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Abstract

Objective—To compare the anesthetic and cardiorespiratory effects of total IV anesthesia with propofol (P-TIVA) or a ketamine-medetomidine-propofol combination (KMP-TIVA) in horses.

Design—Randomized experimental trial.

Animals—12 horses.

Procedure—Horses received medetomidine (0.005 mg/kg [0.002 mg/lb], IV). Anesthesia was induced with midazolam (0.04 mg/kg [0.018 mg/lb], IV) and ketamine (2.5 mg/kg [1.14 mg/lb], IV). All horses received a loading dose of propofol (0.5 mg/kg [0.23 mg/lb], IV), and 6 horses underwent P-TIVA (propofol infusion). Six horses underwent KMP-TIVA (ketamine [1 mg/kg/h {0.45 mg/lb/h}] and medetomidine [0.00125 mg/kg/h {0.0006 mg/lb/h}] infusion; the rate of propofol infusion was adjusted to maintain anesthesia). Arterial blood pressure and heart rate were monitored. Qualities of anesthetic induction, transition to TIVA, and maintenance of and recovery from anesthesia were evaluated.

Results—Administration of KMP IV provided satisfactory anesthesia in horses. Compared with the P-TIVA group, the propofol infusion rate was significantly less in horses undergoing KMP-TIVA (0.14 ± 0.02 mg/kg/min [0.064 ± 0.009 mg/lb/min] vs 0.22 ± 0.03 mg/kg/min [0.1 ± 0.014 mg/lb/min]). In the KMP-TIVA and P-TIVA groups, anesthesia time was 115 ± 17 minutes and 112 ± 11 minutes, respectively, and heart rate and arterial blood pressure were maintained within acceptable limits. There was no significant difference in time to standing after cessation of anesthesia between groups. Recovery from KMP-TIVA and P-TIVA was considered good and satisfactory, respectively.

Conclusions and Clinical Relevance—In horses, KMP-TIVA and P-TIVA provided clinically useful anesthesia; the ketamine-medetomidine infusion provided a sparing effect on propofol requirement for maintaining anesthesia.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine cutaneous analgesia, hemodynamic and respiratory effects, and β-endorphin concentration in spinal fluid and plasma of horses after acupuncture and electroacupuncture (EA).

Animals—8 healthy 10- to 20-year-old mares that weighed between 470 and 600 kg.

Procedure—Each horse received 2 hours of acupuncture and 2 hours of PAES at acupoints Bladder 18, 23, 25, and 28 on both sides of the vertebral column as well as sham needle placement (control treatment). Each treatment was administered in a random order. At least 7 days elapsed between treatments. Nociceptive cutaneous pain threshold was measured by use of skin twitch reflex latency (STRL) and avoidance to radiant heat (≤ 50°C) in the lumbar area. Skin temperature, cardiovascular and respiratory variables, and β-endorphin concentration in spinal fluid (CSF-EN) and plasma (plasma-EN) were measured.

Results—Acupuncture and EA significantly increased STRL and skin temperature. The CSF-EN was significantly increased from baseline values 30 to 120 minutes after onset of EA, but it did not change after acupuncture and control treatments. Heart and respiratory rates, rectal temperature, arterial blood pressure, Hct, total solids and bicarbonate concentrations, base excess, plasma-EN, and results of blood gas analyses were not significantly different from baseline values after acupuncture, EA, and control treatments.

Conclusion and Clinical Relevance—Administration of EA was more effective than acupuncture for activating the spinal cord to release β-endorphins into the CSF of horses. Acupuncture and PAES provided cutaneous analgesia in horses without adverse cardiovascular and respiratory effects. (Am J Vet Res 2002;63:1435–1442)

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in American Journal of Veterinary Research

Abstract

Objective—To determine the effects of IV administration of perzinfotel and a perzinfotel-fentanyl combination on the minimum alveolar concentration (MAC) of isoflurane in dogs.

Animals—6 healthy sexually intact Beagles (3 males and 3 females).

Procedures—All dogs were instrumented with a telemetry device for continuous monitoring of heart rate, arterial blood pressure, and core body temperature (at a femoral artery). Dogs were anesthetized with propofol (6 mg/kg, IV) and isoflurane. Isoflurane MAC values were determined in 3 experiments in each dog, separated by at least 7 days, before (baseline) and after the following treatments: no treatment (anesthetic only), perzinfotel (20 mg/kg, IV), fentanyl (5 μg/kg bolus, IV, followed by a continuous IV infusion at 0.15 μg/kg/min), and a fentanyl-perzinfotel combination (20 mg of perzinfotel/kg, IV, plus the fentanyl infusion). Bispectral index and oxygen saturation as measured by pulse oximetry were also monitored throughout anesthesia.

