Medetomidine is an alpha-2 adrenergic agonist used in veterinary medicine for its sedative, analgesic, and muscle relaxant properties in horses. It acts on the central nervous system by binding to alpha-2 adrenergic receptors, resulting in decreased release of norepinephrine and subsequent sedation. Medetomidine is employed in various clinical settings, including premedication for anesthesia, minor surgical procedures, and managing pain. The effects of medetomidine can be reversed with the administration of atipamezole, an alpha-2 adrenergic antagonist. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacodynamics, pharmacokinetics, and clinical applications of medetomidine in equine practice.
Sacks M, Ringer SK, Bischofberger AS, Berchtold SM, Bettschart-Wolfensberger R.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 ...
Sandbaumhüter FA, Theurillat R, Bettschart-Wolfensberger R, Thormann W.The combination of ketamine and an α -receptor agonist is often used in veterinary medicine. Four different α -receptor agonists, medetomidine, detomidine, xylazine, and romifidine, which differ in their chemical structure and thus in selectivity for the α -receptor and in the sedative and analgesic potency, are typically employed during surgery of equines. Recovery following anesthesia with ketamine and an α -receptor agonist is dependent on the α -receptor agonist. This prompted us to investigate (i) the inhibition characteristics for the N-demethylation of ketamine to norketamine and (...
Ohmura H, Okano A, Mukai K, Fukuda K, Takahashi T.This study evaluated induction of anesthesia and cardiorespiratory and anesthetic effects during maintained anesthesia with the combination of alfaxalone, medetomidine, and butorphanol. Alfaxalone (1.0 mg/kg) was administered to induce anesthesia after premedication with medetomidine (7.0 µg/kg), butorphanol (25 µg/kg), and midazolam (50 µg/kg) in six Thoroughbred horses. Intravenous general anesthesia was maintained with alfaxalone (2.0 mg/(kg∙hr)), medetomidine (5.0 µg/(kg∙hr)), and butorphanol (30 µg/(kg∙hr)) for 60 min. Electrical stimulation of the upper oral mucosa was used to...
Taylor AH, Seymour CJ.Horses may become hypoxaemic during anaesthesia despite a high inspired oxygen fraction (FiO2). A lower FiO2 is used commonly in human beings to minimise atelectasis and to improve lung function, and previously has been shown to be of potential benefit in horses in experimental conditions. Other studies suggest no benefit to using a FiO2 of 0.5 during clinically relevant conditions; however, low FiO2 (0.65) is commonly used in practice and in a large number of studies. The present study was performed to compare the effect of a commonly used FiO2 of 0.65 versus 0.90 on calculated respiratory in...
Wakuno A, Aoki M, Kushiro A, Mae N, Kodaira K, Maeda T, Yamazaki Y, Ohta M.There is limited information on clinical use of the new injectable anaesthetic agent alfaxalone in Thoroughbred horses. Objective: To compare anaesthetic induction and recovery characteristics and cardiopulmonary responses between alfaxalone, ketamine and thiopental in Thoroughbred horses premedicated with medetomidine and midazolam. Methods: Randomised blinded experimental cross-over study. Methods: Six Thoroughbred horses were anaesthetised 3 times with alfaxalone 1 mg/kg bwt, ketamine 2.5 mg/kg bwt or thiopental 4 mg/kg bwt after premedication with medetomidine 6 μg/kg bwt and midazola...
Umar MA, Fukui S, Kawase K, Itami T, Yamashita K.Cardiovascular effects of total intravenous anesthesia using ketamine-medetomidine-propofol drug combination (KMP-TIVA) were determined in 5 Thoroughbred horses undergoing surgery. The horses were anesthetized with intravenous administration (IV) of ketamine (2.5 mg/kg) and midazolam (0.04 mg/kg) following premedication with medetomidne (5 µg/kg, IV) and artificially ventilated. Surgical anesthesia was maintained by controlling propofol infusion rate (initially 0.20 mg/kg/min following an IV loading dose of 0.5 mg/kg) and constant rate infusions of ketamine (1 mg/kg/hr) and medetomidine (1.25...
Ishizuka T, Tamura J, Nagaro T, Sudo K, Itami T, Umar MA, Miyoshi K, Sano T, Yamashita K.Effects of intermittent positive pressure ventilation (IPPV) on cardiopulmonary function were evaluated in horses anesthetized with total intravenous anesthesia using constant rate infusions of medetomidine (3.5 µg/kg/hr), lidocaine (3 mg/kg/hr), butorphanol (24 µg/kg/hr) and propofol (0.1 mg/kg/min) (MLBP-TIVA). Five horses were anesthetized twice using MLBP-TIVA with or without IPPV at 4-week interval (crossover study). In each occasion, the horses breathed 100% oxygen with spontaneous ventilation (SB-group, n=5) or with IPPV (CV-group, n=5), and changes in cardiopulmonary parameters were ...
