Total intravenous anaesthesia with “ketofol” (ketamine/propofol combination) in cats undergoing ovariectomy: intra and post-operative evaluation

Total intravenous anaesthesia with “ketofol” in cats undergoing ovariectomy: intra and post-operative evaluation G. Ravasio, D. Fonda, G. De Carli, Beccaglia M., L. Borghi, A.M. Carotenuto, M. Gallo, A. Zonca Università degli Studi di Milano, Facoltà di Medicina Veterinaria di Milano, via Celoria 10, 20133 (MI) Italy Ketamine (K) and propofol (P) combination CRI is intravenous (IV) association used in humans and veterinary medicine (Arora 2008, Ilkiw & Pascoe 2003). Intraoperative anaesthetic variables and postoperative analgesic and sedative effects were evaluated. Fifteen female cats undergoing ovariectomy received IV loading dose of K plus P (2 mg kg-1 each) (n=8) mixed in the same syringe (ketofol) or ketofol added of dexmedetomidine (0.003 mg kg-1 IV) (n=7), followed by IV infusion of the ketofol mixture (10 mg kg-1 h-1 each). Physiological parameters and venous emogasanalysis were monitored during surgery and the count in the Heinz bodies formation was investigated. Blood concentrations of ketamine, norketamine and propofol were quantified by HPLC analysis. Sedation degree, the quality of recovery and pain assessment were also evaluated in the postoperative period. The intraoperative HR was significantly higher and the time of extubation was significantly shorter in the group receiving ketofol without dexmedetomidine. Blood emogasanalyses were not substantial different among groups and the infusion of propofol did not significantly increase oxidative damage to the red blood cells. The pharmacokinetic profile was similar for propofol and ketamine. During recovery the animals in both groups appeared restful, without pain. The total intravenous anaesthesia (TIVA) with ketofol appeared to be safe in cats, with fast and smooth recovery and adequate analgesia during postoperative period. Decrease HR in dexmedetomidine group resulted in a more stable haemodynamic state, but prolonged recovery time. The infusion of ketofol could represent a useful protocol for TIVA in cats undergoing moderately painful surgery. References: Arora S (2008) Combining ketamine and propofol (“Ketofol”) for emergency department procedural sedation and analgesia: a review. WestJEM 9, 20-23. Ilkiw JE, Pascoe PJ (2003) Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cat. AJVR 64, 913-917