Topic:Dexmedetomidine
Dexmedetomidine is an alpha-2 adrenergic agonist used in veterinary medicine for its sedative and analgesic properties in horses. It acts on the central nervous system to produce sedation, muscle relaxation, and mild analgesia, making it useful for various procedures and diagnostic examinations. The drug's effects are dose-dependent and reversible with specific antagonists, such as atipamezole. Dexmedetomidine is often compared to other sedatives like xylazine and detomidine in terms of onset, duration, and side effects. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacodynamics, pharmacokinetics, and clinical applications of dexmedetomidine in equine practice.
Pharmacopuncture with low-dose dexmedetomidine and saline aquapuncture at acupoint Governing Vessel 24 provides sedation in healthy adult horses. To evaluate sedation in horses following pharmacopuncture with dexmedetomidine at acupoint Governing Vessel 24 (GV-24) compared to aquapuncture at GV-24 or an equivalent dose of dexmedetomidine administered via IV or SC routes. Unassigned: 10 adult mares received 4 treatments in a blinded, randomized, crossover design: (1) dexmedetomidine administered at GV-24 (DexmedGV24; 1 μg/kg); (2) saline administered at GV-24 (SalineGV24; 1.5 mL); (3) dexmedetomidine administered SC on the lateral neck (DexmedSC; 1 μg/kg); or (4) dexmedetomidine administered IV (DexmedIV; 1 μg/kg). Sedation scores (fa...
Dexmedetomidine Prolongs the Duration of Ropivacaine Corneal Anesthesia After Subconjunctival Injection in Healthy Horses. To determine whether dexmedetomidine prolongs corneal anesthesia following subconjunctival ropivacaine injection in healthy equine eyes. Methods: Ten horses with normal ophthalmic exams were enrolled in a randomized, blinded, crossover experiment with a minimum 4-week washout between treatments. Baseline corneal touch thresholds (CTT, cm) were measured via esthesiometry and a subconjunctival injection was performed in the treatment eye with ropivacaine (R, 0.3 mL 0.5%) or dexmedetomidine-ropivacaine (DR, 0.1 mL 0.5 mg/mL + 0.2 mL 0.5%) and saline (control, 0.3 mL) in the contrala...
Effects of Lidocaine Alone Versus Lidocaine-Dexmedetomidine Infusion on Pulmonary Gas Exchange and Respiratory Mechanics During Isoflurane Anesthesia in Horses. Dexmedetomidine improves pulmonary function in dogs and humans, but evidence in horses is scarce. This study evaluated dexmedetomidine infusion on oxygenation and respiratory mechanics in anesthetized horses. Twenty horses undergoing elective surgery were included in a prospective, non-randomized, observational study. Horses received either lidocaine alone (1.3 mg/kg over 15 min, then 3 mg/kg/hour; LIDO) or combined with dexmedetomidine (1.75 μg/kg over 15 min, then 1.75 μg/kg/hour; DL). Respiratory mechanics, gas exchange, and cardiovascular variables were recorded at baseline, post-loading...
Sublingual microcirculation in isoflurane-anesthetized horses receiving dexmedetomidine and lidocaine constant rate infusion. To assess the sublingual microcirculation in horses anesthetized with isoflurane and undergoing constant rate infusion of dexmedetomidine (DEX) and lidocaine (LID). Unassigned: 16 horses undergoing arthroscopy were included in a blind, randomized study comparing 2 groups: a DEX group (DEX-LID; 1.75 μg·kg-1·h-1 with a LID bolus of 1.3 mg·kg-1 followed by a continuous infusion of 0.05 mg·kg-1·min-1) and a LID-only group (LID; at the same dose). Hemodynamic variables, including mean, systolic, and diastolic blood pressure; heart rate; capnography; blood gas analysis; blood lactate; and orth...
Echocardiographic and clinical effects of two sedative doses of Dexmedetomidine in healthy horses. The effects of dexmedetomidine (DEX), as a sedative drug, on echocardiographic measurements have been investigated in many species but not in horses. Therefore, this study aimed to evaluate the echocardiographic and clinical effects of two sedative doses of DEX in healthy horses. Six female crossbred horses weighted 250-330 kg underwent echocardiography before and after sedation by intravenous administration of a low dose of 3.5 μg/kg (LD) and a high dose of 7 μg/kg (HD) of DEX. A significant increase (p≤ 0.05) was observed in the diameters of the pulmonary artery and the left atrium measu...
