Comparison between Propofol/Remifentanil and Ketamine/Remifentanil for TIVA in Beagle Dogs

The cardiopulmonary responses during total intravenous anesthesia (TIVA) between remifentanil/propofol infusion and remifentanil/ketamine infusion in dogs were compared. Fourteen healthy adult beagle dogs were premedicated with acepromazine (0.1 mg/kg, SC) and medetomidine (20 μg/kg, IV), and anesthetized for 3 hr with remifentanil (0.5 μg/kg/min)/propofol (loading dose: 1 mg/kg, CRI: 0.3 mg/kg/min) CRI (group ‘P’) or remifentanil/ketamine (loading dose : 5 mg/kg, CRI: 0.1 mg/kg/min) CRI (group ‘K’), respectively. Hemodynamics, blood gas analysis and behavioral changes during recovery were measured. The level of anesthesia was determined by toe-web clamping test. The level of surgical anesthesia was maintained throughout the experiment in both groups. Systolic arterial pressure, mean arterial pressure, PaO₂ and SpO₂ in group ‘K’ were significantly higher than in group ‘P’, and were maintained near the normal ranges. In addition, PaCO₂ in group ‘K’ was significantly lower than in group ‘P’. However, diastolic arterial pressure, heart rate and respiratory rate were not significantly differed. Mean extubation time from the end of infusion was significantly reduced in group ‘K’, but mean sitting time was significantly reduced in group ‘P’. Mean head-up time and mean walking time were not significantly differed. In group ‘K’, brief muscle rigidity, head waving and licking during recovery were observed. In conclusion, infusion rate of ketamine (0.1 mg/kg/min) with remifentanil (0.5 μg/kg/min) is an appropriate for obtaining the surgical plane of anesthesia. These results showed that group ‘K’ had better cardiopulmonary function than group ‘P’. That is, remifentanil/ketamine CRI is better TIVA protocol than remifentanil/propofol CRI for 3 hr surgery.