Indian Journal of Animal Research

  • Chief EditorK.M.L. Pathak

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Indian Journal of Animal Research, volume 54 issue 2 (february 2020) : 149-154

Effects of xylazine-ketamine, xylazine-propofol and xylazine-ketamine-propofol administration on free radical generation and blood gases in sheep

E. Gokalp1,*, S. Gurgoze and S. Altan1
1Provincial Directorate of Agriculture and Forestry, Sanliurfa-63100, Turkey.
Cite article:- Gokalp E., Altan S. Gurgoze and S. (2018). Effects of xylazine-ketamine, xylazine-propofol and xylazine-ketamine-propofol administration on free radical generation and blood gases in sheep . Indian Journal of Animal Research. 54(2): 149-154. doi: 10.18805/ijar.B-977.
This study was aimed at investigating the effects of xylazine-ketamine, xylazine-propofol and xylazine-ketamine-propofol combinations on oxidative stress, antioxidant capacity and blood gases in sheep. Excluding the control animals, the sheep included in Groups 1, 2 and 3 were administered with combinations of xylazine-ketamine, xylazine-propofol and xylazine-ketamine-propofol, respectively, by intravenous route. The comparison of the three treatment groups with the control group showed that no significant difference existed for TAS, TOS, MDA and CAT levels.  The evaluation of blood gas and electrolyte levels demonstrated a significant decrease in PvO2, cSO2, Na, and Ca levels, and a significant increase in glucose levels. In result, this study showed that the three anaesthetic combinations tested did not have any adverse effect on the oxidant/antioxidant status, but caused significant alterations in blood gas levels.  
The metabolism and toxicity of anaesthetic agents vary. Changes that occur in the activity of antioxidant enzymes are considered to be an important aspect of the varying impact of anaesthetics (Godin and Garnett, 1994). Tissue and blood cell degeneration caused by halothane and enflurane anaesthesia develops as a result of oxidant/antioxidant imbalance (Yamazoe et al., 1998). On the other hand, some other anaesthetics such as propofol are reported to show antioxidant activity (Green et al., 1994).
        
Reports indicate that, owing to chemical similarity, propofol acts like phenolic antioxidants, serving as a synthetic antioxidant, which reacts with free radicals and generates the phenoxy radical (Murphy et al., 1993; Murphy et al., 1992).
        
These reports suggest that ketamine decreases leukocyte myeloperoxidase activity, inhibits nitric oxide synthetase (NOS) activity in leukocytes and shows a radical scavenging effect (Pekoe et al., 1983; Galley et al., 1995; Lupp et al., 1998).
        
Research has been conducted in several species on the impact of various anaesthetic agents on the antioxidant system and blood gases (Kamiloglu et al., 2009; Mannarino et al., 2012; Oku et al., 2011). However, to the authors’ knowledge, the impact of the combinations of xylazine with ketamine and propofol on the antioxidant status and blood gas levels has not been investigated before in sheep. In view of the paucity of information available, this study was designed to investigate the impact of xylazine-ketamine, xylazine-propofol and xylazine-ketamine-propofol combinations on the antioxidant status and blood gases in sheep.
Animals
 
This study was carried out in 28 one-year-old nulliparous and clinically healthy Zom sheep, which weighed 43.27±4.76 kg on average and were obtained from the Research and Practice Farm of Dicle University, Faculty of Veterinary Medicine. The animals were randomly assigned to four equal groups (n=7), one of which was maintained for control purposes.
        
The study was conducted pursuant to the approval of the Local Ethics Board for Animal Experiments of Dicle University (Approval dated 08.05.2012 and numbered 2012/49).
 
Collection of blood samples
 
Blood samples taken from the jugular vein, before the administration of the anaesthetic agents (minute 0) and during anaesthesia (at minutes 15, 30, 60 and 120), into heparinized syringes were immediately used for the measurement of blood gas levels using a portable Enterprise Point-of-Care (EPOC) device (EPOC Blood Analysis, Ottawa, Canada). The device was set to body temperature.
        
The heparinized blood samples were immediately transferred to the laboratory and prepared for analyses. Plasma, obtained by the centrifugation of the blood samples at 3000 rpm for 10 min, were used for the measurement of malondialdehyde (MDA) levels within 3 days of extraction. Erythrocyte catalase (CAT) activity was measured with Beutler’s method (Beutler, 1975) and plasma MDA levels were measured sprectrophotometrically (UV-1601 UV-Visible Spectrophotometer, Shimadzu, Japan) with a modification of the method described by Satoh and Yagi  (Satoh, 1978; Yagi, 1984).
        
