Propofol and fentanyl infusions in dogs of various breeds undergoing surgery

ObjectiveTo report the cardiovascular variables, anaesthetic effects and recovery quality of an anaesthesia technique using variable rate infusion propofol combined with constant rate infusion fentanyl in dogs undergoing elective surgery.Study designProspective clinical trial.AnimalsA total of 27 dogs, aged 2.7 ± 2.65 years and weighing 24 ± 11 kg.MethodsFollowing intramuscular acepromazine (0.03 or 0.05 mg kg^?1) and subcutaneous carprofen (4 mg kg^?1) pre-medication, anaesthesia was induced with propofol (4.0 ± 0.5 mg kg^?1) intravenously (IV). All dogs were ventilated with 100% oxygen to maintain normocapnia. Propofol was infused at 0.4 mg kg^?1 minute^?1 for 20 minutes and then at 0.3 mg kg^?1minute^?1. If mean arterial blood pressure (MAP) decreased below 70 mmHg, propofol infusion was reduced by 0.1 mg kg^?1 minute^?1. Five minutes after induction of anaesthesia, fentanyl was administered (2 μg kg^?1) IV followed by the infusion at 0.5 μg kg^?1 minute^?1 and atropine (40 μg kg^?1) IV. Heart rate, MAP, respiratory rate, tidal volume, end-tidal carbon dioxide, presence of reflexes, movements and recovery times and quality were recorded.ResultsMean anaesthetic duration was 131 ± 38.5 minutes. Mean heart rate peaked 10 minutes after atropine injection and gradually declined, reaching pre-anaesthetic values at 55 minutes. MAP easily was maintained above 70 mmHg. Mean times to return of spontaneous ventilation, extubation, head lift and sternal recumbency were 21 ± 10.1, 33 ± 14.6, 43 ± 19.7 and 65 ± 23.4 minutes, respectively. Recovery was smooth and quiet. The time to sternal recumbency was significantly correlated with the duration of anaesthesia and total dose of propofol; time to extubation was correlated to total dose of propofol.Conclusion and clinical relevancePropofol and fentanyl infusions provided stable cardiovascular function and satisfactory conditions for surgery. Some modifications of infusion rates are required to improve the long-recovery times.     

A clinical study on the effect in horses during medetomidine-isoflurane anaesthesia, of butorphanol constant rate infusion on isoflurane requirements, on cardiopulmonary function and on recovery characteristics

ObjectiveTo test if the addition of butorphanol by constant rate infusion (CRI) to medetomidine–isoflurane anaesthesia reduced isoflurane requirements, and influenced cardiopulmonary function and/or recovery characteristics.Study designProspective blinded randomised clinical trial.Animals61 horses undergoing elective surgery.MethodsHorses were sedated with intravenous (IV) medetomidine (7 μg kg^?1); anaesthesia was induced with IV ketamine (2.2 mg kg^?1) and diazepam (0.02 mg kg^?1) and maintained with isoflurane and a CRI of medetomidine (3.5 μg kg^?1 hour^?1). Group MB (n = 31) received butorphanol CRI (25 μg kg^?1 IV bolus then 25 μg kg^?1 hour^?1); Group M (n = 30) an equal volume of saline. Artificial ventilation maintained end-tidal CO₂ in the normal range. Horses received lactated Ringer’s solution 5 mL kg^?1 hour^?1, dobutamine <1.25 μg kg^?1 minute^?1 and colloids if required. Inspired and exhaled gases, heart rate and mean arterial blood pressure (MAP) were monitored continuously; pH and arterial blood gases were measured every 30 minutes. Recovery was timed and scored. Data were analyzed using two way repeated measures anova, independent t-tests or Mann–Whitney Rank Sum test (p < 0.05).ResultsThere was no difference between groups with respect to anaesthesia duration, end-tidal isoflurane (MB: mean 1.06 ± SD 0.11, M: 1.05 ± 0.1%), MAP (MB: 88 ± 9, M: 87 ± 7 mmHg), heart rate (MB: 33 ± 6, M: 35 ± 8 beats minute^?1), pH, PaO₂ (MB: 19.2 ± 6.6, M: 18.2 ± 6.6 kPa) or PaCO_2. Recovery times and quality did not differ between groups, but the time to extubation was significantly longer in group MB (26.9 ± 10.9 minutes) than in group M (20.4 ± 9.4 minutes).Conclusion and clinical relevanceButorphanol CRI at the dose used does not decrease isoflurane requirements in horses anaesthetised with medetomidine–isoflurane and has no influence on cardiopulmonary function or recovery.     

Comparison between S(+) ketamine–diazepam and S(+) ketamine–midazolam on anesthetic induction and recovery in dogs

S(+) ketamine, one of the two enantiomers of racemic ketamine, is a phencyclidine derivative that induces amnesia and analgesia. Its activity is related to blockade of NMDA receptors and some opioid action. We compared anesthetic induction and recovery quality with S(+) ketamine in combination with diazepam or midazolam in 10 dogs (ASA 1) admitted for elective surgery. After all clinical examinations, the dogs were separated into two groups (G I and G II). All animals received acepromazine (0.1 mg kg^?1) and fentanyl (5 µg kg^?1) IM, 20 minutes before induction with S(+) ketamine (6 mg kg^?1) and diazepam (0.5 mg kg^?1) IV (G I) or midazolam 0.2 mg kg^?1 (G II) IV. The doses of diazepam and midazolam were chosen according to the literature. All dogs were intubated and then maintained with halothane in oxygen at a vaporizer setting sufficient to maintain surgical anesthesia. Quality of induction, time needed for intubation, heart rate, respiratory rate, SpO₂, time to extubation, and quality of recovery were evaluated. The results were analyzed by Student's t‐test. Smooth induction and recovery were observed in all animals. The time to intubation was 45 ± 20 (GI) and 25 ± 6 seconds (GII), HR was 122 ± 12 (GI) and 125 ± 7 beats minute^?1 (GII), RR was 17 ± 2 (GI) and 21 ± 3 breaths minute^?1 (GII), SpO₂ was 96 ± 2 (GI) and 94 ± 1% (GII), time to extubation was 7 ± 3 (GI) and 4 ± 1 minutes (GII). No statistical differences were found in analyses, although time to intubation was less in GII. The results suggested that both combinations could be used safely for anesthetic induction in healthy dogs.     

