Anaesthetic and cardiopulmonary effects of intramuscular morphine, medetomidine and ketamine administered to telemetered cats

The quality and duration of anaesthesia, cardiorespiratory effects and recovery characteristics of a morphine, medetomidine, ketamine (MMK) drug combination were determined in cats. Six healthy, adult female cats were administered 0.2 mg/kg morphine sulphate, 60 microg/kg medetomidine hydrochloride, and 5 mg/kg ketamine hydrochloride intramuscularly. Atipamezole was administered intramuscularly at 120 min after MMK administration. Time to lateral recumbency, intubation, extubation and sternal recumbency were recorded. Cardiorespiratory variables and response to a noxious stimulus were recorded before and at 3 min and 10 min increments after drug administration until sternal recumbency. The time to lateral recumbency and intubation were 1.9+/-1.2 and 4.3+/-1.2 min, respectively. Body temperature and haemoglobin saturation with oxygen remained unchanged compared to baseline values throughout anaesthesia. Respiratory rate, tidal volume, minute volume, heart rate, and blood pressure were significantly decreased during anaesthesia compared to baseline values. One cat met criteria for hypotension (systolic blood pressure <90 mmHg). End tidal carbon dioxide increased during anaesthesia compared to baseline values. All but one cat remained non-responsive to noxious stimuli from 3 to 120 min. Time to extubation and sternal recumbency following atipamezole were 2.9+/-1.1 and 4.7+/-1.0 min, respectively. MMK drug combination produced excellent short-term anaesthesia and analgesia with minimal cardiopulmonary depression. Anaesthesia lasted for at least 120 min in all but one cat and was effectively reversed by atipamezole.     

Factors affecting the relationship between arterial and end-tidal carbon dioxide pressures in the anaesthetised horse

Objective To assess the effects of the duration of anaesthesia, position of recumbency, mode of ventilation, anaesthetic drug protocol, patient age and type of surgical procedure on the usefulness of capnometry as a measure of the partial pressure of arterial carbon dioxide (P_aco ₂) during general anaesthesia in horses. Design A prospective study compared the P_aco ₂ values with those of partial pressure of end-tidal carbon dioxide (ETco ₂) in horses anaesthetised for elective or emergency surgical procedures. The difference between P_aco ₂ and ETco ₂ (P_aco ₂− ETco ₂) and the physiological dead space to tidal volume ratio (V_D/V_T) were calculated. The effects of the study parameters on these variables was determined. Results The agreement between P_aco ₂ and ETco ₂ was poor. P_aco ₂− ETco ₂ and V_D/V_T during the first 60 min of anaesthesia was significantly less than after 60 min of anaesthesia. Mode of ventilation, position of recumbency, anaesthetic drug protocol, patient age and type of procedure did not have a significant affect on either value. Conclusions P_aco ₂− ETco ₂ in anaesthetised horses can be large, making ETco ₂ unreliable as a predictor of P_aco ₂ and for assessment of pulmonary ventilation. For anaesthesia lasting less than 60 min at least one blood gas analysis of an arterial blood sample is required to assess P_aco ₂− ETco ₂. Arterial blood gas analysis should be repeated after 60 min of general anaesthesia.     

Urine-blood carbon dioxide tension gradient in healthy dogs

The urine-blood carbon dioxide tension (PCO2) gradient was measured in 10 healthy mature Beagles after alkalinization of the urine by administration of sodium bicarbonate. The mean (+/- SD) urine-blood PCO2 gradient was 65.92 +/- 14.42 mm of Hg, with range of 38.2 to 82.2 mm of Hg. Mean urine PCO2 was 110.21 +/- 14.19 mm of Hg, with range of 84.1 to 127.3 mm of Hg. Because urine-blood PCO 2 gradient less than 30.0 mm of Hg or urine PCO2 less than 55 mm of Hg in people is diagnostic for a defect in distal nephron acidification, similar values might be applicable to diseases in dogs.     

