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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.
Pharmacokinetics and clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. This study determined the pharmacokinetics and compared the clinical effects of xylazine and dexmedetomidine in horses recovering from isoflurane anesthesia. Six healthy horses aged 8.5 ± 3 years and weighing 462 ± 50 kg were anesthetized with isoflurane for 2 hr under standard conditions on two occasions one-week apart. In recovery, horses received 200 μg/kg xylazine or 0.875 μg/kg dexmedetomidine intravenously and were allowed to recover without assistance. These doses were selected because they have been used for postanesthetic sedation in clinical and research studies. Serial ...
Blood glucose and insulin concentrations after alpha-2-agonists administration in horses with and without insulin dysregulation. In metabolically stable horses, alpha-2-agonists suppress insulin secretion with transient hyperglycemia and rebound hyperinsulinemia. In horses with insulin dysregulation (ID), the effect of alpha-2-agonists has not been investigated; however, both the alpha-2-agonist-induced suppression of insulin secretion and rebound hyperinsulinemia could have clinical relevance. Objective: In horses with ID, alpha-2-agonists will alter insulin and glucose dynamics. Methods: Seven horses with ID and 7 control horses. Methods: In this randomized crossover study, xylazine hydrochloride (1.1 mg/kg) or detomi...
Recent developments in equine dentistry. Equine dentistry is a rapidly developing clinical specialty. It has benefitted from key advances in anatomical and physiological research, development of equipment and instrumentation, utilisation of standing sedation and anaesthesia protocols, a change towards minimally invasive surgical techniques, and the introduction of restorative and endodontic techniques translated from techniques used in human and canine dentistry. Anatomical research has provided further insight into the endodontic system of incisors and cheek teeth and how it changes throughout development with age. Studies of the pe...
Systemic and local effects of lidocaine or mepivacaine when used for intravenous regional anaesthesia of the distal limb in standing sedated horses. Local anaesthetics are being combined clinically with amikacin in intravenous regional limb perfusion (IVRLP), with limited knowledge on the analgesia provided and its onset and duration of action after tourniquet application and release. Objective: To evaluate the systemic clinical effect, limb withdrawal to nociceptive stimulation, and plasma and synovial fluid concentrations after IVRLP with lidocaine or mepivacaine in standing sedated horses. Methods: Prospective, controlled, randomised, cross-over study. Methods: Six healthy adult horses were sedated and received IVRLP with lidocaine, mep...
Recovery quality following a single post-anaesthetic dose of dexmedetomidine or romifidine in sevoflurane anaesthetised horses. Post-anaesthetic sedation is administered to horses to improve recovery quality from inhalant anaesthesia and reduce the risk of catastrophic injury. A single dose of dexmedetomidine for this purpose has not been evaluated clinically. Objective: To determine whether dexmedetomidine improves recovery quality from sevoflurane anaesthesia compared to a previously studied dose of romifidine. Methods: Prospective, randomised, masked clinical trial. Methods: Ninety-nine, adult, client-owned horses anaesthetised for elective procedures completed the trial. Anaesthetic protocol was standardised. Horse...
Comparison of xylazine and detomidine in combination with midazolam/ketamine for field castration in Quarter Horses. The ideal field anaesthetic protocol for castration will offer an adequate duration and depth of anaesthesia using a single injection without compromising safety or recovery quality. Objective: The objective of this study was to compare intravenous (IV) xylazine and detomidine as sedatives in combination with midazolam and ketamine for induction of anaesthesia in horses undergoing field castration. Methods: Randomised, blinded, clinical study. Methods: Fifty-seven male Quarter Horses were randomly assigned to receive xylazine (group X) (1.1 mg/kg bwt) or detomidine (group D) (0.03 mg/kg bwt)...
Effects of acepromazine and xylazine on subjective and objective assessments of forelimb lameness. To facilitate lameness evaluation, sedatives such as xylazine and acepromazine are regularly used in the clinical setting, despite concerns that they may confound lameness assessment. Objective: The objective of this study was to determine the effect of low doses of acepromazine and xylazine on subjective and objective lameness assessment. Methods: Randomised, blinded, crossover study. Methods: Six horses with experimentally induced solar pain were evaluated over a 1-hour period after treatment with intravenous xylazine (0.1 or 0.2 mg/kg), intravenous acepromazine (0.02 or 0.04 mg/kg), intra...
