Prof Application of neuromuscular blockade using Rocuronium for performing different surgeries and its reversal by Neostigmine-Glycopyrrolate combination in dogs:

YUDHVIR RANA; ADARSH KUMAR; ROHIT KUMAR; AMIT KUMAR; S P TYAGI; SARA KAUSHAL; AKSHAY KUMAR; MANGAL SINGH; VIJAY MAHANTESH; KALPNA THAKUR

doi:10.56093/ijans.v93i2.129882

Authors

YUDHVIR RANA CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
ADARSH KUMAR CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
ROHIT KUMAR CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
AMIT KUMAR CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
S P TYAGI CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
SARA KAUSHAL CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
AKSHAY KUMAR CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
MANGAL SINGH CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
VIJAY MAHANTESH CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India
KALPNA THAKUR CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, Himachal Pradesh 176 062 India

https://doi.org/10.56093/ijans.v93i2.129882

Keywords:

Anaesthesia, Glycopyrrolate, IPPV, Muscle relaxation, Neostigmine, Rocuronium

Abstract

This study was executed in the clinical setup to investigate the effects of Rocuronium and its reversal by Neostigmine and Glycopyrrolate (Myopyrolate) combination in Propofol-Isoflurane anaesthetized dogs. Rocuronium-induced neuromuscular blockade was applied to 21 clinical cases. Out of which, 19 cases were of orthopaedic surgeries and 2 cases of ovariohysterectomy. After the animal had stabilized on the mixture of isoflurane and oxygen, the relaxation of muscle was induced using Rocuronium @ 0.5 mg/kg b.wt. Immediately IPPV was provided in volume control mode. Neuromuscular blockade was reversed using a single syringe combination drug having both Neostigmine and Glycopyrrolate (Myopyrolate) @ 0.05 mg/kg b.wt and @ 0.01 mg/kg b.wt, respectively. Rocuronium caused the centering of the ocular globe gradually in less than 30 sec. During orthopaedic surgeries, the reduction of fractured ends became easy without much tissue trauma. In ovariohysterectomy surgeries, the appropriate level of abdominal muscle relaxation further helped in the easy exteriorization of the ovarian stump. The onset time for Rocuronium was 17.64±1.10 sec and its duration of action was 27.82±0.72 min. The use of Rocuronium along with IPPV caused minimal alteration of the physiological parameters with no clinical consequences and thus can be considered a complication-free anaesthetic protocol for interventions demanding muscle relaxation.

Downloads

Download data is not yet available.

References

Alvarez L and Whittemore J. 2009. Liver enzyme elevations in dogs: physiology and pathophysiology. Compendium (Yardley, PA) 31(9): 408–10.

Auer U and Moens Y. 2011. Neuromuscular blockade with rocuronium bromide for ophthalmic surgery in horses. Veterinary Ophthalmology 14(4): 244–47. DOI: https://doi.org/10.1111/j.1463-5224.2010.00870.x

Boolj L H D J. 1997. Neuromuscular transmission and its pharmacological blockade. Pharmacology World Science 19: 1–12.

Briganti A, Barsotti G, Portela D A, Di Nieri C and Breghi G. 2015. Effects of rocuronium bromide on globe position and respiratory function in isoflurane anesthetized dogs: a comparison between three different dosages. Veterinary Ophthalmology 18(2): 89–94. DOI: https://doi.org/10.1111/vop.12108

Dikshit C and Prasad J. 1971. The influence of surgical trauma on blood glucose level during anaesthesia. Indian Journal of Anesthesia 19: 111.