Ventilation-perfusion relationships in the anaesthetised horse

Ventilation-perfusion relationships were studied by the multiple inert gas elimination technique in seven horses while they were conscious and during inhalation anaesthesia with halothane. A generally good match between ventilation and perfusion was found in the conscious, standing horse. During anaesthesia a huge shunt developed, ie perfusion of completely unventilated lung regions, both in dorsal and left lateral recumbency and whether the horse was breathing spontaneously or mechanically ventilated. The shunt was significantly greater and the arterial oxygen tension (PaO2) significantly lower in dorsal than in left lateral recumbency. Little or no perfusion of low VA/Q regions was observed during anaesthesia, whether ventilation was spontaneous or mechanical. Positive end-expiratory pressure (PEEP) did not significantly improve PaO2 or reduce the shunt. Selective mechanical ventilation of dependent lung regions with PEEP reduced the shunt markedly, an effect that was not achieved by conventional mechanical ventilation with general PEEP. The findings seem compatible with alveolar collapse during anaesthesia, causing shunt, whereas the absence of clearly low VA/Q regions questions the role of airway closure as the major disturbance of gas exchange.     

Capnographic Monitoring during Anesthesia with Controlled Ventilation in the Horse

Forty-five horses were maintained on halothane or isoflurane anesthesia for at least 90 minutes and received positive pressure ventilation after the first 30 minutes of anesthesia. Parameters monitored included end-tidal partial pressure of carbon dioxide (ETPCO2), arterial blood pressure, and arterial blood gases and pH. There was a statistically significant correlation between end-tidal carbon dioxide and arterial partial pressure of carbon dioxide (PaCO2) for both halothane and isoflurane anesthesia. There was no significant correlation between end-tidal carbon dioxide and either body weight or systolic blood pressure. No statistically significant difference was found in arterial to end-tidal carbon dioxide difference nor in alveolar dead space because of time or positioning over anesthetic periods of up to 3 hours. It is concluded that end-tidal carbon dioxide monitoring is a satisfactory measure of changes in respiratory acid-base balance with inhalation anesthesia in horses when ventilation is controlled.     

Clinical evaluation of a valveless non-absorber breathing system in spontaneously breathing canine patients

A valveless non-absorber breathing system novel to veterinary anaesthesia is described. The performance of this system was evaluated in 35 anaesthetised spontaneously breathing dogs weighing between 2.1 and 56 kg. Fresh gas flows were reduced incrementally until rebreathing (defined as an increase in end-inspired carbon dioxide tension above 0.2 per cent) started to occur, as measured by capnography. A significant relationship (P < 0.0001) between critical fresh gas flow and bodyweight was determined, and a mean critical fresh gas flow rate of 145 +/- 21 ml/kg/minute was derived for 15 dogs weighing 10 kg or less (mean 6.7 +/- 2.6 kg) and one of 98 +/- 16 ml/kg/minute for the remaining 20 dogs weighing 11 kg or greater (mean 30.2 +/- 13.9 kg). The fresh gas requirements for each group were found to differ significantly (P < 0.0001), although the correlation between critical fresh gas flow and bodyweight was not significant (P = 0.054) in the dogs weighing 10 kg or less. It is suggested that the system may prove an economical and useful addition to the breathing systems currently used in canine anaesthesia.     

Arterial to end-tidal CO2 tension and alveolar dead space in halothane- or isoflurane-anesthetized ponies

The correlation between end-tidal partial pressure of CO2 (PETCO2) and arterial (PaCO2) was determined for spontaneously breathing ponies under halothane or isoflurane anesthesia. The PETCO2 was useful as a trend indicator of PaCO2 during the first 60 minutes of halothane or isoflurane anesthesia when PaCO2 values were less than 60 to 70 mm of Hg. Halothane anesthesia lasting greater than 90 minutes was associated with PaCO2 values in excess of 60 to 70 mm of Hg, a large arterial- to end-tidal PCO2 difference (PaCO2-PETCO2) and a significant increase in alveolar dead space. These effects were not seen during the same period of isoflurane anesthesia. Arterial blood gas analysis is therefore recommended during halothane anesthesia when the PETCO2 is greater than 60 to 70 mm of Hg. A decrease in alveolar capillary perfusion relative to alveolar ventilation is the most likely cause for the increase in alveolar dead space during halothane anesthesia. Based on these findings, isoflurane may be superior to halothane for prolonged anesthesia of spontaneously breathing horses.     

