How to score sedation and adjust the administration rate of sedatives in horses: a literature review and introduction of the Ghent Sedation Algorithm

Schauvliege, Stijn; Cuypers, Charlotte; Michielsen, Anneleen; Gasthuys, Frank; Gozalo-Marcilla, Miguel

doi:10.1016/j.vaa.2018.08.005

Cited by 30 publications

(26 citation statements)

References 29 publications

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“…Head height has previously been used in studies to evaluate the depth of sedation associated with various anesthetic protocols in horses (Schauvliege et al, 2019). The advantage of HH is that it is a quantitative value and horses are not stimulated for the measurement (Ringer et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses

Shane

Langston

Wills

et al. 2021

Vet Pharm & Therapeutics

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An ideal dexmedetomidine protocol has yet to be determined for standing sedation in horses. It was hypothesized that an IV bolus followed by CRI dexmedetomidine would have a quicker increase in plasma concentrations compared with repeated IM injections. In a crossover design, eight adult, female horses were randomly placed into two groups: the CRI group (IV bolus dexmedetomidine at 0.005 mg/kg followed by a CRI at 0.01 mg/kg/h for 15 min then 0.005 mg/kg/h for 60 min) and the IM group (dexmedetomidine at 0.01 mg/kg, followed by 0.005 mg/kg in 30‐min intervals for 60 min). Clearance and elimination half‐life were 134 ± 67.4 ml/kg/min and 44.3 ± 26.3 min, respectively, in the CRI group, and apparent clearance and half‐life were 412 ± 306 ml/kg/min (Cl/F) and 38.9 ± 18.6 min, respectively, in the IM group. Analgesia was evaluated using mechanical pressure threshold. Intravenous dexmedetomidine produced faster onset of sedation and increased pressure threshold compared with IM administration. Individual horses had a large variability in dexmedetomidine plasma concentrations between CRI and IM administration. The odds of a decreased GI motility following IV administration was 12.34 times greater compared with IM administration.

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Section: Discussionmentioning

confidence: 99%

Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses

Shane

Langston

Wills

et al. 2021

Vet Pharm & Therapeutics

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“…The HHAG is a commonly used method to evaluate depth of sedation in horses (Schauvliege, Cuypers, Michielsen, Gasthuys, & Gozalo‐Marcilla, 2019) and, as a passive measurement, does not include response to stimulation but can be assessed objectively. The HHAG decreased initially following MgSO 4 administration to then become no different than baseline.…”

Section: Discussionmentioning

confidence: 99%

Pharmacokinetics of magnesium and its effects on clinical variables following experimentally induced hypermagnesemia

Schumacher

Toribio

Scansen

et al. 2020

Vet Pharm & Therapeutics

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The objectives of this study were to describe pharmacokinetic and pharmacodynamic changes as a result of a single intravenous administration of magnesium sulfate (MgSO4) to healthy horses. MgSO4 is a magnesium salt that has been used to calm horses in equestrian competition and is difficult to regulate because magnesium is an essential constituent of all mammals. Six healthy adult female horses were administered a single intravenous dose of MgSO4 at 60 mg/kg of body weight over 5 min. Blood, urine, and cerebrospinal fluid (CSF) samples were collected, and cardiovascular parameters were monitored and echocardiograms performed at predetermined times. Noncompartmental pharmacokinetic analysis was applied to plasma concentrations of ionized magnesium (Mg2+). Objective data were analyzed using the Wilcoxon rank‐sum test with p < .05 used as a determination for significance. Plasma concentrations of Mg2+ increased nearly fivefold, ionized calcium (Ca2+) decreased by nearly 10%, and the Ca2+ to Mg2+ ratio declined more than 3.5‐fold and remained different than baseline until 24 hr (p < .05). Significant changes were seen with urinary fractional excretion of electrolytes, cardiovascular parameters, and echocardiographic measurements. No changes were detected in CSF electrolyte concentrations. The decrease in Ca2+ result of hypermagnesemia supports the interaction between these cations. Alterations detected in plasma electrolyte concentrations and urinary fractional excretion of electrolytes may serve as biomarkers for regulatory control for the nefarious administration of MgSO4.

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“…It can be speculated that this was associated with an inter‐individual cardiovascular response to the standardized alpha‐2 agonist dosage. A markedly deep level of sedation featured by constant leaning against the stocks and buckling of the limbs before the SF6 bolus injections and a comparatively lower head height above the ground after head support removal was observed in Horse 4. Contrast enhancement was bilaterally negative for this animal.…”

Section: Discussionmentioning

confidence: 99%

Clinical utility, dose determination, and safety of ocular contrast‐enhanced ultrasonography in horses: A pilot study

Blohm

Tichy

Nell

2019

Veterinary Ophthalmology

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Objective To determine efficacy of contrast‐enhanced ultrasonography (CEUS) using different sulfur hexafluoride (SF6) doses to assess blood flow and perfusion in equine eyes and to evaluate safety of SF6 in horses. Procedures Ocular B‐mode and contrast‐enhanced ultrasonography were performed bilaterally in nine sedated university‐owned horses. Intravenous SonoVue® bolus injections of 5, 10, 15, 20, 25, and 30 mL were administered for 2/18, 5/18, 6/18, 3/18, 1/18, and 1/18 eyes, respectively. Doses were increased based on ascending bodyweight. Each eye within one horse was examined utilizing a different dose. Qualitative blood flow and quantitative perfusion were analyzed. Heart and respiratory rates were monitored nonsedated, sedated, and during first and second minutes of CEUS. Results Qualitative contrast enhancement (CE) was visible in 7/9 animals. Quantitative CE was measurable bilaterally in four horses, unilaterally in three individuals, and not detected in two animals. In all horses with unilateral CE, the positive eye received the higher dose. Fifteen mL dose resulted in significantly shorter time to peak than 10 mL (P < .05). Peak intensity, maximum signal increase, and corresponding area under the curve were significantly higher for 15 and 20 mL doses compared with 10 mL (P < .05). Uveal and retinal tissues were enhanced frequently. Twenty‐five and 30 mL doses revealed no CE. Only sedation reduced heart rates significantly (P < .05). Clinically relevant changes in respiratory rates or adverse reactions following SF6 application were not observed. Conclusions Contrast enhancement was in most instances dose‐dependent. Fifteen mL appeared appropriate to assess equine ocular perfusion. The reliability in horses remains questionable; however, CEUS was well‐tolerated.

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How to score sedation and adjust the administration rate of sedatives in horses: a literature review and introduction of the Ghent Sedation Algorithm

Cited by 30 publications

References 29 publications

Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses

Pharmacokinetics and pharmacodynamics of intravenous continuous rate infusion and repeated intramuscular administration of dexmedetomidine in standing horses

Pharmacokinetics of magnesium and its effects on clinical variables following experimentally induced hypermagnesemia

Clinical utility, dose determination, and safety of ocular contrast‐enhanced ultrasonography in horses: A pilot study

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