Dexmedetomidine reduces propofol dose and supports heart-lung

Abstract

OBJECTIVES: This study aimed to assess the effect of dexmedetomidine on the propofol-based anesthesia of cats subjected to ovariohysterectomy. METHODS: Twenty-eight cats were randomly allocated to four groups (seven cats in each) and premedicated with either 5 µg/kg dexmedetomidine (groups Dex 1, Dex 3 and Dex 5) or 0.05 ml saline (Prop group) intramuscularly. After the induction of anesthesia with propofol, total intravenous anesthesia was initiated with 300 µg/kg/min propofol plus 3 ml/kg/h NaCl 0.9% (Prop), or 200 µg/kg/min propofol plus dexmedetomidine at the rates of 1 µg/kg/h (Dex 1), 3 µg/kg/h (Dex 3) or 5 µg/kg/h (Dex 5). Cardiorespiratory variables were assessed 5 mins after induction and every 10 mins thereafter, until the end of anesthesia. The propofol infusion rate was adjusted every 10 mins (± 50 µg/kg/min) to maintain anesthetic depth. The times to extubation, sternal recumbency, ambulation and total recovery were recorded. Pain scoring was performed 1, 2, 4, 8, 12 and 24 h after the end of anesthesia. RESULTS: Dexmedetomidine produced a propofol-sparing effect of 72.8%, 71.1% and 74.6% in the Dex 1, Dex 3 and Dex 5 groups, respectively. Cats in the Prop group maintained higher heart rate values than the other groups, and the mean arterial pressure remained higher in the Dex 3 and Dex 5 groups. Rescue intraoperative analgesia (fentanyl bolus) was most frequent in the Prop group. There was no significant difference in the time of extubation. Cats in the Dex 1 and Dex 3 groups had a faster anesthetic recovery, with shorter times to achieving sternal recumbency, regaining ambulation and reaching full recovery. Cats in the Dex 1 and Dex 5 groups presented the best recovery quality scores, with 4 (range 4-5) and 4 (range 3-5), respectively, while the Prop group scored 1 (range 1-3), the worst anesthetic recovery score among the groups. CONCLUSIONS AND RELEVANCE: The use of dexmedetomidine as a total intravenous anesthesia adjuvant, especially at doses of 1 and 3 µg/kg/h, reduces propofol consumption and improves cardiorespiratory stability and intraoperative analgesia, while promoting a better and quicker recovery from anesthesia.