Villalba M, Santiago I, Gómez de Segura IA.The aim of this investigation was to determine the isoflurane-sparing effect and impact on arterial blood pressure and anaesthetic recovery of a constant rate infusion of medetomidine-propofol in horses. In a prospective, crossover, randomised study, six healthy horses (mean ± SD age, 13.7 ± 7.7 years; weight, 433 ± 51 kg) were anaesthetised twice with isoflurane and were randomly assigned to receive one of two treatments on each occasion, at least 2 weeks apart. The first treatment was saline (CTL group) and the second a medetomidine-propofol infusion (MP group; 1.25 µg/kg...
Grimsrud KN, Ait-Oudhia S, Durbin-Johnson BP, Rocke DM, Mama KR, Rezende ML, Stanley SD, Jusko WJ.The present study characterizes the pharmacokinetic (PK) and pharmacodynamic (PD) relationships of the α2-adrenergic receptor agonists detomidine (DET), medetomidine (MED) and dexmedetomidine (DEX) in parallel groups of horses from in vivo data after single bolus doses. Head height (HH), heart rate (HR), and blood glucose concentrations were measured over 6 h. Compartmental PK and minimal physiologically based PK (mPBPK) models were applied and incorporated into basic and extended indirect response models (IRM). Population PK/PD analysis was conducted using the Monolix software implementing t...
Gozalo-Marcilla M, Gasthuys F, Schauvliege S.To review the literature with regard to the use of different intravenous agents as supplements to inhalational anaesthesia in horses. The Part 2 of this review will focus in the use of opioids and α2 -agonists. Methods: Pubmed and Web of Science. Search terms: horse, inhalant anaesthesia, balanced anaesthesia, partial intravenous anaesthesia, opioids, morphine, pethidine, butorphanol, methadone, fentanyl, alfentanil, remifentanil, sufentanil, xylazine, romifidine, detomidine, medetomidine and dexmedetomidine. Conclusions: Different drugs and their combinations can be administered systemically...
Perotta JH, Canola PA, Lopes MC, Evora PM, Martinez PE, Escobar A, Valadão CA.To evaluate the effects of intravenous (IV) or intramuscular (IM) hyoscine premedication on physiologic variables following IV administration of medetomidine in horses. Methods: Randomized, crossover experimental study. Methods: Eight healthy crossbred horses weighing 330 ± 39 kg and aged 7 ± 4 years. Methods: Baseline measurements of heart rate (HR), cardiac index (CI), respiratory rate, systemic vascular resistance (SVR), percentage of patients with second degree atrioventricular (2(o) AV) block, mean arterial pressure (MAP), pH, and arterial partial pressures of carbon dioxide (PaCO2 ) an...
Yokota S, Hikasa Y, Shimura I, Kusunose S.To investigate effects of various imidazoline and nonimidazoline α-adrenergic agents on aggregation and antiaggregation of bovine and equine platelets. Methods: Blood samples obtained from 8 healthy adult cattle and 16 healthy adult Thoroughbreds. Methods: Aggregation and antiaggregation effects of various imidazoline and nonimidazoline α-adrenergic agents on bovine and equine platelets were determined via a turbidimetric method. Collagen and ADP were used to initiate aggregation. Results: Adrenaline, noradrenaline, or α-adrenoceptor agents alone did not induce changes in aggregation of bov...
Ambrisko TD, Kabes R, Moens Y.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...
Ishizuka T, Itami T, Tamura J, Saitoh Y, Saitoh M, Umar MA, Miyoshi K, Yamashita K, Muir WW.Anesthetic and cardiorespiratory effects of medetomidine, lidocaine, butorphanol and propofol total intravenous anesthesia (MLBP-TIVA) were evaluated in horses undergoing an experimental surgery. Ten horses were premedicated with an intravenous injection (IV) of medetomidine (5 µg/kg) and butorphanol (20 µg/kg). Anesthesia was induced by administration of 1% propofol (3 mg/kg, IV) at a rate of 1 mg/kg/min (n=5, group-1) or 2% propofol administered at a rate of 6 mg/kg/min (n=5, group-2) following administration of lidocaine (1 mg/kg, IV) and then maintained by infusions of propofol, medetomi...
Goodwin WA, Keates HL, Pearson M, Pasloske K.The use of alfaxalone and medetomidine administered as an i.v. infusion to maintain anaesthesia has not previously been reported in the horse. Objective: To investigate the use of alfaxalone in hydroxpropyl-beta-cyclodextrin (Alfaxan) and medetomidine infusion as a field anaesthetic for short-term surgical procedures in the horse. Objective: Alfaxalone-medetomidine anaesthesia is suitable for short-term field anaesthesia in horses. Methods: Eleven healthy colts underwent 45 min of anaesthesia with an i.v. infusion of alfaxalone (2 mg/kg bwt/h) and medetomidine (5 μg/kg bwt/h) for routin...