Serum total antioxidant status (TAS) and total oxidant status (TOS) levels were measured using Erel’s method, which is a fully automatic colorimetric method (Erel, 2004a, Erel, 2004b). The oxidative stress index (OSI) values were calculated with the aid of an auto-analyser (Abbot Aeroset, Abbott Diagnostics, Abbott Park, IL, USA) and commercial kits.
 
Anaesthesia Groups
 
Group 1 (Xylazine-Ketamine): 2.2 mg/kg of ketamine (Ketasol 10%, Richter Pharma Ag) was administered by iv route 5 minutes after the iv administration of 0.1 mg/kg of xylazine (Rompun®, Bayer).
        
Group 2 (Xylazine-Propofol): 3 mg/kg of propofol (Propofol, 2% Fresenius) was administered by iv route 5 minutes after the iv administration of 0.1 mg/kg of xylazine.
        
Group 3 (Xylazine-Ketamine-Propofol): 2.2 mg/kg of ketamine and 3 mg/kg of propofol were both administered by iv route 5 minutes after the iv administration of 0.1 mg/kg of xylazine.
 
Statistical analysis
 
The MINITAB statistical software was used for the statistical analyses of the data obtained in this study. While the measured values were compared with the in-group control values with Dunnett’s test, the comparison of the values obtained for the five different time points was performed with Tukey’s test. The values obtained are presented as mean ± standard deviation (M±SD).
Serum TAS and TOS levels
 
The TAS, TOS and OSI values of the groups are presented in Table 1. In an investigation on the impact of propofol on ischemia-reperfusion damage in rats, Eroglu (2011) observed that the group, which received propofol, had higher TAS levels and lower TOS levels than the control group. On the contrary, Lee (2012) reported that, in dogs, propofol and thiopental anaesthesia decreased TAS levels and increased TOS and OSI levels. Dikmen et al., (2005) determined that the antioxidant potential (AOP) of propofol/remifentanil anaesthesia at minute 60 post-extubation was lower than the values measured at the beginning of induction. In the present study, the comparison of the three treatment groups with the control group showed that no statistically significant difference existed for TAS and TOS levels. However, the TOS levels of the xylazine-propofol group displayed a distinct decrease in comparison to the initial values. The findings obtained in this group suggest that propofol reduces TOS levels by showing antioxidant activity (Murphy et al., 1993; Murphy et al., 1992; Green et al., 1994).
 

Table 1: TAS, TOS, OSI, MDA and CAT measurements of sheep administered with xylazine-ketamine (Group 1), xylazine-propofol (Group 2) and xylazine-ketamine-propofol (Group 3).


 
Malonyldialdehyde
 
The plasma MDA levels of the groups are presented in Table 1. Reports indicate that anaesthetics of different physical and chemical properties cause MDA generation, and even post-anaesthetic tissue and cell degeneration in some cases, through a direct or indirect effect on lipid peroxidation (Yaralýoglu-Gurgoze et al., 2005). Sarýtas et al., (2006) determined that, in dogs, the MDA levels measured 2 h after propofol injection were lower than the preanaesthetic levels. Kamiloglu et al., (2009) found that, in sheep, the plasma MDA levels measured 15 and 30 min after the administration of ketamine were lower than the initial measurements, and also reported that the combined administration of ketamine-xylazine did not alter plasma MDA levels. Pekcan et al., (2011) reported that, in goats, while MDA levels decreased after propofol anaesthesia, in the event of isoflurane anaesthesia, MDA levels were higher at 15 min and lower at 30, 60 and 120 min and 24 h. Allaouchiche et al., (2001) compared the effects of propofol, sevoflurane and desflurane anaesthesia on oxidative stress in pigs and determined that MDA levels significantly decreased during propofol anaesthesia and significantly increased during desflurane anaesthesia, but did not undergo any significant alteration during sevoflurane anaesthesia. In the present study, when compared to the control group, the groups administered with xylazine-propofol and xylazine-ketamine-propofol combinations showed a distinct increase in MDA levels, which was statistically insignificant. The results obtained so far suggest that anaesthetic agents cause MDA generation through their impact on lipid peroxidation (Yaralýoglu-Gurgoze et al., 2005).
 
Antioxidant enzyme activities
 
The erythrocyte CAT activities of the groups are presented in Table 1. Kelemence (2008) reported that propofol anaesthesia was associated with increased GSH-Px and decreased CAT activities and attributed this situation to propofol inhibiting CAT activity by means of an unknown mechanism. Pekcan et al., (2011) reported that, in goats, SOD and CAT activities showed a distinct yet statistically insignificant increase during propofol anaesthesia, when compared to preanaesthetic levels. In the present study, the CAT activity of the groups administered with combinations of xylazine-propofol and xylazine-ketamine-propofol displayed a distinct yet statistically insignificant decrease. This suggests that propofol inhibits CAT activity (Eroglu, 2011; Kelemence, 2008).
 
