Peer-reviewed veterinary case report
IV lidocaine versus fentanyl effects on dog coughing during intubation
By Bravo, Veronica Re et al.·Published in Veterinary anaesthesia and analgesia·2020·Dick White Referrals, United Kingdom·View original on PubMed →
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Original publication title: Comparison between intravenous lidocaine and fentanyl on cough reflex and sympathetic response during endotracheal intubation in dogs.
- Species:
- dog
Plain-English summary
A group of 46 dogs undergoing MRI were given either lidocaine or fentanyl before being intubated, which is when a tube is placed in the airway to help them breathe. The study found that dogs given fentanyl had less coughing and a smaller increase in heart rate during the procedure compared to those given lidocaine. This suggests that fentanyl is better at keeping dogs calm and comfortable during intubation. The dogs in both groups received a sedative called alfaxalone, but those on fentanyl needed a lower dose.
People also search for: dog cough during intubation · fentanyl for dog sedation · lidocaine vs fentanyl for dogs
Abstract
OBJECTIVE: To compare the effects of intravenous (IV) lidocaine and fentanyl on the cough reflex and autonomic response during endotracheal intubation in dogs. STUDY DESIGN: Randomized, blinded, superiority clinical trial. ANIMALS: A total of 46 client-owned dogs undergoing magnetic resonance imaging. METHODS: After intramuscular methadone (0.2 mg kg), dogs were randomized to be administered either IV lidocaine (2 mg kg; group L) or fentanyl (7 μg kg; group F). After 5 minutes, alfaxalone was administered until endotracheal intubation was possible (1 mg kgIV over 40 seconds followed by 0.4 mg kgincrements to effect). Total dose of alfaxalone was recorded and cough reflex at endotracheal intubation was scored. Heart rate (HR) was continuously recorded, Doppler systolic arterial blood pressure (SAP) was measured every 20 seconds. Vasovagal tonus index (VVTI) and changes (Δ) in HR, SAP and VVTI between pre-intubation and intubation were calculated. Groups were compared using univariate and multivariate analysis. Statistical significance was set as p < 0.05. RESULTS: Group F included 22 dogs and group L 24 dogs. The mean (± standard deviation) alfaxalone dose was 1.1 (± 0.2) and 1.35 (± 0.3) mg kgin groups F and L, respectively (p = 0.0008). At intubation, cough was more likely in group L (odds ratio = 11.3; 95% confidence intervals, 2.1 - 94.2; p = 0.01) and HR increased in 87.5% and 54.5% of groups L and F, respectively (p = 0.02). The median (range) ΔHR between pre-intubation and intubation was higher (13.1%; - 4.3 to + 55.1) in group L (p = 0.0021). Between groups, SAP and VVTI were similar. CONCLUSION AND CLINICAL RELEVANCE: At the stated doses, whilst reducing the alfaxalone dose, fentanyl is superior to lidocaine in suppressing the cough reflex and blunting the increase in HR at endotracheal intubation in dogs premedicated with methadone.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/32439239/