Influence of acepromazine on the cardiovascular effects of dobutamine in isoflurane-anaesthetised horses premedicated with romifidine.
Abstract: To explore the influence of acepromazine on the cardiovascular effects of dobutamine in isoflurane-anaesthetised horses premedicated with romifidine. Methods: Prospective randomised clinical trial. Methods: A total of 18 horses undergoing elective arthroscopy were enrolled, of which 12 horses requiring dobutamine were included. Methods: Horses were randomised to receive acepromazine 0.02 mg kg (Group A+) intravenously (IV) or none (Group A-), 35 minutes before anaesthesia. Horses received xylazine 0.2 mg kg concurrently to facilitate IV access. Horses were premedicated with romifidine 0.08 mg kg, induced with ketamine 2.2 mg kg and diazepam 0.08 mg kg IV, and maintained with isoflurane in oxygen. Dobutamine infusion was commenced when mean arterial pressure (MAP) was < 60 mmHg. Cardiovascular data were collected prior to dobutamine, and at a target MAP of ≥ 70 mmHg. Dobutamine start time from induction, duration and dose to reach target MAP were compared using Mann-Whitney U test. Cardiovascular variables were compared using repeated measures ANOVA and post-hoc Fisher's least significant difference test. Results: Cardiac index (CI) and its percentage change from baseline were significantly higher at target MAP in group A+ [62.0 (49.9-74.2) mL minute kg; 42.8 (17.0-68.7) %] than in A- [49.5 (39.6-59.5) mL minute kg; -4.05 (-21.2-13.0) %] (p = 0.049; p = 0.003). Group A+ required significantly earlier dobutamine [20 (18-25) minutes] than group A- [36 (27-60) minutes] (p = 0.02). Group A+ required significantly higher dobutamine dose [1.5 (1-2.5) μg kg minute] to reach target MAP than group A- [0.5 (0.5-1) μg kg minute] (p = 0.009). Conclusions: Dobutamine significantly increased MAP and CI following pre-anaesthetic acepromazine sedation, in isoflurane-anaesthetised horses premedicated with romifidine. Without acepromazine, dobutamine increased MAP but not CI. Interactions between acepromazine, romifidine and dobutamine on the cardiovascular system should be considered.
Copyright © 2024 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
Publication Date: 2024-10-24 PubMed ID: 39665906DOI: 10.1016/j.vaa.2024.10.141Google Scholar: Lookup
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- Journal Article
Summary
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This research article reports on a clinical trial investigating how the drug acepromazine alters the cardiovascular effects of another drug, dobutamine, in horses anesthetised with isoflurane and premedicated with romifidine. It suggests that dobutamine significantly raises mean arterial pressure and cardiac index in horses sedated with acepromazine prior to anaesthesia.
Study Design & Methods
- The study was a prospective randomized clinical trial involving 18 horses that required dobutamine, undergoing elective arthroscopy.
- The horses were randomly divided into two groups, one that received 0.02 mg/kg of acepromazine intravenously (Group A+), and one that did not (Group A-).
- All horses were given 0.2 mg/kg of xylazine alongside acepromazine or none to facilitate intravenous access, then they were premedicated with romifidine, induced with ketamine and diazepam, and maintained under anesthesia with isoflurane in oxygen.
- Dobutamine infusion was started when the mean arterial pressure (MAP) went below 60 mmHg, and cardiovascular data were collected before dobutamine administration, and when the target MAP was at or above 70 mmHg.
Results
- At the target MAP, the cardiac index (CI) and percentage change from baseline CI were significantly higher in the group that received acepromazine (Group A+) than the group that did not.
- The dobutamine start time from induction was significantly earlier in the acepromazine group, and they also required a higher dobutamine dose to reach the target MAP.
Conclusion
- In conclusion, the administration of dobutamine significantly increased MAP and CI in horses that received acepromazine before anaesthesia. Without acepromazine, dobutamine only increased the MAP, not CI.
- The study advises considering the interactions between acepromazine, romifidine, and dobutamine when there’s an impact on the cardiovascular system.
Cite This Article
APA
Wong AM, Schier MF, Hosgood G, Drynan E, Raisis AL.
(2024).
Influence of acepromazine on the cardiovascular effects of dobutamine in isoflurane-anaesthetised horses premedicated with romifidine.
Vet Anaesth Analg, S1467-2987(24)00334-9.
https://doi.org/10.1016/j.vaa.2024.10.141 Publication
Researcher Affiliations
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia. Electronic address: adrian.wong@murdoch.edu.au.
- Veterinary Anaesthesia Specialists, Melbourne, Victoria, Australia.
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia.
- Western Australian Veterinary Emergency and Specialty, Perth, Western Australia, Australia.
- School of Veterinary Medicine, Murdoch University, Perth, Western Australia, Australia.
Conflict of Interest Statement
Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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