FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Acta veterinaria Scandinavica2015; 57(1); 21; doi: 10.1186/s13028-015-0112-4

Clinical and pharmacokinetic evaluation of S-ketamine for intravenous general anaesthesia in horses undergoing field castration.

Abstract: Intravenous anaesthetic drugs are the primary means for producing general anaesthesia in equine practice. The ideal drug for intravenous anaesthesia has high reliability and pharmacokinetic properties indicating short elimination and lack of accumulation when administered for prolonged periods. Induction of general anaesthesia with racemic ketamine preceded by profound sedation has already an established place in the equine field anaesthesia. Due to potential advantages over racemic ketamine, S-ketamine has been employed in horses to induce general anaesthesia, but its optimal dose remains under investigation. The objective of this study was to evaluate whether 2.5 mg/kg S-ketamine could be used as a single intravenous bolus to provide short-term surgical anaesthesia in colts undergoing surgical castration, and to report its pharmacokinetic profile. Results: After premedication with romifidine and L-methadone, the combination of S-ketamine and diazepam allowed reaching surgical anaesthesia in the 28 colts. Induction of anaesthesia as well as recovery were good to excellent in the majority (n = 22 and 24, respectively) of the colts. Seven horses required additional administration of S-ketamine to prolong the duration of surgical anaesthesia. Redosing did not compromise recovery quality. Plasma concentration of S-ketamine decreased rapidly after administration, following a two-compartmental model, leading to the hypothesis of a consistent unchanged elimination of the parent compound into the urine beside its conversion to S-norketamine. The observed plasma concentrations of S-ketamine at the time of first movement were various and did not support the definition of a clear cut-off value to predict the termination of the drug effect. Conclusions: The administration of 2.5 mg/kg IV S-ketamine after adequate premedication provided good quality of induction and recovery and a duration of action similar to what has been reported for racemic ketamine at the dose of 2.2 mg/kg. Until further investigations will be provided, close monitoring to adapt drug delivery is mandatory, particularly once the first 10 minutes after injection are elapsed. Taking into account rapid elimination of S-ketamine, significant inter-individual variability and rapid loss of effect over a narrow range of concentrations a sudden return of consciousness has to be foreseen.
Get Full Text
Publication Date: 2015-05-03 PubMed ID: 25935721PubMed Central: PMC4432908DOI: 10.1186/s13028-015-0112-4Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Clinical Trial
  • Journal Article
  • Research Support
  • Non-U.S. Gov't

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study investigates the effectiveness of using an intravenous dose of 2.5mg/kg S-ketamine for general anaesthesia in horses during field castration, and the associated pharmacokinetic profile. It concluded that this dosage provided good induction and recovery and a duration of action close to that of racemic ketamine.

Research Objectives and Methodology

  • The goal of the study was to ascertain if S-ketamine could provide short-term surgical anaesthesia for horses undergoing field castration with a single 2.5 mg/kg IV dose.
  • The research team also aimed to study the pharmacokinetic profile of S-ketamine, focusing on the onset, duration, and end of the anaesthetic effect.
  • The study involved 28 colts, each premedicated with romifidine and L-methadone. After this premedication, S-ketamine and diazepam were used to induce general anaesthesia.

Findings of Study

  • Most of the colts (22 and 24, respectively) showed good to excellent induction of anaesthesia and recovery.
  • Additional administration of S-ketamine was required in seven horses to prolong the surgical anaesthesia duration, without compromising recovery quality.
  • Plasma concentration of S-ketamine fell quickly after administration, suggesting the substance is quickly transformed into S-norketamine and eliminated via urine.
  • The study could not identify a clear cut-off value to predict termination of S-ketamine’s drug effect, as plasma concentrations were varied.

Conclusions

  • The administration of 2.5 mg/kg IV S-ketamine after adequate premedication resulted in good induction and recovery quality, similar to that achieved with racemic ketamine at the dose of 2.2 mg/kg.
  • Due to the rapid elimination of S-ketamine and the determination that its efficiency differs significantly among individuals, it’s critical to monitor the patient meticulously, especially after the first 10 minutes post-injection.
  • Given the fast loss of S-ketamine’s effect at a narrow range of concentrations, an abrupt return of consciousness should be expected.

