Endocrine and metabolic responses in sheep during halothane and pentobarbitone anaesthesia with dobutamine infusion

The study investigated the stimulus to pituitary-adrenocortical activity (PACA) during halothane anaesthesia. Groups of six sheep were anaesthetized with thiopentone/halothane (TH group), acepromazine/thiopentone/halothane (ATH group) or pentobarbitone (P group). Dobutamine was infused in the TH and ATH groups to prevent hypotension (0.3–1.4 μg/kg/min) and in the P group at 0.05 μg/kg/min. Pulse rate, arterial blood gases and pressure (ABP) were measured and sequential blood samples taken for assay of cortisol, adrenocorticotrophic hormone (ACTH), arginine vasopressin (AVP), glucose and lactate. Pulse rate increased in all groups. Arterial blood pressure decreased by 13% in TH, by 24% in ATH and remained stable in P. All three groups developed hypercapnia and acidosis but were well oxygenated. Cortisol increased in all groups; with ATH the sevenfold rise occurred earlier than with either TH (sixfold rise) or P (fivefold rise). Adrenocorticotrophic hormone changes were as for cortisol but AVP increases were not consistent. Glucose and lactate were stable, but lactate was lowest with ATH. Dobutamine infusion failed to prevent hypotension during halothane anaesthesia and PACA appeared proportional to the hypotension. Dobutamine may have stimulated ACTH and cortisol release after 120 min. Halothane-induced hypotension may cause adrenocortical activity but a direct effect of halothane cannot be ruled out.     

Endocrine and metabolic responses to halothane and pentobarbitone anaesthesia in sheep

Some metabolic and endocrine responses to anaesthesia in sheep were studied. Adult sheep were anaesthetised with thiopentone and halothane (n=9), acepromazine, thiopentone and halothane (n=8) and pentobarbitone (n=10) on separate occasions. Routine cardiovascular monitoring was carried out and blood samples were taken for assay of cortisol, adrenocorticotrophic hormone (ACTH), arginine vasopressin (AVP), glucose and lactate. Halothane anaesthesia induced hypotension, hypercapnia and respiratory acidosis. Sheep anaesthetised with pentobarbitone were also hypercapnic and acidotic but did not develop hypotension. Plasma cortisol, ACTH and AVP (mean maximum values: cortisol: 83 ng/ml, ACTH 278 ng/ml, AVP 135 pg/ml), increased during halothane anaesthesia but did not change significantly from control values during pentobarbitone anaesthesia (mean maximum values: cortisol: 30 ng/ml, ACTH 71 ng/ml, AVP 7.8 pg/ml). Glucose tended to increase during both halothane and pentobarbitone anaesthesia but lactate decreased. It is not clear what facet of halothane anaesthesia evokes the stress response but it may be associated with cardiovascular depression.     

Doxapram infusion during halothane anaesthesia in ponies

Doxapram, 0.05 mg/kg bodyweight/min, was infused during the second hour of 2 h halothane anaesthesia in six ponies. Two of the ponies were anaesthetised on a second occasion as controls and given 5 per cent dextrose in place of the doxapram. Respiratory depression typical of halothane anaesthesia in ponies developed in the first hour of anaesthesia and continued during the second hour in the control animals. During doxapram infusion arterial carbon dioxide tension decreased and pH increased. Arterial blood pressure increased but there was no change in pulse rate, the electrocardiogram or arterial oxygen tension. Anaesthesia lightened during doxapram infusion necessitating an increase in the vapouriser setting in order to prevent arousal. Recovery from anaesthesia appeared unaffected by the doxapram infusion.     

Endocrine and metabolic responses to plasma volume expansion during halothane anaesthesia in ponies

