Comparisons of the effects of acupuncture, electroacupuncture, and transcutaneous cranial electrical stimulation on the minimum alveolar concentration of isoflurane in dogs

OBJECTIVE: To compare the effects of acupuncture (AP), electroacupuncture (EA), and transcutaneous cranial electrical stimulation (TCES) with high-frequency intermittent currents on the minimum alveolar concentration (MAC) of isoflurane and associated cardiovascular variables in dogs. ANIMALS: 8 healthy adult female Beagles. PROCEDURE: Each dog was anesthetized with isoflurane on 4 occasions, allowing a minimum of 10 days between experiments. Isoflurane MAC values were determined for each dog without treatment (controls) and after treatment with AP and EA (AP points included the Large Intestine 4, Lung 7, Governing Vessel 20, Governing Vessel 14, San Tai, and Baihui) and TCES. Isoflurane MAC values were determined by use of noxious electrical buccal stimulation. Heart rate, mean arterial blood pressure (MAP), arterial blood oxygen saturation (Spo2) measured by use of pulse oximetry, esophageal body temperature, inspired and expired end-tidal isoflurane concentrations, end-tidal carbon dioxide concentration, and bispectral index (BIS) were monitored. Blood samples were collected for determination of plasma cortisol concentration. RESULTS: Mean +/- SD baseline MAC of isoflurane was 1.19 +/- 0.1%. Acupuncture did not significantly change MAC of isoflurane. Treatments with EA and TCES significantly lowered the MAC of isoflurane by 10.1% and 13.4%, respectively. The Spo2, heart rate, MAP, BIS, esophageal body temperature, and plasma cortisol concentration were not significantly different after AP, EA, TCES, and control treatments at any time interval. CONCLUSIONS AND CLINICAL RELEVANCE: Use of EA and TCES decreased MAC of isoflurane in dogs without inducing adverse hemodynamic effects. However, the reduction in isoflurane MAC by EA andTCES treatments was not considered clinically relevant.     

Effects of morphine,lidocaine, ketamine,and morphine-lidocaine-ketamine drug combination on minimum alveolar concentration in dogs anesthetized with isoflurane

OBJECTIVE: To determine the effects of constant rate infusion of morphine, lidocaine, ketamine, and morphine-lidocaine-ketamine (MLK) combination on end-tidal isoflurane concentration (ET-Iso) and minimum alveolar concentration (MAC) in dogs anesthetized with isoflurane and monitor depth of anesthesia by use of the bispectral index (BIS). ANIMALS: 6 adult dogs. PROCEDURE: Each dog was anesthetized with isoflurane on 5 occasions, separated by a minimum of 7 to 10 days. Individual isoflurane MAC values were determined for each dog. Reduction in isoflurane MAC, induced by administration of morphine (3.3 microg/kg/min), lidocaine (50 microg/kg/min), ketamine (10 microg/kg/min), and MLK, was determined. Heart rate, mean arterial blood pressure, oxygen saturation as measured by pulse oximetry (Spo2), core body temperature, and BIS were monitored. RESULTS: Mean +/- SD isoflurane MAC was 1.38 +/- 0.08%. Morphine, lidocaine, ketamine, and MLK significantly lowered isoflurane MAC by 48, 29, 25, and 45%, respectively. The percentage reductions in isoflurane MAC for morphine and MLK were not significantly different but were significantly greater than for lidocaine and ketamine. The Spo2, mean arterial pressure, and core body temperature were not different among groups. Heart rate was significantly decreased at isoflurane MAC during infusion of morphine and MLK. The BIS was inversely related to the ET-Iso and was significantly increased at isoflurane MAC during infusions of morphine and ketamine, compared with isoflurane alone. CONCLUSIONS AND CLINICAL RELEVANCE: Low infusion doses of morphine, lidocaine, ketamine, and MLK decreased isoflurane MAC in dogs and were not associated with adverse hemodynamic effects. The BIS can be used to monitor depth of anesthesia.     

