Evaluation of Ketamine Hydrochloride in Combination with Midazolam, Dexmedetomidine and Butorphanol as Balanced Anaesthesia in Cats

Background: As cats undergo stress at the time of presentation before surgery and therefore sedation is required often. It is very difficult to choose a balanced anaesthetic protocol during the surgical intervention in the case of a cat. Therefore, the present study was undertaken to evaluate the effect of ketamine hydrochloride in combination with midazolam, dexmedetomidine and butorphanol as balanced anaesthesia on clinico-physiological, haematological, serum biochemical profile in the surgical management of cats undergoing neutering. Methods: The study was performed on 18 clinical cases of cats which were brought to the Teaching Veterinary Clinical Complex, College of Veterinary Sciences and Animal Husbandry (CVSc and AH), Central Agricultural University (CAU), Selesih, Aizawl, Mizoram for elective surgery such as neutering. Cats were randomly divided into 3 equal groups, i.e. Gr. A, Gr. B and Gr. C. Animals were premedicated with glycopyrrolate @ 0.01 mg/kg, i/m. After 10 minutes of premedication, in Gr. A ketamine hydrochloride @15 mg/kg and midazolam @ 0.5 mg/kg, in Gr. B ketamine hydrochloride @10 mg/ kg and dexmedetomidine@ 5 mcg /kg and in Gr. C ketamine hydrochloride @ 5 mg/kg, dexmedetomidine@ 5 mcg/kg and butorphanol @ 0.2 mg/kg was administered intramuscularly. Clinico-physiological and haemato-biochemical profiles were evaluated at 0 minute (baseline), then at 15, 30 and 60 minutes after administration of anaesthetic agents to evaluate their anaesthetic effect. Result: In the case of time for induction, the quality of induction, assessment of peri-operative analgesia, depth of anaesthesia and quality of recovery there was no significant difference among all three groups. In Gr. B, animals showed significantly higher duration of recumbency (DOE) and recovery. The assessment of peri-operative analgesic effect among the groups revealed that analgesia during the perioperative period appeared best in Gr. C protocol. In regards to depth of anaesthesia, ketamine hydrochloride in combination with dexmedetomidine and butorphanol group showed a better result. Rectal temperature decreased significantly (P greater than 0.05) up to 60th minutes in Gr. A, but it remained within the physiological range. Heart rate raised significantly (p less than 0.05) from the baseline (0 minutes) onwards and decreased significantly (p less than 0.05) till the end (60 minutes) of the study in Gr. C. The respiration rate was significantly (p less than 0.01) different in between time intervals for all three groups. No significant difference was observed on haemato-biochemical observation except glucose level which significantly increased after induction of anaesthesia. In conclusion, treatment with ketamine hydrochloride in combination with dexmedetomidine and butorphanol led to acceptable sedation and mild changes in clinico-physiological, haematological, serum biochemical profile in comparison to the other two groups.

Successful bilateral phacoemulsification and vitrectomy in a Bennett’s wallaby (Macropus rufogriseus)

CASE DESCRIPTION A 7-month-old hand-reared female Bennett’s wallaby (Macropus rufogriseus) was evaluated for bilateral ocular opacity of 3 months’ duration. CLINICAL FINDINGS On physical examination, the wallaby was in good overall condition. An ophthalmic examination revealed mature cataracts in both eyes (OU). The cataracts were suspected to have a nutritional origin as it has been described in hand-reared macropods. Results of tonometry were normal OU. Results of CBC and serum biochemistry were unremarkable. The wallaby was premedicated with medetomidine and ketamine hydrochloride. Ocular ultrasonography performed while the wallaby was anesthetized revealed a thickened and opaque lens, mildly heterogeneous vitreous humor, and no sign of retinal detachment OU. An electroretinogram confirmed functional retinae OU. TREATMENT AND OUTCOME Surgery was considered necessary for welfare reasons. Phacoemulsification and vitrectomy were performed without intraoperative complication. The wallaby recovered uneventfully, and systemic NSAID, topical corticosteroid, and systemic and topical antimicrobial therapy were prescribed. One year later, the animal had vision OU. Physical examination did not show any vision-threatening postoperative complications. CLINICAL RELEVANCE The etiology of nutritional cataracts is not fully understood in macropods, but this condition is rather common in these species. To our knowledge, this is the first detailed report of a successful bilateral phacoemulsification and vitrectomy in a Bennett’s wallaby.