Quantitative characteristics of anesthetic induction with and recovery from isoflurane and sevoflurane in cats

Isoflurane (ISO) is the most commonly administered feline inhalant anesthetic in North America. A newer agent, sevoflurane (SEVO), may provide faster induction and recovery from anesthesia based on its physical characteristics. Accordingly, we compared some induction and recovery characteristics of ISO and SEVO in healthy cats. Six female DSH cats (17.9 ± 9.0 (mean ± SD) months, 3.7 ± 0.3 kg) received four randomly assigned treatments: ISO for 1 hour (IS), SEVO for 1 hour (SS), ISO for 5 hours (IL), and SEVO for 5 hours (SL). Anesthesia was induced in a chamber into which ISO or SEVO was delivered at 2.7 times the individual's MAC (determined previously) in 6 L minute^?1 O₂. Measured (Rascal II, Ohmeda) anesthetic concentration was reported after correction using a multiple gas, standard‐defined calibration curve. For induction, time (seconds) from introduction of inhalant to onset of incoordinated movement (IM), recumbency with movement (RM), recumbency without movement, loss of pedal reflex (PD), and intubation (ET) were recorded. Following intubation, anesthesia was maintained for the required time at 1.25 times the individual's MAC. For recovery, time (seconds) from discontinuation of the inhalant (with continuation of O₂) to first movement, extubation (EXT), start of incoordinated movement, head‐lift, sternal recumbency (SR), crawl, stand/walk with incoordination, and jump without incoordination were recorded. Esophageal normothermia was maintained. Data were analyzed by paired t‐test (induction) or One‐way Repeated Measures anova followed, when appropriate, by Tukey's test (recovery). p < 0.05 was regarded as significant. For induction, IM was not significantly different between ISO and SEVO (118 ± 28 seconds vs. 104 ± 28 seconds). All other induction times were significantly shorter with SEVO vs. ISO, e.g. RM (181 ± 31 seconds vs. 213 ± 31 seconds), PD (426 ± 68 seconds vs. 504 ± 70 seconds), and ET (434 ± 66 seconds vs. 515 ± 69 seconds). For recovery, there were no differences between ISO and SEVO for any stage of recovery, e.g. EXT (IS 588 ± 163 seconds vs. SS 425 ± 109 seconds), SR (IS 735 ± 215 seconds vs. SS 655 ± 337 seconds), and IL (710 ± 658 seconds vs. SL 807 ± 465 seconds). We concluded that quantitative recovery characteristics did not depend on whether cats are anesthetized with equipotent amounts of SEVO or ISO, but some induction end‐points were reached more quickly with SEVO.     

The isoflurane sparing effect of a medetomidine constant rate infusion in horses

This clinical study analysed the anaesthetic sparing effect of a medetomidine constant rate infusion (CRI) during isoflurane anaesthesia in horses. Forty healthy horses undergoing different types of orthopaedic and soft tissue surgeries were studied in a randomized trial. Orthopaedic surgeries were primarily arthroscopies and splint bone extractions. Soft tissue surgeries were principally castrations with one ovariectomy. All horses received 0.03 mg kg^?1 acepromazine IM 1 hour prior to sedation. Group A (11 orthopaedic and nine soft tissue surgeries), was sedated with 1.1 mg kg^?1 xylazine IV, group B (13 orthopaedic and seven soft tissue surgeries) with 7 µg kg^?1 medetomidine IV. Anaesthesia was induced in both groups with 2.2 mg kg^?1 ketamine and diazepam 0.02 mg kg^?1 IV. Maintenance of anaesthesia was with isoflurane (ISO) in 100% oxygen, depth of anaesthesia was always adjusted by the first author. Group B received an additional CRI of 3.5 µg kg^?1 hour^?1 medetomidine. Respiratory rate (RR), heart rate (HR), mean arterial blood pressure (MAP), Fe ′ISO and Fe ′CO₂ were monitored with a methane insensitive monitor (Cardiocap 5, Ohmeda, Anandic, Diessenhofen) and noted every 5 minutes. Arterial blood was withdrawn for gas analysis (PaO₂, PaCO₂) 5 minutes after the induction of anaesthesia and every 30 minutes thereafter. Dobutamine (DOB) was given as a CRI to maintain mean arterial blood pressure above 70 mm Hg. Data were averaged over time (sum of measurements/number of measurements) and tested for differences between groups by unpaired t‐tests. There were no significant differences between the groups in terms of body mass (group A, 508 ± 73.7 kg; group B, 529.25 ± 78.4 kg) or duration of anaesthesia (group A, 125.5 ± 36 minutes; group B, 121.5 ± 48.4 minutes). The mean Fe ′ISO required to maintain a surgical plane of anaesthesia was significantly higher in group A (1.33 ± 0.13%) than in group B (1.07 ± 0.19%; p = 2.78 × 10^?5). Heart rate was different between the two groups (group A, 42.2 ± 8.3; group B, 32.6 ± 3.5; p = 8.8 × 10^?5). Dobutamine requirements were higher in group A (group A, 0.72 ± 0.24 μg kg^?1 minute^?1; group B, 0.53 ± 0.23 μg kg^?1 minute^?1; p = 0.023). Respiratory rate, Fe ′CO₂, PaO₂, PaCO₂ were not different between the groups. Adjustment of anaesthetic depth subjectively was easier with the medetomidine infusion and isoflurane (group B) than with isoflurane as a sole agent (group A). In group A 12 horses and in group B five horses showed purposeful movements on 27 (A) and 12 (B) occasions. They were given thiopental (group A, 0.0114 mg kg^?1 minute^?1; group B, 0.0023 mg kg^?1 minute^?1). In group A, a further 17 horses were given ketamine to deepen anaesthesia (52 occasions, 0.00426 mg kg^?1 minute^?1) whereas in group B only nine horses needed ketamine (34 occasions, 0.00179 mg kg^?1 minute^?1). An infusion of 3.5 µg kg^?1 MED during ISO anaesthesia resulted in a significantly reduced ISO requirement.     

