Effects of intravenously administered glycopyrrolate in anesthetized horses.

The purpose of this study was to determine the heart rate (HR) and blood pressure (BP) effect of glycopyrrolate in anesthetized horses with low HR (< or = 30 beats/min). The horses were randomly treated with glycopyrrolate (2.5 micrograms/kg body weight (BW)) or saline, intravenously (i.v.) (n = 17). If HR failed to increase (by > 5 beats/min within 10 min), glycopyrrolate (same dose) was administered. Heart rate increased by > 5 beats/min in 3 out of 9 horses following the initial glycopyrrolate treatment. Overall changes in HR and mean BP were not significantly different, while systolic and diastolic BP increased significantly (P < 0.025 using a Bonferroni corrected paired t-test). On the 2nd treatment, 3 out of 7 horses given 2.5 micrograms/kg BW glycopyrrolate, and 4 out of 5 horses given 5.0 micrograms/kg BW (total dose) showed an increase in heart rate of > 5 beats/min, which was significant. A significant increase in BP was produced following treatment with 2.5 micrograms/kg BW, but not following 5.0 micrograms/kg BW. A final increase in HR, of > 5 beats/min, was associated with a significant rise in BP (P < 0.05 using an unpaired t-test). In conclusion, an increase in HR can occur with 2.5 to 5.0 micrograms of glycopyrrolate/kg BW, i.v., and results in improvement in BP in anesthetized horses.     

Use of intravenous lidocaine to treat dexmedetomidine-induced bradycardia in sedated and anesthetized dogs

ObjectiveTo assess cardiopulmonary function in sedated and anesthetized dogs administered intravenous (IV) dexmedetomidine and subsequently administered IV lidocaine to treat dexmedetomidine-induced bradycardia.Study designProspective, randomized, crossover experimental trial.AnimalsA total of six purpose-bred female Beagle dogs, weighing 9.1 ± 0.6 kg (mean ± standard deviation).MethodsDogs were randomly assigned to one of three treatments: dexmedetomidine (10 μg kg^–1 IV) administered to conscious (treatments SED1 and SED2) or isoflurane-anesthetized dogs (end-tidal isoflurane concentration 1.19 ± 0.04%; treatment ISO). After 30 minutes, a lidocaine bolus (2 mg kg^–1) IV was administered in treatments SED1 and ISO, followed 20 minutes later by a second bolus (2 mg kg^–1) and a 30 minute lidocaine constant rate infusion (L-CRI) at 50 (SED1) or 100 μg kg^–1 minute^–1 (ISO). In SED2, lidocaine bolus and L-CRI (50 μg kg^–1 minute^–1) were administered 5 minutes after dexmedetomidine. Cardiopulmonary measurements were obtained after dexmedetomidine, after lidocaine bolus, during L-CRI and 30 minutes after discontinuing L-CRI. A mixed linear model was used for comparisons within treatments (p < 0.05).ResultsWhen administered after a bolus of dexmedetomidine, lidocaine bolus and L-CRI significantly increased heart rate and cardiac index, decreased mean blood pressure, systemic vascular resistance index and oxygen extraction ratio, and did not affect stroke volume index in all treatments.Conclusion and clinical relevanceLidocaine was an effective treatment for dexmedetomidine-induced bradycardia in healthy research dogs.     

Effects of glycopyrrolate on cardiorespiratory function in horses anesthetized with halothane and xylazine

OBJECTIVE: To evaluate cardiopulmonary effects of glycopyrrolate in horses anesthetized with halothane and xylazine. ANIMALS: 6 horses. PROCEDURE: Horses were allocated to 2 treatment groups in a randomized complete block design. Anesthesia was maintained in mechanically ventilated horses by administration of halothane (1% end-tidal concentration) combined with a constant-rate infusion of xylazine hydrochloride (1 mg/kg/h, i.v.). Hemodynamic variables were monitored after induction of anesthesia and for 120 minutes after administration of glycopyrrolate or saline (0.9% NaCl) solution. Glycopyrrolate (2.5 microg/kg, i.v.) was administered at 10-minute intervals until heart rate (HR) increased at least 30% above baseline or a maximum cumulative dose of 7.5 microg/kg had been injected. Recovery characteristics and intestinal auscultation scores were evaluated for 24 hours after the end of anesthesia. RESULTS: Cumulative dose of glycopyrrolate administered to 5 horses was 5 microg/kg, whereas 1 horse received 7.5 microg/kg. The positive chronotropic effects of glycopyrrolate were accompanied by an increase in cardiac output, arterial blood pressure, and tissue oxygen delivery. Whereas HR increased by 53% above baseline values at 20 minutes after the last glycopyrrolate injection, cardiac output and mean arterial pressure increased by 38% and 31%, respectively. Glycopyrrolate administration was associated with impaction of the large colon in 1 horse and low intestinal auscultation scores lasting 24 hours in 3 horses. CONCLUSIONS AND CLINICAL RELEVANCE: The positive chronotropic effects of glycopyrrolate resulted in improvement of hemodynamic function in horses anesthetized with halothane and xylazine. However, prolonged intestinal stasis and colic may limit its use during anesthesia.     