The study was designed to contribute to identification of the stimulus to adrenocortical activity during halothane anaesthesia in equidae . Two groups of six ponies were premedicated with acepromazine before induction of anaesthesia with thiopentone and maintenance for 120 min with halothane in oxygen. In group H Haemaccel® modified gelatine plasma replacer was infused (48 ± 13 mL/kg) to maintain mean arterial blood pressure (MABP) close to preanaesthetic values. In group DH, blood pressure was maintained close to preanaesthetic levels with a lower dose of Haemaccel® (10 mL/kg) combined with an infusion of dobutamine. Measurements were made before anaesthesia, at 20 min intervals during anaesthesia and 20 and 120 min after anaesthesia. MABP and blood gases, pulse and respiratory rates were measured, and blood was withdrawn for assay of cortisol, adrenocorticotrophic hormone (ACTH), glucose and lactate. Ponies in both groups became hyperoxic, hypercapnic and developed a respiratory acidosis; pulse rate increased in both groups but this was more marked in group H. Haematocrit decreased by 50% in H and by 20% in DH. Cortisol and ACTH did not change significantly during anaesthesia in either group and the area under the time curve ( AUC _(0–140)) was lower in the DH group. Plasma glucose and lactate remained stable. After the H treatment all ponies had a watery nasal discharge and one pony died from endotoxaemia. This investigation demonstrated that the adrenocortical response to halothane anaesthesia in ponies can be ameliorated by manipulation of ABP using plasma expansion with or without inotrope infusion; however, low dose Haemaccel® with dobutamine was safer and more practical. It is suggested that, although hypotension is not the sole stimulus to adrenocortical activity during halothane anaesthesia, it may contribute, probably through an effect on tissue perfusion.     

Adrenocortical and metabolic responses to dobutamine infusion during halothane anaesthesia in ponies

The study investigated whether hypotension in halothane-anaesthetised ponies is the stimulus inducing an endocrine stress response by assessing the effect of maintenance of normotension with a dobutamine infusion. Groups of six ponies were studied. After premedication with acepromazine (0.04 mg/kg) anaesthesia was induced with thiopentone (10 mg/kg) and maintained for 120 min with halothane (group AN). Dobutamine was infused to effect (1.1–4.4 μg/kg/min) to maintain arterial pressure at pre anaesthetic levels. The conscious group (CON) were prepared as for AN and then received only dobutamine infusion 1.0 μg/kg/min for 120 min. Arterial blood pressure, pH, oxygen and carbon dioxide tension, pulse rate, haematocrit, and plasma cortisol, glucose and lactate concentrations were measured before, at 20 min intervals during anaesthesia, and 20 and 120 min after anaesthesia ceased. Blood pressure remained close to control in both groups. The AN group became hypercapnic and acidotic, pulse rate and haematocrit increased, cortisol increased more than twofold and plasma glucose and lactate did not change. All values remained at control in the CON group except for small increases in haematocrit and decreases in pulse rate. Maintenance of normotension during halothane anaesthesia did not blunt the adrenocortical response to anaesthesia nor did the same dose of dobutamine alone increase plasma cortisol. Hypotension appears not to be the sole stimulus to equine adrenocortical activity during halothane anaesthesia.     

Effect of detomidine or romifidine constant rate infusion on plasma lactate concentration and inhalant requirements during isoflurane anaesthesia in horses

Objective

Influence of detomidine or romifidine constant rate infusion (CRI) on plasma lactate concentration and isoflurane requirements in horses undergoing elective surgery.

Dexmedetomidine continuous rate infusion during isoflurane anaesthesia in canine surgical patients

OBJECTIVE: To determine the effects of three rates of dexmedetomidine (DMED) constant rate infusion (CRI) on overall tissue perfusion, isoflurane (ISO) requirements, haemodynamics and quality of recovery in canine surgical patients. STUDY DESIGN: Prospective, randomized, blinded clinical study. ANIMALS: Client-owned dogs presented for soft tissue or orthopaedic surgery. METHODS: Following intravenous (IV) pre-medication with DMED (5 microg kg(-1)) and buprenorphine (10 microg kg(-1)) and propofol induction, anaesthesia was maintained with ISO in oxygen/air supplemented with a DMED CRI (1, 2 or 3 microg kg(-1) hour(-1); groups 1, 2 and 3, respectively). Ventilation was controlled in all animals using intermittent positive pressure ventilation (IPPV). Monitoring included end-tidal (ET) gases, ECG, arterial blood pressure, body temperature and sequential arterial blood gas and lactate measurements. Quality of recovery was scored after intramuscular (IM) administration of atipamezole (ATI) (12.5 microg kg(-1)). Immediate post-operative analgesia was provided with carprofen and/or buprenorphine. An analysis of variance was conducted for repeated measurements obtained during 80 minutes after first incision. Categorical data were evaluated with Chi-square analyses. RESULTS: Arterial blood pressure remained stable and within clinically acceptable limits. Mean heart rate in group 2 was significantly lower than in group 1. The incidence of 2nd degree AV block type II was significantly higher in group 3. Mean arterial lactate concentrations remained below 2 mmol/L in all groups during the study, with a significant increase occurring during recovery compared with surgery for group 3. Mean e'ISO% was similar and <1% in all groups. Complete recovery from anaesthesia was achieved after ATI administration and was of good quality in all but three animals. CONCLUSIONS AND CLINICAL RELEVANCE: Dexmedetomidine CRI is a reliable and valuable adjunct to ISO anaesthesia in maintaining surgical anaesthesia in ASA I-II dogs. Data reported indicate adequate overall tissue perfusion and a low ISO requirement while enabling a smooth and rapid recovery following ATI. The DMED CRI of 1 microg kg(-1) hour(-1) following a loading dose of 5 microg kg(-1) produced the most favourable results.     

