Views on Alfaxan

Re: Views on Alfaxan

Siobhan Steven — Sun, 08 May 2011 08:59:24 GMT

I am lucky enough to have used Alfaxlone CD on hundreds of patients (literally) as we have had it in Australia for ages, I work at the Uni with one of the Professors who helped develop it. So a couple of tips, draw up the max dose in two syringes (2mg/kg), 1/2 in one and the other 1/2 in the other, as, with good pre med, chances are you will only need one of the syringes, if that. Keep the rest for your next patient...keep in mind it doesn't provide analgesia, if your patient lightens up you can give a 'smiggle' (not a technical term!) more, to stabilise again with IPPV, but you have to balance it with whether they were reacting to Sx stimulus, thus give more analgesia (I use methadone IV mostly). I have found that if there is too much used at induction and it is for a short procedure, say, follow up ortho rads, you do get dysphoria on rare occasions, I leave my catheters in and give some diazapam IV to calm the patient down, once the diazapam wears off so has the Alfaxalone and you have a very awake stable patient. Very rarely I have the odd patient who with a very titrated induction is still dysphoric, so can't be due to 'overdose', and I still give diazapam. I have worked with Docs who just bomb the patient with the max dose, that's when you get induction apnoea and will have to IPPV for 10mins before they breath for themselves, so better to titrate to effect, better economically as well. As far as Sevo is concerned, we have it but mostly still use Iso, I was at the WVC Conference in Las Vegas and went to a talk about volatile agents for GA, where the speaker discussed Sevo, I went up and asked him re advantages after the talk, and he pretty much said that the speed of reaction to changes in % are the main advantages, but don't outweigh the cost of new vaporisers etc. Its fairly marginal compared to Iso, of course you are going to always get people who sing its praises, but the golden rule of GA's is to stick with what you are the most comfortable and know best.He also said, as you may already know, if you are pre-empting any Sx stimulus or moving the patient, say, in a dental, to up the % for a few breathes prior to doing so to ensure the patient doesn't lighten up and have a see-saw GA.

Hope that helps.

Re: Views on Alfaxan

Gemma Harrison — Fri, 29 Apr 2011 13:41:04 GMT

We use Alfaxan and Sevo, and I absolutely love them both! I find the alnimal stays a lot warmer and comes round a lot smoother/quicker. It is also a lot quicker to change depth of anaesthesia.

The only problem we have is alfaxan/sevo with our cat dental pre med. It really knocks them out, so we end up using about 1/4-1/2 of the alfaxan dose.

Re: Views on Alfaxan

Susan Jackson — Wed, 27 Apr 2011 18:47:35 GMT

I also agree, not used it so much recently but seen some really good ga's with it. Cat castrations are great ones to use it on.

I would think that excitement on recovery may be due to pain and not enough pain relief given or given too late. Also poss not enough pre-med and pre-meds given s/c not im. Pre-med worn off if given too soon which might be issue.

Just check your protocols but on the whole like it.

Re: Views on Alfaxan

Steph Phillips — Wed, 27 Apr 2011 15:47:15 GMT

We use alfaxan & iso.. no problems that I know of.. although some dogs do salivate a bit on recovery!

With regards to the thrashing in kennels.. could they possibly be waking up too quickly?

Re: Views on Alfaxan

Katie Drew — Wed, 27 Apr 2011 09:38:31 GMT

We use Alfaxan and Sevo. Both are great, have not had any problems. We tend to give the alfaxan over a minute and that works well with regards to apnoea. Really good stuff.

Re: Views on Alfaxan

ginny — Tue, 26 Apr 2011 22:06:06 GMT

I really like alfaxan. Anyone who knows me knows I am a neurotic anaesthetist!

Prefer it even to thio now - which was my favourite over propofol in healthy animals.

Like the lower volume and have definately seen less post induction apnoea. We use the dose rate of 0.2ml/kg but find that its rare a patient needs the full drawn up dose.

Haven't seen any hypersalivation, excitability or vocalisation on recovery so far.

Haven't used sevo - too expensive.