Results—Without treatment, the mean ± SD isoflurane MAC for all 6 dogs was 1.41 ± 0.10%. Baseline MAC was 1.42 ± 0.08%. Intravenous administration of perzinfotel, fentanyl, and the perzinfotel-fentanyl combination significantly decreased the MAC by 39%, 35%, and 66%, respectively. Perzinfotel and perzinfotel-fentanyl administration yielded significant increases in the bispectral index. Mean, systolic, and diastolic arterial blood pressures significantly increased from baseline values when perzinfotel was administered. Systolic arterial blood pressure significantly increased from the baseline value when perzinfotel-fentanyl was administered. No adverse effects were detected.

Conclusions and Clinical Relevance—IV administration of perzinfotel, fentanyl, or a perzinfotel-fentanyl combination reduced isoflurane MAC in dogs and increased arterial blood pressure.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine the effect of IV administration of perzinfotel on the minimum alveolar concentration (MAC) of isoflurane in dogs.

Animals—6 healthy sexually intact male Beagles.

Procedures—Dogs were instrumented with a telemetry device that permitted continuous monitoring of heart rate, arterial blood pressure, and body temperature. Dogs were anesthetized with propofol (4 to 6 mg/kg, IV) and isoflurane for 30 minutes before determination of MAC of isoflurane. Isoflurane MAC values were determined 4 times, separated by a minimum of 7 days, before and after IV administration of perzinfotel (0 [control], 5, 10, and 20 mg/kg). Bispectral index and percentage hemoglobin saturation with oxygen (SpO2 ) were monitored throughout anesthesia.

Results—Isoflurane MAC was 1.32 ± 0.14%. Intravenous administration of perzinfotel at 0, 5, 10, and 20 mg/kg decreased isoflurane MAC by 0%, 24%, 30%, and 47%, respectively. Perzinfotel significantly decreased isoflurane MAC values, compared with baseline and control values. The bispectral index typically increased with higher doses of perzinfotel and lower isoflurane concentrations, but not significantly. Heart rate, body temperature, and SpO2 did not change, but systolic, mean, and diastolic arterial blood pressures significantly increased with decreases in isoflurane MAC after administration of perzinfotel at 10 and 20 mg/kg, compared with 0 and 5 mg/kg.

Conclusions and Clinical Relevance—IV administration of perzinfotel decreased isoflurane MAC values. Improved hemodynamics were associated with decreases in isoflurane concentration.

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine the effects of constant rate infusion of morphine, lidocaine, ketamine, and morphine- lidocaine-ketamine (MLK) combination on endtidal isoflurane concentration (ET-Iso) and minimum alveolar concentration (MAC) in dogs anesthetized with isoflurane and monitor depth of anesthesia by use of the bispectral index (BIS).

Animals—6 adult dogs.

Procedure—Each dog was anesthetized with isoflurane on 5 occasions, separated by a minimum of 7 to 10 days. Individual isoflurane MAC values were determined for each dog. Reduction in isoflurane MAC, induced by administration of morphine (3.3 µg/kg/min), lidocaine (50 µg/kg/min), ketamine (10 µg/kg/min), and MLK, was determined. Heart rate, mean arterial blood pressure, oxygen saturation as measured by pulse oximetry (SpO2), core body temperature, and BIS were monitored.

Results—Mean ± SD isoflurane MAC was 1.38 ± 0.08%. Morphine, lidocaine, ketamine, and MLK significantly lowered isoflurane MAC by 48, 29, 25, and 45%, respectively. The percentage reductions in isoflurane MAC for morphine and MLK were not significantly different but were significantly greater than for lidocaine and ketamine. The SpO2, mean arterial pressure, and core body temperature were not different among groups. Heart rate was significantly decreased at isoflurane MAC during infusion of morphine and MLK. The BIS was inversely related to the ET-Iso and was significantly increased at isoflurane MAC during infusions of morphine and ketamine, compared with isoflurane alone.

Conclusions and Clinical Relevance—Low infusion doses of morphine, lidocaine, ketamine, and MLK decreased isoflurane MAC in dogs and were not associated with adverse hemodynamic effects. The BIS can be used to monitor depth of anesthesia. (Am J Vet Res 2003;64:1155–1160)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To compare the effects of acupuncture (AP), electroacupuncture (EA), and transcutaneous cranial electrical stimulation (TCES) with high-frequency intermittent currents on the minimum alveolar concentration (MAC) of isoflurane and associated cardiovascular variables in dogs.

Animals—8 healthy adult female Beagles.

