A comparison of cardiorespiratory variables during isoflurane-fentanyl and propofol-fentanyl anaesthesia for surgery in injured cats

OBJECTIVE: To compare haemodynamic and respiratory variables during isoflurane-fentanyl (IF) and propofol-fentanyl (PF) anaesthesia for surgery in injured cats. STUDY DESIGN: Prospective, randomized, controlled clinical study. ANIMALS: Thirty-three client-owned injured cats undergoing orthopaedic surgery. MATERIALS AND METHODS: Pre-anaesthetic medication was intravenous midazolam 1 mg kg(-1), butorphanol 0.4 mg kg(-1) and ketamine 2 mg kg(-1). Anaesthesia was induced with propofol (P) and maintained with either: (a) a continuous rate infusion (CRI) of fentanyl (F) 0.02 mg kg(-1) hour(-1) and isoflurane (initial end-tidal concentration of 1%), (b) a fentanyl CRI (dose as before) and sevoflurane (initial end-tidal concentration of 2%) or (c) a CRI of propofol (12 mg kg(-1) hour(-1)). All three techniques were given to effect until surgical anaesthesia was achieved. Heart rate and rhythm (ECG), mean arterial blood pressure, respiratory rate, tidal volume and end-tidal CO(2) concentration were recorded. Venous blood gas analysis was performed before and after sedation, and at the end of anaesthesia. Blood chemistry and blood cell counts were assessed before, at the end of, and 24 hours after anaesthesia. The variables recorded from cats anaesthetized with IF and PF were compared. RESULTS: Mean end-expiratory isoflurane concentration was 1.19 +/- 0.19%. The propofol infusion rate was 11.4 +/- 0.8 mg kg(-1) hour(-1). No significant differences between the two groups in heart rate were identified; no cardiac dysrhythmias were recorded. Mean arterial blood pressure was significantly lower in IF cats during skin incision (p = 0.01), during surgery without intense surgical stimulation (p < 0.01) and during surgery with intense surgical stimulation (p = 0.01). Nine of 11 cats in the IF group were markedly hypotensive (34-49 mmHg) while seven of 11 cats in group PF were mildly hypotensive (49-59 mmHg). One of 11 cats in group IF and nine of 11 cats in group PF required intermittent positive pressure ventilation (IPPV) to maintain end-tidal CO(2) levels below 6.66 kPa (50 mmHg). CONCLUSION AND CLINICAL RELEVANCE: Despite the necessity to ventilate the lungs of cats in the PF group, arterial blood pressure was better maintained. Propofol-fentanyl anaesthesia is better for surgery in injured cats providing the means to impose IPPV are available.     

舒眠宁对猫麻醉效果的研究

将舒眠宁应用于猫,观察其麻醉诱导时间、维持麻醉时间、苏醒时间、各项生理参数及麻醉效果。给猫肌注舒眠宁0.08 mL/kg后,诱导、维持麻醉、苏醒时间分别为(3.8±0.3)m in,(59±16)m in和(16±13)m in,对各项生理参数影响不明显。在拟进行绝育或去势术的猫静注舒眠宁0.04 mL/kg后,诱导、维持麻醉、苏醒时间分别为(30±5)s、(30±16)m in和(20±12)m in,所监测的生理参数均在正常范围内。将舒眠宁和舒泰分别以0.08 mL/kg和10 mg/kg给猫肌注后,舒泰组出现眼球震颤,舌、头部不自主运动,开口困难、大量流涎等副作用,舒眠宁组则无明显副作用;舒泰比舒眠宁对猫的心率影响大;舒眠宁的肌松效果好于舒泰。     

The effects of diazepam or midazolam on the dose of propofol required to induce anaesthesia in cats

