title: Cardiovascular effects of total intravenous anesthesia using ketamine-medetomidine-propofol (KMP-TIVA) in horses undergoing surgery.
abstract: Cardiovascular effects of total intravenous anesthesia using ketamine-medetomidine-propofol drug combination (KMP-TIVA) were determined in 5 Thoroughbred horses undergoing surgery. The horses were anesthetized with intravenous administration (IV) of ketamine (2.5 mg/kg) and midazolam (0.04 mg/kg) following premedication with medetomidne (5 µg/kg, IV) and artificially ventilated. Surgical anesthesia was maintained by controlling propofol infusion rate (initially 0.20 mg/kg/min following an IV loading dose of 0.5 mg/kg) and constant rate infusions of ketamine (1 mg/kg/hr) and medetomidine (1.25 µg/kg/hr). The horses were anesthetized for 175 ± 14 min (range from 160 to 197 min). Propofol infusion rates ranged from 0.13 to 0.17 mg/kg/min, and plasma concentration (Cpl) of propofol ranged from 11.4 to 13.3 µg/ml during surgery. Cardiovascular measurements during surgery remained within clinically acceptable ranges in the horses (heart rate: 33 to 37 beats/min, mean arterial blood pressure: 111 to 119 mmHg, cardiac index: 48 to 53 ml/kg/min, stroke volume: 650 to 800 ml/beat and systemic vascular resistance: 311 to 398 dynes/sec/cm(5)). The propofol Cpl declined rapidly after the cessation of propofol infusion and was significantly lower at 10 min (4.5 ± 1.5 µg/ml), extubation (4.0 ± 1.2 µg/ml) and standing (2.4 ± 0.9 µg/ml) compared with the Cpl at the end of propofol administration (11.4 ± 2.7 µg/ml). All the horses recovered uneventfully and stood at 74 ± 28 min after the cessation of anesthesia. KMP-TIVA provided satisfactory quality and control of anesthesia with minimum cardiovascular depression in horses undergoing surgery.
authors.affiliation: Department of Veterinary Surgery and Theriogenology, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Borno State, Nigeria.
authors.forename: Mohammed Ahmed
authors.initials: MA
authors.lastname: Umar
authors.forename: Sho
authors.initials: S
authors.lastname: Fukui
authors.forename: Kodai
authors.initials: K
authors.lastname: Kawase
authors.forename: Takaharu
authors.initials: T
authors.lastname: Itami
authors.forename: Kazuto
authors.initials: K
authors.lastname: Yamashita
mesh_terms: D000758:Anesthesia / Q000662:veterinary*; D000762:Anesthesia Recovery Period; D000778:Anesthetics, Dissociative / Q000008:administration & dosage / Q000494:pharmacology; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006736:Horses; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000494:pharmacology; D007275:Injections, Intravenous; D007649:Ketamine / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D020926:Medetomidine / Q000008:administration & dosage / Q000494:pharmacology*; D015742:Propofol / Q000008:administration & dosage / Q000494:pharmacology*; D012119:Respiration / Q000187:drug effects; D013997:Time Factors
chemical_list: D000778:Anesthetics, Dissociative; D006993:Hypnotics and Sedatives; D007649:Ketamine; D020926:Medetomidine; D015742:Propofol