Topic:Diazepam
Diazepam is a benzodiazepine medication that is sometimes used in equine medicine for its sedative, muscle relaxant, and anxiolytic properties. It acts on the central nervous system by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA), which results in calming effects. In horses, diazepam may be used as a pre-anesthetic agent, to manage seizures, or to alleviate anxiety and stress-related behaviors. The pharmacokinetics, dosage, and administration routes of diazepam in horses can vary, and its effects may differ based on individual physiological factors. This page compiles peer-reviewed research studies and scholarly articles that explore the use, effects, and safety considerations of diazepam in equine practice.
Standing gustatory papillae biopsy procedure for antemortem diagnosis of equine grass sickness. Diagnosing equine grass sickness (EGS) requires histopathological evidence of chromatolysis and/or neuronal loss in peripheral autonomic ganglia. Previous investigators performed postmortem biopsies of gustatory papillae located on the tongue and found chromatolytic subgemmal neurons in all 13 EGS horses. The present study aimed to design a standardized lingual biopsy sampling method through a transbuccal approach in healthy standing horses and assess the quality of the obtained samples, to allow antemortem diagnosis of EGS in clinical cases. Methods: 6 healthy horses. Methods: A transbuccal a...
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...
Comparison of two doses of ketamine for induction of anaesthesia in ponies undergoing field castration. Ketamine-based total intravenous anaesthesia techniques are commonly used in equine practice for ponies requiring short procedures such as castration in field conditions. When a longer duration of recumbency than provided by the initial dose of anaesthetic agents is required, administration of supplementary 'top-up' doses of anaesthetic agents is required. Ideally, a single dose of anaesthetic agents would reliably achieve a longer duration of action whilst maintaining adequate anaesthetic, surgical and recovery qualities. Objective: This prospective, randomised and blinded study aimed to comp...
The effects of xylazine or detomidine when used as a pre-anesthetic sedative on recovery quality and duration in horses undergoing elective equine castration. The purpose of this prospective, blinded, randomized clinical trial was to compare the effects of low dose detomidine to xylazine on recovery quality and duration in a castration procedure. Horses were administered either detomidine [0.015 mg/kg body weight (BW)] or xylazine (1.1 mg/kg BW) intravenously (IV) before IV induction with ketamine (2.2 mg/kg BW) and diazepam (0.05 mg/kg BW). Two anesthesiologists who were unaware of treatment allocation scored the recoveries using a simple descriptive scale (with a low number representing the most desirable recovery) and recoveries were timed. Horse...
Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis. Medetomidine partial intravenous anaesthesia (PIVA) has not been compared to xylazine PIVA regarding quality of recovery. This clinical retrospective study compared recoveries following isoflurane anaesthesia balanced with medetomidine or xylazine. The following standard protocol was used: sedation with 7 µg·kg medetomidine or 1.1 mg·kg xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg·h medetomidine or 0.7 mg·kg·h xylazine, and sedation after anaesthesia with 2 µg·kg medetomidine or 0.3 mg·kg xylazine. Recovery was timed and, using vi...
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 l-methadone in isoflurane-anaesthetized and mechanically ventilated ponies. To evaluate the pharmacokinetics and selected pharmacodynamic effects of a commercially available l-methadone/fenpipramide combination administered to isoflurane anaesthetized ponies. Methods: Prospective single-group interventional study. Methods: A group of six healthy adult research ponies (four mares, two geldings). Methods: Ponies were sedated with intravenous (IV) detomidine (0.02 mg kg) and butorphanol (0.01 mg kg) for an unrelated study. Additional IV detomidine (0.004 mg kg) was administered 85 minutes later, followed by induction of anaesthesia using IV diazepam (0.05 mg kg) and keta...
Evaluation of Stress Response under a Standard Euthanasia Protocol in Horses Using Analysis of Heart Rate Variability. The effects of a standard protocol for euthanasia on heart rate variability (HRV) as a consequence of stress response were analyzed in this prospective clinical study. The HRV was determined in 40 horses undergoing euthanasia due to various reasons, at different locations, and with/without owner presence. For euthanasia, horses were sedated with xylazine or a combination of xylazine and butorphanol. General anesthesia was induced using diazepam and ketamine. Afterwards, horses were euthanized with pentobarbital. The ECG data were taken by a Telemetric ECG at three time points (sedation, anesth...
Accelerated Idioventricular Rhythm Associated With Isoflurane Administration in a Foal: A Case Report. A 2-day-old filly was referred to the hospital with abdominal pain and constipation. The foal presented tachycardia, tachypnea, hypoxemia, hyperlactatemia, and abdominal distension. Meconium impaction was diagnosed, and the filly underwent abdominal surgery. Diazepam and butorphanol were administered for anesthesia premedication, but sedative effects were mild. Xylazine was used to enhance sedation and ketamine was subsequently administered for induction. The foal showed swallow reflex and head movement when intubation was attempted. Consequently, isoflurane on oxygen was provided via an anest...
