Kafkas Univ Vet Fak Derg

Journal Home-Page: http://vetdergi.kafkas.edu.tr

19 (Suppl-A): A33-A40, 2013 Online Submission: http://vetdergikafkas.org RESEARCH ARTICLE
DOI: 10.9775/kvfd.2012.7548

Comparison of Propofol-Remifentanil and Propofol-Fentanyl

Anesthesia During Ovariohysterectomy in Dogs [1] [2]
Barış KÜRÜM * Zeynep PEKCAN * Hakan KALENDER **
Ali KUMANDAŞ * Oya CAN MUTAN *** Ertuğrul ELMA *
[1] This research was supported by the Scientific Research Project Unit of Kirikkale University (2007/30)
[2] This study was previously presented at a scientific meeting of XI. Veterinary Surgery Congress, 19-22 May, Belek, Antalya,
TURKEY, 2010
* Kirikkale University, Faculty of Veterinary Medicine, Department of Surgery, TR-71451 Yahsihan, Kirikkale - TURKEY
** Kirikkale University, Faculty of Veterinary Medicine, Department of Obstetrics and Gynaecology, TR-71451 Yahsihan,
Kirikkale - TURKEY
*** Middle East Technical University, Department of Statistics, TR-06800 Cankaya, Ankara - TURKEY

Makale Kodu (Article Code): KVFD-2012-7548

Summary
The aim of the study was to evaluate the cardiorespiratory and clinical effects of propofol and remifentanil anesthesia compared to
propofol and fentanyl anesthesia during ovariohysterectomy in dogs. Sixteen healthy dogs were randomly assigned to two groups. After
premedication with atropine, anesthesia was induced with propofol and maintained with the infusion of propofol at a dose of 0.5 mg/kg/min.
Once stable anesthesia was achieved, 1 µg/kg remifentanil or 2 µg/kg fentanyl was administered intravenously, and infusion was begun at
a dose of 0.6 µg/kg/min and 0.5 µg/kg/min, respectively. Cardiorespiratory variables were recorded after propofol administration combined
with remifentanil or fentanyl at 10-min intervals, and the quality of anesthesia, return of spontaneous ventilation, head lift and sternal position
were also recorded. Apnea was observed after remifentanil and fentanyl administration in all dogs. Heart rate, systolic and mean arterial blood
pressures tended to decrease rapidly after remifentanil and fentanyl administration, and during the first 20 min, in both groups. Although the
difference between times was significant, the difference between groups was statistically insignificant. Recovery periods were longer in the
fentanyl group than in the remifentanil group. The administration of propofol with remifentanil or fentanyl provides a stable haemodynamic
state and depth of anesthesia with a constant infusion, and remifentanil could be preferred to fentanyl when aiming a rapid recovery period.

Keywords: Propofol, Remifentanil, Fentanyl, Anesthesia, Cardiorespiratory, Recovery, Dog

Köpeklerde Ovariohisterektomi Operasyonunda

Propofol-Remifentanil ve Propofol-Fentanil
Anestezisinin Karşılaştırılması
Özet
Bu çalışmanın amacı köpeklerde ovariohysterektomi operasyonunda propofol-remifentanil ile propofol-fentanil anestezisinin etkinliğini
ve kardiyorespiratorik etkilerini karşılaştırmaktır. Bu amaçla 16 adet yetişkin, dişi köpek rastgele iki gruba (n=8) ayrıldı. Anesteziye atropin ile
premedikasyon yapılarak başlandıktan sonra propofol ile indüksiyon yapıldı ve 0.5 mg/kg/dk dozunda propofol infüzyonuna başlandı. Stabil
anesteziden sonra ilk gruba 1 µg/kg remifentanil, ikinci gruba 2 µg/kg fentanyl bolus olarak uygulandı. Remifentanil ve fentanil infüzyonu
sırasıyla 0.6 µg/kg/dk ve 0.5 µg/kg/dk dozunda devam edildi. Kardiyovasküler değişiklikler propofol sonrası, remifentanil veya fentanil sonrası ve
operasyon süresince 10 dakika aralıklarla kaydedildi. Anestezinin derinliği, spontan ventilasyonun başlama, kafayı kaldırma ve sternal pozisyona
gelme zamanları kaydedildi. Tüm olgularda remifentanil ve fentanil uygulamasından sonra apnea oluşumu gözlendi. Her iki grupta da kalp
atım hızı, sistolik (SAP) ve ortalama arteriyel basınç (MAP) değerlerinin remifentanil ve fentanil uygulanmasından sonra hızla düştüğü ve ilk
20 dakikada düşmeye devam ettiği görüldü. Bu değerlerde zaman içindeki farklılıklar istatistiksel olarak anlamlı olarak kaydedilirken, gruplar
arasında istatistiksel açıdan anlamlı olmadığı saptandı. Fentanil grubundaki uyanma süresinin remifentanilden daha uzun olduğu tespit edildi.
Sonuç olarak, köpeklerde ovariohisterektomi operasyonlarında sabit hızla uygulanan propofol-remifentanil veya propofol-fentanil infüzyonunun
stabil hemodinamik parametreleri sağladığı, uyanma süreleri değerlendirildiğinde ise remifentanilin tercih edilebileceği kanısına varılmıştır.

