title: Clinical efficacy and cardiorespiratory effects of alfaxalone, or diazepam/fentanyl for induction of anaesthesia in dogs that are a poor anaesthetic risk.
abstract: OBJECTIVE
  To evaluate the clinical efficacy and cardiorespiratory effects of alfaxalone as an anaesthetic induction agent in dogs with moderate to severe systemic disease.
  
  
  METHODS
  Randomized prospective clinical study.
  
  
  METHODS
  Forty dogs of physical status ASA III-V referred for various surgical procedures.
  
  
  METHODS
  Dogs were pre-medicated with intramuscular methadone (0.2 mg kg(-1) ) and allocated randomly to one of two treatment groups for induction of anaesthesia: alfaxalone (ALF) 1-2 mg kg(-1) administered intravenously (IV) over 60 seconds or fentanyl 5 μg kg(-1) with diazepam 0.2 mg kg(-1) ± propofol 1-2 mg kg(-1) (FDP) IV to allow endotracheal intubation. Anaesthesia was maintained with isoflurane in oxygen and fentanyl infusion following both treatments. All dogs were mechanically ventilated to maintain normocapnia. Systolic blood pressure (SAP) was measured by Doppler ultrasound before and immediately after anaesthetic induction, but before isoflurane administration. Parameters recorded every 5 minutes throughout subsequent anaesthesia were heart and respiratory rates, end-tidal partial pressure of carbon dioxide and isoflurane, oxygen saturation of haemoglobin and invasive systolic, diastolic and mean arterial blood pressure. Quality of anaesthetic induction and recovery were recorded. Continuous variables were assessed for normality and analyzed with the Mann Whitney U test. Repeated measures were log transformed and analyzed with repeated measures anova (p<0.05).
  
  
  RESULTS
  Treatment groups were similar for continuous and categorical data. Anaesthetic induction quality was good following both treatments. Pre-induction and post-induction systolic blood pressure did not differ between treatments and there was no significant change after induction. The parameters measured throughout the subsequent anaesthetic procedures did not differ between treatments. Quality of recovery was very, quite or moderately smooth.
  
  
  CONCLUSIONS
  Induction of anaesthesia with alfaxalone resulted in similar cardiorespiratory effects when compared to the fentanyl-diazepam-propofol combination and is a clinically acceptable induction agent in sick dogs.
authors.affiliation: Queen Mother Hospital, Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, UK. psathae@yahoo.co.uk
authors.forename: Evdokia
authors.initials: E
authors.lastname: Psatha
authors.forename: Hatim I K
authors.initials: HI
authors.lastname: Alibhai
authors.forename: Angeles
authors.initials: A
authors.lastname: Jimenez-Lozano
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Armitage-Chan
authors.forename: David C
authors.initials: DC
authors.lastname: Brodbelt
mesh_terms: D000758:Anesthesia / Q000662:veterinary; D018686:Anesthetics, Intravenous / Q000008:administration & dosage / Q000494:pharmacology; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D001831:Body Temperature / Q000187:drug effects; D003975:Diazepam / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D004283:Dog Diseases / Q000209:etiology*; D004285:Dogs; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006339:Heart Rate / Q000187:drug effects; D008297:Male; D011229:Preanesthetic Medication / Q000662:veterinary*; D011277:Pregnanediones / Q000009:adverse effects / Q000494:pharmacology*; D012119:Respiration / Q000187:drug effects
chemical_list: D018686:Anesthetics, Intravenous; D011277:Pregnanediones; C006477:alphaxalone; D003975:Diazepam; D005283:Fentanyl