A technique to depress desflurane vapor pressure

OBJECTIVE: To determine whether the vapor pressure of desflurane could be decreased by using a solvent to reduce the anesthetic molar fraction in a solution (Raoult's Law). We hypothesized that such an anesthetic mixture could produce anesthesia using a nonprecision vaporizer instead of an agent-specific, electronically controlled, temperature and pressure compensated vaporizer currently required for desflurane administration. ANIMAL: One healthy adult female dog. PROCEDURE AND RESULTS: Propylene glycol was used as a solvent for desflurane, and the physical characteristics of this mixture were evaluated at various molar concentrations and temperatures. Using a circle system with a breathing bag attached at the patient end and a mechanical ventilator to simulate respiration, an in-circuit, nonprecision vaporizer containing 40% desflurane and 60% propylene glycol achieved an 11.5% +/- 1.0% circuit desflurane concentration with a 5.2 +/- 0.4 (0 = off, 10 = maximum) vaporizer setting. This experiment was repeated with a dog attached to the breathing circuit under spontaneous ventilation with a fresh gas flow of 0.5 L minute(-1). Anesthesia was maintained for over 2 hours at a mean vaporizer setting of 6.2 +/- 0.4, yielding mean inspired and end-tidal desflurane concentrations of 8.7% +/- 0.5% and 7.9% +/- 0.7%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Rather than alter physical properties of vaporizers to suit a particular anesthetic agent, this study demonstrates that it is also possible to alter physical properties of anesthetic agents to suit a particular vaporizer. However, propylene glycol may not prove an ideal solvent for desflurane because of its instability in solution and substantial-positive deviation from Raoult's Law.     

Recent advances in inhalation anesthesia.

Both desflurane and sevoflurane offer theoretical and practical advantages over other inhalation anesthetics for horses. The lower solubility of both agents provides improved control of delivery and helps to counteract the confounding influence of the voluminous patient breathing circuit commonly used for anesthetizing horses. The lower solubility should account for faster rates of recovery compared with the older agents; whether or not the quality of recovery differs remains to be objectively evaluated in a broad range of circumstances. The pharmacodynamic effects are, in large part, similar to those of isoflurane (e.g., low arrhythmogenicity) but with some differences. For example, desflurane may be overall more sparing to cardiovascular function (especially during controlled ventilation) compared with isoflurane and sevoflurane, which are roughly similar. Respiratory depression with both new agents is equal to or more depressing than isoflurane, suggesting the use of mechanical ventilation, especially in circumstances of prolonged management (i.e., hours of anesthesia). Both new anesthetics, not surprisingly, are expensive. From this point there are some agent-unique considerations. The anesthetic potency of both agents is less than that of isoflurane, which influences the cost of anesthesia, but also places an upper limit on inspired oxygen concentration (of particular concern with desflurane). Both agents require new vaporizers, but because of the high boiling point and steep vapor-pressure curve of desflurane, new technology was required. This translates into more costly equipment, adding to the cost of desflurane use. In addition, electricity is necessary for the new desflurane vaporizer to function, which limits its portability and adds additional practical considerations in its clinical use. On the other hand, desflurane strongly resists degradation both in vitro and in vivo, but in vitro degradation of sevoflurane by CO2 absorbents may produce renal injury. This may be true especially in association with low fresh-gas inflow rates (used to reduce the cost of using the new agent), and university based practices, where prolonged anesthesia is common.     

