The clinical effects of a low dose dexmedetomidine constant rate infusion in isoflurane anesthetized cats

Simon, Bradley T; Scallan, Elizabeth M.; Coursey, Caleb D; Kiehl, W.M.; Moore, Erica J.

doi:10.1016/j.tvjl.2018.02.008

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…Midazolam often leads to the inhibition of respiration, whereas in this study, there was no significant difference in SpO 2 between the two groups, and the drug did not significantly inhibit respiration. According to Hall et al and Ustun et al, in the course of the operation and the recovery, sedation with dexmedetomidine preserved the respiratory rate and oxygen concentration [12]. The results of this study are consistent with those of these researchers, although respiratory inhabitation related to dexmedetomidine was not obviously lower than that related to propofol [13].…”

Section: Discussionsupporting

confidence: 90%

Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial

Wang

Zhou

Zhang

et al. 2020

BioMed Research International

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Dexmedetomidine refers to an α2-adrenergic receptor agonist causing potent sedative, analgesic, and minimal respiratory depression compared with alternative drugs. The present study was aimed at comparing the efficaciousness and safety of midazolam and dexmedetomidine as sedatives for dental implantation. We recruited 60 patients belonging to group I or II of the American Society of Anesthesiologists (ASA) and treated them with either midazolam or dexmedetomidine in a random manner. Patients’ duration of analgesia after surgery, surgeon and patient degrees of satisfaction, Observer’s Assessment of Alertness/Sedation Scale (OAAS) scores after drug administration, visual analogue scale (VAS) pain scores, and vital signs were recorded variables. Patients administered dexmedetomidine had significantly lower OAAS scores than those administered midazolam (p<0.05). Patients administrated dexmedetomidine had a significantly longer analgesia duration after the surgical procedure than those administered midazolam, and the difference was statistically significant (p<0.05). Dexmedetomidine had a significantly larger number of surgeons satisfied with the level of sedation/analgesia than midazolam (p<0.05). Accordingly, it is considered that dexmedetomidine can achieve better postoperative analgesia, surgeon satisfaction, and sedation than midazolam.

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Section: Discussionsupporting

confidence: 90%

Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial

Wang

Zhou

Zhang

et al. 2020

BioMed Research International

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“…Dexmedetomidine, a highly selective α-2 receptor agonist with potent sedative and analgesic properties, is commonly used as premedication in balanced anesthesia in small animal clinical medicine [ 1 , 2 ]. It has been reported to provide sedative properties paralleling natural sleep, with minimal respiratory depression in rats [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Dexmedetomidine Premedication in Balanced Anesthesia: A Systematic Review and Meta-Analysis in Dogs

Pan

Liu

Lin

et al. 2021

Animals

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Dexmedetomidine is commonly used in small animal anesthesia for its potent sedative and analgesic properties; however, concerns regarding its cardiovascular effects prevent its full adoption into veterinary clinical practice. This meta-analysis was to determine the effects of dexmedetomidine on sedation, analgesia, cardiovascular and adverse reactions in dogs compared to other premedications. Following the study protocol based on the Cochrane Review Methods, thirteen studies were included in this meta-analysis ultimately, involving a total of 576 dogs. Dexmedetomidine administration probably improved in sedation and analgesia in comparison to acepromazine, ketamine and lidocaine (MD: 1.96, 95% CI: [−0.08, 4.00], p = 0.06; MD: −0.95, 95% CI: [−1.52, −0.37] p = 0.001; respectively). Hemodynamic outcomes showed that dogs probably experienced lower heart rate and higher systolic arterial blood pressure and mean arterial blood pressure with dexmedetomidine at 30 min after premedication (MD: −13.25, 95% CI: [−19.67, −6.81], p < 0.0001; MD: 7.78, 95% CI: [1.83, 13.74], p = 0.01; MD: 8.32, 95% CI: [3.95, 12.70], p = 0.0002; respectively). The incidence of adverse effects was comparable between dexmedetomidine and other premedications (RR = 0.86, 95% CI [0.58, 1.29], p = 0.47). In summary, dexmedetomidine provides satisfactory sedative and analgesic effects, and its safety is proved despite its significant hemodynamic effects as part of balanced anesthesia of dogs.