Changes in microcirculation variables in an acute endotoxaemic equine model. Microcirculation is the essential link between macrocirculation and cellular metabolism. Objective: To test our hypotheses that microcirculation variables will show a heterogeneous flow pattern during experimental endotoxaemia, and that fluid therapy and noradrenaline (NA) infusion will normalise altered microcirculation variables. Methods: In vivo experiments. Methods: Six healthy adult horses were anaesthetised with dexmedetomidine, ketamine, and diazepam and were mechanically ventilated under isoflurane anaesthesia. Endotoxaemia was induced with 30 ng kg Escherichia coli lipopolysacchar...
Effects of anesthetic protocol, procedure, and recovery stall and interval on the quality of recovery in repeatedly anesthetized horses. The objective of this prospective study was to investigate whether repeated consecutive general anesthesia in horses undergoing 2 different anesthetic protocols could lead to improved recovery scores. Six healthy female Standardbred horses (453 ± 57 kg; 6.5 ± 4.2 y old) underwent 4 anesthetic protocols over 12 to 13 wk. Procedures 1 and 4 were arthroscopic surgeries [induction: xylazine, diazepam, and ketamine; and maintenance: Fe'Isoflurane (1.1%), lidocaine (2 mg/kg body weight [BW], 50 to 100 μg/min per kg BW), dexmedetomidine (2.5 μg/h per kg BW)]. Procedures 2 and 3 were preparation f...
Dexmedetomidine preconditioning reduces ischaemia-reperfusion injury in equine model of large colon volvulus. Large colon volvulus is a cause of colic in horses with high morbidity and mortality when not promptly treated. More treatment options are needed to improve the outcome of these cases by protecting against the damage caused by ischaemia and reperfusion injury. Objective: To determine the effect of preconditioning with dexmedetomidine prior to induction of ischaemia-reperfusion (IR) injury in a large colon volvulus model in the horse. Methods: Randomised blinded in vivo experiments. Methods: Horses received either a dexmedetomidine (DEX) or saline (CON) constant rate infusion (CRI) immediately ...
Sedation with dexmedetomidine-butorphanol or xylazine-butorphanol continuous intravenous infusions during unilateral ovariectomy in standing donkeys. Intravenous infusions of alpha-2 adrenoceptor sedatives and opioids can potentially facilitate surgery in donkeys while standing. Literature on this subject matter is scant. Objective: Evaluation of efficacy of sedation from α -adrenoceptors (dexmedetomidine or xylazine) and butorphanol during ovariectomy in standing donkeys. Methods: Randomised, masked in vivo experiment. Methods: Thirteen female donkeys were sedated with butorphanol (0.05 mg/kg bwt followed by 0.5 mg/kg bwt/h) IV. Concomitantly, 6 of the 13 jennies were sedated with dexmedetomidine 2.5 mcg/kg bwt followed by 2.5 mcg...
Pharmacokinetics of dexmedetomidine in anaesthetized horses following repeated subcutaneous administration and intravenous constant rate infusion. The inclusion of dexmedetomidine (DEX) within a balanced general anaesthesia protocol is effective in improving the clinical outcome and recovery quality of anaesthesia in horses. This study aimed to determine the pharmacokinetic profile of DEX following repeated subcutaneous (SC) administration at 2 µg/kg every 60 min till the end of the procedure in comparison to intravenous constant rate infusion (CRI) at 1 µg/kg/h in anaesthetized horses undergoing diagnostic procedures up to the end of the diagnostic procedure. Results: In the CRI and SC groups DEX maximum concentrations (Cmax) were ...
Alpha2 Antagonist Vatinoxan Does Not Abolish the Preconditioning Effect of Dexmedetomidine on Experimental Ischaemia-Reperfusion Injury in the Equine Small Intestine. Pharmacological preconditioning with dexmedetomidine has been shown to ameliorate intestinal ischaemia reperfusion injury in different species, including horses. However, it remains unknown if this effect is related to alpha2 adrenoreceptor activity. Therefore, the aim of this study was to determine the effect of dexmedetomidine preconditioning with and without the administration of the peripheral alpha2 antagonist vatinoxan. This prospective randomized experimental trial included 12 horses equally divided between two treatment groups. Horses in group Dex received a bolus of dexmedetomidine fo...
