The effect of volatile anaesthetics on the relative sensitivity of facial and distal thoracic limb muscles to vecuronium in dogs

ObjectiveTo compare n. facialis-m. nasolabialis (nF-mNL) and n. ulnar-mm. carpi flexorii (nU-mCF) sensitivity to vecuronium during halothane or isoflurane anaesthesia.Study designRandomized, prospective, experimental study.AnimalsForty-four client-owned dogs (19 male, 25 female) undergoing surgery; mean age: 5.0 years; mean body mass: 24.7 kg.MethodsThirty minutes after acepromazine (0.05 mg kg^?1) and morphine (0.5 mg kg^?1), anaesthesia was induced with intravenous (IV) thiopental and maintained with either halothane (n = 22) or isoflurane (randomly allocated) in oxygen. The lungs were mechanically ventilated and end-tidal inhaled anaesthetic (Fe’_IAA) maintained at 1.2 × MAC values. Neuromuscular transmission at nF-uNL and nU-mCF was monitored using the train of four count. Vecuronium (50 μg kg^?1 IV) was injected (t = 0) after 15 trains, 50-60 minutes after inhalational anaesthesia began, when Fe’_IAA had been constant for >15 minutes. Times of the disappearance (-) and reappearance (+) of the fourth (T4) and first twitch (T1) were recorded allowing the calculation of: latent (t = 0 to T4-) and manifest onset times (t = 0 to T1-) duration of blockade (T1- to T1+) and drug effect (T4- to T4+) and recovery time (T1+-T4+). Student’s paired t-test was used to compare simultaneous responses at nF-uNL and nU-mCF. An unpaired t-test was used to compare anaesthetic effects.ResultsLatent and manifest onset times were significantly (p < 0.05) briefer, blockade and drug effects were significantly longer and recovery from blockade were significantly slower in the nF-mNL unit in both halothane and isoflurane recipients. Profound block duration and drug action were significantly longer and recovery from blockade were significantly slower in halothane recipients at both nerve-muscle units.Conclusion and clinical relevanceThe nF-mNL was more sensitive than nU-mCF to vecuronium, particularly in halothane-anaesthetized dogs.     

Evaluation of neostigmine antagonism at different levels of vecuronium-induced neuromuscular blockade in isoflurane anesthetized dogs

Residual neuromuscular block (NMB) during recovery from general anesthesia may be minimized by antagonizing NMB with neostigmine. We examined neostigmine for restoring neuromuscular function when administered at 2 levels of vecuronium-induced NMB in dogs. Eight healthy adult dogs received vecuronium 0.1 mg/kg body weight (BW), IV, during isoflurane anesthesia. Recovery from vecuronium occurred spontaneously (control group; C), or was enhanced with neostigmine, 0.04 mg/kg BW, IV, administered when 2 (N2) or 4 (N4) responses to train-of-four (TOF) stimulation were first observed. Duration of NMB was significantly shorter for N2 and N4 than for C. The period of complete NMB was equal for all groups; differences were observed during the recovery phase of NMB. Time of neostigmine-enhanced recovery was significantly shorter for N4 than N2, but overall duration of NMB was not reduced. Recovery from NMB was faster with neostigmine. There is no clinical advantage in delaying neostigmine administration once 2 responses to TOF are present.     

Recovery from neuromuscular block in dogs: restoration of spontaneous ventilation does not exclude residual blockade

ObjectiveTo evaluate if return of spontaneous ventilation to pre-relaxation values indicates complete recovery from neuromuscular blockade.Study designProspective, with each individual acting as its own control.AnimalsTen healthy adult female Beagle dogs weighing 6.2–9.4 kg.MethodsDogs were anesthetized with propofol, dexemedetomidine and isoflurane. Spontaneous ventilation was assessed by measuring end-tidal CO₂, expired tidal volume, peak inspiratory flow, respiratory rate and minute ventilation. Vecuronium 25 μg kg^?1 IV was administered and neuromuscular block was evaluated by measuring the train-of-four (TOF) ratio with acceleromyography in the hind limb. During spontaneous recovery from neuromuscular block, the TOF ratio when each ventilatory variable returned to baseline was recorded.ResultsThis dose of vecuronium produced moderate neuromuscular block in all dogs, with TOF ratio values of 0–18% at maximal block. Expired tidal volume, peak inspiratory flow and minute ventilation returned to pre-relaxation values when the median TOF ratio was ≤ 20%. The median TOF ratio was 42% when the end-tidal CO₂ returned to pre-relaxation values.Conclusions and clinical relevanceSignificant residual neuromuscular block could be measured at the hind limb with acceleromyography when ventilation had spontaneously returned to pre-vecuronium values. Monitoring spontaneous ventilation, including end-tidal CO₂, expired tidal volume, peak inspiratory flow or minute ventilation cannot be used as a surrogate for objective neuromuscular monitoring, and this practice may increase the risk of postoperative residual paralysis.     

