Anesthesia with Ketamine, Propofol and its Combination in Bali Pigs

Pigs are often used as animal models of surgery for humans, especially surgery on the abdominal cavity. In Bali in early 2020 there were many deaths in pigs which were thought to be caused by African Swine Fever (ASF) vision. Death is very common among foreign breed pigs, while the black Bali pigs is stronger and is now being kept by many breeders. The need for pigs for surgical models of animals in humans is increasing, including Bali pigs, which are germplasm which are decreasing in population. Due to the large number of deaths in foreign breed pigs, now many breeders are switching to raising Balinese pigs, which have a stronger body resistance to disease.

Surgery can not be done if anesthesia has not been carried out, then anesthesia is a very important step in surgery. Anesthesia carries a much greater risk than surgical procedures because the life of the anesthetized patient can be threatened. For this reason, the selection of an ideal anesthetic agent is needed to produce analgesia, sedation, relaxation, safety and comfort for the body's vital systems, economical and easy to apply. Until now, there is no anesthetic that meets these ideal criteria

General anesthetic injection and inhalation in pigs has several disadvantages such as hypersalivation, limited peripheral blood vessels, the anatomical shape of the larynx which makes tracheal intubation difficult, and tends to cause laryngospasm. Bali pigs are also difficult to control, so intravenous injections are difficult. With the difficulties mentioned above, the method of anesthesia by giving premedication of anesthesia intramuscularly and 20 minutes later intravenous anesthesia is one of the anesthetic options. Intramuscular anesthetic premedication compound that is often used in pigs is xylazine. Administration of general anesthesia must have a fast induction time and a small volume of administration so that gift anesthesia can be quickly administered. The character of the rapid onset of action of the drug must also have a wide safety margin, provide an immediate hypnotic effect, as well as strong analgesia.

The use of pigs as surgical models, especially for laparoscopic surgery, is growing at this time and has been used in various countries, including Indonesia. Pigs including Balinese pigs are ideal animal models for various training in laparoscopic surgical techniques because the anatomy of pigs in general has similarities with anatomy in humans. Training with pigs as models can refine surgical technique and increase surgical efficiency and expertise. Until now, research on ketamine and propofol anesthesia in Balinese pigs has not been widely reported, including how the physiological response is elicited during anesthesia.

The results of the study on Balinese pigs showed that anesthesia with ketamine at a dose of 4 mg/kg BW intravenously with premedication of xylazine 2 mg/kg BW intramuscularly was well anesthetized even though the duration of anesthesia was quite short but sufficient for tracheal intubation to maintain anesthesia. . Anesthesia with propofol at a dose of 1.5 mg/kg BW intravenously with xylazine premedication at a dose of 2 mg/kg BW intramuscularly has been able to induce anesthesia in Balinese pigs with a longer duration of action than ketamine anesthesia. Meanwhile, the combination of ketamine at a dose of 2 mg/kg BW and propofol 0.75 mg/kg BW intravenously produced the longest anesthetic action compared to when given alone. Anesthesia with ketamine, propofol and their combination showed a pattern of changes in heart rate, respiration, CRT, and oxygen saturation in Balinese pigs which are not so extreme, this proves that ketamine, propofol and their combination at the above doses do not have a significant effect on the cardiovascular and respiratory systems. The occurrence of a decrease in heart rate, respiration, and oxygen saturation occurred in all anesthetics, in addition to the anesthetic agent used, also due to the effect of xylazine premedication, but will lead to normal as the pigs recover consciousness. Xylazine is classified as a muscle relaxant which causes relaxation of the muscles between the ribs and abdomen which can inflate and deflate the chest cavity during respiration so that it affects the frequency of respiration and heart rate during anesthesia. Propofol and its combination at the above doses did not cause a significant effect on the cardiovascular and respiratory systems. A decrease in heart rate, respiration, and oxygen saturation occurred in all anesthetics, in addition to the anesthetic agent used, also due to the effect of xylazine premedication, but will return to normal along with the recovery of consciousness in pigs. Xylazine is classified as a muscle relaxant which causes relaxation of the muscles between the ribs and abdomen which can inflate and deflate the chest cavity during respiration so that it affects the frequency of respiration and heart rate during anesthesia. Propofol and its combination at the above doses did not cause a significant effect on the cardiovascular and respiratory systems. A decrease in heart rate, respiration, and oxygen saturation occurred in all anesthetics, in addition to the anesthetic agent used, also due to the effect of xylazine premedication, but will return to normal along with the recovery of consciousness in pigs. Xylazine is classified as a muscle relaxant which causes relaxation of the muscles between the ribs and abdomen which can inflate and deflate the chest cavity during respiration so that it affects the frequency of respiration and heart rate during anesthesia. and oxygen saturation occurred in all anesthetics, in addition to the anesthetic agent used, it was also due to the effect of xylazine premedication but would return to normal along with the recovery of consciousness in pigs. Xylazine is classified as a muscle relaxant which causes relaxation of the muscles between the ribs and abdomen which can inflate and deflate the chest cavity during respiration so that it affects the frequency of respiration and heart rate during anesthesia. and oxygen saturation occurred in all anesthetics, in addition to the anesthetic agent used, it was also due to the effect of xylazine premedication but would return to normal along with the recovery of consciousness in pigs. Xylazine is classified as a muscle relaxant which causes relaxation of the muscles between the ribs and abdomen which can inflate and deflate the chest cavity during respiration so that it affects the frequency of respiration and heart rate during anesthesia.

            Temperature changethe body with propofol showed a slightly sharper reduction than ketamine or ketamine-propofol. The decrease in temperature occurred in the three treatments, because in the anesthetized state the body's metabolic rate will decrease so that the body's energy formation process that produces heat will also decrease. The use of xylazine premedication also causes a decrease in body metabolism, muscle relaxation and depression of the central nervous system and causes a longer suppression of thermoregulation so that it also affects the decrease in body temperature. There were no extreme changes in the body's physiological response in Balinese pigs under anesthesia with ketamine, propofol and the combination of ketamine-propofol (ketafol) during anaesthesia. This shows that Bali pigs are very tolerant of ketamine anesthetics. propofol or a combination of ketamine and propofol. There were no extreme changes during anesthesia in Balinese pigs such as hypersalivation, bloat, seizures or post-anesthesia death. Meanwhile, in Bali cattle anesthetized with ketamine and propofol, bloat and hyperslivation often occur.

            For surgery that takes a long time, of course, it is necessary to maintain gas anesthesia such as isoflurane. The use of gas anesthesia is less practical and uneconomical for field surgery on large animals because they have to use an anesthetic and oxygen machine which is very expensive. Another alternative is the use of the gravimetric method of anesthesia through infusion drops at a certain speed to maintain the anesthetic state. However, not all anesthetic agents can be used for infusion drops, so research on the gravimetric method with ketamine, propofol and ketamine-propofol anesthesia is needed to obtain the ideal anesthetic effect. as an alternative to general inhalation anesthesia in Balinese pigs.