Evaluation of histamine-provoked changes in airflow using electrical impedance tomography in horses. Electrical impedance tomography (EIT) generates thoracic impedance images of the lungs and has been used to assess ventilation in horses. This technique may have application in the detection of changes in airflow associated with equine asthma. Objective: The objective was to determine if histamine-induced airflow changes observed with flowmetric plethysmography (Δflow) could also be explained using global and regional respiratory gas flow signals calculated from EIT signals. Methods: Experimental in vivo study. Methods: Six horses, sedated using detomidine were fitted with a thoracic EIT b...
Inter-user and intra-user variation of two tonometers in horses. It is currently unknown which of the two devices most commonly used in equine ophthalmology for intraocular pressure (IOP) estimation demonstrates the lowest inter-user and intra-user variation. Objective: To assess the inter-user and intra-user variation of two tonometers in sedated and unsedated horses. Methods: Randomised masked cross-over trial. Methods: Four examiners used the rebound (ICare TonoVet) and applanation (TonoPen ) tonometers to measure the intraocular pressure (IOP) in triplicate in 10 normal horses before and after sedation with xylazine. For inter-user variation, coefficien...
Evaluation of the caudal cervical articular process joints by using a needle arthroscope in standing horses. To determine the safety and efficacy of caudal cervical articular process joint arthroscopy by using needle arthroscopy in standing sedated horses. Methods: Prospective experimental case series. Methods: Six adult horses. Methods: Three horses underwent exploration of bilateral C5-6 vertebral articular process joints and three bilateral C6-7 articular process joints by using a 1.2 × 65-mm needle arthroscope under standing sedation. The 16-gauge arthroscopic trocar and canula assembly was inserted in the desired articular process joint under ultrasonographic guidance without distention of ...
Diagnostic tenoscopy of the carpal sheath with a needle arthroscope in standing sedated horses. To investigate the use of a needle arthroscope for diagnostic tenoscopy of the carpal sheath in standing horses. Methods: Experimental study. Methods: Six forelimbs for the cadaveric part of the study and six horses for the in vivo part of the study. Methods: Six cadaveric limbs were used to perform carpal sheath tenoscopy with a 1.2-mm-diameter needle arthroscope (65 and 100 mm long), followed by tenoscopy with a 4-mm arthroscope through a standard proximolateral approach. Then, unilateral standing carpal sheath tenoscopy was performed in six healthy sedated horses with a 65-mm-long needle ...
The Effect of Sedation, Oral Examination, and Odontoplasty on Systemic Inflammation as Measured by Serum Amyloid A in the Adult Performance Horse. Serum amyloid A (SAA) is one of the major acute phase proteins in horses. It serves as a marker for systemic inflammation and infection, as the concentration can increase 100- to even 1000-fold during systemic disease processes. The objective of this study was to evaluate the effect of sedation, oral examination, and odontoplasty on systemic inflammation as measured by SAA in the adult performance horse. This study included 32 clinically healthy adult performance horses. Blood samples were collected immediately prior to sedation, oral examination, and odontoplasty and 48 and 72 hours afterward...
Diagnostic needle arthroscopy of the tarsocrural joint in standing sedated horses. To develop and assess a needle arthroscopic technique to diagnose conditions of the tarsocrural joint (TCj) in standing sedated horses. Methods: Experimental study. Methods: Six cadaveric hind limbs (phase 1) and six healthy horses (Phase 2). Methods: In phase 1, each TCj was examined with a 1.2-mm-needle arthroscope. Suitability of the needle arthroscope and degree of joint visualization with traditional arthroscopic approaches were assessed. In phase 2, the feasibility of the procedure was assessed in six standing healthy horses. A custom-made splint and base were developed to maintain joint...
Effect of Methadone Combined With Acepromazine or Detomidine on Sedation and Dissociative Anesthesia in Healthy Horses. The aim of this study was to compare the effects of methadone combined with detomidine or acepromazine on the quality of sedation and its influence over dissociative anesthesia in healthy horses. In a crossover design, seven horses were administered with 0.1 mg/kg methadone and 0.02 mg/kg detomidine intravenously (group MD) or 0.1 mg/kg methadone and 0.05 mg/kg acepromazine intravenously (group MA). Subsequently, anesthesia was induced with a combination of 2.2 mg/kg ketamine and 0.1 mg/kg midazolam intravenously. Descriptive scales and footages were used to evaluate the quality of sedat...