Effect of body posture on cardiopulmonary function in horses during five hours of constant-dose halothane anesthesia

Cardiovascular and respiratory functions were serially characterized in 7 healthy, spontaneously breathing, adult horses (from which food had been withheld) during 5 hours of constant 1.06% alveolar halothane (end-expired halothane concentration of 1.06%; equivalent to 1.2 times the minimal alveolar anesthetic concentration for horses). To enable comparison of temporal results in relation to 2 body postures, horses were studied in lateral recumbency (LR) and dorsal recumbency (DR) on separate occasions. Temporal changes in results of measures of circulation previously reported from this laboratory for horses in LR were confirmed (ie, a time-related increase in systemic arterial blood pressure, cardiac output, stroke volume, and PCV). During DR, systemic arterial blood pressure was initially significantly (P less than 0.05) greater and pulmonary artery pressure less than results at comparable periods during LR. Differences ceased to exist with duration of anesthesia. Except for a greater heart rate at hour 5 of DR, no other significant differences in circulation were found between LR and DR. In general, except for PaO2, measures of ventilation did not change with time in either LR or DR. The PaO2 was significantly greater during LR, compared with DR, but the average did not change significantly with time in either body posture.     

The 'Turner' circle absorber: an anaesthetic breathing system for the horse

An inhalation anaesthetic apparatus for the horse is described and the physiological concepts pertaining to its design presented. The internal diameter of all breathing components is 6.2 cm with no change in cross sectional area throughout the circle system. The soda lime capacity is 25 litres (approximately 20 kg). In the horse, which is apparently predisposed to alveolar hypoventilation during inhalation anaesthesia, it is apparent that adequate anaesthetic apparatus design should be directed towards minimising resistance and dead space and providing maximal and efficient carbon dioxide elimination.     

Partial pressures of oxygen and carbon dioxide, pH, and concentrations of bicarbonate, lactate, and glucose in pleural fluid from horses

Samples of pleural fluid from 20 horses with effusive pleural diseases of various causes were evaluated; samples from 19 horses were used for the study. There were differences for pH (P = 0.001) and partial pressure of oxygen (PO2) between arterial blood and nonseptic pleural fluid (P = 0.0491), but there were no differences for pH, PO2, partial pressure of carbon dioxide (PCO2), and concentrations of bicarbonate (HCO3-), lactate, and glucose between venous blood and nonseptic pleural fluid. Paired comparisons of venous blood and nonseptic pleural fluid from the same horse indicated no differences. There were differences (P = 0.0001, each) for pH, PO2, PCO2, and concentrations of HCO3- between arterial blood and septic pleural fluid. Differences also existed for pH (P = 0.0001), PCO2 (P = 0.0003), and concentrations of HCO3- (P = 0.0001), lactate (P = 0.0051), and glucose (P = 0.0001) between venous blood and septic pleural fluid. Difference was not found for values of PO2 between venous blood and septic pleural fluid, although 4 samples of septic pleural fluid contained virtually no oxygen. Paired comparisons of venous blood and septic pleural fluid from the same horse revealed differences (P less than 0.05) for all values, except those for PO2. These alterations suggested functional and physical compartmentalization that separated septic and healthy tissue. Compartmentalization and microenvironmental factors at the site of infection should be considered when developing therapeutic strategies for horses with septic pleural disease.     

