The effect of a 50% inspired mixture of nitrous oxide on arterial oxygen tension in spontaneously breathing horses anaesthetised with halothane

The effect of nitrous oxide (N₂O) on arterial partial pressure of oxygen (P_aO₂) was evaluated in 20 adult horses anaesthetised with halothane. A fresh gas flow rate of 20ml/kg/min, comprising a 1:1 N₂O/oxygen (O₂) mixture, was supplied via the rotameter flowmeters of an anaesthetic machine to a large animal breathing system. The horses breathed spontaneously from the circuit immediately after endotracheal intubation. Ten horses were subsequently positioned in lateral recumbency and ten in dorsal recumbency. A further twenty adult horses were anaesthetised with halothane and acted as controls; halothane in 20mls/kg/min of O₂ being supplied to the same breathing system. Fifty percent NO caused significant decreases in P_aO₂ for horses in lateral and dorsal recumbency. However when administered to horses in lateral recumbency it did not promote arterial hypoxaemia. There was a higher risk of intraopera- tive arterial hypoxaemia (P_aO₂ < 8.6kPa) associated with its use in spontaneously breathing horses in dorsal recumbency. Arterial hypoxaemia occurred in all horses during the first fifteen minutes of recovery but when N₂O was discontinued, halothane in oxygen supplied to the breathing circuit for five minutes at a flow rate of 20ml/kg/minute was sufficient to ensure that diffusion hypoxia did not occur. The magnitude of the hypoxaemia was not signficantly different between the groups. The time taken to adopt sternal recumbency was significantly shorter in the horses that had received N₂O.     

Effect of pre-operative starvation on intra-operative arterial oxygen tension in horses

This study assessed the effect of pre-operative starvation on intramperative arteriaI oxygen tension (PaO₂) by examination of anaesthetic records from starved and non-starved horses undergoing general anaesthesia. PaO₂ data from 69 horses were included, 33 of which were starved pre-operatively and 36 were not. Thirty minutes after induction of anaesthesia the mean PaO₂ in the non-starved group was higher than in the starved group (non-starved 40 [2649] kPa vs starved 30 [15–46] kPa. median and 25–75 percentile) but at 60 and 90 min the values for PaO₂ for the non-starvcd group were lower than those for the starved group (60 min: starved 31 [15–49] kPa vs non-starved 27 [11–38] kPa; 90 min: starved 31 [1244] kPa vs non-starved 22 [12–38] kPa) None of the differences between these values was statistically significant. Pre-operative starvation did not significantly increase intra-operativc PaO₂ under the conditions of this study.     

Pulmonary gas exchange in anaesthetised horses mechanically ventilated with oxygen or a helium/oxygen mixture

Reason for performing study: It is unknown whether administration of gas‐mixtures high in inspired fraction of oxygen (FiO₂) under general anaesthesia may increase formation of pulmonary atelectasis and impair gas exchange. Objective: To evaluate the effects of different FiO₂ on pulmonary gas exchange in isoflurane‐anaesthetised horses breathing a helium/oxygen (He/O₂) mixture. Methods: Thirty healthy mature horses were sedated with i.v. acepromazine (0.02 mg/kg bwt), detomidine (0.002 mg/kg bwt) and xylazine (0.2‐0.4 mg/kg bwt). General anaesthesia was induced with i.v. 5% guaifenesin to effect, diazepam (0.1 mg/kg bwt) and ketamine (2 mg/kg bwt), and maintained with isoflurane. Fifteen horses (Group HX) were ventilated mechanically with gas mixtures of successively increasing FiO₂ (0.25‐0.30, 0.50‐0.55, >0.90), obtained by blending O₂with Heliox (70% He/30% O₂). The other 15 horses (Group O) were ventilated immediately with 100% O₂(FiO₂>0.90). After 20 min of ventilation at the different FiO₂levels in Group HX and after 60 min in Group O, PaO₂ and PaCO₂ were measured and the alveolar to arterial PO₂gradient (P(_A‐a)O₂) was calculated. Data analysis included robust categorical regression with clustering on horse (P<0.05). Results: Inhalation of a He/O₂ mixture with FiO₂ as low as 0.25‐0.30 ensured adequate arterial oxygenation and was associated with a smaller P_(A‐a)O₂ gradient than inhalation of pure O₂ (P<0.05). In Group HX, PaO₂ increased with each rise in FiO2 and so did P(A‐a)O₂ (P<0.05). The PaO₂ was significantly lower and the P_(A‐a)O₂ higher in Group O compared to Group HX at a FiO₂ >0.90 (P<0.05). Conclusions and potential relevance: Administration of a He/O₂gas mixture low in FiO₂ can better preserve lung function than ventilation with pure oxygen. A step‐wise increase of FiO₂ using a He/O₂ gas mixture might offer advantages with respect to pulmonary gas exchange over an immediate exposure to 100% O₂.     

