Total intravenous anesthesia with propofol-ketamine-xylazine with or without remifentanil in thoroughbred horses undergoing castration.
Abstract: We evaluated the clinical efficacy of total intravenous anesthesia (TIVA) with propofol-ketamine-xylazine (PKX) with or without remifentanil for castration in horses. Twenty-four Thoroughbred horses were premedicated with intravenous (IV) xylazine (1.0 mg/kg) and midazolam (0.02 mg/kg) and anesthetized with IV ketamine (1.5 mg/kg) and propofol (1.0 mg/kg). Surgical anesthesia was maintained with constant infusion of propofol (3.0 mg/kg/hr)-ketamine (3.0 mg/kg/hr)-xylazine (1.0 mg/kg/hr) (group PKX: n=8), PKX combined with remifentanil (3.0 µg/kg/hr) (group PKXR3: n=8), or PKX combined with remifentanil (6.0 µg/kg/hr) (group PKXR6: n=8). During anesthesia, none of the horses showed any limb movements, but five, two, and two horses in the PKX, PKXR3, and PKXR6 groups, respectively, showed cremaster muscle contractions. One horse in the PKX group required doubling the PKX infusion rate to continue surgery. Adverse effects of remifentanil (trembling of the nose tip or tongue) were observed in one and three horses in the PKXR3 and PKXR6 groups, respectively. Heart rate and arterial blood pressure were well maintained in all groups. Ventilation was assisted in four, five, and six horses in the PKX, PKXR3, and PKXR6 groups, respectively. Recovery scores in the PKX group were fair in one horse, good in three horses, and excellent in four horses, whereas recovery in all horses in the PKXR3 and PKXR6 groups was judged to be excellent. TIVA with PKX combined with remifentanil 3.0 µg/kg/hr could provide more sufficient anesthetic depth than PKX with fewer clinically significant adverse effects than that with remifentanil 6.0 µg/kg/hr.
©2024 The Japanese Society of Equine Science.
Publication Date: 2024-10-11 PubMed ID: 39411213PubMed Central: PMC11473122DOI: 10.1294/jes.35.35Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- 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 study investigated the clinical effectiveness of complete intravenous anesthesia using a combination of propofol-ketamine-xylazine, either alone or in combination with remifentanil, for horse castration procedures. It concluded that blending in remifentanil at a specific dose with the other anesthetic drugs can provide improved depth of anesthesia with minimal side effects.
Study Details and Methods
- The researchers examined a group of 24 Thoroughbred horses that were undergoing castration. They approached this investigation with the aim of determining the benefits of total intravenous anesthesia (TIVA) with a specific anesthetic regimen.
- All participating horses were premedicated with xylazine and midazolam, two sedative drugs, before being fully anesthetized using a mixture of ketamine and propofol, both common anesthetics.
- The researchers divided the horses into three groups, each receiving a different constant anesthetic infusion during surgery. One group received a mixture of propofol, ketamine, and xylazine (referred to as PKX). The second group received the PKX combination with an added dosage of remifentanil, a strong opioid pain medication, at 3.0 µg/kg/hr (group PKXR3). The third group received the PKX combination with a higher remifentanil dosage of 6.0 µg/kg/hr (group PKXR6).
Results and Observations
- The researchers observed no limb movements in the horses during the anesthesia, indicating the efficacy of the anesthetic combinations. However, some horses showed contraction of the cremaster muscle – responsible for raising and lowering the testes in response to temperature.
- There were differences noted in responses to the anesthetic combinations: one horse in the PKX group required a higher infusion rate of the drug combination to continue the surgery while adverse effects related to common remifentanil side effects were observed in horses from the PKXR groups.
- The study also looked at heart rate and blood pressure, which were maintained appropriately in all groups. However, differences emerged in the need for assisted ventilation across the groups.
- The recovery scores, which were rated following surgery, were generally higher in the PKXR3 and PKXR6 groups with all horses therein being judged to have an excellent recovery. The PKX group experienced more variability in recoveries.
Conclusion
- The study concluded that the combination of TIVA with PKX plus the addition of remifentanil at a dosage of 3.0 µg/kg/hr provided a more sufficient anesthetic depth than the PKX combination alone thus suitable for horse castrations.
- However, the higher dosage of remifentanil – 6.0 µg/kg/hr – resulted in clinically significant adverse side effects indicating that it may be less suitable for this application.
Cite This Article
APA
Otsuka T, Araki M, Mita H, Kambayashi Y, Yoshihara E, Ohta M.
(2024).
Total intravenous anesthesia with propofol-ketamine-xylazine with or without remifentanil in thoroughbred horses undergoing castration.
J Equine Sci, 35(3), 35-41.
https://doi.org/10.1294/jes.35.35 Publication
Researcher Affiliations
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Inashiki, Ibaraki 300-0493, Japan.
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Inashiki, Ibaraki 300-0493, Japan.
- Equine Research Institute, Japan Racing Association, Shimotsuke, Tochigi, Japan.
- Equine Research Institute, Japan Racing Association, Shimotsuke, Tochigi, Japan.
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Inashiki, Ibaraki 300-0493, Japan.
- Equine Research Institute, Japan Racing Association, Shimotsuke, Tochigi, Japan.
References
This article includes 25 references
- Allison A, Robinson R, Jolliffe C, Taylor P M. Evaluation of the use of midazolam as a co-induction agent with ketamine for anaesthesia in sedated ponies undergoing field castration.. Equine Vet. J. 2018;50:321–326.