Anahtar sözcükler: Propofol, Remifentanil, Fentanil, Anestezi, Kardiopulmoner, Uyanma, Köpek

 İletişim (Correspondence)
 +90 532 4467528
 [email protected]
A34
Comparison of Propofol-Remifentanil ...

INTRODUCTION dogs were anesthetized by an anesthetist who was unaware

of the treatment groups (ZP). Atropine (0.05 mg/kg, Atropin,
Propofol is a short-acting, nonbarbiturate sedative drug, Vetas, Turkey) was administered to all dogs subcutaneously
which is rapidly metabolized in dogs 1-4. Minimal accumulation (SC) 45 min before the induction of anesthesia. Following
on repeated or constant administration makes propofol the placement of a catheter in both cephalic veins, propofol
suitable for both the induction and maintenance of anes- (Pofol, Sandoz, Turkey) was administered within 90-120
thesia 5-7. Total intravenous (IV) anesthesia with propofol has seconds as an IV bolus to induce anesthesia. Incremental
been widely investigated in dogs, however, due to the lack doses were administered until a suitably sized, cuffed endo-
of analgesic properties this drug is considered inadequate tracheal tube could be inserted into the trachea. Post-
to provide anesthesia during surgery 5-9. induction apnea was defined as a period of >30 sec without
spontaneous ventilation, and in such cases intermittent
Remifentanil and fentanyl are potent synthetic µ-opioid positive pressure ventilation (IPPV) was initiated manually
agonists. Both drugs are administered to achieve intra- until spontaneous ventilation resumed. Immediately after
operative analgesia. Fentanyl has been widely investigated in intubation, an IV infusion of propofol was started to maintain
veterinary anesthesia for many years. Fentanyl is metabolized anesthesia. Propofol was administered using an infusion
mainly in the liver, and its half life is 2 to 3 h 10. After pump (Accumate 2300, Woo Young Medical, Korea), and the
prolonged infusions, its side effects continue because of its initial infusion rate of propofol was 0.5 mg/kg/min. The dogs
cumulative effect 2,7,11. Its ultra-short action, rapid control of were placed in dorsal recumbency and connected to a semi-
the depth of anesthesia, and lack of dependence on organ closed circle rebreathing system (TMS Maxi 2200; Turkey).
functions for breakdown and clearance make remifentanil The fresh gas flow was 2 l/min. Lactated Ringer’s solution
more advantageous than fentanyl. Remifentanil does not (Ringesol, Vilsan, Turkey) was administered intravenously
accumulate in the body even after prolonged infusion, and at a rate of 10 ml/kg/h throughout anesthesia.
its terminal half-life has been reported to be less than 6
minutes 5,12,13. These properties make remifentanil ideal as A 20 G cannula was placed in the femoral artery per
part of a total IV anesthesia technique 8,14,15. Although vagally cutaneously to monitor arterial blood pressure and obtain
mediated bradycardia often occurs, cardiovascular stability samples for blood gas and acid-base analysis (Gastat Mini,
remains even when remifentanil or fentanyl are combined Techno Medica, Germany). Heart rate (HR), systolic (SAP),
