Document Type : Original Article
Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
Department of Clinical sciences, Faculty of Veterinary Medicine, Razi University, Kermanshah, Iran
Objective- The aim of this study was to evaluate etomidate as an injectable anesthetic in dogs and to use midazolam and methocarbamol as premedication.
Design- Experimental Study.
Animals- Fourteen native young female dogs
Procedure- Dogs were randomly allocated to two groups to receive midazolam (0.5 mg/kg; MiE group) or methocarbamol (20 mg/kg; MeE group) 5 minute before etomidate (2 mg/kg) intravenously. In addition to recording anesthesia time table, physiological and hematobiochemical parameters were also measured at different time points in two groups.
Results- It was found that there was no significant difference between two groups at both induction and recovery time. Heart rate, respiratory rate, and rectal temperature changes in the MiE group were noticeably fluctuating, unlike the MeE group. There was a significant difference in the values of hematocrit, total protein, glucose, and cortisol between the two groups at some time points. Significant increase in ALT and AST activities was observed in MeE group compared to MiE group at some time points.
Conclusion and Clinical Relevance- Intramuscular administration of methocarbamol or midazolam prior to etomidate not only has minimal cardiopulmonary effects and hematobiochemical changes in dogs but provide similar anesthesia and recovery time.
- Hohl CM, Kelly-Smith CH, Yeung TC, Sweet DD, Doyle-Waters MM, Schulzer M. The effect of a bolus dose of etomidate on cortisol levels, mortality, and health services utilization: a systematic review. Annals of Emergency Medicine, 2010; 56(2): 105-113.
- Branson KR. Injectable and alternative anesthetic techniques. In: Tranquilli WJ, Thurmon JC, Grimm KA, eds. Lumb and Jones’ veterinary anesthesia and analgesia. 4th ed. Blackwell Publishing, Ames, 2007; 273-300.
- Zed PJ, Abu‐Laban RB, Harrison DW. Intubating conditions and hemodynamic effects of etomidate for rapid sequence intubation in the emergency department: an observational cohort study. Academic Emergency Medicine, 2006; 13(4): 378-383.
- Yeung JK, Zed PJ. A review of etomidate for rapid sequence intubation in the emergency department. Canadian Journal of Emergency Medicine, 2002; 4(3): 194-198.
- Heidari F, Javdani M, Bigham Sadegh A, Nikousefat Z. Does ketamine-midazolam combination act as a routine and safe chemical restraint in cats? Clinical and hemato-biochemical evaluation. Comparative Clinical Pathology, 2017; 26: 793–797.
- Posner LP, Burns P. Sedative agents: tranquilizers, alpha-2 agonists, and related agents. In: Riviere JE, Papich MG, Eds. Veterinary Pharmacology and Therapeutics. Wiley, 2009; 337–380.
- Kropf J, Hughes JML. Effects of midazolam on cardiovascular responses and isoflurane requirement during elective ovariohysterectomy in dogs. Irish Veterinary Journal, 2018; 71: 26.
- Parr J, Khalifah R. Inhibition of carbonic anhydrases I and II by N-unsubstituted carbamate esters. Journal of Biological Chemistry, 1992; 267(35); 25044-25050.
- Jung H, Chae HK. The safety and efficacy of methocarbamol as a muscle relaxant with analgesic action: analysis of current data. Innovative Biosystems and Bioengineering, 2019; 3(4): 201–211.
- Grimm KA, Lamont LA, Tranquilli WJ, Greene SA, Robertson SA. Lumb and Jones Veterinary anesthesia and analgesia. 5th ed. John Wiley & Sons, Inc., 2015: 248-285.
- Levinson SA, MacFate RP. Clinical laboratory diagnosis. Academic Medicine, 1962; 37(3): 252.
- Burtis CA, Ashwood ER, Tietz textbook of clinical chemistry. Amer Assn for Clinical Chemistry. 1994.
- Schalm OW, Jain NC, Carroll EJ. Veterinary hematology. Lea & Febiger, 1975.
- Mair AR, Pawson P, Courcier E, Flaherty D. A comparison of the effects of two different doses of ketamine used for co-induction of anaesthesia with a target-controlled infusion of propofol in dogs. Veterinary Anaesthesia and Analgesia, 2009; 36(6): 532-538.
- Hall L, Clarke KW, Trine C. Veterinary anesthesia. 10th edn. WB Saunders, London, 2001; 227-228.
- Schwarzkopf K, Hueter L, Simon M, Fritz HG. Midazolam pretreatment reduces etomidate-induced myoclonic movements. Anaesthesia and Intensive Care, 2003; 31(1): 18-20.
- Sams L, Braun C, Allman D, Hofmeister E. A comparison of the effects of propofol and etomidate on the induction of anesthesia and on cardiopulmonary parameters in dogs. Veterinary Anaesthesia and Analgesia, 2008; 35(6): 488-494.
- Hopkins A, Giuffrida M, Larenza MP. Midazolam, as a co‐induction agent, has propofol sparing effects but also decreases systolic blood pressure in healthy dogs. Veterinary Anaesthesia and Analgesia, 2014; 41(1): 64-72.
- Riccó CH, Henao-Guerrero N. Cardiovascular effects of orotracheal intubation following anesthetic induction with propofol, ketamine-propofol, or ketamine-diazepam in premedicated dogs. Journal of the American Veterinary Medical Association, 2014; 244(8): 934-939.
- Jones DJ, Stehling LC, Zauder HL. Cardiovascular responses to diazepam and midazolam maleate in the dog. Anesthesiology, 1979; 51(5): 430-434.