The Komesaroff anaesthetic machine for delivering sevoflurane to dogs

Objective To quantify the vapour output of the Komesaroff machine when using sevoflurane and to determine its performance for inducing and maintaining sevoflurane anaesthesia in dogs. Study design Prospective experimental study. Animals Six clinically normal beagles, aged 3–6 years and weighing 20 ± 1.65 kg (mean ± SEM). Methods The first study was performed using five Komesaroff vaporizers to measure the sevoflurane concentration delivered at each tap setting (I to IV) at 5, 10, 15, 20, 25, 30 and 35 minutes. For this study a ventilator was connected to the Komesaroff machine and set to deliver a tidal volume of 250 mL at 10 cycles minute^?1; oxygen flow was 100 mL minute^?1. A three‐litre reservoir bag was attached to the Y‐piece connector to act as a lung model. In the second study anaesthesia was induced in dogs with sevoflurane delivered by face‐mask mask and carried in 2 L minute^?1 100% oxygen and with the vaporizer set at the fully open position. The quality and speed of induction were recorded. After orotracheal intubation, anaesthesia was maintained for 60 minutes with sevoflurane using an oxygen flow of 100 mL minute^?1. The dogs were allowed to breathe spontaneously. The respiratory rate (RR), heart rate (HR), oesophageal temperature, systolic (SAP) mean (MAP) and diastolic (DAP) arterial pressure, end‐tidal CO₂ concentration (Fe ′_CO2) end‐tidal (Fe ′_SEVO) and peak‐inspired (Fi _SEVO) percentages of sevoflurane, and vaporizer tap setting were recorded every 5 minutes during anaesthesia. Results The delivery of sevoflurane was constant for each vaporizer setting. The mean output of sevoflurane was 0.44 ± 0.01% for setting I, 2.59 ± 0.18% for setting II, 3.28 ± 0.22% for setting III and 3.1 ± 0.5% for setting IV. In the second study, the mean induction time was 7.72 ± 0.60 minutes and the quality of the induction was good in all dogs. The mean vaporizer tap setting for the maintenance of anaesthesia was 3.48 ± 0.12 and the mean values for Fe ′_SEVO and Fi _SEVO were 2.42 ± 0.04% and 2.87 ± 0.06%, respectively. The pedal withdrawal reflex persisted throughout anaesthesia. Conclusions It proved impossible to produce surgical anaesthesia with sevoflurane delivered by the Komesaroff machine despite the highest possible sevoflurane concentration being delivered. Clinical relevance Sevoflurane delivered from the Komesaroff machine cannot be relied upon to maintain surgical anaesthesia in spontaneously breathing dogs.     

Total intravenous anaesthesia (TIVA) with propofol-fentanyl and propofol-midazolam combinations in spontaneously-breathing goats

ObjectiveTo compare the efficacy and cardiopulmonary effects of propofol and fentanyl, with propofol and midazolam for total intravenous anaesthesia.Study designProspective, randomized, crossover experimental study.AnimalsSix goats; three does and three wethers.MethodsGoats received either fentanyl 0.02 mg kg^?1 (treatment FP) or midazolam 0.3 mg kg^?1 (treatment MP) intravenously. One minute later anaesthesia was induced with propofol, then maintained by constant rate infusion of propofol 12.0 mg kg^?1 hour^?1 and fentanyl 0.02 mg kg^?1 hour^?1 (treatment FP) or propofol 12.0 mg kg^?1 hour^?1 and midazolam 0.3 mg kg^?1 hour^?1 (treatment MP) for 90 minutes. Response to noxious stimulus was tested every 10 minutes and propofol dose adjusted to prevent purposeful movement. Cardiopulmonary parameters were measured continuously, and arterial blood-gas analysis performed intermittently. Recovery was timed and quality scored. Results are presented as median (IQR).ResultsDifferences in the propofol induction dose [4.00 (3.96-4.01) and 3.97 (3.91-4.00) mg kg^?1 for treatments FP and MP, respectively] were not significant. Quality of induction in both groups was smooth. The median propofol dose for maintenance was less (p = 0.004) with treatment FP (12.0 mg kg^?1 hour^?1) than MP (18.0 mg kg^?1 hour^?1). Cardiopulmonary function was well maintained with both treatments. Recovery times in minutes from the end of anaesthetic infusion for treatments FP and MP respectively were; to extubation 3.0 (3.0-3.0) and 4.5 (3.3-5.0); to sternal position, 4.5 (3.3-5.0) and 5.0 (5.0-6.5) and to standing 13.0 (10.3-15.0) and 15.0 (11.3-17.3). Quality of recovery was acceptable in both groups, but abnormal behavioural signs were observed after treatment FP.Conclusions and clinical relevanceTotal intravenous anaesthesia with propofol and fentanyl or propofol and midazolam, at the doses studied, in spontaneously-breathing, oxygen-supplemented goats is practicable. Recovery from the fentanyl-propofol combination is not always smooth.     

