title: Development of a xylazine constant rate infusion with or without butorphanol for standing sedation of horses.
abstract: OBJECTIVE
  To elaborate constant rate infusion (CRI) protocols for xylazine (X) and xylazine/butorphanol (XB) which will result in constant sedation and steady xylazine plasma concentrations.
  
  
  METHODS
  Blinded randomized experimental study.
  
  
  METHODS
  Ten adult research horses.
  
  
  METHODS
  Part I: After normal height of head above ground (HHAG = 100%) was determined, a loading dose of xylazine (1 mg kg(-1) ) with butorphanol (XB: 18 μg kg(-1) ) or saline (X: equal volume) was given slowly intravenously (IV). Immediately afterwards, a CRI of butorphanol (XB: 25 μg kg(-1) hour(-1)) or saline (X) was administered for 2 hours. The HHAG was used as a marker of depth of sedation. Sedation was maintained for 2 hours by additional boluses of xylazine (0.3 mg kg(-1)) whenever HHAG >50%. The dose of xylazine (mg kg(-1) hour(-1)) required to maintain sedation was calculated for both groups. Part II: After the initial loading dose, the calculated xylazine infusion rates were administered in parallel to butorphanol (XB) or saline (X) and sedation evaluated. Xylazine plasma concentrations were measured by HPLC-MS-MS at time points 0, 5, 30, 45, 60, 90, and 120 minutes. Data were analyzed using paired t-test, Wilcoxon signed rank test and a 2-way anova for repeated measures (p < 0.05).
  
  
  RESULTS
  There was no significant difference in xylazine requirements (X: 0.69, XB: 0.65 mg kg(-1) hour(-1)) between groups. With treatment X, a CRI leading to prolonged sedation was developed. With XB, five horses (part I: two, part II: three) fell down and during part II four horses appeared insufficiently sedated. Xylazine plasma concentrations were constant after 45 minutes in both groups.
  
  
  CONCLUSIONS
  Xylazine bolus, followed by CRI, provided constant sedation. Additional butorphanol was ineffective in reducing xylazine requirements and increased ataxia and apparent early recovery from sedation in unstimulated horses.
  
  
  CONCLUSIONS
  Data were obtained on unstimulated healthy horses and extrapolation to clinical conditions requires caution.
authors: Section of Anaesthesiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland. sringer@vetclinics.uzh.ch
authors: Simone K
authors: SK
authors: Ringer
authors: Karine G
authors: KG
authors: Portier
authors: Isabelle
authors: I
authors: Fourel
authors: Regula
authors: R
authors: Bettschart-Wolfensberger
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage*; D019162:Anesthetics, Combined / Q000008:administration & dosage*; D000818:Animals; D002077:Butorphanol / Q000008:administration & dosage*; D016292:Procedural Sedation / Q000379:methods / Q000662:veterinary*; D018592:Cross-Over Studies; D005260:Female; D006736:Horses / Q000378:metabolism; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007262:Infusions, Intravenous / Q000379:methods / Q000662:veterinary; D008297:Male; D016037:Single-Blind Method; D014991:Xylazine / Q000008:administration & dosage* / Q000097:blood
chemical_list: D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D006993:Hypnotics and Sedatives; D014991:Xylazine; D002077:Butorphanol