ObjectivesAssess effects of benzodiazepine administration on the propofol dose required to induce anaesthesia in healthy cats, investigate differences between midazolam and diazepam, and determine an optimal benzodiazepine dose for co-induction.Study designProspective, randomised, blinded, placebo-controlled clinical trial.AnimalsNinety client-owned cats (ASA I and II) with a median (interquartile range) body mass of 4.0 (3.4–4.9) kg.MethodsAll cats received 0.01 mg kg⁻¹ acepromazine and 0.2 mg kg⁻¹ methadone intravenously (IV). Fifteen minutes later, sedation was scored on a scale of 1–5, with 5 indicating greatest sedation. Propofol, 2 mg kg⁻¹, administered IV, was followed by either midazolam or diazepam at 0.2, 0.3, 0.4 or 0.5 mg kg⁻¹ or saline 0.1 mL kg⁻¹. Further propofol was administered until endotracheal intubation was possible. Patient signalment, sedation score, propofol dosage and adverse reactions were recorded.ResultsMidazolam and diazepam (all doses) significantly reduced the propofol dose required compared with saline (p < 0.001). There was no difference between midazolam and diazepam in propofol dose reduction (p = 0.488). All individual doses of midazolam reduced propofol requirement compared with saline (0.2 mg kg⁻¹, p = 0.028; 0.3 mg kg⁻¹, p = 0.006; 0.4 mg kg⁻¹, p < 0.001; 0.5 mg kg⁻¹, p = 0.009). Diazepam 0.2 mg kg⁻¹ did not reduce the propofol dose compared with saline (p = 0.087), but the remaining doses did (0.3 mg kg⁻¹, p = 0.001; 0.4 mg kg⁻¹, p = 0.032; 0.5 mg kg⁻¹, p = 0.041). Cats with sedation scores of 3 required less propofol than cats with scores of 2 (p = 0.008). There was no difference between groups in adverse events.Conclusions and clinical relevanceMidazolam (0.2–0.5 mg kg⁻¹) and diazepam (0.3–0.5 mg kg⁻¹) administered IV after 2 mg kg⁻¹ propofol significantly reduced the propofol dose required for tracheal intubation.     

The bispectral index during recovery from halothane and sevoflurane anaesthesia in horses

ObjectiveTo record the bispectral index (BIS) when horses moved during either halothane or sevoflurane anaesthesia and when they made volitional movements during recovery from these anaesthetics.Study designRandomized prospective clinical study.AnimalsTwenty-five client-owned horses undergoing surgery aged 8.8 (± 5.3; 1–19) years (mean ± SD; range).MethodsBaseline BIS values were recorded before pre-anaesthetic medication (BIS_B) and during anaesthesia (BIS_A) maintained with halothane (group H; n = 12) or sevoflurane (group S; n =13) at approximately 0.8–0.9 × minimum alveolar concentrations (MAC). Bispectral indices were recorded during the surgery when unexpected movement occurred (BIS_MA), during recovery when the first movement convincingly associated with consciousness was observed (BIS_M1) and once sternal recumbency was achieved (BIS_ST).ResultsNo significant difference in BIS_M1 was found between halothane- (85 ± 7; 75–93) and sevoflurane- (87 ± 10; 70–98) anaesthetized horses although BIS_A was significantly (p = 0.0002) lower in group S (62 ± 7; 53–72) than group H (74 ± 7; 60–84). Differences between BIS_M1 and BIS_A were significant in sevoflurane (p = 0.00001) and halothane recipients (p = 0.002) but were greater in group S (25 ± 9; 4–38) compared with group H (12 ± 10; ?9–25). In six of eight horses, BIS_MA values ranged between those recorded during anaesthesia and at first movement.Conclusions and clinical relevanceBispectral indices appear to approximate levels of unconsciousness, suggesting that monitoring the BIS may assist equine anaesthesia. However, it does not predict intra-operative movement.     

Effects of two fractions of inspired oxygen on lung aeration and gas exchange in cats under inhalant anaesthesia

ObjectiveTo compare the effects of two fractions of inspired oxygen (FiO₂) (0.4 and 1) on lung aeration and gas exchange during general anaesthesia in cats.Study designRandomized, blinded, controlled study.AnimalsThirty healthy, mixed breed, client owned female cats.Materials and methodsCats were premedicated intramuscularly with acepromazine (0.03 mg kg^?1) and medetomidine (0.015 mg kg^?1). Anaesthesia was induced with propofol (5 mg kg^?1) and, after orotracheal intubation, maintained with isoflurane carried by either 100% oxygen (G100, n = 15) or an oxygen-air mixture with 40% oxygen (G40, n = 15). All cats were placed in dorsal recumbency and breathed spontaneously throughout the entire procedure. Following surgery (ovariectomy), a spiral computed tomography (CT) of the thorax was performed, arterial oxygen (PaO₂) and carbon dioxide (PaCO₂) tensions were measured and alveolar-arterial gradient of oxygen [P(A-a)O₂] calculated. The CT images were analysed for lung aeration by the analysis of radiograph attenuations (Hounsfield units, HU), according to the following classification: hyperinflated area (-1000 to -900 HU), normally aerated area (-900 to -500 HU), poorly aerated area (-500 to -100 HU) and non-aerated area (-100 to +100 HU). The groups were compared using one-way anova.ResultsCompared to G100, the normally-aerated lung area was significantly greater and the poorly-aerated and non-aerated areas were significantly smaller in G40. PaCO₂ was similar in both groups. PaO₂ and P(A-a)O₂ were significantly higher in G100. In both groups, pulmonary atelectasis developed preferentially in the caudal lung fields.ConclusionIn cats anaesthetised with isoflurane, the administration of an FiO₂ of >0.9 significantly impaired lung aeration and gas exchange as compared to an FiO₂ of 0.4.Clinical relevanceAn FiO₂ of 0.4 may better preserve lung aeration and gas exchange in anaesthetised spontaneously breathing cats but monitoring is essential to ensure oxygenation is adequate.     