Cite This Article

APA
Casoni D, Spadavecchia C, Wampfler B, Thormann W, Levionnois OL. (2015). Clinical and pharmacokinetic evaluation of S-ketamine for intravenous general anaesthesia in horses undergoing field castration. Acta Vet Scand, 57(1), 21. https://doi.org/10.1186/s13028-015-0112-4

Publication

Acta veterinaria Scandinavica
ISSN: 1751-0147
NlmUniqueID: 0370400
Country: England
Language: English
Volume: 57
Issue: 1
Pages: 21
PII: 21

Researcher Affiliations

Casoni, Daniela
  • Anesthesiology and Pain Therapy Division, Department of Veterinary Clinical Science of the Vetsuisse Faculty of Berne, Länggassstrasse 124, CH-3012, Berne, Switzerland. daniela.casoni@vetsuisse.unibe.ch.
Spadavecchia, Claudia
  • Anesthesiology and Pain Therapy Division, Department of Veterinary Clinical Science of the Vetsuisse Faculty of Berne, Länggassstrasse 124, CH-3012, Berne, Switzerland. claudia.spadavecchia@vetsuisse.unibe.ch.
Wampfler, Beat
  • Nationales Pferdezentrum Bern, Mingerstrasse 3, CH-3000, Berne, Switzerland. beat.wampfler@bluewin.ch.
Thormann, Wolfgang
  • Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Berne, Murtenstrasse 35, CH-3010, Bern, Switzerland. wolfgang.thormann@ifik.unibe.ch.
Levionnois, Olivier L
  • Anesthesiology and Pain Therapy Division, Department of Veterinary Clinical Science of the Vetsuisse Faculty of Berne, Länggassstrasse 124, CH-3012, Berne, Switzerland. olivier.levionnois@vetsuisse.unibe.ch.

MeSH Terms

  • Anesthesia, General / veterinary
  • Anesthesia, Intravenous / veterinary
  • Anesthetics, Intravenous / administration & dosage
  • Anesthetics, Intravenous / pharmacokinetics
  • Animals
  • Horses / metabolism
  • Horses / surgery
  • Ketamine / administration & dosage
  • Ketamine / pharmacokinetics
  • Male
  • Orchiectomy / veterinary
  • Prospective Studies