Dexmedetomidine Has Differential Effects on the Contractility of Equine Jejunal Smooth Muscle Layers In Vitro. α2 agonists are frequently used in horses with colic, even though they have been shown to inhibit gastrointestinal motility. The aim of this study was to determine the effect of dexmedetomidine on small intestinal in vitro contractility during different phases of ischaemia. Experimental segmental jejunal ischaemia was induced in 12 horses under general anaesthesia, and intestinal samples were taken pre-ischaemia and following ischaemia and reperfusion. Spontaneous and electrically evoked contractile activity of the circular and longitudinal smooth muscles were determined in each sample with a...
Concentrations of dexmedetomidine and effect on biomarkers of cartilage toxicity following intra-articular administration in horses. The goal of this study was to determine plasma, urine, and synovial fluid concentrations and describe the effects on biomarkers of cartilage toxicity following intra-articular dexmedetomidine administration to horses. Methods: 12 research horses. Methods: Horses received a single intra-articular administration of 1 μg/kg or 5 μg/kg dexmedetomidine or saline. Plasma, urine, and synovial fluid were collected prior to and up to 48 hours postadministration, and concentrations were determined. The effects on CS846 and C2C were determined in synovial fluid at 0, 12, and 24 hours postadministration...
Use of dexmedetomidine repeated subcutaneous administration for balanced anaesthesia in horses. A balanced anaesthetic protocol is a common concept in modern veterinary anaesthesia and aims to maintain good intraoperative cardiopulmonary function. In horses, alpha-2-agonists produce sedation and analgesia and have been shown to reduce inhalational anaesthetic requirements when administered intravenously. Furthermore, these drugs can improve recovery quality. Preliminary investigations of subcutaneous dexmedetomidine administration in humans demonstrated a reduced haemodynamic impact if compared with the intravenous route suggesting that dexmedetomidine is adequately absorbed with both ad...
Nasal and tracheobronchial nitric oxide production and its influence on oxygenation in horses undergoing total intravenous anaesthesia. The present study aimed to investigate the effect of endotracheal intubation on nasal and tracheal endogenous NO concentrations, gas exchange and oxygenation in horses undergoing general anaesthesia. In many species a major part of physiological nitric oxide (NO) production takes place in the nasopharynx. Inhaled NO acts as a pulmonary vasodilator and regulates lung perfusion and endotracheal intubation bypasses the nasopharynx. Six horses were randomly assigned to either the "intubated" (INT) or the "non-intubated" (nINT) treatment group. Horses were premedicated with dexmedetomidine (5 μg...
Comparative Evaluation of the Sedative and Analgesic Effects of Caudal Epidural Administration of Lidocaine Alone or in Combination With Xylazine, Detomidine, Medetomidine, and Dexmedetomidine in Mediterranean Miniature Donkeys. The present study aimed to compare the sedative and analgesic effects of caudal epidural administration of lidocaine alone or in combination with four different α-adrenergic agonists in Mediterranean miniature donkeys. A total of ten clinically healthy (five males and five females) Mediterranean miniature donkeys with an age of 5 ± 1 years, a weight of 100 ± 2 kg and a height at the withers of 0.8 ± 0.06 m (mean ± standard deviation) were used in experimental, crossover (Latin square), randomized, and blinded study. Animals were assigned to five treatment groups including lidocaine alone ...
Dexmedetomidine prolongs the duration of action of mepivacaine on anesthesia of the palmar digital nerves of horses. To determine whether palmar digital nerve (PDN) blockade in horses with a combination of dexmedetomidine and mepivacaine would block the response to mechanical force applied to the digit longer than would anesthetizing these nerves with mepivacaine alone or dexmedetomidine alone. Methods: 8 mares with no signs of lameness. Methods: In a randomized, crossover, blinded, experimental study, both PDNs of the same forelimb of each horse were anesthetized by perineural injection with either 30 mg mepivacaine alone, 250 µg of dexmedetomidine alone, or 30 mg mepivacaine combined with 250 µg of dexme...