Arterial-alveolar carbon dioxide tension difference and alveolar dead space in halothane anaesthetised horses

Arterial-alveolar carbon dioxide tension differences (a-A) PCO2 and alveolar dead space were measured during clinical halothane anaesthesia of 110 horses with the help of continuous infra-red carbon dioxide analysis of expiratory gas. Mean (a-A) PCO2 was 1.6 +/- 0.8 kPa. Alveolar dead space expressed as a percentage of alveolar tidal volume had a mean value of 23 +/- 13 per cent. Influence on (a-A) PCO2 and alveolar dead space of the following variables was tested statistically: age, weight, body position, respiration mode and duration of anaesthesia. (a-A) PCO2 was influenced positively by weight (P less than 0.0001) and adoption of dorsal recumbency (P less than 0.01). Alveolar dead space was influenced positively by weight (P less than 0.0005), adoption of dorsal recumbency (P less than 0.01), intermittent positive pressure ventilation (P less than 0.0001) and duration of anaesthesia (P less than 0.05).     

Predictors of arterial oxygen tension in anesthetized horses: 1,610 cases (1992-1994).

OBJECTIVE: To identify factors associated with various arterial partial pressures of oxygen (Pao2) in anesthetized horses. DESIGN: Retrospective study. ANIMALS: 1,450 horses anesthetized a total of 1,610 times with isoflurane or halothane. PROCEDURE: Anesthesia records, particularly results of blood gas analyses, were reviewed, and horses were grouped on the basis of lowest Pao2. RESULTS: For horses with lowest Pao2 < 120 mm Hg, those with low pulse pressure, that underwent anesthesia on an emergency basis, or that were males were more likely to have Pao2 < 80 mm Hg. For horses with lowest Pao2 < 250 mm Hg, those that were positioned in dorsal recumbency, that underwent anesthesia on an emergency basis, or that had a shorter duration of anesthesia were more likely to have lowest Pao2 < 120 mm Hg. For horses with lowest Pao2 < 400 mm Hg, those that were positioned in dorsal recumbency, that underwent anesthesia on an emergency basis, that had a shorter duration of anesthesia, that were older, that were heavier, or that were being ventilated mechanically were more likely to have lowest Pao2 < 250 mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE: Low pulse pressure, emergency case status, dorsal recumbency, and short duration of anesthesia were significantly related with lower Pao2 in anesthetized horses.     

Distribution of cardiac output in anaesthetised horses

The radioactive microsphere method was used to determine the distribution of cardiac output in six anaesthetised ponies. Simultaneous measurements of cardiac output allowed calculation of the tissue perfusions (ml/min/100 g). Allowing for the fact that measurements were carried out on animals under halothane anaesthesia and which had respiratory acidosis, the results were comparable with published values for other species.     

Cardiorespiratory effects of enoximone in anaesthetised colic horses

Reasons for performing study: No studies have been reported on the effects of enoximone in anaesthetised colic horses. Objective: To examine whether enoximone improves cardiovascular function and reduces dobutamine requirement in anaesthetised colic horses. Methods: Forty‐eight mature colic horses were enrolled in this prospective, randomised clinical trial. After sedation (xylazine 0.7 mg/kg bwt) and induction (midazolam 0.06 mg/kg bwt, ketamine 2.2 mg/kg bwt), anaesthesia was maintained with isoflurane in oxygen and a lidocaine constant rate infusion (1.5 mg/kg bwt, 2 mg/kg/h). Horses were ventilated (PaCO₂<8.00 kPa). If hypotension occurred, dobutamine and/or colloids were administered. Ten minutes after skin incision, horses randomly received an i.v. bolus of enoximone (0.5 mg/kg bwt) or saline. Monitoring included respiratory and arterial blood gases, heart rate (HR), arterial pressure and cardiac index (CI). Systemic vascular resistance (SVR), stroke index (SI) and oxygen delivery index (DO₂I) were calculated. For each variable, changes between baseline and T10 within each treatment group and/or colic type (small intestines, large intestines or mixed) were analysed and compared between treatments in a fixed effects model. Differences between treatments until T30 were investigated using a mixed model (α= 0.05). Results: Ten minutes after enoximone treatment, CI (P = 0.0010), HR (P = 0.0033) and DO₂I (P = 0.0007) were higher and SVR lower (P = 0.0043) than at baseline. The changes in CI, HR and SVR were significantly different from those after saline treatment. During the first 30 min after enoximone treatment, DO₂I (P = 0.0224) and HR (P = 0.0003) were higher than after saline administration. Because the difference in HR between treatments was much clearer in large intestine colic cases, an interaction was detected between treatment and colic type in both analyses (P = 0.0076 and 0.0038, respectively). Conclusions: Enoximone produced significant, but short lasting, cardiovascular effects in colic horses. Potential relevance: Enoximone's cardiovascular effects in colic horses were of shorter duration than in healthy ponies.     