Comparative Effect of Epidural Administration of Xylazine or Dexmedetomidine on Echocardiographic Dimensions and Cardiac Indices in Clinically Healthy Donkeys (Equus asinus). The aim of the present study was to assess and compare the changes of the echocardiographic dimensions and cardiac function indices after epidural injection of xylazine or dexmedetomidine in clinically healthy donkeys. In an experimental prospective randomized cross-over study, 10 healthy adult donkeys were injected with saline solution, xylazine (0.20 mg kg), and dexmedetomidine (0.005 mg kg) into the epidural space between the second and third coccygeal vertebrae. Echocardiographic dimensions as well as cardiac function indices were assessed using a 2-3.9 MHz sector transducer, at the l...
Clinical utility, dose determination, and safety of ocular contrast-enhanced ultrasonography in horses: A pilot study. To determine efficacy of contrast-enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Methods: Ocular B-mode and contrast-enhanced ultrasonography were performed bilaterally in nine sedated university-owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different ...
Assessment of clinical and computed tomographic findings for association with the outcome of intraoral cheek tooth extraction in horses and ponies. To describe clinical and CT findings for horses and ponies undergoing intraoral cheek tooth extraction and assess potential associations between these features and outcome of the procedure. 74 horses and 7 ponies. Medical records were searched to identify horses and ponies that underwent CT and intraoral extraction of ≥ 1 cheek tooth with standing sedation. Signalment and clinical variables were recorded, and CT scans were reviewed. Anatomic location and measurements of affected teeth; abnormalities of the periodontium, pulp, infundibula, roots, and tooth shape; fracture presence and type; p...
Effects of Epinephrine, Detomidine, and Butorphanol on Assessments of Insulin Sensitivity in Mares. Sympathoadrenal stimulation may perturb results of endocrine tests performed on fractious horses. Sedation may be beneficial; however, perturbation of results may preclude useful information. Four experiments were designed to 1) determine the effects of epinephrine on insulin response to glucose (IR2G), 2) assess the effects of detomidine (DET), alone or combined with butorphanol (DET/BUT), on IR2G and glucose response to insulin (GR2I), and 3) assess the effects of BUT alone on IR2G. In Experiment 1, mares were administered saline or epinephrine (5 μg/kg BW) immediately before infusion of gl...
Season’s Effects on Some Clinical, Hematological Parameters and Blood Cortisol Level in Sedated Arabian Horses With Xylazine. Influence of heat or cold stress in sedated animals is unclear and requires further investigations. The present study aimed to evaluate the season's effects on some clinical, hematological parameters and blood cortisol level in sedated Arabian horses with xylazine. Therefore, seven Arabian horses were used to investigate heart and respiratory rates, and capillary refill time and serum cortisol level were recorded before (0) and at 5, 15, 60, and 180 minutes postsedation. Heparinized venous samples were collected before (0) and 3 hours postsedation for analysis of hematological analysis. Arte...
Re-evaluation of the pharmacokinetics of xylazine administered to Thoroughbred horses. Xylazine is widely used worldwide as a short-acting sedative in general equine and racing practice. In the UK, although it has a legitimate use during training, equine anti-doping rules state it is a prohibited substance on race day. The aim of the study was to produce a detection time (DT) to better inform European veterinary surgeons so that xylazine can be used appropriately under regulatory rules. Previous publications have various limitations pertaining to analysis method, particularly for plasma and limited length of time of sample collection. In this study, pharmacokinetic data were pro...
A possible solution to model nonlinearity in elimination and distributional clearances with α2 -adrenergic receptor agonists: Example of the intravenous detomidine and methadone combination in sedated horses. The alpha(α) -agonist detomidine is used for equine sedation with opioids such as methadone. We retrieved the data from two randomized, crossover studies where detomidine and methadone were given intravenously alone or combined as boli (STUDY 1) (Gozalo-Marcilla et al., 2017, Veterinary Anaesthesia and Analgesia, 2017, 44, 1116) or as 2-hr constant rate infusions (STUDY 2) (Gozalo-Marcilla et al., 2019, Equine Veterinary Journal, 51, 530). Plasma drug concentrations were measured with a validated tandem Mass Spectrometry assay. We used nonlinear mixed effect modelling and took pharmacokinetic...
Anesthesia, Sedation, and Pain Management of Donkeys and Mules. The number of donkeys in the world may not be increasing but awareness of their use and concern for welfare and pain recognition and treatment are receiving increasing veterinary interest. Therefore, accurate information about anesthesia and analgesia in donkeys and mules is important to more equine practitioners. This review highlights the current knowledge on various anesthetic and analgesic approaches in donkey and mules. The authors emphasize that there is still much information that is not available about donkeys and mules; in many circumstances, the clinician must use available equine in...
