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Total intravenous anesthesia using a midazolam-ketamine-xylazine infusion in horses: 46 cases (2011-2014).

Abstract: This study evaluated use of midazolam, ketamine, and xylazine (MKX) for total intravenous (IV) anesthesia (TIVA) in horses. Medical records of 46 horses undergoing a clinical procedure using MKX for TIVA were reviewed. Age, breed, procedure, heart rate (HR), respiratory rate (RR), pre-anesthetic drugs, induction drugs, and total volume of MKX were recorded. Duration of anesthesia, time to standing, number of attempts to stand, and recovery score were also recorded. All horses were premedicated with an alpha-2 adrenoceptor agonist and anesthesia was induced with ketamine and midazolam. Duration of MKX infusion was 33 ± 14 min. Heart rate and RR decreased during the infusion of MKX. Time to endotracheal extubation was 19 ± 12 min. Horses stood at 33 ± 13 min. Median number of attempts to stand was 1. Maintenance of anesthesia of horses with MKX was useful for a variety of procedures and recovery from anesthesia was good. Cette étude a évalué l’usage du midazolam, de la kétamine et de la xylazine (MKX) pour l’anesthésie intraveineuse (IV) totale (AITT) chez les chevaux. Les dossiers médicaux de 46 chevaux subissant une intervention clinique à l’aide de MKX pour l’AITT ont été évalués. L’âge, la race, l’intervention, la fréquence cardiaque, la fréquence respiratoire, les médicaments pré-anesthésiques, les médicaments d’induction et le volume total de MKX ont été consignés. La durée de l’anesthésie, le délai pour se tenir debout, le nombre de tentatives pour se tenir debout et la note de rétablissement ont aussi été consignés. Tous les chevaux ont reçu une prémédication avec un agoniste alpha-2 adrénocepteur et l’anesthésie a été induite avec de la kétamine et du midazolam. La durée de l’infusion de MKX a été de 33 ± 14 min. La fréquence cardiaque et la fréquence respiratoire ont diminué durant l’infusion de MKX. Le délai jusqu’à l’extubation endotrachéale a été de 19 ± 12 min. Les chevaux se sont tenus debout à 33 ± 13 min. Le nombre médian de tentatives pour se tenir debout était de 1. Le maintien de l’anesthésie chez les chevaux avec MKX était utile pour une diversité d’interventions et le rétablissement de l’anesthésie a été bon.(Traduit par Isabelle Vallières).
Publication Date: 2018-06-16 PubMed ID: 29904202PubMed Central: PMC5901856
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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.

The research analyzed the effectiveness and safety of using a combination of three drugs – midazolam, ketamine, and xylazine (MKX) – for total intravenous anesthesia in horses. The study, which reviewed 46 cases conducted from 2011 to 2014, reported a good recovery rate and indicated that this form of anesthesia could be useful for a range of procedures.

Research Methodology

The researchers conducted a review of the medical records of 46 horses who had undergone total intravenous anesthesia (TIVA) using a mix of midazolam, ketamine, and xylazine for various clinical procedures. The data collected from these records included:

  • Age of the horse
  • Breed of the horse
  • Nature of the clinical procedure
  • Heart Rate (HR)
  • Respiratory Rate (RR)
  • Type of pre-anesthetic and induction drugs used
  • Total volume of MKX administered
  • Duration of anesthesia
  • Time taken to stand after anesthesia
  • Number of attempts made to stand
  • Recovery score post-procedure

All horses involved in the study were premedicated with an alpha-2 adrenoceptor agonist and anesthesia was induced with ketamine and midazolam.

Findings

The researchers found that the average duration of the MKX infusion was approximately 33 minutes, during which the heart rate and respiratory rate decreased. The period until endotracheal extubation averaged at 19 minutes. On average, it took the horses about 33 minutes to stand after anesthesia, with the median number of attempts to stand being one.

Conclusion

The research concluded that the use of MKX for total intravenous anesthesia in horses was both effective and safe. It resulted in a good recovery rate and can be applied to a variety of clinical procedures. The researchers also noted that the reduction in heart rate and respiratory rate during anesthesia did not lead to any adverse effects. The research, however, did not mention any potential side effects of this method, which could be a subject of future studies.

Cite This Article

APA
Aarnes TK, Lerche P, Bednarski RM, Hubbell JAE. (2018). Total intravenous anesthesia using a midazolam-ketamine-xylazine infusion in horses: 46 cases (2011-2014). Can Vet J, 59(5), 500-504.

Publication

ISSN: 0008-5286
NlmUniqueID: 0004653
Country: Canada
Language: English
Volume: 59
Issue: 5
Pages: 500-504

Researcher Affiliations

Aarnes, Turi K
  • Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio 43210, USA.
Lerche, Phillip
  • Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio 43210, USA.
Bednarski, Richard M
  • Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio 43210, USA.
Hubbell, John A E
  • Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, Ohio 43210, USA.