Creighton CM, Lemke KA, Lamont LA, Horney BS, Riley CB.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/...
Creighton CM, Lemke KA, Lamont LA, Horney BS, Doyle AJ.To compare the effect of xylazine bolus versus medetomidine constant rate infusion (MCRI) on serum cortisol and glucose concentrations, urine production, and anesthetic recovery characteristics in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. Methods: Prospective, randomized crossover study. Methods: 10 healthy 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 maintain...
Kempchen S, Kuhn M, Spadavecchia C, Levionnois OL.To evaluate medetomidine as a continuous rate infusion (CRI) in horses in which anaesthesia is maintained with isoflurane and CRIs of ketamine and lidocaine. Methods: Prospective, randomized, blinded clinical trial. Methods: Forty horses undergoing elective surgery. Methods: After sedation and induction, anaesthesia was maintained with isoflurane. Mechanical ventilation was employed. All horses received lidocaine (1.5 mg kg(-1) initially, then 2 mg kg(-1) hour(-1)) and ketamine (2 mg kg(-1) hour(-1)), both CRIs reducing to 1.5 mg kg(-1) hour(-1) after 50 minutes. Horses in group MILK received ...
Grimsrud KN, Mama KR, Steffey EP, Stanley SD.To describe the pharmacodynamics and pharmacokinetics following an intravenous (IV) bolus dose of medetomidine in the horse. Methods: Prospective experimental trial. Methods: Eight, mature healthy horses age 11.7 ± 4.6 (mean ± SD) years, weighing 557 ± 54 kg. Methods: Medetomidine (10 μg kg(-1) ) was administered IV. Blood was sampled at fixed time points from before drug administration to 48 hours post administration. Behavioral, physiological and biochemical data were obtained at predetermined time points from 0 minutes to 24 hours post administration. An algometer was also used to measu...
Oku K, Kakizaki M, Ono K, Ohta M.Seven Thoroughbred horses were castrated under total intravenous anesthesia (TIVA) using propofol and medetomidine. After premedication with medetomidine (5.0 µg/kg, intravenously), anesthesia was induced with guaifenesin (100 mg/kg, intravenously) and propofol (3.0 mg/kg, intravenously) and maintained with constant rate infusions of medetomidine (0.05 µg/kg/min) and propofol (0.1 mg/kg/min). Quality of induction was judged excellent to good. Three horses showed insufficient anesthesia and received additional anesthetic. Arterial blood pressure changed within an acceptable range in all horse...
Bettschart-Wolfensberger R, Dicht S, Vullo C, Frotzler A, Kuemmerle JM, Ringer SK.To test if the addition of butorphanol by constant rate infusion (CRI) to medetomidine-isoflurane anaesthesia reduced isoflurane requirements, and influenced cardiopulmonary function and/or recovery characteristics. Methods: Prospective blinded randomised clinical trial. Methods: 61 horses undergoing elective surgery. Methods: Horses were sedated with intravenous (i.v.) medetomidine (7 μg kg(-1)); anaesthesia was induced with i.v. ketamine (2.2 mg kg(-1)) and diazepam (0.02 mg kg(-1)) and maintained with isoflurane and a CRI of medetomidine (3.5 μg kg(-1) hour(-1)). Group MB (n = 31) receive...
Valverde A.Alpha-2 agonists, such as xylazine, clonidine, romifidine, detomidine, medetomidine, and dexmedetomidine, are potent analgesic drugs that also induce physiologic and behavioral changes, such as hypertension, bradycardia, atrioventricular block, excessive sedation and ataxia, all of which can potentially limit their systemic use as analgesics in some clinical cases. The use of medetomidine and dexmetomidine has been introduced for equine anesthesia/analgesia, and although not approved in this species, their increased specificity for alpha-2 receptors may offer some potential advantages over the...
Valverde A, Rickey E, Sinclair M, Rioja E, Pedernera J, Hathway A, Cruz A.The effects of lidocaine combined with medetomidine or lidocaine alone on cardiovascular function during anaesthesia and their effects on recovery have not been thoroughly investigated in isoflurane-anaesthetised horses. Objective: To determine the effects of an intraoperative i.v. constant rate infusion of lidocaine combined with medetomidine (Group 1) or lidocaine (Group 2) alone on cardiovascular function and on the quality of recovery in 12 isoflurane-anaesthetised horses undergoing arthroscopy. Objective: The combination would depress cardiovascular function but improve the quality of rec...