- Benmansour P, Billinsky J, Duke-Novakovski T, Alcorn J. Blood concentrations of remifentanil during and after infusion in horses anesthetized with isoflurane and dexmedetomidine.. Res. Vet. Sci. 2016;107:202–206.
- Benmansour P, Husulak M L, Bracamonte J L, Beazley S G, Withnall E, Duke-Novakovski T. Cardiopulmonary effects of an infusion of remifentanil or morphine in horses anesthetized with isoflurane and dexmedetomidine.. Vet. Anaesth. Analg. 2014;41:346–356.
- Correa M A, Aguiar A J, Neto F J T, Mendes G M, Steagall P V, Lima A F. Effects of remifentanil infusion regimens on cardiovascular function and responses to noxious stimulation in propofol-anesthetized cats.. Am. J. Vet. Res. 2007;68:932–940.
- Duthie D J. Remifentanil and tramadol.. Br. J. Anaesth. 1998;81:51–57.
- Fujiyama M, Jones T, Duke-Novakovski T. Evaluation of the perioperative stress response from dexmedetomidine infusion alone, with butorphanol bolus or remifentanil infusion compared with ketamine and morphine infusions in isoflurane-anesthetized horses.. Vet. Anaesth. Analg. 2021;48:344–355.
- Funcia J P, Lamuraglia R, Guglielminetti A, Soriano M, Melo M L. Preliminary results of behavioral and cardiopulmonary effects of a constant rate infusion of remifentanil–xylazine for sedation in horses.. J. Equine Vet. Sci. 2016;37:49–53.
- Grandy J L, Steffey E P, Hodgson D S, Woliner M J. Arterial hypotension and the development of postanesthetic myopathy in halothane-anesthetized horses.. Am. J. Vet. Res. 1987;48:192–197.
- Greene S A, Thurmon J C, Tranquilli W J, Benson G J. Cardiopulmonary effects of continuous intravenous infusion of guaifenesin, ketamine, and xylazine in ponies.. Am. J. Vet. Res. 1986;47:2364–2367.
- Hall L W, Gillespie J R, Tyler W S. Alveolar-arterial oxygen tension differences in anaesthetized horses.. Br. J. Anaesth. 1968;40:560–568.
- Johnson C B. Positioning the anaesthetised horse.. Equine Vet. Educ. 1993;5:57–60.
- Kulka A M, Otto K A, Bergfeld C, Beyerbach M, Kästner S B. Effects of isoflurane anesthesia with and without dexmedetomidine or remifentanil on quantitative electroencephalographic variables before and after nociceptive stimulation in dogs.. Am. J. Vet. Res. 2012;73:602–609.
- Mama K R, Steffey E P, Pascoe P J. Evaluation of propofol for general anesthesia in premedicated horses.. Am. J. Vet. Res. 1996;57:512–516.
- Marntell S, Nyman G, Hedenstierna G. High inspired oxygen concentrations increase intrapulmonary shunt in anaesthetized horses.. Vet. Anaesth. Analg. 2005;32:338–347.
- Muir W W, Skarda R T, Sheehan W. Evaluation of xylazine, guaifenesin, and ketamine hydrochloride for restraint in horses.. Am. J. Vet. Res. 1978;39:1274–1278.
- Nolan A M, Hall L W. Total intravenous anaesthesia in the horse with propofol.. Equine Vet. J. 1985;17:394–398.
- Nyman G, Frostell C, Hedenstierna G, Funkquist B, Kvart C, Blomqvist H. Selective mechanical ventilation of dependent lung regions in the anaesthetized horse in dorsal recumbency.. Br. J. Anaesth. 1987;59:1027–1034.
- Pallarols N B, Lamuraglia R, Guglielminetti A, Ortiz de Elguea M F, Carossino M, Funcia J P. Behavioral and cardiopulmonary effects of a constant rate infusion of remifentanil-xylazine for sedation in horses.. J. Equine Vet. Sci. 2020;91:103111.
- Patel S S, Spencer C M. Remifentanil.. Drugs 1996;52:417–427, discussion 428.
- Posner L P, Kasten J I, Kata C. Propofol with ketamine following sedation with xylazine for routine induction of general anaesthesia in horses.. Vet. Rec. 2013;173:550.
- Lamuraglia R, Kirkby P, Funcia J P. Cardiopulmonary effects and recovery quality of remifentanil–isoflurane anesthesia in horses.. J. Equine Vet. Sci. 2015;35:271–276.
- Sage A M, Keating S C, Lascola K M, Schaeffer D J, Clark-Price S C. Cardiopulmonary effects and recovery characteristics of horses anesthetized with xylazine-ketamine with midazolam or propofol.. Vet. Anaesth. Analg. 2018;45:772–781.
- 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;30:25–31.
- Yamashita K, Wijayathilaka T P, Kushiro T, Umar M A, Taguchi K, Muir W W. Anesthetic and cardiopulmonary effects of total intravenous anesthesia using a midazolam, ketamine and medetomidine drug combination in horses.. J. Vet. Med. Sci. 2007;69:7–13.
- Young L E, Bartram D H, Diamond M J, Gregg A S, Jones R S. Clinical evaluation of an infusion of xylazine, guaifenesin and ketamine for maintenance of anaesthesia in horses.. Equine Vet. J. 1993;25:115–119.
Citations
This article has been cited 0 times.Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
