Comparative clinical evaluation of total intravenous anaesthesia with xylazine-ketamine-guaifenesin and dexmedetomidine-ketamine-guaifenesin in horses

Abstract

Background: In India, horses undergoing several surgical procedures that need for safe anaesthetic procedures. For short-term treatments, Total Intravenous Anaesthesia (TIVA) provides several advantages over inhalants. This study evaluates and compares xylazine and dexmedetomidine based TIVA protocols to improve anaesthetic safety, efficacy and recovery quality in equine surgeries, addressing the challenges of equine anaesthetic management. Methods: The study assessed two distinct combinations of total intravenous anaesthesia (TIVA) in horses for anaesthetic parameters, including induction, time and quality of sedation and recovery. The study was a prospective, randomised clinical trial with two groups of six horses each and 12 clinical cases of horses. Acepromazine was administered to the horses as a premedication first. Twenty minutes later, the XKG group received intravenous xylazine and butorphanol, while the DKG group received dexmedetomidine and butorphanol. Xylazine-ketamine-guaifenesin (XKG) or dexmedetomidine-ketamine-guaifenesin (DKG) infusion at a steady rate (1-3 mL/kg/hr) was administered to both groups after ketamine induction. Evaluation of parameters such as time of sedation, quality of sedation, time to induction of anaesthesia, quality of induction, duration of anaesthesia, degree of muscle relaxation, and time and quality of recovery was performed and compared between the groups. Various clinico-physiological parameters, such as heart rate (HR), respiration rate (RR), rectal temperature (RT) and oxygen haemoglobin saturation in the blood (SpO2). Result: The results showed that, compared to the XKG group, the DKG group experienced shorter and more satisfactory sedation and induction times, a shorter recovery period, better quality of recovery and improved cardiopulmonary stability. Both drug combinations proved effective in maintaining anaesthesia during short-term procedures, with good to excellent recovery. These findings support the usage of TIVA protocols based on dexmedetomidine as a viable approach in future to enhance anaesthetic management in equine practices.