Total intravenous anaesthesia in horses using medetomidine and propofol

To examine the clinical suitability of medetomidine-propofol infusions for total intravenous anaesthesia in horses.

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.

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, O2 was delivered (FiO2 > 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 microg kg(-1) hour(-1)) and propofol infused IV to effect (initial dose 0.1 mg kg(-1) minute(-1)). Heart (HR) respiratory (fr) and propofol administration rates, and systemic arterial blood pressures were recorded at 5-minute intervals. Arterial blood gas (O2 and CO2) tensions and pH values were recorded every 15 minutes. Ten minutes after ending medetomidine-propofol infusion, medetomidine (2 microg kg(-1); IV) was given. Cardiopulmonary data were analysed using descriptive statistical techniques.

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; PaO2: 22.1-42.9 (4.9-67.8) kPa; [166-322 (37-508) mmHg], PaCO2: 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 microg kg(-1) atropine (IV). Mean propofol infusion rates were 98-108 microg 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.

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.