The effects of morphine on the recovery of horses from halothane anaesthesia

OBJECTIVE: To investigate the effects of peri-operative morphine on the quality and duration of recovery from halothane anaesthesia in horses. STUDY DESIGN: Prospective randomized study. ANIMALS: Twenty-two client owned horses, ASA category I or II. METHODS: Horses undergoing elective surgical procedures were divided into two groups and paired according to procedure, body position during surgery, body mass and breed. Group M+ received morphine by intravenous injection (0.15 mg kg(-1)) before induction of anaesthesia and then by infusion (0.1 mg kg(-1) hour(-1)) during anaesthesia. Group M- received the same anaesthetic agents except that morphine was excluded. At the end of surgery, the horses were placed in a recovery box and allowed to recover without assistance. Recoveries were recorded on videotape, beginning when the anaesthetist left the recovery box, and ending when the horse stood up. Recoveries were assessed from digital video recordings by three observers, unaware of treatment. The time to first movement, attempting and attaining sternal recumbency and standing were recorded. The quality of various aspects of the recovery was assessed to produce a total recovery score; high numerical values indicate poor recoveries. The duration of anaesthesia and the total dose of morphine administered were recorded. RESULTS: The mean morphine dose (95% CI) was 147 (135-160) mg [equivalent to 0.27 (0.25-0.29) mg kg(-1)]. The recovery scores (median, 95% CI) for the M- and M+ groups were 25, 19-41 and 20, 14-26, respectively. Total score increased as duration of anaesthesia increased, independent of treatment. Untreated (M-) horses made more attempts to achieve sternal recumbency: mean number of attempts (95% CI) for M- was 4.5 (2.7-6.2) compared with 2.0 (1.4-2.6) (M+). Untreated horses made more attempts to stand (2.1, 1.6-2.6) compared with the morphine recipients (1.3, 1.1-1.5). Time to standing (in minutes) was significantly (p = 0.0146) longer for the untreated (31.3, 24.3-38.3) compared with treated animals (26.6, 20.9-32.3). The interval between the first movement in recovery to the time at standing was significantly (p < 0.001) longer for M- (14.5, 12.1-16.9 minutes) compared with M+ animals (7.4, 5.0-9.8 minutes). CONCLUSIONS AND CLINICAL RELEVANCE: Recoveries from anaesthesia in the morphine recipients were characterized by fewer attempts to attain sternal recumbency and standing, and a shorter time from the first recovery movement to the time of standing.     

The effect of the duration of propofol administration on recovery from anesthesia in cats

OBJECTIVE: To determine the effect of induction, a 30-minute, and a 150-minute infusion of propofol on the rate of recovery in cats. STUDY DESIGN: Randomized, cross-over, prospective experimental study. ANIMALS: Six healthy adult spayed female cats (mean 4.3, range 2-7 years old) weighing 3.9 +/- 0.5 kg. METHODS: Cats received each of three treatments: anesthetic induction with propofol (T1), induction followed by a 30-minute infusion (T30) and induction followed by a 150-minute infusion (T150). Propofol infusions were increased or decreased to maintain a sluggish pedal withdrawal reflex. Animals were monitored throughout the anesthetic period and during the recovery. Venous blood samples were collected from a central venous catheter before anesthesia and at 30 minutes for the 30-minute infusion and at 30, 60, 90, 120 and 150 minutes for the 150-minute infusion. The ability of the cat to lift its head, crawl, stand and walk without ataxia was recorded at 5, 10, 20, 40, 60, 80, 120, 160, 180, 210 and 240 minutes after the completion of propofol administration. Data from physiological values were analyzed using either a Student's t-test (30-minute infusion) or an anova (150-minute infusion). A nonparametric Friedman test (and post-hoc Tukey's Studentized range test) was used to determine whether there were differences in the time taken to recover. Results were considered significant if p < 0.05. RESULTS: Time taken to walk without ataxia was significantly greater in T150 (148 +/- 40 minutes) compared with T1 (80 +/- 15 minutes) and T30 (74 +/- 26 minutes). (No other recovery times were significantly different). Anesthesia with propofol was accompanied by a moderate but significant respiratory depression and a decrease in PCV and total protein. CONCLUSIONS AND CLINICAL RELEVANCE: Prolonged anesthesia with propofol in healthy cats may be associated with a delayed recovery.     

