All 3 drugs showed similar effects in relation to anaesthetic induction and recovery qualities and cardiopulmonary responses. However, alfaxalone and thiopental prolonged recovery time compared with ketamine.
Anesthetic and cardiorespiratory effects of total intravenous anesthesia (TIVA) technique
using propofol-guaifenesin-medetomidine (PGM) and alfaxalone-guaifenesin-medetomidine
(AGM) were preliminarily evaluated in Thoroughbred horses undergoing castration. Twelve
male Thoroughbred horses were assigned randomly into two groups. After premedication with
intravenous (IV) administrations of medetomidine (5.0 µg/kg) and
butorphanol (0.02 mg/kg), anesthesia was induced with guaifenesin (10 mg/kg IV), followed
by either propofol (2.0 mg/kg IV) (group PGM: n=6) or alfaxalone (1.0 mg/kg IV) (group
AGM: n=6). Surgical anesthesia was maintained for 60 min at a constant infusion of either
propofol (3.0 mg/kg/hr) (group PGM) or alfaxalone (1.5 mg/kg/hr) (group AGM), in
combination with guaifenesin (80 mg/kg/hr) and medetomidine (3.0
µg/kg/hr). Responses to surgical stimuli, cardiorespiratory values, and
induction and recovery characteristics were recorded throughout anesthesia. During
anesthesia induction, one horse paddled in group PGM. All horses from group AGM were
maintained at adequate anesthetic depth for castration. In group PGM, 3 horses showed
increased cremaster muscle tension and one showed slight movement requiring additional IV
propofol to maintain surgical anesthesia. No horse exhibited apnea, although arterial
oxygen tension decreased in group AGM to less than 60 mmHg. Recovery quality was good to
excellent in both groups. In conclusion, TIVA using PGM and AGM infusion was available for
60 min anesthesia in Thoroughbred horses. TIVA techniques using PGM and AGM infusion
provided clinically acceptable general anesthesia with mild cardiorespiratory depression.
However, inspired air should be supplemented with oxygen to prevent hypoxemia during
anesthesia.
To investigate the clinical pharmacokinetics and pharmacodynamics of intravenous alfaxalone in young Thoroughbred horses, seven Thoroughbred horses were randomly anaesthetised twice with either 1 or 2 mg/kg of intravenous alfaxalone after premedication with medetomidine (6 µg/kg intravenous) and midazolam (20 µg/kg intravenous). Blood samples were collected at predetermined time points up to two hours after administration. Plasma alfaxalone concentrations were quantified by a liquid chromatography tandem-mass spectrometry method and analysed by non-compartmental pharmacokinetic analysis. Induction and recovery qualities were good to excellent for both doses. Recovery time for the 2 mg/kg (median 90 minutes) was significantly longer than that for the 1 mg/kg (median 50 minutes). Respiratory rate for the 2 mg/kg was significantly lower than that for the 1 mg/kg, resulting in hypoxaemia. The median (range) elimination half-life, total clearance and volume of distribution were 58.2 (42.3–70.7) minutes, 11.6 (10.3–14.5) ml/minute/kg and 0.8 (0.7–0.9) l/kg for the 1 mg/kg and 59.8 (47.5–68.0) minutes, 14.7 (12.1–16.0) ml/minute/kg and 0.9 (0.9–1.2) l/kg for the 2 mg/kg, respectively. Alfaxalone is rapidly eliminated from the plasma in young Thoroughbred horses. Respiratory depression should be especially noted when alfaxalone is used in clinical practice.
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