<div>Background: As cats undergo stress at the time of presentation before surgery and therefore sedation is required often. It is very difficult to choose a balanced anaesthetic protocol during the surgical intervention in the case of a cat. Therefore, the present study was undertaken to evaluate the effect of ketamine hydrochloride in combination with midazolam, dexmedetomidine and butorphanol as balanced anaesthesia on clinico-physiological, haematological, serum biochemical profile in the surgical management of cats undergoing neutering. 
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Methods: The study was performed on 18 clinical cases of cats which were brought to the Teaching Veterinary Clinical Complex, College of Veterinary Sciences and Animal Husbandry (CVSc and AH), Central Agricultural University (CAU), Selesih, Aizawl, Mizoram for elective surgery such as neutering. Cats were randomly divided into 3 equal groups, i.e. Gr. A, Gr. B and Gr. C. Animals were premedicated with glycopyrrolate @ 0.01 mg/kg, i/m. After 10 minutes of premedication, in Gr. A ketamine hydrochloride @15 mg/kg and midazolam @ 0.5 mg/kg, in Gr. B ketamine hydrochloride @10 mg/ kg and dexmedetomidine@ 5 mcg /kg and in Gr. C ketamine hydrochloride @ 5 mg/kg, dexmedetomidine@ 5 mcg/kg and butorphanol @ 0.2 mg/kg was administered intramuscularly. Clinico-physiological and haemato-biochemical profiles were evaluated at 0 minute (baseline), then at 15, 30 and 60 minutes after administration of anaesthetic agents to evaluate their anaesthetic effect.&nbsp; 
 
Result: In the case of time for induction, the quality of induction, assessment of peri-operative analgesia, depth of anaesthesia and quality of recovery there was no significant difference among all three groups. In Gr. B, animals showed significantly higher duration of recumbency (DOE) and recovery. The assessment of peri-operative analgesic effect among the groups revealed that analgesia during the perioperative period appeared best in Gr. C protocol. In regards to depth of anaesthesia, ketamine hydrochloride in combination with dexmedetomidine and butorphanol group showed a better result. Rectal temperature decreased significantly (P&gt;0.05) up to 60th minutes in Gr. A, but it remained within the physiological range. Heart rate raised significantly (p&lt;0.05) from the baseline (0 minutes) onwards and decreased significantly (p&lt;0.05) till the end (60 minutes) of the study in Gr. C. The respiration rate was significantly (p&lt;0.01) different in between time intervals for all three groups. No significant difference was observed on haemato-biochemical observation except glucose level which significantly increased after induction of anaesthesia. In conclusion, treatment with ketamine hydrochloride in combination with dexmedetomidine and butorphanol led to acceptable sedation and mild changes in clinico-physiological, haematological, serum biochemical profile in comparison to the other two groups.</div>

Evaluation of Ketamine Hydrochloride in Combination with Midazolam, Dexmedetomidine and Butorphanol as Balanced Anaesthesia in Cats

<div>Eighteen animals with various surgical conditions were divided into three groups of six animals each. Group I received ropivacaine (0.75%) @ 0.25 mg/kg b.wt at sacrococcygeal space. Group II animals received ropivacaine (0.75%) @ 0.25 mg/kg b.wt and dexmedetomidine at 5 &micro;g/kg b.wt in the sacrococcygeal space. Group III animals received ropivacaine (0.75%) @ 0.25 mg/kg b.wt and clonidine @ 2 &micro;g/kg b.wt at sacrococcygeal space. The fastest onset of analgesia was produced by ropivacaine-dexmedetomidine combination followed by ropivacaine-clonidine. RT showed non significant decrease in all groups during post epidural analgesia. A non significant increase in RR was observed in cattle following ropivacaine and ropivacaine-clonidine epidural analgesia. Where as a non significant fall in RR was noticed during ropivacaine-dexmedetomidine combination. A non significant increase in HR was recorded after epidural administration of ropivacaine in group I animals. Whereas group II and III animals showed a non significant decrease in HR throughout the period of study. ECG studies did not reveal any abnormalities except sinus arrhymia in all animals. In group I and III non significant increase in Hb and PCV was observed in the present study. Non significant decrease in Hb and PCV values were recorded in animals subjected to ropivacaine-dexmedetomidine analgesia. A non significant increase in AST, ALT was noticed in all groups of animals. The study suggests that dexmedetomidine is a better adjuvant than clonidine in epidural analgesia as far as cardio-respiratory and Haemato-biochemical parameters are concerned.&nbsp;</div>

