Clinical evaluation of ketamine and lidocaine intravenous infusions to reduce isoflurane requirements in horses under general anaesthesia

Enderle, Alke K; Levionnois, Olivier; Kuhn, M; Schatzmann, U.

doi:10.1111/j.1467-2995.2007.00391.x

Cited by 53 publications

(48 citation statements)

References 26 publications

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“…ketamine at 60 µg per kg body weight per min and i.v. lidocaine at 40 µg per kg body weight per min 9 . Additionally, these horses received loading doses of both i.v.…”

Section: Discussionmentioning

confidence: 99%

“…infusions of ketamine and lidocaine had a mean end-tidal isoflurane (ETISO) concentration of 0.97 ± 0.33%, whereas horses that did not receive infusions of ketamine and lidocaine had a mean ETISO concentration of 1.57 ± 0.22% (ref. 9). In addition to reducing the amount of inhaled anesthetic required, infusion of ketamine during surgery improved postoperative pain management in dogs 10 .…”

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confidence: 93%

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Effect of intravenous ketamine and lidocaine on isoflurane requirement in sheep undergoing orthopedic surgery

et al. 2010

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Intravenous ketamine and lidocaine infusions may be useful adjuncts to inhalation anesthesia for sheep undergoing orthopedic surgery. In this study, 50 female sheep underwent experimental stifle surgery (29 received a meniscal implant and 21 received sham surgery). To induce anesthesia in the sheep, the authors intravenously injected ketamine and diazepam. They administered isoflurane in oxygen to maintain anesthesia and used mechanical ventilation to maintain normal arterial carbon dioxide pressure. Some sheep received intravenous infusions of ketamine and lidocaine during surgery, whereas others did not. Sheep that received a meniscal implant without ketamine-lidocaine required approximately 23% greater isoflurane concentrations than sheep that were given ketamine-lidocaine. These findings suggest that intravenous infusion of ketamine and lidocaine decreases the requirement for isoflurane during orthopedic surgery on anesthetized sheep.

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“…ketamine at 60 µg per kg body weight per min and i.v. lidocaine at 40 µg per kg body weight per min 9 . Additionally, these horses received loading doses of both i.v.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 93%

Effect of intravenous ketamine and lidocaine on isoflurane requirement in sheep undergoing orthopedic surgery

et al. 2010

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“…This was confirmed by Villalba et al (2011) where the addition of morphine did not further reduce the anaesthetic requirement. Enderle et al (2008) reported that volatile anaesthesia with isoflurane and additional intravenous lidocaine and ketamine CRI results in a more stable anaesthesia with less undesirable cardiovascular depression. The sedative and analgesic activity of lidocaine was also demonstrated in conscious horses (Malone et al 2006, Milligan et al 2007).…”

Section: Discussionmentioning

confidence: 99%

“…This result correlates with MAC reduction of volatile agents in the studies of Doherty and Frazier (1998) for 20% of halothane use under experimental condition, and 25% of isoflurane use by Dzikiti et al (2003) in a clinical setting where 2.5 mg kg -1 followed by 3 mg kg-1 h-1 of lidocaine was administered. When ketamine and lidocaine infusions are added to isoflurane anaesthesia, the isoflurane requirement can be further reduced down to 1.0% (Enderle et al 2008). This was confirmed by Villalba et al (2011) where the addition of morphine did not further reduce the anaesthetic requirement.…”

Section: Discussionmentioning

confidence: 99%

Continuous intravenous lidocaine infusion during isoflurane anaesthesia in horses undergoing surgical procedures

