Ketamine has a confounding effect on the psychomotor subscale of the pain scale studied, which may lead to erroneous administration of rescue analgesia. In contrast, alfaxalone was not associated with significant increases in either pain subscale. These effects of ketamine should be considered when evaluating acute postoperative pain in cats.

BackgroundThe aim of this study was to assess validation evidence for a sedation scale for dogs. We hypothesized that the chosen sedation scale would be unreliable when used by different raters and show poor discrimination between sedation protocols.A sedation scale (range 0–21) was used to score 62 dogs scheduled to receive sedation at two veterinary clinics in a prospective trial. Scores recorded by a single observer were used to assess internal consistency and construct validity of the scores. To assess inter-rater reliability, video-recordings of sedation assessment were randomized and blinded for viewing by 5 raters untrained in the scale. Videos were also edited to allow assessment of inter-rater reliability of an abbreviated scale (range 0–12) by 5 different raters.ResultsBoth sedation scales exhibited excellent internal consistency and very good inter-rater reliability (full scale, intraclass correlation coefficient [ICCsingle] = 0.95; abbreviated scale, ICCsingle = 0.94). The full scale discriminated between the most common protocols: dexmedetomidine-hydromorphone (median [range] of sedation score, 11 [1–18], n = 20) and acepromazine-hydromorphone (5 [0–15], n = 36, p = 0.02).ConclusionsThe hypothesis was rejected. Full and abbreviated scales showed excellent internal consistency and very good reliability between multiple untrained raters. The full scale differentiated between levels of sedation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12917-017-1027-2) contains supplementary material, which is available to authorized users.

Rupprecht T, Kuth R, Bowing B, Gerling S, Wagner M, Rascher W. Sedation and monitoring of paediatric patients undergoing open low-field MRI. Acta Paediatr 2000; 89: 1077-8 I. Stockholm.The purpose of this study was to determine the need, effectiveness and safety of sedation and monitoring in infants and children in a paediatric open low-field MRI system. Of 274 patients (median age 9y) examined, only 74 children (median age 25 mo) needed sedation. Sedation was achieved by intravenous administration of midazolam (0.2 mgkg) and etomidate (0.2 mgkg). Mean total doses required were 0.28 and 0.27 mgkg, respectively. With the exception of eight primarily ventilated patients, all children breathed spontaneously. 0 2 saturation, arterial blood pressure and ECG were monitored. The low resonance frequency of the MRI system required a specially designed high frequency (HF) shielding of the monitor system to avoid HF artifacts. The overall sedation rate was markedly lower (74/274 = 27%) compared to a control group previously examined in a closed high-field MRI system (52/111 = 47%). This was due to a significant lower need for sedation in patients aged up to 10 y (p 5 0.0001) in the open MRI unit. General anaesthesia could be avoided in all patients. No significant movement artifacts occurred in any of the MRI examinations and no serious side effects were observed.Conchwm: MRI of children is easier in an open MRI system and with fewer sedations, as in closed hi@-field systems. Sedation by a combination of rnidazolam and etomidate is highly effective and safe. M o n i t o r i n g devices for high-field systems may have to be modified for low-field systems. An inhowe pnediatric MRI unit with an open and special paediatric design is of major advantage for imaging pediatric patients. ) Harte GJ. Gray PH, Lee TC, Steer PA, Charles BG. Haemodynamic responses and population pharmacokinetics of midazolam following administration to ventilated, preterm neonates. J Paediatr Child Health 1997; 33: 335-8 Gremse DA, Kumar S, Sacks AI. Conscious sedation with highdose midazolam for pediatric gastrointestinal endoscopy. South Med J 1997; 90: 821-5 Cote CJ. Sedation for the pediatric patient. A review. Pediatr Clin

The aim of this study was to assess validation evidence for a sedation scale for dogs. We hypothesized that the chosen sedation scale would be unreliable when used by different raters and show poor discrimination between sedation protocols.A sedation scale was used to score 62 dogs scheduled to receive sedation at two veterinary clinics in a prospective trial. Scores recorded by a single observer were used to assess internal consistency and construct validity of the scores. To assess inter-rater reliability, video-recordings of sedation assessment were randomized and blinded for viewing by 5 raters untrained in the scale. Videos were also edited to allow assessment of inter-rater reliability of an abbreviated scale by 5 different raters.Both sedation scales exhibited excellent internal consistency and very good inter-rater reliability (full scale, ICCsingle = 0.95; abbreviated scale, ICCsingle = 0.94). The full scale discriminated between the most common protocols: dexmedetomidine-hydromorphone (11 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18], n = 20) and acepromazine-hydromorphone (5 [0-15], n = 36, p = 0.02).The hypothesis was rejected. Full and abbreviated scales showed excellent internal consistency and very good reliability between multiple untrained raters. The full scale differentiated between levels of sedation.

Objectives The primary study objective was to assess two injectable anesthetic protocols, given to facilitate castration surgery in cats, for equivalence in terms of postoperative analgesia. A secondary objective was to evaluate postoperative eating behavior. Methods Male cats presented to a local clinic were randomly assigned to receive either intramuscular ketamine (5 mg/kg, n = 26; KetHD) or alfaxalone (2 mg/kg, n = 24; AlfHD) in combination with dexmedetomidine (25 μg/kg) and hydromorphone (0.05 mg/kg). All cats received meloxicam (0.3 mg/kg SC) and intratesticular lidocaine (2 mg/kg). Species-specific pain and sedation scales were applied at baseline, 1, 2 and 4 h postoperatively. Time taken to achieve sternal recumbency and begin eating were also recorded postoperatively. Results Pain scale scores were low and showed equivalence between the treatment groups at all time points (1 h, P = 0.38, 95% confidence interval [CI] of the difference between group scores 0-0; 2 h, P = 0.71, 95% CI 0-0; 4 h, P = 0.97, 95% CI 0-0). Four cats crossed the threshold for rescue analgesia (KetHD, n = 1; AlfHD, n = 3). At 1 h, more cats in the KetHD (65%) group than in the AlfHD (42%) group were sedated, but statistical significance was not detected ( P = 0.15, 95% CI -1 to 0). Most AlfHD cats (88%) began eating by 1 h vs 65% of KetHD cats ( P = 0.039). Time to recover sternal recumbency did not differ between groups ( P = 0.86, 95% CI -14.1 to 11.8). Conclusions and relevance These results show that AlfHD and KetHD provide equivalent analgesia as part of a multimodal injectable anesthetic protocol. Alfaxalone is associated with an earlier return to eating.