Evaluation of the use of midazolam as a co‐induction agent with ketamine for anaesthesia in sedated ponies undergoing field castration

Allison, Asher; Robinson, Rebecca; Jolliffe, Colette; Taylor, Polly

doi:10.1111/evj.12759

Cited by 15 publications

(12 citation statements)

References 23 publications

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“…Poor oxygenation of horses under field anaesthesia is commonly reported in the literature . Partial pressures of oxygen ranging from 5.6 to over 9.3 kPa , and SpO 2 90 to 95% have been reported when using similar protocols as the current study. There were no differences in oxygen saturation (SpO 2 89%) between the two groups, nor any adverse effects associated with the use of K5 on respiratory rate and end‐tidal CO 2 when compared with K2.2.…”

Section: Discussionsupporting

confidence: 70%

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A comparison of two ketamine doses for field anaesthesia in horses undergoing castration

Harðardóttir

Murison

Blissitt

et al. 2018

Equine Veterinary Journal

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Summary Background Ketamine at 2.2 mg/kg given i.v. is often used to induce anaesthesia for surgical procedures in horses under field conditions. Commonly, additional doses are needed to complete the surgery. We hypothesised that surgical conditions would be improved when 5 mg/kg of ketamine was used to induce anaesthesia, while induction and recovery qualities would not differ from those when 2.2 mg/kg ketamine was used. Objective To compare the anaesthetic effects of two ketamine doses (5 and 2.2 mg/kg) during field anaesthesia for castration of horses. Study design Prospective, randomised, blinded, clinical study. Method Seventy‐seven client‐owned Icelandic horses presented for castration under field conditions were studied. Pre‐anaesthetic medication was xylazine (0.7 mg/kg) butorphanol (25 μg/kg) and acepromazine (50 μg/kg) injected i.v. Anaesthesia was induced with either 2.2 mg/kg (K2.2) or 5 mg/kg (K5) i.v. of ketamine mixed with diazepam (30 μg/kg). The quality of induction, surgical conditions and recovery were compared using subjective and objective measures, and the number of additional ketamine doses recorded. Results Ketamine 5 mg/kg provided better surgical conditions and a more rapid induction. Recovery quality was subjectively better in K2.2. Five horses in K2.2 and two in K5 required additional ketamine doses. Main limitations While the pre‐anaesthetic sedation and benzodiazepine doses were consistent among horses, the level of sedation and muscle relaxation achieved differed. Conclusion A ketamine dose of 5 mg/kg can be used to improve the quality of field anaesthesia for castration in Icelandic horses. Although recovery quality is subjectively better when using 2.2 mg/kg, no adverse events were observed during recovery with either dose The Summary is available in Portuguese – see

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Section: Discussionsupporting

confidence: 70%

Section: Discussionsupporting

confidence: 70%

A comparison of two ketamine doses for field anaesthesia in horses undergoing castration

Harðardóttir

Murison

Blissitt

et al. 2018

Equine Veterinary Journal

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“…The time to recumbency is longer after administration of a dissociative agent such as ketamine than after barbiturates or alfaxalone. In equine practice, the most commonly used anaesthetic is a combination of ketamine and diazepam (Wohlfender and others 2015); the use of a benzodiazepine such as diazepam or midazolam improves induction quality, ease of intubation and surgical conditions without negatively impacting on cardiovascular parameters and recovery quality (Allison and others 2016). Hypnotic agents such as sodium thiopental produce a more rapid induction of general anaesthesia than ketamine, with the horse often lifting its head at induction; the head should be controlled to stop the horse losing its balance and falling.…”

Section: Inductionmentioning

confidence: 99%

How to do equine anaesthesia in the field

McFadzean¹,

Love²

2017

In Practice

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“…Ketamine mitigates the cardiovascular depression seen with α 2 ‐agonists, which in turn minimises the degree of muscle hypertonicity caused by ketamine, to produce a short period of safe and effective anaesthesia in horses . Induction quality and muscle relaxation can be further improved with the co‐administration of midazolam or diazepam . Anaesthetic duration can be prolonged for 5‐10 minutes by redosing with one third to one half of the induction dose of ketamine, often paired with a similar partial induction dose of xylazine, which is the most frequently used combination in clinical settings …”

Section: Introductionmentioning

confidence: 99%

Comparison of xylazine and detomidine in combination with midazolam/ketamine for field castration in Quarter Horses

Smith¹,

Bass

Damone

et al. 2020

Equine Veterinary Journal

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Background The ideal field anaesthetic protocol for castration will offer an adequate duration and depth of anaesthesia using a single injection without compromising safety or recovery quality. Objectives The objective of this study was to compare intravenous (IV) xylazine and detomidine as sedatives in combination with midazolam and ketamine for induction of anaesthesia in horses undergoing field castration. Study design Randomised, blinded, clinical study. Methods Fifty‐seven male Quarter Horses were randomly assigned to receive xylazine (group X) (1.1 mg/kg bwt) or detomidine (group D) (0.03 mg/kg bwt) as premedication with midazolam (0.05 mg/kg bwt) and ketamine (2.2 mg/kg bwt) anaesthesia. Using simple descriptive scales, quality of sedation, induction, surgical conditions and recovery were scored by blinded observers. Induction, surgery, recovery time and time from induction to standing were recorded. Results There were a greater number of horses with lower sedation score in group D when compared with horses in group X at 5 minutes after the first dose of sedation (11.1%, 66.7% and 2.2% of horses from group D with sedation scores of 1, 2 and 3, vs 0%, 52% and 48% from group X, respectively, P = .05). A significant (P < .01) difference was found between surgical condition scores for group D (63%, 14.8%, 11.1% and 11.1% with surgery scores of 1, 2, 3 and 4, respectively) and group X (28%, 4%, 28% and 40%). Horses in Group D were less likely to require maintenance doses of ketamine (P = .05) with only 26% (7 of 27 horses) in this group requiring additional doses compared to 68% (17 of 25 horses) in group X. Recovery time in minutes (Group D: 24.74 ± 14.80, Group X: 13.08 ± 8.00; P < .01) and induction to standing time in minutes (Group D: 42.2 ± 13.8, Group X: 29.8 ± 8.2; P < .01) were significantly longer for horses in group D compared with group X. Main limitations Multiple surgeons and multiple blinded observers. Conclusions Detomidine as compared with xylazine as premedication results in good quality sedation and surgical conditions and prolonged surgical plane of anaesthesia, without significant differences in induction or recovery quality.

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Evaluation of the use of midazolam as a co‐induction agent with ketamine for anaesthesia in sedated ponies undergoing field castration

Abstract: Ketamine-midazolam co-induction compared to ketamine alone improved quality of induction, ease of intubation and muscle relaxation without impacting recovery quality.

Cited by 15 publications

References 23 publications

A comparison of two ketamine doses for field anaesthesia in horses undergoing castration

A comparison of two ketamine doses for field anaesthesia in horses undergoing castration

How to do equine anaesthesia in the field

Comparison of xylazine and detomidine in combination with midazolam/ketamine for field castration in Quarter Horses

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