Kruger K, Stegmann GF.A partial intravenous protocol was used successfully to maintain anaesthesia in 5 healthy horses. Horses were premedicated with acepromazine, romifidine and butorphanol, induced with guaifenesin and ketamine and maintained on a constant rate infusion of lidocaine, ketamine and medetomidine together with halothane inhalation anaesthesia. Mean end-tidal halothane concentration to maintain a surgical plane of anaesthesia was 0.8 +/- 0.2%. Mean dobutamine requirement to maintain mean arterial pressure above 9.31 kPa was 0.42 +/- 0.3 microg/kg/min. The administration of relatively low doses of lido...
Kalchofner KS, Picek S, Ringer SK, Jackson M, Hässig M, Bettschart-Wolfensberger R.To determine, in mildly hypercapnic horses under isoflurane-medetomidine balanced anaesthesia, whether there is a difference in cardiovascular function between spontaneous ventilation (SV) and intermittent positive pressure ventilation (IPPV). Methods: Prospective randomized clinical study. Methods: Sixty horses, undergoing elective surgical procedures under general anaesthesia: ASA classification I or II. Methods: Horses were sedated with medetomidine and anaesthesia was induced with ketamine and diazepam. Anaesthesia was maintained with isoflurane and a constant rate infusion of medetomidine...
Solano AM, Valverde A, Desrochers A, Nykamp S, Boure LP.Standing surgical procedures are performed commonly in horses under sedation. This approach minimises the morbidity/mortality risks associated with general anaesthesia. The use of a medetomidine and morphine combination has not been investigated in horses despite the usefulness of each drug individually. Objective: To determine the efficacy of a medetomidine and morphine combination to produce standing sedation with minimal cardiorespiratory changes and adequate analgesia for exploratory laparascopy in mature horses. Objective: The combination of medetomidine and morphine will induce reliable ...
Ringer SK, Kalchofner K, Boller J, Fürst A, Bettschart-Wolfensberger R.To compare the effects of two balanced anaesthetic protocols on end-tidal isoflurane (Fe'ISO), cardiopulmonary performance and quality of recovery in horses. Methods: Prospective blinded randomized clinical study. Methods: Sixty-nine client-owned horses, American Society of Anesthesiologists category I and II, undergoing elective surgery. Methods: The horses were premedicated with acepromazine (0.03 mg kg(-1)) IM 30-60 minutes before induction of anaesthesia and were randomly assigned to one of two treatments: in group L (37 horses) xylazine (1 mg kg(-1)) and in group M (31 horses) medetomidin...
Yamashita K, Wijayathilaka TP, Kushiro T, Umar MA, Taguchi K, Muir WW.The anesthetic and cardiopulmonary effects of midazolam, ketamine and medetomidine for total intravenous anesthesia (MKM-TIVA) were evaluated in 14 horses. Horses were administered medetomidine 5 microg/kg intravenously as pre-anesthetic medication and anesthetized with an intravenous injection of ketamine 2.5 mg/kg and midazolam 0.04 mg/kg followed by the infusion of MKM-drug combination (midazolam 0.8 mg/ml-ketamine 40 mg/ml-medetomidine 0.1 mg/ml). Nine stallions (3 thoroughbred and 6 draft horses) were castrated during infusion of MKM-drug combination. The average duration of anesthesia wa...
Umar MA, Yamashita K, Kushiro T, Muir WW.To evaluate the cardiovascular effects of total IV anesthesia with propofol (P-TIVA) or ketamine-medetomidine-propofol (KMP-TIVA) in horses. Methods: 5 Thoroughbreds. Methods: Horses were anesthetized twice for 4 hours, once with P-TIVA and once with KMP-TIVA. Horses were medicated with medetomidine (0.005 mg/kg, IV) and anesthetized with ketamine (2.5 mg/kg, IV) and midazolam (0.04 mg/kg, IV). After receiving a loading dose of propofol (0.5 mg/kg, IV), anesthesia was maintained with a constant rate infusion of propofol (0.22 mg/kg/min) for P-TIVA or with a constant rate infusion of propofol (...
Creighton CM, Lemke KA, Lamont LA, Horney BS, Doyle AJ.To compare the effect of xylazine bolus versus medetomidine constant rate infusion (MCRI) on serum cortisol and glucose concentrations, urine production, and anesthetic recovery characteristics in dorsally recumbent, spontaneously breathing, isoflurane-anesthetized horses. Methods: Prospective, randomized crossover study. Methods: 10 healthy 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 maintain...