The use of the nondepolarizing neuromuscular blocking drug cis-atracurium in dogs

Objective This clinical trial attempted to evaluate the potency, onset and duration of action of cis‐atracurium in dogs. Animals Twenty dogs aged between 1 and 15 years and weighing between 15 and 85 kg admitted for a variety of elective, surgical procedures under general anaesthesia. Materials and methods Following induction of general anaesthesia, the effects of an intravenous loading dose of cis‐atracurium (0.1 mg kg^?1) were evaluated by counting visual responses to train of four (TOF) nerve stimulation. Incremental doses of 0.02 or 0.04 mg kg^?1 cis‐atracurium were administered when the first of four responses to TOF stimulation was present. Results An initial dose of 0.1 mg kg^?1 eliminated all four TOF responses in 18 out of 20 dogs. The same dose, repeated 10 minutes later in two animals in which blockade was incomplete, abolished all responses. In dogs receiving 0.1 mg kg^?1 cis‐atracurium neuromuscular blockade lasted 27.2 ± 9.3 minutes. Up to six incremental doses were given in individual animals; incremental doses appeared to be noncumulative. No untoward side‐effects were observed with the use of this drug. There was considerable variation between individuals in response to cis‐atracurium. Conclusions Cis‐atracurium is an effective neuromuscular blocking agent in the dog, although its potency varies. Clinical Relevance Further studies are required to determine whether observed differences in potency are related to age, breed or sex. Cis‐atracurium may prove useful in dogs with impaired renal and or hepatic function.     

The clinical use of the neuromuscular blocking agent rocuronium in dogs

Objective The aim of this study was to characterize the onset and duration of action of the aminosteroid muscle relaxant rocuronium in dogs under clinical conditions. Study design Prospective single dose trial. Animals Twenty‐three dogs aged between 6 months and 12 years, weighing between 5.5 and 61.5 kg admitted to the University of Liverpool Small Animal Hospital between January and March 2000, and undergoing elective surgical procedures under general anaesthesia. Materials and methods Following induction of general anaesthesia, neuromuscular function was evaluated using train‐of‐four (TOF) stimulation. An initial dose of 0.4 mg kg^?1 rocuronium was administered intravenously (IV) and neuromuscular blockade was monitored by visually assessing the number of responses (twitches) to TOF stimulation (train‐of‐four count: TOFC). Incremental doses of 0.16 mg kg^?1 rocuronium were administered as indicated, when at least two twitches of the TOFC had returned. Results Rocuronium (0.4 mg kg^?1) abolished all responses to TOF stimulation in all dogs. The mean time to onset of neuromuscular blockade (complete abolition of all twitches) was 98 ± 52 seconds. Neuromuscular blockade (absence of all twitches to return of all four) lasted 32.3 ± 8.2 minutes. Incremental doses of 0.16 mg kg^?1 had a mean duration of action of 20.8 ± 4.9 minutes and up to seven increments were shown to be noncumulative. The effects of rocuronium were readily antagonized with neostigmine and atropine. Small transient increases in arterial blood pressure, which occurred in three dogs after the administration of rocuronium, were the only cardiovascular side‐effects observed. Conclusions Rocuronium is an effective nondepolarizing neuromuscular blocking agent in the dog, with a rapid onset of neuromuscular block after intravenous administration and an intermediate duration of action. Clinical relevance Rocuronium produced a neuromuscular block with similar characteristics to those obtained with vecuronium, thus apparently offering little advantage over vecuronium. However, its availability in aqueous solution and a longer shelf‐life increases convenience.     