Minimum alveolar concentration of desflurane in llamas and alpacas

OBJECTIVE: To determine the minimum alveolar concentration (MAC) of desflurane in llamas and alpacas. DESIGN: Prospective study. Animals Six healthy adult llamas and six healthy adult alpacas. PROCEDURE: Anesthesia was induced with desflurane delivered with oxygen through a mask. An endotracheal tube was inserted, and a port for continuous measurement of end-tidal and inspired desflurane concentrations was placed between the endotracheal tube and the breathing circuit. After equilibration at an end-tidal-to-inspired desflurane concentration ratio >0.90 for 15 minutes, a 50-Hz, 80-mA electrical stimulus was applied to the antebrachium until a response was obtained (i.e. gross purposeful movement) or for up to 1 minute. The vaporizer setting was increased or decreased to effect a 10-20% change in end-tidal desflurane concentration, and equilibration and stimulus were repeated. The MAC was defined as the average of the lowest end-tidal desflurane concentration that prevented a positive response and the highest concentration that allowed a positive response. RESULTS: Mean +/- SD MAC of desflurane was 7.99 +/- 0.58% in llamas and 7.83 +/- 0.51% in alpacas. CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of desflurane in llamas and alpacas was in the range of that reported for other species.     

Inhalant anesthetic requirement in cats is animal-dependent

Minimum alveolar concentration (MAC) of an inhalant is an indicator of its anesthetic potency. Individuals vary in their sensitivity to anesthetic agents as demonstrated by different individual MAC values. We hypothesized that individual animal sensitivity would be maintained with different inhalant anesthetics. As part of separate studies, six female DSH cats, aged 24 ± 2.5 (mean ± SD) months and weighing 3.5 ± 0.3 kg, were studied similarly on three separate occasions over a 12‐month period to determine the MAC of isoflurane (ISO), sevoflurane (SEVO), and desflurane (DES), respectively. In each study, chamber induction was followed by orotracheal intubation, and anesthesia was maintained via a nonrebreathing circuit. ECG, pulse oximetry, Doppler systolic blood pressure, end‐tidal gases, and esophageal temperature were monitored. End‐tidal gases were hand‐sampled from a catheter whose tip lay level with the distal end of the ET tube. Gases were analyzed by Raman spectrometry and, for each agent, the analyzer was calibrated with at least three gas standards. MAC was determined in triplicate using standard tail‐clamp technique. Data were analyzed by two‐way anova followed by Tukey's test and significant differences were found. Average MACs (%) for ISO, SEVO, and DES were 1.90 ± 0.18, 3.41 ± 0.65, and 10.27 ± 1.06, respectively. Body temperatures, Doppler systolic blood pressure, and SpO₂ were recorded at the time of MAC determinations for ISO, SEVO, and DES were 38.3 ± 0.3, 38.6 ± 0.1, 38.3 ± 0.35 °C; 71 ± 8, 75 ± 16, 88 ± 12 mm Hg; 99 ± 1, 99 ± 1, 99 ± 1%, respectively. Both the anesthetic agent and the individual cat had significant effects on MAC (p = 0.0001 and 0.0185, respectively). MAC varied between individuals and cats were consistent in their order of sensitivity to inhalant anesthetics across the three agents. Within this group of cats, the relationship of individual MAC to the group MAC for each of the three inhalant agents was maintained. This suggests that any individual may be consistently more or less sensitive to a variety of inhalant agents.     

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.     

Kinetics and potency of halothane,isoflurane, and desflurane in the Northern Leopard frog <Emphasis Type="Italic">Rana pipiens</Emphasis>

Equilibration between delivered and effect site anesthetic partial pressure is slow in frogs. The use of less soluble agents or overpressure delivery may speed equilibration. Ten Northern leopard frogs were exposed to 3-4 constant concentrations of halothane, isoflurane or desflurane and their motor response to noxious electrical stimulation of the forelimb evaluated every 30 minutes until a stable proportion of frogs were immobile. Each frog received each anesthetic and concentration in random order and allowed at least 14 hours to recover between anesthetic exposures. An overpressure technique based upon the kinetics in the first study was then tested with 4 concentrations of desflurane. For halothane, isoflurane and desflurane respectively; the proportion of frogs immobile in response to stimulus became stable after 510, 480 and 180 minutes, and ED50 values were 1.36, 1.67 and 6.78 % atm. Desflurane ED50 delivered by overpressure was not significantly different at 6.85 % atm. Halothane, isoflurane and desflurane are effective general anesthetics in frogs with potencies similar to those reported in mammals. The time required for anesthetic equilibration is fastest with desflurane and can be hastened further by initial delivery of higher partial pressures.     