References

This article includes 38 references
  1. Muir WW, Hubbel JAE. History of Equine Anaesthesia. In: Muir WW, Hubbel JAE, editors. Equine Anesthesia: Monitoring and Emergency Therapy. 2. St. Louis: Saunders Elsevier; 2009. pp. 1–10.
  2. Engelhardt W. [Recovery and psychomimetic reactions following S-(+)-ketamine].. Anaesthesist 1997 Mar;46 Suppl 1:S38-42.
    doi: 10.1007/PL00002463pubmed: 9163277google scholar: lookup
  3. White PF, Way WL, Trevor AJ. Ketamine--its pharmacology and therapeutic uses.. Anesthesiology 1982 Feb;56(2):119-36.
    doi: 10.1097/00000542-198202000-00007pubmed: 6892475google scholar: lookup
  4. Ihmsen H, Geisslinger G, Schüttler J. Stereoselective pharmacokinetics of ketamine: R(-)-ketamine inhibits the elimination of S(+)-ketamine.. Clin Pharmacol Ther 2001 Nov;70(5):431-8.
    doi: 10.1067/mcp.2001.119722pubmed: 11719729google scholar: lookup
  5. Deleforge J, Davot JL, Boisrame B, Delatour P. Enantioselectivity in the anaesthetic effect of ketamine in dogs.. J Vet Pharmacol Ther 1991 Dec;14(4):418-20.
    doi: 10.1111/j.1365-2885.1991.tb00856.xpubmed: 1774818google scholar: lookup
  6. Larenza MP, Knobloch M, Landoni MF, Levionnois OL, Kronen PW, Theurillat R, Schatzmann U, Thormann W. Stereoselective pharmacokinetics of ketamine and norketamine after racemic ketamine or S-ketamine administration in Shetland ponies sedated with xylazine.. Vet J 2008 Sep;177(3):432-5.
    doi: 10.1016/j.tvjl.2007.05.005pubmed: 17604192google scholar: lookup
  7. Larenza MP, Landoni MF, Levionnois OL, Knobloch M, Kronen PW, Theurillat R, Schatzmann U, Thormann W. Stereoselective pharmacokinetics of ketamine and norketamine after racemic ketamine or S-ketamine administration during isoflurane anaesthesia in Shetland ponies.. Br J Anaesth 2007 Feb;98(2):204-12.
    doi: 10.1093/bja/ael336pubmed: 17218377google scholar: lookup
  8. Engelhardt W, Stahl K, Marouche A, Hartung E. [Recovery time after (S)-ketamine or ketamine racemate. Recovery time after short anesthesia in volunteers].. Anaesthesist 1998 Mar;47(3):184-92.
    doi: 10.1007/s001010050546pubmed: 9567151google scholar: lookup
  9. Larenza MP, Althaus H, Conrot A, Balmer C, Schatzmann U, Bettschart-Wolfensberger R. Anaesthesia recovery quality after racemic ketamine or S-ketamine administration to male cats undergoing neutering surgery.. Schweiz Arch Tierheilkd 2008 Dec;150(12):599-607.
    doi: 10.1024/0036-7281.150.12.599pubmed: 19034844google scholar: lookup
  10. Marietta MP, WAY WL, Castagnoli N Jr, Trevor AJ. On the pharmacology of the ketamine enantiomorphs in the rat.. J Pharmacol Exp Ther 1977 Jul;202(1):157-65.
    pubmed: 874812
  11. Ryder S, Way WL, Trevor AJ. Comparative pharmacology of the optical isomers of ketamine in mice.. Eur J Pharmacol 1978 May 1;49(1):15-23.
    doi: 10.1016/0014-2999(78)90217-0pubmed: 658124google scholar: lookup
  12. White PF, Ham J, Way WL, Trevor AJ. Pharmacology of ketamine isomers in surgical patients.. Anesthesiology 1980 Mar;52(3):231-9.
    doi: 10.1097/00000542-198003000-00008pubmed: 6989292google scholar: lookup
  13. Duque JC, Oleskovicz N, Guirro EC, Valadão CA, Soares VE. Relative potency of ketamine and S(+)-ketamine in dogs.. J Vet Pharmacol Ther 2008 Aug;31(4):344-8.
    doi: 10.1111/j.1365-2885.2008.00965.xpubmed: 18638295google scholar: lookup
  14. Casoni D, Spadavecchia C, Adami C. S-ketamine versus racemic ketamine in dogs: their relative potency as induction agents.. Vet Anaesth Analg 2015 May;42(3):250-9.
    doi: 10.1111/vaa.12200pubmed: 25041216google scholar: lookup
  15. Rossetti RB, Gaido Cortopassi SR, Intelizano T, de Lima Machado TS, Ferreira da Cruz RS. Comparison of ketamine and S(+)-ketamine, with romifidine and diazepam, for total intravenous anesthesia in horses.. Vet Anaesth Analg 2008 Jan;35(1):30-7.
    pubmed: 17565569doi: 10.1111/j.1467-2995.2007.00351.xgoogle scholar: lookup
  16. Carroll CL, Huntington PJ. Body condition scoring and weight estimation of horses.. Equine Vet J 1988 Jan;20(1):41-5.
    doi: 10.1111/j.2042-3306.1988.tb01451.xpubmed: 3366105google scholar: lookup
  17. Theurillat R, Knobloch M, Levionnois O, Larenza P, Mevissen M, Thormann W. Characterization of the stereoselective biotransformation of ketamine to norketamine via determination of their enantiomers in equine plasma by capillary electrophoresis.. Electrophoresis 2005 Oct;26(20):3942-51.
    doi: 10.1002/elps.200500059pubmed: 16167314google scholar: lookup
  18. Theurillat R, Knobloch M, Schmitz A, Lassahn PG, Mevissen M, Thormann W. Enantioselective analysis of ketamine and its metabolites in equine plasma and urine by CE with multiple isomer sulfated beta-CD.. Electrophoresis 2007 Aug;28(15):2748-57.
    doi: 10.1002/elps.200600820pubmed: 17600844google scholar: lookup
  19. Bergadano A, Andersen OK, Arendt-Nielsen L, Theurillat R, Thormann W, Spadavecchia C. Plasma levels of a low-dose constant-rate-infusion of ketamine and its effect on single and repeated nociceptive stimuli in conscious dogs.. Vet J 2009 Nov;182(2):252-60.