Cardiopulmonary effects and recovery characteristics associated with 2 sedative protocols for assisted ventilation in healthy neonatal foals. Neonatal foals may require prolonged sedation to permit ventilatory support in the first few days of life. The objective of this study was to evaluate and compare the cardiopulmonary effects and clinical recovery characteristics of 2 sedative/analgesia protocols in healthy foals receiving assisted ventilation. Foals were randomized to receive dexmedetomidine, butorphanol, and propofol (DBP) or midazolam, butorphanol, and propofol (MBP) during a 24-hour period. Infusion rates of dexmedetomidine, midazolam, and propofol were adjusted and propofol boluses administered according to set protocols t...
Cardiopulmonary function and intestinal blood flow in anaesthetised, experimentally endotoxaemic horses given a constant rate infusion of dexmedetomidine. Endotoxaemia causes untoward inflammatory-mediated effects that might be attenuated by dexmedetomidine. Objective: To evaluate the effects of a dexmedetomidine intravenous (IV) infusion on systemic and intestinal haemodynamics and arterial blood gas values in sevoflurane-anaesthetised horses administered Escherichia coli O55:B5 lipopolysaccharides (LPS). Methods: Randomised controlled in vivo experiment. Methods: A total of 13 horses weighing 456 ± 86 kg (mean ± standard deviation) and aged 13.9 ± 9.0 years donated for euthanasia underwent ventral midline celiotomy using sevoflurane...
Evaluation of the perioperative stress response from dexmedetomidine infusion alone, with butorphanol bolus or remifentanil infusion compared with ketamine and morphine infusions in isoflurane-anesthetized horses. To evaluate perioperative stress-related hormones in isoflurane-anesthetized horses administered infusions of dexmedetomidine alone or with butorphanol or remifentanil, compared with ketamine-morphine. Methods: Randomized, prospective, nonblinded clinical study. Methods: A total of 51 horses undergoing elective surgical procedures. Methods: Horses were premedicated with xylazine, anesthesia induced with ketamine-diazepam and maintained with isoflurane and one of four intravenous infusions. Partial intravenous anesthesia (PIVA) was achieved with dexmedetomidine (1.0 μg kg hour; group D; 12 hor...
Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses. An ideal dexmedetomidine protocol has yet to be determined for standing sedation in horses. It was hypothesized that an IV bolus followed by CRI dexmedetomidine would have a quicker increase in plasma concentrations compared with repeated IM injections. In a crossover design, eight adult, female horses were randomly placed into two groups: the CRI group (IV bolus dexmedetomidine at 0.005 mg/kg followed by a CRI at 0.01 mg/kg/h for 15 min then 0.005 mg/kg/h for 60 min) and the IM group (dexmedetomidine at 0.01 mg/kg, followed by 0.005 mg/kg in 30-min intervals for 60 min). Clearance and...
Effectiveness of a paraverterbral nerve block versus local portal blocks for laparoscopic closure of the nephrosplenic space: A pilot study. To compare the effectiveness of a paravertebral nerve block vs local portal blocks for laparoscopic closure of the nephrosplenic space in standing sedated research horses. Methods: Randomized clinical trial. Methods: Twelve horses were randomly allocated to two groups (n = 6 per group), paravertebral block of nerves T , L , and L or local blocks of the three laparoscopic portals. Methods: Horses were sedated with dexmedetomidine (4 μg/kg IV and constant rate infusion [CRI] of 2.5 μg/kg/h) and morphine (50 μg/kg IV and CRI of 30 μg/kg/h). According to group allocation, 20 mL of either lid...
Dexmedetomidine and Bupivacaine Association in Caudal Epidural Injection in Mares. The objective of the study was to compare the effects of caudal epidural bupivacaine and dexmedetomidine (DEX) combination, with bupivacaine or DEX plain for perineal analgesia in mares. Six healthy saddle mares weighing 330-370 kg and aged 10-15 years were used in this study. Each mare was assigned to receive three treatments: 0.04 mg/kg 0.25% bupivacaine (BP), 2 μg/kg DEX (DX), or 0.02 mg/kg bupivacaine and 1 μg/kg DEX (BPDX). The order of treatments was randomized. All drugs were injected into the caudal epidural space (Co1-Co2) through a 16-G Tuohy epidural needle. After the epidur...
