Topic:Sedation
Sedation in horses involves the administration of pharmacological agents to induce a state of calmness, relaxation, or sleepiness. This practice is commonly employed to facilitate veterinary procedures, diagnostic imaging, or transportation by reducing stress and movement in the animal. The primary sedatives used in equine medicine include alpha-2 adrenergic agonists, such as xylazine and detomidine, and opioids, like butorphanol. These agents act on the central nervous system to achieve the desired sedative effects. The choice of sedative and its dosage depend on various factors, including the horse's age, weight, health status, and the procedure's nature. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacology, efficacy, and safety considerations of sedation in equine practice.
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...
Cardiopulmonary effects of an infusion of remifentanil or morphine in horses anesthetized with isoflurane and dexmedetomidine. To examine the cardiopulmonary effects of infusions of remifentanil or morphine, and their influence on recovery of horses anesthetized with isoflurane and dexmedetomidine. Methods: Randomized crossover study with 7-day rest periods. Methods: Six adult horses (507 ± 61 kg). Methods: After the horses were sedated with xylazine, anaesthesia was induced with ketamine and diazepam, and maintained with isoflurane. After approximately 60 minutes, a dexmedetomidine infusion was started (0.25 μg kg(-1) then 1.0 μg(-1) kg(-1) hour(-1) ) in combination with either saline (group S), morphine (0.15 mg ...
A pharmacokinetic/clinical approach to postulate a local action of intra-articular xylazine administration in the horse: a preliminary study. The study aims to evaluate whether the analgesic effect of intra-articular (IA) route of xylazine administered to horses following arthroscopic surgery is due to a local or a systemic action. Two connected studies were performed. In the first, 1 mg/kg b.w. of xylazine was injected IA, and blood samples were taken to assess drug systemic absorption. In addition, systemic effects of the drug (sedation, ataxia or reduction of respiratory and cardiac rate) were registered. Control horses injected with saline IA were included in the study to exclude the influence of anaesthesia in the occurrence o...
Hyoscine-N-butylbromide premedication on cardiovascular variables of horses sedated with medetomidine. 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...
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...
Standing equine surgery of the upper respiratory tract. The purpose of this article is to review the literature and personal experiences of equine surgeons so as to describe procedures that can be performed in the standing sedated horse to alleviate conditions that result in upper respiratory tract obstruction. Upper respiratory tract surgery requires attention to detail, meticulous planning, and careful dissection and execution with little room for error. This article describes a selection of standing upper airway procedures, the indications for and possible complications of these surgeries, and advantages and disadvantages of a particular method....
Standing ophthalmic surgeries in horses. Standing ophthalmic surgery without general anesthesia allows for several routine ophthalmic procedures including eyelid lacerations and enucleations to be performed in the horse, but does contain increased risk of causing tissue damage arising from the inability to eliminate eye and head movements. Heavy sedation and local nerve blocks of the involved motor and sensory nerves are essential in achieving a good outcome from ophthalmic surgery in the nonanesthetized horse. The inability to use an operating microscope in standing surgery in horses prevents performing precise corneal and intraocul...
Standing equine sinus surgery. Trephination of the equine sinuses is a common surgical procedure in sedated standing horses. Standing sinus flap surgery has become increasingly popular in equine referral hospitals and offers several advantages over sinusotomy performed under general anesthesia, including reduced patient-associated risks and costs; less intraoperative hemorrhage, allowing better visualization of the operative site; and allows surgeons to take their time. Other minimally invasive surgical procedures include sinoscopic surgery, balloon sinuplasty, and transnasal laser sinonasal fenestration. Despite the proced...
Evaluation and clinical use of an intraoral inferior alveolar nerve block in the horse. Local anaesthesia is often required to facilitate invasive procedures in equine dental patients under standing sedation. Objective: To show that an intraoral approach can be used to desensitise the inferior alveolar nerve in horses and report complications seen with this technique. Methods: The distance of the mandibular foramen from the distal (caudal) edge of the mandibular third molar tooth, rostral edge of the mandibular ramus and ventral margin of the mandible were measured in 26 adult equine skulls of various ages and breeds. Computed tomography (CT) was used to verify the placement of t...