Use of Propofol–Xylazine and the Anderson Sling Suspension System for Recovery of Horses from Desflurane Anesthesia

Objective— To characterize the behavior of horses recovering in the Anderson Sling Suspension System after 4 hours of desflurane anesthesia and postdesflurane intravenous (IV) administration of propofol and xylazine. Study Design— Experimental study. Animals— Healthy horses (n=6), mean±SEM age 12.3±1.8 years; mean weight 556±27 kg. Methods— Each horse was anesthetized with xylazine, diazepam, and ketamine IV and anesthesia was maintained with desflurane in O₂. At the end of 4 hours of desflurane, each horse was positioned in the sling suspension system and administered propofol–xylazine IV. Recovery events were quantitatively and qualitatively assessed. Venous blood was obtained before and after anesthesia for biochemical and propofol analyses. Results— Anesthetic induction and maintenance were without incident. Apnea commonly accompanied propofol administration. All horses had consistent recovery behavior characterized by a smooth, careful, atraumatic return to a standing posture. Conclusions— Results of this study support careful, selective clinical use of desflurane, propofol–xylazine, and the Anderson Sling Suspension System to atraumatically transition horses with high anesthetic recovery risk to a wakeful standing posture. Clinical Relevance— Technique choices to facilitate individualized, atraumatic recovery of horses from general anesthesia are desirable. Use of IV propofol and xylazine to transition horses from desflurane anesthesia during sling recovery to standing posture may facilitate improved recovery management of high‐injury risk equine patients requiring general anesthesia.     

The Minimum Alveolar Concentration of Desflurane in Cats

Eight adult cats, 4 male and 4 female, (3.5 ± 0.9 [SD] kg) were used to determine the minimum alveolar concentration (MAC) of desflurane. Desflurane (DES) anesthesia was induced in a 20 L chamber with an oxygen inflow of 10 L/min and the DES vaporizer set at 18%. After 3.5 ± 0.5 min, the cats were removed from the chamber and anesthesia was maintained via mask (14% DES, 3L/min O₂) until successful intubation. Anesthesia was maintained with DES in oxygen at a flow of at least 200 mL/kg/min through a nonrebreathing circuit. The time from the start of induction to completion of intubation was 6.2 ± 1.1 min. Esophageal temperature was maintained between 37.8°C and 38.6°C. Hand-collected end-tidal gas samples were obtained from a catheter positioned inside the lumen of the endotracheal tube. Inspired and end-tidal DES concentrations were measured with a Biochem 8100 anesthetic agent monitor that was calibrated with known gas standards and modified to accept hand-collected samples. A constant alveolar concentration of DES was maintained for at least 15 minutes, then a clamp was applied to the tail and the cat observed for gross purposeful movement. The end-tidal DES was then increased (if a positive response) or decreased (if a negative response) by 20% and the test repeated after 15 minutes of constant conditions. The final iteration was 10%. The MAC of DES in these cats was 9.79 ± 0.70 vol %. The F_A/F_I ratio for desflurane was always greater than 0.97.     