Minimum alveolar concentration measures of central nervous system activation in cats anesthetized with isoflurane

OBJECTIVE: To compare the minimum alveolar concentration (MAC) of isoflurane required to prevent corticocerebral activation, autonomic responses, and purposeful movements after somatic or visceral stimulation in cats anesthetized with isoflurane. ANIMALS: 17 healthy spayed female cats. PROCEDURE: Bispectral index (BIS), autonomic parameters, and purposeful movements were monitored before and after somatic or visceral stimuli in cats anesthetized with isoflurane. End-tidal (ET) isoflurane concentration was varied to determine MAC values for cortical arousal (MAC(BIS)), autonomic responsiveness (MAC(BAR)), and purposeful movement (MAC). Bispectral index values > or = 60 were considered to represent corticocerebral activation. RESULTS: Minimum alveolar concentration for purposeful movement was significantly less than MAC(BIS) and MAC(BAR) for both somatic and visceral stimulation. Individual MAC values for somatic stimulation were not significantly different from respective MAC values for visceral stimulation. The percentage of cats that had a BIS response > or = 60 was inversely related to the end-tidal isoflurane concentration. CONCLUSIONS AND CLINICAL RELEVANCE: Corticocerebral arousal and subcortical autonomic reflexes occured at isoflurane anesthetic concentrations at which reflexive or purposeful movements were absent. These results suggested that isoflurane had a preferential effect on voluntary motor output at low end-tidal isoflurane concentrations, and that sensory pathways, subcortical sympathetic output, and cortical responsiveness are less susceptible to the anesthetic effects of isoflurane. Bispectral index values obtained after somatic or visceral stimulation were sensitive for the detection of early changes in cortical excitability.     

Bispectral index,spectral edge frequency 95%, and median frequency recorded for various concentrations of isoflurane and sevoflurane in pigs

OBJECTIVE: To evaluate bispectral index (BIS), spectral edge frequency 95% (SEF), and median frequency (MED) in relation to a visual analogue scale (VAS) as indicators of anesthetic depth for various concentrations of sevoflurane and isoflurane in pigs. ANIMALS: 32 pigs. PROCEDURE: Pigs were randomly allocated to 8 groups (4 pigs/group). An electroencephalogram (EEG) was recorded in each conscious pig. Pigs were then anesthetized by use of sevoflurane (n = 16) or isoflurane (16). Agents were administered in oxygen at minimum alveolar concentrations (MACs) of 1, 1.25, 1.5, and 1.75 MAC in a randomized order. End-tidal sevoflurane and isoflurane concentrations were maintained for 30 minutes, after which an EEG was recorded for 5 minutes; BIS, SEF, and MED were then calculated. Anesthetic depth was evaluated by use of the VAS. Cardiovascular and EEG responses to nociceptive stimuli were evaluated for each anesthetic agent. RESULTS: BIS decreased significantly for the various concentrations of each anesthetic. At equivalent MACs, BIS values were significantly higher during sevoflurane-induced anesthesia than during isoflurane-induced anesthesia. Values of MED and SEF decreased significantly from basal values to 1 MAC of sevoflurane and isoflurane. For both agents, there was good correlation between VAS scores and BIS values and between VAS scores and SEF values. CONCLUSIONS AND CLINICAL RELEVANCE: BIS was useful for predicting changes in anesthetic depth at clinical dosages of inhalant anesthetics. Values of BIS, SEF, and MED were significantly higher during anesthesia induced by administration of sevoflurane than during anesthesia induced by administration of isoflurance at equivalent MACs.     

Minimal Anesthetic Concentration and Cardiopulmonary Dose Response of Isoflurane in Ducks