Taylor AH, Seymour CJ.Horses may become hypoxaemic during anaesthesia despite a high inspired oxygen fraction (FiO2). A lower FiO2 is used commonly in human beings to minimise atelectasis and to improve lung function, and previously has been shown to be of potential benefit in horses in experimental conditions. Other studies suggest no benefit to using a FiO2 of 0.5 during clinically relevant conditions; however, low FiO2 (0.65) is commonly used in practice and in a large number of studies. The present study was performed to compare the effect of a commonly used FiO2 of 0.65 versus 0.90 on calculated respiratory in...
Ohmura H, Okano A, Mukai K, Fukuda K, Takahashi T.This study evaluated induction of anesthesia and cardiorespiratory and anesthetic effects during maintained anesthesia with the combination of alfaxalone, medetomidine, and butorphanol. Alfaxalone (1.0 mg/kg) was administered to induce anesthesia after premedication with medetomidine (7.0 µg/kg), butorphanol (25 µg/kg), and midazolam (50 µg/kg) in six Thoroughbred horses. Intravenous general anesthesia was maintained with alfaxalone (2.0 mg/(kg∙hr)), medetomidine (5.0 µg/(kg∙hr)), and butorphanol (30 µg/(kg∙hr)) for 60 min. Electrical stimulation of the upper oral mucosa was used to...
Tokushige H, Okano A, Arima D, Ito H, Kambayashi Y, Minamijima Y, Ohta M.The aim of the present study was to evaluate clinical efficacy of constant rate infusions (CRIs) of medetomidine-propofol combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. Thirty horses were sedated intravenously (IV) with medetomidine (6.0 μg/kg) and midazolam (0.02 mg/kg) and induced IV with ketamine (1.0 mg/kg) and propofol (1.0 mg/kg). These horses were randomly allocated to three groups and maintained with sevoflurane and CRI of either medetomidine (3.0 μg/kg/h) (Group M; n = 10); or medetomidine (3.0 μg/kg/h) and propofol (3.0 ...
Bettschart-Wolfensberger R, Jäggin-Schmucker N, Lendl C, Bettschart RW, Clarke KW.The minimum alveolar concentration of desflurane when combined with a continuous infusion of medetomidine at 3.5 microg/kg/hour was measured in seven ponies. Anaesthesia was induced with medetomidine (7 microg/kg intravenously) followed by ketamine (2 mg/kg intravenously) and maintained with desflurane in oxygen. The infusion of medetomidine was started 20 minutes after the induction of anaesthesia. The electrical test stimulus was applied at the coronary band (50 V, 10 ms bursts at 5 Hz for one minute), and heart rates and rhythms, arterial blood pressures, and arterial blood gas tensions wer...
Hopster K, Wittenberg-Voges L, Geburek F, Hopster-Iversen C, Kästner SBR.Aim of this prospective experimental study was to assess effects of systemic hypoxemia and hypovolemia on global and gastrointestinal oxygenation and perfusion in anesthetized horses. Therefore, we anesthetized twelve systemically healthy warmblood horses using either xylazine or dexmedetomidine for premedication and midazolam and ketamine for induction. Anesthesia was maintained using isoflurane in oxygen with either xylazine or dexmedetomidine and horses were ventilated to normocapnia. During part A arterial oxygen saturation (SaO) was reduced by reducing inspiratory oxygen fraction in steps...
Ishizuka T, Itami T, Tamura J, Saitoh Y, Saitoh M, Umar MA, Miyoshi K, Yamashita K, Muir WW.Anesthetic and cardiorespiratory effects of medetomidine, lidocaine, butorphanol and propofol total intravenous anesthesia (MLBP-TIVA) were evaluated in horses undergoing an experimental surgery. Ten horses were premedicated with an intravenous injection (IV) of medetomidine (5 µg/kg) and butorphanol (20 µg/kg). Anesthesia was induced by administration of 1% propofol (3 mg/kg, IV) at a rate of 1 mg/kg/min (n=5, group-1) or 2% propofol administered at a rate of 6 mg/kg/min (n=5, group-2) following administration of lidocaine (1 mg/kg, IV) and then maintained by infusions of propofol, medetomi...
Villalba M, Santiago I, Gómez de Segura IA.The aim of this investigation was to determine the isoflurane-sparing effect and impact on arterial blood pressure and anaesthetic recovery of a constant rate infusion of medetomidine-propofol in horses. In a prospective, crossover, randomised study, six healthy horses (mean ± SD age, 13.7 ± 7.7 years; weight, 433 ± 51 kg) were anaesthetised twice with isoflurane and were randomly assigned to receive one of two treatments on each occasion, at least 2 weeks apart. The first treatment was saline (CTL group) and the second a medetomidine-propofol infusion (MP group; 1.25 µg/kg...