Hemodynamic effects of butorphanol in desflurane-anesthetized dogs

ObjectiveTo evaluate the effects of butorphanol on cardiopulmonary parameters in dogs anesthetized with desflurane and breathing spontaneously.Study designProspective, randomized experimental trial.AnimalsTwenty dogs weighing 12 ± 3 kg.MethodsAnimals were distributed into two groups: a control group (CG) and butorphanol group (BG). Propofol was used for induction and anesthesia was maintained with desflurane (10%). Forty minutes after induction, the dogs in the CG received sodium chloride 0.9% (0.05 mL kg^?1 IM), and dogs in the BG received butorphanol (0.4 mg kg^?1 IM). The first measurements of body temperature (BT), heart rate (HR), arterial pressures (AP), cardiac output (CO), cardiac index (CI), central venous pressure (CVP), stroke volume index (SVI), pulmonary arterial occlusion pressure (PAOP), mean pulmonary arterial pressure (mPAP), left ventricular stroke work (LVSW), systemic (SVR) and pulmonary (PVR) vascular resistances, respiratory rate (f_R), and arterial oxygen (PaO₂) and carbon dioxide (PaCO₂) partial pressures were taken immediately before the administration of butorphanol or sodium chloride solution (T0) and then at 15-minute intervals (T15–T75).ResultsIn the BG, HR, AP, mPAP and SVR decreased significantly from T15 to T75 compared to baseline. f_R was lower at T30 than at T0 in the BG. AP and f_R were significantly lower than in the CG from T15 to T75. PVR was lower in the BG than in the CG at T30, while PaCO₂ was higher compared with T0 from T30 to T75 in the BG and significantly higher than in the CG at T30 to T75.Conclusions and clinical relevanceAt the studied dose, butorphanol caused hypotension and decreased ventilation during desflurane anesthesia in dogs. The hypotension (from 86 ± 10 to 64 ± 10 mmHg) is clinically relevant, despite the maintenance of cardiac index.     

Fatal propylene glycol toxicosis in a horse

Toxicosis attributable to propylene glycol (1,2-propanediol) was suspected in an 8-year-old 450- to 500-kg male Quarter Horse. Clinical signs of toxicosis developed within 15 minutes of the accidental iatrogenic oral administration of 3.8 L of propylene glycol. Clinical signs of toxicosis included salivation, sweating, ataxia, and signs of pain. Additionally, at 24 hours after propylene glycol ingestion, the horse became increasingly atactic, had an abnormal breath odor, developed rapid shallow breathing, and was cyanotic. The horse died of apparent respiratory arrest 28 hours after the propylene glycol ingestion. Analysis of serum and combined urine and blood from the kidneys confirmed the presence of propylene glycol. Propylene glycol is used for the treatment and prevention of bovine ketosis, and is similar in appearance to mineral oil. The accidental administration of propylene glycol to horses may result in fatal poisoning.     

氯胺酮与速眠新Ⅱ复合应用对小型猪麻醉的观察

为探讨氯胺酮与速眠新Ⅱ复合应用对实验小型猪的麻醉效果。将氯胺酮与速眠新Ⅱ等量混合,采用肌肉注射法(0.28mL/kg)对12头实验小型猪(11.33kg±0.83kg)进行复合麻醉,观察麻醉起效时间、麻醉持续时间及镇痛效果,并监测麻醉过程中体温、呼吸、心率等生理指标及有无呕吐、流涎等不良反应。小型猪成功麻醉12例,占100%,肌肉注射后(4.2±1.6)min进入麻醉状态,麻醉状态维持(87.3±15.4)min以上,麻醉期间肌肉松弛效果好,动物呼吸和心率平稳,无不良反应。结果表明,采用氯胺酮与速眠新Ⅱ复合麻醉效果好,麻醉过程平稳,生命体征稳定。氯胺酮与速眠新Ⅱ复合应用是较为简便、安全的小型猪麻醉方法,适合于耗时较长的手术或试验的开展。     

Evaluation of the isoflurane‐sparing effects of fentanyl,lidocaine, ketamine,dexmedetomidine, or the combination lidocaine‐ketamine‐dexmedetomidine during ovariohysterectomy in dogs

