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  Discussion on Research Summary: Sedation influences laryngeal function
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DrO

Posted on Monday, Feb 18, 2008 - 7:51 am:

Horses may not tolerate the passage of the endoscope through the nasal passages requiring sedation for examination of Roaring. Sedation prior to examination for laryngeal hemiplegia is a often studied phenomena and still there has not been agreement of whether it effects the results of the test with somewhat conflicting results. This study demonstrates that sedation effects laryngeal abduction and suggests that horses that display hemiplegia only during sedation may be in an early stage of the disease.
DrO

Equine Vet J. 2007 Nov;39(6):553-6.
Sedation with detomidine and acepromazine influences the endoscopic evaluation of laryngeal function in horses.

Lindegaard C, Husted L, Ullum H, Fjeldberg J.
University of Copenhagen, Faculty of Life Sciences, Department of Large Animal Sciences, Dyrlaegevej 48, DK-1870 Frederiksberg C, Denmark.

REASON FOR PERFORMING STUDY: Endoscopy of the upper airways of horses is used as a diagnostic tool and at purchase examinations. On some occasions it is necessary to use sedation during the procedure and it is often speculated that the result of the examination might be influenced due to the muscle-relaxing properties of the most commonly used sedatives. OBJECTIVES: To evaluate the effect of detomidine (0.01 mg/kg bw) and acepromazine (0.05 mg/kg bw) on the appearance of symmetry of rima glottidis, ability to abduct maximally the arytenoid cartilages and the effect on recurrent laryngeal neuropathy (RLN) grade. METHODS: Forty-two apparently normal horses underwent endoscopic examination of the upper airways on 3 different occasions, under the influence of 3 different treatments: no sedation (control), sedation with detomidine and sedation with acepromazine. All examinations were performed with a minimum of one week apart. The study was performed as an observer-blind cross-over study. RESULTS: Sedation with detomidine had a significant effect on the RLN grading (OR = 2.91) and ability maximally to abduct the left arytenoid cartilages (OR = 2.91). Sedation with acepromazine resulted in OR = 2.43 for the RLN grading and OR = 2.22 for the ability to abduct maximally. The ability to abduct maximally the right arytenoid cartilage was not altered. CONCLUSIONS: Sedating apparently healthy horses with detomidine or acepromazine significantly impairs these horses' ability to abduct fully the left but not the right arytenoid cartilage. This resulted in different diagnosis with respect to RLN when comparing sedation to no sedation. POTENTIAL RELEVANCE: Since the ability to abduct the right arytenoid cartilage fully is not altered by sedation, it is speculated that horses changing from normal to abnormal laryngeal function when sedated, might be horses in an early stage of the disease. To confirm or reject these speculations, further studies are needed. Until then sedation during endoscopy should be used with care.
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