Umar MA, Yamashita K, Kushiro T, Muir WW.Objective-To compare the anesthetic and cardiorespiratory effects of total IV anesthesia with propofol (P-TIVA) or a ketamine-medetomidine-propofol combination (KMP-TIVA) in horses. Design-Randomized experimental trial. Animals-12 horses. Procedure-Horses received medetomidine (0.005 mg/kg [0.002 mg/lb], IV). Anesthesia was induced with midazolam (0.04 mg/kg [0.018 mg/lb], IV) and ketamine (2.5 mg/kg [1.14 mg/lb], IV). All horses received a loading dose of propofol (0.5 mg/kg [0.23 mg/lb], IV), and 6 horses underwent P-TIVA (propofol infusion). Six horses underwent KMP-TIVA (ketamine [1 mg/kg/...
Pratt S, Cunneen A, Perkins N, Farry T, Kidd L, McEwen M, Rainger J, Truchetti G, Goodwin W.There is no information directly comparing midazolam with guaifenesin when used in combination with an alpha-2 agonist and ketamine to maintain anaesthesia via i.v. infusion in horses. Objective: To compare ketamine-medetomidine-guaifenesin with ketamine-medetomidine-midazolam for total intravenous anaesthesia (TIVA) in young horses anaesthetised for computerised tomography. Methods: Prospective, randomised, blinded, crossover trial. Methods: Fourteen weanlings received medetomidine 7 μg/kg bwt i.v. and anaesthesia was induced with ketamine 2.2 mg/kg bwt i.v. On two separate occasions hors...
Bryant CE, Clarke KW, Thompson J.Medetomidine was administered intravenously to six sheep at 5, 10 and 20 micrograms kg-1 and to one horse and four ponies at 5 and 10 micrograms kg-1. In both species medetomidine resulted in significant decreases in heart rate and cardiac output and, initially, in an increase in arterial blood pressure. In the ponies this increase in blood pressure was followed by a significant and prolonged decrease, but in the sheep the secondary decrease in blood pressure was not statistically significant. In the sheep, the three doses of medetomidine resulted in profound and significant decreases in arter...
Kushiro T, Yamashita K, Umar MA, Maehara S, Wakaiki S, Abe R, Seno T, Tsuzuki K, Izumisawa Y, Muir WW.The anesthetic sparring and cardiovascular effects produced by midazolam 0.8 mg/ml-ketamine 40 mg/ml-medetomidine 0.05 mg/ml (0.025 ml/kg/hr) drug infusion during sevoflurane in oxygen (MKM-OS) anesthesia was determined in healthy horses. The anesthetic sparring effects of MKM-OS were assessed in 6 healthy thoroughbred horses in which the right carotid artery was surgically relocated to a subcutaneous position. All horses were intubated and ventilated with oxygen using intermittent positive pressure ventilation (IPPV). The end-tidal concentration of sevoflurane (ET(SEV)) required to maintain s...
Kruger K, Stegmann GF.A partial intravenous protocol was used successfully to maintain anaesthesia in 5 healthy horses. Horses were premedicated with acepromazine, romifidine and butorphanol, induced with guaifenesin and ketamine and maintained on a constant rate infusion of lidocaine, ketamine and medetomidine together with halothane inhalation anaesthesia. Mean end-tidal halothane concentration to maintain a surgical plane of anaesthesia was 0.8 +/- 0.2%. Mean dobutamine requirement to maintain mean arterial pressure above 9.31 kPa was 0.42 +/- 0.3 microg/kg/min. The administration of relatively low doses of lido...
Kempchen S, Kuhn M, Spadavecchia C, Levionnois OL.To evaluate medetomidine as a continuous rate infusion (CRI) in horses in which anaesthesia is maintained with isoflurane and CRIs of ketamine and lidocaine. Methods: Prospective, randomized, blinded clinical trial. Methods: Forty horses undergoing elective surgery. Methods: After sedation and induction, anaesthesia was maintained with isoflurane. Mechanical ventilation was employed. All horses received lidocaine (1.5 mg kg(-1) initially, then 2 mg kg(-1) hour(-1)) and ketamine (2 mg kg(-1) hour(-1)), both CRIs reducing to 1.5 mg kg(-1) hour(-1) after 50 minutes. Horses in group MILK received ...
Samimi AS, Molaei MM, Azari O, Rezaei MA, Hashemian A.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 ...
Wakuno A, Maeda T, Kodaira K, Kikuchi T, Ohta M.A three-year old Thoroughbred racehorse was anesthetized with sevoflurane and oxygen inhalation anesthesia combined with constant rate infusion (CRI) of alfaxalone-medetomidine for internal fixation of a third metacarpal bone fracture. After premedication with intravenous (IV) injections of medetomidine (6.0 µg/kg IV), butorphanol (25 µg/kg IV), and midazolam (20 µg/kg IV), anesthesia was induced with 5% guaifenesin (500 ml/head IV) followed immediately by alfaxalone (1.0 mg/kg IV). Anesthesia was maintained with sevoflurane and CRIs of alfaxalone (1.0 mg/kg/hr) and medetomidine (3.0 µg/kg...