<div>Comparative evaluation of ropivacaine, ropivacaine- dexmedetomidine and ropivacaine &ndash; clonidine combinations for epidural analgesia in cattle</div>

Background: There is no gold standard to evaluate postoperative pain in animals. The study was conducted to evaluate haematobiochemical changes following intraperitoneal bupivacaine and bupivacaine-dexmedetomidine in dogs.&nbsp; 
 
Methods: Eighteen clinical cases of dogs requiring laparotomy were randomly divided into three groups viz. Group-B, BD and N comprising of six dogs in each. The animals were premedicated with glycopyrrolate, meloxicam and diazepam. Anaesthetic induction and maintenance was done by using propofol. Intraperitoneally bupivacaine, bupivacaine-dexmedetomidine and normal saline were infused in the three groups. The blood samples were collected prior to pre-medication at 0 min (base line), 30 min (after induction), 2 hrs and 24 hrs interval after intraperitoneal administration of drugs for estimation of haematobiochemical parameters.&nbsp;&nbsp; 
 
Result: The bupivacaine and dexmedetomidine combination reduces the serum glucose and cortisol level which might be indicative of lowered pain response.

​Haematobiochemical Changes during Pain Management with Intraperitoneal Bupivacaine and Bupivacaine-dexmedetomidine in Dogs

<div>Background: Ketamine is rarely used alone because of its association with poor muscle relaxation, tachycardia, catalepsy or muscle rigidity and therefore commonly used in combination with alpha 2 agonist or opioid to minimize the untoward effects. The aim of the present anaesthetic study was to evaluate the clinico-physiological effects of ketamine alone and in combination with dexmedetomidine or butorphanol for inducing adequate anaesthesia in dogs. 
 
Methods: The present anaesthetic study was conducted on 18 (eighteen) healthy dogs of either sex and randomly divided into three groups (K, DK and BK) with six animals in each group. Atropine sulphate @ 0.04 mg/ kg was administered intramuscularly 15 minutes prior to anaesthetic study to all the animals. In group K, ketamine HCl alone was administered @ 5 mg/kg by slow i/v and kept as control. In group DK and BK, after administration of atropine sulphate 15 minutes later dexmedetomidine @ 10 &micro;g/kg i/m and butorphanol @ 0.2 mg/kg i/m were administered respectively. Ten minutes later ketamine HCl was administered @ 5 mg/kg slowly intravenously in both group DK and BK to induce surgical stage of general anaesthesia. The following clinical parameters were recorded viz., onset of sedation, onset of anaesthesia, degree of analgesia, extent of muscle relaxation, duration of anaesthesia and complete recovery. The physiological parameters (rectal temperature, heart rate and respiratory rate) were recorded before anaesthetic study at 0 min. and at 10 minutes after preanaesthetic administration and then at 10, 20, 40, 60, 90, 120 and 180 minutes after ketamine anaesthesia. All the data were analyzed using SPSS v 15.0 statistics software program and presented as mean&plusmn;Standard Error. 
 
Result: The onset of sedation was quicker in group DK followed by group K and BK. Duration of anaesthesia and complete recovery in group DK was significantly (p&lt;0.01) longer than in group K and BK. The degree of analgesia was excellent in group DK and good in group K and BK. The extent of muscle relaxation was excellent in group DK, good in group BK and was poor in group K. The physiological parameters showed transient changes which compensated and remained within normal range during the observation period. The above anaesthetic study suggests that ketamine in combination with dexmedetomidine or butorphanol can be safely used for inducing adequate anaesthesia in dogs. However, dexmedetomidine-ketamine can be used safely for longer duration of surgical procedures in dogs.</div>

Evaluation of Clinico-physiological Effects of Ketamine Alone and in Combination with Dexmedetomidine or Butorphanol in Atropinized Dogs

<div>Background: Horses mount a huge stress response to anesthesia when compared to other animals, hence are risky candidates for anesthesia. Inhalant anesthetic agents offer more control to anesthetic depth and facilitate rapid recovery, hence are considered to be safer than intravenous agents for surgical procedures requiring more than an hour, however, newer drug combinations are being explored to minimize the undesired consequences and dose rate of inhalant agents. The present study explored the safety of dexmedetomidine, ketamine and lidocaine constant rate infusion alone or as a combination along with Isoflurane for safer anesthesia in horses. 
 
