Medetomidine-ketamine anaesthesia induction followed by medetomidine-propofol in ponies: infusion rates and cardiopulmonary side effects.
Abstract: To search for long-term total i.v. anaesthesia techniques as a potential alternative to inhalation anaesthesia. Objective: To determine cardiopulmonary effects and anaesthesia quality of medetomidine-ketamine anaesthesia induction followed by 4 h of medetomidine-propofol anaesthesia in 6 ponies. Methods: Sedation consisted of 7 microg/kg bwt medetomidine i.v. followed after 10 min by 2 mg/kg bwt i.v. ketamine. Anaesthesia was maintained for 4 h with 3.5 microg/kg bwt/h medetomidine and propofol at minimum infusion dose rates determined by application of supramaximal electrical pain stimuli. Ventilation was spontaneous (F(I)O2 > 0.9). Cardiopulmonary measurements were always taken before electrical stimulation, 15 mins after anaesthesia induction and at 25 min intervals. Results: Anaesthesia induction was excellent and movements after pain stimuli were subsequently gentle. Mean propofol infusion rates were 0.89-0.1 mg/kg bwt/min. No changes in cardiopulmonary variables occured over time. Range of mean values recorded was: respiratory rate 13.0-15.8 breaths/min; PaO2 29.1-37.9 kPa; PaCO2 6.2-6.9 kPa; heart rate 31.2-40.8 beats/min; mean arterial pressure 90.0-120.8 mmHg; cardiac index 44.1-59.8 ml/kg bwt/min; mean pulmonary arterial pressure 11.8-16.4 mmHg. Recovery to standing was an average of 31.1 mins and ponies stood within one or 2 attempts. Conclusions: In this paper, ketamine anaesthesia induction avoided the problems encountered previously with propofol. Cardiovascular function was remarkably stable. Hypoxaemia did not occur but, despite F(I)O2 of > 0.9, minimal PaO2 in one pony after 4 h anaesthesia was 8.5 kPa. Conclusions: The described regime might offer a good, practicable alternative to inhalation anaesthesia and has potential for reducing the fatality rate in horses.
Publication Date: 2003-05-21 PubMed ID: 12755436DOI: 10.2746/042516403776148354Google Scholar: Lookup
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- Journal Article
Summary
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The research article investigates an intravenous anaesthesia technique, which uses a drug combination of medetomidine, ketamine, and propofol, as a potential substitute for inhalation anaesthesia in ponies. The study examines the effects of this anaesthesia on cardiopulmonary variables and anaesthesia quality.
Research method and anaesthesia protocol
- The study was conducted on six ponies. The anaesthetic protocol involved inducing sedation with medetomidine, followed by administration of ketamine 10 minutes later.
- After induction with medetomidine and ketamine, anaesthesia was maintained with medetomidine and propofol for a duration of 4 hours.
- Supramaximal electrical pain stimuli were used to determine the minimum infusion dose rates of propofol.
- The ponies’ ventilation was allowed to occur spontaneously and cardiopulmonary measurements were taken at regular intervals.
Research findings and anaesthesia evaluation
- The induction of anaesthesia was found to be excellent and movements post application of pain stimuli were gentle, suggesting the protocol resulted in effective anaesthesia.
- There were no noted changes over time in cardiopulmonary variables like respiratory rate, heart rate, arterial pressures, and cardiac index.
- The recovery to standing post-anaesthesia was within an average of 31.1 minutes and most ponies stood within one or two attempts.
- Moreover, the anaesthesia protocol avoided problems that had been previously associated with propofol.
Conclusions of the study
- The protocol using medetomidine-ketamine for induction of anaesthesia and medetomidine-propofol for maintenance resulted in stable cardiovascular function and was associated with minimal hypoxaemia.
- The study concludes that the anaesthetic regime explored might provide a reliable alternative to inhalation anaesthesia for ponies and other horses, potentially reducing fatalities associated with equine anaesthesia.
Cite This Article
APA
Bettschart-Wolfensberger R, Bowen IM, Freeman SL, Weller R, Clarke KW.
(2003).
Medetomidine-ketamine anaesthesia induction followed by medetomidine-propofol in ponies: infusion rates and cardiopulmonary side effects.
Equine Vet J, 35(3), 308-313.
https://doi.org/10.2746/042516403776148354 Publication
Researcher Affiliations
- Department of Farm Animal and Equine Medical Surgery, The Royal Veterinary College, University of London, Hatfield, UK.
MeSH Terms
- Anesthetics, Dissociative / administration & dosage
- Anesthetics, Dissociative / adverse effects
- Anesthetics, Intravenous / administration & dosage
- Anesthetics, Intravenous / adverse effects
- Animals
- Blood Pressure / drug effects
- Drug Therapy, Combination
- Heart Rate / drug effects
- Horses / physiology
- Hypnotics and Sedatives / administration & dosage
- Hypnotics and Sedatives / adverse effects
- Infusions, Intravenous / veterinary
- Ketamine / administration & dosage
- Ketamine / adverse effects
- Medetomidine / administration & dosage
- Medetomidine / adverse effects
- Propofol / administration & dosage
- Propofol / adverse effects
- Respiration / drug effects
Citations
This article has been cited 5 times.- Nie J, Chen W, Jia Y, Zhang Y, Wang H. Comparison of remifentanil and esketamine in combination with propofol for patient sedation during fiberoptic bronchoscopy. BMC Pulm Med 2023 Jul 11;23(1):254.
- Kerr CL, Keating SCJ, Arroyo LG, Viel L. Cardiopulmonary effects and recovery characteristics associated with 2 sedative protocols for assisted ventilation in healthy neonatal foals. Can J Vet Res 2021 Oct;85(4):251-260.
- 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).
- Tokushige H, Araki M, Kusano K, Arima D, Ito H, Yamazaki Y, Urayama S, Kambayashi Y, Tateno O, Ohta M. A retrospective comparison of induction with thiopental/guaifenesin and propofol/ketamine in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine during arthroscopic surgery. J Equine Sci 2019 Jul;30(2):25-31.
- Umar MA, Fukui S, Kawase K, Itami T, Yamashita K. Cardiovascular effects of total intravenous anesthesia using ketamine-medetomidine-propofol (KMP-TIVA) in horses undergoing surgery. J Vet Med Sci 2015 Mar;77(3):281-8.
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