The case for in circuit vaporizers.

In circuit vaporizers have some characteristics that differ from out of circuit vaporizers. In circuit vaporizers are easy to use, effective, and offer several clinical advantages.     

Vaporizer position.

The vaporizers that are positioned outside of the circle have known constant output concentrations and are not affected by positive pressure ventilation. The vaporizers that are positioned inside the circle system have unknown, variable output concentrations and are markedly affected by positive pressure ventilation. Either type can be safely used if its operating characteristics are understood.     

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.     

Evaluation of isoflurane and sevoflurane vaporizers over a wide range of oxygen flow rates

OBJECTIVE: To examine the accuracy and precision of isoflurane and sevoflurane anesthetic vaporizers. SAMPLE POPULATION: 5 identical isoflurane and 5 identical sevoflurane vaporizers. PROCEDURES: Oxygen flow rates from 0.02 to 10 L/min were used with different vaporizer dial settings. Agent concentrations were measured at the common gas outlet by use of a refractometer. Accuracy was defined as the difference between measured agent concentrations, and dial settings were expressed as a percentage of the applied dial settings. Precision was defined as SD of the measured agent concentrations for each combination of dial setting and flow. RESULTS: Isoflurane values were generally greater than the dial settings. Accuracy of the isoflurane vaporizer was > 20% when 0.6% and 1% was dialed. Accuracy of the sevoflurane vaporizer was always within +/- 20% but decreased at 0.02 L/min flow and at combinations of high flow and high dial settings. Overall precision of the isoflurane vaporizer was better than that of the sevoflurane vaporizer. CONCLUSIONS AND CLINICAL RELEVANCE: A possible explanation for the inaccuracy of the isoflurane vaporizer may be that it was manufactured to be accurate with air but not oxygen, which must be accounted for when using the vaporizer with oxygen, especially with nonrebreathing systems. The sevoflurane vaporizer may not deliver accurate agent concentrations at high flow and high dial settings. Both vaporizers are suitable for clinical use with a wide range of oxygen flow rates if these precautions are properly addressed.     

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.     

PRACTICAL PROBLEMS WITH VETERINARY ANAESTHESIA MACHINES

Many types of anaesthetic machines are available to practicing veterinary surgeons, ranging from the obsolescent to the most modern. To practice anaesthesia safely, veterinary surgeons should understand the functions of the machines, vaporizers, and breathing systems with which they work. In addition, veterinary surgeons should employ procedures for evaluation of their anaesthetic equipment to assure, as much as possible, safety for their patients and the personnel who use the apparatus.     

Effectiveness of passive gas-scavenging canisters attached to isoflurane anesthesia systems under standard-use conditions in a laboratory animal facility

Chronic exposure to trace levels of waste anesthetic gases has been linked to higher incidences of neurologic and reproductive dysfunction, hepatic and renal toxicity, and neoplasia in health care professionals. We have shown that low levels of isoflurane emissions are likely in conventional laboratory animal treatment rooms during the use of standard anesthesia delivery systems equipped with activated charcoal canisters for passive gas scavenging. In the present study, we surveyed the effectiveness of canisters (attached to well‐maintained precision isoflurane vaporizers) in current use throughout our AAALAC‐accredited laboratory animal facility. Canisters (Omnicon f/air) had been weighed prior to use and then attached to dual‐loop systems (face mask and induction box circuits) from 1 week to 6 months of service. Isoflurane emissions were measured using a pre‐calibrated, portable infrared spectrophotometer by attaching each canister to the face‐mask circuit, occluding the face mask and closing the stopcock to the induction circuit, and running the system at uniform isoflurane concentration (2%) and oxygen flow rate (1 L minute^?1). Samples were taken in animal procedure rooms (size range, 45–80 m³) in which the air turnover rate ranged between 20 and 30 nonrecirculating changes per hour. Nine of the 60 canisters (15%) in current use were found to have exceeded the manufacturer's recommended use‐life (defined as a weight increase of 50 g). Of these nine, seven canisters did not scavenge isoflurane at all (indicated by emissions greatly exceeding 100 ppm). Isoflurane was not detected in the operator's breathing zone under normal use conditions (i.e. gas directed to both circuits at once). Of the 51 canisters that had not exceeded their rated use‐life, 12 (23.5%) exhausted isoflurane at >2 ppm. Our data show that (i) the potential for exposure to waste isoflurane emissions will depend on the configuration of the delivery system and that (ii) enhanced attention to canister surveillance may be warranted even in well‐run facilities.     

