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Gary C.w. England - One of the best experts on this subject based on the ideXlab platform.
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Effect of Romifidine on gastrointestinal motility, assessed by transrectal ultrasonography.
Equine veterinary journal, 2010Co-Authors: Sarah L. Freeman, Gary C.w. EnglandAbstract:A technique of transrectal ultrasonography was developed to investigate the effects of Romifidine 80 and 120 microg/kg bwt on intestinal motility in the horse. Motility of the small intestine, caecum and left ventral colon were assessed following injection of Romifidine and a saline control, using a blinded, cross-over study design in 6 horses. Measurements were taken at 15, 30, 60, 120, 180 and 240 min after drug administration. There was a slight nonsignificant decrease in motility in the control group over the 4 h study period. Both doses of Romifidine produced a marked decrease in gastrointestinal motility and were associated with the presence of reduced (nonpropulsive) contractions. Transrectal ultrasonography proved suitable for monitoring changes in the type and frequency of intestinal motility in the horse.
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Cardiovascular effects of Romifidine in the standing horse.
Research in veterinary science, 2002Co-Authors: Sarah L. Freeman, Regula Bettschart-wolfensberger, I. M. Bowen, H I K Alibhai, Gary C.w. EnglandAbstract:Abstract The cardiovascular effects of Romifidine, an alpha-2 adrenoreceptor agonist, were investigated in six horses using two doses (80 and 120 μg kg −1 ) in a cross-over study design. Cardiac index and mixed venous oxygenation were significantly decreased at 15 and 30 minutes after both doses of Romifidine. Systemic vascular resistance was significantly increased with Romifidine (120 μg kg −1 ). Arterial blood pressure increased initially and then gradually decreased; the doses of decrease was significant at 90 and 120 minutes with Romifidine 80 and 120 μg kg −1 . There were minimal differences between the two doses of Romifidine, and both should be used with care especially in horses with cardiovascular compromise, or when used in combination with other cardiovascular depressant drugs.
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Investigation of Romifidine and detomidine for the clinical sedation of horses
The Veterinary record, 2000Co-Authors: Sarah L. Freeman, Gary C.w. EnglandAbstract:The effects of two intravenous doses of Romifidine (80 and 120 μg/kg) and one dose of detomidine (20 μg/kg) were compared in a blinded study in 30 horses requiring to be sedated for routine dental treatment. Several physiological parameters were assessed before and for two hours after the administration of the drugs, and the horses9 teeth were rasped 30 minutes after they were administered. Romifidine produced a dose-dependent effect on most parameters. Detomidine at 20 μg/kg was similar to Romifidine at 120 μg/kg in the magnitude of its sedative effects, but was similar to Romifidine at 80 μg/kg in its duration. There were no significant differences between the three treatments in terms of the clinical procedure score.
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Comparison of sedative effects of Romifidine following intravenous, intramuscular, and sublingual administration to horses.
American journal of veterinary research, 1999Co-Authors: Sarah L. Freeman, Gary C.w. EnglandAbstract:Objective To compare sedative effects of Romifidine following IV, IM, or sublingual (SL) administration in horses. Animals 30 horses that required sedation for routine tooth rasping. Procedure Horses (n = 10/group) were given Romifidine (120 microg/kg) IV, IM, or SL. Heart rate, respiratory rate, head height, distance between the ear tips, thickness of the upper lip, response to auditory stimulation, response to tactile stimulation, and degree of ataxia were recorded every 15 minutes for 180 minutes. Tooth rasping was performed 60 minutes after administration of Romifidine, and overall adequacy of sedation was assessed. Results IV and IM administration of Romifidine induced significant sedation, but SL administration did not induce significant sedative effects. Scores for overall adequacy of sedation after IV and IM sedation were not significantly different from each other but were significantly different from scores for horses given Romifidine SL. Sedative and other effects varied among groups during the first 60 minutes after drug administration; thereafter, effects of IV and IM administration were similar. Conclusions and clinical relevance Onset of action was fastest and degree of sedation was greater after IV, compared with IM, administration of Romifidine, but duration of action was longer after IM administration. Sublingual administration did not result in clinically important sedative effects.
