Anesthesia using diazepam and propofol caused the least disturbance of heart rate variability, while ketamine significantly increased the standard deviation of regular sinus beats compared to other protocols (p=0.015).
RCT (n=24)
Blinded assessment
Randomly assigned
No
Does the choice of anesthetic protocol affect heart rate variability and echocardiography parameters in healthy cats?
In healthy cats undergoing elective surgery, an anesthetic protocol of diazepam and propofol causes the least disturbance to heart rate variability compared to alfaxalone, ketamine, or xylazine/tiletamine/zolazepam.
p-value: p=0.015
Heart rate variability (HRV) is one of the assessments of cardiovascular risk during general anesthesia. This study aimed to assess the effects of an anesthetic drug on HRV in cats and to provide information for clinical applications. Twenty-four healthy client-owned cats of various breeds, 12 females and 12 males scheduled for elective surgery, were enrolled in this study. The cats were premedicated and induced with 4 protocols: protocol 1, diazepam (0.3 mg/kg) and propofol (2-4 mg/kg) IV; protocol 2, diazepam (0.3 mg/kg) and alfaxalone (1-3 mg/kg) IV; protocol 3, diazepam (0.3 mg/kg) and ketamine (3-5 mg/kg) IV; and protocol 4, xylazine (1 mg/kg) and tiletamine/zolazepam (Zoletil) (5 mg/kg) IM. The heart rate and HRV of the 24 cats were collected before and at least 1 h after administering the anesthetic drugs. Echocardiography was performed to evaluate heart function. Oscillometric blood pressure monitoring was used to obtain the mean blood pressure. After anesthetic drug administration, higher heart rates were found in cats premedicated and induced with alfaxalone (p = 0.045) than in the other protocols. The lowest heart rate (HR) values were found in cats in protocol 4 using xylazine and Zoletil. The HRV low frequency (LF) and high frequency (HF) power ratios increased in all protocols except for cats premedicated and intubated with propofol. The standard deviation of the regular sinus beats (SDNN) was higher in cats premedicated and induced with ketamine than in other anesthetic protocols (p = 0.015). An increase in sympathetic activity and reduced HRV is associated with high blood pressure and left atrial dimension. The percentage of fractional shortening (FS) decreased in cats premedicated with ketamine. The results showed that the anesthesia method using diazepam and propofol caused the least disturbance of HRV compared with other anesthesia methods that were used in this study.
Panprom et al. (2024) conducted an RCT in Healthy cats scheduled for elective surgery (n=24). Diazepam and ketamine vs. Other anesthetic protocols (propofol, alfaxalone, or xylazine/tiletamine-zolazepam) was evaluated on Standard deviation of the regular sinus beats (SDNN) (p=0.015). Anesthesia using diazepam and propofol caused the least disturbance of heart rate variability, while ketamine significantly increased the standard deviation of regular sinus beats compared to other protocols (p=0.015).