Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
권호 표지
DOI QR코드

DOI QR Code

Retrospective Evaluation of Alfaxalone as an Induction Agent of Inhalation Anesthesia: 150 Cases

호흡마취 유도제로서 alfaxalone의 후향적 평가: 150례

  • Jang, Min (Department of Veterinary Clinical Sciences, BK21 and Research Institute of Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Son, Won-gyun (Department of Veterinary Clinical Sciences, BK21 and Research Institute of Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Jo, Sang-min (Department of Veterinary Clinical Sciences, BK21 and Research Institute of Veterinary Science, College of Veterinary Medicine, Seoul National University) ;
  • Lee, Inhyung (Department of Veterinary Clinical Sciences, BK21 and Research Institute of Veterinary Science, College of Veterinary Medicine, Seoul National University)
  • 장민 (서울대학교 수의과대학, BK21.수의과학연구소) ;
  • 손원균 (서울대학교 수의과대학, BK21.수의과학연구소) ;
  • 조상민 (서울대학교 수의과대학, BK21.수의과학연구소) ;
  • 이인형 (서울대학교 수의과대학, BK21.수의과학연구소)
  • Received : 2015.02.23
  • Accepted : 2015.04.14
  • Published : 2017.04.28
Download PDF
⟨ Previous Next ⟩

Abstract

This study was performed to evaluate the clinical efficacy of alfaxalone for induction of inhalation anesthesia in small animal practice. Patient data were collected according to anesthetic records (136 dogs and 14 cats) presented to the Veterinary Medical Teaching Hospital of Seoul National University for surgeries and diagnostic imaging from July 2013 to March 2014. Anesthetic results included signalment, American Society of Anesthesiologists (ASA) grade, premedicated drugs, procedures, induction quality, and recovery after anesthesia. One hundred fifty anesthetic events were classified according to the ASA grade. Three patients were ASA grade I, 52 patients grade II, 86 patients grade III, and 9 patients grade IV, respectively. The most common premedication was midazolam and hydromorphone combination (n = 59, 39.3%) follow by acepromazine and hydromorphone combination (n = 22, 14.7%). The majority of anesthesia procedures were diagnostic imaging (n = 33, 22.0%) and ophthalmic surgeries (n = 31, 20.7%), followed by soft tissue surgeries (n = 27, 18.0%), and orthopedic surgeries (n = 20, 13.3%). Intravenous alfaxalone provided smooth induction for inhalation anesthesia in almost cases, but transient apnea and twitching/paddling were observed after induction and during recovery, respectively. In addition, alfaxalone did not show pain response during intravenous administration. Alfaxalone showed smooth induction of inhalation anesthesia in dogs and cats with mild to severe systemic disease (ASA 2-4). Alfaxalone was considered as an acceptable induction agent for patients with higher risk in small animal practice.

