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Home / Equine Research Bank / Animals (Basel) / Comparison of Recovery Quality Following Medetomidine versus...
Animals : an open access journal from MDPI2021; 11(8); 2440; doi: 10.3390/ani11082440

Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis.

Abstract: Medetomidine partial intravenous anaesthesia (PIVA) has not been compared to xylazine PIVA regarding quality of recovery. This clinical retrospective study compared recoveries following isoflurane anaesthesia balanced with medetomidine or xylazine. The following standard protocol was used: sedation with 7 µg·kg medetomidine or 1.1 mg·kg xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg·h medetomidine or 0.7 mg·kg·h xylazine, and sedation after anaesthesia with 2 µg·kg medetomidine or 0.3 mg·kg xylazine. Recovery was timed and, using video recordings, numerically scored by two blinded observers. Influence of demographics, procedure, peri-anaesthetic drugs, and intraoperative complications (hypotension, hypoxemia, and tachycardia) on recovery were analysed using regression analysis ( < 0.05). A total of 470 recoveries (medetomidine 279, xylazine 191) were finally included. Following medetomidine, recoveries were significantly longer (median (interquartile range): 57 (43-71) min) than xylazine (43 (32-59) min) ( < 0.001). However, the number of attempts to stand was similar (medetomidine and xylazine: 2 (1-3)). Poorer scores were seen with increased pre-anaesthetic dose of xylazine, intraoperative tetrastarch, or salbutamol. However, use of medetomidine or xylazine did not influence recovery score, concluding that, following medetomidine-isoflurane PIVA, recovery is longer, but of similar quality compared to xylazine.
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Publication Date: 2021-08-19 PubMed ID: 34438896PubMed Central: PMC8388745DOI: 10.3390/ani11082440Google Scholar: Lookup
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  • Journal Article

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.

This retrospective study evaluated how recovery from anaesthesia in horses varied between two anaesthetics, medetomidine and xylazine. Results indicated that while recovery took longer with medetomidine, the overall quality of recovery was similar for both drugs.

Objective of the Study

  • This study aimed to compare the quality of recovery of horses after being anaesthetized with either medetomidine or xylazine. The researchers employed retrospective analysis, which involves using past data and observations to conduct the investigation.

Methodology

  • The standardized protocol employed in the study included pre-anaesthesia sedation with either of the two drugs being tested, induction of anaesthesia with ketamine/diazepam, maintenance with isoflurane and either medetomidine or xylazine, and post-anaesthesia sedation with the subject drugs.
  • Recovery was timed, and the horses’ recovery efforts were recorded on video then numerically scored by observers unaware of the anaesthetic used. This scoring system aimed to create a truly quantitative data pool for the researchers to assess.
  • The study also analysed factors such as the subject’s demographics, the surgical procedure, the use of other drugs during anaesthesia, and the incidence of complications such as hypotension, hypoxemia, and tachycardia.

Findings

  • The study included 470 recoveries (279 with medetomidine, and 191 with xylazine). The recoveries with medetomidine took significantly longer than those with xylazine. The median recovery time was 57 minutes (with a range of 43-71 minutes) for medetomidine, compared to 43 minutes (range 32-59 minutes) for xylazine.
  • Contrary to the time it took for the horses to recover, the number of attempts they made to stand after anaesthesia was similar for both drugs (2 attempts on average).
  • The researchers observed poorer recovery scores with a higher pre-anaesthetic dose of xylazine and the intraoperative use of tetrastarch (a starch-based blood plasma substitute) or salbutamol (a drug commonly used to treat asthma and other respiratory illnesses).
  • Nevertheless, despite the lengthened recovery time with medetomidine, there was no significant effect of either drug on the quality of recovery, as judged by the recovery scores.

Conclusion

  • The study concluded that even though recoveries after medetomidine are longer, the recovery quality is equivalent to that of xylazine. These findings are beneficial for both veterinary practitioners and horse owners in understanding the effects of different anaesthetics and their impacts on recovery.

