title: Partial antagonization of midazolam-medetomidine-ketamine in cats--atipamezole versus combined atipamezole and flumazenil.
abstract: Two different methods, administered both subcutaneously and intravenously, to reverse intramuscular midazolam-medetomidine-ketamine, are evaluated. Eighteen cats were anaesthetized twice each 5 min after premedication with atropine 0.04 mg/kg using midazolam 0.5 mg/kg, medetomidine 0.02 mg/kg and ketamine 2.0 mg/kg intramuscularly in one syringe. Because this study was conducted in co-operation with a dental prophylaxis project, cats had to be immobilized for approximately 1 h. Therefore, anaesthesia was prolonged with propofol to effect, if necessary. After 68+/-11 min on average, immobilization was partially reversed by either atipamezole 0.05 mg/kg subcutaneously (group A/SC, n=7) or intravenously (group A/IV, n=10), or by atipamezole 0.05 mg/kg and flumazenil 0.05 mg/kg subcutaneously (group AF/SC, n=10) or intravenously (group AF/IV, n=9), respectively. These four groups were additionally compared with a non-reversed group. Recovery time and total time of immobilization (until cats regained a standing position) were not significantly shortened using the antagonists. However, unconsciousness and sedation (expressed through parameters like the time taken to head lifting, crawling, sitting and the return of righting reflex) were significantly shortened by the antagonists, especially if administered intravenously. Abnormal behaviour, such as vocalization, licking, hyperaesthesia, restlessness or salivation, was observed in all groups. However, excitation and hyperaesthesia were not observed in group AF/IV, whereas in this group only intensified salivation occurred. The addition of flumazenil showed no significant difference to atipamezole alone, but subcutaneous administration of atipamezole alone was not sufficient in the dosage used to show an advantage compared to non-reversed cats.
authors.affiliation: Centre of Preclinical Research, Klinikum rechts der Isar, Technical University, Ismaninger Str. 22, 81675 Munich, Germany. hanna.e@gmx.de
authors.forename: J
authors.initials: J
authors.lastname: Ebner
authors.forename: U
authors.initials: U
authors.lastname: Wehr
authors.forename: C
authors.initials: C
authors.lastname: Baumgartner
authors.forename: W
authors.initials: W
authors.lastname: Erhardt
authors.forename: J
authors.initials: J
authors.lastname: Henke
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000494:pharmacology; D000758:Anesthesia / Q000379:methods / Q000662:veterinary*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D002415:Cats / Q000502:physiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005442:Flumazenil / Q000008:administration & dosage / Q000494:pharmacology*; D018757:GABA Modulators / Q000494:pharmacology; D006339:Heart Rate / Q000187:drug effects; D007093:Imidazoles / Q000008:administration & dosage / Q000494:pharmacology*; D007275:Injections, Intravenous / Q000662:veterinary; D007279:Injections, Subcutaneous / Q000662:veterinary; D007649:Ketamine / Q000008:administration & dosage; D008297:Male; D020926:Medetomidine / Q000008:administration & dosage; D008874:Midazolam / Q000008:administration & dosage; D012119:Respiration / Q000187:drug effects; D013997:Time Factors
chemical_list: D000317:Adrenergic alpha-Antagonists; D019162:Anesthetics, Combined; D000778:Anesthetics, Dissociative; D018686:Anesthetics, Intravenous; D018757:GABA Modulators; D007093:Imidazoles; C050701:atipamezole; D005442:Flumazenil; D007649:Ketamine; D020926:Medetomidine; D008874:Midazolam