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Dose‐sparing effects of Romifidine premedication for thiopentone and halothane anaesthesia in the dog
The Journal of small animal practice, 1997Co-Authors: Gary C.w. England, R.a. HammondAbstract:Two intravenous doses of romlfidine (40 and 80 micrograms/kg) and a placebo were compared as premedicants for anaesthesia induced with thiopentone and maintained using halothane in oxygen. Romifidine significantly and linearly reduced the induction dose of thiopentone; placebo-treated dogs required 15.1 +/- 3.6 mg/kg, while dogs treated with 40 micrograms/kg and 80 micrograms/kg Romifidine required 6.5 +/- 1.6 and 3.9 +/- 0.3 mg/kg thiopentone, respectively. Romifidine also significantly and linearly reduced the end tidal halothane concentration necessary to maintain a predetermined level of anaesthesia; placebo-treated dogs required 1.6 +/- 0.3 per cent halothane, while dogs treated with 40 micrograms/kg and 80 micrograms/kg Romifidine required 1.3 +/- 0.4 and 0.8 +/- 0.2 per cent, respectively. Romifidine produced a significant shortening in the recovery from anaesthesia, and the higher dose of Romifidine significantly improved the overall quality of anaesthesia.
Claudia Spadavecchia - One of the best experts on this subject based on the ideXlab platform.
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Antinociceptive effects of levomethadone in standing horses sedated with Romifidine.
Veterinary anaesthesia and analgesia, 2021Co-Authors: Nicole Studer, Sabina Diez Bernal, Wolfgang Thormann, Olivier Levionnois, Claudia SpadavecchiaAbstract:Abstract Objective To evaluate the antinociceptive effect of a bolus of intravenous levomethadone administered to horses during Romifidine constant rate infusion (CRI). Study design Prospective, randomized, masked, crossover experimental study. Animals A group of eight adult Warmblood horses (seven geldings, one mare) aged 6.6 ± 4.4 years, weighing 548 ± 52 kg [mean ± standard deviation (SD)]. Methods Levomethadone 0.1 mg kg–1 or an equivalent volume of saline (control) was administered intravenously to standing horses 60 minutes after starting a Romifidine CRI. Blood samples to quantify Romifidine and levomethadone plasma concentrations by capillary electrophoresis were collected up to 150 minutes after levomethadone administration. The nociceptive withdrawal reflex threshold (NWRT) was determined continuously using an automated threshold tracking device. Sedation and cardiopulmonary variables were assessed at regular intervals. A pharmacokinetic-pharmacodynamic (PK-PD) model was elaborated. Data are presented as mean ± SD or median (interquartile range, 25%–75%) where appropriate. Differences between groups were considered statistically significant for p Results Horses exhibited higher NWRTs after levomethadone administration than after saline (123 ± 9% versus 101 ± 9% relative to baseline, p Conclusions and clinical relevance A single injection of levomethadone has the potential to increase the NWRT during Romifidine CRI in horses and can be administered in combination with α2-adrencoceptor agonists to enhance antinociception in horses. However, individual variation is marked.
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Pharmacokinetic-pharmacodynamic modelling of the antinociceptive effect of a Romifidine infusion in standing horses.
