{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T11:13:34Z","timestamp":1789038814297,"version":"build-2803163510"},"reference-count":34,"publisher":"American Veterinary Medical Association (AVMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ajvr"],"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:p><jats:bold>Objective<\/jats:bold>\u2014To evaluate the use of midazolam, ketamine, and xylazine for total IV anesthesia (TIVA) in horses.<\/jats:p>\n<jats:p><jats:bold>Animals<\/jats:bold>\u20146 healthy Thoroughbred mares.<\/jats:p>\n<jats:p><jats:bold>Procedures<\/jats:bold>\u2014Horses were sedated with xylazine (1.0 mg\/kg, IV). Anesthesia was induced with midazolam (0.1 mg\/kg, IV) followed by ketamine (2.2 mg\/kg, IV) and was maintained with an IV infusion of midazolam (0.002 mg\/kg\/min), ketamine (0.03 mg\/kg\/min), and xylazine (0.016 mg\/kg\/min). Horses underwent surgical manipulation and injection of the palmar digital nerves; duration of the infusion was 60 minutes. Additional ketamine (0.2 to 0.4 mg\/kg, IV) was administered if a horse moved its head or limbs during procedures. Cardiopulmonary and arterial blood variables were measured prior to anesthesia; at 10, 20, 30, 45, and 60 minutes during infusion; and 10 minutes after horses stood during recovery. Recovery quality was assessed by use of a numeric (1 to 10) scale with 1 as an optimal score.<\/jats:p>\n<jats:p><jats:bold>Results<\/jats:bold>\u2014Anesthesia was produced for 70 minutes after induction; supplemental ketamine administration was required in 4 horses. Heart rate, respiratory rate, arterial blood pressures, and cardiac output remained similar to preanesthetic values throughout TIVA. Arterial partial pressure of oxygen and oxygen saturation of arterial hemoglobin were significantly decreased from preanesthetic values throughout anesthesia; oxygen delivery was significantly decreased at 10- to 30-minute time points. Each horse stood on its first attempt, and median recovery score was 2.<\/jats:p>\n<jats:p><jats:bold>Conclusions and Clinical Relevance<\/jats:bold>\u2014Midazolam, ketamine, and xylazine in combination produced TIVA in horses. Further studies to investigate various dosages for midazolam and ketamine or the substitution of other \u03b1<jats:sub>2<\/jats:sub>-adrenoceptor for xylazine are warranted.<\/jats:p>","DOI":"10.2460\/ajvr.73.4.470","type":"journal-article","created":{"date-parts":[[2012,3,27]],"date-time":"2012-03-27T19:05:57Z","timestamp":1332875157000},"page":"470-475","source":"Crossref","is-referenced-by-count":26,"title":["Evaluation of a midazolam-ketamine-xylazine infusion for total intravenous anesthesia in horses"],"prefix":"10.2460","volume":"73","author":[{"given":"John A. 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cardiopulmonary effects and plasma concentrations in horses","volume":"41","author":"Hubbell","year":"1980"},{"key":"ref3","series-title":"Am J Vet Res","first-page":"2364","article-title":"Cardiopulmonary effects of continuous intravenous infusion of guaifenesin, ketamine, and xylazine in ponies","volume":"47","author":"Greene","year":"1986"},{"key":"ref4","series-title":"Equine Vet J","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1111\/j.2042-3306.1993.tb02919.x","article-title":"Clinical evaluation of an infusion of xylazine, guaifenesin and ketamine for maintenance of anaesthesia in horses","volume":"25","author":"Young","year":"1993"},{"key":"ref5","series-title":"Am J Vet Res","first-page":"1274","article-title":"Evaluation of xylazine, guaifenesin, and ketamine hydrochloride for restraint in horses","volume":"39","author":"Muir","year":"1978"},{"key":"ref6","series-title":"J Am Vet Med Assoc","first-page":"1646","article-title":"Prolongation of anesthesia with xylazine, ketamine, and guaifenesin in horses: 64 cases (1986\u20131989)","volume":"197","author":"McCarty","year":"1990"},{"key":"ref7","series-title":"Equine Vet