Propofol anaesthesia for surgery in late gestation pony mares

Objective To characterize propofol anaesthesia in pregnant ponies. Animals Fourteen pony mares, at 256 ± 49 days gestation, undergoing abdominal surgery to implant fetal and maternal vascular catheters. Materials and methods Pre‐anaesthetic medication with intravenous (IV) acepromazine (20 µg kg^?1), butorphanol (20 µg kg^?1) and detomidine (10 µg kg^?1) was given 30 minutes before induction of anaesthesia with detomidine (10 µg kg^?1) and ketamine (2 mg kg^?1) IV Maternal arterial blood pressure was recorded (facial artery) throughout anaesthesia. Arterial blood gas values and plasma concentrations of glucose, lactate, cortisol and propofol were measured at 20‐minute intervals. Anaesthesia was maintained with propofol infused initially at 200 µg kg^?1 minute^?1, and at 130–180 µg kg^?1 minute^?1 after 60 minutes, ventilation was controlled with oxygen and nitrous oxide to maintain PaCO₂ between 5.0 and 6.0 kPa (37.6 and 45.1 mm Hg) and PaO₂ between 13.3 and 20.0 kPa (100 and 150.4 mm Hg). During anaesthesia flunixin (1 mg kg^?1), procaine penicillin (6 IU) and butorphanol 80 µg kg^?1 were given. Lactated Ringer's solution was infused at 10 mL kg^?1 hour^?1. Simultaneous fetal and maternal blood samples were withdrawn at 85–95 minutes. Recovery from anaesthesia was assisted. Results Arterial blood gas values remained within intended limits. Plasma propofol levels stabilized after 20 minutes (range 3.5–9.1 µg kg^?1); disposition estimates were clearance 6.13 ± 1.51 L minute^?1 (mean ± SD) and volume of distribution 117.1 ± 38.9 L (mean ± SD). Plasma cortisol increased from 193 ± 43 nmol L^?1 before anaesthesia to 421 ± 96 nmol L^?1 60 minutes after anaesthesia. Surgical conditions were excellent. Fetal umbilical venous pH, PO₂ and PCO₂ were 7.35 ± 0.04, 6.5 ± 0.5 kPa (49 ± 4 mm Hg) and 6.9 ± 0.5 kPa (52 ± 4 mm Hg); fetal arterial pH, PO₂ and PCO₂ were 7.29 ± 0.06, 3.3 ± 0.8 kPa (25 ± 6 mm Hg) and 8.7 ± 0.9 kPa (65 ± 7 mm Hg), respectively. Recovery to standing occurred at 46 ± 17 minutes, and was generally smooth. Ponies regained normal behaviour patterns immediately. Conclusions and clinical relevance Propofol anaesthesia was smooth with satisfactory cardiovascular function in both mare and fetus; we believe this to be a suitable anaesthetic technique for pregnant ponies.     

Minimum end‐tidal sevoflurane concentration necessary to prevent movement during a constant rate infusion of morphine,or morphine plus dexmedetomidine in ponies

ObjectiveTo compare the effects of a constant rate infusion (CRI) of dexmedetomidine and morphine to those of morphine alone on the minimum end-tidal sevoflurane concentration necessary to prevent movement (MAC_NM) in ponies.Study designProspective, randomized, crossover, ‘blinded’, experimental study.AnimalsFive healthy adult gelding ponies were anaesthetized twice with a 3-week washout period.MethodsAfter induction of anaesthesia with sevoflurane in oxygen (via nasotracheal tube), the ponies were positioned on a surgical table (T0), and anaesthesia was maintained with sevoflurane (Fe‘SEVO 2.5%) in 55% oxygen. Monitoring included pulse oximetry, electrocardiography and measurement of anaesthetic gases, arterial blood pressure and body temperature. The ponies were mechanically ventilated and randomly allocated to receive IV treatment M [morphine 0.15 mg kg^?1 (T10-T15) followed by a CRI (0.1 mg kg^?1 hour^?1)] or treatment DM [dexmedetomidine 3.5 μg kg^?1 plus morphine 0.15 mg kg^?1 (T10-T15) followed by a CRI of dexmedetomidine 1.75 μg kg^?1 hour^?1 and morphine 0.1 mg kg^?1 hour^?1]. At T60, a stepwise MAC_NM determination was initiated using constant current electrical stimuli at the skin of the lateral pastern region. Triplicate MAC_NM estimations were obtained and then averaged in each pony. Wilcoxon signed-rank test was used to detect differences in MAC between treatments (a = 0.05).ResultsSevoflurane-morphine MAC_NM values (median (range) and mean ± SD) were 2.56 (2.01–4.07) and 2.79 ± 0.73%. The addition of a continuous infusion of dexmedetomidine significantly reduced sevoflurane MAC_NM values to 0.89 (0.62–1.05) and 0.89 ± 0.22% (mean MAC_NM reduction 67 ± 11%).Conclusion and clinical relevanceCo-administration of dexmedetomidine and morphine CRIs significantly reduced the MAC_NM of sevoflurane compared with a CRI of morphine alone at the reported doses.     