with propofol 7,9,16. diastolic (DAP) and mean (MAP) arterial blood pressures,
end-tidal carbon dioxide (PE’CO2), oxygen saturation (SpO2),
Remifentanil has gained popularity in human medicine in and body temperature were recorded before the infusion
recent years. Although several pharmacokinetic and pharmaco- of propofol and during anesthesia at 10-min intervals
dynamic studies have demonstrated its distribution and with a multiparameter monitor (Petas, KMA 800, Turkey).
clearance, there are only a few reports published on its clinical Anesthesia was considered stable in terms of no changes
use in dogs 6,8,13-15,17. in the blood pressure and heart rate for 5 min, no palpebral
reflexes and no tone of the jaw muscle. Once a stable plane of
Although the bolus administration of fentanyl is frequently
anesthesia was maintained, a bolus of 1 µg/kg remifentanil
used in veterinary practice, to the authors’ knowledge, this
(Ultiva, GlaxoSmithKline, Turkey) or 2 µg/kg fentanyl (Fentanyl
is the first clinical study on the use of remifentanil given as
Citrate, Antigen Pharmaceuticals, Germany) was administered
a bolus administration in dogs 18.
intravenously to the remifentanil and fentanyl groups,
The aims of this study were to evaluate the cardio- respectively, and infusion was begun at a dose of 0.6 µg/
respiratory and clinical effects of propofol and remifentanil kg/min and 0.5 µg/kg/min, respectively. Following the
anesthesia compared to propofol and fentanyl anesthesia depression of spontaneous ventilation, manual IPPV with a
during ovariohysterectomy in dogs. The length of the recovery respiratory rate of 14 breaths/minute was initiated with 100
period was also recorded. percent oxygen and continued to maintain PE’CO2 between
35-45 mm Hg. To ensure that pH, arterial O2 (PaO2) and
arterial bicarbonate (HCO3) values were within the reference
MATERIAL and METHODS ranges, arterial blood gases were measured by blood gas
analyzers at 15-min intervals.
Sixteen client-owned, adult female dogs, aged between
8 months and 5 years (mean 1.7 years), and weighing between The dose of propofol infused was changed according to
14 and 36 kg (mean 23.2 kg), which were admitted for elective the clinical assessment of the depth of anesthesia based on
ovariohysterectomy, were studied. Each animal was randomly the observation of changes in blood pressure and heart rate,
assigned to one of two groups of eight. They were considered presence of palpebral reflex, increases in jaw and abdominal
to be healthy based on physical and haematological exami- muscle tone during traction on the ovaries, as evaluated by
nation. The study was approved by the local Ethics Committee the surgeon. Deviations of more than 20% in heart rate and
(Approvel number: 08/48). All dogs were fasted overnight blood pressure, during the incision and traction of the ovaries,
and water was withheld for 2 h prior to anesthesia. All without palpebral reflex or increase in the muscle tone, were
 A35
KÜRÜM, PEKCAN, KALENDER
KUMANDAŞ, CAN MUTAN, ELMA

