Randomized clinical trial of the effects of a combination of acepromazine with morphine and midazolam on sedation, cardiovascular variables and the propofol dose requirements for induction of anesthesia in dogs

The present study evaluated the effects of acepromazine combined with midazolam and morphine on sedation and cardiovascular variables as well as the propofol dose required for induction of anesthesia in dogs compared with acepromazine–morphine or midazolam–morphine. Dogs were randomly assigned to receive an intramuscular administration of (1) acepromazine (0.05 mg/kg) with 0.5 mg/kg of morphine (group AM, n = 10), (2) midazolam (0.5 mg/kg) with 0.5 mg/kg of morphine (group MM, n = 9), or (3) acepromazine with midazolam and morphine at the same doses (group AMM, n = 10). After 30 min, sedation was assessed by a numeric descriptive scale (NDS, range 0–3) and a simple numerical scale (SNS, range 0–10). Dogs were then administered IV propofol to allow endotracheal intubation.NDS and SNS scores were significantly higher in the AMM than in the MM group (P < 0.05). There was a trend towards more dogs presenting with intense sedation (NDS = 3) in AMM (6/10 dogs) compared with AM (1/10 dogs) and MM (1/9 dogs) (P = 0.057). The propofol dose required for induction of anesthesia was significantly lower in AMM (4.0 mg/kg) compared with MM (6.0 mg/kg, P < 0.01) but not AM (4.6 mg/kg). Heart rate decreased in AM after treatment and after intubation. Blood pressure decreased in groups AM and AMM following treatment and in all groups after intubation. The combination AMM resulted in intense sedation more frequently than AM and MM, and provided the greatest sparing effect in the propofol dose. Administration of AM and AMM but not MM decreased blood pressure although hypotension was not recorded in healthy dogs.