    doi: 10.1016/j.tvjl.2008.06.003pubmed: 18706837google scholar: lookup
  20. Kerr CL, McDonell WN, Young SS. A comparison of romifidine and xylazine when used with diazepam/ketamine for short duration anesthesia in the horse.. Can Vet J 1996 Oct;37(10):601-9.
    pmc: PMC1576482pubmed: 8896874
  21. Klöppel H, Leece EA. Comparison of ketamine and alfaxalone for induction and maintenance of anaesthesia in ponies undergoing castration.. Vet Anaesth Analg 2011 Jan;38(1):37-43.
    doi: 10.1111/j.1467-2995.2010.00584.xpubmed: 21214708google scholar: lookup
  22. Geisslinger G, Hering W, Thomann P, Knoll R, Kamp HD, Brune K. Pharmacokinetics and pharmacodynamics of ketamine enantiomers in surgical patients using a stereoselective analytical method.. Br J Anaesth 1993 Jun;70(6):666-71.
    doi: 10.1093/bja/70.6.666pubmed: 8329260google scholar: lookup
  23. White M, de Graaff P, Renshof B, van Kan E, Dzoljic M. Pharmacokinetics of S(+) ketamine derived from target controlled infusion.. Br J Anaesth 2006 Mar;96(3):330-4.
    doi: 10.1093/bja/aei316pubmed: 16415315google scholar: lookup
  24. Herd DW, Anderson BJ, Holford NH. Modeling the norketamine metabolite in children and the implications for analgesia.. Paediatr Anaesth 2007 Sep;17(9):831-40.
    doi: 10.1111/j.1460-9592.2007.02257.xpubmed: 17683400google scholar: lookup
  25. Kaka JS, Klavano PA, Hayton WL. Pharmacokinetics of ketamine in the horse.. Am J Vet Res 1979 Jul;40(7):978-81.
    pubmed: 507501
  26. Waterman AE, Robertson SA, Lane JG. Pharmacokinetics of intravenously administered ketamine in the horse.. Res Vet Sci 1987 Mar;42(2):162-6.
    pubmed: 3589163
  27. Nolan A, Reid J, Welsh E, Flaherty D, McCormack R, Monteiro AM. Simultaneous infusions of propofol and ketamine in ponies premedicated with detomidine: a pharmacokinetic study.. Res Vet Sci 1996 May;60(3):262-6.
    doi: 10.1016/S0034-5288(96)90051-Xpubmed: 8735519google scholar: lookup
  28. Lankveld DP, Driessen B, Soma LR, Moate PJ, Rudy J, Uboh CE, van Dijk P, Hellebrekers LJ. Pharmacodynamic effects and pharmacokinetic profile of a long-term continuous rate infusion of racemic ketamine in healthy conscious horses.. J Vet Pharmacol Ther 2006 Dec;29(6):477-88.
    doi: 10.1111/j.1365-2885.2006.00794.xpubmed: 17083451google scholar: lookup
  29. Zhao X, Venkata SL, Moaddel R, Luckenbaugh DA, Brutsche NE, Ibrahim L, Zarate CA Jr, Mager DE, Wainer IW. Simultaneous population pharmacokinetic modelling of ketamine and three major metabolites in patients with treatment-resistant bipolar depression.. Br J Clin Pharmacol 2012 Aug;74(2):304-14.
    doi: 10.1111/j.1365-2125.2012.04198.xpmc: PMC3630750pubmed: 22295895google scholar: lookup
  30. Sams R, Pizzo P. Detection and identification of ketamine and its metabolites in horse urine.. J Anal Toxicol 1987 Mar-Apr;11(2):58-62.
    doi: 10.1093/jat/11.2.58pubmed: 3573725google scholar: lookup
  31. Larenza MP, Peterbauer C, Landoni MF, Levionnois OL, Schatzmann U, Spadavecchia C, Thormann W. Stereoselective pharmacokinetics of ketamine and norketamine after constant rate infusion of a subanesthetic dose of racemic ketamine or S-ketamine in Shetland ponies.. Am J Vet Res 2009 Jul;70(7):831-9.
    doi: 10.2460/ajvr.70.7.831pubmed: 19566468google scholar: lookup
  32. Marntell S, Nyman G, Funkquist P. Dissociative anaesthesia during field and hospital conditions for castration of colts.. Acta Vet Scand 2006;47(1):1-11.
    doi: 10.1186/1751-0147-47-1pmc: PMC1618963pubmed: 16722301google scholar: lookup
  33. Wojtasiak-Wypart M, Soma LR, Rudy JA, Uboh CE, Boston RC, Driessen B. Pharmacokinetic profile and pharmacodynamic effects of romifidine hydrochloride in the horse.. J Vet Pharmacol Ther 2012 Oct;35(5):478-88.
    doi: 10.1111/j.1365-2885.2011.01347.xpubmed: 22233529google scholar: lookup
  34. Muir WW, Skarda RT, Sheehan WC. Hemodynamic and respiratory effects of xylazine-morphine sulfate in horses.. Am J Vet Res 1979 Oct;40(10):1417-20.
    pubmed: 525863
  35. Brunson DB, Majors LJ. Comparative analgesia of xylazine, xylazine/morphine, xylazine/butorphanol, and xylazine/nalbuphine in the horse, using dental dolorimetry.. Am J Vet Res 1987 Jul;48(7):1087-91.
    pubmed: 3631691
  36. Clarke KW, Paton BS. Combined use of detomidine with opiates in the horse.. Equine Vet J 1988 Sep;20(5):331-4.
    doi: 10.1111/j.2042-3306.1988.tb01540.xpubmed: 3181117google scholar: lookup
  37. Schatzman U, Armbruster S, Stucki F, Busato A, Kohler I. Analgesic effect of butorphanol and levomethadone in detomidine sedated horses.. J Vet Med A Physiol Pathol Clin Med 2001 Aug;48(6):337-42.
    doi: 10.1046/j.1439-0442.2001.00366.xpubmed: 11554491google scholar: lookup
  38. Corletto F, Raisis AA, Brearley JC. Comparison of morphine and butorphanol as pre-anaesthetic agents in combination with romifidine for field castration in ponies.. Vet Anaesth Analg 2005 Jan;32(1):16-22.
    doi: 10.1111/j.1467-2995.2004.00184.xpubmed: 15663735google scholar: lookup