assumed to indicate inadequate analgesia, and 1 µg/kg RESULT

fentanyl or 0.5 µg/kg remifentanil was administered intra-
venously. A heart rate less than 60 beats/min for 5 min with
The mean dose of propofol required to allow intubation
the presence of hypotension (MAP<60) was treated with
was 5.7±0.7 mg/kg (ranged from 4.9 to 7.1) in the remifentanil
atropine (0.02 mg/kg, IV).
group and 5.9±1.4 mg/kg (ranged from 4.5 to 7.9) in the
Ovariohysterectomy was performed via a midline fentanyl group. The differences between the groups for the
abdominal incision using a standard technique by the required dose of propofol were not statistically significant.
same surgeon. No apnea was recorded after propofol administration, and
respiratory rates ranged from 10 to 16 breaths/min. Therefore,
Carprofen (2 mg/kg, IV, Rimadyl, Pfizer, Turkey) 19 and there was no need to initiate IPPV after anesthetic induction
morphine (0.2 mg/kg, intramuscularly (IM), Morphine, Galen with propofol.
Ilac, Turkey) were administered 20 and 10 minutes before
the end of the operation, respectively. Propofol, remifentanil or Mean surgical times for the remifentanil and fentanyl
fentanyl infusions were stopped once surgery was completed. groups were 45.0±5.3 min and 43.75±5.2 min, respectively,
Manual ventilation was continued until spontaneous ven- and did not differ statistically between the groups.
tilation resumed, and the time to the first spontaneous
The mean heart rate of the dogs was 143±16 beats per
ventilation, head lift and sternal recumbency were also
minute (bpm) (ranged from 111 to 170) in the remifentanil
recorded.
group and 140±18 bpm (ranged from 114 to 168) in
Pain scores were recorded at 0, 1, 2, 3, 4, 8, 12 and 24 h the fentanyl group before remifentanil and fentanyl
after recovery. Postoperative analgesia was provided with administration. No arrhythmias were recorded during
0.2 mg/kg morphine administered intramuscularly every anesthesia. Heart rate tended to decrease significantly
four hours for the first 24 h after surgery. Each dog received after remifentanil and fentanyl administration (P=0.0004),
4 mg/kg carprofen orally each day for three days after the and during the first 20 min in both groups but not different
operation. Pain was scored using a multifactorial scoring between groups (Fig. 1). Although heart rate decreased,
system 20. The subjective and objective variables were recorded bradycardia was not recorded and atropine was not
to assess the pain score. A score of 0 to 16 was possible, readministered to any of the dogs.
with increased scores indicative of greater pain. During the
observation period, analgesia was considered inadequate MAP was 85.25±20.84 mmHg in the remifentanil group
if the total pain score was ≥ 8, and morphine (0.2 mg/kg, IM) and 84.86±12.95 mmHg in the fentanyl group after propofol
was administered as a rescue analgesic postoperatively 20. administration, and it was decreased to 66.85±18.99 mmHg
and 65.50±15.22 mmHg after remifentanil and fentanyl
Statistical analysis: Statistical analyses were performed administration, respectively (Fig. 2). In both groups, the highest
with commercial software (SPSS, USA). All data were reported values for SAP, MAP, and DAP were recorded after propofol
as mean ± standard deviations (SD). The normality check of administration alone and the lowest values were recorded
the variables was performed by the Shapiro-Wilk test, and after remifentanil or fentanyl administration prior to the
according to these test results, between- and within-group operation. The decrease in SAP, MAP and DAP was significant
differences in heart rate, SAP, MAP, DAP and temperature between times (P<0.047) but not significant between
were analyzed by analysis of variance (ANOVA) for repeated groups. Although SAP, DAP, and MAP were approximately the
measures. Also, the differences in recovery periods between same between groups for most time points, SAP and MAP
groups were tested by the independent sample t-test. All were transiently higher 30 min after fentanyl administration
differences were considered significant for P<0.05. compared to the remifentanil group (Fig. 2, 3 and 4).

Fig 1. The heart rate of the dogs (mean±SD) during

ovariohysterectomy (OH). The heart rates of the two
groups did not differ significantly. The 0. minute time
point shows the time at which remifentanil or fentanyl
was administered

Şekil 1. Köpeklerin ovariohisterektomi (OH) sıra-

sındaki kalp ritmleri (ortalama±SD). İki grup arasındaki
kalp ritm farklılığı istatistiksel açıdan önemli bulun-
mamıştır. “0” zamanı fentanil veya remifentanilin
uygulanmaya başlandığı zamandır
A36
Comparison of Propofol-Remifentanil ...

Fig 2. The mean arterial blood pressure (MAP) of the

dogs (mean±SD) during ovariohysterectomy. The
MAP of the two groups did not differ significantly.
The 0. minute time point shows the time at which
remifentanil or fentanyl was administered

Şekil 2. Köpeklerin OH sırasındaki ortalama arteriyel

kan basınçları (ortalama±SD). İki grup arasındaki
ortalama arteriyel kan basınç değerleri istatistiksel
açıdan önemli bulunmamıştır. “0” zamanı fentanil veya
remifentanilin uygulanmaya başlandığı zamandır

Fig 3. The systolic arterial blood pressure (SAP) of the

dogs (mean±SD) during ovariohysterectomy. The
SAP of the two groups did not differ significantly.
The 0. minute time point shows the time at which
remifentanil or fentanyl was administered

