Dexmedetomidine or fentanyl? Cardiovascular stability and analgesia during propofol-ketamine total intravenous anaesthesia in experimental pigs

Lervik, Andreas; Raszplewicz, Joanna; Ranheim, Birgit; Solbak, Susanna; Toverud, Simen F; Haga, Henning Andreas

doi:10.1016/j.vaa.2017.08.012

Cited by 20 publications

(24 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…DEX appears to be superior to lidocaine and fentanyl in terms of MIR reduction of ketofol. Consistent with the results of the current study, in a study conducted on pigs, the combination use of ketamine-propofol-DEX has been observed to have more analgesic properties compared to the time when fentanyl was substituted to DEX [31].…”

Section: Discussionsupporting

confidence: 90%

WITHDRAWN: Determination of Minimum Infusion Rate and Cardiorespiratory Effects of Total Intravenous Anesthesia of Ketofol With or Without Lidocaine, Fentanyl or Dexmedetomidine in Dogs

Rastabi

Naddaf

Mosallanejad

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Ketofol is a 1:1 mixture of ketamine and propofol that has been proposed for induction and maintenance of anesthesia aiming to provide more cardiovascular stability and less undesirable impacts compared to the use of propofol and ketamine alone. However, it has been associated with exacerbated respiratory depression in dogs. Diminishing the dose of ketofol may improve cardiovascular effects and attenuate respiratory depression. The present study was designed to evaluate the effect of adding lidocaine, fentanyl or dexmedetomidine at the required dose and cardiorespiratory variables in dogs undergoing total intravenous anesthesia (TIVA) with ketofol. In phase I, twelve dogs were induced and maintained with two out of four anesthetic regimens of KET: ketofol (4 mg/kg and 0.3 mg/kg/min, respectively), KLD; ketofol and lidocaine (1.5 mg/kg and 0.25 mg/kg/min, respectively), KFN: ketofol and fentanyl (LD: 5 µg/kg and 0.1 µg/kg/min, respectively) and KDX: ketofol and dexmedetomidine (2 µg/kg and 2 mg/kg/h, respectively). Minimum infusion rate (MIR) of ketofol was determined in this phase. Subsequently, in phase II, other twelve dogs were given the same anesthetic regimens for 60 min similar to the previous phase, except the infusion rate of ketofol. Cardiorespiratory variables were recorded in predetermined interval. Results: In phase I, mean MIR of ketofol for KET, KLD, KFN and KDX were determined to have decreasing manner as 0.35, 0.23, 0.15, and 0.08 mg/kg/min, respectively. In phase II, the times of recovery events were shorter in KFN and KDX than KET and KLD. Notably, HR was significantly higher than baseline during anesthesia in KET and KLD, which also was significantly lower than baseline in KFN and KDX at several time points. Significant higher values of MAP were observed over time in KDX. In all treatments, there was a decrease in respiratory rate and pH as well as an increase in PCO2 during the anesthesia session. Conclusions: It was concluded that despite decreasing the dose of ketofol, none of the added drugs attenuated respiratory depression caused by ketofol.

show abstract

Section: Discussionsupporting

confidence: 90%

WITHDRAWN: Determination of Minimum Infusion Rate and Cardiorespiratory Effects of Total Intravenous Anesthesia of Ketofol With or Without Lidocaine, Fentanyl or Dexmedetomidine in Dogs

Rastabi

Naddaf

Mosallanejad

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The cause of this vascular unresponsiveness cannot be elucidated in our study. The cardiac index found at baseline in this experiment was similar in both groups, and also similar to that found in our previous publication in normovolemic pig given either fentanyl or dexmedetomidine in combination with propofol and ketamine (2). This leads us to believe that the cardiovascular effects Cardiac index (CI), stroke volume index (SVI), and total peripheral resistance (TPR) are illustrated as Mean ± SEM, and black line and filled circles represent pigs anesthetized with propofol 8 mg kg −1 h −1 .…”

Section: Discussionsupporting

confidence: 91%

Macrocirculatory Parameters and Oxygen Debt Indices in Pigs During Propofol Or Alfaxalone Anesthesia When Subjected to Experimental Stepwise Hemorrhage

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: Pigs are anesthetized when used for emergency procedures live tissue training (LTT) of civilian and military medical personnel or for experimental purposes, but there is a paucity in the literature regarding anesthesia of pigs for this purpose.Objective(s): The main goals of the study were to compare oxygen debt, macrocirculatory parameters, and time to cardiac arrest between pigs in hemorrhagic shock and anesthetized with propofol-ketamine-dexmedetomidine or alfaxalone-ketamine-dexmedetomidine.Design: A prospective, non-blinded randomized study design was used. Sixteen pigs were randomized in blocks of four to be anesthetized with either propofol-ketamine-dexmedetomidine (n = 8) or alfaxalone-ketamine-dexmedetomidine (n = 8) as a continuous infusion.Interventions: Premedication with ketamine 15 mg kg−1 and midazolam 1 mg kg−1 was given i.m. Anesthesia was maintained with propofol 8 mg kg−1 h−1 or alfaxalone 5 mg kg−1 h−1 combined with ketamine 5 mg kg−1 h−1 and dexmedetomidine 4 μg kg−1 h−1 i.v. A stepwise, volume-controlled model for hemorrhage was created by exsanguination.Main Outcome Measures: Indices of oxygen debt (lactate, base excess, and oxygen extraction), macrocirculatory (PR, SAP, DAP, MAP, and CI, SVI, and TPR) variables, and time to death was compared between groups.Results: Pigs in the alfaxalone group had significantly higher SAP than pigs given propofol. No difference in other macrocirculatory variables or indices of oxygen debt could be found. A blood loss of 50% of the total blood volume or more was possible in most pigs with both anesthetic regimes.Conclusions: Pigs anesthetized with propofol or alfaxalone combined with ketamine and dexmedetomidine tolerated substantial blood loss.