Anaesthetic sparing effect of local anaesthesia of the ovarian pedicle during ovariohysterectomy in dogs

ObjectiveTo evaluate the effect of local anaesthesia of the mesovarium on end-tidal isoflurane (Fe′_iso) concentration and vital parameters during canine ovariohysterectomy.Study designProspective, randomized, blinded study.AnimalsTwenty client-owned dogs undergoing elective ovariohysterectomy. Mean age 1.7 (±0.53, SD) years and mean body weight 21 kg (±5.9, SD).MethodsPre-medication was with intravenous acepromazine (0.02 mg kg⁻¹) and methadone (0.1 mg kg⁻¹). Anaesthesia was induced with propofol and maintained with isoflurane in oxygen. One group (n = 10) received local infiltration of the mesovarium with 0.5 mL lidocaine 2% and one group (n = 10) with 0.5 mL NaCl 0.9%. Heart (HR) and respiratory rates (fr), invasive mean arterial blood pressure (MAP) and Fe′_isowere recorded. The Fe′_iso was adjusted according to changes in HR, RR and MAP. Time points used for comparison were T1 (after induction of anaesthesia before surgery), T2 (after lidocaine infiltration of the mesovarium) and T3 (surgical manipulation of the ovaries). Data were analysed using a mixed model for repeated measurement anova and the Tukey adjustment. Results are presented as mean ± SD; p < 0.05 was considered significant.ResultsIn both groups, HR and fr remained stable at the three time points. Mean values ranged from 84 to 94 beats minute⁻¹ and from 10 to 14 breaths minute⁻¹. The Fe′_iso was significantly lower at T3 compared to T1 and mean values ranged from 0.95% to 1.24%. The mean arterial blood pressure was significantly higher at T3 compared to T1 and mean values ranged from 58 to 96 mm Hg. At none of the time points were there significant differences between the two groups for HR, fr, MAP or Fe′_iso.ConclusionNeither an isoflurane sparing effect nor a difference in autonomic response to surgery was demonstrated following local anaesthesia of the mesovarium.Clinical relevanceThere appeared to be minimal benefit from local anaesthesia of the mesovarium during this study.     

RESEARCH PAPER: Incidence of elevation of cardiac troponin I prior to and following routine general anaesthesia in dogs

ObjectiveTo estimate the incidence of raised cTnI after general anaesthesia in dogs and to explore major risk factors influencing this.Study designProspective clinical study.AnimalsA total of 107 (ASA physical status 1?2) dogs, 63% male and 37% female, median age 5 years (range 0.3–13.4), median weight 24.4 kg (range 4.2–66.5 kg) undergoing anaesthesia for clinical purposes.MethodsVenous blood samples were taken within 24 hours prior to induction and 24 hours after the termination of anaesthesia. Serum concentrations of cardiac troponin I were measured using a chemiluminescent enzyme immunometric assay with a lower level of detection of 0.20 ng mL^?1 (below this level <0.20 ng mL^?1). Continuous data were assessed graphically for normality and paired and unpaired data compared with the Wilcoxon signed ranks and Mann–Whitney U‐tests respectively. Categorical data were compared with the Chi squared or Fisher’s exact test as appropriate (p < 0.05).ResultsOf the 107 dogs recruited, 100 had pre‐ and post‐anaesthetic cTnI measured. The median pre‐anaesthesia cTnI was ‘<0.20’ ng mL^?1 (range ‘<0.20’–0.43 ng mL^?1) and the median increase from pre‐anaesthesia level was 0.00 ng mL^?1 (range ?0.12 to 0.61 ng mL^?1). Fourteen dogs had increased cTnI after anaesthesia relative to pre‐anaesthesia (14%, 95% CI 7.2–20.8%, range of increase 0.03–0.61 ng mL^?1). Six animals had cTnI levels that decreased (range 0.02–0.12 ng mL^?1). Older dogs were more likely to have increased cTnI prior to anaesthesia (OR = 5.32, 95% CI 1.35–21.0, p = 0.007) and dogs 8 years and over were 3.6 times as likely to have an increased cTnI after anaesthesia (95% CI 1.1–12.4, p = 0.028).Conclusion and clinical relevanceIncreased cTnI after anaesthesia relative to pre‐anaesthesia levels was observed in a number of apparently healthy dogs undergoing routine anaesthesia.     