Standing equine dental surgery. Dental surgeries refer to procedures that affect the dental tissues or their supporting structures. With the development of specific, efficacious, and conservative treatments, morbidity risks have been lowered and chances of benefiting the health of equids improved. Advances in quality of sedation, analgesia, and locoregional anesthesia allow a majority of dental surgeries to be performed in the standing patient. This update focuses on an orthograde endodontic technique, a minimally invasive buccotomy technique, with the potential to combine it with a transbuccal screw extraction technique, an...
Anesthesia and analgesia for standing equine surgery. Morbidity and mortality rate in equine anesthesia is still unacceptably high. Thus it is critical contemplating whether the benefit of general anesthesia for a specific patient and procedure outweighs the risks. Sedative protocols that would allow performing diagnostic and surgical procedures with the patient remaining standing would therefore be ideal. Infusion of short-acting agents allows to rapidly achieve a titratable steady state of sedation. Supplementing sedatives and tranquilizers with systemic analgesic or regional anesthetic techniques (i.e. epidurals) facilitates standing surgical ...
Ultrasound-guided atlanto-occipital puncture for cerebrospinal fluid analysis on the standing horse. The atlanto-occipital site (AO) is convenient for retrieving an adequate volume and quality of cerebrospinal fluid (CSF) in the diagnosis of neurological disease in horses. However, general anaesthesia is not always possible for horses displaying severe neurological signs, or for economical reasons. The objectives of the present work were to determine the feasibility and safety of ultrasound-guided CSF puncture at the AO site on the standing horse. Seven horses (six healthy and one mildly ataxic) were sedated with acepromazine (0.02 mg/kg bodyweight intravenously or 0.04 mg/kg bodyweight intra...
Propofol with ketamine following sedation with xylazine for routine induction of general anaesthesia in horses. To document the suitability of intravenous propofol and ketamine following sedation with xylazine for routine anaesthetic induction in horses. Retrospective. 100 client-owned horses. Anaesthetic records were evaluated to determine: signalment, anaesthetic drug and dosages, need for additional induction agents, notation of any adverse events, duration of anaesthesia and recovery characteristics (rough or smooth, and rapid or prolonged). Horses were sedated with xylazine 0.99±(0.2) mg/kg intravenous and 23 horses were also administered butorphanol 0.02±(0.001) mg/kg intravenous. Horses were an...
[The effectiveness of romifidine on myocardial function in horses with and without heart disease, evaluated with M-mode echocardiography and PW-tissue Doppler imaging]. The aim of this study was to evaluate to what extent the myocardial function in horses (measured by PW-tissue Doppler = PW-TDI) is affected during a sedation with romifidine (0.04 mg/kg, i. v.), particularly in case of an accompanying heart disease. Based on an echo- and electrocardiographic examination, a total of 45 horses was subdivided into group 1 (no heart disease), group 2 (heart disease without increased heart dimensions) and group 3 (heart disease with increased heart dimensions). Heart rate (HF), M-mode- (FS%) and TDI-measurements were performed before and after the application of ro...
Diagnostic stifle joint arthroscopy using a needle arthroscope in standing horses. To assess use of an 18 g arthroscope for diagnostic stifle joint examination in the standing horse. Methods: Phase 1 used cadaver limbs and simultaneous ultrasonographic assessment. Phase 2 used 6 normal horses where stifles were assessed in both a standing and flexed position. Phase 3 used horses with suspected stifle injury or disease. Methods: Normal horses (n = 6) to assess ability to perform diagnostic procedure (phase 2) and 3 clinical cases (phase 3). Methods: Five cadaver limbs were used in phase 1 to assess all stifle joints. Phase 2 used standing sedated and locally anesthetized hors...
Laparoscopic removal of a bladder urolith in a standing horse. An 11-year-old Arabian gelding was evaluated for hematuria, stranguria, and pollakiuria that had been observed for 1 week. Results: Transrectal palpation revealed a 5-cm firm round mass in the urinary bladder. Cystoscopy and transrectal ultrasonography confirmed the diagnosis of urinary bladder urolithiasis. Results: A multiportal transparalumbar fossa laparoscopic approach was selected for cystotomy and urolith removal. Cystotomy and urolith removal was performed with sedation and local anesthesia with the horse standing. No perioperative complications were observed. Urination returned to nor...