show abstract

“…All drugs were diluted using 0.9% NaCl (Natriumklorid Fresenius Kabi, Fresenius Kabi, Halden, Norway) and were given as a continuous infusion delivered by syringe drivers (Alaris GH Plus, BD Medical, Franklin Lakes, NJ, USA). The doses of propofol, ketamine and dexmedetomidine were chosen based on the results from a previous study [4]. The alfaxalone dose used was based on a dose titration pilot study in four pigs, where the lowest infusion rate abolishing the motor response to the same standardised electrical nociceptive stimulation used in the previous study [4] was determined.…”

Section: Anaesthesia Monitoring and Data Collectionmentioning

confidence: 99%

“…The doses of propofol, ketamine and dexmedetomidine were chosen based on the results from a previous study [4]. The alfaxalone dose used was based on a dose titration pilot study in four pigs, where the lowest infusion rate abolishing the motor response to the same standardised electrical nociceptive stimulation used in the previous study [4] was determined.…”

Section: Anaesthesia Monitoring and Data Collectionmentioning

confidence: 99%

“…In a previous publication, a total intravenous anaesthetic (TIVA) protocol containing propofol, ketamine and dexmedetomidine was found to provide stable cardiovascular conditions and excellent antinociception in healthy pigs [4]; features that are important when delivering anaesthesia during invasive surgical procedures in experimental animals. The effect on spontaneous ventilation was not examined in that study, but propofol has long been known to cause hypoventilation or even apnoea in several animal species including dogs and sheep when given intravenously [5,6].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A comparison of respiratory function in pigs anaesthetised by propofol or alfaxalone in combination with dexmedetomidine and ketamine

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background: General anaesthesia in pigs maintained with intravenous drugs such as propofol may cause respiratory depression. Alfaxalone gives less respiratory depression than propofol in some species. The aim of the investigation was to compare respiratory effects of propofol-ketamine-dexmedetomidine and alfaxalone-ketamine-dexmedetomidine in pigs. Sixteen pigs premedicated with ketamine 15 mg/kg and midazolam 1 mg/kg intramuscularly were anaesthetised with propofol or alfaxalone to allow endotracheal intubation, followed by propofol 8 mg/kg/h or alfaxalone 5 mg/kg/h in combination with ketamine 5 mg/kg/h and dexmedetomidine 4 µg/kg/h given as a continuous infusion for 60 min. The pigs breathed spontaneously with an FIO 2 of 0.21. Oxygen saturation (SpO 2), end-tidal CO 2 concentration (PE′CO 2), respiratory rate (f R) and inspired tidal volume (V T) were measured, and statistically compared between treatments. If the SpO 2 dropped below 80% or if PE′CO 2 increased above 10.0 kPa, the pigs were recorded as failing to complete the study, and time to failure was statistically compared between treatments. Results: Alfaxalone treated pigs had significantly higher respiratory rates and lower PE′CO 2 than propofol treated pigs, with a f R being 7.3 /min higher (P = 0.01) and PE′CO 2 0.8 kPa lower (P = 0.05). SpO 2 decreased by 0.6% and f R by 1.0 /min per kg increase in body weight in both treatment groups. Three of eight propofol treated and two of eight alfaxalone treated pigs failed to complete the study, and times to failure were not significantly different between treatments (P = 0.75). Conclusions: No major differences in respiratory variables were found when comparing treatments. Respiratory supportive measures must be available when using both protocols.

show abstract

Dexmedetomidine or fentanyl? Cardiovascular stability and analgesia during propofol-ketamine total intravenous anaesthesia in experimental pigs

Cited by 20 publications

References 43 publications

WITHDRAWN: Determination of Minimum Infusion Rate and Cardiorespiratory Effects of Total Intravenous Anesthesia of Ketofol With or Without Lidocaine, Fentanyl or Dexmedetomidine in Dogs

WITHDRAWN: Determination of Minimum Infusion Rate and Cardiorespiratory Effects of Total Intravenous Anesthesia of Ketofol With or Without Lidocaine, Fentanyl or Dexmedetomidine in Dogs

Macrocirculatory Parameters and Oxygen Debt Indices in Pigs During Propofol Or Alfaxalone Anesthesia When Subjected to Experimental Stepwise Hemorrhage

A comparison of respiratory function in pigs anaesthetised by propofol or alfaxalone in combination with dexmedetomidine and ketamine

Contact Info

Product

Resources

About