DOI
https://doi.org/10.18849/ve.v5i4.318Abstract
PICO question
In dogs undergoing elective procedures does the use of medetomidine during premedication result in an increase in anaesthetic complication rates, when compared to acepromazine?
Clinical bottom line
Category of research question
Treatment
The number and type of study designs reviewed
Four papers were critically reviewed, all of which were randomised controlled trials
Strength of evidence
Strong
Outcomes reported
There were some statistically significant differences between using medetomidine and acepromazine as premedications in the outcomes measured, but as the clinical parameters including blood pressure were still within acceptable clinical limits, the clinical benefits of these findings remain undetermined. There is also evidence to suggest that patients premedicated with medetomidine have less of a perioperative stress response than those receiving acepromazine, but in addition may have increased risk of cardiac conduction disturbances, but the clinical importance of these findings is also unknown
Conclusion
The overall findings showed that either drug can be used as a suitable premedication, but the differences in pain score postoperatively shown in one small study mean that due to its poor analgesic properties it is recommended when using acepromazine instead of medetomidine, that additional analgesia should be given to reduce postoperative pain for better animal welfare
How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
References
Abouleish, A.E., Leib, M.L. and Cohen, N.H. (2015). ASA Provides Examples to Each ASA Physical Status Class. ASA Newsletter. 79, 38–49.
Dahl, J.B. and Møiniche S. (2005). Pre-emptive analgesia. British Medical Bulletin. 71(1), 13–27. DOI: https://doi.org/10.1093/bmb/ldh030
Desborough, J.P. (2000). The stress response to trauma and surgery. British Journal of Anaesthesia. 85, 109–117. DOI: https://doi.org/10.1093/bja/85.1.109
Egger, C.M. (2016). BSAVA manual of canine and feline anaesthesia and analgesia. British Small Animal Veterinary Association (BSAVA Manuals Series).
Grimm, K.A., Tranquilli, W.J., Thurmon, J.C. and Benson, G.J. (2000). Duration of nonresponse to noxious stimulation after intramuscular administration of butorphanol, medetomidine, or a butorphanol-medetomidine combination during isoflurane administration in dogs. American Journal of Veterinary Research. 61(1), 42–7. DOI: https://doi.org/10.2460/ajvr.2000.61.42
Grint, N.J., Alderson, B. and Dugdale, A.H. (2010). A comparison of acepromazine-buprenorphine and medetomidine-buprenorphine for preanesthetic medication of dogs. Journal of the American Veterinary Medical Association. 237(12), 1431–7. DOI: http://dx.doi.org/10.2460/javma.237.12.1431
Grood, P.M.R.M.D., Coenen, L.G.J., Egmond, J.V., Booij, L.H.D.J. and Crul, J.F. (1987). Propofol emulsion for induction and maintenance of anaesthesia. A combined technique of general and regional anaesthesia. Acta Anaesthesiologica Scandinavica, 31(3), 219–223. DOI: http://dx.doi.org/10.1111/j.1399-6576.1987.tb02554.x
Kashou, A.H., Goyal, A., Nguyen, T. and Chhabra, L. (2020). Atrioventricular Block. StatPearls Publishing.
Kovalcuka, L., Birgele, E., Bandere, D. and Williams, D.L. (2013). The effects of ketamine hydrochloride and diazepam on the intraocular pressure and pupil diameter of the dog’s eye. Veterinary Ophthalmology. 16(1), 29–34. DOI: https://doi.org/10.1111/j.1463-5224.2012.01015.x
Laing, S., Paul, V. and Murison, P.J. (2009). The effects of nitrous oxide on recovery from isoflurane anaesthesia in dogs. Journal of Small Animal Practice. 50(2), 82–86. DOI: https://doi.org/10.1111/j.1748-5827.2008.00689.x
Lerche, P., Reid, J. and Nolan, AM. (2000). Comparative study of propofol or propofol and ketamine for the induction of anaesthesia in dogs. Veterinary Record. 146, 571–574. DOI: http://dx.doi.org/10.1136/vr.146.20.571
Lynch, C. (1986). Differential depression of myocardial contractility by halothane and isoflurane in vitro. Anesthesiology. 64, 620–631. DOI: http://dx.doi.org/10.1097/00000542-198605000-00013
Murrell, J.C. (2016). BSAVA manual of canine and feline anaesthesia and analgesia. British Small Animal Veterinary Association (BSAVA Manuals Series).