Şekil 3. Köpeklerin OH sırasındaki sistolik arteriyel kan

basınçları (ortalama±SD). İki grup arasındaki sistolik
arteriyel kan basınç değerleri istatistiksel açıdan
önemli değildir. “0” zamanı fentanil veya remifentanilin
uygulanmaya başlandığı zamandır

Fig 4. The diastolic arterial blood pressure (MAP) of

the dogs (mean±SD) during ovariohysterectomy. The
DAP of the two groups did not differ significantly. The 0.
minute time point shows the time at which remifentanil
or fentanyl was administered

Şekil 4. Köpeklerin OH sırasındaki diyastolik arteriyel

kan basınçları (ortalama±SD). İki grup arasındaki
diyastolik arteriyel kan basınç değerleri istatistiksel
açıdan önemli bulunmamıştır. “0” zamanı fentanil veya
remifentanilin uygulanmaya başlandığı zamandır

Apnea was recorded immediately after remifentanil for mean arterial blood pH (reference range 7.35-7.45), PaO2
and fentanyl administration in all dogs, therefore manual (above 500 mmHg when an animal is breathing 100% O2)
IPPV was continued throughout the operation. Mean and HCO3 (reference range 18-25 mmol/l) values. The blood
times to return of spontaneous respiration, head lift and gas values were given in Table 1.
sternal position were shorter in the remifentanil group
than in the fentanyl group (Fig. 5). They were 17.5±6.85 None of the dogs were given supplemental intraoperative
min, 33.3±16.3 min and 50.8±17.1 min in the remifentanil analgesics. One dog in the remifentanil group and two dogs
group, and 22.7±11.04, 37.0±15.9, 66.25±35.9 min in the in the fentanyl group whined immediately after extubation,
fentanyl group, respectively. However, the difference was however, it only lasted 10 min. They did not appear to be in
statistically not significant. pain and supplemental analgesia was not given. The multi-
modal pain scale was not greater than 7/16. All dogs recovered
There was no significant difference between the groups without postoperative complications.
 A37
KÜRÜM, PEKCAN, KALENDER
KUMANDAŞ, CAN MUTAN, ELMA

Fig 5. Mean times (mean±SD) to return of spontaneous

respiration, head lift and sternal position after ovario-
hysterectomy in dogs. The times of the two groups did
not differ significantly

Şekil 5. OH operasyonu sonlandıktan sonra köpek-

lerin spontan solunumlarının başladığı, kafalarını kal-
dırabildikleri ve sternal pozisyona geçtikleri zaman-
ların ortalaması (mean±SD). İki grup arasındaki
zamanlar açısından fark istatistiksel olarak önemli
bulunmamıştır

Table 1. Blood gas values of the dogs. The 0. min time point shows the time at which remifentanil or fentanyl was administered
Tablo 1. Köpeklerin kan gazı değerleri. “0” zamanı fentanil veya remifentanilin uygulanmaya başlandığı zamandır
Parameter Drug 0. minute 15. minute 30. minute 45. minute
Remifentanil 7.4±0.05 7.39±0.04 7.38±0.09 7.38±0.09
pH
Fentanyl 7.42±0.02 7.41±0.06 7.4±0.02 7.39±0.04
Remifentanil 488±20 490±15 515±45 532±20
PaO2 (mmHg)
Fentanyl 492±60 520±74 545±32 567±38
Remifentanil 22.0±08 21.4±0.9 20.9±0.4 20.5±1.5
HCO3 (mmol/l)
Fentanyl 22.8±0.4 22.4±0.4 21.1±0.9 18.94±0.7

DISCUSSION in studies in which lower propofol doses were administered.