Effects of metaraminol bitartrate on intraocular pressure in dogs under halothane anesthesia

The effects of metaraminol bitartrate on intraocular pressure (IOP) were studied in dogs anesthetized with halothane. Forty-five healthy, adult, mixed-breed dogs, of both sexes, were divided into three groups of 15 dogs each (GI, GII and GIII) and maintained under general anesthesia with halothane after tranquilization with levomepromazine and induction with thiopental. Saline (0.9%) was administered intravenously (IV) to GI through continuous infusion, at a velocity of 0.125 mL kg⁻¹ min⁻¹. GII and GIII received metaraminol 0.004% IV, at a dose of 5 μg kg⁻¹ min⁻¹, at 0.125 mL kg⁻¹ min⁻¹ and at a dose of 2 μg kg⁻¹ min⁻¹, at 0.06 mL kg⁻¹ min⁻¹, respectively. IOP was measured by applanation tonometry (Tono-Pen) before and during anesthesia. Results showed that IOP decreased in GI, increased in GII, and remained at basal levels in GIII. Continuous infusion of metaraminol at 2 μg kg min⁻¹ maintained IOP at pretest levels, while infusion at 5 μg kg⁻¹ min⁻¹ produced an elevation of IOP.     

Failure to reverse prolonged vecuronium-induced neuromuscular blockade with edrophonium in an anesthetized dog

A case of prolonged muscle relaxation after vecuronium in an anesthetized dog is presented. After using peripheral nerve stimulation to confirm partial recovery of neuromuscular transmission, administration of 0.5 mg/kg IV of intravenous edrophonium failed to complete the reversal process. Subsequent administration of neostigmine resulted in complete recovery from blockade. Without monitoring neuromuscular function with a peripheral nerve stimulator until reversal was complete, it was very likely this patient would have been extubated with incomplete neuromuscular transmission. Several factors affecting the duration of neuromuscular blockade and its reversal are addressed.     

The effect of inhalant anesthetic and body temperature on peri-anesthetic serum concentrations of transdermally administered fentanyl in dogs

Objectives To determine whether moderate hypothermia during anesthesia significantly affects the serum concentration of transdermally delivered fentanyl and whether halothane or isoflurane affect these concentrations. Study Design Randomized cross‐over experimental trial. Animals Six mature, healthy Beagles (three males, three females) weighing 10.6 ± 0.43 kg. Methods A 50‐µg hour^?1 fentanyl patch was applied 36 hours prior to anesthesia. Anesthesia was induced at time 0 (t = 0). Each dog received four treatments: isoflurane + normothermia (ISO‐NORM), isoflurane + hypothermia (ISO‐HYPO), halothane + normothermia (HAL‐NORM), and halothane + hypothermia (HAL‐HYPO). Dogs were intubated and maintained at 1.5 times MAC. Animals in the hypothermia treatments were cooled to 35 °C during anesthesia. Serum fentanyl analysis was performed at ?36, ?24, ?12, 0, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 7, 8, 9, 10, 18, and 26 hours. Direct arterial blood pressures and arterial blood gases were monitored. Results The mean body temperatures (±SEM) during the anesthetic period for the four treatments were: ISO‐NORM = 37.7 ± 0.07 °C, ISO‐HYPO = 35.8 ± 0.1 °C, HAL‐NORM = 37.7 ± 0.06 °C, and HAL‐HYPO = 35.8 ± 0.13 °C. The mean (±SEM) serum fentanyl concentrations (SFC) for both hypothermia treatments were significantly lower than baseline concentrations at t = 1 hour and persisted for the duration of anesthesia for the ISO‐HYPO treatment but only from t = 1 to 2 hours for the HAL‐HYPO treatment. Serum fentanyl concentrations returned to baseline within one hour of the end of anesthesia, regardless of body temperature. There were no significant differences between treatments for systolic or diastolic blood pressure but mean blood pressures were higher during normothermia versus hypothermia during the last hour of anesthesia. Conclusions and clinical relevance Hypothermia during inhalation anesthesia produced a significant reduction in SFC using transdermal administration and was more protracted with isoflurane than halothane anesthesia. While significant reductions in SFC occurred, the SFC were still within the range believed to confer analgesia.     