Barrier pressure at the gastroesophageal junction in anesthetized dogs.

OBJECTIVE: To evaluate the effect of body position on barrier pressure at the gastroesophageal junction in anesthetized Greyhounds and to assess alterations in barrier pressure following gastropexy. ANIMALS: 8 adult Greyhounds. PROCEDURE: Barrier pressure at the gastroesophageal junction was measured by fast (1 cm/s) and slow (1 cm/10 s) withdrawal of a subminiature strain gauge transducer through the gastroesophageal junction in 8 anesthetized dogs. The effect of body position was measured. Each dog then was placed in right-lateral recumbency, and gastropexy was performed in the left flank. Additional measurements were obtained 1, 5, 10, 20, and 30 minutes after gastropexy. RESULTS: Barrier pressure for dogs positioned in sternal recumbency (mean +/- SEM, 1.1 +/- 0.53 mm Hg) was significantly less than for dogs positioned in right lateral or left lateral recumbency. Following gastropexy, there was a steady increase in barrier pressure. Thirty minutes after gastropexy, barrier pressure was significantly higher (13.36 +/- 3.46 mm Hg), compared with the value before surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Barrier pressure in anesthetized dogs is highly variable and influenced by body position. This is most likely the result of anatomic interrelationships between the diaphragm, stomach, and terminal portion of the esophagus. Gastropexy also increases barrier pressure in the immediate postoperative period, which may be clinically relevant in terms of understanding how resolution of gastroesophageal reflux disease associated with hiatal hernia may be affected by gastropexy combined with hernia reduction.     

The cardiovascular sparing effect of fentanyl and atropine, administered to enflurane anesthetized dogs.

Cardiovascular effects of high dose opioid together with low dose inhalant were compared with inhalant alone to determine whether opioid/inhalant techniques were less depressant on the cardiovascular system. The effects of positive pressure ventilation and increasing heart rate to a more physiological level were also studied. Cardiovascular measurements recorded during administration of enflurane at 1.3 minimum alveolar concentration (MAC; 2.89 +/- 0.02%) to spontaneously breathing dogs (time 1) and during controlled ventilation [arterial carbon dioxide tension at 40 +/- 3 mmHg (time 2)] were similar. At time 2, mixed venous oxygen tension and arterial and mixed venous carbon dioxide tensions were significantly decreased, while arterial and mixed venous pH were significantly increased compared to measurements at time 1. After administration of fentanyl to achieve plasma fentanyl concentration of 71.7 +/- 14.4 ng/mL and reduction of enflurane concentration to yield 1.3 MAC multiple (0.99 +/- 0.01%), heart rate significantly decreased, while mean arterial pressure, central venous pressure, stroke index, and systemic vascular resistance index increased compared to measurements taken at times 1 and 2. Pulmonary arterial occlusion pressure was significantly increased compared to measurements taken at time 2. After administration of atropine until heart rate was 93 +/- 5 beats/min (plasma fentanyl concentration 64.5 +/- 13.5 ng/mL) heart rate, mean arterial pressure, cardiac index, oxygen delivery index, and venous admixture increased significantly compared to values obtained at all other times.(ABSTRACT TRUNCATED AT 250 WORDS)     

Cardiovascular and pulmonary effects of atropine reversal of oxymorphone-induced bradycardia in dogs.

