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Home / Equine Research Bank / Vet Anaesth Analg / Clinical evaluation of ketamine and lidocaine intravenous in...
Veterinary anaesthesia and analgesia2009; 35(4); 297-305; doi: 10.1111/j.1467-2995.2007.00391.x

Clinical evaluation of ketamine and lidocaine intravenous infusions to reduce isoflurane requirements in horses under general anaesthesia.

Abstract: To compare isoflurane alone or in combination with systemic ketamine and lidocaine for general anaesthesia in horses. Methods: Prospective, randomized, blinded clinical trial. Methods: Forty horses (ASA I-III) undergoing elective surgery. Methods: Horses were assigned to receive isoflurane anaesthesia alone (ISO) or with ketamine and lidocaine (LKI). After receiving romifidine, diazepam, and ketamine, the isoflurane end-tidal concentration was set at 1.3% and subsequently adjusted by the anaesthetist (unaware of treatments) to maintain a light plane of surgical anaesthesia. Animals in the LKI group received lidocaine (1.5 mg kg(-1) over 10 minutes, followed by 40 microg kg(-1) minute(-1)) and ketamine (60 microg kg(-1) minute(-1)), both reduced to 65% of the initial dose after 50 minutes, and stopped 15 minutes before the end of anaesthesia. Standard clinical cardiovascular and respiratory parameters were monitored. Recovery quality was scored from one (very good) to five (very poor). Differences between ISO and LKI groups were analysed with a two-sample t-test for parametric data or a Fischer's exact test for proportions (p < 0.05 for significance). Results are mean +/- SD. Results: Heart rate was lower (p = 0.001) for LKI (29 +/- 4) than for ISO (34 +/- 6). End-tidal concentrations of isoflurane (ISO: 1.57% +/- 0.22; LKI: 0.97% +/- 0.33), the number of horses requiring thiopental (ISO: 10; LKI: 2) or dobutamine (ISO:8; LKI:3), and dobutamine infusion rates (ISO:0.26 +/- 0.09; LKI:0.18 +/- 0.06 microg kg(-1) minute(-1)) were significantly lower in LKI compared to the ISO group (p < 0.001). No other significant differences were found, including recovery scores. Conclusions: These results support the use of lidocaine and ketamine to improve anaesthetic and cardiovascular stability during isoflurane anaesthesia lasting up to 2 hours in mechanically ventilated horses, with comparable quality of recovery.
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Publication Date: 2009-06-16 PubMed ID: 19522888DOI: 10.1111/j.1467-2995.2007.00391.xGoogle Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial

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 research article describes a clinical trial assessing whether the systemic use of ketamine and lidocaine in combination with isoflurane can reduce the need for isoflurane during general anaesthesia in horses, thus possibly improving their cardiovascular stability.

Methodology

  • The study was a prospective, randomized, blinded clinical trial involving 40 horses of varying health conditions (as per ASA physical status classification I-III) undergoing elective surgery.
  • The horses were put into one of two groups. One received isoflurane anaesthesia alone (ISO), while the other received isoflurane anaesthesia alongside ketamine and lidocaine (LKI).
  • Prior to anaesthesia, each horse was given romifidine, diazepam, and ketamine. The concentration of isoflurane – a type of gas anaesthetic – was then set at 1.3% and adjusted by the anaesthetist (who had no knowledge of the treatments) to maintain a light plane of surgical anaesthesia.
  • The horses in the LKI group were administered lidocaine and ketamine which were reduced to 65% of the initial dose after 50 minutes and stopped 15 minutes before the end of anaesthesia.
  • Standard vital signs like heart rate, blood pressure, and respiratory rate were monitored for the horses and the quality of recovery was also assessed, with one being a very good recovery and five being a very poor one.

Results

  • This study shows that heart rate and end-tidal concentrations of isoflurane were significantly lower in the LKI group compared to the ISO group.
  • Furthermore, the number of horses requiring additional anaesthetics, namely thiopental and dobutamine, was lower in the LKI group than in the ISO group. This suggests that the LKI group might have had better anaesthetic and cardiovascular stability.
  • However, the study did not find any significant differences in other measurements, such as recovery scores, between the two groups.

Conclusion

  • Based on the results, the researchers concluded that the combined use of ketamine and lidocaine with isoflurane improved anaesthetic and cardiovascular stability in horses during anaesthesia, with comparable quality of recovery to isoflurane alone.
  • These findings suggest that this combination, if used appropriately, could be a better option when conducting a general anaesthesia in horses.