It was confirmed in previous studies that hypotension is less
Propofol alone has proved to be unsatisfactory for major pronounced when propofol is administered slowly 5,8,25.
surgical procedures as it has no analgesic properties and The remifentanil and fentanyl infusion rates used in our
the dose required to suppress responses to surgical
study were extrapolated from published data 7,8,14. A dose-
manipulations induces severe cardiovascular and respiratory
dependent adverse effect frequently associated with the
adverse effects 1,6,8,12,21. Thus, it may be combined with some
use of opioids is bradycardia 2,7,17,30. Allweiler et al.15 adminis-
opioids like remifentanil or fentanyl. In this study, both
tered two different doses of remifentanil to dogs without
drugs are considered as ideal analgesics for continuous
anticholinergic injections, and reported a need for glyco-
infusion when combined with propofol 2,5,7,17,22,23.
pyrrolate injections because of severe bradycardia related
The mean induction dose of propofol in this study was the to the dose of remifentanil. In another study conducted
same with that reported for unpremedicated dogs in several by Murrell et al.8, although the administered doses of
studies 24,25. Apnea was a frequent adverse effect after rapid remifentanil were the same as those administered in this
bolus propofol administration for induction 25-28. Musk et study, atropine was re-administered during the operation
al.29 investigated 4 different doses of propofol and recorded because of the decrease in heart rate and blood pressure
a higher incidence of apnea with higher doses. There are also in two among 15 dogs. The bradycardia expected after the
studies, in which propofol was administered slowly for bolus administration of remifentanil or fentanyl not having
induction and no adverse effects associated with respiratory been observed was attributed to the use of atropine for
depression were reported 7,8,22. In this study, none of the preanesthesia. Heart rate was not recorded below 80 beats/
animals exhibited apnea after induction with propofol, which min during any of the procedures. It was determined that
may have resulted from slow IV administration and the dis- premedication with 0.05 mg/kg atropine was enough to
continuation of injections after a satisfactory depth of prevent remifentanil or fentanyl-induced bradycardia.
anesthesia was achieved for intubation 5,6,9,21.
Steagall et al. 16 administered atropine to ameliorate
Propofol is a negative inotrope and reduces systemic bradycardia, associated with a reduction in MAP, in other
vascular resistance, causing dose-dependent hypotension. words, atropine was not administered as a premedicant to
Marked decreases in systemic blood pressure were reported prevent opioid-induced cardiovascular side effects. In this
previously 3,27. Although the dose of propofol administered study, 3 dogs in the remifentanil group exhibited low MAP
was higher than in some studies, mean SAP, MAP and DAP (<60 mmHg) after bolus injections, but these values increased
after propofol administration were similar to those reported to the reference range of the anesthesia within five minutes.
A38
Comparison of Propofol-Remifentanil ...

During this period, atropine was not administered to any of opioid administration, and slight increases were recorded
the animals because bradycardia was not recorded and MAP immediately after the operation had begun in both groups.
increased spontaneously. It was thought that the reason As these increases were below 20% and no muscle tone
for the decrease in MAP in the remifentanil group could be contraction was felt, they were not considered clinically
related to the bolus injection. In previous studies, remifentanil important. It was suggested that the combination of propofol
was not administered as a bolus for induction, and this is with remifentanil or fentanyl in these dose ranges provided
the first research on the use of a bolus dose of remifentanil good anesthesia with small individual variations in SAP, DAP
for induction. and MAP.