Veterinary anaesthesia and analgesia, 2019Co-Authors: Sabina Diez Bernal, Nicole Studer, Wolfgang Thormann, Claudia Spadavecchia, Olivier LevionnoisAbstract:Abstract Objective To evaluate the effect of a Romifidine infusion on antinociception and sedation, and to investigate its relationship to plasma concentration. Study design Prospective, experimental, non-randomized trial. Animals A total of 10 healthy adult warmblood horses. Methods Romifidine (loading dose: 0.08 mg kg-1, infusion: 0.03 mg kg-1 hour-1) was administered intravenously (IV) over 120 minutes. Romifidine plasma concentrations were determined by capillary electrophoresis. Sedation quality and nociceptive thresholds were evaluated at regular time points before, during and after Romifidine administration. The nociceptive withdrawal reflex was elicited by electrical stimulation at the thoracic limb using a dedicated threshold tracking algorithm and recorded by electromyography at the deltoid muscle. A pharmacokinetic-pharmacodynamic model was established and correlation between Romifidine plasma concentration and main output variables tested. Results A two compartmental model best described the Romifidine pharmacokinetic profile. The nociceptive thresholds increased compared to baseline in all horses from 10 to 146 minutes after Romifidine administration (p Conclusions and clinical relevance Romifidine elicited a marked antinociceptive effect. Romifidine-induced antinociception appeared with a delayed onset and lasted longer than sedation after discontinuing its administration.
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comparison of the effects of the alpha 2 agonists detomidine Romifidine and xylazine on nociceptive withdrawal reflex and temporal summation in horses
Veterinary Anaesthesia and Analgesia, 2009Co-Authors: Helene Rohrbach, Urs Schatzmann, Toni Korpivaara, Claudia SpadavecchiaAbstract:Abstract Objective To evaluate and compare the antinociceptive effects of the three alpha-2 agonists, detomidine, Romifidine and xylazine at doses considered equipotent for sedation, using the nociceptive withdrawal reflex (NWR) and temporal summation model in standing horses. Study design Prospective, blinded, randomized cross-over study. Animals Ten healthy adult horses weighing 527–645 kg and aged 11–21 years old. Methods Electrical stimulation was applied to the digital nerves to evoke NWR and temporal summation in the left thoracic limb and pelvic limb of each horse. Electromyographic reflex activity was recorded from the common digital extensor and the cranial tibial muscles. After baseline measurements a single bolus dose of detomidine, 0.02 mg kg−1, Romifidine 0.08 mg kg−1, or xylazine, 1 mg kg−1, was administered intravenously (IV). Determinations of NWR and temporal summation thresholds were repeated at 10, 20, 30, 40, 60, 70, 90, 100, 120 and 130 minutes after test-drug administration alternating the thoracic limb and the pelvic limb. Depth of sedation was assessed before measurements at each time point. Behavioural reaction was observed and recorded following each stimulation. Results The administration of detomidine, Romifidine and xylazine significantly increased the current intensities necessary to evoke NWR and temporal summation in thoracic limbs and pelvic limbs of all horses compared with baseline. Xylazine increased NWR thresholds over baseline values for 60 minutes, while detomidine and Romifidine increased NWR thresholds over baseline for 100 and 120 minutes, respectively. Temporal summation thresholds were significantly increased for 40, 70 and 130 minutes after xylazine, detomidine and Romifidine, respectively. Conclusions and clinical relevance Detomidine, Romifidine and xylazine, administered IV at doses considered equipotent for sedation, significantly increased NWR and temporal summation thresholds, used as a measure of antinociceptive activity. The extent of maximal increase of NWR and temporal summation thresholds was comparable, while the duration of action was drug-specific.
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Effect of Romifidine on the nociceptive withdrawal reflex and temporal summation in conscious horses.