Improvement in arterial oxygen tension with change in posture in anaesthetised horses

Observations were made on horses spontaneously breathing oxygen, with halothane at a constant end tidal concentration. The horses were positioned in dorsal recumbency for the first 45 minutes of each anaesthetic episode during which the arterial oxygen tension (PaO2) was found to peak and then decline. The remaining 60 minutes of each anaesthesia was used to test the effect of various manoeuvres on PaO2. The PaO2 of horses decreased further both when remaining in dorsal recumbency and when repositioned in right or left recumbency. In contrast, placing the horses in sternal recumbency for these remaining 60 minutes caused the PaO2 to rise rapidly providing evidence for redistribution of ventilation. Replacing some inspired oxygen with less absorbable nitrogen did not improve PaO2 in dorsal recumbency. Thus there was no evidence that the low PaO2 of dorsal recumbency was associated with alveoli that had collapsed because of gas absorption.     

High caudal epidural anaesthesia with local anaesthetics or alpha(2)-agonists in calves

The objective of this study was to examine the efficacy of a caudal epidural anaesthesia using lidocaine or xylazine in a high volume for analgesia of the flank, navel and hamstring tendon. Fourteen calves weighing 57.7 +/- 5.1 kg and 37.9 +/- 9.3 (mean +/- SEM) days old were randomly divided into two groups of seven calves each. Calves belonging to the lidocaine group were given a 2% lidocaine solution in the sacrococcygeal vertebral space epidurally at a volume of 0.4 ml/kg (8 mg/kg) body weight (BW). Animals of the xylazine group were administered an epidural anaesthesia with xylazine at a dose of 0.1 mg/kg BW, diluted with a 0.9% saline solution to a corresponding final volume of 0.4 ml/kg BW. Heart rate and respiratory rate were measured and the degree and duration of analgesia was determined by the response to a skin prick with a hypodermic needle over a period of 350 min after epidural injection. After epidural anaesthesia with lidocaine the mean heart rate increased during dorsal recumbency, whereas after xylazine both heart rate and respiratory rate decreased significantly (P < 0.05). The epidural injection of xylazine compared with lidocaine caused longer (P < 0.05) analgesia at the hamstring tendon (mean +/- SEM, 120.7 +/- 29.7 min versus 93.6 +/- 3.5 min) and at the flank (100.7 +/- 24.4 min versus 78.3 +/- 11.1 min). There were no differences in the intensity of analgesia between groups. After xylazine application analgesia at the navel was achieved for 95.0 +/- 14.1 min whereas after lidocaine injection sufficient analgesia at the navel was found in just two of seven calves for 55 and 95 min respectively. Based on above experiences, a second study was performed, in which a combination of xylazine and local anaesthetics was used and the injection volume was increased to prove the efficacy of caudal epidural anaesthesia in 15 calves (26.3 +/- 26.7 days; 57.1 +/- 19.5 kg) submitted to the clinic for regular umbilical surgery. In these cases the xylazine (0.1 mg/kg BW) was diluted with 2% lidocaine (n = 7) or 2% procaine (n = 8) to a corresponding final volume of 0.5-0.6 ml/kg BW. In all cases complete anaesthesia of the surgical area was achieved and no adverse effects were observed. Overall the high volume caudal epidural anaesthesia represents an effective, safe, cheap and easy to perform alternative for anaesthesia of the navel, flank and hamstring tendon in calves without major side effects.     