Yamashita K, Satoh M, Umikawa A, Tsuda A, Yajima Y, Tsubakishita S, Seno T, Katoh S, Izumisawa Y, Kotani T.The anesthetic and cardiovascular effects of a combination of continuous intravenous infusion using a mixture of 100 g/L guaifenesin-4 g/L ketamine-5 mg/L medetomidine (0.25 ml/kg/hr) and oxygen-sevoflurane (OS) anesthesia (GKM-OS anesthesia) in horses were evaluated. The right carotid artery of each of 12 horses was raised surgically into a subcutaneous position under GKM-OS anesthesia (n=6) or OS anesthesia (n=6). The end-tidal concentration of sevoflurane (EtSEV) required to maintain surgical anesthesia was around 1.5% in GKM-OS and 3.0% in OS anesthesia. Mean arterial blood pressure (MABP)...
Troya-Portillo L, López-Sanromán J, Villalba-Orero M, Santiago-Llorente I.Standing surgery under sedation reduces anesthetic-related mortality in horses. Medetomidine, alone and combined with morphine in a constant rate infusion (CRI), has been described for standing surgery but their cardiorespiratory, sedative and antinociceptive effects have never been compared. The addition of ketamine could improve analgesia in these procedures with minimal cardiorespiratory consequences. The objectives were to compare the cardiorespiratory effects, quality of sedation, antinociception and ataxia produced by administration of a medetomidine-based CRI with morphine, ketamine or ...
Oku K, Kakizaki M, Ono K, Ohta M.Seven Thoroughbred horses were castrated under total intravenous anesthesia (TIVA) using propofol and medetomidine. After premedication with medetomidine (5.0 µg/kg, intravenously), anesthesia was induced with guaifenesin (100 mg/kg, intravenously) and propofol (3.0 mg/kg, intravenously) and maintained with constant rate infusions of medetomidine (0.05 µg/kg/min) and propofol (0.1 mg/kg/min). Quality of induction was judged excellent to good. Three horses showed insufficient anesthesia and received additional anesthetic. Arterial blood pressure changed within an acceptable range in all horse...
Yamashita K, Yonezawa K, Izumisawa Y, Kotani T.The antagonistic effects of atipamezole (20, 40, 60, 80, and 100 micrograms/kg i.v.) on medetomidine (10 micrograms/kg i.v.)-induced sedation were evaluated in horses. Although 20 and 40 micrograms/kg of atipamezole were not sufficient to reverse the sedation, 60 micrograms/kg did effectively reverse the sedation. Atipamezole at 80 micrograms/kg was more potent, and significantly shortened the duration of sedation without any apparent side effects, but a higher dose of 100 micrograms/kg was not more effective than 80 micrograms/kg. The possible use of atipamezole as a reversal agent may enhanc...
Tapio HA, Raekallio MR, Mykkänen AK, Al-Ramahi D, Scheinin M, Hautajärvi HJ, Männikkö S, Vainio O.A constant rate infusion (CRI) of medetomidine is used to balance equine inhalation anesthesia, but its cardiovascular side effects are a concern. This experimental crossover study aimed to evaluate the effects of vatinoxan (a peripheral α2-adrenoceptor antagonist) on cardiorespiratory and gastrointestinal function in anesthetized healthy horses. Six horses received medetomidine hydrochloride 7μg/kg IV alone (MED) or with vatinoxan hydrochloride 140μg/kg IV (MED+V). Anesthesia was induced with midazolam and ketamine and maintained with isoflurane and medetomidine CRI for 60min. Heart rate, ...
Hollis AR, Pascal M, Van Dijk J, Jolliffe C, Kaartinen J.To compare the efficacy of a medetomidine constant rate infusion (CRI) with a detomidine CRI for standing sedation in horses undergoing high dose rate brachytherapy. Methods: Randomized, controlled, crossover, blinded clinical trial. Methods: A total of 50 horses with owner consent, excluding stallions. Methods: Each horse was sedated with intravenous acepromazine (0.02 mg kg-1), followed by an α2-adrenoceptor agonist 30 minutes later and then by butorphanol (0.1 mg kg-1) 5 minutes later. A CRI of the same α2-adrenoceptor agonist was started 10 minutes after butorphanol administration and ma...