Keywords

References

  1. Ambros B, Duke-Novakovski T, Pasloske KS. Comparison of the anesthetic efficacy and cardiopulmonary effects of continuous rate infusions of alfaxalone-2-hydroxypropyl-$\beta$-cyclodextrin and propofol in dogs. Am J Vet Res 2008; 69: 1391-1398. https://doi.org/10.2460/ajvr.69.11.1391
  2. Amengual M, Flaherty D, Auckburally A, Bell AM, Scott EM, Pawson P. An evaluation of anaesthetic induction in healthy dogs using rapid intravenous injection of propofol or alfaxalone. Vet Anaesth Analg 2013; 40: 115-123. https://doi.org/10.1111/j.1467-2995.2012.00747.x
  3. Brodbelt DC, Hammond R, Tuminaro D, Pfeiffer DU, Wood JL. Risk factors for anaesthetic-related death in referred dogs. Vet Rec 2006; 158: 563-564. https://doi.org/10.1136/vr.158.16.563
  4. Clarke KW, Trim CM, Hall LW. An introduction to anaesthesia and general considerations. In: Veterinary anaesthesia, 11th ed. Edinburgh: Elsevier Saunders. 2014: 3-18.
  5. Clarke KW, Trim CM, Hall LW. General pharmacology of the injectable agents used in anaesthesia. In: Veterinary anaesthesia, 11th ed. Edinburgh: Elsevier Saunders. 2014: 135-154.
  6. Clarke KW, Trim CM, Hall LW. Anaesthesia of the dog. In: Veterinary anaesthesia, 11th ed. Edinburgh: Elsevier Saunders. 2014: 405-498.
  7. Ferre PJ, Pasloske K, Whittem T, Ranasinghe MG, Li Q, Lefebvre HP. Plasma pharmacokinetics of alfaxalone in dogs after an intravenous bolus of Alfaxan-CD RTU. Vet Anaesth Analg 2006; 33: 229-236. https://doi.org/10.1111/j.1467-2995.2005.00264.x
  8. Hofmeister EH, Quandt J, Braun C, Shepard M. Development, implementation and impact of simple patient safety interventions in a university teaching hospital. Vet Anaesth Analg 2014; 41: 243-248. https://doi.org/10.1111/vaa.12124
  9. Maney JK, Shepard MK, Braun C, Cremer J, Hofmeister EH. A comparison of cardiopulmonary and anesthetic effects of an induction dose of alfaxalone or propofol in dogs. Vet Anaesth Analg 2013; 40: 237-244. https://doi.org/10.1111/vaa.12006
  10. Mathis A1, Pinelas R, Brodbelt DC, Alibhai HI. Comparison of quality of recovery from anaesthesia in cats induced with propofol or alfaxalone. Vet Anaesth Analg 2012; 39: 282-290. https://doi.org/10.1111/j.1467-2995.2011.00707.x
  11. Michou JN, Leece EA, Brearley JC. Comparison of pain on injection during induction of anaesthesia with alfaxalone and two formulations of propofol in dogs. Vet Anaesth Analg 2012; 39: 275-281. https://doi.org/10.1111/j.1467-2995.2012.00709.x
  12. Muir W, Hubbell JA, Bednarski RM, Lerche P. Preanesthetic and perioperative medication. In: Handbook of veterinary anesthesia, 5th ed. St. Louis: Elsevier. 2013: 22-57.
  13. Muir W, Lerche P, Wiese A, Nelson L, Pasloske K, Whittem T. Cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in dogs. Vet Anaesth Analg 2008; 35: 451-462. https://doi.org/10.1111/j.1467-2995.2008.00406.x
  14. Muir W, Lerche P, Wiese A, Nelson L, Pasloske K, Whittem T. The cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in cats. Vet Anaesth Analg 2009; 36: 42-54. https://doi.org/10.1111/j.1467-2995.2008.00428.x
  15. Murrell JC. Premedication and sedation. In: BSAVA manual of canine and feline anaesthesia and analgesia, 2nd ed. Gloucester: British Sm Anim Vet Assoc. 2007: 120-132.
  16. O'Hagan B, Pasloske K, McKinnon C, Perkins NR, Whittem T. Clinical evaluation of alfaxalone as an anaesthetic induction agent in dogs less than 12 weeks of age. Aust Vet J 2012; 90: 346-350. https://doi.org/10.1111/j.1751-0813.2012.00974.x
  17. O'Hagan B, Pasloske K, McKinnon C, Perkins NR, Whittem T. Clinical evaluation of alfaxalone as an anaesthetic induction agent in cats less than 12 weeks of age. Aust Vet J 2012; 90: 395-401. https://doi.org/10.1111/j.1751-0813.2012.00983.x
  18. Picard P, Tramer MR. Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg 2000; 90: 963-969. https://doi.org/10.1213/00000539-200004000-00035
  19. Psatha E, Alibhai HI, Jimenez-Lozano A, Armitage-chan E, Brodbelt DC. Clinical efficacy and cardiorespiratory effects of alfaxalone, or diazepam/fentanyl for induction of anaesthesia in dogs that are a poor anaesthetic risk. Vet Anaesth Analg 2011; 38: 24-36. https://doi.org/10.1111/j.1467-2995.2010.00577.x
  20. Rodriguez JM, Munoz-Rascon P, Navarrete-Calvo R, Gomez-Villamandos RJ, Dominguez Perez JM, Fernandez Sarmiento JA, Quiros Carmona S, Granados Machuca MM. Comparison of the cardiopulmonary parameters after induction of anaesthesia with alphaxalone or etomidate in dogs. Vet Anaesth Analg 2012; 39: 357-365. https://doi.org/10.1111/j.1467-2995.2011.00695.x
  21. Szebeni J, Alving CR, Rosivall L, Bunger R, Baranyi L, Bedocs P, Toth M, Barenholz. Animal models of complement- mediated hypersensitivity reactions to liposomes and other lipid-based nanoparticles. J Liposome Res 2007; 17: 107-117. https://doi.org/10.1080/08982100701375118