ObjectiveTo evaluate the isoflurane‐sparing effects of an intravenous (IV) constant rate infusion (CRI) of fentanyl, lidocaine, ketamine, dexmedetomidine, or lidocaine‐ketamine‐dexmedetomidine (LKD) in dogs undergoing ovariohysterectomy.Study designRandomized, prospective, blinded, clinical study.AnimalsFifty four dogs.MethodsAnesthesia was induced with propofol and maintained with isoflurane with one of the following IV treatments: butorphanol/saline (butorphanol 0.4 mg kg^?1, saline 0.9% CRI, CONTROL/BUT); fentanyl (5 μg kg^?1, 10 μg kg^?1 hour^?1, FENT); ketamine (1 mg kg^?1, 40 μg kg^?1 minute^?1, KET), lidocaine (2 mg kg^?1, 100 μg kg^?1 minute^?1, LIDO); dexmedetomidine (1 μg kg^?1, 3 μg kg^?1 hour^?1, DEX); or a LKD combination. Positive pressure ventilation maintained eucapnia. An anesthetist unaware of treatment and end‐tidal isoflurane concentration (Fe′Iso) adjusted vaporizer settings to maintain surgical anesthetic depth. Cardiopulmonary variables and Fe′Iso concentrations were monitored. Data were analyzed using anova (p < 0.05).ResultsAt most time points, heart rate (HR) was lower in FENT than in other groups, except for DEX and LKD. Mean arterial blood pressure (MAP) was lower in FENT and CONTROL/BUT than in DEX. Overall mean ± SD Fe′Iso and % reduced isoflurane requirements were 1.01 ± 0.31/41.6% (range, 0.75 ± 0.31/56.6% to 1.12 ± 0.80/35.3%, FENT), 1.37 ± 0.19/20.8% (1.23 ± 0.14/28.9% to 1.51 ± 0.22/12.7%, KET), 1.34 ± 0.19/22.5% (1.24 ± 0.19/28.3% to 1.44 ± 0.21/16.8%, LIDO), 1.30 ± 0.28/24.8% (1.16 ± 0.18/32.9% to 1.43 ± 0.32/17.3%, DEX), 0.95 ± 0.19/54.9% (0.7 ± 0.16/59.5% to 1.12 ± 0.16/35.3%, LKD) and 1.73 ± 0.18/0.0% (1.64 ± 0.21 to 1.82 ± 0.14, CONTROL/BUT) during surgery. FENT and LKD significantly reduced Fe′Iso.Conclusions and clinical relevanceAt the doses administered, FENT and LKD had greater isoflurane‐sparing effect than LIDO, KET or CONTROL/BUT, but not at all times. Low HR during FENT may limit improvement in MAP expected with reduced Fe′Iso.     

Closed System Delivery of Halothane and Isoflurane with a Vaporizer in the Anesthetic Circle

Forty-four healthy dogs undergoing elective ovariohysterectomy were anesthetized with halothane or isoflurane delivered with an in-circuit vaporizer with closed system flow rates or an out-of-circuit vaporizer with semi-closed system flow rates. When dogs were anesthetized with halothane, there were no differences in heart rate, blood pressure, body temperature, respiratory rate, or lingual venous pH, PCO2, or PO2 during induction and maintenance. Lingual venous PO2 was significantly less but still within a clinically acceptable range when isoflurane was used in an in-circuit vaporizer. Recovery times tended to be longer with in-circuit vaporizers. The amount of anesthetic used was not affected by vaporizer location. In-circuit vaporizers were suitable for delivery of halothane or isoflurane to healthy dogs.     

Other new and potentially useful inhalational anesthetics.

Sevoflurane and desflurane are volatile inhaled anesthetics that are currently being investigated as possible improvements for the anesthetic management of human patients. Information to date suggests these agents have several advantages over existing clinical agents. For example, the blood/gas partition coefficient for both agents is lower than that of other halogenated anesthetics. Consistent with this physical characteristic is a more rapid induction of and emergence from anesthesia. Both cause a dose-related depression of cardiopulmonary function, which is comparable to isoflurane. Results of studies to date favor desflurane over sevoflurane because it is less soluble in blood, is stable in soda lime, is biodegraded the least of any volatile anesthetic, and is not toxic.     

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.     

Embryo Production in Superovulated Goats Treated with Insulin Before or After Mating or By Continuous Propylene Glycol Supplementation