American journal of veterinary research, 2005Co-Authors: Claudia Spadavecchia, Lars Arendt-nielsen, Ole Kæseler Andersen, Luciano Spadavecchia, Urs SchatzmannAbstract:OBJECTIVE To investigate the action of a single IV administration of Romifidine on the thresholds of the nociceptive withdrawal reflex (NWR) and temporal summation in conscious horses. ANIMALS 10 adult horses. PROCEDURE Single electrical stimulations were applied on the digital nerves to evoke NWR from the left forelimb and hind limb. Repeated electrical stimulations (10 stimuli, 5 Hz) were given to obtain temporal summation. Surface electromyographic reflex activity was recorded from the common digital extensor and cranial tibial muscles. After baseline assessment of NWR and temporal summation thresholds, Romifidine (80 microg x kg(-1), IV) was administered. Successive determinations of NWR and temporal summation thresholds were performed 5, 25, and 55 minutes after administration. RESULTS Romifidine significantly increased the current intensities necessary to evoke NWR and temporal summation in forelimbs and hind limbs of horses. Values were significantly higher than baseline values 55 minutes after Romifidine administration. After administration of Romifidine, a facilitation of reflex components of tactile origin was observed when repeated stimulations were applied. CONCLUSIONS AND CLINICAL RELEVANCE Results confirm antinociceptive activity of Romifidine and may represent an objective demonstration of the well-known hypersensitivity to tactile stimuli observed in horses receiving alpha2-adrenoreceptor agonists in clinical practice. Romifidine can be included in analgesic and anesthetic protocols to provide additional analgesia in horses.
Antonio De Queiroz-neto - One of the best experts on this subject based on the ideXlab platform.
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Comparison of the effects of Romifidine and an emulsion of amitraz on sedation and spontaneous locomotor activity of horses
Universidade de São Paulo. Faculdade de Medicina Veterinária e Zootecnia, 2008Co-Authors: Mendes, Marina Ceccato, Reis, Renata Gemio Dos, Valadão, Carlos Augusto Araújo, Antonio De Queiroz-netoAbstract:Amitraz (AM) and Romifidine (RMF), two alpha-2 adrenoceptor agonists, produce sedative effect and decrease spontaneous locomotor activity (SLA) of horses. The behavioral effects and sedation after intravenous injection of RMF (0.06mg/kg) or AM 0.1mg/kg (AM 0.1) or AM 0.4mg/kg (AM 0.4) were compared in horses. RMF caused head ptosis (HP) until 45 min. The lower AM dose induced HP from 45 to 60 minutes and from 120 to 150 minutes, and the higher dose induced HP until 180 minutes. Data concerning changes in SLA were not conclusive. RMF or AM 0.4 caused a greater sedation than AM 0.1 until 20 min. After 20 minutes, the sedation caused by AM 0.4 was greater than that of RMF or AM 0.1. Romifidine caused consistent sedation until 45 minutes. The amitraz emulsion produced a dose-dependent sedation until 180 minutes. Comparing to Romifidine, the emulsion of amitraz induced a more substantial sedation. At dosages and dilution applied, amitraz is an effective sedative for horses.Os agonistas de receptores adrenérgicos do tipo alfa-2 amitraz (AM) e romifidina (RMF) produzem efeito sedativo e reduzem a atividade locomotora espontânea (ALE) em eqüinos. Compararam-se os efeitos sedativos e comportamentais da injeção intravenosa de RMF (0,06mg/kg) ou AM 0,1mg/kg (AM 0,1) ou 0,4mg/kg (AM 0,4) em cavalos. RMF provocou ptose de cabeça (PC) por 45 minutos. O amitraz provocou PC entre 45 e 60 e entre 120 e 150 minutos com a dose menor, e por 180 minutos com a dose maior. Os dados relacionados à ALE não foram conclusivos. RMF ou AM 0,4 causaram sedação mais intensa que AM 0,1 até 20 minutos. Após 20 minutos, a sedação provocada pelo AM 0,4 foi mais intensa que para a RMF ou o AM 0,1. A romifidina causou sedação por 45 minutos. A emulsão de amitraz provocou sedação dose-dependente por 180 minutos. Em relação à romifidina, o amitraz produziu uma sedação mais consistente. Nas doses e na diluição aplicada, o amitraz é eficaz como sedativo para cavalos
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Sedative and antinociceptive effects of Romifidine and xylazine in Thoroughbred mares
Arquivo Brasileiro de Medicina Veterinária e Zootecnia, 2006Co-Authors: F. G. Christovão, G. Zamur, M. I. Mataqueiro, Antonio De Queiroz-netoAbstract:The sedative and antinociceptive effects of Romifidine (0.1mg/kg) and of xylazine (1.0mg/kg) on Thoroughbred mares were studied. Sedation was evaluated by quantifying spontaneous locomotor activity (SLA) and head height (HH) in animals placed in automated individual behaviour stalls. Antinociception was determined utilizing a heat irradiation lamp recording the latency time for the hoof withdrawal reflex (HWRL) and the latency time for the skin twitch reflex (STRL) in a randomised block design with 10 replicates. Comparison of the sedative effects of Romifidine and of xylazine on SLA showed a faster effect for xylazine. Regarding the sedative effect of the substances based on HH, Romifidine caused a longer-lasting effect. Romifidine caused an increase in HWRL and STRL, and xylazine, an agent known for its analgesic effect, did not have an antinociceptive effect based on STRL result. The antinociceptive effect of Romifidine was more pronounced than the xylazine effect.