Effects of tramadol on the minimum alveolar concentration of sevoflurane in dogs

ObjectiveTo evaluate the effect of tramadol on sevoflurane minimum alveolar concentration (MAC_SEVO) in dogs. It was hypothesized that tramadol would dose-dependently decrease MAC_SEVO.Study designRandomized crossover experimental study.AnimalsSix healthy, adult female mixed-breed dogs (24.2 ± 2.6 kg).MethodsEach dog was studied on two occasions with a 7-day washout period. Anesthesia was induced using sevoflurane delivered via a mask. Baseline MAC (MAC_B) was determined starting 45 minutes after tracheal intubation. A noxious stimulus (50 V, 50 Hz, 10 ms) was applied subcutaneously over the mid-humeral area. If purposeful movement occurred, the end-tidal sevoflurane was increased by 0.1%; otherwise, it was decreased by 0.1%, and the stimulus was re-applied after a 20-minute equilibration. After MAC_B determination, dogs randomly received a tramadol loading dose of either 1.5 mg kg^?1 followed by a continuous rate infusion (CRI) of 1.3 mg kg^?1 hour^?1 (T1) or 3 mg kg^?1 followed by a 2.6 mg kg^?1 hour^?1 CRI (T2). Post-treatment MAC determination (MAC_T) began 45 minutes after starting the CRI. Data were analyzed using a mixed model anova to determine the effect of treatment on percentage change in baseline MAC_SEVO (p < 0.05).ResultsThe MAC_B values were 1.80 ± 0.3 and 1.75 ± 0.2 for T1 and T2, respectively, and did not differ significantly. MAC_T decreased by 26 ± 8% for T1 and 36 ± 12% for T2. However, there was no statistically significant difference in the decrease between the two treatments.Conclusion and clinical relevanceTramadol significantly reduced MAC_SEVO but this was not dose dependent at the doses studied.     

The effect of low dose rocuronium bromide on eyeball position, muscle relaxation, and ventilation in dogs

A central eyeball position is often required during sedation or anaesthesia to facilitate examination of the eye. However, use of neuromuscular blockade to produce a central eye position may result in depressed ventilation. This study evaluated the eyeball position, muscle relaxation and changes in ventilation during general anaesthesia after the IV administration of 0.1 mg kg^?1 rocuronium. With client consent, 12 dogs of different breeds, body mass 27.2 ± 11.8 kg, aged 5.6 ± 2.8 years (mean ± SD) were anaesthetized for ocular examination. Pre‐anaesthetic medication was 0.01 mg kg^?1 medetomidine and 0.2 mg kg^?1 butorphanol IV. Anaesthesia was induced with propofol to effect and maintained with 10 mg kg^?1 hour^?1 propofol by infusion. The dogs were placed in left lateral recumbency, their trachea intubated and connected to a circle breathing system (Fi O₂ = 1.0). All dogs breathed spontaneously. The superficial peroneal nerve of the right hind leg was stimulated every 15 seconds with a train‐of‐four (TOF) stimulation pattern and neuromuscular function was assessed with an acceleromyograph (TOF‐Guard). Adequacy of ventilation was measured with the Ventrak 1550. After 10 minutes of anaesthesia to allow stabilisation of baseline values, 0.1 mg kg^?1 rocuronium was administered IV. Minute volume (Vm ), tidal volume (Vt ), respiratory rate (RR), Pe ′CO₂ and maximal depression of T1 and TOF ratio were measured. Data were analysed using a paired t‐test. The changes in the eyeball position were recorded. A total of 100 ± 33 seconds after the injection of rocuronium, T1 was maximally depressed to 62 ± 21% and the TOF ratio to 42 ± 18% of baseline values. Both variables returned to baseline after 366 ± 132 seconds (T1) and 478 ± 111 seconds (TOF). There was no significant reduction in Vm (2.32 ± 1.1 L minute^?1), Vt (124.1 ± 69.3 mL) and RR (10 ± 3.8 breaths minute^?1) and no increase in Pe ′CO₂ (6.5 ± 2.1 kPa (48.8 ± 16.1 mm Hg)) throughout the procedure. The eyeball rotated to a central position 35 ± 7 seconds after rocuronium IV and remained there for a minimum of 20 ± 7 minutes in all dogs. We conclude that rocuronium at a dose of 0.1 mg kg^?1 can be administered to dogs IV with minimal changes in ventilatory variables. The eyeball is fixed in a central position for at least 20 minutes, which greatly facilitates clinical examination.     

Cardiovascular,respiratory, electrolyte and acid–base balance during continuous dexmedetomidine infusion in anesthetized dogs

ObjectiveTo evaluate the cardiovascular, respiratory, electrolyte and acid–base effects of a continuous infusion of dexmedetomidine during propofol–isoflurane anesthesia following premedication with dexmedetomidine.Study designProspective experimental study.AnimalsFive adult male Walker Hound dogs 1–2 years of age averaging 25.4 ± 3.6 kg.MethodsDogs were sedated with dexmedetomidine 10 μg kg^?1 IM, 78 ± 2.3 minutes (mean ± SD) before general anesthesia. Anesthesia was induced with propofol (2.5 ± 0.5 mg kg^?1) IV and maintained with 1.5% isoflurane. Thirty minutes later dexmedetomidine 0.5 μg kg^?1 IV was administered over 5 minutes followed by an infusion of 0.5 μg kg^?1 hour^?1. Cardiac output (CO), heart rate (HR), ECG, direct blood pressure, body temperature, respiratory parameters, acid–base and arterial blood gases and electrolytes were measured 30 and 60 minutes after the infusion started. Data were analyzed via multiple linear regression modeling of individual variables over time, compared to anesthetized baseline values. Data are presented as mean ± SD.ResultsNo statistical difference from baseline for any parameter was measured at any time point. Baseline CO, HR and mean arterial blood pressure (MAP) before infusion were 3.11 ± 0.9 L minute^?1, 78 ± 18 beats minute^?1 and 96 ± 10 mmHg, respectively. During infusion CO, HR and MAP were 3.20 ± 0.83 L minute^?1, 78 ± 14 beats minute^?1 and 89 ± 16 mmHg, respectively. No differences were found in respiratory rates, PaO₂, PaCO₂, pH, base excess, bicarbonate, sodium, potassium, chloride, calcium or lactate measurements before or during infusion.Conclusions and clinical relevanceDexmedetomidine infusion using a loading dose of 0.5 μg kg^?1 IV followed by a constant rate infusion of 0.5 μg kg^?1 hour^?1 does not cause any significant changes beyond those associated with an IM premedication dose of 10 μg kg^?1, in propofol–isoflurane anesthetized dogs. IM dexmedetomidine given 108 ± 2 minutes before onset of infusion showed typical significant effects on cardiovascular parameters.     