Citations

This article has been cited 7 times.
  1. Chen J, Zou X, Hu B, Yang Y, Wang F, Zhou Q, Shen M. Effect of different doses of esketamine compared with fentanyl combined with propofol on hypotension in patients undergoing painless abortion surgery: a prospective, randomized, double-blind controlled clinical trial. BMC Anesthesiol 2022 Sep 28;22(1):305.
    doi: 10.1186/s12871-022-01848-6pubmed: 36171562google scholar: lookup
  2. Wise IK, Klöppel H, Leece EA. Comparison of two doses of ketamine for induction of anaesthesia in ponies undergoing field castration. Open Vet J 2021 Oct-Dec;11(4):747-754.
    doi: 10.5455/OVJ.2021.v11.i4.27pubmed: 35070872google scholar: lookup
  3. Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
    doi: 10.3390/ani11061777pubmed: 34198637google scholar: lookup
  4. Liao YQ, Ma J, He Y, Su YW, Xu MZ, Zhang MQ. Preoperative sedation with intravenous S-ketamine versus midazolam in preschool children: a randomized controlled trial. BMC Anesthesiol 2025 Nov 21;25(1):582.
    doi: 10.1186/s12871-025-03454-8pubmed: 41272466google scholar: lookup
  5. Liu Y, Gong Z, Zhang L, Yang X, Zhu J, Zhou X, Liao X. Esketamine attenuates traumatic brain injury by modulating STAT3-mediated Glycolysis and immune responses. BMC Neurosci 2025 Mar 7;26(1):21.
    doi: 10.1186/s12868-025-00941-zpubmed: 40055623google scholar: lookup
  6. Helal IE, Al-Abbadi HA, Hashem MA, Abdelrazek HMA, Shekidef MH, Ahmed MF. Analgesic Effect of Dexmedetomidine-Nalbuphine Combination vs. Dexmedetomidine Alone in Donkeys Undergoing Field Castration under Total Intravenous Anesthesia. Animals (Basel) 2024 Aug 23;14(17).
    doi: 10.3390/ani14172452pubmed: 39272237google scholar: lookup
  7. Si J, Li X, Wang Y, Feng N, Cui M. Effects of adding low-dose esketamine to sufentanil and propofol sedation during cervical conization: a single-centre, randomized controlled trial. BMC Anesthesiol 2024 Jan 4;24(1):15.
    doi: 10.1186/s12871-023-02389-2pubmed: 38178016google scholar: lookup
Subscribe to our newsletter
Join 99,658 horse owners like you who receive our email updates on horse health and nutrition.