title: Ketamine as a part of anaesthetic management in a dog with twiddler's syndrome.
abstract: An 11-year-old male German shepherd dog was referred for possible pacemaker implantation. A routine 6-lead electrocardiogram revealed a third-degree atrio-ventricular block with a heart rate of 40 to 45 beats/minute. A transvenous pacemaker implantation procedure was scheduled. The dog was premedicated with 10 µg/kg acepromazine and 5 mg/kg pethidine. A dose of 5 mg/kg ketamine and 0·2 mg/kg diazepam were used for induction and isoflurane in O2 and a constant rate infusion of ketamine (20 to 30 µg/kg/minute) were administered for maintenance of general anaesthesia. Due to a twiddler's syndrome, the pacemaker had to be repositioned. For the second procedure, the same protocol was employed except for a lower dose of ketamine both for induction (3 mg/kg) and constant rate infusion (10 to 15 µg/kg/minute). Ketamine appeared to be useful for both management of anaesthesia and cardiac pacemaker implantation in the absence of a temporary pacemaker.
authors.affiliation: Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Chirurgica e Radiodiagnostica, Via S. Costanzo, 4 - 06126, Perugia, Italy.
authors.forename: V
authors.initials: V
authors.lastname: De Monte
authors.affiliation: Università degli Studi di Bari "Aldo Moro" Dipartimento delle Emergenze e dei Trapianti di Organi Sezione di Cliniche Veterinarie e Produzioni Animali, SP per Casamassima km 3-70010, Valenzano (Bari), Italy.
authors.forename: F
authors.initials: F
authors.lastname: Staffieri
authors.affiliation: Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Medica, Via S. Costanzo, 4 - 06126, Perugia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Birettoni
authors.affiliation: Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Chirurgica e Radiodiagnostica, Via S. Costanzo, 4 - 06126, Perugia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Bufalari
mesh_terms: D000768:Anesthesia, General / Q000662:veterinary*; D000778:Anesthetics, Dissociative; D000818:Animals; D054537:Atrioventricular Block / Q000662:veterinary; D004283:Dog Diseases / Q000601:surgery*; D004285:Dogs; D007649:Ketamine; D008297:Male; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000662:veterinary*; D019919:Prosthesis Implantation / Q000662:veterinary; D013577:Syndrome
chemical_list: D000778:Anesthetics, Dissociative; D007649:Ketamine