Cowling N, Woldeyohannes S, Sole Guitart A, Goodwin W.Near infrared spectroscopy (NIRS) noninvasively measures peripheral tissue oxygen saturation (StO) and may be useful to detect early changes in StO in anaesthetized and critically ill horses. This study aimed to identify the muscle belly that provided the highest percentage of successful StO readings and the highest mean StO value. Fifty adult horses were enrolled in a prospective controlled study. StO was measured at six different muscles in each horse, for each intervention: hair overlying the muscle was clipped (post clipping: PC), clipped skin was cleaned with chlorhexidine (post-surgical ...
Menozzi A, Pozzoli C, Poli E, Colla C, Placenza G, Bertini S.We investigated the effects of different selective α -adrenergic receptor (AR) agonists (detomidine, medetomidine, xylazine, and brimonidine) on the contractions of horse-isolated bronchi induced by electrical field stimulation (EFS) and by carbachol. No effects were observed on the contraction induced by carbachol, while α -AR agonists reduced EFS-evoked contractions in a concentration-related fashion. The rank order of potency (pD ) was brimonidine (7.40 ± 0.20) >medetomidine (7.09 ± 0.24) >detomidine (6.13 ± 0.55) >xylazine (4.59 ± 0.16). The maximal effects (E ) were -56.3% ...
Perotta JH, Canola PA, Lopes MC, Evora PM, Martinez PE, Escobar A, Valadão CA.To evaluate the effects of intravenous (IV) or intramuscular (IM) hyoscine premedication on physiologic variables following IV administration of medetomidine in horses. Methods: Randomized, crossover experimental study. Methods: Eight healthy crossbred horses weighing 330 ± 39 kg and aged 7 ± 4 years. Methods: Baseline measurements of heart rate (HR), cardiac index (CI), respiratory rate, systemic vascular resistance (SVR), percentage of patients with second degree atrioventricular (2(o) AV) block, mean arterial pressure (MAP), pH, and arterial partial pressures of carbon dioxide (PaCO2 ) an...
Umar MA, Fukui S, Kawase K, Itami T, Yamashita K.Cardiovascular effects of total intravenous anesthesia using ketamine-medetomidine-propofol drug combination (KMP-TIVA) were determined in 5 Thoroughbred horses undergoing surgery. The horses were anesthetized with intravenous administration (IV) of ketamine (2.5 mg/kg) and midazolam (0.04 mg/kg) following premedication with medetomidne (5 µg/kg, IV) and artificially ventilated. Surgical anesthesia was maintained by controlling propofol infusion rate (initially 0.20 mg/kg/min following an IV loading dose of 0.5 mg/kg) and constant rate infusions of ketamine (1 mg/kg/hr) and medetomidine (1.25...
Kim A, Sasaki N, Lee I, Seo JP.The purpose of this study was to assess the cardiorespiratory and behavioral responses to the combination of medetomidine and tramadol (M-T) or butorphanol (M-B) in standing laparoscopic ovariectomy in horses. One ovary was removed under M-T and the contralateral ovary was removed under M-B with at least 4 weeks between operations at random. Horses were sedated using intravenous medetomidine (5 µg/kg) followed by tramadol (1 mg/kg) or butorphanol (10 µg/kg) after 5 min. Sedation was maintained through the repeated injection of medetomidine (1 µg/kg) and tramadol (0.4 mg/kg) or medetomidine ...
Ishizuka T, Tamura J, Nagaro T, Sudo K, Itami T, Umar MA, Miyoshi K, Sano T, Yamashita K.Effects of intermittent positive pressure ventilation (IPPV) on cardiopulmonary function were evaluated in horses anesthetized with total intravenous anesthesia using constant rate infusions of medetomidine (3.5 µg/kg/hr), lidocaine (3 mg/kg/hr), butorphanol (24 µg/kg/hr) and propofol (0.1 mg/kg/min) (MLBP-TIVA). Five horses were anesthetized twice using MLBP-TIVA with or without IPPV at 4-week interval (crossover study). In each occasion, the horses breathed 100% oxygen with spontaneous ventilation (SB-group, n=5) or with IPPV (CV-group, n=5), and changes in cardiopulmonary parameters were ...
Mizobe F, Wakuno A, Okada J, Otsuka T, Ishikawa Y, Kurimoto S.A total of 20 racehorses with longitudinal fractures underwent internal fixation surgery under sevoflurane anesthesia combined with infusion of medetomidine (3 µg/kg/hr) alone (10 horses, group M) or medetomidine and fentanyl (7 µg/kg/hr) (10 horses, group FM). In group FM, the end-tidal sevoflurane concentration during surgery was maintained significantly lower than in group M (2.8-2.9% for group M vs. 2.2-2.6% for group FM, P<0.01). The mean arterial blood pressure was maintained over 70 mmHg using dobutamine infusion (group M, 0.36-0.54 µg/kg/min; group FM, 0.27-0.65 µg/kg/min), and ...
