Microcirculation assessment of dexmedetomidine constant rate infusion during anesthesia of dogs with sepsis from pyometra: a randomized clinical study

Nagashima, Julio Ken; Gonçalves, Lucas Alaião; Pereira, Marcos Aurélio; Talib, Mariana SF.; Olveira, Clair M. de; Ambrósio, Aline Magalhães; Fantoni, Denise Tabacchi

doi:10.1016/j.vaa.2022.07.005

Cited by 5 publications

(9 citation statements)

References 36 publications

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“…These findings are in contrast with a recent canine clinical study that failed to show a mortality benefit or improved microcirculation when using dexmedetomidine compared with fentanyl in septic dogs with pyometra [ 14 ]. However, the prior study did find MAP was higher in dogs receiving a dexmedetomidine CRI during isoflurane anaesthesia compared to a fentanyl CRI.…”

Section: Discussioncontrasting

confidence: 98%

“…The length of hospitalization between the two groups was not statistically different: 7 (4-10) days in the DEX group vs. 7 (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) days in the NaCl group (p = 0.14).…”

Section: Dexmentioning

confidence: 82%

“…It is unknown if a higher dose of dexmedetomidine in dogs of the current study would have influenced MAP and vasopressor requirements. The dosage used (1 mcg/kg/h) was based on prior reports of dogs undergoing surgery, which used dosages of 1 to 3 mcg/kg/h [ 14 , 15 , 16 ]. The 1 mcg/kg/h dose was chosen based on a study that suggests dexmedetomidine can contribute to a balanced and stable plane of postoperative analgesia for up to 24 h [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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Impact of a Dexmedetomidine Intravenous Infusion in Septic Dogs: Preliminary Study

Di Franco,

Boysen,

Vannozzi

et al. 2024

Animals

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The purpose of this study was to determine if a continuous rate infusion (CRI) of dexmedetomidine decreases vasopressor requirements in septic dogs undergoing surgery. Vital parameters, sequential organ failure assessment (SOFA) score, vasopressor requirement, and 28-day mortality were recorded. Dogs were randomly divided into two groups: a dexmedetomidine (DEX) (1 mcg/kg/h) group and a control group (NaCl), which received an equivalent CRI of NaCl. Dogs were premedicated with fentanyl 5 mcg/kg IV, induced with propofol, and maintained with sevoflurane and a variable rate fentanyl infusion. DEX or NaCl infusions were started 10 min prior to induction. Fluid-responsive hypotensive patients received repeated Ringer’s lactate boluses (2 mL/kg) until stable or they were no longer fluid-responsive. Patients that remained hypotensive following fluid boluses received norepinephrine at a starting dose of 0.05 mcg/kg/min, with increases of 0.05 mcg/kg/min. Rescue adrenaline boluses were administered (0.001 mg/kg) if normotension was not achieved within 30 min of starting norepinephrine. The NaCl group received a significantly higher dose of norepinephrine (0.8, 0.4–2 mcg/kg/min) than the DEX group (0.12, 0–0.86 mcg/kg/min). Mortality was statistically lower in the DEX group (1/10) vs. the NaCl group (5/6). Results of this study suggest that a 1 mcg/kg/h CRI of dexmedetomidine decreases the demand for intraoperative vasopressors and may improve survival in septic dogs.

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Section: Discussioncontrasting

confidence: 98%

Section: Dexmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

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Impact of a Dexmedetomidine Intravenous Infusion in Septic Dogs: Preliminary Study

Di Franco,

Boysen,

Vannozzi

et al. 2024

Animals

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“…It could be interesting to evaluate this aspect in veterinary medicine since currently, according to the authors’ knowledge, there is only one clinical study conducted on canine septic patients. In this study dexmedetomidine in CRI at a dosage of 3 mcg/kg/h was compared to fentanyl in dogs with pyometra, the authors concluded that dexmedetomidine could be used during general anesthesia of septic dogs without causing microcirculatory and hemodynamic impairment ( 70 ).…”

Section: Dexmedetomidine In Critical Patientsmentioning

confidence: 99%

Multiple uses of dexmedetomidine in small animals: a mini review

2023

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Dexmedetomidine is an alpha-2 adrenergic agonist, which use had an exponential increase in human and veterinary medicine in the last 10 years. The aim of this mini review is to summarize the various uses of dexmedetomidine underlining its new applications and capabilities in the small animals’ clinical activity. While this drug was born as sedative in veterinary medicine, some studies demonstrated to be effective as an analgesic both in single administration and in continuous infusion. Recent studies have also shown the role of dexmedetomidine as an adjuvant during locoregional anesthesia, increasing the duration of the sensitive block and consequently decreasing the demand for systemic analgesics. The various analgesic properties make dexmedetomidine an interesting drug for opioid-free analgesia. Some studies highlighted a potential neuroprotective, cardioprotective and vasculoprotective role of dexmedetomidine, thus conferring it a place in critical care medicine, such as trauma and septic patients. Dexmedetomidine has demonstrated to be a multitasking molecule and it is ready to face new challenges.

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“…Dexmedetomidine, a highly selective α2-adrenoreceptor agonist, functions as a sedative and analgesic for animal and human anesthesia, given either as a single dose or via continuous infusion [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ], with typical doses ranging from 0.5 to 3 mcg/kg/h [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Dexmedetomidine Sedation in Dogs: Impact on Electroencephalography, Behavior, Analgesia, and Antagonism with Atipamezole

Ko,

Murillo,

Weil

et al. 2024

Veterinary Sciences

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This study aimed to assess the impact of dexmedetomidine constant rate infusion (CRI) on key parameters in dogs. Six dogs received a 60 µg/kg/h dexmedetomidine infusion over 10 min, followed by three 15 min decremental CRIs (3, 2, and 1 µg/kg/h). A subsequent reversal phase employed 600 µg/kg/h atipamezole over 5 min. Continuous electroencephalogram (EEG) assessment, and cardiorespiratory and analgesia monitoring (every 3 min) were conducted, including analgesia evaluation through responses to electric stimulation. Dexmedetomidine induced profound sedation, evidenced by lateral recumbency and immobility. Patient State Index (PSI) decreased from awake (90.4 ± 4.3) to Phase 1 (50.9 ± 30.7), maintaining sedation (29.0 ± 18.1 to 33.1 ± 19.1 in Phases 2–4). Bradycardia (37.8 ± 3.5 bpm, lowest at Phase 3) and hypertension (133.7 ± 17.0 mmHg, highest at Phase 1) were observed, with minimal analgesia. Atipamezole promptly reversed sedation, restoring cognitive function (tail wagging behavior), and normalizing cardiovascular parameters. During atipamezole CRI, the EEG exhibited a transition from delta waves to alpha and low beta waves. This transition was observed alongside gradual increases in PSI and electromyographic activities. Additionally, spindle activities disappeared during this process. This study’s results suggest potential clinical utility for EEG-guided dexmedetomidine sedation with reversal using atipamezole, warranting further investigation.

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Microcirculation assessment of dexmedetomidine constant rate infusion during anesthesia of dogs with sepsis from pyometra: a randomized clinical study

Cited by 5 publications

References 36 publications

Impact of a Dexmedetomidine Intravenous Infusion in Septic Dogs: Preliminary Study

Impact of a Dexmedetomidine Intravenous Infusion in Septic Dogs: Preliminary Study

Multiple uses of dexmedetomidine in small animals: a mini review

Dexmedetomidine Sedation in Dogs: Impact on Electroencephalography, Behavior, Analgesia, and Antagonism with Atipamezole

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