title: ETORPHINE-KETAMINE-MEDETOMIDINE TOTAL INTRAVENOUS ANESTHESIA IN WILD IMPALA (AEPYCEROS MELAMPUS) OF 120-MINUTE DURATION.
abstract: There is a growing necessity to perform long-term anesthesia in wildlife, especially antelope. The costs and logistics of transporting wildlife to veterinary practices make surgical intervention a high-stakes operation. Thus there is a need for a field-ready total intravenous anesthesia (TIVA) infusion to maintain anesthesia in antelope. This study explored the feasibility of an etorphine-ketamine-medetomidine TIVA for field anesthesia. Ten wild-caught, adult impala ( Aepyceros melampus ) were enrolled in the study. Impala were immobilized with a standardized combination of etorphine (2 mg) and medetomidine (2.2 mg), which equated to a median (interquartile range [IQR]) etorphine and medetomidine dose of 50.1 (46.2-50.3) and 55.1 (50.8-55.4) μg/kg, respectively. Recumbency was attained in a median (IQR) time of 13.9 (12.0-16.5) min. Respiratory gas tensions, spirometry, and arterial blood gas were analyzed over a 120-min infusion. Once instrumented, the TIVA was infused as follows: etorphine at a variable rate initiated at 40 μg/kg per hour (adjusted according to intermittent deep-pain testing); ketamine and medetomidine at a fixed rate of 1.5 mg/kg per hour and 5 μg/kg per hour, respectively. The etorphine had an erratic titration to clinical effect in four impala. Arterial blood pressure and respiratory and heart rates were all within normal physiological ranges. However, arterial blood gas analysis revealed severe hypoxemia, hypercapnia, and acidosis. Oxygenation and ventilation indices were calculated and highlighted possible co-etiologies to the suspected etorphine-induced respiratory depression as the cause of the blood gas derangements. Impala recovered in the boma post atipamezole (13 mg) and naltrexone (42 mg) antagonism of medetomidine and etorphine, respectively. The etorphine-ketamine-medetomidine TIVA protocol for impala may be sufficient for field procedures of up to 120-min duration. However, hypoxemia and hypercapnia are of paramount concern and thus oxygen supplementation should be considered mandatory. Other TIVA combinations may be superior and warrant further investigation.
authors.forename: Gareth E
authors.initials: GE
authors.lastname: Zeiler
authors.forename: George F
authors.initials: GF
authors.lastname: Stegmann
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Fosgate
authors.forename: Roxanne K
authors.initials: RK
authors.lastname: Buck
authors.forename: Sabine B R
authors.initials: SB
authors.lastname: Kästner
authors.forename: Maya
authors.initials: M
authors.lastname: Kummrow
authors.forename: Christina
authors.initials: C
authors.lastname: Gerlach
authors.forename: Leith C R
authors.initials: LC
authors.lastname: Meyer
mesh_terms: D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000494:pharmacology; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000494:pharmacology; D000771:Anesthesia, Intravenous / Q000662:veterinary*; D000778:Anesthetics, Dissociative / Q000008:administration & dosage / Q000494:pharmacology; D000818:Animals; D000835:Animals, Wild; D000866:Antelopes; D004334:Drug Administration Schedule; D005048:Etorphine / Q000008:administration & dosage / Q000494:pharmacology*; D007649:Ketamine / Q000008:administration & dosage / Q000494:pharmacology*; D020926:Medetomidine / Q000008:administration & dosage / Q000494:pharmacology*
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000778:Anesthetics, Dissociative; D005048:Etorphine; D007649:Ketamine; D020926:Medetomidine
keywords: Aepyceros melampus; TIVA; etorphine; impala; ketamine; medetomidine