The effect of hyoscine on dobutamine requirement in spontaneously breathing horses anaesthetized with halothane

OBJECTIVE: To determine whether hyoscine has a sparing effect on the volume of dobutamine required to maintain mean arterial pressure (MAP) at 70 mmHg in horses anaesthetized with halothane. STUDY DESIGN: Prospective, randomized, controlled clinical trial. ANIMALS: Twenty adult horses weighing 507 +/- 97 kg (mean +/- SD), aged 10 +/- 5 years. MATERIALS AND METHODS: Pre-anaesthetic medication in all horses was intramuscular (IM) acepromazine (40 mug kg(-1)) and intravenous (IV) detomidine (0.02 mg kg(-1)). Anaesthesia was induced with ketamine (2.2 mg kg(-1) IV) and diazepam (0.02 mg kg(-1) IV), and maintained with halothane in oxygen. Horses breathed spontaneously. Flunixin (1.1 mg kg(-1) IV) was given to provide analgesia. Heart rate, ECG, invasive arterial pressure, respiratory rate, percentage end-tidal carbon dioxide, percentage end-tidal halothane and partial pressure of oxygen and carbon dioxide in arterial blood and blood pH were monitored. Dobutamine was infused by an infusion pump to maintain MAP at 70 mmHg. Horses were randomly assigned to receive saline or hyoscine (0.1 mg kg(-1)) IV 30 minutes after induction. The heart rate, MAP and volume of dobutamine infused over 30-minute periods were measured and analysed statistically using a one-way anova. RESULTS: After administration of hyoscine, heart rate increased for 10 minutes (p < 0.01) and MAP for 5 minutes (p < 0.01). There was no difference in the volume of dobutamine infused over 30 minutes between horses given hyoscine or saline, although there was a wide individual variation in dobutamine requirements. No side effects of hyoscine were seen. CONCLUSIONS: The increase in heart rate and blood pressure that occurs after 0.1 mg kg(-1) hyoscine is given IV in anaesthetized horses, is of short duration and does not significantly alter the amount of dobutamine required to maintain arterial pressure over the next 30 minutes. Clinical relevance The short duration of action of 0.1 mg kg(-1) hyoscine IV may limit its usefulness for correction of hypotension in horses anaesthetized with halothane. Further work is necessary to investigate the effects of higher or repeated doses or constant rate infusions of hyoscine.     

A dose titration study into the effects of diazepam or midazolam on the propofol dose requirements for induction of general anaesthesia in client owned dogs,premedicated with methadone and acepromazine

ObjectiveTo assess the effect of a benzodiazepine co–induction on propofol dose requirement for induction of anaesthesia in healthy dogs, to describe any differences between midazolam and diazepam and to determine an optimal benzodiazepine dose for co–induction.Study designProspective, randomised, blinded placebo controlled clinical trial.AnimalsNinety client owned dogs (ASA I–III, median body mass 21.5kg (IQR 10–33)) presented for anaesthesia for a variety of procedures.MethodsDogs were randomised to receive saline 0.1 mL kg^?1, midazolam or diazepam at 0.2, 0.3, 0.4 or 0.5 mg kg^?1. All dogs received 0.01 mg kg^?1 acepromazine and 0.2 mg kg^?1 methadone intravenously (IV). Fifteen minutes later, sedation was assessed and scored prior to anaesthetic induction. Propofol, 1 mg kg^?1, was administered IV, followed by the treatment drug. Further propofol was administered until endotracheal intubation was possible. Recorded data included patient signalment, sedation score, propofol dosage and any adverse reactions.ResultsMidazolam (all groups combined) significantly reduced propofol dose requirement compared to saline (p < 0.001) and diazepam (p = 0.008). Midazolam (0.4 mg kg^?1) significantly reduced propofol dose requirement (p = 0.014) compared to saline, however other doses failed to reach statistical significance. Diazepam did not significantly reduce propofol dose requirement compared to saline (p = 0.089). Dogs weighing <5 kg, regardless of treatment group, required a greater propofol dose than those weighing 5–40 kg (p = 0.002) and those >40 kg (p = 0.008). Dogs which were profoundly sedated required less propofol than those which were mildly sedated (p < 0.001) and adequately sedated (p = 0.003).Conclusions and clinical relevanceMidazolam (0.4 mg kg^?1) given IV after 1 mg kg^?1 of propofol significantly reduced the further propofol dose required for intubation compared to saline. At the investigated doses, diazepam did not have significant propofol dose sparing effects.     