A comparison of two ketamine doses for field anaesthesia in horses undergoing castration. Ketamine at 2.2 mg/kg given i.v. is often used to induce anaesthesia for surgical procedures in horses under field conditions. Commonly, additional doses are needed to complete the surgery. We hypothesised that surgical conditions would be improved when 5 mg/kg of ketamine was used to induce anaesthesia, while induction and recovery qualities would not differ from those when 2.2 mg/kg ketamine was used. Objective: To compare the anaesthetic effects of two ketamine doses (5 and 2.2 mg/kg) during field anaesthesia for castration of horses. Methods: Prospective, randomised, blinded, clinical stud...
Role of the equine CYP3A94, CYP3A95 and CYP3A97 in ketamine metabolism in presence of medetomidine, diazepam and methadone studied by enantioselective capillary electrophoresis. The anesthetic ketamine is often combined with analgesics and benzodiazepines in equine medicine. Therefore, drug-drug interactions are possible. Enzyme kinetics for ketamine N-demethylation were determined using equine CYP3A94, CYP3A95 and CYP3A97, and the effect of medetomidine, diazepam and methadone on the ketamine metabolism was studied in vitro. Ketamine was incubated with the CYPs or equine liver microsomes (ELM) alone or in presence of medetomidine, diazepam and/or methadone for different times. Norketamine levels were determined using enantioselective capillary electrophoresis (CE) wi...
The Modification and Performance of a Large Animal Anesthesia Machine (Tafonius®) in Order to Deliver Xenon to a Horse. Xenon, due to its interesting anesthetic properties, could improve the quality of anesthesia protocols in horses despite its high price. This study aimed to modify and test an anesthesia machine capable of delivering xenon to a horse. Methods: An equine anesthesia machine (Tafonius, Vetronic Services Ltd., UK) was modified by including a T-connector in the valve block to introduce xenon, so that the xenon was pushed into the machine cylinder by the expired gases. A xenon analyzer was connected to the expiratory limb of the patient circuit. The operation of the machine was modeled and experimen...
Clinical comparison of dexmedetomidine and medetomidine for isoflurane balanced anaesthesia in horses. To compare the effects of two balanced anaesthetic protocols (isoflurane-dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses. Methods: Prospective, blinded, randomized clinical study. Methods: Sixty healthy adult warm blood horses undergoing elective surgery. Methods: Thirty horses each were sedated with dexmedetomidine 3.5 μg kg (group DEX) or medetomidine 7 μg kg (group MED) intravenously. After assessing and supplementing sedation if necessary, anaesthesia was induced with ketamine/diazepam and maintained with isoflurane in oxygen/air and ...
Alfaxalone for maintenance of anaesthesia in ponies undergoing field castration: continuous infusion compared with intravenous boluses. To compare alfaxalone as continuous intravenous (IV) infusion with intermittent IV injections for maintenance of anaesthesia in ponies undergoing castration. Methods: Prospective, randomized, 'blinded' clinical study. Methods: A group of 33 entire male Welsh ponies undergoing field castration. Methods: After preanaesthetic medication with IV detomidine (10 μg kg) and butorphanol (0.05 mg kg), anaesthesia was induced with IV diazepam (0.05 mg kg) followed by alfaxalone (1 mg kg). After random allocation, anaesthesia was maintained with either IV alfaxalone 2 mg kg hour (group A; n ...
Effect of detomidine or romifidine constant rate infusion on plasma lactate concentration and inhalant requirements during isoflurane anaesthesia in horses. Influence of detomidine or romifidine constant rate infusion (CRI) on plasma lactate concentration and isoflurane requirements in horses undergoing elective surgery. Methods: Prospective, randomised, blinded, clinical trial. Methods: A total of 24 adult healthy horses. Methods: All horses were administered intramuscular acepromazine (0.02 mg kg) and either intravenous detomidine (0.02 mg kg) (group D), romifidine (0.08 mg kg) (group R) or xylazine (1.0 mg kg) (group C) prior to anaesthesia. Group D was administered detomidine CRI (10 μg kg hour) in lactated Ringer's solution (LRS), group...
The effect of anesthetic drug choice on accuracy of high-definition oscillometry in laterally recumbent horses. To determine the accuracy of high-definition oscillometry (HDO) for arterial pressure measurement during injectable or inhalation anesthesia in horses. Methods: Prospective, clinical study. Methods: Twenty-four horses anesthetized for procedures requiring lateral recumbency. Methods: Horses were premedicated with xylazine, and anesthesia induced with diazepam-ketamine. Anesthesia was maintained with xylazine-ketamine-guaifenesin combination [TripleDrip (TD; n = 12) or isoflurane (ISO; n = 12)]. HDO was used to obtain systolic (SAP), mean (MAP) and diastolic (DAP) arterial pressures, and he...