Cite This Article

APA
Kälin I, Henze IS, Ringer SK, Torgerson PR, Bettschart-Wolfensberger R. (2021). Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis. Animals (Basel), 11(8), 2440. https://doi.org/10.3390/ani11082440

Publication

Animals : an open access journal from MDPI
ISSN: 2076-2615
NlmUniqueID: 101635614
Country: Switzerland
Language: English
Volume: 11
Issue: 8
PII: 2440

Researcher Affiliations

Kälin, Isabel
  • Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Henze, Inken S
  • Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Ringer, Simone K
  • Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Torgerson, Paul R
  • Section of Epidemiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.
Bettschart-Wolfensberger, Regula
  • Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland.

Conflict of Interest Statement

The authors declare no conflict of interest.

References

This article includes 45 references
  1. Dugdale AH, Taylor PM. Equine anaesthesia-associated mortality: where are we now?. Vet Anaesth Analg 2016 May;43(3):242-55.
    doi: 10.1111/vaa.12372pubmed: 26970940google scholar: lookup
  2. Johnston GM, Eastment JK, Wood J, Taylor PM. The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.. Vet Anaesth Analg 2002 Oct;29(4):159-170.
    doi: 10.1046/j.1467-2995.2002.00106.xpubmed: 28404360google scholar: lookup
  3. Clark-Price SC. Recovery of horses from anesthesia.. Vet Clin North Am Equine Pract 2013 Apr;29(1):223-42.
    doi: 10.1016/j.cveq.2012.11.001pubmed: 23498055google scholar: lookup
  4. Taylor PM, Clarke KW. Inhalation Anaesthesia. Handbook of Equine Anaesthesia Elsevier; London, UK: 2007; pp. 55–85.
  5. Goetz TE, Manohar M, Nganwa D, Gustafson R. A study of the effect of isoflurane anaesthesia on equine skeletal muscle perfusion.. Equine Vet J Suppl 1989 Jun;(7):133-7.
    doi: 10.1111/j.2042-3306.1989.tb05673.xpubmed: 9118096google scholar: lookup
  6. Manohar M, Gustafson R, Goetz TE, Nganwa D. Systemic distribution of blood flow in ponies during 1.45%, 1.96%, and 2.39% end-tidal isoflurane-O2 anesthesia.. Am J Vet Res 1987 Oct;48(10):1504-10.
    pubmed: 3674561
  7. Duke T, Filzek U, Read MR, Read EK, Ferguson JG. Clinical observations surrounding an increased incidence of postanesthetic myopathy in halothane-anesthetized horses.. Vet Anaesth Analg 2006 Mar;33(2):122-7.
    doi: 10.1111/j.1467-2995.2005.00189.xpubmed: 16476002google scholar: lookup
  8. Gozalo-Marcilla M, Gasthuys F, Schauvliege S. Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 1: lidocaine and ketamine.. Vet Anaesth Analg 2014 Jul;41(4):335-45.
    doi: 10.1111/vaa.12179pubmed: 24815750google scholar: lookup
  9. Gozalo-Marcilla M, Gasthuys F, Schauvliege S. 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.. Vet Anaesth Analg 2015 Jan;42(1):1-16.
    doi: 10.1111/vaa.12196pubmed: 24984895google scholar: lookup
  10. Pöppel N, Hopster K, Geburek F, Kästner S. Influence of ketamine or xylazine supplementation on isoflurane anaesthetized horses--a controlled clinical trial.. Vet Anaesth Analg 2015 Jan;42(1):30-8.
    doi: 10.1111/vaa.12176pubmed: 24815552google scholar: lookup