Comparison of sevoflurane and isoflurane anesthetic index in unpremedicated dogs

Anesthetic respiratory effects of sevoflurane (SEVO) were compared with isoflurane (ISO) in unpremedicated dogs. Minimum alveolar concentration (MAC), apneic concentration (AC), and anesthetic index (AI) of SEVO and ISO were determined in eight 1‐year‐old healthy dogs, weighing 19 ± 3 kg (mean ± SEM) in a randomized complete block multiple cross‐over design. Dogs were mask‐induced with either SEVO or ISO in 100% oxygen. Following endotracheal intubation, dogs were instrumented, mechanically ventilated, and MAC was determined using a tail‐clamp method. Next, spontaneous ventilation was re‐established, and anesthetic concentration was increased to determine the AC. Throughout the anesthetic event, heart rate (HR), systolic blood pressure (SAP), mean blood pressure (MAP), diastolic blood pressure (DAP), respiratory rate (RR), end‐tidal carbon dioxide (Pe ′CO₂), and oxyhemoglobin saturation (SpO₂) were recorded at 3‐minute intervals. Following AC determination, AI was calculated as AC/MAC, and dogs were allowed to recover. Each dog was anesthetized four times (twice with ISO and SEVO each) at 1‐week intervals. All data were analyzed using the two‐way anova . Multiple comparisons were performed between ISO and SEVO treatments. Statistical significance was set at p < 0.05. Significant differences were noted between agents for MAC (SEVO, 2.13 ± 0.10%; ISO, 1.38 ± 0.14%; p < 0.0001), AC (SEVO, 7.34 ± 0.13%; ISO, 3.60 ± 0.13%; p < 0.0001), and AI (SEVO, 3.46 ± 0.22; ISO, 2.63 ± 0.14; p = 0.0002). Physiologic parameters were compared between SEVO and ISO at 1MAC, 2MAC, 3MAC, and AC. No differences were noted between SEVO and ISO treatments for cardiovascular parameters (HR, SAP, MAP, DAP). Significant differences were noted, favoring SEVO, for all respiratory parameters (RR, Pe ′CO₂, SpO₂) at increasing MAC multiples. Additionally, regression analysis was conducted for physiologic variable data points. Analysis of Pe ′CO₂ data points demonstrated a significant slope difference of ?6.47 ± 1.02 (B_SEVO ? B_ISO; p < 0.0001; r² = 0.6042) favoring SEVO. While expected dose‐related ventilatory depression was noted for both agents, all the respiratory parameters for SEVO demonstrated less respiratory depression than ISO at equipotent doses. These results indicated that SEVO caused less dose‐dependent ventilatory depression than ISO, having a significantly higher AI and causing less detrimental change in pulmonary parameters at increasing levels of MAC.     

Determination of the sevoflurane sparing effect of methadone in cats

ObjectiveTo determine the magnitude and duration of sevoflurane minimum alveolar concentration (MAC) reduction following a single intravenous (IV) dose of methadone in cats.Study designProspective experimental study.AnimalsEight (four females and four males) healthy mixed-breed adult (1–2 years) cats weighing 5.82 ± 0.42 kg.MethodsAnesthesia was induced and maintained with sevoflurane. Intravenous catheters facilitated administration of methadone and lactated Ringer’s solution. After baseline MAC determination in triplicate using a tail clamp technique, 0.3 mg kg^?1 of methadone was administered IV. End-tidal sevoflurane concentration (e′SEVO) was reduced and MAC was redetermined. In an effort to determine the duration of MAC reduction, measurements were repeated in a stepwise manner until MAC values returned to baseline. After the last stimulation, the e′SEVO was increased to 1.2 individual MAC for 15 minutes, then sevoflurane was discontinued and cats were allowed to recover from anesthesia.ResultsBaseline sevoflurane MAC was 3.18 ± 0.06%. When compared with baseline the sevoflurane MAC after methadone administration was significantly reduced by 25, 15 and 7% at 26, 76 and 122 minutes, respectively. The final MAC value (3.09 ± 0.07%) determined 156 minutes after methadone administration was not significantly different from baseline.Conclusions and clinical relevanceIntravenous methadone (0.3 mg kg^?1) significantly decreased MAC of sevoflurane in cats but the effect was short-lived.     

Effects of vatinoxan in dogs premedicated with medetomidine and butorphanol followed by sevoflurane anaesthesia: a randomized clinical study