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<div>Methods: The study was conducted on 28 horses divided into S, D, DK and DKL groups having 7 animals in each. Xylazine (1 mg/kg) and butorphanol (0.05mg/kg) were given intravenously for premedication. Ketamine (2 mg/kg) and midazolam (0.2 mg/kg) were used for induction and anesthesia was maintained with isoflurane. Normal saline (1000ml/hour), Dexmedetomidine (2&micro;g/kg/hr), Dexmedetomidine and ketamine (2 &micro;g/kg/hr and 2 mg/kg/hr) and Dexmedetomidine, ketamine and lidocaine (2 &micro;g/kg/hr, 2 mg/kg/hr and 2 mg/kg/h) were given as CRI in groups S, D, DK and DKL, respectively. Thiopentone sodium (250mg bolus, 5%) was given as a fast intravenous bolus whenever required. Anesthetic efficacy was evaluated based on clinical, haemato-biochemical, hemodynamic, and endocrine variables. 
 
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<div>Result: A significant decline in mean arterial pressure was noticed in group DKL but changes in CVP and SpO2 in different groups were non-significant. Higher Blood glucose and low Insulin levels were seen in group DK during 45-60 min. Constant rate infusions of Dexmedetomidine, Ketamine and Lidocaine alone or in combination produced a significant sparing effect on Isoflurane and thiopentone while they improved peri-operative quality of anesthesia in horses.</div>

<div>Studies to Evaluate the Safety of Constant Rate Infusions of Dexmedetomidine, Ketamine and Lidocaine Alone or in Combination during Isoflurane Anesthesia in Horses</div>

<div>Background: Dexmedetomidine has been reported to induce anti-apoptotic effects and metastatic progression in lung cancer. In the current investigation, the effect of &beta;-Caryophyllene on dexmedetomidine induced cell proliferation and apoptosis of lung cancer cells and tumor growth in mice was studied.&nbsp; 
 
Methods: A549 cell line was cultured with either dexmedetomidine alone or together with &beta;-Caryophyllene for 24 h and analysed for cell proliferation with MTT assay. ELISA based kit was used to determine apoptotic DNA fragmentation. Western blotting was used to determine expression levels of target proteins. The induction of experimental lung tumor in rat model was achieved through the injection of A549 tumor cells subcutaneously into the middle left side of the mice after anesthetization with pentobarbital (35 mg/kg) at 2.8 &times; 106 cells in 400 &mu;l of PBS. 
 
Result: We found that &beta;-Caryophyllene exerts the anti-proliferative effects on A549 cells. Furthermore, &beta;-Caryophyllene significantly prevents apoptotic cell death and causes up-regulation of PGC-1&alpha; and TFAM compared to dexmedetomidine treated cells. We observed that &beta;-Caryophyllene suppressed tumor development in mice significantly compared to dexmedetomidine treated group without changing body weight.</div>

Dexmedetomidine Associated Lung Cancer Proliferation and Tumor Growth is Prevented by &beta;-Caryophyllene: Role of AMPK Activation and PGC-1&alpha;/TFAM Over Expression

Background: Propofol is intravenous short acting general anaesthetic most popular drug for induction and maintenance of anaesthesia in veterinary practice due to its rapid induction and smooth recovery. However, as sole general anaesthetic, it is unsatisfactory because of its poor analgesic property and causing hypotension and apnoea. Therefore, it commonly used in combination with opioid or alpha 2 agonist to minimize the untoward effects. The aim of the present study was to evaluate the sedative, analgesic and anaesthetic efficacy of propofol in combination with butorphanol, dexmedetomidine or acepromazine premedication in dogs. 
 