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Sedative and antinociceptive effects of Romifidine and xylazine in Thoroughbred mares Efeito sedativo e antinociceptivo da romifidina e xilazina em éguas Puro Sangue Inglês
Universidade Federal de Minas Gerais, 2006Co-Authors: F. G. Christovão, G. Zamur, M. I. Mataqueiro, Antonio De Queiroz-netoAbstract:The sedative and antinociceptive effects of Romifidine (0.1mg/kg) and of xylazine (1.0mg/kg) on Thoroughbred mares were studied. Sedation was evaluated by quantifying spontaneous locomotor activity (SLA) and head height (HH) in animals placed in automated individual behaviour stalls. Antinociception was determined utilizing a heat irradiation lamp recording the latency time for the hoof withdrawal reflex (HWRL) and the latency time for the skin twitch reflex (STRL) in a randomised block design with 10 replicates. Comparison of the sedative effects of Romifidine and of xylazine on SLA showed a faster effect for xylazine. Regarding the sedative effect of the substances based on HH, Romifidine caused a longer-lasting effect. Romifidine caused an increase in HWRL and STRL, and xylazine, an agent known for its analgesic effect, did not have an antinociceptive effect based on STRL result. The antinociceptive effect of Romifidine was more pronounced than the xylazine effect.Compararam-se os efeitos sedativos e antinociceptivos da romifidina (0,1mg/kg) e da xilazina (1,0mg/kg) em éguas da raça Puro Sangue Inglês. A sedação foi quantificada por meio da atividade locomotora espontânea (ALE) e altura da cabeça (AC) em baias individuais automatizadas para o estudo do comportamento. A antinocicepção foi avaliada utilizando uma lâmpada de irradiação de calor registrando-se a latência para o reflexo de retirada do membro (LRRM) e a latência para o reflexo do frêmito cutâneo (LRFC), em delineamento experimental em blocos ao acaso com 10 repetições. O efeito sedativo sobre a ALE foi de aparecimento mais rápido no grupo exposto à xilazina, ao passo que a ptose da cabeça foi mais prolongada no grupo que recebeu romifidina. A romifidina promoveu aumento da LRRM e LRFC e a xilazina não causou efeito antinociceptivo medido pela LRFC. O efeito antinociceptivo da romifidina foi mais pronunciado que o da xilazina
Theresa Maria Müller - One of the best experts on this subject based on the ideXlab platform.