Endocrine, haematological and metabolic responses to sevoflurane anaesthesia in lambs

Objective To compare the magnitude and duration of the peri‐operative haematological, endocrine and metabolic effects of surgery performed under sevoflurane anaesthesia. Study Design Prospective randomized study. Animals Ten, 55‐day‐old lambs of both sexes, mean weight 20.8 ± 0.3 kg (range 18.5–23.6 kg). Methods Animals were randomly allocated to two equal groups. All were anaesthetized with sevoflurane for 3 hours. Surgery (end‐to‐end anastomosis of the right carotid artery and right jugular vein) was performed in animals of Group 1 only. The electrocardiogram, pulse oximetry, cardiac output and noninvasive arterial blood pressure (NIBP) were monitored. Venous blood samples (5 mL) were taken 30 minutes before induction of anaesthesia (T = 0) and 1 (T1), 24 (T2), 48 hours (T3) and 7 days (T4) after anaesthesia in order to measure plasma cortisol, ACTH, insulin, cyclic adenosine monophosphate (cAMP), glucose, protein concentrations and haematological variables. Results Sevoflurane decreased NIBP (minimum mean value: 64 ± 3 mm Hg) in both groups. Plasma cortisol and ACTH concentration increased in Group 1 (maximum mean values: cortisol: 136.2 nmol L^?1, ACTH: 54.5 pmol L^?1) and Group 2 (maximum mean values: cortisol: 128.7 nmol L^?1, ACTH: 44.0 pmol L^?1). Cyclic AMP increased only in Group 1 (9.3 nmol) 1 hour after anaesthesia. Neutrophilia, lymphopaenia and a decreased PCV were observed in both groups 1 hour after anaesthesia. Plasma protein and glucose concentrations did not change. Conclusions Increased ACTH and cortisol concentrations recorded 1 hour after anaesthesia suggest that sevoflurane induces a stress response in lambs. Clinical relevance The study did not identify the mechanism by which sevoflurane induces a stress response although hypotension is implicated.     

Plasma concentrations of cortisol, testosterone, glucose and blood gases in male goats during anaesthesia with pentobarbitone sodium

Fasting for 24 h had no statistically significant effect on cortisol, glucose or testosterone concentrations. A dose of pentobarbitone sodium which induced light anaesthesia resulted in an immediate decrease in cortisol values from 5.0-11.1 ng/ml to 2.2-3.6 ng/ml until waking-this latter event was accompanied by an excessive release of cortisol (up to 16.6 ng/ml). In two out of three goats testosterone concentrations decreased from 4.0-9.0 ng/ml to less than 0.5 ng/ml after pentobarbitone; low values were maintained for 4.5-6 hours. Glucose concentrations were unaffected. Precise doses of pentobarbitone (20 mg/kg or 30 mg/kg) resulted in similar cortisol profiles as above but with higher concentrations achieved upon waking from the higher dose of pentobarbitone. On two out of nine occasions increased PCO2 values were recorded concurrently with increased cortisol concentrations during the period of anaesthesia, suggesting that a sufficiently strong stressful stimulus can break through the pentobarbitone blockade.     

The stress response to anaesthesia in ponies: barbiturate anaesthesia

Information on the equine stress response to anaesthesia and surgery is sparse but offers a promising approach to elucidating the high anaesthetic risk in this species. Previous work has shown that halothane anaesthesia induces substantial metabolic and endocrine changes. This paper reports the effects of barbiturate anaesthesia. Anaesthesia was induced with thiopentone in six ponies and no further agents were given. They stood within 30 mins. On another occasion, these animals, and three further ponies, were anaesthetised with pentobarbitone and anaesthesia was maintained for 2 h. No surgery was performed on either occasion. Plasma concentrations of glucose, lactate, non esterified fatty acids, cortisol, insulin, catecholamines and adrenocorticotrophic hormone were measured at the same time intervals in both groups before, during and after anaesthesia. There were no significant changes in hormones or metabolites during either period of anaesthesia and normotension was maintained. This was in marked contrast to the substantial stress response and hypotension under halothane anaesthesia in the same ponies. These results suggest that barbiturates may induce less of a stress response than halothane in horses. Recovery after 2 h of pentobarbitone anaesthesia was poor, precluding its clinical use. The need for a non-cumulative intravenous agent or a non-hypotensive volatile agent for use in equine anaesthesia is discussed.     