Schuhbeck¹,

Kuhn²,

Spadavecchia³

et al. 2012

PHK

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SummaryThe aim of the present study was to evaluate the adjunction of lidocaine as a continuous intravenous (IV) infusion during general anaesthesia with isoflurane in a clinical setting. For this purpose sixty horses (ASA I-III) undergoing elective surgery were assigned to a prospective, blinded, randomized clinical trial. After induction of anaesthesia, isoflurane end-tidal concentration was set at 1.3% and subsequently adjusted to maintain surgical plane of anaesthesia. Horses assigned to the group ISO-L (n=40) received IV lidocaine (1.5 mg kg -1 , followed by 2.4 mg kg -1 hr -1 , reduced later to 2 mg kg -1 hr -1 ) until 15 minutes before the end of the anaesthesia, while the control group ISO (n=20) received physiologic saline solution. All horses were ventilated mechanically. Mean arterial pressure (MAP) was maintained over 70 mmHg by IV infusion of dobutamine when necessary. Recovery quality was scored from one (very good) to five (very poor). The isoflurane concentration required in ISO-L group decreased down to 24% less (1.2% vs. 1.57%, P<0.05) than in the ISO group with time. Physiological parameters were similar in both groups. Recovery phases were scored of slight, but significant poorer quality (P=0.034) in horses receiving lidocaine (2, IQR 1-3) than in the control group (1, IQR 1-2), although the quality was still acceptable. The use of a continuous IV infusion of lidocaine at 2-2.4 mg kg -1 hr -1 during general anaesthesia allowed for 24% reduction of the isoflurane requirement, without relevant difference in clinical cardiovascular parameters. Under the condition of the present study, the administration of lidocaine tended to reduce moderately the quality of recovery from anaesthesia. . Nach Prä-medikation mit Romifidin und Narkoseeinleitung mit Diazepam und Ketamin wurden die Tiere orotracheal intubiert und an ein Kreissystem angeschlossen. Die endexspiratorische Isoflurankonzentration wurde auf 1.3 % eingestellt und während der gesamten Narkosedauer angepasst, um ein Narkosestadium der chirurgischen Toleranz aufrechtzuerhalten. Nach 50 Minuten wurde die Infusionsrate des Lidocain auf 2 mg kg -1 h -1 reduziert und die Infusion 15 Minuten vor Narkoseende gestoppt. Die klinischen Standardparameter für Atmung und Kreislauf wurden aufgezeichnet. Durch mechanische Beatmung wurde der endexspiratorische CO 2 -Wert auf 5,3 kPa (40 mmHg) gehalten. Der mittlere arterielle Blutdruck wurde über 70 mmHg gehalten und wenn nötig durch Dobutamin Infusion unterstützt. Bei Anzeichen ungenü-gender Narkosetiefe (Nystagmus und/oder Bewegung), erhielten die Pferde Thiopental (0.5-1.5 mg kg -1 ). Bei Narkoseende erhielten die Pferde jeweils zusätzlich einen Bolus Romifidin (0.01 mg kg -1 ). Die Aufwachphase wurde bewertet von 1 (sehr gut) bis 5 (sehr schlecht). Die benötigte Isofluran Konzentration für die Pferde in der Gruppe ISO-L nahm während der gesamten Narkosedauer stetig ab, so dass nach 60 min 24% weniger Isofluran notwendig war (1.2%), als in der reinen ISO-Gruppe (1.57%). Die physiologischen Parameter waren...

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“…In goats, lidocaine given as a constant rate infusion (CRI) of 100 μg/kg/ min decreased the minimum alveolar concentration of isoflurane by 18.7% (DOHERTy et al, 2007). In horses, the isoflurane requirement was reduced by 61% when lidocaine was administered at 100 μg/kg/min along with ketamine (50 μg/kg/ min) (ENDERLE et al, 2008). Mannarino (2002) observed that the inclusion of 250 μg/kg/minute of lidocaine in the protocol with propofol reduced the dose of the propofol needed by 21% whithout hemodynamic changes.…”

