Plasma concentrations at two dexmedetomidine constant rate infusions in isoflurane anaesthetized horses: a clinical study

Abstract

Objective: To determine dexmedetomidine plasma concentrations at two infusion rates in isoflurane anaesthetized horses and compare cardiovascular effects and anaesthetic recovery between treatments.

Study design: Prospective, randomized, masked clinical study.

Animals: Healthy, adult, client-owned, non-food producing horses presented for castration.

Methods: Premedication consisted of acepromazine, romifidine and morphine, and anaesthesia was induced with ketamine and midazolam. The horses were randomized to receive dexmedetomidine 0.5 μg kg^-1 hour^-1 (treatment DL, n = 7) or 1.75 μg kg^-1 hour^-1 (treatment DH, n = 7) for 90 minutes of isoflurane anaesthesia at an end-tidal concentration of 1.2%. Venous plasma concentrations were determined with liquid chromatography-electrospray-ionization-tandem mass spectrometry. Jugular venous and arterial blood was sampled for blood gas analysis at the start and end of the infusion. Changes in cardiovascular variables from the start to the end of the infusion, and recovery parameters were statistically compared between treatments.

Results: Fourteen male horses, 2-6 years old, 325-536 kg were included. Mean ± standard deviation dexmedetomidine plasma concentrations at 30, 60 and 90 minutes with treatment DL were 0.22 ± 0.05, 0.29 ± 0.07 and 0.33 ± 0.08 ng mL^-1, and with treatment DH were 0.65 ± 0.11, 0.89 ± 0.10 and 1.01 ± 0.10 ng mL^-1. The 95% confidence interval for change minute^-1 in dexmedetomidine plasma concentrations between 75 and 90 minutes was 0-1% for both treatments. With treatment DH, the heart rate decreased significantly more from the beginning to the end of the infusion compared to DL (p = 0.043). No other significant differences were found between treatments in cardiovascular or recovery parameters.

Conclusions and clinical relevance: Infusion of dexmedetomidine in isoflurane anaesthetized horses resulted in plasma concentrations with low variation at both infusion rates, approaching stable levels after 75 minutes of infusion. No differences of clinical importance were found when comparing cardiovascular variables and quality of recovery between treatments.

Keywords: anaesthesia; dexmedetomidine; equine; infusion; plasma concentrations.