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.
Neuromodulation using percutaneous electrical nerve stimulation for the management of trigeminal-mediated headshaking: A safe procedure resulting in medium-term remission in five of seven horses. There are no consistently safe and effective methods for the treatment of trigeminal-mediated headshaking in horses. In affected horses, the trigeminal nerve is sensitised, appearing to result in neuropathic pain. Percutaneous electrical nerve stimulation (PENS) therapy is a minimally invasive neuromodulatory treatment used in people to manage neuropathic pain. Objective: To determine whether PENS therapy is safe, tolerated and effective for the management of trigeminal-mediated headshaking in horses. Methods: Descriptive case series. Methods: Seven horses diagnosed with trigeminal-mediated he...
Pharmacokinetics and physiologic effects of alprazolam after a single oral dose in healthy mares. The objective of this study was to evaluate the pharmacokinetic properties and physiologic effects of a single oral dose of alprazolam in horses. Seven adult female horses received an oral administration of alprazolam at a dosage of 0.04 mg/kg body weight. Blood samples were collected at various time points and assayed for alprazolam and its metabolite, α-hydroxyalprazolam, using liquid chromatography/mass spectrometry. Pharmacokinetic disposition of alprazolam was analyzed by a one-compartmental approach. Mean plasma pharmacokinetic parameters (±SD) following single-dose administration of ...
Influence of detomidine on atrial fibrillation cycle length measured by intracardiac electrogram recording and by colour tissue Doppler imaging in horses. Shortening of atrial fibrillation cycle length (AFCL) is a marker of atrial electrical remodelling due to atrial fibrillation (AF). Objective: To investigate the effect of administration of detomidine on AFCL measured invasively from an intra-atrial electrogram (AFCLEGM) and noninvasively by tissue Doppler imaging (AFCLTDI). We hypothesised that detomidine would have no effect on AFCL but would improve the ease of TDI measurements and facilitate noninvasive AFCL determination. Methods: Prospective clinical study. Methods: Measurements were performed before and after i.v. administration of 7.5â...
Modified lamellar keratoplasties for the treatment of deep stromal abscesses in horses. To describe a surgical modification of deep lamellar endothelial keratoplasty (DLEK) and posterior lamellar keratoplasty (PLK) procedures, to facilitate surgery on standing horses under-sedation. Methods: Four client-owned horses, for which the owners declined surgery under general anesthesia, underwent standing corneal lamellar keratoplasty procedures for the treatment of deep corneal stromal abscesses. Methods: All four horses were placed in stocks and sedated with detomidine. Local eyelid and retrobulbar blocks were performed to provide local analgesia and akinesia, and each horse's head wa...
Comparison of midazolam and diazepam as co-induction agents with ketamine for anaesthesia in sedated ponies undergoing field castration. To compare intravenous (IV) midazolam and diazepam administered with ketamine for induction of anaesthesia in ponies, already sedated with detomidine, undergoing field castration. Methods: Prospective, randomised, 'blinded', clinical study. Methods: Twenty Welsh pony yearlings. Methods: After IV injection of detomidine (20 μg kg(-1) ) and phenylbutazone (4.4 mg kg(-1) ) ponies were allocated to receive either IV midazolam (group M) or diazepam (group D) (both 0.06 mg kg(-1) ) with ketamine (2.2 mg kg(-1) ) for induction of anaesthesia. Using simple descriptive scales, quality of sedat...
Scintigraphic tracking of mesenchymal stem cells after intravenous regional limb perfusion and subcutaneous administration in the standing horse. To assess distribution, uptake, and persistence of radiolabeled mesenchymal stem cells (MSC) using scintigraphy after intravenous regional limb perfusion (RLP) and subcutaneous injections in standing, sedated horses. Methods: Experimental study. Methods: Horses (n = 12). Methods: Six horses had RLP performed through the cephalic vein on 1 limb and subcutaneous injection in the metacarpal area in the opposite limb. The other 6 horses had RLP performed through the lateral palmar digital vein and subcutaneous injection in the coronary band. A pneumatic tourniquet was used for the RLP. MSC were la...
Effects of age on the pharmacokinetics and selected pharmacodynamics of intravenously administered fentanyl in foals. The use of fentanyl is limited in adult horses, in part due to potential for central nervous system excitation. The pharmacokinetics and the plasma concentration-related behavioural actions of fentanyl have not been described for young foals. The goal of the present study was to describe the pharmacokinetics and behavioural effects of fentanyl following administration to the same group of foals at 3 different ages. Experimental study in healthy foals. Fentanyl was administered i.v. (4 μg/kg bwt) to a group of 9 foals on 3 separate occasions at 6–8, 20–22 and 41–42 days of age. Blood sam...
