Comparison of the Effects of Medetomidine/Ketamine and Xylazine/Ketamine Anesthesia and Its Reversal by Atipamezole on Cardiovascular Functions in Cats

Abstract

The aim of this study was to investigate the short-term cardiovascular effects of medetomidine/ketamine (MED-KET) and xylazine/ketamine (XYZ-KET) anesthesia regimes and its reversal (atipamezole) in cats through using echocardiography. Twenty sexually intact female cats (weighing between 2.2 and 3.6 kg, and between 0.5 and 5.5 years of age) referred for ovariohysterectomy procedure. Electrocardiogram, non-invasive blood pressure, respiratory rate, heart rate and pulse oximetry were monitored throughout the anesthesia. Both groups showed declines in left ventricular diameter (LVD%) and left ventricular ejection fraction (EF) after anesthesia induction (T0 vs. T1, all, p<0.05); nevertheless, the reduction and starting pattern of LVD% and left ventricular EF presented important intergroup distinction. In conclusion, echocardiographic values effected significantly after anesthesia with MED-KET and XYZ-KET; and atipamezole can be useful for return to baseline values quickly and safely in cats after abdominal surgery such as ovariohysterectomy.

Keywords

• Antagonized
• Echocardiography
• Heart
• Atipamezole

Kedilerde Medetomidin/Ketamin ve Ksilazin/Ketamin Anestezisinin Kardiovasküler Fonksiyonlar Üzerindeki Etkilerinin ve Atipamezol ile Geri Dönüşümünün Karşılaştırılması

Abstract

Bu çalışmanın amacı, medetomidin/ketamin (MED-KET) ve ksilazin/ketamin (KSZ-KET) anestezisindeki kedilerde kısa süreli kardiyovasküler etkilerini ve atipamezol ile bu etkilerinin geri dönüşümünü ekokardiyografi tekniği ile araştırmaktı. Erişkin 20 dişi kedi (ağırlığı 2.2-3.6 kg ve yaşı 0.5-5.5 arasında) ovariyohisterektomi için getirildi. Elektrokardiyogram, invaziv olmayan kan basıncı ölçümü, solunum sayısı, kalp atımı ve periferik oksijen düzeyi anestezi süresince izlendi. Her iki grup anestezi indüksiyonundan sonra sol ventrikül çapı (%LVD) ve sol ventrikül fırlatma fraksiyonu (EF) azalması (T0’a karşı T1, p<0.05) göstermiştir. Bununla birlikte azalma ve başlangıç değerlerine dönüş gruplar arasında istatistiki olarak farklıydı. Sonuç olarak, MED-KET ve KSZ-KET ile anestezi sonrası ekokardiyografik değerlerin anlamlı düzeyde etkilendiği ve atipamezolün, ovariohisterektomi gibi abdominal cerrahiler sonrasında kedilerde hızlı ve güvenli bir şekilde başlangıç değerlerine dönüş için faydalı olabileceği kanısına varıldı.

Keywords

• Antagonist
• Ekokardiyografi
• Atipamezol
• Kalp

References

1. Allen DG (1982). Echocardiographic study of the anesthetized cat. Can J Comp Med, 46 (2), 115-122.
2. Anandmay AK, Dass LL, Sharma AK, Gupta MK, et al (2016). Clinico-anesthetic changes following administration of propofol alone and in combination of meperidine and pentazocine lactate in dogs. Vet World, 9 (11), 1178-1183.
3. Ancrenaz M (1994). Use of Atipamezole to Reverse Xylazine Tranquilization in Captive Arabian Oryx (Oryx leucoryx). J Wild Dis, 30 (4), 592-595.
4. Astner S (1998). Vergleich intramuskulaer verabreichter Kombinationsanaesthesien beim Kaninchen Xylazin/Ketamin, Medetomidin/Ketamin, Medetomidin/Fentanyl/ Midazolam [PhD dissertation]. Munich, Germany: Ludwig Maximilians University of Munich.
5. Baumgartner C, Bollerhey M, Ebner J, et al (2010). Effects of ketamine-xylazine intravenous bolus injection on cardiovascular function in rabbits. Can J Vet Res, 74 (3), 200–208.
6. Baumgartner C, Bollerhey M, Ebner J, et al (2010). Effects of medetomidine-midazolam-fentanyl IV bolus injections and its reversal by specific antagonists on cardiovascular function in rabbits. Can J Vet Res, 74 (4), 286–298.
7. Baumgartner C, Bollerhey M, Henke J, et al (2008). Effects of propofol on ultrasonic indicators of haemodynamic function in rabbits. Vet Anaesth Analg, 35 (2), 100–112.
8. Bergman SA (1999). Ketamine: review of its pharmacology and its use in pediatric anesthesia. Anesth Prog, 46 (1), 10–20.