Reversal of profound rocuronium or vecuronium-induced neuromuscular block with sugammadex in isoflurane-anaesthetised dogs

This study evaluated the use of sugammadex for reversal of profound neuromuscular blockade induced with rocuronium or vecuronium in dogs. Anaesthesia was induced and maintained with isoflurane in oxygen in eight dogs on two occasions. Neuromuscular blockade was monitored using peroneal nerve stimulation and acceleromyography. Rocuronium 0.6 mg/kg or vecuronium 0.1mg/kg was administered intravenously (IV), followed 5 min later by sugammadex 8 mg/kg IV. Lag and onset time of rocuronium and vecuronium, lag time from sugammadex injection to recovery of first twitch response, recovery of T1/T0 to 25% and 75%, recovery index, and time to recovery of the train-of-four ratio (T4/T1) to 0.9 were recorded. Cardiovascular and respiratory parameters were also noted. Statistical analysis was performed using one-way ANOVA. Onset time for rocuronium (37 ± 18s; [mean ± SD]) was significantly shorter than for vecuronium (62 ± 15s) (P<0.04). No other significant differences were found between the two groups. After both rocuronium and vecuronium blockade, T4/T1 recovered to 0.9 in under 2 min after sugammadex (58.1 ± 67.8s and 98.1 ± 70.3s, respectively; P<0.32). Sugammadex can reverse profound neuromuscular blockade induced by vecuronium or rocuronium safely and rapidly in isoflurane-anaesthetised dogs.     

Effects of sevoflurane,propofol or alfaxalone on neuromuscular blockade produced by a single intravenous bolus of rocuronium in dogs

ObjectiveTo compare the effects of sevoflurane, propofol and alfaxalone on the neuromuscular blockade induced by a single intravenous bolus of rocuronium in dogs.Study designA randomized, prospective, crossover experimental study.AnimalsA total of eight adult Beagle dogs (four female, four male), weighing 8.9–15.3 kg and aged 5–7 years.MethodsThe dogs were anesthetized three times with 1.25× minimum alveolar concentration of sevoflurane (SEVO treatment) and 1.25× minimum infusion rate of propofol (PROP treatment) or alfaxalone (ALFX treatment) at intervals of ≥14 days. Neuromuscular function was monitored with train-of-four (TOF) stimulation of the peroneal nerve by acceleromyography. After recording the control TOF ratio (TOFRC), a single bolus dose of rocuronium (1 mg kg^–1) was administered intravenously. The times from rocuronium administration to achieving TOF count 0 (onset time), from achieving TOF count 0 to the reappearance of TOF count 4 (clinical blockade period), from 25% to 75% of TOFRC (recovery index) and from achieving TOF count 0 to TOF ratio/TOFRC >0.9 (total neuromuscular blockade duration) were recorded.ResultsThe onset time and recovery index did not differ among the treatments. The median clinical blockade period was longer in the SEVO treatment [27.3 (26.0–30.3) minutes] than in PROP [16.6 (15.4–18.0) minutes; p = 0.002] and ALFX [22.4 (18.6–23.1) minutes; p = 0.017] treatments; and longer in the ALFX treatment than in the PROP treatment (p = 0.020). The mean total neuromuscular blockade duration was longer in the SEVO treatment (43.7 ± 9.9 minutes) than in PROP (25.1 ± 2.7 minutes; p < 0.001) and ALFX (32.5 ± 8.4 minutes; p = 0.036) treatments.Conclusions and clinical relevanceCompared with alfaxalone and propofol, sevoflurane prolonged rocuronium-induced neuromuscular blockade by a significantly greater extent in dogs.     