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Effect of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during standing cheek tooth removal
BMC veterinary research, 2017Co-Authors: Theresa Maria Müller, Klaus Hopster, Astrid Bienert-zeit, Karl Rohn, Sabine B.r. KästnerAbstract:Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during cheek tooth removal. Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with Romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with Romifidine (same dose) and butorphanol (0.02 mg/kg; CRI 0.04 mg/kg/h). Group RM received Romifidine (same dose) and midazolam (0.02 mg/kg; CRI 0.06 mg/kg/h) whereas group RK was administered Romifidine (same dose) and ketamine (0.5 mg/kg; CRI 1.2 mg/kg/h). If sedation was not adequate a top up bolus of Romifidine (0.01 mg/kg) was administered. The quality of sedation and the conditions for tooth extraction, the level of ataxia, chewing, head and tongue movement were evaluated by using a scoring system. The investigator was blinded to the applied sedation protocol. Furthermore, serum cortisol concentrations before, during and after the procedure were analyzed to gain more information about the stress level of the horses. Horses in group RM showed significantly less chewing and tongue activity compared to horses sedated with Romifidine alone or with butorphanol additionally, but also significantly higher levels of ataxia. The quality of sedation was significantly better if Romifidine was administered in combination with ketamine compared to Romifidine alone. Furthermore, horses of group RK needed less additional Romifidine boli compared to all other groups. Blood cortisol concentrations during surgery in groups RB and RM remained unchanged. Horses of group R showed higher cortisol concentrations during sedation compared to horses of groups RB and RM. Romifidine alone at an initial bolus dose of 0.03 mg/kg followed by a constant rate infusion of 0.05 mg/kg/h was insufficient to obtain an adequate level of sedation and led to increased stress levels, whereas the addition of butorphanol inhibited the stress response. The combination of Romifidine with either midazolam or ketamine improved sedation quality and surgical conditions.
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Effect of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during standing cheek tooth removal
BMC, 2017Co-Authors: Theresa Maria Müller, Klaus Hopster, Astrid Bienert-zeit, Karl Rohn, Sabine B.r. KästnerAbstract:Abstract Background Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during cheek tooth removal. Methods Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with Romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with Romifidine (same dose) and butorphanol (0.02 mg/kg; CRI 0.04 mg/kg/h). Group RM received Romifidine (same dose) and midazolam (0.02 mg/kg; CRI 0.06 mg/kg/h) whereas group RK was administered Romifidine (same dose) and ketamine (0.5 mg/kg; CRI 1.2 mg/kg/h). If sedation was not adequate a top up bolus of Romifidine (0.01 mg/kg) was administered. The quality of sedation and the conditions for tooth extraction, the level of ataxia, chewing, head and tongue movement were evaluated by using a scoring system. The investigator was blinded to the applied sedation protocol. Furthermore, serum cortisol concentrations before, during and after the procedure were analyzed to gain more information about the stress level of the horses. Results Horses in group RM showed significantly less chewing and tongue activity compared to horses sedated with Romifidine alone or with butorphanol additionally, but also significantly higher levels of ataxia. The quality of sedation was significantly better if Romifidine was administered in combination with ketamine compared to Romifidine alone. Furthermore, horses of group RK needed less additional Romifidine boli compared to all other groups. Blood cortisol concentrations during surgery in groups RB and RM remained unchanged. Horses of group R showed higher cortisol concentrations during sedation compared to horses of groups RB and RM. Conclusion Romifidine alone at an initial bolus dose of 0.03 mg/kg followed by a constant rate infusion of 0.05 mg/kg/h was insufficient to obtain an adequate level of sedation and led to increased stress levels, whereas the addition of butorphanol inhibited the stress response. The combination of Romifidine with either midazolam or ketamine improved sedation quality and surgical conditions
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Einfluss von Butorphanol, Midazolam oder Ketamin auf die Romifidin-basierte Sedierung während der Zahnextraktion beim Pferd