Cardiopulmonary effects of dopamine hydrochloride in anaesthetised horses

Dopamine hydrochloride was infused intravenously into six horses anaesthetised with halothane. Three dose rates; 0.5, 2.5 and 5.0 micrograms/kg/min, were evaluated in each horse. The cardiac output was significantly increased at 15 and 30 mins following administration of dopamine at 2.5 and 5.0 micrograms/kg/min. The heart rate, facial artery pressure and pulmonary artery pressure remained unchanged. Total peripheral resistance was significantly decreased at 30 mins with 2.5 micrograms/kg/min and at 15 and 30 mins with 5.0 micrograms/kg/min. No significant change was produced in packed cell volume, total protein, white blood cell count, platelets, glucose or lactate at any infusion rate. Supraventricular premature contractions occurred in one horse and episodes of tachycardia occurred in two horses during infusion of dopamine at 5.0 micrograms/kg/min. The results of the investigation demonstrated that dopamine administered at 2.5 and 5.0 micrograms/kg/min effectively increased the cardiac output of halothane anaesthetised horses and that dopamine at the high dosage may cause dysrhythmias.     

Mixed venous oxygen tension as an estimate of cardiac output in anesthetized horses

The relationship between mixed venous O2 tension and cardiac output was studied in six anesthetized horses breathing 100% O2. Cardiac output, O2 consumption, mean arterial pressure, heart rate, and arterial and venous blood gases were measured after administration of xylazine or dobutamine to horses in lateral, sternal, and dorsal recumbencies. After approximately 3 hours, Escherichia coli endotoxin was administered while horses were in dorsal recumbency, and all measurements were repeated. Relationships between cardiac index (CI) and PVO2, heart rate, mean arterial pressure, jugular PVO2, and PVO2 of blood from a superficial limb vein were evaluated by linear regression analysis. Mean arterial pressure was significantly (P less than 0.05) correlated with CI in horses in all positions and after endotoxin administration. However, data points were poorly grouped. Heart rate and CI were significantly correlated in horses in all positions, but not after endotoxin administration. Correlations between jugular PVO2 and PVO2 of blood from a superficial limb vein were not significant in horses in sternal recumbency, and PVO2 of blood from a superficial limb vein was not significantly correlated with CI in horses in lateral recumbency. There was a significant and tight correlation between PVO2 and CI in horses in all positions and after endotoxin administration.     

Radiographic evidence of impaired pulmonary function in laterally recumbent anaesthetised horses.

Studies in conscious and anaesthetised ponies demonstrated that starvation, anaesthesia and changes in body position influence the radiographic appearance of the lungs in the lateral and dorsoventral views. Radiographic appearances could not be closely correlated with blood gas values, but they suggested that the volume of the lowermost lung of the laterally recumbent animal is greatly reduced.     

Comparison of arterial blood pressure measurements obtained invasively or oscillometrically using a Datex S/5 Compact monitor in anaesthetised adult horses

Objective

To assess agreement between noninvasive blood pressure (NIBP) oscillometrically-derived values from a multiparameter monitor (Datex Ohmeda S/5 Compact) with those obtained by invasive blood pressure (IBP) measurement in anaesthetised horses undergoing elective surgery.

Ureteral ligation prevents the haemodynamic effect of frusemide in pentobarbitol anaesthetised horses

Frusemide reduces pulmonary vascular pressures in resting horses and attenuates exercise-induced increases in these pressures in exercising horses. The mechanism underlying these effects of frusemide is unclear. We tested the hypothesis that the haemodynamic effects of frusemide are dependent on diuresis by examining the effect of frusemide in anaesthetised horses in which diuresis was prevented by ligation of ureters. Twenty four horses were assigned randomly to one of 4 treatments: 1) frusemide (1 mg/kg bwt i.v.) and intact ureters; 2) frusemide and ligated ureters; 3) saline placebo and ligated ureters; and 4) frusemide and phenylbutazone (4.4 mg/kg bwt i.v. 12 h and 15 min before frusemide) and ligated ureters. Frusemide administration to anaesthetised horses with intact ureters increased plasma total protein concentration and reduced mean right atrial, pulmonary artery and aortic pressures. There was no significant effect of frusemide administration on haemodynamic variables or plasma total protein concentration in horses with ligated ureters. The combination of frusemide and phenylbutazone increased mean right atrial, pulmonary artery and aortic pressures in horses with ligated ureters. This study demonstrates that, in anaesthetised horses, the haemodynamic effect of frusemide is dependent upon diuresis. We interpret these results as providing further evidence that the haemodynamic effect of frusemide in horses is attributable to a reduction in plasma and blood volume.