Section: Introductionmentioning

confidence: 99%

High doses of lidocaine as a constant rate infusion in propofol/fentanyl anaesthetized sheep: cardiorespiratory effects

et al. 2013

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The aim of this study was to investigate the cardiorespiratory and anesthetic-sparing effects of a highdose CRI of lidocaine (200 μg/kg/min) administered with a propofol/fentanyl regimen to sheep. Twelve adult, castrated male sheep (BW= 32.1 ± 4.9 kg), were used in a prospective, randomized clinical trial. All animals were premedicated with xylazine (0.05 mg/kg, i.m.). Animals in the GPF group were induced with propofol (3 mg/kg) and fentanyl (2.5 μg/kg) intravenously, and anesthesia was maintained with a CRI of propofol (500 μg/kg/min) and fentanyl (0.15 μg/kg/min). In the GPFL group, animals were induced with propofol (3 mg/kg), fentanyl (2.5 μg/kg) and lidocaine (2.5 mg/kg) intravenously, and anesthesia was maintained with a CRI of propofol (500 μg/kg/min), fentanyl (0.15 μg/kg/min) and lidocaine (200 μg/kg/min); after ten minutes of anesthesia, the propofol dose was reduced by 25% (from 500 μg/kg/min to 375 μg/kg/min). Cardiorespiratory parameters were recorded from 15 minutes after preanesthetic medication administration (T0) to the end of the anesthetic procedure (T7). The time points were as follows: T0 -15 minutes after preanesthetic medication administration; T1 -after anesthesia induction and orotracheal intubation; T2 -15 minutes of anesthesia; T3 -during traction on the liver; T4 -during bowel clamping; T5 -during muscle suture; T6 -at the end of skin suture; and T7 -15 minutes after the end of anesthesia. Apnea was present in all animals during anesthesia induction and required mechanical ventilation. There was no statistical difference in HR and MAP between any time points compared to the baseline value (p > 0.05); MAP was lower in the GPF group (p < 0.05) at time T6. In conclusion, this dose of lidocaine was sufficient to reduce the propofol requirement by 25%. A high-dose CRI of lidocaine in combination with a propofol/fentanyl regmine did not promote significant cardiovascular changes and was effective in reducing the propofol dose by 25%. ResumoO objetivo desse estudo foi investigar os efeitos cardiorrespiratórios e a redução na dose de propofol, mediante a infusão contínua de altas doses de lidocaína (200 μg/kg/min) em associação ao propofol/ fentanil. Para tanto, foram utilizados 12 ovinos machos castrados (peso médio de 32,1 ± 4,9 kg), distribuídos em dois grupos de seis animais, designados como grupo GPF e GPFL em estudo clínico, prospectivo e aleatório. Todos os animais foram pré-medicados com xilazina (0,05 mg/kg, i.m.). A indução anestésica do grupo GPF constou de propofol (3 mg/kg) e fentanil (2,5 μg/kg) adminitrados por via intravenosa e a anestesia foi mantida com a infusão contínua de propofol (500 μg/kg/min) e fentanil (0,15 μg/kg/min). No grupo GPFL foram induzidos a anestesia com propofol (3 mg/kg), fentanil (2,5 μg/kg) e lidocaína (2,5 mg/kg), i.v.; após 10 minutos de manutenção anestésica, neste grupo a dose de propofol foi reduzida em 25% (500 μg/kg/min para 375 μg/kg/min). Os parâmetros cardiorrespiratórios foram coletados 15 minutos após a medicação pré-anestésica (T...

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Clinical evaluation of ketamine and lidocaine intravenous infusions to reduce isoflurane requirements in horses under general anaesthesia

Cited by 53 publications

References 26 publications

Effect of intravenous ketamine and lidocaine on isoflurane requirement in sheep undergoing orthopedic surgery

Effect of intravenous ketamine and lidocaine on isoflurane requirement in sheep undergoing orthopedic surgery

Continuous intravenous lidocaine infusion during isoflurane anaesthesia in horses undergoing surgical procedures

High doses of lidocaine as a constant rate infusion in propofol/fentanyl anaesthetized sheep: cardiorespiratory effects

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