A Comparative Evaluation of the Anaesthetic Properties of Bupivacaine Hydrochloride and Ketamine Hydrochloride with Dextrose Given Intrathecally for Inguinal Hernia Repair - A Randomized Controlled Study in a Tertiary Centre in South Kerala

The above article has been withdrawn on authors’ request. Original CitationSebastian R, Kamalakshi RK, Parambath JM, et al. A comparative evaluation of the anaesthetic properties of upivacaine hydrochloride and ketamine hydrochloride with dextrose given intrathecally for inguinal hernia repair – a randomized controlled study in a tertiary centre in south Kerala. J Evid Based Med Healthc 2021;8(31):2830- 2834. DOI:10.18410/jebmh/2021/518

Combination of ketamine and xylazine to reduce pain during electroejaculation in dogs

The present study evaluated the efficiency of a ketamine-xylazine combination to attenuate the pain associated to electroejaculation (EEJ) in dogs. To that end, 10 dogs of undetermined breed were anesthetized (i.m.) with a mixture of 8mg.kg-1 ketamine hydrochloride (Cetamin®, Syntec, Brazil) and 1mg.kg-1 IM xylazine hydrochloride (Xilazin®, Syntec, Brazil) and subjected to EEJ procedures. Painful stimuli were detected by cardiorespiratory rate, measured every 5 min, and body temperature, taken before and after EEJ. Mean values for the parameters evaluated decreased, suggesting that the anesthesia protocol used is safe for semen collection by EEJ and can relieve the pain associated to this procedure.

KETAMINE INFUSION FOR MANAGEMENT OF EARLY POSTOPERATIVE PAIN FOLLOWING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY: ASSESSMENT OF OPTIMUM DOSE

Background: This study is aimed to assess an optimal dose of ketamine infusion for management of early postoperative pain in elective laparoscopic cholecystectomy. Intensity of pain, requirement of rescue analgesics and tness to discharge were assessed during immediate postoperative period. Methodology: Randomised controlled prospective clinical trial was conducted in 140 patients of laparoscopic cholecystectomy and, allocated in four groups of 35 each. Standard anaesthetic regimen was used in all patients, using propofol for induction, atracurium for muscle relaxation and isourane for maintenance of anaesthesia. Continuous infusion of the test drug was administered by intravenous cannula placed in alternate hand -1 -1 from start of port placement till wound closure. Group K1, K2 and K3 received an infusion of ketamine hydrochloride at a rate of 20 µg kg min , 30 -1 -1 -1 -1 µg kg min and, 40 µg kg min respectively, while Group N received normal saline. Postoperative pain score, requirement of rescue analgesia, degrees of sedation and postoperative cognitive function were examined postoperatively. Results: -1 Visual analog scale score ≥ 4 was considered signicant pain and, rescue analgesic injection diclofenac sodium 75mg kg was administered. Duration of analgesia was 130.71 ± 82.41, 457.14 ± 150.373, 520.97 ± 189.338 and, 524.83 ± 141.436 minutes in group N, K1, K2 and K3 respectively. Out of 35 patients 28, 4, 0 and, 0 patients required three doses of diclofenac sodium in 24 hours in N, K1, K2 and K3 group respectively. Conclusions: -1 -1 Continuous infusion of ketamine hydrochloride at a rate of 30 µg kg min during intraoperative period provide effective pain relief during early postoperative period without inuencing cognitive function of the patients.