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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.
Laparoscopically assisted cecal cannulation in standing horses. Access to the equine cecum is required for various therapeutic and experimental procedures, including decompression, fluid therapy, and transfaunation. Traditional approaches via laparotomy are highly invasive. This study aimed to describe a minimally invasive, laparoscopically assisted technique for cecal cannulation in standing horses. Unassigned: Seven horses underwent the procedure under sedation and paravertebral anesthesia. Two right flank accesses were created: a 10-mm laparoscopic port for visualization and a 2-cm minilaparotomy for cecal exteriorization. A Foley catheter was inserted ...
Green Light-Activated Rose Bengal Cross-Linking in 81 Horses With Complex Corneal Ulcers and Stromal Abscesses. To assess the efficacy and safety of Rose Bengal and green light corneal cross-linking (RGX) as an adjunctive treatment for complicated corneal ulcers and stromal abscesses in horses. Methods: A retrospective analysis included 81 horses (82 eyes) treated with RGX between 2018 and 2024. Cases involved complicated corneal diseases such as melting keratitis, fungal keratitis, deep stromal defects, and stromal abscesses. Treatment consisted of topical or iontophoretic administration of 1% Rose Bengal followed by green light irradiation (550 nm; 150 J/cm) for 10 min. Most procedures (76.8%) w...
Comparing isoflurane and desflurane: A prospective randomised blinded clinical trial in horses undergoing elective surgery. The recovery period is associated with the greatest risk of injury for horses undergoing anaesthesia. Recovery quality and duration can be influenced by the volatile agent. Methods: This prospective, randomised blinded clinical investigation recruited 101 healthy client-owned horses undergoing elective surgery at one UK equine hospital. Anaesthesia was standardised, and horses were randomly assigned to receive desflurane or isoflurane for maintenance. Horses were ventilated to normocapnia and received dobutamine to maintain mean arterial blood pressure above 60 mmHg. All the patients received ...
Videofluoroscopy shows clinically relevant changes in swallow metrics and esophageal transit in normal horses with xylazine, anticholinergic use, and varied feed consistency. To investigate the effects of varied feed consistency and administration of xylazine or N-butylscopolammonium bromide on 3 phases of swallowing and characterize esophageal motility following barium administration via nasoesophageal tube. Unassigned: 8 healthy horses were enrolled for 2.5 consecutive weeks. Horses underwent experimental videofluoroscopic swallow studies before and after sedated and anticholinergic interventions. Esophageal motility was assessed with barium administered via nasoesophageal tube and with barium-admixed feedstuffs of 3 consistencies with increasing viscosity. Phase...
Evaluation of the impact of acepromazine on tissue oxygenation in horses sedated with detomidine. Sedation with α₂-agonists can impair microcirculation and oxygen delivery. This prospective randomized crossover study investigated whether administering acepromazine maleate before detomidine hydrochloride maintains higher peripheral tissue oxygen saturation (StO₂) in sedated horses. Eight healthy adult horses randomly received intravenous detomidine (10 μg/kg) either alone (D) or in combination with acepromazine (20 μg/kg; DA), with a one-week washout. Hemoglobin concentration and central venous oxygen saturation (ScvO₂) were measured at baseline. Tissue oxygen saturation, tissue ...
Use of a Fogarty balloon catheter for management of distal nasolacrimal duct atresia in a standing sedated horse. A 4-year-old Arabian cross paint mare was referred for evaluation of chronic mucopurulent discharge and epiphora of the left eye. Ophthalmic and radiographic evaluations confirmed distal nasolacrimal duct atresia with absence of the nasolacrimal orifice. Initial minimally invasive treatments, including guidewire-assisted catheterization and diode laser photoablation, were unsuccessful. Definitive treatment was achieved using a Fogarty arterial embolectomy catheter under standing sedation. Controlled balloon inflation and deflation enabled progressive dilation of the obstructed duct, and a surg...
Physiological and behavioural effects of continuous remifentanil-xylazine administration in donkeys. Remifentanil and xylazine are used as continuous infusions to facilitate standing surgery in horses. Their use for this purpose has not been reported in donkeys. Objective: To evaluate the behavioural, sedative, and cardiorespiratory effects of continuous intravenous infusion of remifentanil and xylazine in donkeys. Methods: Non-blinded in vivo experiments. Methods: Ten donkeys were sedated with an intravenous bolus of xylazine (0.8 mg/kg). After 3 min, continuous infusions of xylazine (0.65 mg/kg/h) and remifentanil (6 μg/kg/h) were administered for 60 min. Cardiorespiratory physio...