Disposition, behavioural and physiological effects of escalating doses of intravenously administered fentanyl to young foals. Foal responses to a broader range of plasma fentanyl concentrations than currently reported are desirable to support (or not) clinical use. Objective: To describe fentanyl plasma concentrations following an escalating i.v. fentanyl dosing schedule in foals aged 5-13 days and describe selected, associated dose- and time-related behavioural and physiological responses to plasma fentanyl concentration. Methods: Experimental. Methods: Fentanyl was administered i.v. in an escalating fashion (2, 4, 8, 16 and 32 μg/kg bwt) at 10-min intervals. Blood samples were collected before and at selected time...
The pharmacokinetics of dexmedetomidine administered as a constant rate infusion in horses. Dexmedetomidine, the most selective α2-adrenoceptor agonist in clinical use, is increasingly being used in both conscious and anaesthetized horses; however, the pharmacokinetics and sedative effects of this drug administered alone as an infusion are not previously described in horses. Seven horses received an infusion of 8 μg dexmedetomidine/kg/h for 150 min, venous blood samples were collected, and dexmedetomidine concentrations were assayed using liquid chromatography-mass spectrometry (LC/MS) and analyzed using noncompartmental pharmacokinetic analysis. Sedation was scored as the distance...
Antinociceptive effects of three escalating dexmedetomidine and lignocaine constant rate infusions in conscious horses. Dexmedetomidine and lignocaine IV are used clinically to provide analgesia in horses. The aims of this study were to investigate the antinociceptive effects, plasma concentrations and sedative effects of 2, 4 and 6 µg/kg/h dexmedetomidine IV, with a bolus of 0.96 µg/kg preceding each continuous rate infusion (CRI), and 20, 40 and 60 µg/kg/min lignocaine IV, with a bolus of 550 µg/kg preceding each CRI, in 10 Swiss Warmblood horses. Electrically elicited nociceptive withdrawal reflexes were evaluated by deltoid muscle electromyography. Nociceptive threshold and tolerance were determ...
An accelerometric measure of the gait pattern in horses after the administration of sublingual detomidine. The locomotor pattern alterations produced after the administration of a sublingual detomidine gel was measured by an accelerometric method in horses. Using a randomized two-way crossover design, all animals (n = 6) randomly received either detomidine gel or a placebo administered sublingually. A triaxial accelerometric device was used for gait assessment 15 minutes before (baseline) and every 10 minutes after each treatment for a period of 180 minutes. Eight different parameters were calculated, including speed, stride frequency, stride length, regularity, dorsoventral, propulsion, mediolater...
Pharmacokinetics and pharmacodynamics of intravenous dexmedetomidine in the horse. The aim of the study was to describe the pharmacokinetics and selected pharmacodynamics of intravenous dexmedetomidine in horses. Eight adult horses received 5 μg/kg dexmedetomidine IV. Blood samples were collected before and for 10 h after drug administration to determine dexmedetomidine plasma concentrations. Pharmacokinetic parameters were calculated using noncompartmental analysis. Data from one outlier were excluded from the statistical summary. Behavioral and physiological responses were recorded before and for 6 h after dexmedetomidine administration. Dexmedetomidine concentrations dec...
Pharmacokinetics and pharmacodynamics of xylazine administered by the intravenous or intra-osseous route in adult horses. In certain situations, an alternate route for parenteral drug administration in horses may be useful. The intra-osseous (IO) route may provide a safe alternative to the intravenous (i.v.) route for administration of sedatives to horses when the i.v. route is inaccessible or undesirable. Six adult horses were administered xylazine i.v. or IO in a block-randomized crossover design. For the i.v. trial, both jugular veins were catheterized, and one was used for xylazine administration, while the other was used for blood collection. For the IO trial, one jugular vein was catheterized for blood coll...
Antinociceptive effect of buprenorphine and evaluation of the nociceptive withdrawal reflex in foals. To elicit and evaluate the NWR (nociceptive withdrawal reflex) in 2 and 11 day old foals, to investigate if buprenorphine causes antinociception and determine if the NWR response changes with increasing age. The effect of buprenorphine on behaviour was also evaluated. Methods: Prospective, experimental cross-over trial. Methods: Nine Norwegian Fjord research foals. Methods: Buprenorphine, 10 μg kg(-1) was administered intramuscularly (IM) to the same foal at 2 days and at 11 days of age. The NWR and the effect of buprenorphine were evaluated by electromyograms recorded from the left deltoid m...
