Dexmedetomidine–methadone–ketamine versus dexmedetomidine–methadone–alfaxalone for cats undergoing ovariectomy. (November 2017)

• Record Type: Journal Article
• Authors: Fernandez-Parra, Rocio; Adami, Chiara; Dresco, Thomas; Donnelly, Thomas M.; Zilberstein, Luca
• Is Part Of: Veterinary anaesthesia and analgesia. Volume 44:Number 6(2017)
• Page Start: 1332
• Page End: 1340
• Publication Date: 2017-11
• Subjects: alfaxalone -- cats -- ketamine -- methadone -- ovariectomy; Veterinary anesthesia -- Periodicals; 636.089
• DOI: 10.1016/j.vaa.2017.03.010
• Languages: English
• ISSNs: 1467-2987

Abstract

Abstract: Objective: To compare the duration, quality of anaesthesia and analgesia, and quality of recovery of dexmedetomidine and methadone combined with either ketamine or alfaxalone. Study design: Randomized, prospective clinical trial. Animals: A group of 44 healthy client-owned cats presenting for ovariectomy. Methods: Cats were randomly assigned to one of the two treatment groups: DAM ( n = 22), which was administered intramuscularly (IM) dexmedetomidine (15 μg kg −1 ), methadone (0.3 mg kg −1 ) and alfaxalone (3 mg kg −1 ), and DKM ( n = 22), which was administered IM dexmedetomidine (15 μg kg −1 ), methadone (0.3 mg kg −1 ) and ketamine (3 mg kg −1 ). During anaesthesia, heart rate, respiratory rate and systolic arterial pressure were measured every 5 minutes. Cats that moved or had poor muscle relaxation were administered an additional 1 mg kg −1 of either alfaxalone (DAM) or ketamine (DKM) intravenously (IV). In cases of increased autonomic responses to surgical stimulation, fentanyl (2 μg kg −1 ) was administered IV. At the end of the surgery, atipamezole (75 μg kg −1 ) was administered IM, and the times to both sternal recumbency and active interaction were recorded. Quality of recovery was evaluated with a simple descriptive scale. The UNESP-Botucatu multidimensional composite pain scale and a visual analogue scale were used to evaluate postoperative analgesia at the return of active interaction and 1, 2 and 3 hours later. Results: The additional anaesthesia and rescue fentanyl requirements were similar between groups. The quality of recovery was better in the DAM group than in the DKM group [simple descriptive scale scores: 0 (0–1) and 1 (0–3), respectively; p = 0.002]. Postoperative pain scores decreased progressively over time in both groups, with no significant differences ( p = 0.08) between them. Conclusions and clinical relevance: Both protocols provided comparable quality of anaesthesia and analgesia and were suitable for cats undergoing ovariectomy. In combination with methadone and dexmedetomidine, alfaxalone and ketamine showed comfortable and reliable recoveries.