The minimal anesthetic concentration (MAC) for isoflurane was determined during spontaneous ventilation in nine male Peking ducks (7 to 12 weeks of age; 3.0 +/- 0.4 kg). While each bird was awake, arterial blood was collected for analysis of pH, PaCO2, and PaO2. After anesthesia was induced with isoflurane in oxygen, MAC was determined for isoflurane in each bird during spontaneous ventilation in a manner similar to MAC determinations in mammals. Pulmonary dose-response data were collected at 1 MAC and 1.5 MAC. Anesthetic index (Al; an index of anesthetic-induced apnea) was calculated from ducks that became apneic. The MAC for isoflurane was 1.30 +/- 0.23% (mean +/- SD). There was a dose-dependent decrease in ventilation as evidenced by a statistically significant increase in PaCO2. Apnea or unacceptable hypercarbia (PaCO2 greater than 110 mm Hg), or both, were common occurrences at end-tidal isoflurane concentrations greater than 1.5 MAC. Anesthetic index calculated from four ducks was 1.65 +/- 0.13 (mean +/- SEM). There was no significant difference between the means of either heart rate or mean arterial blood pressure in birds at 1.0 and 1.5 MAC.     

Relationship of bispectral index to minimum alveolar concentration multiples of sevoflurane in cats

OBJECTIVE: To determine the relationship between bispectral index (BIS) and minimum alveolar concentration (MAC) multiples of sevoflurane in cats. ANIMALS: 8 domestic cats. PROCEDURE: Each cat was anesthetized twice with sevoflurane. First, the MAC of sevoflurane for each cat was determined by use of the tail clamp method. Second, cats were anesthetized with sevoflurane at each of 5 MAC multiples administered in random order. Ventilation was controlled, and after a 15-minute equilibration period at each MAC multiple of sevoflurane, BIS data were collected for 5 minutes and the median value of BIS calculated. RESULTS: The mean (+/- SD) MAC of sevoflurane was 3.3 +/- 0.2%. The BIS values at 0.5 MAC could not be recorded as a result of spontaneous movement in all 8 cats. The BIS values at 2.0 MAC were confounded by burst suppression in all 8 cats. Over the range of 0.8 to 1.5 MAC, BIS values decreased significantly with increasing end-tidal sevoflurane concentrations. Mean (+/- SD) BIS measurements were 30 +/- 3, 21 +/- 3, and 5 +/- 2 at 0.8, 1.0, and 1.5 MAC, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Values of BIS are inversely and linearly related to end-tidal sevoflurane concentrations in anesthetized cats, and BIS may be a useful predictor of CNS depression in this species. The consistently low BIS values recorded in this study suggest that clinical BIS end points used to titrate anesthetic agents in humans may not be applicable to cats.     

Effect of medetomidine administration on bispectral index measurements in dogs during anesthesia with isoflurane

OBJECTIVE: To determine the relationship between bispectral index (BIS) and minimum alveolar concentration (MAC) multiples of isoflurane after IM injection of medetomidine or saline (0.9% NaCl) solution in anesthetized dogs. ANIMALS: 6 dogs. PROCEDURE: Each dog was anesthetized 3 times with isoflurane. First, the MAC of isoflurane for each dog was determined by use of the tail clamp method. Second, anesthetized dogs were randomly assigned to receive an IM injection of medetomidine (8 microg x kg(-1)) or an equal volume of isotonic saline (0.9% NaCl) solution 30 minutes prior to beginning BIS measurements. Last, anesthetized dogs received the remaining treatment (medetomidine or isotonic saline solution). Dogs were anesthetized at each of 4 MAC multiples of isoflurane. Ventilation was controlled and atracurium (0.2 mg/kg followed by 6 microg/kg/min as a continuous infusion, IV) administered. After a 20-minute equilibration period at each MAC multiple of isoflurane, BIS data were collected for 5 minutes and median values of BIS calculated. RESULTS: BIS significantly decreased with increasing MAC multiples of isoflurane over the range of 0.8 to 2.0 MAC. Mean (+/- SD) MAC of isoflurane was 1.3 +/- 0.2%. During isoflurane-saline anesthesia, mean BIS measurements at 0.8, 1.0, 1.5, and 2.0 MAC were 65 +/- 8, 60 +/- 7 52 +/- 3, and 31 +/- 28, respectively. During isoflurane-medetomidine anesthesia, mean BIS measurements at 0.8, 1.0, 1.5, and 2.0 MAC were 77 +/- 4, 53 +/- 7, 31 +/- 24, and 9 +/- 20, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: BIS monitoring in dogs anesthetized with isoflurane has a predictive value in regard to degree of CNS depression. During isoflurane anesthesia, our results support a MAC-reducing effect of medetomidine.     