Anti-nociceptive and sedative effects of romifidine, tramadol and their combination administered intravenously slowly in ponies. To evaluate the anti-nociceptive and sedative effects of slow intravenous (IV) injection of tramadol, romifidine, or a combination of both drugs in ponies. Methods: Within-subject blinded. Methods: Twenty ponies (seven male, 13 female, weighing mean ± SD 268.0 ± 128 kg). Methods: On separate occasions, each pony received one of the following three treatments IV; romifidine 50 μg kg(-) (R) tramadol 3 mg kg(-1) given over 15 minutes (T) or tramadol 3 mg kg(-1) followed by romifidine 50 μg kg(-1) (RT). Physiologic parameters and caecal borborygmi (CB) were measured and sedation ...
Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 2: opioids and alpha-2 adrenoceptor agonists. 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...
Sedative and mechanical hypoalgesic effects of butorphanol in xylazine-premedicated donkeys. Combinations of α2 -adrenoceptor and opioid agonists are commonly used in equids, but little scientific information is available on donkeys. Objective: To compare the sedative and hypoalgesic effects of xylazine alone or in combination with different dosages of butorphanol in donkeys. Methods: Placebo-controlled, operator-blinded, randomised, crossover, Latin square study. Methods: Six donkeys received intravenous normal saline and normal saline (NS-NS); xylazine (0.5 mg/kg bwt) and normal saline (X-NS); xylazine and 10 μg/kg bwt butorphanol (X-B10); xylazine and 20 μg/kg bwt butorpha...
Evaluation of a romifidine constant rate infusion protocol with or without butorphanol for dentistry and ophthalmologic procedures in standing horses. To compare the clinical usefulness of constant rate infusion (CRI) protocols of romifidine with or without butorphanol for sedation of horses. Methods: Prospective 'blinded' controlled trial using block randomization. Methods: Forty healthy Freiberger stallions. Methods: The horses received either intravenous (IV) romifidine (loading dose: 80 μg kg(-1) ; infusion: 30 μg kg(-1)  hour(-1) ) (treatment R, n = 20) or romifidine combined with butorphanol (romifidine loading: 80 μg kg(-1) ; infusion: 29 μg kg(-1)  hour(-1) , and butorphanol loading: 18 μg kg(-1) ; infusion: 25 μ...
Spectral-domain optical coherence tomography evaluation of the cornea, retina, and optic nerve in normal horses. To determine the feasibility of using a handheld spectral-domain optical coherence tomography (SD-OCT) instrument to characterize normal corneal, retinal, and optic nerve head anatomy in vivo in standing horses. Methods: Clinically normal horses under sedation, palpebral nerve blockage, and pharmacologically induced mydriasis were imaged with a SD-OCT instrument (Envisu SD-OCT, Bioptigen, Inc., Morrisville, NC). Radial volumes from the cornea (axial, superior, inferior, nasal, and temporal), and rectangular volumes from the retina (dorsal, ventral, nasal, and temporal) and optic nerve head wer...
The effects of intravenous romifidine on intraocular pressure in clinically normal horses and horses with incidental ophthalmic findings. Original study. Objective: To evaluate the effect of sedation with romifidine hydrochloride 1% (Sedivet: Boehringer-Ingelheim) on intraocular pressure (IOP) in the normal horse and horses with incidental ophthalmic findings as measured by applanation tonometry. Methods: Nineteen clinically normal horses (13 geldings, six mares) and eight horses (three geldings, five mares) with incidental ophthalmic findings were included in this study. Methods: All horses underwent complete ophthalmic examination with pharmacologic mydriasis a minimum of 2 weeks prior to IOP evaluation. Baseline intraocular p...
Ultrasound-guided injection of the median artery in the standing sedated horse. Injection of the median artery of horses leads to better distribution and persistence of mesenchymal stem cells than i.v. regional limb perfusion. Due to technical difficulties, intra-arterial injections thus far have only been performed under general anaesthesia. Objective: To assess the feasibility of injection of the median artery in standing sedated horses. Methods: Experimental study. Methods: Six horses were included in the study. After median and ulnar regional analgesia, radiographic contrast material was injected in the median artery of both front limbs, using a catheter in one limb a...
Effects of xylazine, romifidine, or detomidine on hematology, biochemistry, and splenic thickness in healthy horses. Alpha-2 agonist-induced changes in packed cell volume (PCV), total solids (TS), selected biochemical parameters, and splenic thickness were investigated in horses. Four healthy mares were treated in a blinded, randomized, cross-over design with a dose of xylazine (0.5 mg/kg), romifidine (0.04 mg/kg), or detomidine (0.01 mg/kg) IV, and detomidine (0.02 mg/kg) IM. Hematology, TS, colloid osmotic pressure (COP), plasma osmolality; glucose, lactate, urea (BUN) and electrolyte concentrations; venous blood pH and ultrasonographic splenic thickness were evaluated at intervals for 300 min. Repeated me...
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, 1Â 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...