J","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1111\/j.2042-3306.1998.tb04102.x","article-title":"Cardiovascular effects of surgical castration during anaesthesia maintained with halothane or infusion of detomidine, ketamine, and guaifenesin in ponies","volume":"30","author":"Taylor","year":"1998"},{"key":"ref8","series-title":"J Vet Med Sci","doi-asserted-by":"publisher","first-page":"229","DOI":"10.1292\/jvms.62.229","article-title":"Combination of continuous infusion using a mixture of guaifenesin-ketamine-medetomidine and sevoflurane anesthesia in horses","volume":"62","author":"Yamashita","year":"2000"},{"key":"ref9","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.2460\/ajvr.2002.63.1655","article-title":"Comparison of the cardiopulmonary effects of anesthesia maintained by continuous infusion of romifidine, guaifenesin, and ketamine with anesthesia maintained by inhalation of halothane in horses","volume":"63","author":"McMurphy","year":"2002"},{"key":"ref10","series-title":"Equine Vet J","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1111\/j.2042-3306.1978.tb02266.x","article-title":"An investigation of the action and haemolytic effect of glyceryl guaiacolate in the horse","volume":"10","author":"Schatzman","year":"1978"},{"key":"ref11","series-title":"J Am Vet Med Assoc","first-page":"619","article-title":"Evaluation of concentrated solutions of guaifenesin for equine anesthesia","volume":"176","author":"Grandy","year":"1980"},{"key":"ref12","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1111\/j.1532-950X.1992.tb00089.x","article-title":"Effects of 5% and 10% guaifenesin infusion on equine vascular endothelium","volume":"21","author":"Herschl","year":"1992"},{"key":"ref13","series-title":"The pharmacologic basis of therapeutics","first-page":"401","article-title":"Hypnotics and sedatives","author":"Charney","year":"2006"},{"key":"ref14","series-title":"Am J Vet Res","first-page":"1756","article-title":"Pharmacodynamic and pharmacokinetic properties of diazepam in horses","volume":"43","author":"Muir","year":"1982"},{"key":"ref15","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1111\/j.1532-950X.1990.tb01237.x","article-title":"A comparison of xylazine-diazepamketamine and xylazine-guaifenesin-ketamine in equine anesthesia","volume":"19","author":"Brock","year":"1990"},{"key":"ref16","series-title":"Am J Vet Res","first-page":"1472","article-title":"Physiologic effects of anesthesia induced and maintained by intravenous administration of a climazolam-ketamine combination in ponies premedicated with acepromazine and xylazine","volume":"57","author":"Bettschart-Wolfensberger","year":"1996"},{"key":"ref17","series-title":"Veterinary anesthesia and analgesia","first-page":"301","article-title":"Dissociative anesthetics","author":"Lin","year":"2007"},{"key":"ref18","series-title":"Am J Vet Res","first-page":"737","article-title":"Xylazine and tiletaminezolazepam anesthesia in horses","volume":"50","author":"Hubbell","year":"1989"},{"key":"ref19","series-title":"Am J Vet Res","first-page":"770","article-title":"Cardiorespiratory effects of a tiletamine\/zolazepam-ketamine-detomidine combination in horses","volume":"60","author":"Muir","year":"1999"},{"key":"ref20","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1111\/j.1532-950X.1992.tb00072.x","article-title":"Xylazine-ketamine and detomidine-tiletamine-zolazepam anesthesia in horses","volume":"21","author":"Wan","year":"1992"},{"key":"ref21","series-title":"Ars Veterinaria","first-page":"210","article-title":"Comparison of the sedative and antinociceptive effects of midazolam and diazepam in horses","volume":"18","author":"Zamur","year":"2002"},{"key":"ref22","series-title":"Vet Rec","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1136\/vr.149.5.147","article-title":"Comparison of thiopentone\/guaifenesin, ketamine\/guaifenesin and ketamine\/midazolam for the induction of horses to be anesthetized with isoflurane","volume":"149","author":"Gangl","year":"2001"},{"key":"ref23","series-title":"J