Seventeen adult and cyclic Moxoto goats were synchronized using 60 mg MPA vaginal sponge for 11 days and 50 μg cloprostenol, 48 h before sponge removal, and superovulated with 120 mg pFSH i.m. in decreasing doses at 12 h intervals for three consecutive days. In seven goats, 0.2 IU/kg BW/day of long acting insulin was subcutaneously injected at same time as pFSH, and in the other five goats, the same dose of insulin was injected for three consecutive days starting 24 h after mating. Finally, five goats were supplemented with an oral dose of 80 ml/goat/day of propylene glycol continuously during the experiment. The animals were flushed at 7 days after mating and the embryos were classified based on International Embryo Transfer Society criteria. Blood samples were collected every 3 days for insulin assay. Administration of insulin raised the insulin levels of the goats (p < 0.05), whereas in the group treated with propylene glycol, insulin rate was different only between FSH treatment and after mating (p < 0.05). Similar rates of recovery for total (80.05 ± 9.78%) or transferable structures (61.03 ± 15.13%) were obtained. Treatment was not influenced (p > 0.05) by responsiveness to superovulation, which averaged 64%. By contrast, insulin treatments were shown to increase the number of embryos considered excellent with respect to goats supplemented with propylene glycol (p < 0.05). When insulin was given before mating, a strong relationship (r = 0. 90) (p < 0.05) between number of transferable embryo and ovulations was observed in the animals. In conclusion, superovulated goats treated with low doses of exogenous insulin resulted in an enhancement in embryo quality, which was related to changes in circulating insulin concentrations.     

Respiratory reflexes in spontaneously breathing anesthetized dogs in response to nasal administration of sevoflurane, isoflurane, or halothane

OBJECTIVE: To characterize respiratory reflexes elicited by nasal administration of sevoflurane (Sevo), isoflurane (Iso), or halothane (Hal) in anesthetized dogs. ANIMALS: 8 healthy Beagles. PROCEDURE: A permanent tracheostomy was created in each dog. Two to 3 weeks later, dogs were anesthetized by IV administration of thiopental and alpha-chloralose. Nasal passages were isolated such that inhalant anesthetics could be administered to the nasal passages while the dogs were breathing 100% O2 via the tracheostomy. Respiratory reflexes in response to administration of each anesthetic at 1.2 and 2.4 times the minimum alveolar concentration (MAC) and the full vaporizer setting (5%) were recorded. Reflexes in response to administration of 5% of each anesthetic also were recorded following administration of lidocaine to the nasal passages. RESULTS: Nasal administration of Sevo, Iso, and Hal induced an immediate ventilatory response characterized by a dose-dependent increase in expiratory time and a resulting decrease in expired volume per unit of time. All anesthetics had a significant effect, but for Sevo, the changes were smaller in magnitude. Responses to administration of each anesthetic were attenuated by administration of lidocaine to the nasal passages. CONCLUSIONS AND CLINICAL RELEVANCE: Nasal administration of Sevo at concentrations generally used for mask induction of anesthesia induced milder reflex inhibition of breathing, presumably via afferent neurons in the nasal passages, than that of Iso or Hal. Respiratory reflexes attributable to stimulation of the nasal passages may contribute to speed of onset and could promote a smoother induction with Sevo, compared with Iso or Hal.     

Cardiopulmonary and acid-base effects of desflurane and sevoflurane in spontaneously breathing cats

The cardiopulmonary effects of desflurane and sevoflurane anesthesia were compared in cats breathing spontaneously. Heart (HR) and respiratory (RR) rates; systolic (SAP), diastolic (DAP) and mean arterial (MAP) pressures; partial pressure of end tidal carbon dioxide (PETCO2), arterial blood pH (pH), arterial partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2); base deficit (BD), arterial oxygen saturation (SaO2) and bicarbonate ion concentration (HCO3) were measured. Anesthesia was induced with propofol (8+/-2.3mg/kg IV) and maintained with desflurane (GD) or sevoflurane (GS), both at 1.3 MAC. Data were analyzed by analysis of variance (ANOVA), followed by the Tukey test (P<0.05). Both anesthetics showed similar effects. HR and RR decreased when compared to the basal values, but remained constant during inhalant anesthesia and PETCO2 increased with time. Both anesthetics caused acidemia and hypercapnia, but BD stayed within normal limits. Therefore, despite reducing HR and SAP (GD) when compared to the basal values, desflurane and sevoflurane provide good stability of the cardiovascular parameters during a short period of inhalant anesthesia (T20-T60). However, both volatile anesthetics cause acute respiratory acidosis in cats breathing spontaneously.     