Blood biochemical response to sodium bicarbonate infusion during sublethal endotoxemia in ponies

Hypertonic NaHCO3 infusion caused blood volume expansion, increased blood bicarbonate concentration, and delayed the onset of hypophosphatemia in ponies with endotoxemia. However, NaHCO3 infusion did not normalize blood pH, and it increased blood L-lactate concentration, and caused hypokalemia, hypernatremia, and hyperosmolality. The deleterious effects of NaHCO3 infusion in endotoxemia ponies outweighed the beneficial effects. The role of hypertonic NaHCO3 given IV for treatment of endotoxemia in equids must be reevaluated.     

Effects of pentobarbitone anaesthesia and atropine on the intravenous glucose tolerance test in normal dogs

The effect of atropine (0·1 mg/kg b.w. s.c.) and of pentobarbitone anaesthesia (25 mg/kg b.w.) on the plasma glucose clearance and insulin response to an intravenous load of 600 mg and 1,250 mg/kg b.w. glucose was studied in twenty-four normal young Dalmatian dogs (ten male, fourteen female). Neither the rate of disappearance of glucose from the circulation, nor the insulin release following both glucose loads was altered by atropine. However, the disposal of intravenous glucose was significantly (P < 0·01) delayed and the insulin release significantly decreased under pentobarbitone anaesthesia. It is suggested that a decreased blood flow through the pancreas during pentobarbitone anaesthesia is most likely the cause of the decreased insulin release which in turn causes a delayed rate of disappearance of glucose from the circulation. It is therefore concluded that an intravenous glucose tolerance test, as diagnostic procedure, should never be done in anaesthetized dogs.     

Balance and urinary excretion of calcium, magnesium and phosphorus in response to high concentrate feeding and lactate infusion in lambs

Two experiments were conducted to investigate the influence of dietary concentrate level and iv lactate infusion on the urinary excretion and balance of Ca, Mg and P in lambs. In Exp. 1, six ruminal fistulated, crossbred wethers (25 kg) were fed diets of 0, 50 and 70% concentrate for 5-d periods (periods 1, 2 and 3, respectively) followed by 25 d on a 90% concentrate diet (periods 4, 5 and 6, respectively). Collections were made for all days except 6 to 10 and 16 to 20 on the 90% concentrate diet. Dry matter intakes increased with each increase in dietary concentrate until the initial period of 90% concentrate (period 4) when intakes were lowest. Intakes increased (P less than .05) during the latter two periods of 90% concentrate feeding compared with period 4. Rumen fluid pH decreased and rumen L (+) lactate increased with increasing concentrate intake. Blood pH and bicarbonate both decreased with increasing concentrate intake indicating a mild disturbance in acid-base balance. Plasma concentrations of Ca, Mg and P decreased with increased concentrate intake and were elevated (P less than .05) for periods 5 and 6 compared with period 4. Plasma alkaline phosphatase activity and urinary hydroxyproline excretion both increased (P less than .05) for periods 5 and 6. Four of the six animals were in negative Ca balance for the initial period of 90% concentrate feeding, but showed highest Ca retentions for periods 5 and 6. Magnesium and P balance appeared unaffected by increased concentrate intake. Disturbances in Ca metabolism appeared to be short-term and nondetrimental; the animals responded with increased growth and Ca retentions once adjusted to the high concentrate diet. In Exp. 2, four Hampshire ewes (32 kg) were used in a 4 X 4 Latin square design with treatments being saline (.9% NaCl, w/v), L (+) lactate, D (-) lactate and D, L-lactate infused iv in a saline solution to supply .6 mM/kg body weight of each isomer in 15 min. Plasma and urine samples were taken 0, .5, 1, 1.5, 3, 6 and 12 h from the start of infusion. Total urinary excretion of Ca (P less than .04) and Mg (P less than .02) were elevated for all lactate infusions as compared with saline. Total P excretion was greater (P = .06) for all lactate infusions compared with saline and was increased (P less than .05) for the D, L-lactate treatment as compared with the D- and L-lactate treatments.(ABSTRACT TRUNCATED AT 400 WORDS)