ObjectiveTo investigate effects of vatinoxan in dogs, when administered as intravenous (IV) premedication with medetomidine and butorphanol before anaesthesia for surgical castration.Study designA randomized, controlled, blinded, clinical trial.AnimalsA total of 28 client-owned dogs.MethodsDogs were premedicated with medetomidine (0.125 mg m^?2) and butorphanol (0.2 mg kg^?1) (group MB; n = 14), or medetomidine (0.25 mg m^?2), butorphanol (0.2 mg kg^?1) and vatinoxan (5 mg m^?2) (group MB-VATI; n = 14). Anaesthesia was induced 15 minutes later with propofol and maintained with sevoflurane in oxygen (targeting 1.3%). Before surgical incision, lidocaine (2 mg kg^?1) was injected intratesticularly. At the end of the procedure, meloxicam (0.2 mg kg^?1) was administered IV. The level of sedation, the qualities of induction, intubation and recovery, and Glasgow Composite Pain Scale short form (GCPS-SF) were assessed. Heart rate (HR), respiratory rate (f_R), mean arterial pressure (MAP), end-tidal concentration of sevoflurane (Fe′Sevo) and carbon dioxide (Pe′CO₂) were recorded. Blood samples were collected at 10 and 30 minutes after premedication for plasma medetomidine and butorphanol concentrations.ResultsAt the beginning of surgery, HR was 61 ± 16 and 93 ± 23 beats minute^?1 (p = 0.001), and MAP was 78 ± 7 and 56 ± 7 mmHg (p = 0.001) in MB and MB-VATI groups, respectively. No differences were detected in f_R, Pe′CO₂, Fe′Sevo, the level of sedation, the qualities of induction, intubation and recovery, or in GCPS-SF. Plasma medetomidine concentrations were higher in group MB-VATI than in MB at 10 minutes (p = 0.002) and 30 minutes (p = 0.0001). Plasma butorphanol concentrations were not different between groups.Conclusions and clinical relevanceIn group MB, HR was significantly lower than in group MB-VATI. Hypotension detected in group MB-VATI during sevoflurane anaesthesia was clinically the most significant difference between groups.     

Effects of continuous intravenous infusion of morphine and morphine‐tramadol on the minimum alveolar concentration of sevoflurane and electroencephalographic entropy indices in dogs

ObjectiveTo compare the effects of continuous rate infusions (CRIs) of intravenous (IV) morphine and morphine-tramadol on the minimum alveolar concentration (MAC) of sevoflurane, and on electroencephalographic entropy indices in dogs.DesignProspective study.AnimalsEight young, healthy German shepherds, weighing 26.3 ± 3.1 kg (mean ± SD).MethodsAnaesthesia was induced and maintained with sevoflurane. A standard tail-clamp technique was used for MAC determination. Within one anaesthetic period, MAC was first determined during sevoflurane anaesthesia alone (MAC_B); then during morphine infusion (MAC_M), (loading dose 0.5 mg kg⁻¹IM; CRI, 0.2 mg kg⁻¹hour⁻¹⁾ then finally during morphine-tramadol infusion (tramadol loading dose 1.5 mg kg⁻¹IV; CRI, 2.6 mg kg⁻¹ hour⁻¹) (MAC_MT). At each change, periods of 45 minutes were allowed for equilibration. Stated entropy (SE), response entropy (RE), and RE-SE differences were measured five minutes prior to and during tail clamping.ResultsThe MAC_B was 2.1 ± 0.3vol%. The morphine and morphine-tramadol infusions reduced MAC to 1.6 ± 0.3vol% and 1.3 ± 0.3vol%, respectively. MAC was decreased below baseline more during morphine-tramadol than during morphine alone (39 ± 9% versus 25 ± 6%, respectively; p = 0.003). All SE and RE and most RE-SE differences were increased significantly (p < 0.05) over pre-stimulation in all groups when the dogs responded purposefully to noxious stimulation. When no response to noxious stimulation occurred, the entropy indices did not change.Conclusion and clinical relevanceIn dogs, combined morphine-tramadol CRI decreased sevoflurane MAC more than morphine CRI alone. Entropy indices changed during nociceptive responses in anaesthetized animals, suggesting that entropy measurements may be useful in determining anaesthetic depth in dogs.     

Effect of fentanyl on the induction dose and minimum infusion rate of propofol preventing movement in dogs

Objective

To determine the effect of fentanyl on the induction dose of propofol and minimum infusion rate required to prevent movement in response to noxious stimulation (MIR_NM) in dogs.

Effects of constant rate infusions of dexmedetomidine,remifentanil and their combination on minimum alveolar concentration of sevoflurane in dogs

ObjectiveTo evaluate the effects of constant rate infusions (CRIs) of dexmedetomidine and remifentanil alone and their combination on minimum alveolar concentration (MAC) of sevoflurane in dogs.Study designRandomized crossover experimental study.AnimalsA total of six (three males, three females) healthy, adult neutered Beagle dogs weighing 12.6 ± 1.4 kg.MethodsAnesthesia was induced with sevoflurane in oxygen until endotracheal intubation was possible and anesthesia maintained with sevoflurane using positive-pressure ventilation. Each dog was anesthetized five times and was administered each of the following treatments: saline (1 mL kg^–1 hour^–1) or dexmedetomidine at 0.1, 0.5, 1.0 or 5.0 μg kg^–1 loading dose intravenously over 10 minutes followed by CRI at 0.1, 0.5, 1.0 or 5.0 μg kg^–1 hour^–1, respectively. Following 60 minutes of CRI, sevoflurane MAC was determined in duplicate using an electrical stimulus (50 V, 50 Hz, 10 ms). Then, CRI of successively increasing doses of remifentanil (0.15, 0.60 and 2.40 μg kg^–1 minute^–1) was added to each treatment. MAC was also determined after 30 minutes equilibration at each remifentanil dose. Isobolographic analysis determined interaction from the predicted doses required for a 50% MAC reduction (ED₅₀) with remifentanil, dexmedetomidine and remifentanil combined with dexmedetomidine, with the exception of dexmedetomidine 5.0 μg kg^–1 hour^–1, obtained using log-linear regression analysis.ResultsThe sevoflurane MAC decreased dose-dependently with increasing infusion rates of dexmedetomidine and remifentanil. Remifentanil ED₅₀ values were lower when combined with dexmedetomidine than those obtained during saline–remifentanil. Synergistic interactions between dexmedetomidine and remifentanil for MAC reduction occurred with dexmedetomidine at 0.5 and 1.0 μg kg^–1 hour^–1.Conclusions and clinical relevanceCombined CRIs of dexmedetomidine and remifentanil synergistically resulted in sevoflurane MAC reduction. The combination of dexmedetomidine and remifentanil effectively reduced the requirement of sevoflurane during anesthesia in dogs.     