Cardiorespiratory and antinociceptive effects of two different doses of lidocaine administered to horses during a constant intravenous infusion of xylazine and ketamine. This study investigated the antinociceptive effects of a constant rate infusion (CRI) of lidocaine during xylazine and ketamine anesthesia in horses and aimed to correlate these effects with cardiorespiratory variables, bispectral index (BIS) and plasma lidocaine concentrations. Six adult crossbred mares weighing 320-400 kg were anesthetized on three different occasions. Sedation was performed with xylazine (0.75 mg/kg IV) and anesthetic induction with guaifenesin (75 mg/kg IV) and ketamine (2 mg/kg IV). Anesthesia was maintained with 37.5 μg/kg/min of xylazine and 87.5 μg/kg/min of ketamine...
Effect of postoperative xylazine administration on cardiopulmonary function and recovery quality after isoflurane anesthesia in horses. To evaluate equine cardiopulmonary function and recovery quality after administration of 0.25 or 0.50 mg/kg xylazine intravenously (IV) during recovery. Methods: Randomized, blinded, prospective, clinical study. Methods: Horses (n = 20). Methods: During recovery after 3 hours of isoflurane anesthesia for arthroscopic surgery, horses were administered either 0.25 mg/kg (G25, n = 10) or 0.50 mg/kg (G50, n = 10) xylazine intravenously. Vital signs and arterial blood samples were obtained during recovery before sedation (baseline), 5, 10, 20, 30, and 45 minutes after xylazine and 30 minutes after ...
Clinical and pharmacokinetic effects of regional or general anaesthesia on intravenous regional limb perfusion with amikacin in horses. Antimicrobial i.v. regional limb perfusion (IV-RLP) is clinically performed on anaesthetised or sedated horses with or without regional anaesthesia. To date, no scientific data are available on the clinical and pharmacokinetic effects of these anaesthetic protocols on antimicrobial IV-RLP, which is believed to result in better tourniquet efficiency due to decreased movement. Objective: To determine the effects of regional or general anaesthesia on the clinical and synovial pharmacokinetic parameters of amikacin administered by IV-RLP to horses. Methods: Experimental crossover study. Methods: E...
Qualitative and quantitative interpretation of computed tomography of the lungs in healthy neonatal foals. To qualitatively describe lung CT images obtained from sedated healthy equine neonates (≤ 14 days of age), use quantitative analysis of CT images to characterize attenuation and distribution of gas and tissue volumes within the lungs, and identify differences between lung characteristics of foals ≤ 7 days of age and foals > 7 days of age. Methods: 10 Standardbred foals between 2.5 and 13 days of age. Methods: Foals were sedated with butorphanol, midazolam, and propofol and positioned in sternal recumbency for thoracic CT. Image analysis software was used to exclude lung from nonlung str...
Evaluation of acepromazine-induced hemodynamic alterations and reversal with norepinephrine infusion in standing horses. The effects of norepinephrine (NOR) infusion on hemodynamic alterations induced with sedative doses of acepromazine (ACP) were evaluated. Infusion of NOR at 1 μg/kg body weight (BW)/minute for 15 min was administered to 5 standing horses 45 min (T45) after intravenous injection of ACP at 0.1 mg/kg BW. Systolic arterial blood pressure (SAP) and hemodynamic parameters were evaluated on the median artery. Parameters were evaluated every 5 min from 45 to 65 min (T65) at 75 (T75), 90 (T90), and 105 (T105) minutes after ACP administration, and the vessel's surface (SURF), diameter (DIAM), circumfer...
Nociceptive thermal threshold testing in horses – effect of neuroleptic sedation and neuroleptanalgesia at different stimulation sites. Aim of the study was to compare the effect of neuroleptic sedation with acepromazine and neuroleptanalgesia with acepromazine and buprenorphine on thermal thresholds (TT) obtained at the nostrils and at the withers. The study was carried out as a randomized, blinded, controlled trial with cross-over design. Thermal thresholds were determined by incremental contact heat applied to the skin above the nostril (N) or the withers (W). Eleven horses were treated with saline (S), acepromazine (0.05 mg/kg) (ACE) or acepromazine and buprenorphine (0.0075 mg/kg) (AB) intravenously (IV). Single stimula...
