Abstract
Objective
To compare the effects of intravenous (IV) lidocaine and fentanyl on the cough reflex
and autonomic response during endotracheal intubation in dogs.
Study design
Randomized, blinded, superiority clinical trial.
Animals
A total of 46 client-owned dogs undergoing magnetic resonance imaging.
Methods
After intramuscular methadone (0.2 mg kg–1), dogs were randomized to be administered either IV lidocaine (2 mg kg–1; group L) or fentanyl (7 μg kg–1; group F). After 5 minutes, alfaxalone was administered until endotracheal intubation
was possible (1 mg kg–1 IV over 40 seconds followed by 0.4 mg kg–1 increments to effect). Total dose of alfaxalone was recorded and cough reflex at
endotracheal intubation was scored. Heart rate (HR) was continuously recorded, Doppler
systolic arterial blood pressure (SAP) was measured every 20 seconds. Vasovagal tonus
index (VVTI) and changes (Δ) in HR, SAP and VVTI between pre-intubation and intubation
were calculated. Groups were compared using univariate and multivariate analysis.
Statistical significance was set as p < 0.05.
Results
Group F included 22 dogs and group L 24 dogs. The mean (± standard deviation) alfaxalone
dose was 1.1 (± 0.2) and 1.35 (± 0.3) mg kg–1 in groups F and L, respectively (p = 0.0008). At intubation, cough was more likely in group L (odds ratio = 11.3; 95%
confidence intervals, 2.1 – 94.2; p = 0.01) and HR increased in 87.5% and 54.5% of groups L and F, respectively (p = 0.02). The median (range) ΔHR between pre-intubation and intubation was higher
(13.1%; – 4.3 to + 55.1) in group L (p = 0.0021). Between groups, SAP and VVTI were similar.
Conclusion and clinical relevance
At the stated doses, whilst reducing the alfaxalone dose, fentanyl is superior to
lidocaine in suppressing the cough reflex and blunting the increase in HR at endotracheal
intubation in dogs premedicated with methadone.
Keywords
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Article info
Publication history
Published online: April 21, 2020
Accepted:
November 11,
2019
Received:
July 19,
2019
Identification
Copyright
© 2020 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.