  11. Kalchofner KS, Picek S, Ringer SK, Jackson M, Hässig M, Bettschart-Wolfensberger R. A study of cardiovascular function under controlled and spontaneous ventilation in isoflurane-medetomidine anaesthetized horses.. Vet Anaesth Analg 2009 Sep;36(5):426-35.
    doi: 10.1111/j.1467-2995.2009.00477.xpubmed: 19709046google scholar: lookup
  12. Devisscher L, Schauvliege S, Dewulf J, Gasthuys F. Romifidine as a constant rate infusion in isoflurane anaesthetized horses: a clinical study.. Vet Anaesth Analg 2010 Sep;37(5):425-33.
    doi: 10.1111/j.1467-2995.2010.00556.xpubmed: 20712609google scholar: lookup
  13. Schauvliege S, Marcilla MG, Verryken K, Duchateau L, Devisscher L, Gasthuys F. Effects of a constant rate infusion of detomidine on cardiovascular function, isoflurane requirements and recovery quality in horses.. Vet Anaesth Analg 2011 Nov;38(6):544-54.
    doi: 10.1111/j.1467-2995.2011.00659.xpubmed: 21988809google scholar: lookup
  14. Sacks M, Ringer SK, Bischofberger AS, Berchtold SM, Bettschart-Wolfensberger R. Clinical comparison of dexmedetomidine and medetomidine for isoflurane balanced anaesthesia in horses.. Vet Anaesth Analg 2017 Sep;44(5):1128-1138.
    doi: 10.1016/j.vaa.2016.12.061pubmed: 29037800google scholar: lookup
  15. Yamashita K, Tsubakishita S, Futaok S, Ueda I, Hamaguchi H, Seno T, Katoh S, Izumisawa Y, Kotani T, Muir WW. Cardiovascular effects of medetomidine, detomidine and xylazine in horses.. J Vet Med Sci 2000 Oct;62(10):1025-32.
    doi: 10.1292/jvms.62.1025pubmed: 11073071google scholar: lookup
  16. Bettschart-Wolfensberger R, Bettschart RW, Vainio O, Marlin D, Clarke KW. Cardiopulmonary Effects of a Two Hour Medetomidine Infusion and Its Antagonism by Atipamezole in Horses and Ponies. Vet. Anaesth. Analg. 1999;26:8–12.
    doi: 10.1111/j.1467-2995.1999.tb00176.xgoogle scholar: lookup
  17. Ringer SK, Schwarzwald CC, Portier KG, Ritter A, Bettschart-Wolfensberger R. Effects on cardiopulmonary function and oxygen delivery of doses of romifidine and xylazine followed by constant rate infusions in standing horses.. Vet J 2013 Feb;195(2):228-34.
    doi: 10.1016/j.tvjl.2012.06.036pubmed: 22841452google scholar: lookup
  18. Wiederkehr A, Barbarossa A, Ringer SK, Jörger FB, Bryner M, Bettschart-Wolfensberger R. Clinical Randomized Comparison of Medetomidine and Xylazine for Isoflurane Balanced Anesthesia in Horses.. Front Vet Sci 2021;8:603695.
    doi: 10.3389/fvets.2021.603695pmc: PMC8093396pubmed: 33959647google scholar: lookup
  19. Landis JR, Koch GG. The measurement of observer agreement for categorical data.. Biometrics 1977 Mar;33(1):159-74.
    doi: 10.2307/2529310pubmed: 843571google scholar: lookup
  20. de Miguel Garcia C, Campoy L, Parry S, Miller JE, Martin-Flores M, Gleed RD. Questionnaire on the process of recovering horses from general anesthesia and associated personnel injury in equine practice.. Vet Anaesth Analg 2021 Mar;48(2):223-229.
    doi: 10.1016/j.vaa.2020.12.005pubmed: 33536139google scholar: lookup
  21. Voulgaris DA, Hofmeister EH. Multivariate analysis of factors associated with post-anesthetic times to standing in isoflurane-anesthetized horses: 381 cases.. Vet Anaesth Analg 2009 Sep;36(5):414-20.
    doi: 10.1111/j.1467-2995.2009.00472.xpubmed: 19558369google scholar: lookup