Pharmacokinetics of single-dose intragastric and intravenous pregabalin administration in clinically normal horses. To assess pharmacokinetics of pregabalin in horses after a single intragastric or IV dose. Methods: 5 healthy adult mares. Methods: Horses received 1 dose of pregabalin (approx 4 mg/kg) via nasogastric tube in a crossover-design study; after a 3-week washout period, the same dose was administered IV. Food was not withheld. Plasma pregabalin concentrations in samples obtained 0 to 36 hours after administration were measured by use of ultra-performance liquid chromatography with triple quadrupole tandem mass spectrometry. Pharmacokinetic variables were estimated by means of noncompartmental anal...
Evaluation of sedation for standing clinical procedures in horses using detomidine combined with buprenorphine. To examine the effect of including buprenorphine with detomidine for sedation of horses undergoing clinical procedures. Methods: Partially blinded, randomised, prospective clinical field trial. Methods: Eighty four client-owned horses scheduled for minor surgery or diagnostic investigation under standing sedation. Methods: The effects of buprenorphine (5 μg kg(-1) ) (Group B, n = 46) or placebo (5% glucose solution) (Group C, n = 38) in combination with detomidine (10 μg kg(-1) ) were compared in standing horses undergoing minor clinical procedures. The primary outcome measure was succ...
Accelerometric comparison of the locomotor pattern of horses sedated with xylazine hydrochloride, detomidine hydrochloride, or romifidine hydrochloride. To evaluate the duration of effects on movement patterns of horses after sedation with equipotent doses of xylazine hydrochloride, detomidine hydrochloride, or romifidine hydrochloride and determine whether accelerometry can be used to quantify differences among drug treatments. Methods: 6 healthy horses. Methods: Each horse was injected IV with saline (0.9% NaCl) solution (10 mL), xylazine diluted in saline solution (0.5 mg/kg), detomidine diluted in saline solution (0.01 mg/kg), or romifidine diluted in saline solution (0.04 mg/kg) in random order. A triaxial accelerometric device was used f...
Management of zebras and zebra hybrids (zebroids). Equine practitioners are sometimes asked to treat zebras or zebra-horse or zebra-donkey hybrids. Although these equids are subject to many of the same health issues as domestic horses, they cannot be handled like horses and generally require heavy sedation to full anesthesia, even for minor procedures. This usually necessitates the use of ultrapotent narcotics administered by remote delivery systems. This article discusses the handling, sedation, anesthesia, and common medical issues of zebras and zebra hybrids.
Thoracoscopic diaphragmatic hernia repair in a warmblood mare. To describe successful repair of a diaphragmatic hernia in a standing sedated horse using a minimally invasive thoracoscopic technique. Methods: Clinical report. Methods: Warmblood mare with a diaphragmatic hernia. Results: An 18-year-old Warmblood mare with severe colic was referred for surgical treatment of small intestinal strangulation in a diaphragmatic defect. Twelve days after initial conventional colic surgery, left-sided laparoscopy in the standing sedated mare for diaphragmatic herniorrhaphy failed because the spleen obscured the hernia. One week later, a left-sided thoracoscopy was ...
Pharmacokinetics of midazolam after intravenous administration to horses. Midazolam is used to control seizures in horses and to enhance muscle relaxation, but its pharmacokinetics are unknown. Objective: To determine the pharmacokinetics and sedative effects of midazolam in horses. Methods: Blinded, randomised, crossover design. Methods: Midazolam was administered i.v. at either 0.05 or 0.1 mg/kg bwt to 6 horses on 2 occasions at least 7 days apart using a crossover design. Blood samples were collected before and at predetermined times through 24 h after administration. Serum midazolam concentrations were determined by a liquid chromatography tandem-mass spectromet...
Influence of detomidine and xylazine on spleen dimensions and on splenic response to epinephrine infusion in healthy adult horses. To compare the changes in splenic length and thickness and in packed cell volume (PCV) following detomidine or xylazine administration and subsequent epinephrine infusion. Objective: Spleen relaxation occurs following xylazine or detomidine administration and interferes with subsequent splenic contractile response to epinephrine. Methods: Randomized non-blinded crossover experimental study. Methods: 6 healthy adult mares. Methods: The mares received an intravenous (IV) epinephrine infusion (1 μg kg(-1 ) minute(-1) over 5 minutes) one hour after IV administration of detomidine (0.01 mg kg(-1) ...