Tachycardia and muscle tremors following intravenous administration of detomidine to a horse undergoing standing surgery. Detomidine hydrochloride is an alpha adrenoceptor agonist that is commonly used in equine practice to provide sedation and analgesia for horses undergoing standing procedures. Reported effects following intravenous administration of detomidine in horses include bradycardia, bradyarrhythmias, transient hypertension, sweating, piloerection and dose-dependent sedation, ataxia and analgesia. This case report describes a novel response characterised by tachycardia and profound muscle tremors following the administration of intravenous detomidine to a horse undergoing a standing procedure.
Standing excision of the nasal septum of 12 horses. To describe the technique of and complications associated with excising the nasal septum of horses with the horse standing and to report the outcome of horses undergoing this procedure. Methods: Retrospective study. Methods: A total of Twelve horses affected with disease of the nasal septum. Methods: The septum of each horse was excised with the horse sedated. All horses underwent rhinotomy, and six also underwent laryngotomy, to position three loops of obstetrical wire used to make three of four septal incisions. The sites of laryngotomy and rhinotomy were desensitized by infiltrating local a...
Impact of sequential administration of detomidine, butorphanol, and midazolam on sedation, ataxia, stimulus response, and bispectral index in horses. Standing sedation is a safe and cost-effective alternative to general anesthesia in horses, but challenges include achieving adequate drug effect to block the stimulus response without inducing ataxia or recumbency. A benefit of midazolam has been reported in equine dental procedures. Seeking synergy, a combination of lower doses of several pharmacologic agents, including midazolam, may improve the quality of sedation while minimizing adverse effects. Bispectral index (BIS) correlates with sedation scores in human ICU patients, but the correlation between sedation scores and BIS has not been e...
Pharmacokinetics of Remimazolam Versus Midazolam After Intravenous Administration to Horses. Remimazolam (RMZ) is a new short-half-life benzodiazepine used in humans. We compared the pharmacokinetics and sedative effects of RMZ with those of midazolam (MDZ) in Thoroughbred horses. Six Thoroughbreds received a single IV dose of RMZ 0.05 mg/kg or MDZ 0.05 mg/kg in a randomized crossover design. Blood samples were collected, and plasma RMZ and MDZ concentrations were measured by LC-MS/MS. Plasma concentrations were analyzed by using non-compartmental analysis and a nonlinear mixed effect model. The half-life of RMZ (0.77 ± 0.15 h) was significantly shorter than that of MDZ (3....
Preanesthetic Administration of Trazodone Does Not Impact Anesthetic Recovery Scores in Horses. Trazodone is administered to hospitalized equine patients to aid in behavioral management, but the effects on the anesthetic recovery period have not been investigated. This study sought to determine if there is an association between trazodone administration and recovery quality, recovery time, need for sedation, or need for reversal agent administration. We hypothesized that there would be no difference in recovery scores, recovery time, additional sedation, or reversal agent administration between horses that received preanesthetic trazodone and horses that did not. Records were reviewed to...
Cervical epidural catheter for administration of detomidine and morphine in a model of carpal synovitis in the horse. To determine the analgesic effects of detomidine and morphine administered by cervical epidural catheter (CEC) on a model of thoracic limb pain. Methods: Prospective, randomized, blinded crossover study. Methods: Five adult horses. Methods: Cervical epidural catheters were placed under ultrasound guidance, followed by induction of lipopolysaccharide (LPS)-mediated carpal synovitis. Horses received either saline or detomidine/morphine (DM; 10 μg/kg, 0.1 mg/kg, respectively) via CEC 4 h after synovitis. After a 7 day washout, synovitis was induced in the contralateral carpus, and the alternate ...
Ultrasonographic Assessment of Caudal Vena Cava Collapsibility Index, Caudal Vena Cava-to-Aorta, and Femoral Vein-to-Artery Ratios in Healthy Sedated Adult Horses. (1) Background: Ultrasonography of major vessels helps evaluate fluid status and responsiveness in critical human and canine patients. Aims: transrectal and inguinal ultrasonography of caudal vena cava (CVC), aorta (Ao), and femoral artery (FA) and vein (FV) in horses; calculate CVC collapsibility index (CI CVC) and vein-to-artery ratios; compare B- and M-mode; and evaluate repeatability and reproducibility. (2) Methods: B-mode and M-mode video loops were recorded twice by transrectal (Ao, CVC) and inguinal ultrasonography (FV, FA) by two operators on 17 healthy, sedated adult horses. Diameter...
Midline vs. flank laparotomy- criteria for choosing the optimal surgical technique for uterine torsion correction in the mare. Uterine torsion in mares belongs to maternal pregnancy disorders, accounting for 5-10% of complications in the last trimester of pregnancy. Two surgical techniques for repositioning uterine torsion are used: flank laparotomy in local anesthesia on a standing mare (SFL) and midline laparotomy carried out under general anesthesia (MI). The study aims to present the exact protocol used by the authors to qualify a mare with uterine torsion for surgery using one of the above-mentioned methods.A total of 19 mares were operated on, of which 13 underwent midline laparotomy under general anesthesia, an...
Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse. To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy. Methods: Case report. Methods: A 17-year-old Tennessee Walking Horse gelding. Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, B...
Effects of Sedation on Rectal Temperature During Equine Dental Procedures Performed in Cold to Warm Ambient Temperatures. Sedation is important for safe equine dental procedures, but it is unknown if there is a higher risk of sedation causing hypothermia in procedures performed during cold months. The authors hypothesize that sedation for a dental procedure will significantly decrease rectal body temperature in cold as compared to warm ambient temperatures. Adult equids ( = 246), from a private equine dentistry practice, that underwent dental equilibration, were selected for the study. Each horse's weight was estimated and sedation was administered intravenously (0.01 mg/kg detomidine and 0.01 mg/kg butor...
Global survey on the utilisation and experiences with different retrobulbar anaesthesia techniques in horses. Retrobulbar anaesthesia (RBA) is relevant for ocular surgery in standing sedated horses. Objective: Gathering insights on experiences with RBA techniques. Methods: Cross-sectional survey. Methods: An online survey collected information on the respondents' professional background, indications, injection methods, use of ultrasound assistance, medication, and complications associated with RBA in horses. Results: Two-hundred and thirty-eight veterinarians from 25 countries contributed. 86.1% were members of veterinary specialty colleges. RBA indications were enucleation (97.8%), corneal surgery (2...
Optimizing equine standing sedation: continuous infusion of detomidine and butorphanol enhances stability but prolongs ataxia. This study aimed to compare the sedation quality and cardiorespiratory and behavioral effects of detomidine administered intravenously, either in intermittent boluses or as a continuous rate infusion, with butorphanol in horses pre-medicated with acepromazine for odontoplasty procedures. Unassigned: A prospective clinical study was conducted with fifteen adult horses randomly assigned to two groups: Bolus group (BG, = 7) and Infusion group (IG, = 8). Both groups received acepromazine premedication, followed by detomidine administration (bolus or infusion). Butorphanol was administered either...
Analgesic and Gastrointestinal Effects of Methadone in Horses Undergoing Orchiectomy. A multimodal approach is recommended to optimize perioperative pain control in animals, although opioid use in horses remains limited due to the risks of central nervous system (CNS) stimulation and reduced intestinal motility. A group of 19 healthy, male, mixed-breed horses were divided into two groups and medicated with acepromazine (0.05 mg kg) and detomidine (10 µg kg), with methadone (0.05 mg kg) (ADM) or saline (ADS) administered intravenously (IV). Physiological variables, intestinal motility, gastric distention, and facial pain (EQUUS-FAP) were evaluated one day before (DB), before th...
The effect of cervical epidural injection of morphine and the combination of morphine and detomidine on recovery from anesthesia in adult horses. To evaluate the effect of cervical epidural injection of morphine alone and morphine in combination with detomidine on recovery from anesthesia in horses. Methods: Blinded, randomized, crossover, Latin square design. Methods: A group of six healthy adult horses aged 9 ± 3 years and weighing 471 ± 76 kg (mean ± standard deviation). Methods: Horses were administered each of three treatments during a 1 hour general anesthetic with a 4 day washout period. Treatments were: 1) cervical epidural injection of saline 0.011 mL kg (S); 2) morphine 0.1 mg kg (M); and 3) morphine 0.1 mg kg with detomidi...
Sedative effects of detomidine and midazolam combination in horses. The combination of detomidine and midazolam may provide safer sedation with muscle-relaxant effects, which are particularly necessary during standing procedures. Unassigned: Thus, the objective of this study was to evaluate the sedative and muscle-relaxant effects of the detomidine/midazolam combination in horses through a pharmacodynamic study. Unassigned: Five horses were used and subjected to four experimental protocols: 15 µg/kg of detomidine (D15); a combination of detomidine (15 µg/kg) with 25 µg/kg (DM25), 50 µg/kg (DM50), or 75 µg/kg (DM75) of midazolam administered intravenously....
Innovating for Curriculum Design Using a Text-Mining Exploration of Common Clinical Topics in Equine Primary Care. To ensure veterinary students are prepared for clinical practice, curricula must provide opportunities for students to learn about the cases most frequently seen in practice. Currently, there is a gap in the literature with regard to the identification of common clinical topics encountered in equine primary care practice in the UK. This study aims to address this gap by utilizing text-mining techniques on electronic medical records (EMRs) to produce a ranked list of the most common clinical topics encountered in equine primary care in the UK. The study included 1,092,731 rows of data from 150,...