A randomized, blinded, controlled trial of the antiemetic effect of ondansetron on dexmedetomidine-induced emesis in cats

ObjectiveTo determine the effect of ondansetron on the incidence of vomiting in cats pre-medicated with dexmedetomidine and buprenorphine.Study designRandomized, blinded, controlled trial.AnimalsEighty-nine female domestic shorthair cats, aged 3–60 months (median, 12 months) and weighing 1.2–5.1 kg.MethodsEach cat received dexmedetomidine (40 μg kg^?1) plus buprenorphine (20 μg kg^?1), intramuscularly as pre-anesthetic medication. Cats were assigned to three treatment groups: ondansetron (0.22 mg kg^?1, intramuscular [IM]), either 30 minutes before the pre-anesthetic medication (ONDA group, n = 31) or with the pre-anesthetic medication (OPM group, n = 30) mixed with the pre-anesthetic medications in the same syringe, or not to receive the antiemetic (control group, n = 28). Emesis was recorded as an all-or-none response. The number of episodes of emesis and the time until onset of the first emetic episode were recorded for each cat. Clinical signs of nausea were recorded whenever they occurred, and a numerical rating scale was used to quantify these signs. Data were analyzed using Kruskal–Wallis and Chi-square test; a Bonferroni correction was made for six comparisons; thus, the two-sided p for significance was 0.05/6 = 0.008.ResultsThere was a significant reduction in the number of cats vomiting, in the episodes of vomiting/cat, the time elapsed between the premedication and the first vomiting and the severity of nausea in the OPM group compared to the ONDA and control groups.Conclusions and clinical relevanceIn cats, the administration of ondansetron (0.22 mg kg^?1) ameliorates and reduced the severity of dexmedetomidine-induced nausea and vomiting only when it was administered in association with this drug.     

Comparison of the effects of propofol or alfaxalone for anaesthesia induction and maintenance on respiration in cats

ObjectiveTo compare the effects of propofol and alfaxalone on respiration in cats.Study designRandomized, ‘blinded’, prospective clinical trial.AnimalsTwenty cats undergoing ovariohysterectomy.MethodsAfter premedication with medetomidine 0.01 mg kg⁻¹ intramuscularly and meloxicam 0.3 mg kg⁻¹ subcutaneously, the cats were assigned randomly into two groups: group A (n = 10) were administered alfaxalone 5 mg kg⁻¹ minute⁻¹ followed by 10 mg kg⁻¹ hour⁻¹ intravenously (IV) and group P (n = 10) were administered propofol 6 mg kg⁻¹ minute⁻¹ followed by 12 mg kg⁻¹hour⁻¹ IV for induction and maintenance of anaesthesia, respectively. After endotracheal intubation, the tube was connected to a non-rebreathing system delivering 100% oxygen. The anaesthetic maintenance drug rate was adjusted (± 0.5 mg kg⁻¹ hour⁻¹) every 5 minutes according to a scoring sheet based on physiologic variables and clinical signs. If apnoea > 30 seconds, end-tidal carbon dioxide (Pe′CO₂) > 7.3 kPa (55 mmHg) or arterial haemoglobin oxygen saturation (SpO₂) < 90% occurred, manual ventilation was provided. Methadone was administered postoperatively. Data were analyzed using independent-samples t-tests, Fisher's exact test, linear mixed-effects models and binomial test.ResultsManual ventilation was required in two and eight of the cats in group A and P, respectively (p = 0.02). Two cats in both groups showed apnoea. Pe′CO₂ > 7.3 kPa was recorded in zero versus four and SpO₂ < 90% in zero versus six cats in groups A and P respectively. Induction and maintenance dose rates (mean ± SD) were 11.6 ± 0.3 mg kg⁻¹ and 10.7 ± 0.8 mg kg⁻¹ hour⁻¹ for alfaxalone and 11.7 ± 2.7 mg kg⁻¹ and 12.4 ± 0.5 mg kg⁻¹ hour⁻¹ for propofol.Conclusion and clinical relevanceAlfaxalone had less adverse influence on respiration than propofol in cats premedicated with medetomidine. Alfaxalone might be better than propofol for induction and maintenance of anaesthesia when artificial ventilation cannot be provided.     