9. Dyson DH, Maxie MG (1999). Morbidity and mortality associated with anesthetic management in small animal veterinary practice in Ontario. J Anim Hosp Assoc, 35 (4), 325–335.
10. Erhardt W, Wohlrab S, Kılıç N, Werner C, Henke J (2001). Comparison of the anaesthesia combinations racemic-ketamine/medetomidine and S-Ketamine-medetomidine in syrian golden hamsters (mesocricetus auratus). J Vet Anaest, 28 (4), 212-213.
11. Hanatani A, Yoshiyama M, Takeuchi K, et al (1998). Angiotensin II type 1-receptor antagonist candesartan cilexitil prevents left ventricular dysfunction in myocardial infarcted rats. Jpn J Pharmacol, 78 (1), 45–54.
12. Henke J, Astner S, Brill T, et al (2005). Comparative study of three intramuscular anaesthetic combinations (medetomidine/ketamine, medetomidine/fentanyl/ midazolam and xylazine/ketamine) in rabbits. Vet Anaesth Analg, 32 (5), 261–270.
13. Hollis AR, Pascal M, Van Dijk J, Jolliffe C, Kaartinen J (2020). Behavioural and cardiovascular effects of medetomidine constant rate infusion compared with detomidine for standing sedation in horses. Vet Anaesth Analg, 47 (1), 76-81.
14. Hopster K, Wittenberg-Voges L, Kästner SBR (2017). Xylazine infusion in isoflurane-anesthetized and ventilated healthy horses: Effects on cardiovascular parameters and intestinal perfusion. Can J Vet Res, 81 (4), 249-254.
15. Kawahara Y, Tanonaka K, Daicho T, et al (2005). Preferable Anesthetic Conditions for Echocardiographic Determination of Murine Cardiac Function. J Pharmacol Sci, 99 (1), 95-104.
16. Kılıç N, Henke J, Pragst I, Erhardt W (2001). Comparison of three different medetomidin/ketamin kombinations in NMRI mice. J Vet Anaest, 28 (4), 211-212.
17. Kılıç N (2004). A Comparison between Medetomidine-Ketamine and Xylazine-Ketamine Anaesthesia in Rabbits. Turk J Vet Anim Sci, 28 (5), 921-926.
18. Kılıç N, Henke J. Erhardt W (2004). Ketamine-medetomidine anaesthesia beim hamsters (mesocricetus auratus): ein klinischer Vergleich zwischen subkutaner und intraperitonealer Applikation. Tierarztl Prax Ausg K Kleintiere Heimtiere, 32, 384-388.
19. Lee SW, Hankes GH, Purohit RC, et al (1990). Comparative study of ultrasonography and arteriography of the carotid artery of xylazine-sedated and halothane-anesthetized goats. Am J Vet Res, 51 (1), 109–113.
20. Lee C, Jones TA (2018). Effects of Ketamine Compared with Urethane Anesthesia on Vestibular Sensory Evoked Potentials and Systemic Physiology in Mice. J Am Assoc Lab Anim Sci, 57 (3), 268-277.
21. Lin J, Figuerado Y, Montgomery A ve ark. (2021). Efficacy of ketamine for initial control of acute agitation in the emergency department: A randomized study. Am J Emerg Med, 44, 306-311.
22. Lunn JN, Mushin WW (1982). Mortality associated with anaesthesia. Anaesthesia, 37 (8), 856.
23. Melanie B (2005). Sonographische Darstellung des Einflusses der Injektionsnarkose Methoden Propofol, Ketamin-Xylazin oder Medetomidin Midazolam-Fentanyl auf die Vasoaktivität und Hämodynamik beim Kaninchen. Inaugural-Dissertation, München.
24. O'Gara BP, Beydoun NY, Mueller A, Kumaresan A, Shaefi S (2022). Anesthetic Preferences for Cardiac Anesthesia: A Survey of the Society of Cardiovascular Anesthesiologists. Anesth Analg, doi: 10.1213/ANE.0000000000006147.
25. Raisis AL, Blissitt KJ, Henley W, et al (2005). The effects of halothane and isoflurane on cardiovascular function in laterally recumbent horses. Brit J Anaesth, 95 (3), 317–325.
26. Říha H, Papoušek F, Neckář J, et al (2012). Effects of Isoflurane Concentration on Basic Echocardiographic Parameters of the Left Ventricle in Rats. Physiol Res, 61 (4), 419-423.
27. Riou B, Viars P, Lecarpentier Y (1990). Effects of ketamine on the cardiac papillary muscle of normal hamsters and those with cardiomyopathy. Anesthesiology, 73 (5), 910–918.
28. Roth DM, Swaney JS, Dalton ND, et al (2002). Impact of anesthesia on cardiac function during echocardiography in mice. Am J Physiol Heart Circ Physiol, 282 (6), 2134–2140.
29. Salla KM, Tuns CI, Bennett RC ve ark. (2017). Cardiovascular effects of premedication with medetomidine alone and in combination with MK-467 or glycopyrrolate in dogs subsequently anesthetized with isoflurane. Am J Vet Res, 78 (11), 1245-1254.
30. Simonini A, Brogi E, Cascella M, Vittori A (2022). Advantages of ketamine in pediatric anesthesia. Open Med (Wars), 17 (1), 1134-1147.
31. Smith TC (2009). Hypnotics and intravenous anaesthetic agents. In: Fundamentals of Anaesthesia. Smith TC, Pinnock C, LIN T (eds), 3rd ed., Cambridge University Press, Cambridge, 2009, pp 569-583.
32. Talukder H, Hikasa Y, Takahashi H, et al (2009). Antagonistic effects of atipamezole and yohimbine on medetomidine-induced diuresis in healthy dogs. Can J Vet Res, 73 (4), 260–270.
33. Wessler B, Madias C, Pandian N, et al (2011). Short term effects of ketamine and isoflurane on left ventricular ejection fraction in an experimental swine model. ISRN Cardiol, 2011, 582658.
34. Vilar JM, Batista M, Pérez R ve ark. (2018). Comparison of 3 anesthetic protocols for the elective cesarean-section in the dog: Effects on the bitch and the newborn puppies. Anim Reprod Sci, 190, 53-62.
35. Yang X-P, Liu Y-H, Rhaleb N-E, et al (1999). Echocardiographic assessment of cardiac function in conscious and anesthetized mice. Am J Physiol Heart Circ Physiol, 277 (5), 1967–1974.
36. Zatroch KK, Sakai DM, Parry S, Campoy L, Martin-Flores M (2019). Evaluation of atipamezole as a treatment for dexmedetomidine-induced cardiovascular depression in anesthetized cats. Am J Vet Res, 80 (5) , 455-460.