Oxymorphone was administered intravenously (IV) to 10 dogs (0.4 mg/kg initial dose followed by 0.2 mg/kg three times at 20-minute intervals). Four hours after the last dose of oxymorphone, heart rates were less than 60 bpm in six dogs. After atropine (0.01 mg/kg IV) was administered, heart rate decreased in five dogs and sinus arrhythmia or second degree heart block occurred in four of them. A second injection of atropine (0.01 mg/kg IV) was administered 5 minutes after the first and the heart rates increased to more than 100 bpm in all six dogs. Ten minutes after the second dose of atropine, heart rate, cardiac output, left ventricular minute work, venous admixture, and oxygen transport were significantly increased, whereas stroke volume, central venous pressure, systemic vascular resistance, and oxygen extraction ratio were significantly decreased from pre-atropine values. The PaCO2 increased and the PaO2 decreased but not significantly. The oxymorphone-induced bradycardia did not produce any overtly detrimental effects in these healthy dogs. Atropine reversed the bradycardia and improved measured cardiovascular parameters.     

Comparison of direct and indirect blood pressure measurements in anesthetized dogs.

The precision and accuracy of an indirect oscillometric blood pressure measurement technique (Dinamap 8100) was assessed in 11 anesthetized Beagle dogs weighing 8 to 11.5 kg. Direct blood pressure measurements were made by catheterization of the lingual artery, and simultaneous indirect measurements were determined by placing a cuff over the median artery (midradial area). Blood pressure measurements at 2 different planes of anesthesia (light and deep) were recorded in triplicate. At a light plane of anesthesia, the Dinamap 8100 underestimated diastolic and mean arterial pressure, and at a deep anesthetic plane overestimated systolic pressure. The indirect technique had good repeatability of systolic pressures. Regression analysis for the 2 techniques showed excellent correlation (r = 0.93). The results indicate that the indirect oscillometric blood pressure measurement technique provides a good estimate of systolic, diastolic, and mean arterial pressure in dogs weighing 8-11.5 kg.     

Assessment of 3 audible monitors during hypotension in anesthetized dogs.

Severe hypotension was produced in 8 dogs during halothane anesthesia. Three monitors detecting respiratory rate, Doppler signal and pulse rate were compared to direct blood pressure measurements. Deep anesthesia was most consistently detected using the respiratory monitor. The signal fade of the Doppler device was best at detecting hypotension from blood loss. Changes in heart rate were not useful.     

Clearance of nasal mucus in nonanesthetized and anesthetized dogs

Clearance rates for nasal mucus in the maxillary turbinate region were measured in 8 Beagle dogs. 99mTc Macroaggregated albumin (10 microliters) was instilled in the nasal maxillary region of dogs under general anesthesia. A gamma camera was used to detect movement of the 99mTc macroaggregated albumin in the nose for 1 hour after it was instilled. Velocity of mucus was measured in the 8 dogs each under 3 conditions of anesthesia: anesthesia with pentobarbital given IV (20 mg/kg of body weight), anesthesia with halothane gas, and no anesthesia. Mean velocities (+/- SD) were 3.7 +/- 1.4 mm/min in dogs anesthetized with pentobarbital, 4.3 +/- 2.5 mm/min in dogs anesthetized with halothane, and 3.4 +/- 1.7 mm/min in awake dogs. The differences between the 3 anesthetic conditions were not significant at the P less than 0.05 level. Use of anesthesia at a light surgical plane provides a controlled method for measurement of clearance of nasal mucus with minimal alterations from the nonanesthetized state.     

The effect of epidural injection speed on epidural pressure and distribution of solution in anesthetized dogs

ObjectiveTo determine the effect of injection speed on epidural pressure (EP), injection pressure (IP), epidural distribution (ED) of solution, and extent of sensory blockade (SB) during lumbosacral epidural anesthesia in dogs.Study designProspective experimental trial.AnimalsTen healthy adult Beagle dogs weighing 8.7 ± 1.6 kg.MethodsGeneral anesthesia was induced with propofol administered intravenously and maintained with isoflurane. Keeping the dogs in sternal recumbency, two spinal needles connected to electrical pressure transducers were inserted into the L6-L7 and the L7-S1 intervertebral epidural spaces for EP and IP measurements, respectively. Bupivacaine 0.5% diluted in iohexol was administered epidurally to each dog via spinal needle at L7-S1 intervertebral space, at two rates of injection (1 and 2 mL minute^?1 groups), with a 1-week washout period. Epidural distribution was verified with computed tomography, and SB was evaluated after arousal by pinching the skin with a mosquito hemostatic forceps over the vertebral dermatomes. The results were analyzed according to each injection speed, using paired t- and Wilcoxon signed-rank tests.ResultsMean ± SD of baseline EP and IP values were 2.1 ± 6.1 and 2.6 ± 7.1 mmHg, respectively. Significant differences were observed between 1 and 2 mL minute^?1 groups for peak EP (23.1 ± 8.5 and 35.0 ± 14.5 mmHg, p = 0.047) and peak IP (68.5 ± 10.7 and 144.7 ± 32.6 mmHg, p <0.001). However, the median (range) of the ED, 11.5 (4–22) and 12 (5–21) vertebrae, and SB, 3.5 (0–20) and 1 (0–20) dermatomes, values of the two groups were not related to injection speed.Conclusions and clinical relevanceThe EP profile during injection was measured by separating the injection and pressure monitoring lines. The increase in epidural injection speed increased the EP, but not the ED or the SB in dogs.     

