CLINICO-PHYSIOLOGICAL EVALUATION OF KETAMINE AND LIGNOCAINE AS CONTINUOUS RATE INFUSION (CRI) FOR PROPOFOL ANAESTHESIA IN DOGS.
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Date
2018
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COLLEGE OF VETERINARY AND ANIMAL SCIENCES, POOKODE WAYANAD
Abstract
General anaesthesia with sustained analgesia is inevitable for most of the
surgical procedures performed. Additional analgesia without deepening
anaesthesia, could be attained by administering analgesic drugs as continuous rate
infusion (CRI). A CRI with analgesics will also help in reducing the total
anaesthetic requirement during a surgical procedure. Accordingly, the study was
conducted to find out the clinico-physiological effects of ketamine and lignocaine
as continuous rate infusion for propofol anaesthesia in dogs. The study was carried
out in twelve dogs presented for neutering at the surgery out-patient unit of Kerala
Veterinary and Animal Sciences University. Female dogs presented for spaying,
were selected and randomly divided into group I and group II with six animals each.
All the animals were premedicated with injection of tramadol @ 4 mg/kg body
weight and xylazine @ 1 mg/kg body weight mixed together in a single syringe and
given as intramuscular injection. General anaesthesia was induced in all the animals
using injection of diazepam @ 0.2 mg/kg body weight intravenous, immediately
followed by propofol injection given intravenously “to effect”. In group I animals,
anaesthesia was maintained using propofol given intravenously as bolus injection
as and when required “to effect”. In group II animals, anaesthesia was maintained
using ketamine @ 10 µg/kg/min and lignocaine @ 30 µg/kg/min mixed in 100 ml
normal saline and administered intravenously as continuous rate infusion (CRI)
throughout the period of surgery using a flow regulator set at 100 ml per hour speed.
Propofol, if required was administered intravenously.
The quality of anaesthetic induction was excellent in all the animals studied.
There was profound sedation in all the twelve animals studied, following
intravenous administration of diazepam and propofol. Transition to anaesthesia was
calm and smooth in all animals with profound jaw muscle relaxation, which
facilitated an easy endotracheal intubation. Time taken for induction had no
significant variations between group I and group II. Rectal temperature, rate of
respiration and capillary refill time recorded were within normal limits in all the
animals. Heart rate and pulse rate were found to be elevated in group I and group II
throughout the anaesthetic period. Blood pressure was observed to be enhanced and
stabilised in group II than in group I. The values were observed within the normal
range. Electrocardiogram recordings did not reveal any kind of cardiac
abnormalities throughout the study period instead a tachycardia could be observed
in animals of both the groups. The EtCO2 values were higher with non-significant
difference between the groups. An improvement in the saturation of oxygen in
peripheral blood could be observed in group II animals which was not observed in
group I animals during the period of study. All the animals had a calm recovery
except for two animals of group II, where a short period of paddling have been
observed prior to the attempts to stand. The time taken for recovery was prolonged
in animals of group II as compared to the animals of group I. The dogs which
received CRI required less amount of propofol top up for the maintenance of
anaesthesia, which proves the sparing effect of ketamine-lignocaine CRI on the
requirement of propofol and hence the protocol is proven to be economic.
It could be thus concluded that the dogs sedated with intramuscular injection
of xylazine-tramadol, followed by an induction with diazepam-propofol and
maintained with a continuous rate infusion of ketamine and lignocaine provided
excellent analgesia, adequate muscle relaxation, improvement in the saturation of
oxygen in peripheral blood, smooth quality of induction and recovery and an
enhanced hemodynamics with minimal adverse effects on cardiovascular and
respiratory systems. The protocol is also proven to be economic due to the sparing
effect of ketamine-lignocaine CRI on the requirement of propofol.
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