  22. Young SS, Taylor PM. Factors influencing the outcome of equine anaesthesia: a review of 1,314 cases.. Equine Vet J 1993 Mar;25(2):147-51.
    doi: 10.1111/j.2042-3306.1993.tb02926.xpubmed: 8467775google scholar: lookup
  23. Bird AR, Morley SJ, Sherlock CE, Mair TS. The Outcomes of Epidural Anaesthesia in Horses with Perineal and Tail Melanomas: Complications Associated with Ataxia and the Risks of Rope Recovery. Equine Vet. Educ. 2019;31:567–574.
    doi: 10.1111/eve.12911google scholar: lookup
  24. Auckburally A, Flaherty D. Recovery from Anaesthesia in Horses: 1. What Can Go Wrong?. Practice 2009;31:340–347.
    doi: 10.1136/inpract.31.7.340google scholar: lookup
  25. Rüegg M, Bettschart-Wolfensberger R, Hartnack S, Junge HK, Theiss F, Ringer SK. Comparison of Non-Assisted versus Head and Tail Rope-Assisted Recovery after Emergency Abdominal Surgery in Horses. Pferdeheilkunde 2016;32:469–478.
    doi: 10.21836/PEM20160508google scholar: lookup
  26. Hubbell JAE, Muir WW. Considerations for Induction, Maintenance, and Recovery. Equine Anesthesia 2nd ed. W.B. Saunders; Saint Louis, MO, USA: 2009; pp. 381–396.
  27. Platt JP, Simon BT, Coleman M, Martinez EA, Lepiz MA, Watts AE. The effects of multiple anaesthetic episodes on equine recovery quality.. Equine Vet J 2018 Jan;50(1):111-116.
    doi: 10.1111/evj.12728pubmed: 28772349google scholar: lookup
  28. Valverde A, Black B, Cribb NC, Hathway A, Daw A. Assessment of unassisted recovery from repeated general isoflurane anesthesia in horses following post-anesthetic administration of xylazine or acepromazine or a combination of xylazine and ketamine.. Vet Anaesth Analg 2013 Jan;40(1):3-12.
    doi: 10.1111/j.1467-2995.2012.00782.xpubmed: 23016627google scholar: lookup
  29. Parviainen AK, Trim CM. Complications associated with anaesthesia for ocular surgery: a retrospective study 1989-1996.. Equine Vet J 2000 Nov;32(6):555-9.
    doi: 10.2746/042516400777584659pubmed: 11093632google scholar: lookup
  30. Krein SR, Lindsey JC, Blaze CA, Wetmore LA. Evaluation of risk factors, including fluconazole administration, for prolonged anesthetic recovery times in horses undergoing general anesthesia for ocular surgery: 81 cases (2006-2013).. J Am Vet Med Assoc 2014 Mar 1;244(5):577-81.
    doi: 10.2460/javma.244.5.577pubmed: 24548232google scholar: lookup
  31. Trim CM, Adams JG, Cowgill LM, Ward SL. A retrospective survey of anaesthesia in horses with colic.. Equine Vet J Suppl 1989 Jun;(7):84-90.
    doi: 10.1111/j.2042-3306.1989.tb05663.xpubmed: 9118115google scholar: lookup
  32. McCoy AM, Hackett ES, Wagner AE, Mama KR, Hendrickson DA. Pulmonary gas exchange and plasma lactate in horses with gastrointestinal disease undergoing emergency exploratory laparotomy: a comparison with an elective surgery horse population.. Vet Surg 2011 Jul;40(5):601-9.
    doi: 10.1111/j.1532-950X.2011.00840.xpubmed: 21539581google scholar: lookup
  33. Dupont J, Serteyn D, Sandersen C. Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse.. Front Vet Sci 2018;5:235.
    doi: 10.3389/fvets.2018.00235pmc: PMC6174201pubmed: 30327770google scholar: lookup