There are discrepancies between studies. Some researchers In a recent study, a 0.3 µg/kg/min constant rate infusion
reported bradycardia and hypotension during remifentanil of remifentanil was administered in conjunction with a
or fentanyl infusions because of the stimulation of µ-opioid target-controlled infusion of propofol, which reduced the
receptors and the central vagotonic effect 7,17,30. On the required propofol dose by as much as 55% 9. In the present
contrary, some other researchers observed stabilized haemo- study, the administered doses of propofol and remifentanil
dynamic variables during remifentanil or fentanyl infusions were approximately twice as much as that administered in
resulting from no effect on myocardial contractility, no hista- the study by Beier et al.9, and SAP, DAP and MAP were lower
mine release and preserved arterial baroreflex integrity 5,9,12. than those reported in the recent study. It was considered
Hatschbach et al.17 used propofol and remifentanil during that blood pressures would have been higher if a lower
ovariohysterectomy operations in bitches. These researchers dose of propofol had been administered after remifentanil
reported slight decrease in blood pressure before the or fentanyl infusion.
operation and an increase in blood pressure during the
The arterial blood pressures were reduced after remi-
traction of the ovaries and uterus. Consequently, they reported
fentanil or fentanyl administration. The decrease in SAP
that 0.3 µg/kg/min remifentanil was not enough to eliminate
in the remifentanil group was clinically more pronounced
the surgical stimulus. In the same study, it was emphasized
than in the fentanyl group, and continued until the 40th
that hypotension could be observed after propofol adminis-
min. The reason for the decrease in SAP in the remifentanil
tration. However, in our study, neither bradycardia nor hypo-
group could be the administration of a bolus of 1 µg/kg
tension was observed after propofol administration. It was
remifentanil, as remifentanil infusion was administered
considered that the hypotension recorded by Hatschbach
without bolus injections in previous studies 8,9,18.
et al.17 prior to remifentanil administration may have arisen
from the hypotensive effect of methotrimeprazine, which Adequate anesthesia can be maintained using different
was used as a premedicant with propofol. The result of this doses of propofol and remifentanil 9,17. O’Hare et al.18
study is in agreement with the report of Gimenes et al.6, investigated the effects of different doses of propofol and
suggesting that 0.5 µg/kg/min remifentanil was enough remifentanil on recovery times in people. They reported
to eliminate surgical nociception. shorter recovery times when the maintenance of anesthesia
was achieved using a higher dose of remifentanil and lower
Grimm et al.31 reported slight decrease in SAP, DAP and
dose of propofol instead of a lower dose of remifentanil and
MAP after fentanyl administration alone within 60 min. higher dose of propofol. It was not aimed to demonstrate
Andreoni and Hughes 7 administered propofol and fentanyl a propofol-sparing effect of remifentanil or fentanyl, so the
with various operations in dogs. They administered atropine doses administered were not changed unless the depth of
immediately after fentanyl to counteract anticipated brady- anesthesia was too deep or unsatisfactory. The dogs could
cardia and made reductions in the rate of propofol infusions have recovered earlier if the dose of propofol was lower and
on the basis of the decrease in blood pressure Ethier et al.23 the dose of remifentanil was higher.
administered fentanyl and propofol during a 24-h period
without a surgical stimulation, and reported that the cardio- Mean times to return of spontaneous respiration, head
vascular variables were slightly lower than the reference lift and sternal position were similar to those reported in
values. Furthermore, Beier et al.9 compared propofol and other studies. Hughes and Nolan 2 administered propofol
propofol-remifentanil anesthesia and recorded a significant and fentanyl without surgery, and recorded the first
decrease in DAP and slight increase in SAP in the propofol- spontaneous respiration in 26±7 min and head lift in
remifentanil group. Murrell et al.8 administered propofol 59±12 min. In this study, although mean times to return of
and remifentanil and reported a biphasic increase in blood spontaneous respiration were similar to those reported by
pressure during surgery as the administration dose of propofol Hughes and Nolan 2, the mean time of head lift was shorter.
was altered according to the signs of the depth of anesthesia. The reason for a shorter period of head lift in this study
When the depth of anesthesia was found to be inadequate could be surgery, as in the study conducted by Hughes and
for surgery, especially during the traction of the ovaries, an Nolan 2, there was no surgery or painful procedures and
additional dose of propofol and/or remifentanil was given the dogs lay down for longer periods. Furthermore, Murrell
to the dogs. In the present study, in both groups, the lowest et al.8 administered propofol and remifentanil during
arterial pressures were recorded within 10 min after ovariohysterectomy and recorded the time to return of
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KÜRÜM, PEKCAN, KALENDER
KUMANDAŞ, CAN MUTAN, ELMA

