Induction of anaesthesia with remifentanil after bolus midazolam administration in Landrace/Large White swine

TY - JOUR

T1 - Induction of anaesthesia with remifentanil after bolus midazolam administration in Landrace/Large White swine

AU - Zacharioudaki, Argyro

AU - Lelovas, Pavlos

AU - Sergentanis, Theodoros N.

AU - Karlis, George

AU - Hansen, Axel K.

AU - Papalois, Apostolos

AU - Xanthos, Theodoros

PY - 2017/11

Y1 - 2017/11

N2 - Objective To investigate an alternative combination for anaesthesia induction in swine. Study design Randomized, ‘blinded’ experimental study. Animals Forty-five Landrace/Large White swine weighing 20.0 ± 1.5 kg. Methods Pulse oximetry, heart rate (HR) and blood pressure were measured after premedication with ketamine, midazolam and atropine as well as after intubation following induction with a fixed dose of 0.2 mg kg−1 midazolam combined with 1, 2, 3, 4 or 5 μg kg−1 remifentanil (groups R1, R2, R3, R4 and R5, respectively). Intubation was evaluated using a numerical scoring system assessing jaw relaxation, resistance to the laryngoscope, vocal cord position, vocal cord movement and response to intubation. The time required to intubate and necessity for an additional midazolam dose were recorded. Baseline and post-intubation variables were compared with paired t tests, whereas for differences between the remifentanil groups the Spearman's rank correlation coefficient was estimated. Multivariate regression analysis was performed to disentangle the effect of remifentanil dose and the additional midazolam. Results Higher dose of remifentanil was associated with better vocal cord position (p < 0.001), better response to intubation (p < 0.001), shorter time required for intubation (p = 0.030) and less frequent necessity for additional administration of midazolam (p = 0.004). In total, 39.5% of the animals required additional midazolam. In groups R1, R4 and R5, there were decreases in HRs (p = 0.009, p = 0.008 and p = 0.032, respectively) between baseline and post-intubation phase; in groups R3 and R4, there were decreases in systolic blood pressure (p = 0.040 and p = 0.019, respectively). In the multivariate analysis, remifentanil dose was not associated with the observed changes in haemodynamic variables. One animal developed apnoea and four electrocardiographic anomalies; all resolved without pharmaceutical interventions. Conclusions and clinical relevance A combination of 0.2 mg kg−1 midazolam with 4 or 5 μg kg−1 remifentanil may provide an alternative method of anaesthesia induction for swine.

AB - Objective To investigate an alternative combination for anaesthesia induction in swine. Study design Randomized, ‘blinded’ experimental study. Animals Forty-five Landrace/Large White swine weighing 20.0 ± 1.5 kg. Methods Pulse oximetry, heart rate (HR) and blood pressure were measured after premedication with ketamine, midazolam and atropine as well as after intubation following induction with a fixed dose of 0.2 mg kg−1 midazolam combined with 1, 2, 3, 4 or 5 μg kg−1 remifentanil (groups R1, R2, R3, R4 and R5, respectively). Intubation was evaluated using a numerical scoring system assessing jaw relaxation, resistance to the laryngoscope, vocal cord position, vocal cord movement and response to intubation. The time required to intubate and necessity for an additional midazolam dose were recorded. Baseline and post-intubation variables were compared with paired t tests, whereas for differences between the remifentanil groups the Spearman's rank correlation coefficient was estimated. Multivariate regression analysis was performed to disentangle the effect of remifentanil dose and the additional midazolam. Results Higher dose of remifentanil was associated with better vocal cord position (p < 0.001), better response to intubation (p < 0.001), shorter time required for intubation (p = 0.030) and less frequent necessity for additional administration of midazolam (p = 0.004). In total, 39.5% of the animals required additional midazolam. In groups R1, R4 and R5, there were decreases in HRs (p = 0.009, p = 0.008 and p = 0.032, respectively) between baseline and post-intubation phase; in groups R3 and R4, there were decreases in systolic blood pressure (p = 0.040 and p = 0.019, respectively). In the multivariate analysis, remifentanil dose was not associated with the observed changes in haemodynamic variables. One animal developed apnoea and four electrocardiographic anomalies; all resolved without pharmaceutical interventions. Conclusions and clinical relevance A combination of 0.2 mg kg−1 midazolam with 4 or 5 μg kg−1 remifentanil may provide an alternative method of anaesthesia induction for swine.

KW - endotracheal intubation

KW - midazolam

KW - remifentanil

KW - swine

U2 - 10.1016/j.vaa.2017.04.002

DO - 10.1016/j.vaa.2017.04.002

M3 - Journal article

C2 - 29167072

AN - SCOPUS:85037640367

SN - 1467-2987

VL - 44

SP - 1353

EP - 1362

JO - Veterinary Anaesthesia and Analgesia

JF - Veterinary Anaesthesia and Analgesia

IS - 6

ER -