  34. McMurphy RM, Cribb PH. Alleviation of postanesthetic hypoxemia in the horse.. Can Vet J 1989 Jan;30(1):37-41.
    pmc: PMC1680984pubmed: 17423205
  35. Hubbell JA, Muir WW. Oxygenation, oxygen delivery and anaesthesia in the horse.. Equine Vet J 2015 Jan;47(1):25-35.
    doi: 10.1111/evj.12258pubmed: 24612155google scholar: lookup
  36. Kock Nicolaisen AS, Bendix Nygaard A, Christophersen MT, Jensen DB, Lindegaard C. Effect of Head and Tail Rope-Assisted Recovery of Horses after Elective and Emergency Surgery under General Anaesthesia. Equine Vet. Educ. 2020.
    doi: 10.1111/eve.13397google scholar: lookup
  37. Whitehair KJ, Steffey EP, Willits NH, Woliner MJ. Recovery of horses from inhalation anesthesia.. Am J Vet Res 1993 Oct;54(10):1693-702.
    pubmed: 8250395
  38. Arndt S, Hopster K, Sill V, Rohn K, Kästner SBR. Comparison between head-tail-rope assisted and unassisted recoveries in healthy horses undergoing general anesthesia for elective surgeries.. Vet Surg 2020 Feb;49(2):329-338.
    doi: 10.1111/vsu.13347pubmed: 31705685google scholar: lookup
  39. Taylor PM, Clarke KW. Anaesthetic Problems. Handbook of Equine Anaesthesia Elsevier; London, UK: 2007; pp. 124–175.
  40. Scarabelli S, Rioja E. Retrospective evaluation of correlation and agreement between two recovery scoring systems in horses.. Vet Rec 2018 Feb 10;182(6):169.
    doi: 10.1136/vr.104546pmc: PMC5870460pubmed: 29196490google scholar: lookup
  41. Vettorato E, Chase-Topping ME, Clutton RE. A comparison of four systems for scoring recovery quality after general anaesthesia in horses.. Equine Vet J 2010 Jul;42(5):400-6.
    doi: 10.1111/j.2042-3306.2010.00093.xpubmed: 20636775google scholar: lookup
  42. Suthers JM, Christley RM, Clutton RE. Quantitative and qualitative comparison of three scoring systems for assessing recovery quality after general anaesthesia in horses.. Vet Anaesth Analg 2011 Jul;38(4):352-62.
    doi: 10.1111/j.1467-2995.2011.00629.xpubmed: 21672127google scholar: lookup
  43. Donaldson LL, Dunlop GS, Holland MS, Burton BA. The recovery of horses from inhalant anesthesia: a comparison of halothane and isoflurane.. Vet Surg 2000 Jan-Feb;29(1):92-101.
    doi: 10.1111/j.1532-950X.2000.00092.xpubmed: 10653499google scholar: lookup
  44. Menzies MP, Ringer SK, Conrot A, Theurillat R, Kluge K, Kutter AP, Jackson M, Thormann W, Bettschart-Wolfensberger R. Cardiopulmonary effects and anaesthesia recovery quality in horses anaesthetized with isoflurane and low-dose S-ketamine or medetomidine infusions.. Vet Anaesth Analg 2016 Nov;43(6):623-634.
    doi: 10.1111/vaa.12359pubmed: 26915545google scholar: lookup
  45. Farmer E, Chase-Topping M, Lawson H, Clutton RE. Factors affecting the perception of recovery quality in horses after anaesthesia.. Equine Vet J 2014 May;46(3):328-32.
    doi: 10.1111/evj.12133pubmed: 23819890google scholar: lookup

Citations

This article has been cited 1 times.
  1. Straticò P, Varasano V, Palozzo A, Guerri G, Celani G, Revelant O, Petrizzi L. Retrospective Study on Risk Factors and Short-Term Outcome of Horses Referred for Colic from 2016 to 2022.. Vet Sci 2022 Oct 3;9(10).
    doi: 10.3390/vetsci9100545pubmed: 36288158google scholar: lookup
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