Rate of change of oxygen concentration for a large animal circle anesthetic system

OBJECTIVE: To describe the effects of changes in circuit volume and oxygen inflow rate on inspired oxygen concentration for a large animal circle anesthetic system. STUDY POPULATION: A large animal circle anesthetic system, a 10 L/min flowmeter, and 20- and 40-L breathing bags. PROCEDURE: Circuit volume was determined by a carbon dioxide dilution technique. Oxygen flow rates of 3, 6, and 10 L/min were delivered to the circuit with the large breathing bag, and a flow rate of 6 L/min was used with the small bag. Gas samples were collected during a 20-minute period. The time constant (tau) and half-time (T1/2) were calculated and compared with measured values. RESULTS: Mean +/- SEM volume of the breathing circuit with a 20- and 40-L breathing bag was 32.97 +/- 0.91 L and 49.26 +/- 0.58 L, respectively. The tau from measurements was 11.97, 6.10, and 3.60 minutes at oxygen flow rates of 3, 6, and 10 L/min, respectively, for the large breathing bag and 3.73 minutes at a flow rate of 6 L/min for the small breathing bag. The T1/2 was 8.29, 4.22, and 2.49 minutes at oxygen flow rates of 3, 6, and 10 L/min, respectively, for the large breathing bag and 2.58 minutes for the small breathing bag. CONCLUSIONS AND CLINICAL RELEVANCE: This study emphasizes that there are delays in the rate of increase in the inspired oxygen concentration that accompany use of conventional large animal circle anesthetic systems and low rates of inflow for fresh oxygen.     

Circulatory, respiratory and behavioral responses in isoflurane anesthetized llamas

Objectives To evaluate the circulatory, respiratory and behavioral effects of isoflurane (ISO) anesthesia in llamas during mechanical ventilation and spontaneous breathing. Design Prospective randomised study. Animals Six adult, neutered male llamas (10 ± 1 years [mean ± SD], 179 ± 32 kg). Materials and methods Animals in which the minimum alveolar concentration (MAC) had been previously determined were anesthetized with ISO in oxygen. Inspired and end‐tidal (ET) ISO were sampled continuously. Arterial blood pH, respiratory and circulatory variables, and clinical signs of anesthesia were recorded at three doses (1.0, 1.5 and 2.0 times the individual animal's MAC; mean MAC value 1.13%) of ISO during spontaneous and controlled ventilation. A series of Latin squares was used to determine order of dose. Controlled ventilation (CV) (target PaCO₂ 38 ± 5 mm Hg [5.0 ± 0.6 kPa]) preceded spontaneous ventilation (SV) at each dose. Animals breathed spontaneously for approximately 10 minutes prior to data collection. Body temperature was maintained at 37 ± 0.6 °C. Circulatory and respiratory data were analysed with a mixed model, least squares analysis of variance, for repeated measures taken at equally spaced intervals. p < 0.05. Results Dose and mode of ventilation had significant influences on measured variables. For example, heart rate increased as dose increased; 67 ± 14 beats minute^?1 at 1.0 MAC‐CV versus 77 ± 6 beats minute^?1 at 2 MAC‐CV. Conversely, mean arterial pressure decreased with increasing dose; 82 ± 13 mm Hg at MAC‐CV versus 52 ± 15 mm Hg at 2 MAC‐CV. Arterial CO₂ increased with increasing dose during SV; 45 ± 5 mm Hg [6 ± 0.6 kPa] at MAC versus 53 ± 4 mmHg [7 ± 0.5 kPa] at 2 MAC. Reflex activity (e.g. palpebral reflex) and muscle tone (e.g. jaw tone) decreased while eyelid aperture increased with increasing anesthetic dose. Conclusions and Clinical Relevance The influence of ISO dose and mode of ventilation on circulatory and respiratory variables in llamas is qualitatively similar to that reported in other species. Changes in reflex activity and muscle tone may be used to guide appropriate anesthetic delivery in ISO‐induced llamas.