Electrocardiographic and cardiopulmonary effects of intramuscular administration of glycopyrrolate and romifidine in conscious beagle dogs

Objective To determine the electrocardiographic and cardiopulmonary effects of IM administration of romifidine with and without prior administration of glycopyrrolate in conscious dogs. Study design Prospective randomized study. Animals Twelve healthy, adult beagles. Materials and methods Dogs were assigned at random to each of three treatments with glycopyrrolate (six dogs), and to each of three treatments without glycopyrrolate (six dogs). Baseline data were recorded, and saline solution or glycopyrrolate (10 µg kg^–1) was given IM. After 15 minutes, saline solution (control) or romifidine (20 or 40 µg kg^–1) was given IM. An ECG, heart rate (HR), systemic blood pressures, and respiratory rate (RR) were recorded before and 2.5, 5, 10, 15, 30, 45, 60, 75, 90, 105 and 120 minutes after romifidine administration. Rectal temperature (RT), pH, PaCO₂, PaO₂, hematocrit and plasma protein were determined before and 15, 30, 60 and 120 minutes after romifidine administration. Data were analyzed using analysis of variance for repeated measures and Tukey multiple comparison tests. Results Without glycopyrrolate, HR (beats minute^–1) decreased to minimum values (mean ± SD) of 52 ± 7 and 49 ± 12 (control 89 ± 20) 45 minutes after administration of romifidine at doses of 20 and 40 µg kg^–1, respectively. Sinus bradycardia (HR < 60 beats minute^–1), which persisted for up to 120 minutes, was observed in five of six and six of six dogs given romifidine at doses of 20 and 40 µg kg^–1, respectively. With glycopyrrolate, decreases in HR were prevented and mean arterial pressure (mm Hg) increased to maximum values of 139 ± 25 and 173 ± 17 (control 113 ± 11) 30 minutes after administration of romifidine at doses of 20 and 40 µg kg^–1, respectively. With and without glycopyrrolate, RR did not change appreciably, RT decreased, and pH, PaCO₂, PaO₂, hematocrit and plasma protein did not change after administration of romifidine. Conclusions and clinical relevance In healthy conscious beagles, IM administration of romifidine at doses of 20 and 40 µg kg^–1 causes sinus bradycardia which persists for up to 120 minutes. Administration of glycopyrrolate 15 minutes before administration of romifidine, prevents sinus bradycardia and induces moderate increases in arterial pressure.     

Cardiopulmonary effects of thoracoscopy in anesthetized normal dogs

Objective To evaluate the effect of an open‐chest condition on oxygen delivery in anesthetized dogs. Study design Prospective, controlled experimental study. Animals Eight clinically normal adult Walker Hound dogs weighing 25.6–29.2 kg. Methods Eight anesthetized dogs underwent an open‐chest operation after the insertion of thoracoscopy cannulae in the lateral chest walls . A Swan Ganz catheter was used to both measure hemodynamic parameters and obtain mixed venous blood samples for blood gas analysis. A dorsal pedal catheter was placed to both measure arterial blood pressure and obtain blood samples for blood gas analysis. Oxygen delivery index and oxygen extraction ratio were calculated. A randomized block anova for repeated measures was used to evaluate the effect of the treatment on hemodynamic and pulmonary parameters. Results Creation of an open chest did not significantly affect oxygen delivery index (DO₂I; p = 0.545). It induced a significant decrease in arterial oxygen partial pressure (PaO₂; p = 0.018) and arterial oxygen content (CaO₂; p = 0.025). It induced a significant increase in shunt fraction (p = 0.023), physiologic dead space (p = 0.015), and alveolar‐arterial oxygen difference (p = 0.019). Arterial partial pressure of carbon dioxide (PaCO₂; p = 0.766) and arterial hemoglobin oxygen saturation (SaO₂; p = 0.178) were not significantly affected. Diastolic (DPAP; p = 0.050) and mean (MPAP; p = 0.033) pulmonary arterial pressures were significantly increased by opening the chest. Other hemodynamic parameters were not significantly affected. Conclusions Opening the thoracic cavity is not detrimental to hemodynamic function and oxygen delivery in normal dogs, although impaired gas exchange does occur. Clinical relevance Close monitoring of patients is recommended during open‐chest thoracoscopy as adverse effects on gas exchange can contribute to hypoxemia.     