Surgical implantation of radiotelemetry devices in American river otters

The Oklahoma Department of Wildlife Conservation elected to investigate the feasibility of reintroducing American river otters (Lutra canadensis) into Oklahoma waterways. Intra-abdominal radiotelemetry devices were selected to monitor otter movements following release. For implantation of those devices, the anesthetic regimen included a mixture of ketamine HCl, xylazine, and acepromazine maleate given intramuscularly followed by delivery of isoflurane through precision vaporizers. A ventral midline approach and adherent surgical barrier drapes facilitated aseptic placement of the devices, with minimal tissue damage and loss of insulating pelage. Absorbable monofilament suture (polydioxanone) was used in a buried 3-layer closure of surgical incisions. The incisions healed rapidly and without complications.     

Modification of a Nonrebreathing Circuit Adapter to Prevent Barotrauma in Anesthetized Patients

Barotrauma, pneumothorax, and pneumomediastinum occurred in two anesthetized cats in which the waste gas outlet of a nonrebreathing circuit was occluded. To prevent any similar cases of barotrauma, we have modified our nonrebreathing circuit adapters by inserting a 15 cm H₂O PEEP valve into the gas pathway of the nonrebreathing circuit adapter. This PEEP valve prevents the circuit and airway pressures from exceeding 15 cm H₂O if the pop-off valve of the nonrebreathing circuit adapter is inadvertently left closed.     

The Cancellation of Mirror-image Electrocardiograms in the Horse

The paper describes the use of a four-electrode cancellation technique, employing a bridge circuit to cancel mirror-image ECGs on the body surface of six horses. The axes joining points at which good cancellations were obtained were plotted on planar diagrams. Evidence is presented which suggests that a considerable proportion of cardiac activity could be regarded as though arising from the activity of a single resultant dipole although there is probably some mobility of the dipole centre during different parts of the cardiac cycle.     

Evaluation of a non-rebreathing circuit for small animal anaesthesia

Several new multi-purpose non-rebreathing anaesthetic systems have been developed for human anaesthesia. This study evaluated a New Zealand designed non-rebreathing circuit, the Palmerston Valve, in anaesthetised spontaneously breathing dogs and compared it to the widely used Lack coaxial circuit. Arterial blood gas measurements 60 minutes after induction demonstrated comparable slight increases in PaCO₂ in nearly all dogs maintained on the Palmerston Valve and Lack coaxial circuit with halothane and oxygen mixtures, and a fresh gas flow rate of 70 ml/kg/min.

Results suggest the Palmerston Valve is at least as efficient as the Lack coaxial circuit, while offering in the same unit the potential for economical controlled ventilation.     

Evaluation of a non-rebreathing circuit for small animal anaesthesia

Several new multi-purpose non-rebreathing anaesthetic systems have been developed for human anaesthesia. This study evaluated a New Zealand designed non-rebreathing circuit, the Palmerston Valve, in anaesthetised spontaneously breathing dogs and compared it to the widely used Lack coaxial circuit. Arterial blood gas measurements 60 minutes after induction demonstrated comparable slight increases in PaCO2 in nearly all dogs maintained on the Palmerston Valve and Lack coaxial circuit with halothane and oxygen mixtures, and a fresh gas flow rate of 70 ml/kg/min. Results suggest the Palmerston Valve is at least as efficient as the Lack coaxial circuit, while offering in the same unit the potential for economical controlled ventilation.     

