Clinical and pharmacokinetic effects of regional or general anaesthesia on intravenous regional limb perfusion with amikacin in horses

dc.contributor.authorMahne, Arnold Theofilus
dc.contributor.authorRioja-Garcia, Eva
dc.contributor.authorMarais, Hendrik Johannes
dc.contributor.authorVillarino, N.F.
dc.contributor.authorRubio-Martinez, Luis M.
dc.contributor.emailarnold.mahne@up.ac.zaen_US
dc.date.accessioned2014-07-08T08:38:17Z
dc.date.issued2014-05
dc.description.abstractREASONS FOR PERFORMING STUDY : Antimicrobial i.v. regional limb perfusion (IV-RLP) is clinically performed on anaesthetised or sedated horses with or without regional anaesthesia. To date, no scientific data are available on the clinical and pharmacokinetic effects of these anaesthetic protocols on antimicrobial IV-RLP, which is believed to result in better tourniquet efficiency due to decreased movement. OBJECTIVE : To determine the effects of regional or general anaesthesia on the clinical and synovial pharmacokinetic parameters of amikacin administered by IV-RLP to horses. STUDY DESIGN : Experimental crossover study. METHODS : Eight healthy horses received 4 treatments of amikacin IV-RLP in a randomised, blinded, crossover design: standing sedation without regional anaesthesia (CNT); standing sedation with i.v. regional anaesthesia; standing sedation with perineural regional anaesthesia (PNA); or general anaesthesia. Synovial fluid amikacin concentrations were measured over 24 h and regional pharmacokinetic parameters calculated. Heart and respiratory rates, visual analogue scale of discomfort, number of times the limb was lifted and number of additional sedations administered were recorded. Analysis of variance crossover analysis was applied with significance level at P<0.05. RESULTS : Amikacin concentrations and regional pharmacokinetic parameters did not differ significantly among treatments. Visual analogue scores (mean ± s.d.) were significantly lower with PNA (19 ± 15) vs. i.v. regional anaesthesia (69 ± 36) or CNT (81 ± 13; P<0.001). Significantly less lifting of the limb (mean ± s.d.) occurred with PNA (20 ± 20) vs. CNT (54 ± 22; P<0.04). CONCLUSIONS : Perineural regional anaesthesia before IV-RLP was most effective in providing comfort to standing, sedated horses without significantly affecting the regional pharmacokinetic parameters of amikacin. High variability of synovial amikacin concentrations was present. The use of general anaesthesia for IV-RLP is not justified based on this study.en_US
dc.description.librarianhb2014en_US
dc.description.urihttp://onlinelibrary.wiley.com/journal/10.1001/(ISSN)2042-3306en_US
dc.identifier.citationMahne, AT, Rioja, E, Marais, HJ, Villarino, NF & Rubio-Martinez, LM 2014, 'Clinical and pharmacokinetic effects of regional or general anaesthesia on intravenous regional limb perfusion with amikacin in horses', Equine Veterinary Journal, vol. 46, no. 3, pp. 375-379.en_US
dc.identifier.issn0425-1644 (print)
dc.identifier.other10.1111/evj.12125
dc.identifier.urihttp://hdl.handle.net/2263/40624
dc.language.isoenen_US
dc.publisherWiley-Blackwellen_US
dc.rights© 2013 EVJ Ltd. The definite version is available at : http://onlinelibrary.wiley.com/journal/10.1001/(ISSN)2042-3306.en_US
dc.subjectHorsesen_US
dc.subjectRegional limb perfusionen_US
dc.subjectAmikacinen_US
dc.subjectGeneral anaesthesiaen_US
dc.subjectRegional anaesthesiaen_US
dc.subjectPharmacokineticsen_US
dc.subject.lcshVeterinary anaesthesiaen_ZA
dc.titleClinical and pharmacokinetic effects of regional or general anaesthesia on intravenous regional limb perfusion with amikacin in horsesen_US
dc.typePostprint Articleen_US

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