Diltoer M and Camu F. 1988. Glucose homeostasis and insulin secretion during isoflurane anesthesia in humans. Anesthesiology 68(6): 880–86. DOI: https://doi.org/10.1097/00000542-198806000-00008

Dugdale A H, Adams W A and Jones R S. 2002. The clinical use of the neuromuscular blocking agent rocuronium in dogs. Veterinary Anaesthesia and Analgesia 29: 49–53 DOI: https://doi.org/10.1046/j.1467-2987.2001.00057.x

Dunne J R, Malone D, Tracy J K, Gannon C and Napolitano L M. 2002. Perioperative anemia: an independent risk factor for infection, mortality, and resource utilization in surgery. Journal of Surgical Research 102(2): 237–44. DOI: https://doi.org/10.1006/jsre.2001.6330

Duncan A. 2012. Hyperglycemia and perioperative glucose management. Current pharmaceutical design 18(38): 6195– 6203. DOI: https://doi.org/10.2174/138161212803832236

Frischmeyer K J, Miller P E, Bellay Y, Smedes S L and Brunson D B. 1993. Parenteral anticholinergics in dogs with normal and elevated intraocular pressure. Veterinary Surgery 22(3): 230–34. DOI: https://doi.org/10.1111/j.1532-950X.1993.tb00390.x

Hammond R A and England G C W. 1994. The effect of medetomidine premedication upon propofol induction and infusion anaesthesia in the dog. Veterinary Anaesthesia and Analgesia 21(1): 24–28. DOI: https://doi.org/10.1111/j.1467-2995.1994.tb00478.x

Hofmeister E H, Williams C O, Braun C and Moore P A. 2006. Influence of lidocaine and diazepam on peri-induction intraocular pressures in dogs anesthetized with propofol– atracurium. Canadian Journal of Veterinary Research 70(4): 251.

Khuenl-Brady K S and Sparr H. 1996. Clinical pharmacokinetics of rocuronium bromide. Clinical Pharmacokinetics 31(3): 174–83. DOI: https://doi.org/10.2165/00003088-199631030-00002

Khurana A. 2014. ‘Clinical evaluation of diazepam-butorphanol or acepromazine-butorphanol for sedation during propofol halothane anaesthesia in dogs.’ MVSc. Thesis, Department of Veterinary Surgery and Radiology, CSKHPKV Palampur, India

Kitamura T, Ogawa M, Kawamura G, Sato K and Yamada Y. 2009. The effects of sevoflurane and propofol on glucose metabolism under aerobic conditions in fed rats. Anesthesia and Analgesia 109(5): 1479–85. DOI: https://doi.org/10.1213/ANE.0b013e3181b8554a

Kovalcuka L, Birgele E, Bandere D and Williams D L. 2013. The effects of ketamine hydrochloride and diazepam on the intraocular pressure and pupil diameter of the dog’s eye. Veterinary ophthalmology 16(1): 29–34. DOI: https://doi.org/10.1111/j.1463-5224.2012.01015.x

Kumar R. 2017. ‘Studies on positive pressure ventilation during anaesthesia in dogs.’ MVSc thesis, Department of Veterinary Surgery and Radiology, Chaudhary Sarwan Kumar Himachal Pradesh Krishi Vishvavidyalaya, Palampur, India.

Kumar R, Kumar A, Kumar A and Tyagi S P. 2019. Comparison of atracurium and vecuronium as muscle relaxants for ocular and orthopaedic interventions in dogs. Indian Journal of Animal Research 54(1): 106–09. DOI: https://doi.org/10.18805/ijar.B-3730

Maeda K, Iwasaki M, Itou Y, Iwai S and Okano S. 2018. Effect of propofol continuous-rate infusion on intravenous glucose tolerance test in Dogs. Veterinary Science Research Journal 5(2): 43. DOI: https://doi.org/10.3390/vetsci5020043

McMurphy R M, Davidson H J and Hodgson D S. 2004. Effects of atracurium on intraocular pressure, eye position, and blood pressure in eucapnic and hypocapnic isoflurane-anesthetized dogs. American Journal of Veterinary Research 65(2): 179– 82. DOI: https://doi.org/10.2460/ajvr.2004.65.179

Miranda L C G D, Barrucand L, Costa J and Verçosa N. 2008. Comparative study between one and two effective doses (ED95) of Rocuronium for tracheal intubation. Brazilian Journal of Anesthesiology 58: 202–09. DOI: https://doi.org/10.1590/S0034-70942008000300002