A new anaesthetic circuit for use in the dog

A co–axial non–rebreathing circuit for use in small animal anaesthesia is described. The advantages and disadvantages of this type of circuit are discussed in relation to other circuits in current use.     

A NEW METHOD OF CLOSED CIRCUIT ANAESTHESIA UTILISING HALOTHANE AND METHOXYFLURANE

Experiences with a new technique of closed circuit anaesthesia used for 1003 surgical cases involving cats and dogs are described. The technique utilises the combined vapors of methoxyflurane and halothane from dual, low-resistance vaporisers situated in series, and supported by low flow rates of 100% oxygen in the inspiratory limb of the anaesthetic machine. This anaesthetic circuit can be adapted for many surgical procedures involving both controlled and spontaneous ventilation techniques and for young and old animals. The technique is considered safe, economical and easily managed and pollution of the operating theatre is eliminated by the use of the completely closed circuit.     

采用红外光谱技术检测反刍动物甲烷排放

反刍动物甲烷排放监测一直难以建立起精确的评估体系,其中一个重要原因是常用检测反刍动物甲烷排放的方法不够完善,另外检测仪器受外部环境的影响,难以保证其准确度和灵敏度。目前,红外光谱检测技术正在被广泛应用于反刍动物甲烷排放检测,一些基于红外光谱检测技术的最新检测方法,如甲烷激光检测(LMD)、傅里叶变换红外光谱检测(FTIR)、Green Feed(GF)系统和便携式自动开路气体量化系统(GQS)也得到广泛运用。与以往常用方法相比,红外光谱检测技术具有一定优势。本文根据现有文献,从红外光谱检测的原理、可靠性及与其他常见方法对比,论述了红外光谱检测方法在反刍动物甲烷排放中的应用现状和应用前景,旨在为精确检测反刍动物的甲烷排放提供参考。     

Use of an isolated intestinal circuit to evaluate the effect of ischemia and reperfusion on mucosal permeability of the equine jejunum

OBJECTIVES: To evaluate the efficacy of an isolated perfusion circuit and the effect of ischemia-reperfusion on mucosal permeability of the jejunum. STUDY DESIGN: In vitro study of intestinal mucosal permeability. ANIMALS: Twelve healthy adult horses. METHODS: A control segment of jejunum was placed in an isolated perfusion circuit for 240 minutes and mucosal permeability was measured. After detecting no deleterious effects of the isolated system on the control intestine, low flow ischemia was created in experimental segments for 20, 40, 60 and 90 minutes followed by 60 minutes of reperfusion and mucosal permeability was evaluated. At the completion of the studies, histologic evaluation was used to determine mucosal grades, surface area, and volume. RESULTS: Control tissue was maintained in the isolated circuit for 240 minutes without effect on mucosal grade, surface area, or volume relative to intact tissue. After ischemia-reperfusion, mucosal grade increased, and volume and surface area decreased progressively with longer periods of ischemia. Mucosal clearance of albumin remained constant during 240 minutes of perfusion in control tissue and was elevated after ischemia-reperfusion. CONCLUSIONS: No deleterious changes were noted in jejunum perfused with this isolated circuit, whereas alterations in mucosal permeability were present after ischemia-reperfusion. CLINICAL RELEVANCE: The isolated perfusion circuit successfully maintained an isolated segment of jejunum within physiologic limits, and can be used to evaluate the effects of injury and the efficacy of pharmaceuticals to attenuate these changes.     

Japanese Society for Animal Reproduction: award for outstanding research 2002. Mechanisms controlling neurohypophysial hormone release in the rat