Minimum alveolar concentration of isoflurane in mechanically ventilated Dumeril monitors

OBJECTIVE: To determine minimum alveolar concentration (MAC) of isoflurane in mechanically ventilated Dumeril monitors (Varanus dumerili). DESIGN: Prospective study. ANIMALS: 10 healthy adult Dumeril monitors. PROCEDURE: Anesthesia was induced with isoflurane in oxygen delivered through a face mask. Monitors were endotracheally intubated, and end-tidal and inspired isoflurane concentrations were continuously measured. After equilibration at an end-tidal-to-inspired isoflurane concentration ratio of >0.9 for 20 minutes, an electrical stimulus (50 Hz, 50 V) was delivered to the ventral aspect of the tail for up to 1 minute and the monitor was observed for purposeful movement. End-tidal isoflurane concentration was then decreased by 10%, and equilibration and stimulation were repeated. The MAC was calculated as the mean of the lowest end-tidal isoflurane concentration that prevented positive response and the highest concentration that allowed response. A blood sample for blood gas analysis was collected from the tail vein at the beginning and end of the anesthetic period. RESULTS: Mean +/- SD MAC of isoflurane was 1.54 +/- 0.17%. Mean heart rates at the upper and lower MAC values were 32.4 +/- 3 beats/min and 34 +/- 4.5 beats/min, respectively. During the experiment, PaCo2 decreased significantly from 43.1 mm Hg to 279 mm Hg and blood pH and HCO3 concentration increased significantly from 7.33 to 7.64 and from 25.3 to 32.9 mmol/L, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of isoflurane in Dumeril monitors was similar to that reported in mammals but lower than values reported in other reptiles. This difference may be reflective of the more advanced cardiovascular physiologic features of monitor lizards.     

Relationship of bispectral index to hemodynamic variables and alveolar concentration multiples of sevoflurane in puppies

The relationships between bispectral index (BIS), cardiovascular variables and minimum alveolar concentration (MAC) multiples of sevoflurane in puppies were determined. Five puppies were anesthetized with sevoflurane on two occasions. First, the individual sevoflurane MAC values were determined for each puppy. Secondly, dogs were anesthetized with sevoflurane at each of 5 MAC multiples, 0.75, 1, 1.25, 1.5 and 1.75 MAC administered in random order. Hemodynamic parameters and BIS data were collected for 20 min. Somatic stimulus was then applied and the same parameters and data were collected for 6 min. Correlation between BIS and end tidal sevoflurane and between BIS and hemodynamic parameters were studied. We found positive significant correlation in both cases. BIS is lower in puppies that in adults at the same alveolar anesthetic concentrations and sevoflurane appears to be a safe anesthetic in puppies.     

Anesthetic potency and cardiopulmonary effects of sevoflurane in goats: comparison with isoflurane and halothane.

The anesthetic potency and cardiopulmonary effects of sevoflurane were compared with those of isoflurane and halothane in goats. The (mean +/- SD) minimal alveolar concentration (MAC) was 0.96 +/- 0.12% for halothane, 1.29 +/- 0.11% for isoflurane, and 2.33 +/- 0.15% for sevoflurane. Cardiopulmonary effects of sevoflurane, halothane and isoflurane were examined at end-tidal concentrations equivalent to 1, 1.5 and 2 MAC during either spontaneous or controlled ventilation (SV or CV). During SV, there were no significant differences in respiration rate, tidal volume and minute ventilation between anesthetics. Dose-dependent decreases in both tidal volume and minute ventilation induced by halothane were greater than those by either sevoflurane or isoflurane. Hypercapnia and acidosis induced by sevoflurane were not significantly different from those by either isoflurane or halothane at 1 and 1.5 MAC, but were less than those by halothane at 2 MAC. There was no significant difference in heart rate between anesthetics during SV and CV. During SV, all anesthetics induced dose-dependent decreases in arterial pressure, rate pressure product, systemic vascular resistance, left ventricular minute work index and left ventricular stroke work index. Systemic vascular resistance with isoflurane at 2 MAC was lower than that with sevoflurane. During CV, sevoflurane induced dose-dependent circulatory depression (decreases in arterial pressure, cardiac index, rate pressure product, systemic vascular resistance, left ventricular minute work index and right ventricular minute work index), similar to isoflurane. Halothane did not significantly alter systemic vascular resistance from 1 to 2 MAC.     

