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Total intravenous anaesthesia in horses using medetomidine and propofol.Bettschart-Wolfensberger R, Kalchofner K, Neges K, Kästner S, Fürst A Equine Clinic, Vetsuisse Faculty University of Zürich, Zürich, Switzerland. Abstract Objective To examine the clinical suitability of medetomidine-propofol infusions for total intravenous anaesthesia in horses. Animals Fifty client-owned horses of mixed breed, age [mean +/- SD (range)] 6.6 +/- 4.4 (0.04-18) years, mass 478 +/- 168.3 (80-700) kg presented for a range of operations requiring general anaesthesia. Materials and methods Pre-anaesthetic medication was intravenous (IV) medetomidine 7 mug kg(-1). Anaesthesia was induced with IV ketamine (2 mg kg(-1)) and diazepam (0.02 mg kg(-1)). After endotracheal intubation, O(2) was delivered (FiO(2) > 0.85). Positive pressure ventilation was initiated if breath-holding in excess of 1 minute occurred. Anaesthesia was maintained with a constant rate medetomidine infusion (3.5 mug kg(-1) hour(-1)) and propofol infused IV to effect (initial dose 0.1 mg kg(-1) minute(-1)). Heart (HR) respiratory (f(r)) and propofol administration rates, and systemic arterial blood pressures were recorded at 5-minute intervals. Arterial blood gas (O(2) and CO(2)) tensions and pH values were recorded every 15 minutes. Ten minutes after ending medetomidine-propofol infusion, medetomidine (2 mug kg(-1); IV) was given. Cardiopulmonary data were analysed using descriptive statistical techniques. Results Thirty-three orthopaedic, seven integumentary and 10 elective abdominal operations were performed. Cardiopulmonary data, presented as range of mean individual (and absolute individual minimum and maximum values) were: HR: 28.0-39.2 (16-88) beats minute(-1); mean arterial blood pressure: 74.0-132.5 (42-189) mmHg; PaO(2): 22.1-42.9 (4.9-67.8) kPa; [166-322 (37-508) mmHg], PaCO(2): 6.7-8.1 (4.2-11.8) kPa [50-61 (32-88) mmHg] and pH 7.35-7.39 (7.15-7.48). Positive pressure ventilation was required in 23 horses. In three horses, HR values below 20 beats minute(-1) were treated with 20 mug kg(-1) atropine (IV). Mean propofol infusion rates were 98-108 mug kg(-1) minute(-1). During anaesthesia, movement occurring in 14 horses was controlled with thiopental. Duration of anaesthesia was 111.6 +/- 41.4 (46-225) minutes. Recovery in all horses was uneventful and completed within 42.2 +/- 19.8 (12-98) minutes. Conclusions and clinical relevance Medetomidine-propofol infusion produces adequate conditions for a range of surgical procedures. Cardiovascular function was adequate, as no pressor agents were required. Positive pressure ventilation was required in 23 horses. Published 21 November 2005 in Vet Anaesth Analg, 32(6): 348-54.
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