The effects of medetomidine on radial nerve blockade with mepivacaine in dogs

OBJECTIVE: To compare the sensory and motor effects of adding medetomidine to mepivicaine, administered either perineurally or systemically, for radial nerve block in dogs. STUDY DESIGN: Prospective randomized cross-over study. ANIMALS: Six healthy Beagles, aged 18.7 +/- 6.3 months and weighing 10.4 +/- 1.3 kg. METHODS: Dogs were anesthetized briefly with sevoflurane on three separate occasions and received each treatment administered in random order: mepivacaine 5 mg kg(-1) perineurally around the radial nerve with saline 0.01 mL kg(-1) intramuscularly (CONTROL); mepivacaine 5 mg kg(-1) and medetomidine 0.01 mg kg(-1) combined, perineurally with saline 0.01 mL kg(-1) intramuscularly (MEDPN); mepivacaine 5 mg kg(-1) perineurally around the radial nerve with medetomidine 0.01 mg kg(-1) intramuscularly (MEDIM). All nerve blocks were performed with the aid of a nerve locator. Motor effects were evaluated based on the ability to bear weight. Sensory effects were evaluated by the response to a graded-electrical stimulus. These were evaluated at 5-minute intervals for the first hour, and at 10-minute intervals thereafter. Mean intervals were calculated as follows: time to motor block onset, duration of motor block, time to peak sensory block, duration of peak sensory block (i.e. period of no response to maximal stimulus intensity), and duration of residual sensory block (i.e. time to return to baseline sensory function). Treatment means were compared using a one-way analysis of variance for repeated measures and, where significant differences were noted, a Student-Newman-Keuls test was applied; p < 0.05 was considered significant. RESULTS: Medetomidine, administered either systemically or perineurally, significantly prolonged duration of peak motor block, peak sensory block, and residual sensory block compared with CONTROL. CONCLUSION: Medetomidine prolonged sensory and motor blockade after radial nerve block with mepivacaine in dogs. CLINICAL RELEVANCE: Medetomidine may prove to be a useful adjunct to peripheral nerve blockade with local anesthetics.     

The effects of propofol, isoflurane and sevoflurane on vecuronium infusion rates for surgical muscle relaxation in dogs

OBJECTIVE: To compare the constant rate infusion (CRI) of vecuronium required to maintain a level of neuromuscular blockade adequate for major surgeries, e.g. thoracotomy or laparotomy, in dogs anaesthetized with a CRI of fentanyl and either propofol, isoflurane or sevoflurane. STUDY DESIGN: Prospective, randomized, cross-over study. ANIMALS: Thirteen male beagles (age, 9-22 months; body mass 6.3-11.3 kg). MATERIALS AND METHODS: Dogs were anaesthetized with propofol (24 mg kg(-1) hour(-1) IV CRI; group P), isoflurane (1.3% end-tidal concentration; group I) or sevoflurane (2.3% end-tidal concentration; group S) with fentanyl (5 microg kg(-1) hour(-1) IV, CRI). Sixty to seventy minutes after induction of anaesthesia, vecuronium was administered at a rate of 0.4, 0.3 and 0.2 mg kg(-1) hour(-1) in groups P, I and S respectively. To determine the degree of neuromuscular block, a peripheral nerve was stimulated electrically using the train-of-four (TO4) stimulus pattern. Evoked muscle contractions were evaluated using a neuromuscular monitoring device. Once the TO4 ratio reached 0, the continuous infusion rate was decreased and adjusted to maintain a TO4 count of 1. Continuous infusion was continued for 2 hours. The infusion rate of vecuronium was recorded 20, 40, 60, 80, 100 and 120 minutes after the start of infusion. RESULTS: The mean continuous infusion rates of vecuronium during stable infusion were 0.22 +/- 0.04 (mean +/- SD), 0.10 +/- 0.02 and 0.09 +/- 0.02 mg kg(-1) hour(-1) in groups P, I and S respectively. There were statistically significant differences between the rates in groups P and I and between the rates in groups P and S. Conclusions and clinical relevance In healthy dogs, the recommended maintenance infusion rate of vecuronium is 0.2 mg kg(-1) hour(-1) under CRI propofol-fentanyl anaesthesia and 0.1 mg kg(-1) hour(-1) during CRI fentanyl-isoflurane or sevoflurane anaesthesia.     

Speed of reversal of vecuronium neuromuscular block with different doses of neostigmine in anesthetized dogs

Objectives

Neostigmine is routinely used to reverse non-depolarizing neuromuscular block. Given its indirect mechanism, a plateau may exist whereby increasing doses of neostigmine do not result in clinical benefit. This study was designed to measure the speed of reversal of vecuronium-induced neuromuscular block in isoflurane-anesthetized dogs after the administration of three doses of neostigmine as used in clinical practice.