Miyazaki Y, Sunaga H, Hobo S, Miyano K and Uezono S. 2016. Pancuronium enhances isoflurane anesthesia in rats via inhibition of cerebral nicotinic acetylcholine receptors. Journal of anesthesia 30(4): 671–76. DOI: https://doi.org/10.1007/s00540-016-2178-1

Musk G C, Pang D S, Beths T and Flaherty D A. 2005. Target‐controlled infusion of propofol in dogs–evaluation of four targets for induction of anaesthesia. Veterinary Record 157(24): 766–70. DOI: https://doi.org/10.1136/vr.157.24.766

Nagahama S, Nishimura R, Mochizuki M and Sasaki N. 2006. The effects of Propofol, Isoflurane and Sevoflurane on vecuronium infusion rates for surgical muscle relaxation in dogs. Veterinary Anaesthesia and Analgesia 33(3): 169–74. DOI: https://doi.org/10.1111/j.1467-2995.2005.00252.x

Naghibi K H, Yaraghi A and Adibi P. 2002. Haemoglobin and hematocrit changes during uncomplicated anesthesia: General anaesthesia and local anaesthesia. Journal of Research in Medicine Science 7(4): 9.

Naryal S. 2020. ‘Continuous rate intravenous infusion of propofol in dogs.’ MVSc Thesis, Department of veterinary surgery and radiology, CSK Himachal Pradesh Krishi Vishvavidyalaya, Palampur, India.

Neves C D, Favarato L S C, Filho J D R, Pompermayer L G, Silva E C, Leite H M and Santos L C. 2014. Evaluation of Rocuronium associated to Acepromazine, Propofol and Isofluorane in the anesthesia of female canines submitted to Elective Ovaryhysterectomy. Global Journal of Medical Research 14(4): 7–12.

Popovici C P, Mircean M, Scurtu I, Ober C, Pestean C, Sevastre B and Oana L. 2014. Rocuronium use in anaesthetics protocol in canine patients with orthopaedic disease. Bulletin UASVM Veterinary Medicine 71(2): 462–66. DOI: https://doi.org/10.15835/buasvmcn-vm:10796

Redondo J I, Suesta P, Serra I, Soler C, Soler G, Gil L and Gómez‐ Villamandos R J. 2012. Retrospective study of the prevalence of post anaesthetic hypothermia in dogs. Veterinary Record 171(15): 374–74. DOI: https://doi.org/10.1136/vr.100476

Sakata H, Ishikawa Y, Ishihara G, Oyama N, Itami T, Umar M A, Sano T and Yamashita K. 2019. Effect of sevoflurane anaesthesia on neuromuscular blockade produced by rocuronium infusion in dogs. Journal of Veterinary Medical Science 81: 425–33. DOI: https://doi.org/10.1292/jvms.18-0479

Tanaka T, Nabatame H and Tanifuji Y. 2005. Insulin secretion and glucose utilization are impaired under general anesthesia with sevoflurane as well as isoflurane in a concentration-independent manner. Journal of Anesthesia 19(4): 277–81. DOI: https://doi.org/10.1007/s00540-005-0341-1

Vore S J, Aycock E D, Veldhuis J D and Butler P C. 2001. Anesthesia rapidly suppresses insulin pulse mass but enhances the orderliness of insulin secretory process. American Journal of Physiology-Endocrinology and Metabolism 281(1): 93–99. DOI: https://doi.org/10.1152/ajpendo.2001.281.1.E93

Wagner A E, Muir W W and Hinchiff K W. 1991. Cardiovascular effects of xylazine and detomidine in horses. American Journal of Veterinary Research 52(5): 651–57.

Xue F S, Liao X, Tong S Y, Liu J H, An G and Luo L K. 1998. Dose–response and time course of the effect of rocuronium bromide during sevoflurane anaesthesia. Anaesthesia 53(1): 25–30. DOI: https://doi.org/10.1111/j.1365-2044.1998.00278.x