Evaluation of infusions of xylazine with ketamine or propofol to modulate recovery following sevoflurane anesthesia in horses

Ann E. Wagner Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523

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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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Eugene P. Steffey Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA 95616.

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Peter W. Hellyer Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523

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Abstract

Objective—To determine whether infusion of xylazine and ketamine or xylazine and propofol after sevoflurane administration in horses would improve the quality of recovery from anesthesia.

Animals—6 healthy adult horses.

Procedures—For each horse, anesthesia was induced by administration of xylazine, diazepam, and ketamine and maintained with sevoflurane for approximately 90 minutes (of which the last 60 minutes were under steady-state conditions) 3 times at 1-week intervals. For 1 anesthetic episode, each horse was allowed to recover from sevoflurane anesthesia; for the other 2 episodes, xylazine and ketamine or xylazine and propofol were infused for 30 or 15 minutes, respectively, after termination of sevoflurane administration. Selected cardiopulmonary variables were measured during anesthesia and recovery. Recovery events were monitored and subjectively scored.

Results—Cardiopulmonary variables differed minimally among treatments, although the xylazine-propofol infusion was associated with greater respiratory depression than was the xylazine-ketamine infusion. Interval from discontinuation of sevoflurane or infusion administration to standing did not differ significantly among treatments, but the number of attempts required to stand successfully was significantly lower after xylazine-propofol infusion, compared with the number of attempts after sevoflurane alone. Scores for recovery from anesthesia were significantly lower (ie, better recovery) after either infusion, compared with scores for sevoflurane administration alone.

Conclusions and Clinical Relevance—Xylazine-ketamine or xylazine-propofol infusion significantly improved quality of recovery from sevoflurane anesthesia in horses. Xylazine-ketamine or xylazine-propofol infusions may be of benefit during recovery from sevoflurane anesthesia in horses for which a smooth recovery is particularly critical. However, oxygenation and ventilation should be monitored carefully.

Abstract

Objective—To determine whether infusion of xylazine and ketamine or xylazine and propofol after sevoflurane administration in horses would improve the quality of recovery from anesthesia.

Animals—6 healthy adult horses.

Procedures—For each horse, anesthesia was induced by administration of xylazine, diazepam, and ketamine and maintained with sevoflurane for approximately 90 minutes (of which the last 60 minutes were under steady-state conditions) 3 times at 1-week intervals. For 1 anesthetic episode, each horse was allowed to recover from sevoflurane anesthesia; for the other 2 episodes, xylazine and ketamine or xylazine and propofol were infused for 30 or 15 minutes, respectively, after termination of sevoflurane administration. Selected cardiopulmonary variables were measured during anesthesia and recovery. Recovery events were monitored and subjectively scored.

Results—Cardiopulmonary variables differed minimally among treatments, although the xylazine-propofol infusion was associated with greater respiratory depression than was the xylazine-ketamine infusion. Interval from discontinuation of sevoflurane or infusion administration to standing did not differ significantly among treatments, but the number of attempts required to stand successfully was significantly lower after xylazine-propofol infusion, compared with the number of attempts after sevoflurane alone. Scores for recovery from anesthesia were significantly lower (ie, better recovery) after either infusion, compared with scores for sevoflurane administration alone.

Conclusions and Clinical Relevance—Xylazine-ketamine or xylazine-propofol infusion significantly improved quality of recovery from sevoflurane anesthesia in horses. Xylazine-ketamine or xylazine-propofol infusions may be of benefit during recovery from sevoflurane anesthesia in horses for which a smooth recovery is particularly critical. However, oxygenation and ventilation should be monitored carefully.

Contributor Notes

Supported by a grant from the College Research Council, College of Veterinary Medicine and Biomedical Sciences, Colorado State University.

Presented as an oral abstract at the 8th World Congress of Veterinary Anesthesia, Knoxville, Tenn, September 2003.

The authors thank Tara Raske and Pamela Vogel for technical assistance and Lucien Brevard for assistance in evaluating recoveries.

Address correspondence to Dr. Wagner (aewagner@colostate.edu).
  • 1.

    Martinez EA, Wagner AE, Driessen B, et al. Guidelines for anesthesia in horses. American College of Veterinary Anesthesiologists. Available at: www.acva.org/docs/Equine. Accessed Nov 28, 2010.

    • Search Google Scholar
    • Export Citation
  • 2.