2015Co-Authors: Theresa Maria MüllerAbstract:This study was performed to investigate the influence of butorphanol, midazolam or ketamine on Romifidine based standing sedation in horses during cheek tooth removal. The quality of sedation and tooth extraction, the level of ataxia, head and tongue movement as well as chewing during sedation were evaluated. Furthermore blood and saliva cortisol concentrations were analyzed to gain more information about the stress and pain level of the horses. Forty horses presented for cheek tooth extraction at the Clinic for Horses, University of Veterinary Medicine Hannover, foundation were used. The horses were between three and twenty-seven years of age and consisted of twenty-nine Warmbloods, seven ponies, one Thoroughbred and three Draft Horses, all of which had vital parameters within normal limits. Matched pair randomization was used to assign the horses to the different treatment groups, thereby assuring proper homogeneity and comparability between groups. Horses of the Romifidine group (group R) were injected with a bolus of Romifidine (0.03 mg/kg bw) i.v. followed by a continuous rate infusion (CRI) of Romifidine (0.05 mg/kg bw/h). The Romifidine and butorphanol group (group RB) received Romifidine at the same dose as group R and butorphanol (0.02 mg/kg bw i.v.) as bolus followed by a CRI of Romifidine and butorphanol (0.04 mg/kg bw/h). The Romifidine and midazolam group (group RM) received Romifidine at the same dose as group R and a bolus of midazolam (0.02 mg/kg bw i.v.) followed by a CRI of 0.06 mg/kg bw/h. The Romifidine and ketamine group (group RK) received Romifidine at the same dose as group R and a bolus ketamine (0.5 mg/kg bw i.v.) followed by CRI of 1.2 mg/kg bw/h. A scoring system was used to evaluate the sedation quality during cheek tooth extraction. Heart rate and respiratory rate were measured every ten minutes. Within the same ten minute time intervals ataxia, chewing and tongue activity as well as head movements of the horses were graded using a scoring system (score 1-5). If the sedation was not deep enough, an additional Romifidine bolus (0.01 mg/kg bw i.v.) was administered. After successful cheek tooth extraction, the quality of sedation and extraction was graded by the surgeon. For stress level evaluation blood samples were collected from all horses before, during and after surgery for measurement of serum cortisol concentrations. In addition, saliva samples were obtained at three different time points and analyzed for cortisol content, to evaluate the reliability of this less invasive sample collection method in contrast to the conventionally used blood sample. For analysis of the data SAS Version 9.3 (SAS Institute, Cary NC) was used. The value for statistical significance was set at p≤0.05. Differences in ataxia were tested with perumtation test and post-hoc sidak-test for repeated measurements. The comparison of head height and sedation as well as cheek tooth extraction quality was determined by analysis of variance. Head movement at different time points were analyzed by non parametric analysis of variance using the Kruskal-Wallis test followed by pair-wise comparison between groups with Wilcoxon 2 Sample test. The association between behavioral parameters and quality of sedation was tested by Spearman rank correlation. Correlations between saliva cortisol level and blood cortisol level were determined by Pearson correlation. Blood cortisol concentrations were compared by one way analysis of variance and multiple pair-wise comparison of the mean values. The results showed statistically significant less chewing and tongue movement within group RM in contrast to group R and group RB. But horses of group RM also showed significantly higher levels of ataxia compared to groups RK and RB. The sedation quality of group RK was significantly better compared to group R. Furthermore group RK needed the least additional Romifidine boli during surgery. Blood cortisol concentrations decreased during cheek tooth extraction in all groups, but in group R und RK. The horses of group R had overall higher cortisol concentrations during the intervention compared to horses of the other groups. Post operatively a significant increase of blood cortisol levels was evident in all groups but group RB. Baseline cortisol concentrations were reached two hours after end of surgery in all groups but group R. Due to blood contamination and insufficient amount of saliva, many saliva samples had to be discarded since analysis yielded unreliable results. Correlation between blood and saliva cortisol concentration was fair (r= 0.54). The results of this study showed that a combination of Romifidine and midazolam for standing sedation facilitates oral manipulations in the horse even though higher levels of ataxia are to be expected with this drug combination. Standing sedation for cheek tooth extraction with Romifidine alone lead to a higher stress level compared to the drug combination groups. The addition of butorphanol provided better pain relief during as well as after surgery. An improvement of sedation quality and better surgical conditions for tooth extraction were obtained by the combination of Romifidine and ketamine.
Sabine B.r. Kästner - One of the best experts on this subject based on the ideXlab platform.