spontaneous respiration as 11.1 min and head lift time as response in acepromazine premedicated dogs. Vet Anaesth Analg, 38, 54-
16.7 min. As higher doses of propofol and remifentanil 62, 2011.
were administered in the present study, mean times to 7. Andreoni V, Hughes JML: Propofol and fentanyl infusions in dogs of
various breeds undergoing surgery. Vet Anaesth Analg, 36, 523-531, 2009.
return of spontaneous respiration and head lift were longer
8. Murrell JC, Van Notten RW, Hellebrekers LJ: Clinical investigation of
than those reported in the previous study. When the two remifentanil and propofol for the total intravenous anesthesia of dogs. Vet
groups were compared, it was observed that the mean Rec, 156, 804-808, 2005.
times were longer in the fentanyl group than in the remifentanil 9. Beier SL, de Araujo Aguiar AJ, Vianna PT, Mattoso CR, Massone F: Effect
group. The differences between the two groups throughout of remifentanil on requirements for propofol administered by use of a target-
the recovery period can be explained by the cumulative effect controlled infusion system for maintaining anesthesia in dogs. Am J Vet
Res, 70, 703-709,2009.
of fentanyl 2, which extends the recovery period.
10. Lamont LA, Mathews KA: Opioids, non-steroidal anti-inflammatories,
Due to the rapid metabolism of fentanyl and remifentanil, and analgesic adjuvants. In, Tranquilli WJ, Thurmon JC, Grimm KA (Eds): Lumb
& Jones’Veterinary Anesthesia and Analgesia. 4th ed., pp. 241-271, Blackwell,
it is important to give an analgesic before the end of remi- Iowa, USA, 2007.
fentanil and fentanyl administration to ensure a gradual 11. Sano T, Nishimurai R, Kanazawa H, Igarashi E, Nagata Y, Mochizuki M,
transition of intraoperative to postoperative analgesia 8,15,20. Sasaki N: Pharmacokinetics of fentanyl after single intravenous injection
In the present study, carprofen and morphine were adminis- and constant rate infusion in dogs. Vet Anaesth Analg, 33, 266-273, 2005.
tered for postoperative analgesia prior to the end of remi- 12. Hoffman WE, Cunningham F, James MK, Baugman MD, Albrecht MD:
fentanil and fentanyl infusion. All dogs made an uneventful Effects of remifentanil, a new short-acting opioid, on cerebral blood flow,
brain electrical activity, and intracranial pressure in dogs anesthetized with
recovery, and none of the dogs showed signs of pain.
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As the semi-conscious period during recovery is a high- 13. Kabbaj M, Vachon P, Varin F: Impact of peripheral elimination on the
concentration-effect relationship of remifentanil in anaesthetized dogs.
risk period, it is important to select a short-acting anesthetic Br J Anaesth, 94, 357-365, 2005.
drug 8. With respect to the recovery period, remifentanil 14. Michelsen LG, Salmenpera M, Hug Jr CC, Fania S, VandeerMeer D:
could be preferred to fentanyl because of the rapid Anesthetic potency of remifentanil in dogs. Anesthesiology, 84, 865-872, 1996.
return of spontaneous respiration, consciousness and full 15. Allweiler S, Brodbelt DC, Borer K, Hammont RA, Alibhai HIK: The
awakening 5,8,17. isoflurane-sparing and clinical effects of a constant rate infusion of remifentanil
in dogs. Vet Anaest Analg, 34, 388-393, 2007.
The quality of anesthesia and analgesia was judged 16. Steagall PVM, Neto TFJ, Minto BW, Campagnol D, Correa MA: Evaluation
to be satisfactory and it was concluded that a constant of the isoflurane-sparing effects of lidocaine and fentanyl during surgery
rate infusion of propofol combined with remifentanil or in dogs. J Am Vet Med Assoc, 229, 522-527, 2006.
fentanyl was efficient for ovariohysterectomy in bitches. In 17. Hatschbach E, Silva FC, Beier SL, Lima FM, Massone F: Comparative
study between target-controlled infusion and continuous infusion anesthesia
conclusion, propofol with remifentanil or fentanyl provides
in dogs treated with methotrimeprazine and treated with propofol and
haemo-dynamic stability and a stable depth of anesthesia remifentanil. Acta Cir Bras, 23, 65-72, 2008.
with a constant rate of infusion during ovariohysterectomy 18. O’Hare RA, Mirakhur RK, Reid JE, Breslin DS, Hayes A: Recovery from
in dogs. Remifentanil could be preferred to fentanyl propofol anesthesia supplemented with remifentanil. Br J Anaesth, 86, 361-
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monitoring of heart rate, blood pressure and respiration is 19. Aiello SE: Non-steroidal antiinflamatory drugs. The Merk Veterinary Manual.
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agents/ nonsteroidal_anti-inflammatory_drugs.html. Accessed: 09.12.2012.
Further studies to optimize the dose ratios are considered
20. Pekcan Z, Koc B: The postoperative analgesic effects of epidurally
worthwhile. administered morphine and transdermal fentanyl patch after ovario-
hysterectomy in dogs. Vet Anaest Analg, 37, 557-565, 2010.
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