Hyoscine-N-butylbromide premedication on cardiovascular variables of horses sedated with medetomidine

Perotta, João Henrique; Canola, Paulo Aléscio; Lopes, M. C. S.; Évora, Patricia Martinez; Martinez, Paulo E. B.; Escobar, André; Valadão, C. A. A.

doi:10.1111/vaa.12139

Cited by 8 publications

(11 citation statements)

References 26 publications

(62 reference statements)

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“…; Perotta et al . ). Their use may still be valuable in emergency reversal of profound bradycardia (<24 beats/min) in association with hypotension (mean arterial pressure <60–65 mmHg).…”

Section: Reversal Of Undesirable Effects Of α2‐adrenoceptor Agonistsmentioning

confidence: 97%

“…; Perotta et al . ). The intramuscular route of administration is preferred for the anticholinergics to minimise the unwanted cardiovascular effects (Perotta et al .…”

Section: Reversal Of Undesirable Effects Of α2‐adrenoceptor Agonistsmentioning

confidence: 97%

“…) and medetomidine‐induced (Perotta et al . ) bradycardia in sedated horses. The detomidine‐induced gastrointestinal hypomotility is not perpetuated by hyoscine, unlike atropine.…”

Section: Reversal Of Undesirable Effects Of α2‐adrenoceptor Agonistsmentioning

confidence: 98%

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A review of clinical approaches to antagonism of alpha₂‐adrenoreceptor agonists in the horse

Zeiler

2014

Equine Veterinary Education

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SummaryAlpha2-adrenoceptor agonists xylazine, romifidine, detomidine and, in some cases, medetomidine and dexmedetomidine, are fundamental drugs used in equine practice. There are situations where the undesirable pharmacodynamic effects (ataxia, prolonged sedation, bradycardia and ileus) or accidental overdose of these drugs may need to be antagonised. The α 2-adrenoceptor antagonists tolazoline, yohimbine and atipamezole can be used to antagonise undesirable effects. However, despite being effective, α 2-adrenoceptor antagonists are also not without undesirable pharmacodynamic effects. Excitement, muscle trembling and triggered inappropriate stress responses are a few of the more serious undesirable effects. Horses demonstrate a variable response to the antagonists thus recommending dose rates become fraught with difficulty. It is therefore recommended that the α 2-adrenoceptor antagonist should be titrated to the desired clinical effect. Consequently, other reversal agents, such as anticholinergics (atropine, glycopyrrolate and hyoscine), have been administered for the treatment of α 2-adrenoceptor agonist-induced bradycardia. Anticholinergics cannot be recommended for routine use in horses due to the undesirable cardiovascular effects and potentiation of α 2-adrenoceptor agonist-induced gastrointestinal hypomotility. Novel peripheral acting α 2-adrenoceptor antagonists, such as MK-467, are currently under scrutiny in veterinary anaesthesia in an effort to antagonise the undesirable effects of α 2-adrenoceptor agonists without compromising on the level of sedation. This review examines the current literature on the α 2-adrenoceptor antagonists used in horses and makes recommendations on how to use these drugs safely in an attempt to prevent undesirable pharmacodynamic effects.

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“…; Perotta et al . ). Their use may still be valuable in emergency reversal of profound bradycardia (<24 beats/min) in association with hypotension (mean arterial pressure <60–65 mmHg).…”

Section: Reversal Of Undesirable Effects Of α2‐adrenoceptor Agonistsmentioning

confidence: 97%

“…; Perotta et al . ). The intramuscular route of administration is preferred for the anticholinergics to minimise the unwanted cardiovascular effects (Perotta et al .…”

Section: Reversal Of Undesirable Effects Of α2‐adrenoceptor Agonistsmentioning

confidence: 97%

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A review of clinical approaches to antagonism of alpha₂‐adrenoreceptor agonists in the horse

Zeiler

2014

Equine Veterinary Education

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“…Hyoscine NBB is a non‐traditional anticholinergic alkaloid agent derived from Hyoscyamus niger (Henbane) and has been used as a successful alternative to atropine to treat detomidine‐induced (Pimenta et al 2011), romifidine‐induced (Marques et al 1998) and medetomidine‐induced (Perotta et al 2014) bradycardia in sedated horses. Hyoscine NBB is licensed for use in horses in the UK and is widely used in equine practice as an antispasmodic drug because of a short duration of effect on the gastrointestinal tract (Roelvink et al 1991).…”