Redondo, J.I., Rubio, M., Soler, G., Serra, I., Soler, C. and Gómez‐Villamandos, R.J. (2007). Normal Values and Incidence of Cardiorespiratory Complications in Dogs During General Anaesthesia. A Review of 1281 Cases. Journal of Veterinary Medicine Series A. 54(9), 470–477. DOI: https://doi.org/10.1111/j.1439-0442.2007.00987.x
Reid, J., Nolan, A., Hughes, J., Lascelles, D., Pawson, P. and Scott, E. (2007). Development of the short-form Glasgow Composite Measure Pain Scale (CMPS-SF) and derivation of an analgesic intervention score. Animal Welfare. 16, 97–104.
Smith, L.J., Yu, J.K., Bjorling, D.E. and Waller, K. (2001). Effects of hydromorphone or oxymorphone, with or without acepromazine, on preanesthetic sedation, physiologic values, and histamine release in dogs. Journal of the American Veterinary Medical Association. 218, 1101–1105. DOI: https://doi.org/10.2460/javma.2001.218.1101
Thurmon, J.C., Tranquilli, W.J. and Benson, G.J. (1996). Preanesthetics and anesthetics adjuncts. Veterinary Anesthesia (3rd ed.). Thurmon JC, Tranquilli WJ, Benson GJ (eds). Williams & Wilkins, Baltimore, USA, pp. 183–189.
Tsai, T.Y., Chang, S.K., Chon, P.Y., Yeh, L.S. (2013). Comparison of postoperative effects between lidocaine infusion, meloxicam and their combination in dogs undergoing ovariohysterectomy. Veterinary Anaesthesia Analgesia. 40, 615–22. DOI: https://doi.org/10.1111/vaa.12064
Väisänen, M., Raekallio, M., Kuusela, E., Huttunen, P., Leppäluoto, J., Kirves P. and Vainio, O. (2002). Evaluation of the perioperative stress response in dogs administered medetomidine or acepromazine as part of the preanesthetic medication. American Journal of Veterinary Research. 63(7), 969–975. DOI: https://doi.org/10.2460/ajvr.2002.63.969
Väisänen, M., Vainio, O., Raekallio, M., Hietanen, H., and Huikuri, H. (2005). Results of 24-hour ambulatory electrocardiography in dogs undergoing ovariohysterectomy following premedication with medetomidine or acepromazine. Journal of the American Veterinary Medical Association. 226(5), 738–745. DOI: https://doi.org/10.2460/javma.2005.226.738
Wamaitha, M.N., Mogoa, E.M. and Mande, J.D. (2019). Evaluation of anesthesia produced by ketofol in acepromazine- or medetomidine-sedated dogs. Journal of advanced veterinary and animal research. 6(2), 215–221. DOI: http://doi.org/10.5455/javar.2019.f335
License
Veterinary Evidence uses the Creative Commons copyright Creative Commons Attribution 4.0 International License. That means users are free to copy and redistribute the material in any medium or format. Remix, transform, and build upon the material for any purpose, even commercially - with the appropriate citation.
Similar Articles
- Kiriaki Pavlidou, Lysimachos G Papazoglou, The effect of pre-emptive incisional bupivacaine block on postoperative pain after coeliotomy in dogs , Veterinary Evidence: Vol. 6 No. 1 (2021): The first issue of 2021
- Chris Webb, Julia Deutsch, In bitches, is ovariectomy/ovariohysterectomy by laparoscopy less painful postoperatively than by midline open laparotomy? , Veterinary Evidence: Vol. 6 No. 1 (2021): The first issue of 2021
You may also start an advanced similarity search for this article.