Measurement of intraocular pressure in healthy anesthetized horses during hoisting. To measure intraocular pressure (IOP) in horses during hoisting after induction of anesthesia. Methods: Prospective nonrandomized clinical study. Methods: Eighteen healthy adult horses aged [mean±standard deviation (SD)] 10±4.2 years and weighing 491±110 kg anesthetized for elective procedures. Methods: IOP was measured in the superior eye of each horse based on planned recumbency after induction of anesthesia. Measurements were taken directly after premedication with xylazine or detomidine with butorphanol, after induction with diazepam-ketamine, after intubation, when suspended by the ho...
Effects of dobutamine hydrochloride on cardiovascular function in horses anesthetized with isoflurane with or without acepromazine maleate premedication. OBJECTIVE To determine the effects of acepromazine maleate premedication on cardiovascular function before and after infusion of dobutamine hydrochloride for 30 minutes in isoflurane-anesthetized horses. ANIMALS 6 healthy adult horses. PROCEDURES Each horse was anesthetized once following premedication with acepromazine (0.02 mg/kg, IV) administered 30 minutes prior to anesthetic induction (ACP+ treatment) and once without premedication (ACP- treatment). Anesthesia was induced with IV administration of xylazine hydrochloride (0.8 mg/kg), ketamine hydrochloride (2.2 mg/kg), and diazepam (0.08 m...
The effect of dobutamine and bolus crystalloid fluids on the cardiovascular function of isoflurane-anaesthetised horses. Cardiac output does not always increase with dobutamine administration in anaesthetised horses and information on peripheral perfusion is lacking. Objective: To determine the effect of intravenous (i.v.) dobutamine infusion with and without a concurrent 20 mL/kg bodyweight (bwt) bolus of crystalloid fluids on the cardiovascular function of acepromazine premedicated, hypotensive, isoflurane-anaesthetised horses. Methods: Randomised, cross-over experiment. Methods: A total of 6 horses aged 5-13 years, weighing 464-578 kg were premedicated with acepromazine 0.02 mg/kg bwt and then sedated with xy...
Blood concentrations of remifentanil during and after infusion in horses anesthetized with isoflurane and dexmedetomidine. To determine blood remifentanil concentration in isoflurane-anesthetized horses during and after a 1h remifentanil and dexmedetomidine infusion. Methods: Prospective study. Methods: Six adult mixed breed horses with (mean±SD) bodyweight of 507±61kg and 14±4years of age. Methods: Following sedation with xylazine IV, anesthesia was induced with ketamine IV mixed with diazepam IV. Anesthesia was maintained with isoflurane in oxygen. After 52±7min for instrumentation, dexmedetomidine (0.25μgkg(-1) followed by 1.0μg(-1)kg(-1)h(-1)) and remifentanil infusions (6μgkg(-1)h(-1)) were administere...
Characterization of equine cytochrome P450: role of CYP3A in the metabolism of diazepam. Research on drug metabolism and pharmacokinetics in large animal species including the horse is scarce because of the challenges in conducting in vivo studies. The metabolic reactions catalyzed by cytochrome P450s (CYPs) are central to drug pharmacokinetics. This study elucidated the characteristics of equine CYPs using diazepam (DZP) as a model compound as this drug is widely used as an anesthetic and sedative in horses, and is principally metabolized by CYPs. Diazepam metabolic activities were measured in vitro using horse and rat liver microsomes to clarify the species differences in enzy...
Comparison of midazolam and diazepam as co-induction agents with ketamine for anaesthesia in sedated ponies undergoing field castration. To compare intravenous (IV) midazolam and diazepam administered with ketamine for induction of anaesthesia in ponies, already sedated with detomidine, undergoing field castration. Methods: Prospective, randomised, 'blinded', clinical study. Methods: Twenty Welsh pony yearlings. Methods: After IV injection of detomidine (20 μg kg(-1) ) and phenylbutazone (4.4 mg kg(-1) ) ponies were allocated to receive either IV midazolam (group M) or diazepam (group D) (both 0.06 mg kg(-1) ) with ketamine (2.2 mg kg(-1) ) for induction of anaesthesia. Using simple descriptive scales, quality of sedat...
Buprenorphine provides better anaesthetic conditions than butorphanol for field castration in ponies: results of a randomised clinical trial. A prospective, randomised, blinded, clinical trial in 47 ponies compared butorphanol and buprenorphine administered intravenously with detomidine prior to castration under anaesthesia. Detomidine 12 μg/kg intravenously was followed by butorphanol 25 μg/kg (BUT) or buprenorphine 5 μg/kg (BUP) before induction of anaesthesia with intravenous ketamine and diazepam. Quality of sedation, induction and recovery from anaesthesia, response to tactile stimulation, and surgical conditions were scored. If anaesthesia was inadequate 'rescue' was given with intravenous ketamine (maximum three dose...
