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The effect of anesthetic induction with propofol, alfaxalone or ketamine on intraocular pressure in cats: a randomized masked clinical investigation

  • Yael Shilo-Benjamini
    Correspondence
    Corresponding author.Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, POB 12, Rehovot 7610001, Israel
    Affiliations
    Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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  • Oren Pe’er
    Affiliations
    Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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  • Wiessam Abu Ahmad
    Affiliations
    Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
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  • Ron Ofri
    Affiliations
    Koret School of Veterinary Medicine, The Robert H Smith Faculty of Agriculture, Food and Environment, The Hebrew University of Jerusalem, Rehovot, Israel
    Search for articles by this author
Published:November 18, 2022DOI:https://doi.org/10.1016/j.vaa.2022.11.005

      Abstract

      Objective

      To compare the effect of propofol, alfaxalone and ketamine on intraocular pressure (IOP) in cats.

      Study design

      Prospective, masked, randomized clinical trial.

      Animals

      A total of 43 ophthalmologically-normal cats scheduled to undergo general anesthesia for various procedures.

      Methods

      Following baseline IOP measurements using applanation tonometry, anesthesia was induced with propofol (n = 15), alfaxalone (n = 14) or ketamine (n = 14) administered intravenously to effect. Then, midazolam (0.3 mg kg−1) was administered intravenously and endotracheal intubation was performed without application of topical anesthesia. The IOP was measured following each intervention. Data was analyzed using one-way anova and repeated measures mixed design with post hoc analysis. p-value < 0.05 was considered significant.

      Results

      Mean ± standard error IOP at baseline was not different among groups (propofol 18 ± 0.6, alfaxalone 18 ± 0.7, ketamine 17 ± 0.5 mmHg). Following induction of anesthesia, IOP increased significantly compared with baseline in the propofol (20 ± 0.7 mmHg), but not in the alfaxalone (19 ± 0.8 mmHg) or ketamine (16 ± 0.7 mmHg) groups. Midazolam administration resulted in significant decrease from the previous measurement in the alfaxalone group (16 ± 0.7 mmHg), but not in the propofol (19 ± 0.7 mmHg) or the ketamine (16 ± 0.8 mmHg) groups. A further decrease was measured after intubation in the alfaxalone group (15 ± 0.9 mmHg).

      Conclusions and clinical relevance

      Propofol should be used with caution in cats predisposed to perforation or glaucoma, as any increase in IOP should be avoided.

      Keywords

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