Sedative and electrocardiographic effects of low dose dexmedetomidine in healthy cats / Efeitos sedativos e eletrocardiográficos da baixa dose de dexmedetomidina em gatos saudáveis

In feline veterinary practice sedation is often needed to perform diagnostic or minimally invasive procedures, minimize stress, and facilitate handling. The mortality rate of cats undergoing sedation is significantly higher than dogs, so it is fundamental that the sedatives provide good cardiovascular stability. Dexmedetomidine (DEX) is an α2-adrenergic receptor agonist utilized in cats to provide sedation and analgesia, although studies have been utilized high doses, and markedly hemodynamic impairments were reported. The aim of this study was to prospectively investigate how the sedative and electrocardiographic effects of a low dose of DEX performing in cats. Eleven healthy cats were recruited; baseline sedative score, systolic arterial pressure, electrocardiography, and vasovagal tonus index (VVTI) were assessed, and repeated after ten minutes of DEX 5μg/kg intramuscularly (IM). A smooth sedation was noticed, and emesis and sialorrhea were common adverse effects, observed on average seven minutes after IM injection. Furthermore, electrocardiographic effects of a low dose of DEX mainly include decreases on heart rate, and increases on T-wave amplitude. The augmentation on VVTI and appearance of respiratory sinus arrhythmia, as well as sinus bradycardia in some cats, suggesting that DEX enhances parasympathetic tonus in healthy cats, and therefore will be best avoid in patients at risk for bradycardia.(AU)

Na rotina clínica da medicina veterinária felina a sedação é frequentemente requerida para realização de procedimentos diagnósticos ou minimamente invasivos, para minimizar o estresse e facilitar o manuseio dos pacientes. A taxa de mortalidade de gatos submetidos à sedação é mais elevada do que em cães, por esse motivo, é fundamental que os sedativos confiram estabilidade hemodinâmica. A dexmedetomidina (DEX) é um α2-agonista utilizado em felinos para promover sedação e analgesia, porém os estudos têm utilizado doses elevadas, e com isso prejuízos hemodinâmicos importantes foram relatados. O objetivo desta investigação foi avaliar os efeitos sedativos e eletrocardiográficos da baixa dose de DEX em gatos. Para tal, onze felinos saudáveis foram recrutados, foram obtidos valores basais para escore de sedação, pressão arterial sistólica e eletrocardiografia, além do índice de tônus vaso vagal (ITVV). Após dez minutos da aplicação intramuscular (IM) de DEX 5μg/kg todos os exames foram repetidos. Após a DEX, sedação suave foi detectada, e a êmese e sialorreia foram efeitos adversos comuns, observados em média 7 minutos após a injeção IM. Ademais, os principais efeitos eletrocardiográficos foram redução na frequência cardíaca e aumento na amplitude da onda T. O ITVV mais elevado e surgimento de arritmia sinusal respiratória, bem como bradicardia sinusal em alguns gatos, sugerem que a DEX eleva o tônus parassimpático, e por esse motivo deve ser utilizada com cautela em pacientes com predisposição à bradicardia.(AU)

Dexmedetomidine low dose followed by constant rate infusion and antagonism by atipamezole in isoflurane-anesthetized cats: an echocardiographic study.

OBJECTIVE: To investigate the effects of a low dose of dexmedetomidine (DEX) followed by constant rate infusion (CRI) and reversal with atipamezole on systolic and diastolic functions in isoflurane-anesthetized healthy cats. STUDY DESIGN: Prospective cohort study. ANIMALS: A group of 11 client-owned adult cats. METHODS: Baseline transthoracic echocardiography (TTE) was performed, followed by intramuscular (IM) administration of DEX (5 µg kg-1). After 10 minutes, sedation was scored, adverse effects were recorded and another TTE performed. Approximately 40 minutes after DEX administration, anesthesia was induced by isoflurane mask and maintained with 1.2% end-tidal isoflurane and DEX CRI (1 µg kg-1 hour-1) for 80 minutes. Physiological variables were recorded every 10 minutes, and TTE was repeated 10, 30 and 60 minutes after the start of anesthesia. CRI was stopped, atipamezole (30 µg kg-1) was administered IM and a final TTE was performed after 10 minutes. Repeated measures over time were submitted to one-way analysis of variance or Kruskal-Wallis test according to data distribution; significance was assumed at p < 0.05. RESULTS: After DEX premedication, mild sedation and a slight but significant increase in systolic arterial pressure occurred, and vomiting was a common adverse effect. The cardiac output (CO) and heart rate decreased during anesthesia, with no changes after administration of atipamezole. Trivial valvular insufficiencies were commonly seen after DEX premedication and during CRI. Myocardial radial and longitudinal systolic functions were not affected by sedation or by anesthesia. The late phase of diastole on both right and left ventricles was affected by isoflurane-DEX CRI. Global left ventricular myocardial performance was not impaired. CONCLUSIONS: and clinical relevance Decreased CO and late diastolic impairment were observed in healthy cats administered a low dose of DEX for premedication followed by anesthesia with isoflurane and DEX CRI.