Anesthetic evaluation of administration of intravenous alfaxalone in comparison with propofol and ketamine/diazepam inductions in alpacas Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/rr1721104

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  • Alfaxalone (3a-hydroxy-5a-pregnane-11,20-dione) is a neuroactive steroid that can induce anesthesia. It has recently been reformulated and solubilized in 2-hydroxypropyl-β-cyclodextrin (HCPD). Propofol and the combination of ketamine and diazepam are commonly used induction drugs in all species. The objective of this prospective randomized and crossover design study was to evaluate the safety and efficacy of induction with this new formulation of intravenous alfaxalone in alpacas and to compare these effects to those of propofol and the combination of ketamine/diazepam. Five healthy alpacas (96.7± 19.9 kg, 9.6± 3.1 years old) were anesthetized on three different occasions with propofol, ketamine/diazepam or alfaxalone by titrated intravenous injection. Quality of induction and intubation was assessed using a simple descriptive scale and quality of recovery was scored: 1 (very poor)- 5 (excellent). The auricular artery was catheterized to measure systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures and for collection of arterial blood to obtain blood gases and electrolytes. Electrocardiography, pulse oximetry (SpO₂), respiratory rate, and end-tidal carbon dioxide partial pressure (P[subscript E]´CO₂) were also monitored. Repeated measures ANOVA was used to assess effects of drug and time. Statistical significance was set at p < 0.05. We observed that the mean dose of alfaxalone sufficient to allow intubation in our alpacas was 2.1 mg kg⁻¹. Induction was excellent with all protocols. Heart rate (HR), SAP and MAP were significantly higher following alfaxalone compared to ketamine/diazepam. Lactate after standing following alfaxalone was higher compared to minutes 1 and 6 after alfaxalone administration and to propofol (standing) (p < 0.05). All alpacas required oxygen supplementation due to PE´CO₂ > 60 mmHg and/or SpO₂ < 90% at minute 1. Time from induction to standing was longer with alfaxalone (34.08± 3.16 minutes) than propofol (19± 4.3 minutes) or ketamine/diazepam (24.9± 1.67 minutes). Recovery quality median scores were clinically and statistically different: 2 (alfaxalone), 4 (ketamine/diazepam), and 5 (propofol). Tremors, paddling, rolling over, seizure-like activity and thrashing characterized recovery from alfaxalone. In conclusion, all protocols were adequate for induction but recovery quality was worse with alfaxalone. HR, SAP, MAP were increased at minute 1 in all protocols. Transient hypercapnia and hypoxia was observed with all protocols. Based on this study, alfaxalone used alone in un-premedicated alpacas is not recommended due to poor recoveries.
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