Pharmacokinetics and clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. This study determined the pharmacokinetics and compared the clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. Six healthy horses aged 8.5 ± 3 years and weighing 462 ± 50 kg were anesthetized with isoflurane for 2 hr under standard conditions on two occasions one-week apart. In recovery, horses received 200 μg/kg xylazine or 0.875 μg/kg dexmedetomidine intravenously and were allowed to recover without assistance. These doses were selected because they have been used for postanesthetic sedation in clinical and research studies. Serial ...
Recovery quality following a single post-anaesthetic dose of dexmedetomidine or romifidine in sevoflurane anaesthetised horses. Post-anaesthetic sedation is administered to horses to improve recovery quality from inhalant anaesthesia and reduce the risk of catastrophic injury. A single dose of dexmedetomidine for this purpose has not been evaluated clinically. Objective: To determine whether dexmedetomidine improves recovery quality from sevoflurane anaesthesia compared to a previously studied dose of romifidine. Methods: Prospective, randomised, masked clinical trial. Methods: Ninety-nine, adult, client-owned horses anaesthetised for elective procedures completed the trial. Anaesthetic protocol was standardised. Horse...
Comparative Effect of Epidural Administration of Xylazine or Dexmedetomidine on Echocardiographic Dimensions and Cardiac Indices in Clinically Healthy Donkeys (Equus asinus). The aim of the present study was to assess and compare the changes of the echocardiographic dimensions and cardiac function indices after epidural injection of xylazine or dexmedetomidine in clinically healthy donkeys. In an experimental prospective randomized cross-over study, 10 healthy adult donkeys were injected with saline solution, xylazine (0.20 mg kg), and dexmedetomidine (0.005 mg kg) into the epidural space between the second and third coccygeal vertebrae. Echocardiographic dimensions as well as cardiac function indices were assessed using a 2-3.9 MHz sector transducer, at the l...
Plasma concentrations at two dexmedetomidine constant rate infusions in isoflurane anaesthetized horses: a clinical study. To determine dexmedetomidine plasma concentrations at two infusion rates in isoflurane anaesthetized horses and compare cardiovascular effects and anaesthetic recovery between treatments. Methods: Prospective, randomized, masked clinical study. Methods: Healthy, adult, client-owned, non-food producing horses presented for castration. Methods: Premedication consisted of acepromazine, romifidine and morphine, and anaesthesia was induced with ketamine and midazolam. The horses were randomized to receive dexmedetomidine 0.5 μg kg hour (treatment DL, n = 7) or 1.75 μg kg hour (treatment DH, n =...
Total intravenous anesthesia with alfaxalone, dexmedetomidine and remifentanil in healthy foals undergoing abdominal surgery. To evaluate effects of anesthesia induced with alfaxalone and maintained with alfaxalone, dexmedetomidine and remifentanil infusions in foals. Methods: Prospective, experimental study. Methods: A group of six healthy foals [median (range) 11 (8-33) days] undergoing abdominal surgery. Methods: Intravenous (IV) dexmedetomidine (3-7μgkg) provided sedation for insertion of a pulmonary artery catheter. IV anesthesia was induced with alfaxalone (2mgkg) and maintained with alfaxalone (6mgkghour), dexmedetomidine (1μgkghour) and remifentanil (3μgkghour). Foals were endotracheally intubated and lung...
Comparison of desflurane and propofol at equipotent doses in combination with a constant rate infusion of dexmedetomidine on global and peripheral perfusion and oxygenation in horses. OBJECTIVE To determine global and peripheral perfusion and oxygenation during anesthesia with equipotent doses of desflurane and propofol combined with a constant rate infusion of dexmedetomidine in horses. ANIMALS 6 warmblood horses. PROCEDURES Horses were premedicated with dexmedetomidine (3.5 μg•kg, IV). Anesthesia was induced with propofol or ketamine and maintained with desflurane or propofol (complete crossover design) combined with a constant rate infusion of dexmedetomidine (7 μg•kg •h). Microperfusion and oxygenation of the rectal, oral, and esophageal mucosa were measured bef...