Minimum anesthetic concentration and cardiovascular dose-response relationship of isoflurane in cinereous vultures (Aegypius monachus)

This study aimed to determine the minimum anesthetic concentration (MAC) and dose-related cardiovascular effects of isoflurane during controlled ventilation in cinereous vultures (Aegypius monachus). The MAC was determined for 10 cinereous vultures as the midpoint between the end-tidal isoflurane concentration that allows gross purposeful movement and that which prevents the movement in response to clamping a pedal digit. Immediately after the MAC was determined, the cardiovascular effects of isoflurane at 1.0, 1.5, and 2.0 times the MAC were investigated in seven of the 10 birds. The MAC of isoflurane for 10 cinereous vultures during controlled ventilation was 1.06 +/- 0.07% (mean +/- SD). When the isoflurane concentration was increased to 1.5 and 2.0 times the MAC, there was significant dose-dependent decrease in the arterial blood pressure. However, the heart rate did not change over a range of 1.0 to 2.0 times the MAC.     

Minimum alveolar concentration of isoflurane in green iguanas and the effect of butorphanol on minimum alveolar concentration

OBJECTIVE: To determine minimum alveolar concentration (MAC) of isoflurane in green iguanas and effects of butorphanol on MAC. DESIGN: Prospective randomized trial. ANIMALS: 10 healthy mature iguanas. PROCEDURE: in each iguana, MAC was measured 3 times: twice after induction of anesthesia with isoflurane and once after induction of anesthesia with isoflurane and IM administration of butorphanol (1 mg/kg [0.45 mg/lb]). A blood sample was collected from the tail vein for blood-gas analysis at the beginning and end of the anesthetic period. The MAC was determined with a standard bracketing technique; an electrical current was used as the supramaximal stimulus. Animals were artificially ventilated with a ventilator set to deliver a tidal volume of 30 mL/kg (14 mL/lb) at a rate of 4 breaths/min. RESULTS: Mean +/- SD MAC values during the 3 trials (2 without and 1 with butorphanol) were 2.0 +/- 0.6, 2.1 +/- 0.6, and 1.7 +/- 0.7%, respectively, which were not significantly different from each other. Heart rate and end-tidal partial pressure of CO2 were also not significantly different among the 3 trials. Mean +/- SD heart rate was 48 +/- 10 beats/min; mean end-tidal partial pressure of CO2 was 22 +/- 10 mm Hg.There were no significant differences in blood-gas values for samples obtained at the beginning versus the end of the anesthetic period. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the MAC of isoflurane in green iguanas is 2.1% and that butorphanol does not have any significant isoflurane-sparing effects.     

Effects of epidural administration of dexmedetomidine on the minimum alveolar concentration of isoflurane in dogs

Objective-To evaluate the effects of epidural administration of 3 doses of dexmedetomidine on isoflurane minimum alveolar concentration (MAC) and characterize changes in bispectral index (BIS) induced by nociceptive stimulation used for MAC determination in dogs. Animals-6 adult dogs. Procedures-Isoflurane-anesthetized dogs received physiologic saline (0.9% NaCl) solution (control treatment) or dexmedetomidine (1.5 [DEX1.5], 3.0 [DEX3], or 6.0 [DEX6] mug/kg) epidurally in a crossover study. Isoflurane MAC (determined by use of electrical nociceptive stimulation of the hind limb) was targeted to be accomplished at 2 and 4.5 hours. Changes in BIS attributable to nociceptive stimulation and cardiopulmonary data were recorded at each MAC determination. Results-With the control treatment, mean +/- SD MAC values did not change over time (1.57 +/- 0.23% and 1.55 +/- 0.25% at 2 and 4.5 hours, respectively). Compared with the control treatment, MAC was significantly lower at 2 hours (13% reduction) but not at 4.5 hours (7% reduction) in DEX1.5-treated dogs and significantly lower at 2 hours (29% reduction) and 4.5 hours (13% reduction) in DEX3-treated dogs. The DEX6 treatment yielded the greatest MAC reduction (31% and 22% at 2 and 4.5 hours, respectively). During all treatments, noxious stimulation increased BIS; but changes in BIS were correlated with increases in electromyographic activity. Conclusions and Clinical Relevance-In dogs, epidural administration of dexmedetomidine resulted in dose-dependent decreases in isoflurane MAC and that effect decreased over time. Changes in BIS during MAC determinations may not represent increased awareness because of the possible interference of electromyographic activity.     

