixty-six dogs, divided into three groups of 22 dogs each, were given different premedication drugs "morphine" (0.2 mg/kg), "morphine + medetomidine (5 μg/kg)", "morphine + acepromazine (0.03 mg/kg)", then similarly induced and maintained under general anaesthesia. The PTA, HR (heart rate) and MAP (mean arterial pressure) were assessed at S (steady-state), Cut (cutaneous incision), PTA E (PTA Event, assessed 1 min before a significant PTA decrease), HDR (Haemodynamic reaction, assessed 5 min before an increase of ≥ 20% in HR and/or MAP). For each group, the dynamic variation of PTA (ΔPTA) was calculated and a Receiver Operating Characteristics (ROC) curve was performed to detect if any of the premedication drugs may alter the performance of PTA index to predict intraoperative haemodynamic reactions. In all groups, a haemodynamic reaction was detected after Cut, PTA E and HDR and was preceded with a significant decrease of PTA, except for "morphine + medetomidine" group which showed a significant drop of PTA only at PTA E and HDR. The ΔPTA showed a fair performance in all groups (a mean [95%

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Hemodynamic, respiratory and sedative effects of progressively increasing doses of acepromazine in conscious dogs

Cited by 19 publications

References 8 publications

Sedative effects of acepromazine in combination with nalbuphine or butorphanol, intramuscularly or intravenously, in healthy cats: a randomized, blinded clinical trial

Sedative effects of acepromazine in combination with nalbuphine or butorphanol, intramuscularly or intravenously, in healthy cats: a randomized, blinded clinical trial

Evaluation of two different etorphine doses combined with azaperone in blesbok (Damaliscus pygargus phillipsi) immobilisation

Performance of the Parasympathetic Tone Activity (PTA) index to assess the intraoperative nociception using different premedication drugs in anaesthetised dogs

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