MeSH Terms

  • Anesthesia, Intravenous / veterinary
  • Anesthetics, Dissociative / administration & dosage
  • Anesthetics, Dissociative / pharmacology
  • Animals
  • Drug Therapy, Combination
  • Horse Diseases / surgery
  • Horses / physiology
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / pharmacology
  • Infusions, Intravenous / veterinary
  • Ketamine / administration & dosage
  • Ketamine / pharmacology
  • Midazolam / administration & dosage
  • Midazolam / pharmacology
  • Retrospective Studies
  • Xylazine / administration & dosage
  • Xylazine / pharmacology

References

This article includes 17 references
  1. Hubbell JA, Saville WJ, Bednarski RM. The use of sedatives, analgesic and anaesthetic drugs in the horse: an electronic survey of members of the American Association of Equine Practitioners (AAEP).. Equine Vet J 2010 Sep;42(6):487-93.
  2. Young LE, Bartram DH, Diamond MJ, Gregg AS, Jones RS. Clinical evaluation of an infusion of xylazine, guaifenesin and ketamine for maintenance of anaesthesia in horses.. Equine Vet J 1993 Mar;25(2):115-9.
  3. Muir WW, Skarda RT, Sheehan W. Evaluation of xylazine, guaifenesin, and ketamine hydrochloride for restraint in horses.. Am J Vet Res 1978 Aug;39(8):1274-8.
    pubmed: 697134
  4. Greene SA, Thurmon JC, Tranquilli WJ, Benson GJ. Cardiopulmonary effects of continuous intravenous infusion of guaifenesin, ketamine, and xylazine in ponies.. Am J Vet Res 1986 Nov;47(11):2364-7.
    pubmed: 3789495
  5. McCarty JE, Trim CM, Ferguson D. Prolongation of anesthesia with xylazine, ketamine, and guaifenesin in horses: 64 cases (1986-1989).. J Am Vet Med Assoc 1990 Dec 15;197(12):1646-50.
    pubmed: 2276967
  6. Pang DSJ. Anesthetic and analgesic adjunctive drugs. 2015; pp. 244–259.
  7. Grandy JL, McDonell WN. Evaluation of concentrated solutions of guaifenesin for equine anesthesia.. J Am Vet Med Assoc 1980 Apr 1;176(7):619-22.
    pubmed: 6989792
  8. Lechner MD, Kreuscher H. [Chemical compatibility of ketamine and midazolam in infusion solutions].. Anaesthesist 1990 Jan;39(1):62-5.
    pubmed: 2305952
  9. Hubbell JA, Aarnes TK, Lerche P, Bednarski RM. Evaluation of a midazolam-ketamine-xylazine infusion for total intravenous anesthesia in horses.. Am J Vet Res 2012 Apr;73(4):470-5.
    pubmed: 22452492doi: 10.2460/ajvr.73.4.470google scholar: lookup
  10. Kerr CL, McDonell WN, Young SS. A comparison of romifidine and xylazine when used with diazepam/ketamine for short duration anesthesia in the horse.. Can Vet J 1996 Oct;37(10):601-9.
    pmc: PMC1576482pubmed: 8896874
  11. Yamashita K, Wijayathilaka TP, Kushiro T, Umar MA, Taguchi K, Muir WW. Anesthetic and cardiopulmonary effects of total intravenous anesthesia using a midazolam, ketamine and medetomidine drug combination in horses.. J Vet Med Sci 2007 Jan;69(1):7-13.
    pubmed: 17283393doi: 10.1292/jvms.69.7google scholar: lookup
  12. McMurphy RM, Young LE, Marlin DJ, Walsh K. Comparison of the cardiopulmonary effects of anesthesia maintained by continuous infusion of romifidine, guaifenesin, and ketamine with anesthesia maintained by inhalation of halothane in horses.. Am J Vet Res 2002 Dec;63(12):1655-61.
    pubmed: 12492279doi: 10.2460/ajvr.2002.63.1655google scholar: lookup
  13. Lerche P. Total intravenous anesthesia in horses.. Vet Clin North Am Equine Pract 2013 Apr;29(1):123-9.
    pubmed: 23498048doi: 10.1016/j.cveq.2012.11.008google scholar: lookup
  14. Hubbell JA, Kelly EM, Aarnes TK, Bednarski RM, Lerche P, Liu Z, Lakritz J. Pharmacokinetics of midazolam after intravenous administration to horses.. Equine Vet J 2013 Nov;45(6):721-5.
    pubmed: 23489241doi: 10.1111/evj.12049google scholar: lookup
  15. Muir WW. Anxiolytics, nonopioid sedataive-analgesics, and opioid analgesics. 2009; pp. 185–209.
  16. 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.
  17. Steblaj B, Schauvliege S, Pavlidou K, Gasthuys F, Savvas I, Duchateau L, Kowalczyk L, Moens Y. Comparison of respiratory function during TIVA (romifidine, ketamine, midazolam) and isoflurane anaesthesia in spontaneously breathing ponies Part I: blood gas analysis and cardiorespiratory variables.. Vet Anaesth Analg 2014 Nov;41(6):583-91.
    pubmed: 25099938doi: 10.1111/vaa.12167google scholar: lookup

Citations

This article has been cited 3 times.
  1. Cunneen A, Pratt S, Perkins N, McEwen M, Truchetti G, Rainger J, Farry T, Kidd L, Goodwin W. Total Intravenous Anaesthesia with Ketamine, Medetomidine and Midazolam as Part of a Balanced Anaesthesia Technique in Horses Undergoing Castration. Vet Sci 2021 Jul 26;8(8).
    doi: 10.3390/vetsci8080142pubmed: 34437464google 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. Helal IE, Al-Abbadi HA, Hashem MA, Abdelrazek HMA, Shekidef MH, Ahmed MF. Analgesic Effect of Dexmedetomidine-Nalbuphine Combination vs. Dexmedetomidine Alone in Donkeys Undergoing Field Castration under Total Intravenous Anesthesia. Animals (Basel) 2024 Aug 23;14(17).
    doi: 10.3390/ani14172452pubmed: 39272237google scholar: lookup