Use of the bispectral index as a monitor of anesthetic depth in cats anesthetized with isoflurane

OBJECTIVE: To determine whether the prestimulation bispectral index (BIS) value or relative change in BIS after noxious stimulation can be used to assess the depth of isoflurane anesthesia in cats. ANIMALS: 17 healthy female cats. PROCEDURE: Electroencephalogram (EEG) patterns and BIS values were examined in cats that received increasing end-tidal (ET) isoflurane concentrations. Subsequently, BIS values were determined before and after either a noxious somatic or visceral stimulus in cats that received ET isoflurane concentrations ranging from 1.8% to 2.4%. Electrical stimuli of the tail base and bladder distension to 50 cm of water were the somatic and visceral stimuli, respectively. RESULTS: he resting BIS at ET isoflurane concentrations from 1.4% to 1.9% steadily decreased concurrently with increasing degrees of EEG suppression. Prestimulation BIS values, however, were not related to 1.8% to 2.4% ET isoflurane concentrations and not useful for prediction of BIS values or hemodynamic and movement responses after a noxious stimulus. The poststimulation BIS value and the difference between mean BIS values before and after stimulation were inversely correlated with increasing ET isoflurane concentrations. Poststimulation BIS values > 60 were observed at ET isoflurane concentrations greater than those associated with a movement response after a stimulus. CONCLUSIONS AND CLINICAL RELEVANCE: The prestimulation BIS value has limited use in assessing anesthetic depth in cats during isoflurane anesthesia. The change in BIS values after a noxious somatic or visceral stimulus was a reliable measure of anesthetic depth and may be a useful measure of early arousal from the hypnotic state.     

Evaluation of induction characteristics and hypnotic potency of isoflurane and sevoflurane in healthy dogs

OBJECTIVE: To determine induction characteristics and the minimum alveolar concentration (MAC) at which consciousness returned (MACawake) in dogs anesthetized with isoflurane or sevoflurane. ANIMALS: 20 sexually intact male Beagles. PROCEDURES: In experiment 1, 20 dogs were randomly assigned to have anesthesia induced and maintained with isoflurane or sevoflurane. The MAC at which each dog awoke in response to auditory stimulation (MACawake-noise) was determined by decreasing the end-tidal concentration by 0.1 volume (vol %) every 15 minutes and delivering a standard audible stimulus at each concentration until the dog awoke. In experiment 2, 12 dogs received the same anesthetic agent they were administered in experiment 1. After duplicate MAC determination, the end-tidal concentration was continually decreased by 10% every 15 minutes until the dog awoke from anesthesia (MACawake). RESULTS: Mean induction time was significantly greater for isoflurane-anesthetized dogs (212 seconds), compared with the sevoflurane-anesthetized dogs (154 seconds). Mean+/-SD MACawake-noise was 1.1+/-0.1 vol % for isoflurane and 2.0+/-0.2 vol % for sevoflurane. Mean MAC was 1.3+/-0.2 vol % for isoflurane and 2.1+/-0.6 vol % for sevoflurane, and mean MACawake was 1.0+/-0.1 vol % for isoflurane and 1.3+/-0.3 vol % for sevoflurane. CONCLUSIONS AND CLINICAL RELEVANCE: Sevoflurane resulted in a more rapid induction than did isoflurane. The MACawake for dogs was higher than values reported for both agents in humans. Care should be taken to ensure that dogs are at an appropriate anesthetic depth to prevent consciousness, particularly when single-agent inhalant anesthesia is used.     