The risk of passive regurgitation during general anaesthesia in a population of referred dogs in the UK

Objective To evaluate the risk of passive regurgitation during anaesthesia, and to identify major factors associated with this in dogs attending the Queen Mother Hospital for Animals (QMHA), the Royal Veterinary College. Study design A case‐control study nested within the cohort of dogs undergoing anaesthesia with inhalation agents. Animal population All dogs undergoing general anaesthesia at the referral hospital between October 2006 and September 2008 (4271 cases). Methods All dogs anaesthetized at the QMHA during the study period were included. Regurgitating cases were defined as dogs for which reflux material was observed at the external nares or in the mouth, either during anaesthesia or before return to normal consciousness immediately after general anaesthesia. The risk of regurgitation was estimated and risk factors for regurgitation were evaluated with multivariable logistic regression (p < 0.05). Results The overall risk of regurgitation was 0.96% (41 cases out of 4271 anaesthetics, 95% confidence interval [95% CI] 0.67–1.25%). Exclusion of animals where pre‐existing disease was considered a contributing factor to regurgitation (n = 14) resulted in a risk of passive regurgitation of 0.63% (27 cases of 4257 anaesthetics, 95% CI 0.40–0.87%). In the multivariable logistic regression model, procedure and patient weight were significantly associated with regurgitation. Dogs undergoing orthopaedic surgery were 26.7 times more likely to regurgitate compared to dogs undergoing only diagnostic procedures. Dogs weighing more than 40 kg were approximately five times more likely to regurgitate than those weighing <20 kg. Conclusions and clinical relevance This study highlights the rare but important occurrence of perioperative regurgitation and identifies that dogs undergoing orthopaedic procedures, and those weighing more than 40 kg, are particularly at risk. Further work is required to evaluate the reasons for these observations.     

Effect of endogenous progesterone and oestradiol-17β on the incidence of gastro-oesophageal reflux and on the barrier pressure during general anaesthesia in the female dog

Objective To investigate the potential effect of increased blood progesterone (P₄) and oestradiol‐17β (E₂) concentrations on the barrier pressure (BrP) and the incidence of gastro‐oesophageal reflux (GOR) in female dogs under general anaesthesia. Study design Prospective, blinded experimental trial. Animals Seven female, adult, healthy dogs weighing 14–21 kg and aged 1–7 years. Methods Each of the animals was studied under the influence of high blood E₂ and basal P₄ (study O), basal E₂ and high P₄ (study P) and basal E₂ and P₄ (study C) concentrations. Animals were premedicated with acepromazine and anaesthesia was induced with thiopental and maintained with halothane. Lower oesophageal pH was monitored continuously for 1 hour after induction. GOR was defined as oesophageal pH >7.5 or <4. Manometry of the posterior oesophageal sphincter (POS) was then performed using the slow pull‐through technique. Results Acid GOR was detected in only one animal of study O. The three studies did not differ significantly in GOR. Mean BrP was 11.2 (study O), 9.1 (study P) and 11.6 mmHg (study C). No significant differences were detected with respect to mean BrP, intra‐gastric pressure and POS pressure. Conclusions It is unlikely that the increased concentrations of E₂ or P₄ during the normal ovarian cycle influence the functional efficiency of the POS as a major barrier to GOR in healthy, female dogs under general anaesthesia. Clinical relevance The fact that female dogs undergoing obstetrical surgery represented a substantial sub‐group of the animals which developed postoperative benign oesophageal stricture, should probably not be attributed to the effects of increased concentrations of female sex steroid hormones.     

Effects of guaiphenesin on the equine electroencephalogram during anaesthesia with halothane in oxygen

Objective To identify and characterize the effects of guaiphenesin (GGE) on the electroencephalogram during halothane anaesthesia. Study design Prospective controlled study. Animals Eight healthy Welsh mountain pony geldings between 5 and 9 years old and weighing between 270 and 330 kg (mean 301 kg). Methods Anaesthesia was induced with thiopentone and maintained using halothane in oxygen. End tidal halothane was maintained above 0.75 and below 0.85%. The EEG was recorded continuously and a binaural broad band click stimulus was provided throughout the experiment at 6.1224 Hz. An infusion of 1500 mg GGE was given over 5 minutes. Samples were taken for blood gas analysis and plasma GGE assay (HPLC) 5 minutes prior to the start of the infusion and at 3, 5, 7, 10, 15, 20, 30, 45 and 60 minutes thereafter. The median and 95th percentile of the EEG were calculated using standard statistical techniques and the mid‐latency of the auditory evoked response was generated. The values of EEG variables at each time point were compared to the average value for the 15 minute period before the infusion was started. Arterial blood gas values and plasma GGE concentration were compared to the baseline sample taken prior to the start of the infusion. Comparisons were made using analysis of variance for repeated measures followed by Dunnett's test if a significant difference was detected. Results The peak serum plasma concentration was 49.6 ± 7.8 μg mL^?1 (mean ± SD) occurring five minutes after the start of the infusion. The 95% spectral edge frequency (F95) of the EEG decreased by a maximum of 5.2 ± 14.3% 5 minutes after the start of the GGE infusion. This change did not reach statistical significance (p= 0.07). When three nonresponders were excluded, the depression in F95 at 5 minutes in the remaining five animals became 13.0 ± 12.0% and was statistically significant (p= 0.02). No changes were seen in median frequency of the EEG or the second differential of the middle latency auditory evoked potential. Conclusions These results did not demonstrate any statistically significant GGE‐induced changes in the EEG. However, there was some visible depression of F95 in five of the animals studied even though the dose of GGE used was considerably less than that used in most clinical circumstances. Clinical relevance The EEG effects seen in this study concur with the commonly held view that while GGE has some sedative effects, it is not a reliable anaesthetic agent.     

