Effect of administration of propofol and xylazine hydrochloride on recovery of horses after four hours of anesthesia with desflurane

Eugene P. Steffey Department of Surgical and Radiological Sciences, School of Veterinary Medicine and KL Maddy Equine Analytical Chemistry Laboratory, California Animal Health and Food Safety Laboratory, University of California, Davis, CA 95616.

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Khursheed R. Mama Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523.

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Robert J. Brosnan Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Ayako Imai Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616.

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Lara K. Maxwell KL Maddy Equine Analytical Chemistry Laboratory, California Animal Health and Food Safety Laboratory, University of California, Davis, CA 95616.

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Cynthia A. Cole KL Maddy Equine Analytical Chemistry Laboratory, California Animal Health and Food Safety Laboratory, University of California, Davis, CA 95616.

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Scott D. Stanley KL Maddy Equine Analytical Chemistry Laboratory, California Animal Health and Food Safety Laboratory, University of California, Davis, CA 95616.

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Abstract

Objective—To compare characteristics of horses recovering from 4 hours of desflurane anesthesia with and without immediate postanesthetic IV administration of propofol and xylazine.

Animals—8 healthy horses (mean ± SEM age, 6.6 ± 1.0 years; mean body weight, 551 ± 50 kg).

Procedures—Horses were anesthetized twice. Both times, anesthesia was induced with a combination of xylazine hydrochloride, diazepam, and ketamine hydrochloride and then maintained for 4 hours with desflurane in oxygen. Choice of postanesthetic treatment was randomly assigned via a crossover design such that each horse received an IV injection of propofol and xylazine or saline (0.9% NaCl) solution after the anesthetic episode. Recovery events were quantitatively and qualitatively assessed. Venous blood samples were obtained before and after anesthesia for determination of serum creatine kinase activity and plasma propofol concentration.

Results—Anesthetic induction and maintenance were unremarkable in all horses. Compared with administration of saline solution, postanesthetic administration of propofol and xylazine resulted in an increased interval to emergence from anesthesia but improved quality of recovery-related transition to standing. Compared with administration of saline solution, administration of propofol also delayed the rate of decrease of end-tidal concentrations of desflurane and carbon dioxide and added to conditions promoting hypoxemia and hypoventilation.

Conclusions and Clinical Relevance—Propofol and xylazine administered IV to horses after 4 hours of desflurane anesthesia improved the quality of transition from lateral recumbency to standing but added potential for harmful respiratory depression during the postanesthetic period.

Abstract

Objective—To compare characteristics of horses recovering from 4 hours of desflurane anesthesia with and without immediate postanesthetic IV administration of propofol and xylazine.

Animals—8 healthy horses (mean ± SEM age, 6.6 ± 1.0 years; mean body weight, 551 ± 50 kg).

Procedures—Horses were anesthetized twice. Both times, anesthesia was induced with a combination of xylazine hydrochloride, diazepam, and ketamine hydrochloride and then maintained for 4 hours with desflurane in oxygen. Choice of postanesthetic treatment was randomly assigned via a crossover design such that each horse received an IV injection of propofol and xylazine or saline (0.9% NaCl) solution after the anesthetic episode. Recovery events were quantitatively and qualitatively assessed. Venous blood samples were obtained before and after anesthesia for determination of serum creatine kinase activity and plasma propofol concentration.

Results—Anesthetic induction and maintenance were unremarkable in all horses. Compared with administration of saline solution, postanesthetic administration of propofol and xylazine resulted in an increased interval to emergence from anesthesia but improved quality of recovery-related transition to standing. Compared with administration of saline solution, administration of propofol also delayed the rate of decrease of end-tidal concentrations of desflurane and carbon dioxide and added to conditions promoting hypoxemia and hypoventilation.

Conclusions and Clinical Relevance—Propofol and xylazine administered IV to horses after 4 hours of desflurane anesthesia improved the quality of transition from lateral recumbency to standing but added potential for harmful respiratory depression during the postanesthetic period.

Contributor Notes

Dr. Imai's present address is the Department of Anesthesia, Japan Animal Referral Medical Center, 2-5-8 Kuji, Takatsu-ku, Kawasaki, Kanagawa 213-0032, Japan.

Dr. Maxwell's present address is the Department of Physiological Sciences, Center for Veterinary Health Sciences, Oklahoma State University, Stillwater, OK 74078.

Dr. Cole's present address is Professional Services Group, IDEXX Pharmaceuticals Inc, 7009 Albert Pick Rd, Greensboro, NC 27410.

Supported by the School of Veterinary Medicine Center for Equine Health with funds provided by the Oak Tree Racing Association, the State of California Satellite Wagering Account, and private donors.

Desflurane and propofol were donated by Baxter Healthcare.

Presented as a poster at the Association of Veterinary Anaesthetists Autumn Meeting, Vienna, September 2004.

The authors thank Dr. N. Willits for statistical advice and analysis and Dr F. O. Ascoli, Dr. J. H. N. Soares, R. Cervantes, D. Hermes, V. Long, and R. Morgan for technical assistance.

Address correspondence to Dr. Steffey.
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