Reduction of isoflurane MAC by fentanyl or remifentanil in rats

Objective The main objective of the study was to determine the effects of three different infusion rates of fentanyl and remifentanil on the minimum alveolar concentration (MAC) of isoflurane in the rat. A secondary objective was to assess the cardiovascular and respiratory effects of the two opioid drugs. Animal population Thirty‐seven male Wistar rats were randomly allocated to one of six treatment groups. Material and methods For all treatment groups anaesthesia was induced with 5% isoflurane in oxygen using an induction chamber. A 14‐gauge catheter was used for endotracheal intubation, and anaesthesia was maintained with isoflurane delivered in oxygen via a T‐piece breathing system. A baseline determination of the minimum alveolar concentration of isoflurane (MAC_ISO) was made for each animal. Fentanyl (15, 30, 60 µg kg^?1 hour^?1) or remifentanil (60, 120, 240 µg kg^?1 hour^?1) were infused intravenously into a previously cannulated tail vein. Thirty minutes after the infusion started, a second MAC_ISO (MAC_ISO+drug) was determined. The carotid artery was cannulated to monitor the arterial pressure and to take samples for arterial gas measurements. Cardiovascular (heart rate and arterial pressure) and respiratory (respiratory rate and presence/absence of apnoea) effects after opioid infusion were also recorded. Results Fentanyl (15, 30, 60 µg kg^?1 hour^?1) and remifentanil (60, 120, 240 µg kg^?1 hour^?1) similarly reduced isoflurane MAC in a dose‐dependent fashion: by 10% at lower doses, 25% at medium doses and by 60% at higher doses of both the drugs. Both opioids reduced the respiratory rate in a similar way for all doses tested. No episodes of apnoea were recorded in the remifentanil groups, while administration of fentanyl resulted in apnoea in three animals (one at each dose level). The effects on the cardiovascular system were similar with both drugs. Conclusions We conclude that the intraoperative use of remifentanil in the rat reduces the MAC of isoflurane, and that this anaesthetic sparing effect is dose‐dependent and similar to that produced by fentanyl at the doses tested. Clinical relevance The use of remifentanil during inhalant anaesthesia in the rat can be considered an intravenous alternative to fentanyl, providing similar reduction in isoflurane requirements. Due to its rapid offset, it is recommended that alternative pain relief be instituted before it is discontinued.     

The effects of pre-anesthetic administration of xylazine on the cardiovascular responses to dobutamine in halothane anaesthetized horses

Studies evaluating the effects of dobutamine in horses do not consistently report increases in cardiac output despite increases in arterial blood pressure. The concurrent administration of the α₂ agonist clonidine, in people, inhibited the chronotropic effects of dobutamine and increased left ventricular stroke work ( Zimpfer et al. 1982 ). Our study was performed to determine if pre‐medication with an α₂ agonist affects the response to dobutamine in anaesthetized horses. Eleven horses were anaesthetized on four separate occasions for one of four randomly assigned treatments; (I) no xylazine, no dobutamine (II) xylazine, no dobutamine (III) no xylazine, dobutamine, and (IV) xylazine, dobutamine. Horses received 0.02 mg kg^?1 of butorphanol IV 10 minutes prior to anesthetic induction. Two minutes prior to induction, groups II and IV received 0.5 mg kg^?1 of IV xylazine. Anaesthesia was induced with 6–7 mg kg^?1 of thiopental and maintained with halothane. End‐tidal halothane concentrations were maintained between 1.1 and 1.2% in groups I and III, and 0.9–1.0% for groups II and IV. Heart rate, cardiac output, right atrial pressure, and systolic (SAP), diastolic (DAP) and mean (MAP) arterial pressure were recorded 30 minutes after beginning halothane anaesthesia (T10). Cardiac output was estimated using Lithium dilution ( Linton et al. 2000 ). Baseline measurements were repeated twice, at 5‐minute intervals (T5 and T0). At time 0 (T0), an IV infusion of either saline (100 mL hour^?1) or dobutamine (0.001 mg kg^?1 minute^?1) was started and data recorded at 5‐minute intervals for 30 minutes (T5 – T30). Stroke volume and systemic vascular resistance (SVR) were calculated. Data were analysed using repeated measures anova (p < 0.01 significant) and Newman–Keuls for multiple comparisons. Cardiac output and stroke volume increased over time in groups III and IV. Cardiac index was higher in groups III and IV than in groups I and II from T10 until completion of the study. Estimates of cardiac index at T30 for groups I–IV were 45 ± 9, 46 ± 11, 71 ± 11, and 78 ± 19 mL kg^?1 minute^?1, respectively (mean ± SD). Stroke index was higher in groups III and IV than in groups I and II from T15 to T30. Values for stroke index at T30 for groups I–IV were 0.98 ± 0.19, 1.11 ± 0.18, 1.46 ± 0.21, 1.74 ± 0.33 mL kg^?1. Heart rate decreased from T10–T30 in groups I and II. Heart rate was greater in groups I and III than in groups II and IV at T5 and T0. Values for heart rate at T0 for groups I–IV were 48 ± 5, 42 ± 5, 50 ± 4, 43 ± 4 beats minute^?1. Systolic arterial pressure, DAP and MAP were higher in groups III and IV than in groups I and II from T5 to T30. There were no differences in SVR between groups. Dobutamine at 0.001 mg kg^?1 minute^?1 increased cardiac output, blood pressure, and stroke volume. Premedication with xylazine at 0.5 mg kg^?1 did not appear to affect the response to dobutamine.