- Rodríguez JM, Muñoz-Rascón P, Navarrete-Calvo R, Gómez-Villamandos RJ, Domínguez Pérez JM, Fernández Sarmiento JA, Quirós Carmona S, Granados Machuca MM. Comparison of the cardiopulmonary parameters after induction of anaesthesia with alphaxalone or etomidate in dogs. Veterinary Anaesthesia and Analgesia, 2012; 39(4): 357-365.
- Haskins S, Pascoe PJ, Ilkiw JE, Fudge J, Hopper K, Aldrich J. Reference cardiopulmonary values in normal dogs. Comparative Medicine, 2005; 55(2): 156-161.
- Castro LNG, Mehta JH, Brayanov JB, Mullen GJ. Quantification of respiratory depression during pre-operative administration of midazolam using a non-invasive respiratory volume monitor. Plos One, 2017; 12(2): e0172750.
- Kästner S. Intravenous anaesthetics, In: BSAVA manual of canine and feline anesthesia and analgesia. British Small Animal Veterinary Association Gloucester. 2007; 133-149.
- Ko JC, Thurmon JC, Benson GJ, Tranquilli WJ, Olson WA, Vaha-Vahe AT. Hemodynamic and anesthetic effects of etomidate infusion in medetomidine-premedicated dogs. American Journal of Veterinary Research, 1994; 55(6): 842-846.
- Nagel M, Muir W, Nguyen K. Comparison of the cardiopulmonary effects of etomidate and thiamylal in dogs. American Journal of Veterinary Research, 1979; 40(2): 193-196.
- Perk EC, Güzel Ö, Gülanber EG. Etomidate/alfentanil anaesthesia in dogs and its effects on pulse oxymeter, electrocardiography and haematological parameters. Turkish Journal of Veterinary and Animal Sciences, 2002; 26 (5): 1021-1024.
- Bornkamp JL, Robertson S, Isaza NM, Harrison K, DiGangi BA, Pablo L. Effects of anesthetic induction with a benzodiazepine plus ketamine hydrochloride or propofol on hypothermia in dogs undergoing ovariohysterectomy. American Journal of Veterinary Research, 2016; 77(4): 351-357.
- Silverstein D, Hopper K. Small Animal Critical Care Medicine. (2nd Edn). Chapter 164 – Benzodiazepines. Ralph C. Harvey, 2015; 864-866.
- Demirkan İ, Atalan G, Gökce Hİ, Özaydin Y, Çelebý F. Comparative study of butorphanol-ketamin HCl and xylazine-ketamin HCl combinations for their clinical and cardiovascular/respiratory effects in healthy dogs. Turkish Journal of Veterinary and Animal Sciences, 2002; 26(5): 1073-1075.
- Tobias TA, Schertel ER. Shock: concepts and managements. In: DiBartola SP, ed. Fluid therapy in small animal practice.WB Saunders, Philadelphia, 1992; 436-470.
- Dehghani S, Sharifnia N, Yahyaei M, Souri A. Clinical, haematological and biochemical effects of xylazine, ketamine and their combination in caprine and feline. Veterinary Anaesthesia and Analgesia, 1991; 18: 129-133.
- Gonzalez Gil A, Illera J, Silvan G, Illera MJ. Effects of the anaesthetic/tranquillizer treatments on selected plasma biochemical parameters in NZW rabbits. Laboratory Animals, 2003; 37(2): 155-161.
- Allison S, Tomlin P, Chamberlain M. Some effects of anaesthesia and surgery on carbohydrate and fat metabolism. British Journal of Anaesthesia, 1969; 41(7): 588-593.
- Diltoer M, Camu F. Glucose homeostasis and insulin secretion during isoflurane anesthesia in humans. Anesthesiology, 1988; 68(6): 880-886.
- Ahmad RA, Amarpal PK, Kinjavdekar P, Aithal HP, Pawde AM, Kumar D. Evaluation of anaesthetic stress following administration of dexmedetomidine and its combinations with midazolam, fentanyl and ketamine in dogs. Indian Journal of Animal Sciences, 2012; 82(12): 1495-1498.
- Lipiner-Friedman D, Sprung CL, Laterre PF, Weiss Y, Goodman SV, Vogeser M, Briegel J, Keh D, Singer M, Moreni R, Bellissant E, Annane D. Adrenal function in sepsis: the retrospective Corticus cohort study. Critical Care Medicine, 2007; 35: 1012–1018.
- Cuthbertson BH, Sprung CL, Annane D, Chevret S, Garfield M, Goodman S, Lattere PF, Vincent JL, Freivogel K, Reinhart K, Singer M, Payen D, Weiss YG. The effects of etomidate on adrenal responsiveness and mortality in patients with septic shock. Intensive Care Medicine, 2009; 35: 1868–1876.
- Qin B, Hu H, Cao B, Zhu Z. Effects of continuous infusion of etomidate at various dose rates on adrenal function in dogs. BMC Anesthesiology, 2016; 16: 2.
- Kuo T, McQueen A, Chen TC, Wang JC. Regulation of Glucose Homeostasis by Glucocorticoids. Advances in Experimental Medicine and Biology, 2015; 872: 99-126.
- Strombeck D, Guildford W. Hepatic necrosis and acute hepatic failure. Small Animal Gastroenterology. London: Wolfe Publishing, 1991; 574-592.
- Gülanber E, Baştan A, Taşal İ, Aktaş M, Arıkan N. Köpeklerde Midazolam ve Ketaminle Genel Anestezi. İstanbul Üniversitesi Veteriner Fakültesi Dergisi, 2001; 27(2): 401-409.
- Bethesda L. Clinical and Research Information on Drug-Induced Liver Injury [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases. 2012 [Updated 2017 Jan 30].