Vet Med Sci","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1292\/jvms.69.7","article-title":"Anesthetic and cardiopulmonary effects of total intravenous anesthesia using a midazolam, ketamine and medetomidine drug combination in horses","volume":"69","author":"Yamashita","year":"2007"},{"key":"ref24","series-title":"Pferdeheikunde","first-page":"388","article-title":"Combined anesthesia with isoflurane and an infusion of a mixture of ketamine, midazolam and one of three alpha2 agonists for castration in horses","volume":"23","author":"Mosing","year":"2007"},{"key":"ref25","series-title":"J Vet Med Sci","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1292\/jvms.67.379","article-title":"Anesthetic and cardiovascular effects of balanced anesthesia using constant rate infusion of midazolam-ketamine-medetomidine with inhalation of oxygen-sevoflurane (MKM-OS anesthesia) in horses","volume":"67","author":"Kushiro","year":"2005"},{"key":"ref26","series-title":"Anaesthesist","first-page":"62","article-title":"Chemical compatibility of ketamine and midazolam in infusion solutions [in German]","volume":"39","author":"Lechner","year":"1990"},{"key":"ref27","series-title":"Vet Surg","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1111\/j.1532-950X.1992.tb00058.x","article-title":"Hemodynamic function during neurectomy in halothane-anesthetized horses with or without constant dose detomidine infusion","volume":"21","author":"Wagner","year":"1992"},{"key":"ref28","series-title":"Handbook of equine anesthesia","first-page":"33","article-title":"Clarke KW. Intravenous anesthesia","author":"Taylor","year":"1999"},{"key":"ref29","series-title":"J Am Vet Med Assoc","first-page":"216","article-title":"Effects of preanesthetic medication, anesthesia, and position of recumbency on central venous pressure in horses","volume":"170","author":"Klein","year":"1977"},{"key":"ref30","series-title":"Am J Vet Res","first-page":"1518","article-title":"Hemodynamic and respiratory effects of a xylazine-acetylpromazine drug combination in horses","volume":"40","author":"Muir","year":"1979"},{"key":"ref31","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1111\/j.1467-2995.2005.00199.x","article-title":"High inspired oxygen concentrations increase intrapulmonary shunt in anaesthetized horses","volume":"32","author":"Marntell","year":"2005"},{"key":"ref32","series-title":"Vet Anaesth Analg","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1046\/j.1467-2987.2001.00046.x","article-title":"Intravenous anaesthesia using detomidine, ketamine, and guaiphenesin for laparotomy in pregnant pony mares","volume":"28","author":"Taylor","year":"2001"},{"key":"ref33","series-title":"Equine anesthesia monitoring and emergency therapy","first-page":"334","article-title":"Oxygen supplementation and ventilatory support","author":"Kerr","year":"2009"},{"key":"ref34","series-title":"Am J Vet Res","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.2460\/ajvr.2002.63.1061","article-title":"Effect of general anesthesia and minor surgical trauma on urine and serum measurements in horses","volume":"63","author":"Watson","year":"2002"}],"container-title":["American Journal of Veterinary Research"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/73\/4\/ajvr.73.4.470.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/73\/4\/ajvr.73.4.470.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/downloadpdf\/journals\/ajvr\/73\/4\/ajvr.73.4.470.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,7]],"date-time":"2025-03-07T12:29:21Z","timestamp":1741350561000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/ajvr\/73\/4\/ajvr.73.4.470.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,4]]},"references-count":34,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.2460\/ajvr.73.4.470","relation":{},"ISSN":["0002-9645"],"issn-type":[{"value":"0002-9645","type":"print"}],"subject":[],"published":{"date-parts":[[2012,4]]}}}