Methods: The present study was conducted on 18 healthy adult dogs of either sex and randomly divided into three groups (ButP, DexP and AceP) with six animals in each. Glycopyrrolate @ 0.02 mg/kg was administered intramuscularly 10 minutes prior to the anaesthetic administration in all the dogs. The animals of group ButP, DexP and AceP were premedicated intramuscularly with butorphanol @ 0.3 mg/kg b.wt., dexmedetomidine @ 10 &micro;g/kg b.wt. and acepromazine @ 0.4 mg/kg b.wt. respectively. Ten minutes later propofol was injected intravenously at a dose of 7 mg/kg b.wt. to induce general anesthesia. The following clinical parameters were recorded viz., onset of sedation, onset of anaesthesia, degree of analgesia, extent of muscle relaxation, duration of anaesthesia and complete recovery. All the data were analyzed using SPSS v 25.0 statistics software program and presented as mean&plusmn;Standard Error. 
 
Result: The onset of sedation and induction of anaesthesia was earlier in group DexP followed by AceP and ButP. Group DexP exhibited significantly (P&lt;0.05) longer duration of anaesthesia and complete recovery than groups ButP and AceP. All the groups had excellent analgesia; however animals of group DexP showed longer duration of analgesia. All the reflexes were abolished completely with longer duration of muscle relaxation in group DexP. The above anaesthetic study suggests that propofol in combination with dexmedetomidine; butorphanol or acepromazine can be safely used for inducing surgical anaesthesia in dogs. However, dexmedetomidine-propofol combination produced prolonged duration of anaesthesia with better quality suitable for long surgical procedure in dogs.

Sedative, Analgesic and Anaesthetic Evaluation of Propofol in Combination with Butorphanol, Dexmedetomidine and Acepromazine in Clinically Healthy Dogs

Background: The present study was conducted to evaluate the anaesthetic efficacy of butorphanol, dexmedetomidine or acepromazine in combination with thiopentone sodium for inducing general anaesthesia in healthy dogs. 
 
Methods: Eighteen adult dogs of either sex were randomly divided into three groups (ButTHIO, DexTHIO and AceTHIO) with six animals in each. Ten minutes prior to the anaesthetic administration, all the dogs were administered with glycopyrrolate @ 0.02 mg/kg I/M. The animals of group ButTHIO, DexTHIO and AceTHIO were premedicated intramuscularly with butorphanol @ 0.3 mg/kg b.wt., dexmedetomidine @ 10 &micro;g/kg b.wt. and acepromazine @ 0.4 mg/kg b.wt. respectively. General anaesthesia was induced with thiopentone sodium @ 18 mg/kg b.wt. intravenously. Onset of sedation and anaesthesia, degree of analgesia, extent of muscle relaxation, duration of anaesthesia, complete recovery from anaesthesia and different reflexes were recorded for evaluation of anaesthetic efficacy. 
 
Result: The onset of sedation and induction of anaesthesia was quicker in group DexTHIO followed by AceTHIO and ButTHIO. Duration of anaesthesia and complete recovery were significantly (P&lt;0.05) longer in group DexTHIO as compared to group ButTHIO and AceTHIO. Analgesia was excellent in all the groups but persisted for longer duration in animals of group DexTHIO. All the reflexes abolished completely with longer duration of muscle relaxation in group DexTHIO. It could be concluded that thiopentone sodium in combination with either dexmedetomidine or butorphanol or acepromazine can be used safely for inducing surgical anaesthesia in dogs. However, dexmedetomidine-thiopentone combination produced prolonged duration of anaesthesia with better quality for long surgical procedure in dogs.

Comparative Anaesthetic Evaluation of Butorphanol, Dexmedetomidine or Acepromazine in Combination with Thiopentone Sodium for Inducing General Anaesthesia in Healthy Dogs

Background: Anaesthetic management of horses for a successful surgery is of utmost importance but a risky procedure than other companion animals. Peri-aneasthetic morbidity and mortality in horses could be alarming if proper combinations of drugs were not used. Balanced anaesthetic combinations are being explored by various authors to find safer combinations.Therefore current study was planned to evaluate the effect of CRI of ketamine alone and ketamine-dexmedetomidine combination for isoflurane anesthesia in horses. 
 