Ultrasonographic-anatomic correlation and imaging protocol for the spleen in anesthetized dogs

Sonographic and/or anatomic observations were made of the spleen in 27 dogs. Anatomic studies were used to establish precise correlations between the gross anatomic features of the organ and its ultrasonographic image. In 8 anesthetized dogs, ultrasonographic images of the spleen were made in dorsal, transverse, and sagittal planes. When it was incident to the ultrasonic beam, the splenic capsule was represented by a fine echogenic line that defined the boundaries of the organ. The splenic substance had a uniformly mottled echogenicity apart from the anechoic lumen of the splenic venous rami, which were detected at and near the hilus of the spleen. Less regularly, splenic arterial rami were detected at the hilus, but not within the splenic substance. Dorsal and transverse images were made with the ultrasonic transducer perpendicular to the left thoracic and abdominal wall at the 11th intercostal space and caudoventrad to it. Sagittal images were produced with the transducer's face directed craniad, placed parallel to the left lateral abdominal wall, and pushed under the costal arch. The adoption of such an ultrasonographic imaging protocol ensures that all of the spleen is inspected. A definitive opinion can then be given as to whether the spleen is normal or abnormal. Pathologic changes in the spleen must also be differentiated from changes in adjacent organs or structures.     

Effects of volatile anesthetics on the activity of laryngeal 'drive' receptors in anesthetized dogs.

Effects of halothane, isoflurane and sevoflurane on laryngeal drive receptor activity were studied in the afferent activity of the superior laryngeal nerve in anesthetized spontaneously breathing dogs. Of 40 single units recorded, most of them (65%) responded to the volatile anesthetics applied to the isolated larynx at a concentration of 5%. The exposure to the anesthetics resulted in either an inspiratory increase (15%), both inspiratory and expiratory decrease (54%), or both inspiratory increase and expiratory decrease (31%) responses. The average discharge frequency of the receptors tended to be decreased on inhalation of the anesthetics, where significant decreases were observed in both respiratory phases for halothane and at expiration for isoflurane, but in neither respiratory phase for sevoflurane. These results support an advantage of sevoflurane over halothane and isoflurane for induction of anesthesia to minimize the influence of the activity of laryngeal drive receptors on the breathing pattern and airway stability.     

Effect of metoclopramide on gastro-esophageal reflux in anesthetized dogs

Administration of morphine before anesthesia leads to gastro-esophageal reflux (GER) in over 50% of dogs during the subsequent anesthetic. This GER is clinically silent but can lead to aspiration pneumonitis, esophagitis and esophageal stricture. In this prospective clinical study we aimed to determine the effect of metoclopramide on gastro-esophageal reflux (GER) in dogs undergoing elective orthopedic surgery. Dogs were admitted to the study if they were healthy, and had no history of vomiting or dysphagia. Dogs were fasted for an average of 18.2 ± 4.3 (mean ± SD) hours prior to induction of anesthesia. Anesthesia in all dogs included acepromazine, morphine, thiopental and isoflurane in oxygen. By random allocation, half the dogs received metoclopramide (M) as an IV bolus (0.4 mg kg^–1) and then infusion (0.3 mg kg^–1hour^–1), the others received equivalent volumes of saline (S). To measure esophageal pH a sensor-tipped catheter was placed with the tip 5–7 cm cranial to the lower esophageal sphincter, and connected to a computer for continual data collection. The pH of any fluid running from the mouth or nose was measured. Gastro-esophageal reflux was defined as a decrease in esophageal pH below 4 or an increase above 7.5. Fisher's Exact test was used to test significance of differences in incidence between groups. Separate multivariable logistic regression models were created for each outcome to assess the effects of risk factors on outcome. There were seven cases of GER in 16 dogs receiving M and 8/14 in those receiving S. There were no significant differences between M and S treated dogs in age, weight, duration of anesthesia and fasting, thiopental dose or incidence of vomiting. The administration of metoclopramide at this dose did not significantly reduce the incidence of GER in these anesthetized dogs.