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“…Therefore, pharmacokinetic studies are needed to clarify whether a higher CRI of tramadol would result in more important anaesthetic-sparing effects and whether they would be safe for domestic cats. In contrast, the use of dexmedetomidine in a single dose or CRI has been widely reported in cats (Souza et al 2010;Pypendop et al 2011;Ravasio et al 2012;Simon et al 2018;Raffe 2020). Dexmedetomidine (0.5 mg/kg LD and CRI 0.5 mg/kg/h) reduces the overall isoflurane requirements to maintain the anaesthesia by 21% https://doi.org/10.17221/138/2020-VETMED in cats undergoing an ovariohysterectomy (Simon et al 2018).…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, the use of dexmedetomidine in a single dose or CRI has been widely reported in cats (Souza et al 2010;Pypendop et al 2011;Ravasio et al 2012;Simon et al 2018;Raffe 2020). Dexmedetomidine (0.5 mg/kg LD and CRI 0.5 mg/kg/h) reduces the overall isoflurane requirements to maintain the anaesthesia by 21% https://doi.org/10.17221/138/2020-VETMED in cats undergoing an ovariohysterectomy (Simon et al 2018). In cats sedated with dexmedetomidine (4 mg/kg), an epidural anaesthesia with lidocaine (1 mg/kg) associated with the CRI of dexmedetomidine (15 mg/kg/h) significantly decreased isoflurane consumption and resulted in a better quality but longer duration recovery in relation to the use of epidural lidocaine or epidural lidocaine-dexmedetomidine (2 mg/kg) (Souza et al 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine is an alpha-2-agonist characterised by high specificity for alpha-2 receptors and has pronounced sedative and hypnotic effects, potentiating anaesthetic agents (Carollo et al 2008;Souza et al 2010). A low dose of a dexmedetomidine constant rate infusion (CRI) (0.5 mg/kg/h) reduces the isoflurane requirements for the maintenance of anaesthesia with minimal effects on the HR in cats undergoing an ovariohysterectomy (Simon et al 2018). Tramadol is a synthetic codeine analogue whose analgesic effects result from complex interactions with opiate receptors and activation of the descending inhibitory pathways.…”

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confidence: 99%

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Effects of dexmedetomidine or tramadol continuous rate infusions on the propofol requirements and cardiorespiratory variables in propofol-ketamine-midazolam anaesthetised cats

Souza¹,

Anjos²,

Kersul³

et al. 2022

Vet. Med. - Czech

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The aim of this study was to compare the effects of midazolam-ketamine alone or in combination with dexmedetomidine or tramadol in a constant rate infusion (CRI) on the minimum infusion rate (MIR) of propofol and the cardiorespiratory function in cats undergoing an ovariohysterectomy (OH). This was a prospective, randomised, blinded clinical study. Twenty-four healthy female mixed-breed cats were premedicated with ketamine and midazolam. Propofol was used for the induction and maintenance of the anaesthesia (starting at 18 mg/kg/h). Cats were assigned to groups (n = 8) to receive one of the following intravenous treatments: midazolam-ketamine group (MKG; ketamine 0.6 mg/kg/h); midazolam-ketamine-dexmedetomidine group [MKDG; ketamine 0.6 mg/kg/h and dexmedetomidine loading dose (LD) 1 mg/kg, CRI 1 mg/kg/h)] or midazolam-ketamine-tramadol group [MKTG; ketamine 0.6 mg/kg/h and tramadol (LD 2 mg/kg, CRI 1 mg/kg/h)]. During the OH, the propofol infusion was adjusted based on the clinical signs to maintain adequate anaesthetic depth. Selected variables were measured before (T0) and after (T1) the anaesthesia induction and during six surgical time points (T2–T7). The mean arterial pressure was higher and the heart rate was lower in MKDG at T1 (than in MKG and MKTG). The mean ± SD MIR of propofol were 17.4 ± 3.2, 15.0 ± 2.8 and 12.6 ± 3.5 mg/kg/h for MKG, MKTG, and MKDG, respectively. We conclude that, compared to midazolam-ketamine alone, midazolam-ketamine-tramadol and midazolam-ketamine-dexmedetomidine reduced the MRI of propofol by 13.8% and 27.5%, respectively, without significant changes in the selected indicators.

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The clinical effects of a low dose dexmedetomidine constant rate infusion in isoflurane anesthetized cats

Cited by 6 publications

References 27 publications

Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial

Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial

Efficacy and Safety of Dexmedetomidine Premedication in Balanced Anesthesia: A Systematic Review and Meta-Analysis in Dogs

Effects of dexmedetomidine or tramadol continuous rate infusions on the propofol requirements and cardiorespiratory variables in propofol-ketamine-midazolam anaesthetised cats

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