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Effect of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during standing cheek tooth removal
BMC veterinary research, 2017Co-Authors: Theresa Maria Müller, Klaus Hopster, Astrid Bienert-zeit, Karl Rohn, Sabine B.r. KästnerAbstract:Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during cheek tooth removal. Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with Romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with Romifidine (same dose) and butorphanol (0.02 mg/kg; CRI 0.04 mg/kg/h). Group RM received Romifidine (same dose) and midazolam (0.02 mg/kg; CRI 0.06 mg/kg/h) whereas group RK was administered Romifidine (same dose) and ketamine (0.5 mg/kg; CRI 1.2 mg/kg/h). If sedation was not adequate a top up bolus of Romifidine (0.01 mg/kg) was administered. The quality of sedation and the conditions for tooth extraction, the level of ataxia, chewing, head and tongue movement were evaluated by using a scoring system. The investigator was blinded to the applied sedation protocol. Furthermore, serum cortisol concentrations before, during and after the procedure were analyzed to gain more information about the stress level of the horses. Horses in group RM showed significantly less chewing and tongue activity compared to horses sedated with Romifidine alone or with butorphanol additionally, but also significantly higher levels of ataxia. The quality of sedation was significantly better if Romifidine was administered in combination with ketamine compared to Romifidine alone. Furthermore, horses of group RK needed less additional Romifidine boli compared to all other groups. Blood cortisol concentrations during surgery in groups RB and RM remained unchanged. Horses of group R showed higher cortisol concentrations during sedation compared to horses of groups RB and RM. Romifidine alone at an initial bolus dose of 0.03 mg/kg followed by a constant rate infusion of 0.05 mg/kg/h was insufficient to obtain an adequate level of sedation and led to increased stress levels, whereas the addition of butorphanol inhibited the stress response. The combination of Romifidine with either midazolam or ketamine improved sedation quality and surgical conditions.
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Effect of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during standing cheek tooth removal
BMC, 2017Co-Authors: Theresa Maria Müller, Klaus Hopster, Astrid Bienert-zeit, Karl Rohn, Sabine B.r. KästnerAbstract:Abstract Background Standing surgery, especially dental procedures, are commonly performed in horses. This leads to an increasing demand for reliable sedation protocols. Therefore, it was the purpose of this study to investigate the influence of butorphanol, midazolam or ketamine on Romifidine based sedation in horses during cheek tooth removal. Methods Forty horses presented for tooth extraction were divided in four groups using matched pair randomization. Group R was sedated with Romifidine (bolus 0.03 mg/kg, followed by a constant rate infusion (CRI) 0.05 mg/kg/h) and group RB with Romifidine (same dose) and butorphanol (0.02 mg/kg; CRI 0.04 mg/kg/h). Group RM received Romifidine (same dose) and midazolam (0.02 mg/kg; CRI 0.06 mg/kg/h) whereas group RK was administered Romifidine (same dose) and ketamine (0.5 mg/kg; CRI 1.2 mg/kg/h). If sedation was not adequate a top up bolus of Romifidine (0.01 mg/kg) was administered. The quality of sedation and the conditions for tooth extraction, the level of ataxia, chewing, head and tongue movement were evaluated by using a scoring system. The investigator was blinded to the applied sedation protocol. Furthermore, serum cortisol concentrations before, during and after the procedure were analyzed to gain more information about the stress level of the horses. Results Horses in group RM showed significantly less chewing and tongue activity compared to horses sedated with Romifidine alone or with butorphanol additionally, but also significantly higher levels of ataxia. The quality of sedation was significantly better if Romifidine was administered in combination with ketamine compared to Romifidine alone. Furthermore, horses of group RK needed less additional Romifidine boli compared to all other groups. Blood cortisol concentrations during surgery in groups RB and RM remained unchanged. Horses of group R showed higher cortisol concentrations during sedation compared to horses of groups RB and RM. Conclusion Romifidine alone at an initial bolus dose of 0.03 mg/kg followed by a constant rate infusion of 0.05 mg/kg/h was insufficient to obtain an adequate level of sedation and led to increased stress levels, whereas the addition of butorphanol inhibited the stress response. The combination of Romifidine with either midazolam or ketamine improved sedation quality and surgical conditions