Effect of meloxicam and butorphanol on minimum alveolar concentration of isoflurane in rabbits

OBJECTIVE: To determine the effects of meloxicam and butorphanol on minimum alveolar concentration of isoflurane (MAC(ISO)) in rabbits. ANIMALS: 10 healthy young adult female rabbits. PROCEDURE: Rabbits were anesthetized with isoflurane on 3 occasions in a blinded, randomized complete block design to determine the MAC(ISO) associated with administration of meloxicam (0, 0.3, or 1.5 mg/kg, PO) and butorphanol (0.4 mg/kg, IV). The MAC(ISO) was determined by use of a paw clamp technique as the end-tidal concentration of isoflurane halfway between the values that allowed or inhibited purposeful movement. Rectal temperature, end-tidal CO2 concentration, heart rate, oxygen saturation, and arterial blood pressure were measured to evaluate cardiopulmonary function. RESULTS: Mean +/- SE MAC(ISO) in saline (0.9% NaCl) solution-treated rabbits was 2.49 +/- 0.07% and was not significantly different from that associated with administration of meloxicam at 0.3 mg/kg (2.56 +/- 0.07%) or 1.5 mg/kg (2.66 +/- 0.07%). Butorphanol significantly reduced the MAC(ISO) to 2.30 +/- 0.07% when administered with saline solution alone, 2.27 +/- 0.07% when administered with 0.3 mg of meloxicam/kg, and 2.33 +/- 0.07% when administered with 1.5 mg of meloxicam/kg. The percentage reduction in MAC(ISO) was significantly greater for rabbits that received butorphanol and meloxicam at either dose, compared with butorphanol and saline solution. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that meloxicam does not have a direct isoflurane-sparing effect and does not interfere with the anesthetic-sparing effect of butorphanol in rabbits.     

The effects of ketamine on the minimum alveolar concentration of isoflurane in cats

OBJECTIVES: To determine the minimum alveolar concentration (MAC) of isoflurane during the infusion of ketamine. STUDY DESIGN: Prospective, experimental trial. ANIMALS: Twelve adult spayed female cats weighing 5.1 +/- 0.9 kg. METHODS: Six cats were anesthetized with isoflurane in oxygen, intubated and attached to a circle-breathing system with mechanical ventilation. Catheters were placed in a peripheral vein for the infusion of fluids and ketamine, and the jugular vein for blood sampling for the measurement of ketamine concentrations. An arterial catheter was placed to allow blood pressure measurement and sampling for the measurement of PaCO2, PaO2 and pH. PaCO2 was maintained between 29 and 41 mmHg (3.9-5.5 kPa) and body temperature was kept between 37.8 and 39.3 degrees C. Following instrumentation, the MAC of isoflurane was determined in triplicate using a tail clamp method. A loading dose (2 mg kg(-1) over 5 minutes) and an infusion (23 microg kg(-1) minute(-1)) of ketamine was started and MAC was redetermined starting 30 minutes later. Two further loading doses and infusions were used, 2 mg kg(-1) and 6 mg kg(-1) with 46 and 115 microg kg(-1) minute(-1), respectively and MAC was redetermined. Cardiopulmonary measurements were taken before application of the noxious stimulus. The second group of six cats was used for the measurement of steady state plasma ketamine concentrations at each of the three infusion rates used in the initial study and the appropriate MAC value determined from the first study. RESULTS: The MAC decreased by 45 +/- 17%, 63 +/- 18%, and 75 +/- 17% at the infusion rates of 23, 46, and 115 microg kg(-1) minute(-1). These infusion rates corresponded to ketamine plasma concentrations of 1.75 +/- 0.21, 2.69 +/- 0.40, and 5.36 +/- 1.19 microg mL(-1). Arterial blood pressure and heart rate increased significantly with ketamine. Recovery was protracted. CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of isoflurane was significantly decreased by an infusion of ketamine and this was accompanied by an increase in heart rate and blood pressure. Because of the prolonged recovery in our cats, further work needs to be performed before using this in patients.     