Section: Discussionmentioning

confidence: 99%

The use of hyoscine N‐butylbromide to treat intraoperative bradycardia during isoflurane anaesthesia in three horses

Loomes¹

2020

Equine Veterinary Education

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Intraoperative bradycardia is not an uncommon complication in anaesthetised horses and it has been recommended that severe bradycardia (defined as heart rate (HR) <25 beats/min) during general anaesthesia, when associated with hypotension (mean arterial pressure (MAP) <70 mmHg) and other signs of inadequate tissue perfusion, should be treated with anticholinergics. Muscarinic antagonists, such as atropine and glycopyrrolate, cause positive chronotropism and dromotropism (improved atrioventricular conduction) by competitively blocking the effects of acetylcholine at muscarinic receptors in the heart. However, in horses, prolonged intestinal hypomotility and colic have been associated with the use of atropine and glycopyrrolate which has led to the investigation of the use of hyoscine Nbutylbromide (hyoscine NBB) to treat alpha 2 agonist-induced bradycardia in horses. This report describes the successful use of hyoscine NBB to treat symptomatic intraoperative bradycardia in three isoflurane-anaesthetised horses. Case 1 Case historyA 3-year-old 555 kg Warmblood gelding presented for bilateral stifle arthroscopy under general anaesthesia. Preanaesthetic examination identified a second-degree atrioventricular (AV) block which disappeared after trot up. Physical examination was otherwise unremarkable.

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“…En un estudio realizado por Perotta y colaboradores la administración previa de hioscina con α2-adrenérgicos previene la bradicardia y los bloqueos AV de segundo grado (4). La premedicación con hioscina genera un incremento en la FC y supresión de bradicardia inducida por α2-adrenérgicos (10).…”

Section: Descripción Del Casounclassified

Uso de N-butilbromuro de hioscina en premedicación anestésica en un equino con un bloqueo atrioventricular Mobitz tipo II

M.¹,

Flórez

Lenis

et al. 2016

Rev. Med. Vet.

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El bloqueo atrioventricular (AV) segundo grado Mobitz tipo II, a diferencia del bloqueo Mobitz tipo I, se caracteriza por presentar un intervalo PR normal antes de una onda P no conductiva y después de esta. Algunos bloqueos se producen por causas fisiológicas, metabólicas, estructurales y por la administración de medicamentos α2-adrenérgicos. Se ha registrado que la mayoría de los bloqueos y bradicardias responden a la atropina o glicopirrolato. En este informe de caso se presenta un equino macho, raza cuarto de milla, de cinco años de edad, remitido al Centro de Veterinaria y Zootecnia de la Universidad CES para una artroscopia del carpo izquierdo. Tras el derribo del paciente con la administración de xilacina, diazepam y ketamina, para iniciar el procedimiento quirúrgico, el paciente presenta una bradicardia marcada (10 latidos por minuto). Por lo tanto, se decide posponer la cirugía. Posterior a su reincorporación, se le diagnostica un bloqueo AV de segundo grado Mobitz tipo II, el cual al momento de tratarse solo responde a N-butilbromuro de hioscina.

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Hyoscine-N-butylbromide premedication on cardiovascular variables of horses sedated with medetomidine

Cited by 8 publications

References 26 publications

A review of clinical approaches to antagonism of alpha₂‐adrenoreceptor agonists in the horse

A review of clinical approaches to antagonism of alpha₂‐adrenoreceptor agonists in the horse

The use of hyoscine N‐butylbromide to treat intraoperative bradycardia during isoflurane anaesthesia in three horses

Uso de N-butilbromuro de hioscina en premedicación anestésica en un equino con un bloqueo atrioventricular Mobitz tipo II

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Hyoscine-N-butylbromide premedication on cardiovascular variables of horses sedated with medetomidine

Cited by 8 publications

References 26 publications

A review of clinical approaches to antagonism of alpha2‐adrenoreceptor agonists in the horse

A review of clinical approaches to antagonism of alpha2‐adrenoreceptor agonists in the horse

The use of hyoscine N‐butylbromide to treat intraoperative bradycardia during isoflurane anaesthesia in three horses

Uso de N-butilbromuro de hioscina en premedicación anestésica en un equino con un bloqueo atrioventricular Mobitz tipo II

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A review of clinical approaches to antagonism of alpha₂‐adrenoreceptor agonists in the horse

A review of clinical approaches to antagonism of alpha₂‐adrenoreceptor agonists in the horse