Effects of thiopentone on the equine electroencephalogram during anaesthesia with halothane in oxygen

Objective To characterise the effects of thiopentone on the equine electroencephalogram during halothane anaesthesia. Study design Prospective controlled study. Animals Eight healthy Welsh mountain pony geldings between 5 and 9 years old and weighing between 270 and 330 kg (mean 301 kg). Methods Anaesthesia was induced with thiopentone and maintained using halothane in oxygen. End tidal halothane was maintained above 0.75 and below 0.85%. EEG was recorded continuously and a binaural broad band click stimulus was provided throughout the experiment at 6.1224 Hz. An infusion of 500 mg thiopentone was given over 5 minutes. Samples were taken for blood gas analysis and plasma thiopentone assay (HPLC) 5 minutes prior to the start of the infusion and at 3, 5, 7, 10, 15, 20, 30, 45 and 60 minutes. The median and 95th percentile of the EEG were calculated using standard statistical techniques and the mid‐latency of the auditory evoked response was generated. The values of EEG variables at each time point were compared to the average value for the 15 minute period before the infusion was started. Arterial blood gas values and plasma thiopentone concentration were compared to the baseline sample taken prior to the start of the infusion. Comparisons were made using analysis of variance for repeated measures followed by Dunnett's test if a significant difference was detected. Results The peak serum plasma concentration was 14.5 ± 2.4 µg mL^?1 (mean ± SD) occurring 5 minutes after the start of the infusion. The 95% spectral edge frequency of the EEG decreased by a maximum of 27.4 ± 18.4% 7 minutes after the start of the thiopentone infusion. No changes were seen in median frequency of the EEG or the second differential of the middle latency auditory evoked response. Conclusions These results, coupled with the lack of antinociceptive action of thiopentone, support the hypothesis that median frequency of the EEG may be a useful indicator of nociception in anaesthetized animals. Clinical relevance If the EEG is to become a useful monitoring technique then it is important to understand the relative contribution of changing plasma concentrations of the agents used in anaesthesia.     

Measurement of the puncture profile and extradural pressure of cattle during extradural anaesthesia

ObjectiveTo measure the pressure profile during caudal extradural puncture and subsequent extradural anaesthesia in cattle and to investigate the presence of extradural pressure waves.Study designProspective experimental study.AnimalsEleven cattle aged 4.1 ± 2.5 years (range 0.8 to 8.8 years), with a body weight of 613 ± 162 kg (range 302–840 kg).MethodsCaudal extradural puncture was performed. To measure the extradural pressure profile, the needle was connected to an electronic pressure transducer placed at the height of the base of the tail. The pressure profile was recorded for 3 minutes following extradural puncture. Lack of resistance to injection of saline was assessed. One minute and 10 minutes after extradural anaesthesia with procaine extradural pressure was recorded. Correct extradural needle placement was assessed by clinical response.ResultsThree minutes after extradural puncture the median pressure was ?16 (range ?25 to 25) mmHg. Pressure in the extradural space 1 minute after the lack of resistance, 3 seconds after injection, and 10 minutes after injection was ?15 (?24 to 33) mmHg, 8 (?17 to 84) mmHg, and ?7 (?25 to 27) mmHg respectively. Pressure waves were visible after puncture, after lack of resistance, 3 seconds and 10 minutes after injection, in 4, 6, 8 and 7 cattle respectively. Pressure after testing lack of resistance, after the injection of local anaesthetic, as well as at the end of the measurement, period was significantly higher than baseline. All cattle showed clinical signs indicative of successful extradural needle placement.Conclusion and clinical relevance Extradural pressure was sub-atmospheric in 82% of the animals. Pressure waves were not consistently present before or after extradural injection, which limits their usefulness to confirm correct extradural needle placement. Extradural pressures increase significantly after injection of local anaesthetic solution. However, the clinical significance of the increase in extradural pressures was not clear.