Pharmacokinetic-pharmacodynamic modelling of the antinociceptive effect of a romifidine infusion in standing horses. To evaluate the effect of a romifidine infusion on antinociception and sedation, and to investigate its relationship with plasma concentration. Methods: Prospective, experimental, nonrandomized trial. Methods: A total of 10 healthy adult warmblood horses. Methods: Romifidine (loading dose: 0.08 mg kg, infusion: 0.03 mg kg hour) was administered intravenously over 120 minutes. Romifidine plasma concentrations were determined by capillary electrophoresis. Sedation quality and nociceptive thresholds were evaluated at regular time points before, during and after romifidine administration. The noci...
Synovial butorphanol concentrations and mechanical nociceptive thresholds after intravenous regional limb perfusion in standing sedated horses. To determine synovial butorphanol concentrations and mechanical nociceptive threshold (MNT) changes after butorphanol intravenous regional limb perfusion (IVRLP). Methods: Experimental ANIMALS: Six adult horses. Methods: Cephalic IVRLP was performed with 10 mg butorphanol in sedated horses with a wide rubber tourniquet and a total volume of 30 mL. Radiocarpal synovial fluid and serum concentrations along with MNT were evaluated prior to and 0.5, 1, 2, 4, and 6 hours after IVRLP. Butorphanol concentrations were determined with liquid chromatography coupled to tandem mass spectrometry posi...
Behavioural and cardiovascular effects of medetomidine constant rate infusion compared with detomidine for standing sedation in horses. 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...
State-of-the-Art Diagnostic Methods to Diagnose Equine Spinal Disorders, With Special Reference to Transcranial Magnetic Stimulation and Transcranial Electrical Stimulation. Spinal cord disorders are a common problem in equine medicine. However, finding the site of the lesion is challenging for veterinarians because of a lack of sensitive diagnostic methods that can assess neuronal functional integrity in horses. Although medical imaging is frequently applied to help diagnose corticospinal disorders, this approach does not reveal functional information. For the latter, transcranial magnetic stimulation (TMS) and more recently transcranial electrical stimulation (TES) can be useful. These are brain stimulation techniques that create either magnetic or electrical fi...
Ceratohyoidectomy in standing sedated horses. To investigate the feasibility and complications associated with ceratohyoidectomy (CHE) in standing sedated horses unaffected (experimental horses) and standing sedated horses affected (clinical cases) with temporohyoid osteoarthropathy (THO). Methods: Case series. Methods: Six experimental horses and four clinical cases. Methods: Standing CHE was performed in six experimental horses euthanized 30 minutes (n = 3) and 7 days (n = 3) postoperatively. The four clinical cases were presented because of central facial nerve paralysis (n = 3), vestibular ataxia (n = 3), auricular hemorrhage (n =...
Evaluation of the effects of commonly used α2-adrenergic receptor agonists alone and in combination with butorphanol tartrate on objective measurements of lameness in horses. To determine the effects of 3 α2-adrenergic receptor agonists (α2-ARAs), alone or in combination with butorphanol tartrate, on objective measurements of lameness in horses. Methods: 17 adult polo horses with naturally occurring forelimb or hind limb lameness (or both). Methods: In a crossover design, each horse received each protocol (saline [0.09% NaCl] solution [2 mL, IV] or xylazine hydrochloride [0.33 mg/kg, IV], detomidine hydrochloride [0.007 mg/kg, IV], or romifidine hydrochloride [0.033 mg/kg, IV] alone or in combination with butorphanol [0.007 mg/kg, IV]) in random order, with a was...
Protocols using detomidine and oxytocin induce ex copula ejaculation in stallions. Tricyclic antidepressives, such as imipramine, indirectly induce ejaculation by increasing the noradrenaline concentration, which triggers an α-adrenergic response, whereas α-adrenergic agonists, such as xylazine and detomidine, directly trigger ejaculation by activating the α-1 adrenergic receptors. Furthermore, serum oxytocin concentrations in stallions increase drastically before ejaculation, but decline immediately thereafter, implicating the role of this hormone in emission. The objectives of the present study were to: 1) compare the efficiency of various protocols for inducing ex copu...
Effect of standard clinical procedures on blood glucose concentration in clinically healthy horses. Blood glucose concentrations fluctuate with stress, but little is known on how it is influenced by clinical procedures. The objective was to investigate the effect of clinical procedures on blood glucose concentration in healthy horses. Methods: Prospective, experimental study. Seven hospital-owned research horses were included in the study. A total of 4 horses were sampled either during a control sedation trial or during 3 different student workshops (prepurchase, oral, and rectal examination-the latter 2 with sedation). Blood samples were taken every 15 minutes and glucose concentration in w...