Bispectral monitoring in dogs subjected to ovariohysterectomy and anesthetized with halothane, isoflurane or sevoflurane

ObjectiveTo assess the effect of halothane (H), isoflurane (I) or sevoflurane (S) on the bispectral index (BIS), and the effect of the addition of meperidine in dogs subjected to ovariohysterectomy.Study designProspective, randomized, blinded, clinical trial.AnimalsForty-eight female mixed-breed dogs, with weights varying from 10 to 25 kg.MethodsAll dogs were premedicated with acepromazine (A) (0.1 mg kg^?1 IM) or A and meperidine (M) (3 mg kg^?1 IM) and they were divided into six groups of eight animals (AH, AMH, AI, AMI, AS, and AMS). Fifteen minutes after premedication they were anesthetized with propofol (5 mg kg^?1 IV) and then orotracheally intubated. Anesthesia was maintained with halothane, isoflurane or sevoflurane, respectively. The BIS,

variables were recorded at 15 minutes after administering pre-anesthetic medication (T0); 10 minutes of anesthesia maintenance (T1); right ovarian pedicle ligation (T2); muscle suturing (T3); skin suture (T4) and 10 minutes after terminating the inhalant anesthetic (T5), respectively.ResultsBIS values were decreased at all times when compared to the baseline values in all groups (p < 0.05). In the comparative assessment between groups, the values obtained at T0 and T1 were similar for all groups. At T2, the values in AMH were lower than those obtained in AI, AMI and AS (p < 0.05). At the same time significantly higher values were found for AI when compared to AMS (p < 0.01). There was a correlation between the bispectral index and the expired anesthetic fraction in all groups.Conclusions and clinical relevanceWithin groups given the same inhalant anesthetic the bispectral index was a good indicator for the degree of hypnosis in dogs, indicating a good correlation with the amount of anesthetic and the nociceptive stimulation. BIS was a less reliable indicator of relative anesthetic depth when comparing equipotent end-tidal concentrations between the three inhalants.     

Pharmacokinetics of morphine in combination with dexmedetomidine and maropitant following intramuscular injection in dogs anaesthetized with halothane

The purpose of this study was to evaluate the pharmacokinetics of morphine in combination with dexmedetomidine and maropitant injected intramuscularly in dogs under general anaesthesia. Eight healthy dogs weighing 25.76 ± 3.16 kg and 3.87 ± 1.64 years of age were used in a crossover study. Dogs were randomly allocated to four groups: (1) morphine 0.6 mg/kg; (2) morphine 0.3 mg/kg + dexmedetomidine 5 μg/kg; (3) morphine 0.3 mg/kg + maropitant 1 mg/kg; (4) morphine 0.2 mg/kg + dexmedetomidine 3 μg/kg + maropitant 0.7 mg/kg. Blood samples were collected before, 15 and 30 min, and 1, 2, 3 4, 6 and 8 hr after injection of the test drugs. Plasma concentration of the drugs was determined by liquid chromatography-mass spectrometry. The elimination half-life (T_1/2) of morphine was higher and the clearance rate (CL) was lower when combined with dexmedetomidine (T_1/2 = 77.72 ± 20.27 min, CL = 119.41 ± 23.34 ml kg⁻¹ min⁻¹) compared to maropitant (T_1/2 = 52.73 min ± 13.823 ml kg⁻¹ min⁻¹, CL = 178.57 ± 70.55) or morphine alone at higher doses (T_1/2 = 50.53 ± 12.55 min, CL = 187.24 ± 34.45 ml kg⁻¹ min⁻¹). Combining morphine with dexmedetomidine may increase the dosing interval of morphine and may have a clinical advantage.     

The effect of topical treatment on esophageal pH during acid reflux in dogs

OBJECTIVE: To determine the effect of suction, lavage and instillation of sodium bicarbonate solution on esophageal pH during acidic gastro-esophageal reflux (GER) in anesthetized dogs. STUDY DESIGN: Prospective, clinical trial. ANIMALS: Ten healthy dogs, 4.8 +/- 2.4 years old, and weighing 37.1 +/- 7.9 kg. METHODS: Dogs were admitted to the study if they were under general anesthesia and regurgitation occurred. A sensor-tipped catheter was used to measure esophageal pH. On study entry the esophagus was suctioned. After an interval of at least 5 minutes, if the esophageal pH was still less than 4 the esophagus was lavaged with tap water and again suctioned. In 6 dogs 20 mL of dilute bicarbonate solution was instilled into the esophageal lumen. RESULTS: Suctioning fluid from the esophagus did not change the pH significantly. Lavage with tap water caused the pH to increase above 4 in four dogs, with the average pH increasing from 1.2 +/- 0.5 to 3.5 +/- 4.9. In all dogs where dilute bicarbonate solution was instilled, esophageal pH increased to above 6 for up to 180 (mean +/- SD, 89 +/- 81) minutes. CONCLUSIONS AND CLINICAL RELEVANCE: Suctioning refluxate from the esophagus does not change the pH of the esophageal lumen. Instillation of a small volume of bicarbonate solution predictably increased the pH above 4 following an episode of acidic GER. Care must be taken that fluid is instilled into the lumen of the esophagus, and not into the trachea.     

