2025 – NR 1 RAID – 7 PHENYLEPHRINE In a prospective study in horses (Lukasik et al., 1997) phenylephrine was given intranasally to anesthetized horses in dorsal recumbency approximately 30 minutes prior to the end of the procedure. Its vasoconstrictive effect reduces swelling in the upper airways and the effect lasts for about one hour (Lukasik et al., 1997). In the study, 5 ml of 0,15% phenylephrine was given in each nostril. This dose was calculated for a 500 kg horse, which means that the dose would have to be reduced for smaller horses and foals due to the risk of hypertension. Hypertension is one adverse effect that may occur. For that reason, the horses were monitored every five minutes before and after administration, and neither heart rate or blood pressure changed from baseline over time for the horses that received phenylephrine compared to placebo. The result showed that of the horses that received phenylephrine, only two horses (10%) required placement of a nasal tube in the recovery, whilst 12 horses (60%) from the control group required a nasal tube. The two horses from the phenylephrine group who required a nasal tube received phenylephrine 46 respectively 54 minutes prior to extubation, which may have been too early, since the positive effect might had diminished by the time of extubation (Lukasik et al. 1997). Phenylephrine is not used at the hospital today, but it will be included in the intervention. Since the study by Lukasik et al. (1997) indicated that two horses received phenylephrine too early, one may suggest that horses at this hospital are administered phenylephrine 15 minutes prior to the end of surgery. It should not be given to individuals that are hypovolemic or hypertensive due to the risk of hypertension. The cost of phenylephrine is £14 per bottle (10 mg), if approximately 15 mg are used for an adult patient it will be £21 extra per patient. A 12 ml syringe (8p) is also needed, as well as a 20G needle (2p), a pair of non- sterile gloves (16p) and a dog urinary catheter (76p). In total, this will cost £22. These costs, in comparison to the costs of potential complications that may occur, like pneumonia, are very small.
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