Pregabalin contributes to increased recovery time from isoflurane anaesthesia for magnetic resonance imaging in horses. Pregabalin reduces excitatory neurotransmitter release and is used for anxiolysis in humans, cats, and horses. The effects of pregabalin on equine recovery following isoflurane anaesthesia are unknown. Objective: To determine if pre-anaesthetic oral pregabalin influences recovery time and/or quality from isoflurane anaesthesia in horses undergoing elective magnetic resonance imaging (MRI) of the appendicular skeleton. Methods: Retrospective cohort study. Methods: Anaesthetic and recovery data from 52 healthy horses in which pregabalin (PG) was administered and 76 control horses (CG) undergoing...
Evaluating the extent to which ataxia and responsiveness to stimuli reflect the efficacy of xylazine sedation using pharmacokinetics. Clinical assessments of equine sedation typically rely on subjective observations, the accuracy of which is paramount to the safety of equine veterinary procedures. Methods: To assess the degree in which subjective clinical sedative evaluations reflect pharmacokinetic measurements of equine drug metabolism, xylazine hydrochloride, an alpha-2 adrenoreceptor agonist, was administered to 36 horses of varying breed and age at a dosage of 0.5 mg/kg body weight. Subjective clinical parameters were scored at 5-, 15-, 30-, 45- and 60-minutes post xylazine administration and included responsiveness to ...
Equine skin grafting using the punch graft technique. This tutorial aims to illustrate and instruct on the technique of punch skin grafting in the horse. Unassigned: A 10-year-old paint gelding with a 9 X 6-cm chronic granulating wound to the left forelimb was utilized for this tutorial. Unassigned: The chronic wound was debrided with sharp dissection, and the limb was pressure bandaged overnight. Twenty-four hours later, the horse was sedated for punch skin grafting. The ventral pectoral region was aseptically prepared for skin harvest and locally anesthetized. An 8-mm biopsy punch was used to harvest the grafts. The subcutaneous tissue was then...
The effects of a long-duration intravenous infusion of detomidine, with and without vatinoxan, on equine energy metabolism and urine composition. To assess the effects of a 4 hour detomidine constant rate infusion (CRI) with and without a vatinoxan CRI on energy metabolism and urine composition. Methods: Randomized, blinded, crossover study. Methods: Eight Finnhorses, 587 (550-620) kg [median (range)] and 13 (4-16) years old. Methods: Horses were administered an intravenous (IV) detomidine loading dose (0.01 mg kg) followed by 240 minutes CRI (0.015 mg kg hour) (DET) and the same detomidine protocol combined with an IV vatinoxan loading dose (0.15 mg kg) and CRI (0.05 mg kg hour) (DET+VAT). Blood samples for glucose, insulin, non-esteri...
Donkey and Hybrid Anaesthetic Mortality in an Observational, Prospective, Multicentre Cohort Study. Equid anaesthetic mortality is of interest to practitioners. Data for donkey and hybrid mortality have not been specifically described. The main aim of this worldwide observational, prospective, multicentre cohort study was to report on mortality in the 7 days following a general anaesthetic or standing sedation in donkeys and hybrids. This study hypothesised that donkeys and hybrids would have higher mortalities compared to horses. Data were collected as part of the fourth Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4). A total of 825 cases were included, with 757 donkeys ...
[Sonographic diagnosis of lingual abscess formation in 2 horses with feeding difficulties]. Feeding disorders in horses may have various underlying causes. A thorough clinical examination of the oral cavity is essential for clarification and is often supplemented by imaging techniques such as oral endoscopy, radiography, and computed tomography (CT) of the head. Sonographic examinations of the head and oral cavity are less commonly described diagnostic methods for the investigation of feeding disorders. This case report describes 2 horses presented to the clinic due to impaired feed intake. In both cases the radiographic examination of the head did not reveal any abnormalities relate...
Efficacy of caudal epidural injection of Xylazine-Lidocaine HCl and detomidine-lidocaine HCl in domestic horses (Equus ferus caballus). The current study was prepared to compare the efficacy of xylazine-lidocaine HCl and detomidine-lidocaine HCl following caudal epidural injection in horses, evaluating sedation, analgesia, physiological parameters, and hemato-biochemical values. This study was applied to six healthy adult horses (300-350 kg, > 4 years of age). The horses were randomly divided into two equal groups. Group 1 (seven horses) received xylazine (0.17 mg/kg bwt) + lidocaine HCl (0.06 mg/kg bwt), while Group 2 received detomidine (0.03 mg/kg bwt) + lidocaine HCl (0.06 mg/kg bwt) via caudal epidural i...