Xylazine and tiletamine-zolazepam anesthesia in horses

The cardiopulmonary and anesthetic effects of xylazine in combination with a 1:1 mixture of tiletamine and zolazepam were determined in 6 horses. Each horse was given xylazine IV or IM, as well as tiletamine-zolazepam IV on 4 randomized occasions. Anesthetics were administered at the rate of 1.1 mg of xylazine/kg of body weight, IV, 1.1 mg of tiletamine-zolazepam/kg, IV (treatment 1); 1.1 mg of xylazine/kg, IV, 1.65 mg of tiletamine-zolazepam/kg, IV (treatment 2); 1.1 mg of xylazine/kg, IV, 2.2 mg of tiletamine-zolazepam/kg, IV (treatment 3); and 2.2 mg of xylazine/kg, IM, 1.65 mg of tiletamine-zolazepam/kg, IV (treatment 4). Tiletamine-zolazepam doses were the sum of tiletamine plus zolazepam. Xylazine, when given IV, was given 5 minutes before tiletamine-zolazepam. Xylazine, when given IM, was given 10 minutes before tiletamine-zolazepam. Tiletamine-zolazepam induced recumbency in all horses. Duration of recumbency in group 1 was 31.9 +/- 7.2 (mean +/- 1 SD) minutes. Increasing the dosage of tiletamine-zolazepam (treatments 2 and 3) significantly (P less than 0.05) increased the duration of recumbency. Xylazine caused significant (P less than 0.05) decreases in heart rate and cardiac output and significant (P less than 0.05) increases in central venous pressure and mean pulmonary artery pressure 5 minutes after administration. Respiratory rate was decreased. Arterial blood pressures increased significantly (P less than 0.05) after xylazine was administered IV in treatments 1 and 3, but the increases were not significant in treatment 2. Xylazine administered IM caused significant (P less than 0.05) increases in central venous pressure and significant (P less than 0.05) decreases in cardiac output.(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinical evaluation of intranasal benzodiazepines, alpha-agonists and their antagonists in canaries

OBJECTIVE: To evaluate the effects of intranasal benzodiazepines (midazolam and diazepam), alpha(2)-agonists (xylazine and detomidine) and their antagonists (flumazenil and yohimbine) in canaries. STUDY DESIGN: Prospective randomized study. ANIMALS: Twenty-six healthy adult domesticated canaries of both sexes, weighing 18.3 +/- 1.0 g. METHODS: In Study 1 an attempt was made to determine the dose of each drug that allowed treated canaries to be laid in dorsal recumbency for at least 5 minutes, i.e. its effective dose. This involved the evaluation of various doses, during which equal volumes of the tested drug were administered slowly into each nostril. In study 2 the onset of action, duration and quality of sedation induced by each drug at its effective dose were evaluated. The efficacy of flumazenil and yohimbine in antagonizing the effects of the sedative drugs was also studied. RESULTS: In study 1 administration of 25 microL per nostril diazepam (5 mg mL(-1) solution) or midazolam (5 mg mL(-1) solution) to each bird caused adequate sedation within 1-2 minutes; birds did not move when placed in dorsal recumbency. After administration of 12 microL per nostril of either xylazine (20 mg mL(-1)) or detomidine (10 mg mL(-1)), birds seemed heavily sedated and assumed sternal recumbency but could not be placed in dorsal recumbency. Higher doses of xylazine (0.5 mg per nostril) or detomidine (0.25 mg per nostril) prolonged sedation but did not produce dorsal recumbency. In study 2 in all treatment groups, onset of action was rapid. Duration of dorsal recumbency was significantly longer (p < 0.05) with diazepam (38.4 +/- 10.5 minutes) than midazolam (17.1 +/- 2.2 minutes). Intranasal flumazenil (2.5 microg per nostril) significantly reduced recumbency time. Duration of sedation was longer with alpha(2)-agonists compared with benzodiazepines. Detomidine had the longest duration of effect (257.5 +/- 1.5 minutes) and midazolam the shortest (36.9 +/- 2.4 minutes). Nasally administered flumazenil significantly reduced the duration of sedation with diazepam and midazolam while yohimbine (120 microg per nostril) effectively antagonized the effects of xylazine and detomidine. CONCLUSION: Intranasal benzodiazepines produce rapid and effective sedation in canaries. Intranasal alpha(2) agonists produce sedation but not sustained recumbency. Specific antagonists are also effective when used by this route. Clinical relevance Intranasal sedative drug administration is an acceptable alternative method of drug delivery in canaries.     