Blood gases and electrolyte levels
 
The blood gases and electrolyte levels of the groups are presented in Table 2. In a study on the cardiovascular effects of anaesthetics in goats, it was determined that while the combined use of xylazine and ketamine did not alter PaO2 levels, it increased  PaCO2 levels at 5, 15 and 60 min and decreased pH levels at 5 and 15 min (Afshar et al., 2005). Izci et al., (1993) attributed the decrease observed in PaO2 during anaesthesia to xylazine reducing the tidal volume and respiratory rate. Another report suggested that the relaxing effect of ketamine on bronchial smooth muscle leads to hypoventilation and decreased blood oxygen levels, resulting in decreased PaO2 levels (Baniadam et al., 2007). In a research carried out in dogs, it was determined that the administration of propofol for the induction of anaesthesia did not alter pH, PaCO2 and HCO-3 levels in comparison to the initial values, but increased SaO2, PaO2 and PvO2 levels (Mannarino et al., 2012). On the other hand, Sams et al., (2008) reported that in dogs administered with propofol for the induction of anaesthesia, PaO2 and SaO2 levels fell below the initial levels. Prassinos et al., (2005) determined that the use of ketamine and propofol for the induction of anaesthesia in goats led to hypoxemia, which resulted from respiratory failure trigerred by the anaesthetics used. Oku et al., (2011) indicated that, in horses, as a result of a decreased respiratory rate throughout propofol-medetomidine anaesthesia, the PaO2 level decreased and the PaCO2 level increased. Cullen and Reynoldson (1997) reported that propofol decreased PaO2 levels and increased PaCO2 levels, whilst Keegan et al. (1993) observed that propofol did not cause any alteration in PaO2 and PaCO2 levels. Lin et al., (1997) determined that, in comparison to a group administered with xylazine-ketamine-halothane, another group that received propofol had higher PvO2 levels between 15 and 30 min, lower PvCO2 levels at 30 min and lower BE values at 15 and 30 min. In the present study, the investigation of blood gas and electrolyte levels demonstrated that, when compared to the control group, the decrease observed in the PvO2 level at 15, 30 and 120 min in the group administered with xylazine-ketamine (p<0.01, p<0.001, p<0.01) and at only 30 min in the groups that received xylazine-propofol and xylazine-ketamine-propofol (p<0.001) was statistically significant. Furthermore, the decrease detected in the cSO2 level at 15, 60 and 120 min in the group administered with xylazine-ketamine (p<0.05, p<0.01, p<0.01) and at only 60 min in the group that received xylazine-propofol (p<0.01) was also found to be statistically significant. The decrease detected in the PvO2 level in all three of the treatment groups could be related to the anaesthetics decreasing the respiratory rate (Izci et al., 1993; Prassinos et al., 2005; Cullen and Reynoldson 1997).
 

Table 2: Blood Gases and electrolyte levels in sheep administered with xylazine-ketamine (Group 1), xylazine-propofol (Group 2) and xylazine-ketamine-propofol (Group 3).


        
While no alteration was detected in Na and Ca levels during xylazine-ketamine anaesthesia in greyhounds (Camkerten et al., 2013) and dogs (Izci et al., 1993), Casas- Díaz et al., (2011) reported to have measured decreased Na levels in wild goats during xylazine-ketamine anaesthesia. Research conducted in greyhounds and goats have shown that anaesthesia causes an increase in glucose levels (Camkerten et al., 2013; Ismail et al., 2010). When compared to the control group, in all three of the treatment groups, Na levels were observed to have significantly decreased at 30 and 60 min (p<0.01, p<0.05). In the groups that were administered with xylazine-ketamine and xylazine-ketamine-propofol, both the Na (p<0.05) and Ca (p<0.001) levels were determined to have significantly decreased at 120 min of anaesthesia. In the present study, although all three of the treatment groups displayed a distinct increase in glucose levels, only the increase detected at 15 min in the xylazine-ketamine group was found to be statistically significant (p<0.05). The slight increase observed in the glucose levels was attributed to an increase in the secretion of adrenaline or corticosteroids (Ismail et al., 2010).
The present study demonstrated that anaesthetic combinations of xylazine-ketamine, xylazine-propofol and xylazine-ketamine-propofol did not have any significant adverse effect on plasma lipid peroxidation and oxidant/antioxidant status, but decreased blood gas levels. In conclusion, veterinary practitioners are advised to be cautious during surgery performed under anaesthesia in animals with a history of respiratory and cardiovascular disease.

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