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BMC veterinary research2017; 13(1); 381; doi: 10.1186/s12917-017-1299-6

Effect of butorphanol, midazolam or ketamine on romifidine based sedation in horses during standing cheek tooth removal.

Abstract: Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on romifidine based sedation in horses during cheek tooth removal. Methods: Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with romifidine (same dose) and butorphanol (0.02 mg/kg; CRI 0.04 mg/kg/h). Group RM received romifidine (same dose) and midazolam (0.02 mg/kg; CRI 0.06 mg/kg/h) whereas group RK was administered romifidine (same dose) and ketamine (0.5 mg/kg; CRI 1.2 mg/kg/h). If sedation was not adequate a top up bolus of romifidine (0.01 mg/kg) was administered. The quality of sedation and the conditions for tooth extraction, the level of ataxia, chewing, head and tongue movement were evaluated by using a scoring system. The investigator was blinded to the applied sedation protocol. Furthermore, serum cortisol concentrations before, during and after the procedure were analyzed to gain more information about the stress level of the horses. Results: Horses in group RM showed significantly less chewing and tongue activity compared to horses sedated with romifidine alone or with butorphanol additionally, but also significantly higher levels of ataxia. The quality of sedation was significantly better if romifidine was administered in combination with ketamine compared to romifidine alone. Furthermore, horses of group RK needed less additional romifidine boli compared to all other groups. Blood cortisol concentrations during surgery in groups RB and RM remained unchanged. Horses of group R showed higher cortisol concentrations during sedation compared to horses of groups RB and RM. Conclusions: Romifidine alone at an initial bolus dose of 0.03 mg/kg followed by a constant rate infusion of 0.05 mg/kg/h was insufficient to obtain an adequate level of sedation and led to increased stress levels, whereas the addition of butorphanol inhibited the stress response. The combination of romifidine with either midazolam or ketamine improved sedation quality and surgical conditions.
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Publication Date: 2017-12-06 PubMed ID: 29212478PubMed Central: PMC5719754DOI: 10.1186/s12917-017-1299-6Google Scholar: Lookup
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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 investigates the effects of different drugs — butorphanol, midazolam, or ketamine — when used in combination with romifidine to sedate horses undergoing a common dental procedure, standing cheek tooth removal.

Study Design and Methods

  • The study involved forty horses undergoing tooth extraction, divided into four groups by a matched pair randomization method.
  • All groups were sedated with romifidine at specified doses, but each had different additional drugs. Group RB had added butorphanol, RM had added midazolam and RK had added ketamine.
  • The quality and adequacy of sedation were evaluated using a scoring system assessed for various factors like chewing, head and tongue movement, and ataxia (lack of coordination).
  • To gauge the stress levels of the horses, serum cortisol concentrations were analyzed before, during, and after the procedure.

Key Findings

  • Horses in group RM, those sedated with romifidine and midazolam, showed significantly less chewing and tongue activity but had higher levels of ataxia.
  • The sedation quality was better when romifidine was combined with ketamine, which also reduced the need for additional romifidine.
  • In groups RB and RM, blood cortisol concentrations, indicative of stress levels, remained unchanged during the surgery as compared to group R (Romifidine alone), which showed higher cortisol concentrations and increased stress levels.

Conclusions of the Study

  • It was concluded that sedating horses with only romifidine led to insufficient sedation and increased stress levels during tooth extraction procedures.
  • On the other hand, the addition of butorphanol to romifidine effectively inhibited the stress response in the horses.
  • The combination of romifidine with either midazolam or ketamine showed an improvement in the sedation quality and the conditions for tooth extraction.

Cite This Article

APA
Müller TM, Hopster K, Bienert-Zeit A, Rohn K, Kästner SBR. (2017). Effect of butorphanol, midazolam or ketamine on romifidine based sedation in horses during standing cheek tooth removal. BMC Vet Res, 13(1), 381. https://doi.org/10.1186/s12917-017-1299-6

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 13
Issue: 1
Pages: 381

Researcher Affiliations

Müller, Theresa Maria
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany. theresa.maria@gmx.de.
Hopster, Klaus
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
Bienert-Zeit, Astrid
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
Rohn, Karl
  • Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
Kästner, Sabine B R
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.

MeSH Terms

  • Anesthetics / therapeutic use
  • Anesthetics, Combined
  • Animals
  • Butorphanol / therapeutic use
  • Conscious Sedation / methods
  • Conscious Sedation / veterinary
  • Female
  • Horses / surgery
  • Hydrocortisone / blood
  • Imidazoles / therapeutic use
  • Ketamine / therapeutic use
  • Male
  • Midazolam / therapeutic use
  • Tooth Extraction / methods
  • Tooth Extraction / veterinary

Conflict of Interest Statement

ETHICS APPROVAL: The protocol was reviewed and approved by an internal, institutional committee (University of Veterinary Medicine, Hannover). The protocol was also approved by the “Animal Welfare Committee” of the University of Veterinary Medicine, Hannover University. In our case this committee not only decided that the study protocol met all necessary requirements but also concluded that the study design met all requirements of good and common clinical practice regardless of the assignment to a specific group in this study. Therefore, step three, approval by the state committee, the “Ethics Committee for Animal Experiments of Lower Saxony” Germany, was not necessary for this specific study. Before conducting the sedation and dental procedure all owners were informed about this study and gave their consent. CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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Citations

This article has been cited 8 times.
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