Objective To evaluate the sedative and analgesic effects of intramuscular buprenorphine with either dexmedetomidine or acepromazine, administered as premedication to cats and dogs undergoing elective surgery. Study design Prospective, randomized, blinded clinical study. Animals Forty dogs and 48 cats. Methods Animals were assigned to one of four groups, according to anaesthetic premedication and induction agent: buprenorphine 20gkg1 with either dexmedetomidine (dex) 250gm2 or acepromazine (acp) 0.03mgkg1, followed by alfaxalone (ALF) or propofol (PRO). Meloxicam was administered preoperatively to all animals and anaesthesia was always maintained using isoflurane. Physiological measures and assessments of pain, sedation and mechanical nociceptive threshold (MNT) were made before and after premedication, intraoperatively, and for up to 24hours after premedication. Data were analyzed with one-way, two-way and mixed between-within subjects anova, KruskallWallis analyses and Chi squared tests. Results were deemed significant if p0.05, except where multiple comparisons were performed (p0.005). Results Cats premedicated with dex were more sedated than cats premedicated with acp (p<0.001) and ALF doses were lower in dex cats (1.2 +/- 1.0mgkg1) than acp cats (2.5 +/- 1.9mgkg1) (p=0.041). There were no differences in sedation in dogs however PRO doses were lower in dex dogs (1.5 +/- 0.8mgkg1) compared to acp dogs (3.3 +/- 1.1mgkg1) (p<0.001). There were no differences between groups with respect to pain scores or MNT for cats or dogs. Conclusion Choice of dex or acp, when given with buprenorphine, caused minor, clinically detectable, differences in various characteristics of anaesthesia, but not in the level of analgesia. Clinical relevance A combination of buprenorphine with either acp or dex, followed by either PRO or ALF, and then isoflurane, accompanied by an NSAID, was suitable for anaesthesia in dogs and cats undergoing elective surgery. Choice of sedative agent may influence dose of anaesthetic induction agent.