Blood gas and acid-base status during tiletamine/zolazepam anaesthesia in dogs

OBJECTIVE: To evaluate the effect of the tiletamine/zolazepam (TZ) combination (Zoletil 100; Virbac, Carros, France) with and without atropine on blood gas values and acid-base status in dogs. STUDY DESIGN: Randomized cross-over experimental study. ANIMALS: Six healthy adult cross-bred dogs, weighing 11.0-18.5 kg. MATERIALS AND METHODS: Each dog received four different drug treatments at intervals of at least 15 days: (i) 5 mg kg(-1) intravenous (IV) TZ (TZ.IV); (ii) 10 mg kg(-1) intramuscular (IM) TZ (TZ.IM); (iii) atropine, 20 microg kg(-1) IV, followed 5 minutes later by 5 mg kg(-1) TZ IV (A.TZ.IV); and (IV) atropine (same dose) given 5 minutes before 10 mg kg(-1) TZ IM (A.TZ.IM). Arterial blood samples were collected from each dog before drug administration (baseline) at induction of anaesthesia (time 0) and 2, 5, 10 and 30 minutes thereafter. RESULTS: Transient hypoxaemia and respiratory acidosis were observed just after induction. PaO(2) and SaO(2) dropped, while H(+) concentration and PaCO(2) rose significantly above baseline values. In groups TZ.IV and A.TZ.IV, PaO(2) values as low as 6.0-6.4 kPa (45-48 mm Hg) were recorded. However, there was no significant difference in blood gas variables among the groups encountered during the evaluation period. The overall change in [HCO(3) (-)] and base excess (BE) was not significant among groups. Atropine did not affect the above variables. CONCLUSIONS AND CLINICAL RELEVANCE: Tiletamine/zolazepam injection may induce transient hypoxaemia and respiratory acidosis, but acid-base status changes are clinically unimportant. Particularly, close observation of dogs is recommended during the first 5-10 minutes after induction with TZ, especially in animals with cardiopulmonary disease. TZ should perhaps not be used in animals intolerant of tachycardia.     

Effect of morphine on the bispectral index during isoflurane anesthesia in dogs

ObjectiveTo assess the effect of morphine on the bispectral index (BIS) in dogs during isoflurane anesthesia maintained at a constant end–tidal concentration.Study designProspective, randomized, experimental trial.AnimalsEight adult Beagle dogs, weighing between 7.1 and 9.8 kg.MethodsAnesthesia was induced with isoflurane via a face mask. Dog's tracheas were intubated and anesthesia maintained with isoflurane at a constant end–tidal concentration (e′Iso) of 1.81% for a 30–minute equilibration period. Pulmonary ventilation was controlled to normocapnia. After equilibration, baseline values were recorded prior to intravenous administration of morphine sulfate (0.5 mg kg^?1) (MT) or an equal volume of saline (CT). Measurements for heart rate, systolic, diastolic and mean arterial pressure (SAP, DAP and MAP) were recorded at 10, 20, 30, 45, 60, 75, 90, 105 and 120 minutes after treatment. Bispectral index was recorded every 10 seconds for 3 minutes for each time measurement. Venous blood samples were collected at baseline, 10, 20, 30, 45, 60 and 120 minutes for determination of morphine serum concentrations. Anesthesia was discontinued after the last measurement and dogs were allowed to recover.ResultsBaseline BIS for MT and CT at 1.81%e′Iso were 63 ± 10 and 58 ± 9, respectively. Bispectral index in MT was 4–8% lower at 20, 75, 90 and 105 minutes compared with CT. There were no differences in BIS between baseline and any subsequent measurement within either MT or CT. Heart rate, SAP, MAP, and DAP decreased after morphine administration.Conclusion and clinical relevanceIntravenous administration of 0.5 mg kg^?1 morphine sulfate did not cause clinically significant changes in the BIS of unstimulated dogs during isoflurane anesthesia at an e′Iso of 1.81%.