    Hodgson DS, Dunlop CI. General anesthesia for horses with specific problems. Vet Clin North Am Equine Pract 1990; 6:625650.

  • 3.

    Young SS, Taylor PM. Factors influencing the outcome of equine anaesthesia: a review of 1,314 cases. Equine Vet J 1993; 25:147151.

  • 4.

    Johnston GM, Taylor PM, Holmes MA, et al. Confidential enquiry into perioperative equine fatalities (CEPEF-1): interim results of the United Kingdom study, in Proceedings. 41st Annu Meet Am Assoc Equine Pract 1995;192193.

    • Search Google Scholar
    • Export Citation
  • 5.

    Matthews NS, Hartsfield SM, Mercer D, et al. Recovery from sevoflurane anesthesia in horses: comparison to isoflurane and effect of postmedication with xylazine. Vet Surg 1998; 27:480485.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6.

    Leece EA, Corletto F, Brearley JC. A comparison of recovery times and characteristics with sevoflurane and isoflurane anaesthesia in horses undergoing magnetic resonance imaging. Vet Anaesth Analg 2008; 35:383391.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Young LE, Bartram DH, Diamond MJ, et al. Clinical evaluation of an infusion of xylazine, guaifenesin, and ketamine for maintenance of anaesthesia in horses. Equine Vet J 1993; 25:115119.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Mama KR, Pascoe PJ, Steffey EP, et al. Comparison of two techniques for total intravenous anesthesia in horses. Am J Vet Res 1998; 59:12921298.

    • Search Google Scholar
    • Export Citation
  • 9.

    Mama KR, Wagner AE, Steffey EP, et al. Evaluation of xylazine and ketamine for total intravenous anesthesia in horses. Am J Vet Res 2005; 66:10021007.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Wagner AE, Mama KR, Steffey EP, et al. A comparison of equine recovery characteristics after isoflurane or isoflurane followed by a xylazine-ketamine infusion. Vet Anaesth Analg 2008; 35:154160.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Mama KR, Steffey EP, Pascoe PJ. Evaluation of propofol for general anesthesia in premedicated horses. Am J Vet Res 1996; 57:512516.

  • 12.

    Bettschart-Wolfensberger R, Freeman S, Bettschart RW, et al. Assessment of a medetomidine/propofol total intravenous anaesthesia, (TIVA) for clinical anaesthesia in equidae. Pferdeheilkunde 2002; 18:3948.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Muir WW, Lerche P & Erichson D. Anaesthetic and cardiorespiratory effects of propofol at 10% for induction and 1% for maintenance of anaesthesia in horses. Equine Vet J 2009; 41:578585.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Steffey EP, Mama KR, Brosnan RJ, et al. Effect of administration of propofol and xylazine hydrochloride on recovery of horses after four hours of anesthesia with desflurane. Am J Vet Res 2009; 70:956963.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Steffey EP, Brosnan RJ, Galuppo LD, et al. Use of propofol-xylazine and the Anderson sling suspension system for recovery of horses from desflurane anesthesia. Vet Surg 2009; 38:927933.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Steffey EP, Mama KR, Galey FD, et al. Effects of sevoflurane dose and mode of ventilation on cardiopulmonary function and blood biochemical variables in horses. Am J Vet Res 2005; 66:606614.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Littell RC, Milliken GA, Stroup WW, et al. The SAS system for mixed models. Cary, NC: SAS Institute Inc, 1996.

  • 18.

    Bergadano A, Lauber R, Zbinden A, et al. Blood/gas partition coefficients of halothane, isoflurane and sevoflurane in horse blood. Br J Anaesth 2003; 91:276278.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Whitehair KJ, Steffey EP, Willits NH, et al. Recovery of horses from inhalation anesthesia. Am J Vet Res 1993; 54:16931702.

  • 20.

    Wagner AE, Bednarski RM, Muir WW III. Hemodynamic effects of carbon dioxide during intermittent positive pressure ventilation in horses. Am J Vet Res 1990; 51:19221929.

    • Search Google Scholar
    • Export Citation
  • 21.

    Khanna AK, McDonell WN, Dyson DH, et al. Cardiopulmonary effects of hypercapnia during controlled intermittent positive pressure ventilation in the horse. Can J Vet Res 1995; 59:213221.

    • Search Google Scholar
    • Export Citation
  • 22.

    Wagner AE, Muir WW III, Hinchcliff KW. Cardiovascular effects of xylazine and detomidine in horses. Am J Vet Res 1991; 52:651657.

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