To explore mechanisms of osmotic control of neurohypophysial hormone release, electrical activity of magnocellular neurons (MCNs) in the hypothalamus, related neurons and efferent renal sympathetic nerve activity (RSNA) were recorded from urethane-anesthetized rats. Local osmotic stimulation applied to organum vasculosum of the lamina terminalis (OVLT) or median preoptic nucleus (MnPO) excited MCNs. Although OVLT neurons projected to MCNs were unresponsive to hyperosmotic stimulation, those projected to MnPO and also receiving excitatory inputs from MCNs, were excited by it. MnPO neurons, which were driven by OVLT stimulation and projected to MCNs, were also osmosensitive. Excitatory connections thus exist from MCNs to OVLT, from OVLT to MnPO and from MnPO to MCNs. Neurons in each of these connections were osmosensitive. This circuit thus appears to constitute an osmoreceptor complex essential for the osmoreception of MCNs. MnPO neurons constituting a part of the osmosensitive circuit were also sensitive to hemodynamic change. Thus this circuit may integrate hemodynamic and osmotic information. Local anesthesia of MnPO diminished activation of RSNA and pressor response induced by third cerebroventricular injection of hypertonic saline. The results suggest that the osmosensitive circuit is involved in body fluid regulation not only by controlling vasopressin secretion but also by modulating sympathetic outflow.     

Observations on the use of glyceryl guaiacolate as an adjunct to general anaesthesia in horses

Twenty-one horses undergoing clinical surgery and diagnostic procedures received 15% glyceryl guaiacolate followed by a rapid intravenous injection of a thiobarbiturate for induction of anaesthesia. Premedication was with atropine and acepromazine. Induction was smooth and free from problems apart from transient apnoea in some horses. Maintenance of anaesthesia was with oxygen and halothane administered by means of a closed circle system with soda-lime absorber and with the vaporiser out of circuit. During the period immediately following induction, the heart rate increased and the respiratory rate fell. Blood gas estimations were carried out on 6 horses during anaesthesia. These horses showed respiratory acidosis. Arterial blood oxygen tension values were above those reported in conscious horses. Use of glyceryl guaiacolate in this way provides a safe induction and enables transition to a stable maintenance period which is followed by a quiet and uneventful recovery.     

Effect of a leukocyte-depleting filter in an extracorporeal circuit used for low-flow ischemia and reperfusion of equine jejunum

OBJECTIVE: To determine effect of leukocyte depletion on hematologic, morphologic, and metabolic variables of equine jejunum after induction of arterial low-flow ischemia and reperfusion by use of an extracorporeal circuit. ANIMALS: 14 healthy adult horses. PROCEDURE: A segment of jejunum was surgically removed and maintained in an isolated circuit for 3 hours (control group), arterial flow was reduced to 20% of baseline for 40 minutes followed by 1 hour of reperfusion (low-flow group), or leukocyte depletion was filter-induced, and low-flow ischemia and reperfusion were conducted as in the low-flow control group (filter-treated group). Various metabolic, hemodynamic, and histomorphologic variables were evaluated, including effects of electrical field stimulation and L-N-nitro-arginine-methyl-ester (L-NAME) on contractile activity. RESULTS: The extracorporeal circuit appeared to maintain the jejunum within physiologic limits for an extended period. Low-flow ischemia with reperfusion induced significant differences in various measurements, compared with control specimens. Significant differences were not detected between the low-flow and filter-treated groups. Myeloperoxidase activity was greater in the low-flow group than the control group, whereas a difference was not detected between control and filter-treated groups. CONCLUSIONS AND CLINICAL RELEVANCE: The extracorporeal circuit maintained intestine for 3 hours in a physiologic state and may be used for simulation of tissue injury. Leukocyte depletion generally did not attenuate the effects of low-flow ischemia and reperfusion on equine small intestine.     

The Distribution of Calcitonin Gene-Related Peptide in Gastric Vagal Circuit of Rats

In the present study, we performed the retrograde tracing method using the neurotropic pseudorabies virus bartha strain (PRV-Ba) and immunohistochemistry against CGRP, to identify whether CGRP exists in the gastric monosynaptic vagal circuit between dorsal motor nucleus of vagus nerve (DMV) and nucleus tractus solitarius (NTS). At the results, PRV immunoreactive neurons were found in both DMV and NTS. However, CGRP-immunoreactive cells were present only in NTS, which contained no double-labeled neurons for PRV and CGRP. These results suggest that CGRP may not have a neuronal function in gastric vagal circuit of rat.