Methods: Twenty four clinical cases of horses were randomly divided into three groups S, D and DK, having eight animals in each. Xylazine (1 mg/kg) and butorphanol (0.05 mg/kg) were given intravenously for premedication and ketamine (2 mg/kg) and midazolam (0.2 mg/kg) were used for induction of anesthesia. Normal saline (1000 ml/hour), ketamine alone (2 mg/kg/hr), ketamine (2 mg/kg/hr) and dexmedetomidine (2 &micro;g/kg/hr) combination were given as CRI in groups S, K and KD, respectively. Thiopentone sodium (200 mg bolus, 5%) was given as fast intravenous to facilitate endotracheal intubation in some of the cases. Anesthesia was maintained with isoflurane in oxygen and anesthetic efficacy was evaluated based on clinical and haematological parameters.&nbsp; 
 
Result: Overall quality of sedation, muscle relaxation, response to surgical stimuli, quality of intubation, anesthetic depth and quality of recovery was significantly (p&lt;0.05) better in group KD. Down-time (min) and duration of anesthesia were non significantly less in group KD. CRI of ketamine and dexmedetomidine combination was having significant (p&lt;0.05) thiopentone sodium and isoflurane sparing effect.&nbsp; Heart rateand RR, did not show any significant variation among groups but rectal temperature was significantly low in KD group than groups S and K. CRI of ketamine-Dexmedetomidine combination produced a better quality of anesthesia and significant thiopentone sodium and isoflurane sparing effect thus was found suitable for anesthesia of horses.

Clinical and Hematological Effect of Constant Rate Infusion of Ketamine Alone and Ketamine-dexmedetomidine Combination on Isoflurane Anesthesia in Horses

<div>Background: The study was conducted to evaluate the immunological effects of Propofol, Ketamine and Isoflurane in Dexmedetomidine and Butorphanol premedicated dogs. 
 
Methods: Four groups of dogs (A, B, C and D), 6 animals in each, were premedicated with Glycopyrrolate, Dexmedetomidine and Butorphanol. Induction was done with Propofol (A and B) and Ketamine (C and D). Anaesthesia was maintained with Isoflurane (A and C), Propofol (B) and Ketamine (D). The cytokine mRNA expressions and cell mediated immunity response were studied before and after anesthesia at different time intervals.&nbsp; 
 
Result: The down regulation of IL-2 was observed during the study period with significant changes in Group A, C and D except group B. The IL-4 and IL-10 showed non-significant up regulation in all the groups and gradually returned to the pre-induction level. The IL-6 showed significant down regulation at 2 hours and day 1 and up regulation on day 3 in all the groups. The TGF-&beta; showed up regulation in all the groups and then came to the pre-induction level with significant changes in Group A, C and D.</div>

Evaluation of Ketamine Hydrochloride in Combination with Midazolam, Dexmedetomidine and Butorphanol as Balanced Anaesthesia in Cats

Comparative evaluation of ropivacaine, ropivacaine- dexmedetomidine and ropivacaine – clonidine combinations for epidural analgesia in cattle

Haematobiochemical Changes during Pain Management with Intraperitoneal Bupivacaine and Bupivacaine-dexmedetomidine in Dogs

Evaluation of Clinico-physiological Effects of Ketamine Alone and in Combination with Dexmedetomidine or Butorphanol in Atropinized Dogs

Studies to Evaluate the Safety of Constant Rate Infusions of Dexmedetomidine, Ketamine and Lidocaine Alone or in Combination during Isoflurane Anesthesia in Horses

Dexmedetomidine Associated Lung Cancer Proliferation and Tumor Growth is Prevented by β-Caryophyllene: Role of AMPK Activation and PGC-1α/TFAM Over Expression

Sedative, Analgesic and Anaesthetic Evaluation of Propofol in Combination with Butorphanol, Dexmedetomidine and Acepromazine in Clinically Healthy Dogs

Comparative Anaesthetic Evaluation of Butorphanol, Dexmedetomidine or Acepromazine in Combination with Thiopentone Sodium for Inducing General Anaesthesia in Healthy Dogs

Clinical and Hematological Effect of Constant Rate Infusion of Ketamine Alone and Ketamine-dexmedetomidine Combination on Isoflurane Anesthesia in Horses

Immunological Effects of Propofol, Ketamine and Isoflurane in Dexmedetomidine and Butorphanol Premedicated Dogs