Recovery from desflurane anesthesia in horses with and without post-anesthetic xylazine. The objective of this study was to compare recovery from desflurane anesthesia in horses with or without post-anesthetic xylazine. Six adult horses were anesthetized on 2 occasions, 14 d apart using a prospective, randomized crossover design. Horses were sedated with xylazine, induced to lateral recumbency with ketamine and diazepam, and anesthesia was maintained with desflurane. One of 2 treatments was administered intravenously at the end of anesthesia: xylazine [0.2 mg/kg body weight (BW)] or an equivalent volume of saline. Recovery parameters were recorded and assessed by 2 blinded observe...
Effect of body position on intra-abdominal pressures and abdominal perfusion pressures measured at three sites in horses anesthetized with short-term total intravenous anesthesia. To assess effects of body position on direct measurements of intra-abdominal pressure (IAP) and abdominal perfusion pressure (APP) in horses anesthetized with total intravenous anesthesia (TIVA). Methods: 9 healthy adult horses. Methods: Instrumentation in unsedated standing horses involved insertion of an arterial catheter for blood pressure measurements and 3 intraperitoneal cannulas (left flank, right flank, and ventral abdomen) for IAP measurements. Baseline values were measured for heart rate, respiratory rate, systolic arterial blood pressure, mean arterial blood pressure (MAP), diastoli...
Prolonged anesthesia using sevoflurane, remifentanil and dexmedetomidine in a horse. A 10-year old Arabian mare had a slow-growing mass on the lower right mandible and required a large partial mandibulectomy. Methods: No abnormalities were detected apart from the mass. Results: A temporary tracheostomy was performed pre-operatively. Anesthesia was induced with xylazine followed by ketamine and diazepam. For 13 hours, anesthesia was maintained using sevoflurane, dexmedetomidine and remifentanil infusions, with the exception of surgical preparation time. Intra-operatively, ventilation was delivered through the cuffed tracheotomy tube. Heart and respiratory rates, ECG, arterial ...
Effects of inspired oxygen concentration on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses. To compare the effects of 2 fractions of inspired oxygen, 50% and > 95%, on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses. Methods: 8 healthy adult horses. Methods: In a crossover study design, horses were assigned to undergo each of 2 anesthetic sessions in random order, with 1 week separating the sessions. In each session, horses were sedated with xylazine hydrochloride (1.0 mg/kg, IV) and anesthesia was induced via IV administration of diazepam (0.05 mg/kg) and ketamine (2.2 mg/kg) Anesthesia was subsequently maintained with isoflurane in 50% or > 95% o...
Influence of drugs on the response characteristics of the LiDCO sensor: an in vitro study. In a previous study, the authors found a large bias (50%) for lithium (LiDCO) compared with thermodilution cardiac output measurement methods in ponies receiving i.v. infusions of xylazine, ketamine, and midazolam. This prompted the authors to examine the effect of drugs on the LiDCO sensor. Methods: Drugs and lithium were dissolved in 0.9% saline to produce the following solutions: saline, saline-lithium, saline-drug, and saline-drug-lithium. The drug concentrations were overlapping the range of clinical interest as estimated from the published literature. These 38°C solutions were pumped th...
Comparison of the effects of xylazine bolus versus medetomidine constant rate infusion on cardiopulmonary function and depth of anesthesia in horses anesthetized with isoflurane. To compare the effects of xylazine bolus versus medetomidine constant rate infusion (MCRI) on cardiopulmonary function and depth of anesthesia in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. Methods: Prospective, randomized crossover study. Methods: 10 healthy adult Standardbreds. Methods: Horses were premedicated with xylazine or medetomidine IV. Anesthesia was induced with diazepam and ketamine and maintained with isoflurane for 150 minutes. For the xylazine treatment, end-tidal isoflurane concentration was maintained at 1.7%, and xylazine (0.2 mg/kg [0.09 mg/...
[Comparison of the effects of xylazine and romifidine administered perioperatively on the recovery of anesthetized horses]. Comparison of the effects of xylazine and romifidine administered perioperatively on the recovery of anesthetized horses. The present study was designed to compare recoveries from anesthesia following the use of romifidine or xylazine in horses. In a prospective blind randomized clinical trial, 28 horses, undergoing elective arthroscopy, were randomly allocated into 2 groups. The intravenous anesthesia protocol used in the xylazine group was: butorphanol [0.02 mg/kg body weight (BW)] and xylazine (0.5 to 0.7 mg/kg BW) for premedication, diazepam (0.1 mg/kg BW) and ketamine (2.2 mg/kg BW) for i...