Cite This Article

APA
Enderle AK, Levionnois OL, Kuhn M, Schatzmann U. (2009). Clinical evaluation of ketamine and lidocaine intravenous infusions to reduce isoflurane requirements in horses under general anaesthesia. Vet Anaesth Analg, 35(4), 297-305. https://doi.org/10.1111/j.1467-2995.2007.00391.x

Publication

Veterinary anaesthesia and analgesia
ISSN: 1467-2995
NlmUniqueID: 100956422
Country: United States
Language: English
Volume: 35
Issue: 4
Pages: 297-305

Researcher Affiliations

Enderle, Alke K
  • Wahlstedt Private Equine Veterinary Clinic, Wahlstedt, Germany.
Levionnois, Olivier L
    Kuhn, Matthias
      Schatzmann, Urs

        MeSH Terms

        • Anesthesia Recovery Period
        • Anesthesia, General / veterinary
        • Anesthetics, Dissociative
        • Anesthetics, Inhalation / administration & dosage
        • Anesthetics, Inhalation / pharmacokinetics
        • Anesthetics, Local / administration & dosage
        • Anesthetics, Local / pharmacology
        • Animals
        • Female
        • Heart Rate / drug effects
        • Heart Rate / physiology
        • Horses / physiology
        • Infusions, Intravenous / veterinary
        • Isoflurane / administration & dosage
        • Isoflurane / pharmacokinetics
        • Ketamine / administration & dosage
        • Ketamine / pharmacology
        • Lidocaine / administration & dosage
        • Lidocaine / pharmacology
        • Male
        • Prospective Studies
        • Random Allocation

        Citations

        This article has been cited 9 times.
        1. Dmitrović P, Vanaga J, Dupont J, Franck T, Gougnard A, Detilleux J, Kovalcuka L, Salciccia A, Serteyn D, Sandersen C. Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses.. Animals (Basel) 2021 Oct 9;11(10).
          doi: 10.3390/ani11102922pubmed: 34679943google scholar: lookup
        2. 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
        3. Fang H, Li HF, Yang M, Zhang FX, Liao R, Wang RR, Wang QY, Zheng PC, Zhang JP. Effect of ketamine combined with lidocaine in pediatric anesthesia.. J Clin Lab Anal 2020 Apr;34(4):e23115.
          doi: 10.1002/jcla.23115pubmed: 31733006google scholar: lookup
        4. Kropf J, Hughes JML. Effects of midazolam on cardiovascular responses and isoflurane requirement during elective ovariohysterectomy in dogs.. Ir Vet J 2018;71:26.
          doi: 10.1186/s13620-018-0136-ypubmed: 30568789google scholar: lookup
        5. Dholakia U, Clark-Price SC, Keating SCJ, Stern AW. Anesthetic effects and body weight changes associated with ketamine-xylazine-lidocaine administered to CD-1 mice.. PLoS One 2017;12(9):e0184911.
          doi: 10.1371/journal.pone.0184911pubmed: 28910423google scholar: lookup
        6. Re M, Canfrán S, Largo C, Gómez de Segura IA. Effect of Lidocaine-Ketamine Infusions Combined with Morphine or Fentanyl in Sevoflurane-Anesthetized Pigs.. J Am Assoc Lab Anim Sci 2016;55(3):317-20.
          pubmed: 27177566
        7. Queiroz-Williams P, Doherty TJ, da Cunha AF, Leonardi C. Effects of ketamine and lidocaine in combination on the sevoflurane minimum alveolar concentration in alpacas.. Can J Vet Res 2016 Apr;80(2):141-5.
          pubmed: 27127341
        8. Sharp PS, Shaw K, Boorman L, Harris S, Kennerley AJ, Azzouz M, Berwick J. Comparison of stimulus-evoked cerebral hemodynamics in the awake mouse and under a novel anesthetic regime.. Sci Rep 2015 Jul 28;5:12621.
          doi: 10.1038/srep12621pubmed: 26218081google scholar: lookup
        9. Cesarovic N, Jirkof P, Rettich A, Nicholls F, Arras M. Combining sevoflurane anesthesia with fentanyl-midazolam or s-ketamine in laboratory mice.. J Am Assoc Lab Anim Sci 2012 Mar;51(2):209-18.
          pubmed: 22776121
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