Total intravenous anaesthesia (TIVA) with propofol-fentanyl and propofol-midazolam combinations in spontaneously-breathing goats

Abstract

Objective To compare the efficacy and cardiopulmonary effects of propofol and fentanyl, with propofol and midazolam for total intravenous anaesthesia.

Study design Prospective, randomized, crossover experimental study.

Animals Six goats; three does and three wethers.

Methods Goats received either fentanyl 0.02 mg kg−1 (treatment FP) or midazolam 0.3 mg kg−1 (treatment MP) intravenously. One minute later anaesthesia was induced with propofol, then maintained by constant rate infusion of propofol 12.0 mg kg−1 hour−1 and fentanyl 0.02 mg kg−1 hour−1 (treatment FP) or propofol 12.0 mg kg−1 hour−1 and midazolam 0.3 mg kg−1 hour−1 (treatment MP) for 90 minutes. Response to noxious stimulus was tested every 10 minutes and propofol dose adjusted to prevent purposeful movement. Cardiopulmonary parameters were measured continuously, and arterial blood-gas analysis performed intermittently. Recovery was timed and quality scored. Results are presented as median (IQR).

Results Differences in the propofol induction dose [4.00 (3.96–4.01) and 3.97 (3.91–4.00) mg kg−1 for treatments FP and MP, respectively] were not significant. Quality of induction in both groups was smooth. The median propofol dose for maintenance was less (p = 0.004) with treatment FP (12.0 mg kg−1 hour−1) than MP (18.0 mg kg−1 hour−1). Cardiopulmonary function was well maintained with both treatments. Recovery times in minutes from the end of anaesthetic infusion for treatments FP and MP respectively were; to extubation 3.0 (3.0–3.0) and 4.5 (3.3–5.0); to sternal position, 4.5 (3.3–5.0) and 5.0 (5.0–6.5) and to standing 13.0 (10.3–15.0) and 15.0 (11.3–17.3). Quality of recovery was acceptable in both groups, but abnormal behavioural signs were observed after treatment FP.

Conclusions and clinical relevance Total intravenous anaesthesia with propofol and fentanyl or propofol and midazolam, at the doses studied, in spontaneously-breathing, oxygen-supplemented goats is practicable. Recovery from the fentanyl-propofol combination is not always smooth.