Procedure—Each dog was anesthetized with isoflurane on 4 occasions, allowing a minimum of 10 days between experiments. Isoflurane MAC values were determined for each dog without treatment (controls) and after treatment with AP and EA (AP points included the Large Intestine 4, Lung 7, Governing Vessel 20, Governing Vessel 14, San Tai, and Baihui) and TCES. Isoflurane MAC values were determined by use of noxious electrical buccal stimulation. Heart rate, mean arterial blood pressure (MAP), arterial blood oxygen saturation (SpO2) measured by use of pulse oximetry, esophageal body temperature, inspired and expired end-tidal isoflurane concentrations, end-tidal carbon dioxide concentration, and bispectral index (BIS) were monitored. Blood samples were collected for determination of plasma cortisol concentration.

Results—Mean ± SD baseline MAC of isoflurane was 1.19 ± 0.1%. Acupuncture did not significantly change MAC of isoflurane. Treatments with EA and TCES significantly lowered the MAC of isoflurane by 10.1% and 13.4%, respectively. The SpO2, heart rate, MAP, BIS, esophageal body temperature, and plasma cortisol concentration were not significantly different after AP, EA, TCES, and control treatments at any time interval.

Conclusions and Clinical Relevance—Use of EA and TCES decreased MAC of isoflurane in dogs without inducing adverse hemodynamic effects. However, the reduction in isoflurane MAC by EA and TCES treatments was not considered clinically relevant. (Am J Vet Res 2005;66:1364–1370)

Full access
in American Journal of Veterinary Research
in Journal of the American Veterinary Medical Association
in Journal of the American Veterinary Medical Association

Abstract

Objective—To estimate the prevalence and characteristics of pain in dogs and cats examined by an emergency service at a veterinary teaching hospital and evaluate the response of dogs and cats with signs of pain to analgesic treatment.

Design—Cross-sectional study.

Animals—317 dogs and 112 cats.

Procedure—A questionnaire was used to categorize the characteristics of pain. The location, cause, and signs of pain were determined by obtaining a thorough history and conducting a physical examination. Pain was categorized by type (superficial somatic, deep somatic, or visceral), mechanism (inflammatory, neuropathic, or both), severity (mild, moderate, or severe), and duration. Evidence for primary or secondary hypersensitivity and hyposensitivity to manipulation was determined. The response to single or multiple analgesic drug administration was assessed.

Results—179 (56%) dogs and 60 (54%) cats had signs of pain. In most of these dogs and cats, pain was classified as acute (< 24 hours' duration) and of moderate severity and was associated with primary hypersensitivity. Most dogs had deep somatic pain; most cats had visceral pain. Inflammation was the most common mechanism. One hundred nineteen (66%) dogs and 41 (68%) cats were treated with analgesic drugs. Analgesic treatment was considered effective in 73 (61%) dogs and 31 (76%) cats.

Conclusions and Clinical Relevance—Results suggest that moderate to severe acute somatic pain caused by inflammation is common in dogs and cats examined by an emergency service and that a combination of multiple analgesic drugs is more effective than any single analgesic drug in the treatment of pain in these dogs and cats. (J Am Vet Med Assoc 2005;226:2004–2009)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective–To determine prevalence of pain among dogs and cats examined as outpatients at a veterinary teaching hospital and characteristics of pain in dogs and cats with evidence of pain.

Design–Cross-sectional study.

Animals–1,153 dogs and 652 cats examined as outpatients at The Ohio State University during 2002.

Procedure–A questionnaire was administered to owners of all dogs and cats. For dogs and cats with evidence of pain, the cause, signs, anatomic location, type (superficial somatic, deep somatic, or visceral), duration, and severity of the pain and the principle mechanism (inflammatory, neuropathic, both, or unknown) responsible for the pain were determined on the basis of questionnaire responses and results of physical examination. The presence of primary hyperalgesia, secondary hyperalgesia, allodynia, and hyposensitivity was recorded.

Results–231 (20%) dogs and 92 (14%) cats had evidence of pain. Dogs with evidence of pain were significantly older and heavier than dogs without. Cats with evidence of pain were significantly older than cats without. In most dogs and cats with evidence of pain, the pain was determined to be of short duration (< 7 days), of mild or moderate severity, somatic, associated with primary hyperalgesia, and inflammatory. Analgesic drugs were frequently administered to dogs with chronic pain, but were not always considered effective.

Conclusions and Clinical Relevance–Results suggest that mild or moderate pain associated with inflammation may be seen in dogs and cats examined as outpatients. Older, heavier dogs and older cats were more likely to have evidence of pain. (J Am Vet Med Assoc 2004;224:1459–1463)

Full access
in Journal of the American Veterinary Medical Association