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Application of fast-track surgery principles to evaluate effects of atipamezole on recovery and analgesia following ovariohysterectomy in cats anesthetized with dexmedetomidine-ketamine-hydromorphone

Michelle M. M. HasiukDepartment of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.

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Dean BrownDepartment of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.

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Claire CooneyCity of Calgary Animal Services Centre Clinic, 2201 Portland St SE, Calgary, AB T2G 4M7, Canada.

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Marta GunnCity of Calgary Animal Services Centre Clinic, 2201 Portland St SE, Calgary, AB T2G 4M7, Canada.

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Daniel S. J. PangDepartment of Veterinary Clinical and Diagnostic Sciences, Faculty of Veterinary Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Hotchkiss Brain Institute, University of Calgary, Calgary, AB T2N 1N4, Canada.

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Abstract

Objective—To evaluate the effects of atipamezole hydrochloride on recovery and analgesia following ovariohysterectomy in cats anesthetized with a dexmedetomidine hydrochloride, ketamine hydrochloride, and hydromorphone hydrochloride combination, in accordance with fast-track surgery principles.

Design—Prospective, randomized, clinical trial.

Animals—44 cats.

Procedures—Cats were anesthetized with a combination of dexmedetomidine (15 μg/kg [6.8 μg/lb]), ketamine (5 mg/kg [2.3 mg/lb]), and hydromorphone (0.05 mg/kg [0.023 mg/lb]), IM, supplemented with isoflurane in oxygen. Immediately after ovariohysterectomy, cats received meloxicam (0.2 mg/kg [0.09 mg/lb]) SC and either atipamezole (75 μg/kg [34.1 μg/lb]) or an equivalent volume of saline (0.9% NaCl) solution IM. Pain and sedation were scored at baseline (prior to surgery) and at predetermined intervals after surgery. Time to sternal recumbency was recorded.

Results—The atipamezole group recovered to sternal recumbency faster (median, 15 minutes; range, 5 to 60 minutes) than the saline solution group (median, 60 minutes; range, 15 to 90 minutes]). Pain scores did not differ between groups or at any time, compared with baseline, and were below the intervention threshold for most cats. Sedation scores were significantly greater in the saline solution group (median, 0; range, 0 to 2) at 2 hours after surgery, compared with the atipamezole group (median, 0; range, 0 to 0).

Conclusions and Clinical Relevance—Results indicated that administration of atipamezole, compared with saline solution, allowed for a faster recovery from anesthesia with dexmedetomidine-ketamine-hydromorphone in cats following ovariohysterectomy without compromising analgesia. These findings have implications for the provision of appropriate postoperative analgesia following ovariohysterectomy in cats. (J Am Vet Med Assoc 2015;246:645–653)

Abstract

Objective—To evaluate the effects of atipamezole hydrochloride on recovery and analgesia following ovariohysterectomy in cats anesthetized with a dexmedetomidine hydrochloride, ketamine hydrochloride, and hydromorphone hydrochloride combination, in accordance with fast-track surgery principles.

Design—Prospective, randomized, clinical trial.

Animals—44 cats.

Procedures—Cats were anesthetized with a combination of dexmedetomidine (15 μg/kg [6.8 μg/lb]), ketamine (5 mg/kg [2.3 mg/lb]), and hydromorphone (0.05 mg/kg [0.023 mg/lb]), IM, supplemented with isoflurane in oxygen. Immediately after ovariohysterectomy, cats received meloxicam (0.2 mg/kg [0.09 mg/lb]) SC and either atipamezole (75 μg/kg [34.1 μg/lb]) or an equivalent volume of saline (0.9% NaCl) solution IM. Pain and sedation were scored at baseline (prior to surgery) and at predetermined intervals after surgery. Time to sternal recumbency was recorded.

Results—The atipamezole group recovered to sternal recumbency faster (median, 15 minutes; range, 5 to 60 minutes) than the saline solution group (median, 60 minutes; range, 15 to 90 minutes]). Pain scores did not differ between groups or at any time, compared with baseline, and were below the intervention threshold for most cats. Sedation scores were significantly greater in the saline solution group (median, 0; range, 0 to 2) at 2 hours after surgery, compared with the atipamezole group (median, 0; range, 0 to 0).

Conclusions and Clinical Relevance—Results indicated that administration of atipamezole, compared with saline solution, allowed for a faster recovery from anesthesia with dexmedetomidine-ketamine-hydromorphone in cats following ovariohysterectomy without compromising analgesia. These findings have implications for the provision of appropriate postoperative analgesia following ovariohysterectomy in cats. (J Am Vet Med Assoc 2015;246:645–653)

Contributor Notes

Supported by Zoetis. Ms. Hasiuk received a summer student scholarship from Zoetis and the SURE program of the University of Calgary Faculty of Veterinary Medicine.

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The authors thank Arlene Johnson, Doris Porter, Jackie Walters, Karen Brick, Lee Head, Tiffany Ramsden, Sonja Gavora, and Wendy Weed for technical assistance.

Address correspondence to Dr. Pang (dsjpang@ucalgary.ca).