The effect of hypovolemia due to hemorrhage on the minimum alveolar concentration of isoflurane in the dog

OBJECTIVE: To determine the effect of hypovolemia on the minimum alveolar concentration (MAC) of isoflurane in the dog. STUDY DESIGN: Randomized, cross-over trial. ANIMAL POPULATION: Six healthy intact mixed breed female dogs weighing 18.2-29.0 kg. METHODS: Dogs were randomly assigned to determine the MAC of isoflurane in a normovolemic or hypovolemic state with a minimum of 18 days between trials. On both occasions, anesthesia was initially induced and maintained for 40 minutes with isoflurane delivered in oxygen while vascular catheters were placed in the cephalic vein and dorsal metatarsal artery. In dogs assigned to the hypovolemic group, 30 mL kg(-1) of blood was removed at 1 mL kg(-1) minute(-1) from the arterial catheter. All dogs were allowed to recover from anesthesia. Thirty minutes after the discontinuation of isoflurane, anesthesia was re-induced with isoflurane in oxygen delivered by face mask. The tracheas were intubated, and connected to an anesthetic machine with a Bain anesthetic circuit. Mechanical ventilation was instituted at a rate of 10 breaths minute(-1) with the tidal volume set to deliver 10-15 mL kg(-1). Airway gases were monitored continuously and tidal volume was adjusted to maintain an end-tidal carbon dioxide level of 35-40 mmHg (4.67-5.33 kPa). Body temperature was maintained at 37-38 degrees C (98.6-100.4 degrees F). The MAC determination was performed using an electrical stimulus applied to the toe web and MAC was defined as the mean value of end-tidal isoflurane between the concentrations at which a purposeful movement did and did not occur in response to the electrical stimulus. The MAC values were compared between groups using a Student's t-test. RESULTS: The MAC of isoflurane was significantly less in hypovolemic dogs (0.97 +/- 0.03%) compared with normovolemic dogs (1.15 +/- 0.02%) (p < 0.0079). CONCLUSIONS AND CLINICAL RELEVANCE: The MAC of isoflurane is reduced in dogs with hypovolemia resulting from hemorrhage. Veterinarians should be prepared to deliver a lower percentage of isoflurane to maintain anesthesia in hypovolemic dogs during diagnostic and therapeutic procedures.     

Use of bispectral index to monitor depth of anesthesia in isoflurane-anesthetized dogs

OBJECTIVE: To evaluate the correlation between the bispectral index (BIS) and end-tidal isoflurane (ET(ISO)) concentration and compare the use of 3 BIS sensor positions in dogs. ANIMALS: 6 adult dogs. PROCEDURES: Mechanically ventilated dogs received pancuronium, and depth of anesthesia was altered by increasing ET(ISO) concentration from 1.5% to 2.3% and 3.0%. The BIS, suppression ratio (relative percentage of isoelectric electroencephalographic waveforms), and signal quality index (SQI) were recorded at each ET(ISO) concentration for each of 3 BIS sensor positions (frontal-occipital, bifrontal, and frontal-temporal positions). RESULTS: The BIS and ET(ISO) concentration were poorly correlated; regardless of sensor positioning, mean BIS values did not change significantly as ET(ISO) was increased. At 3% isoflurane, regardless of sensor positioning, there was an increase in suppression ratio coincident with BIS < 40 in some dogs, whereas paradoxic increases in BIS (> 60) were recorded in others. Furthermore, at 3.0% isoflurane, the SQI was significantly lower for the bifrontal sensor position (compared with values for the other positions), but low SQI values prevented recording of BIS values from the frontal-occipital sensor position in 2 dogs. Overall, BIS values derived from the 3 sensor positions did not differ. CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, BIS values may not reflect changes in depth of isoflurane anesthesia in the absence of noxious stimulation. Of the 3 sensor positions, frontal-temporal positioning provided better correlation with changes in depth of anesthesia induced via changes in isoflurane concentrations. However, the sensor placements yielded similar results at SQI values > 50.