Sedative effects of midazolam and xylazine with or without ketamine and detomidine alone following intranasal administration in Ring-necked Parakeets

OBJECTIVE: To evaluate the effects of intranasal administration of midazolam and xylazine (with or without ketamine) and detomidine and their specific antagonists in parakeets. DESIGN: Prospective study. ANIMALS: 17 healthy adult Ring-necked Parakeets (Psittacula krameri) of both sexes (mean weight, 128.83+/-10.46 g [0.28+/-0.02 lb]). PROCEDURE: The dose of each drug or ketamine-drug combination administered intranasally that resulted in adequate sedation (ie, unrestrained dorsal recumbency maintained for >or=5 minutes) was determined; the onset of action, duration of dorsal recumbency, and duration of sedation associated with these treatments were evaluated. The efficacy of the reversal agents flumazenil, yohimbine, and atipamezole was also evaluated. RESULTS: In parakeets, intranasal administration of midazolam (7.3 mg/kg [3.32 mg/lb]) or detomidine (12 mg/kg [5.45 mg/lb]) caused adequate sedation within 2.7 and 3.5 minutes, respectively. Combinations of midazolam (3.65 mg/kg [1.66 mg/lb]) and xylazine (10 mg/kg [4.55 mg/lb]) with ketamine (40 to 50 mg/kg [18.2 to 22.7 mg/lb]) also achieved adequate sedation. Compared with detomidine, duration of dorsal recumbency was significantly longer with midazolam. Intranasal administration of flumazenil (0.13 mg/kg [0.06 mg/lb]) significantly decreased midazolam-associated recumbency time. Compared with the xylazineketamine combination, duration of dorsal recumbency was longer after midazolam-ketamine administration. Intranasal administration of flumazenil, yohimbine, or atipamezole significantly decreased the duration of sedation induced by midazolam, xylazine, or detomidine, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Intranasal administration of sedative drugs appears to be an acceptable method of drug delivery in Ring-necked Parakeets. Reversal agents are also effective when administered via this route.     

Use of end-tidal CO2 tension to predict arterial CO2 values in isoflurane-anesthetized equine neonates.

End-tidal carbon dioxide tension (PetCO2) and arterial carbon dioxide tension (PaCO2) were determined and compared in isoflurane-anesthetized spontaneously breathing equine neonates. End-tidal carbon dioxide and PaCO2 values increased with respect to time. Difference between values of PetCO2 and PaCO2 increased over time. End-tidal carbon dioxide tension was useful to predict changes in and was more closely correlated with PaCO2 early in the anesthetic period (T less than or equal to 60 minutes). The dead space volume to tidal volume (Vd/Vt) ratio increased with respect to time, indicating increase in physiologic dead space in isoflurane-anesthetized foals. The data indicate that the increased difference between widening of the PetCO2 and PaCO2 values over time may have been attributable to hypoventilation and decreased pulmonary capillary perfusion of alveoli.     

Effect of reducing inspired oxygen concentration on oxygenation parameters during general anaesthesia in horses in lateral or dorsal recumbency

Objective

To compare the effects of two concentrations of oxygen delivered to the anaesthetic breathing circuit on oxygenation in mechanically ventilated horses anaesthetised with isoflurane and positioned in dorsal or lateral recumbency.

Methods

Selected respiratory parameters and blood lactate were measured and oxygenation indices calculated, before and during general anaesthesia, in 24 laterally or dorsally recumbent horses. Horses were randomly assigned to receive 100% or 60% oxygen during anaesthesia. All horses were anaesthetised using the same protocol and intermittent positive pressure ventilation (IPPV) was commenced immediately following anaesthetic induction and endotracheal intubation. Arterial blood gas analysis was performed and oxygenation indices calculated before premedication, immediately after induction, at 10 and 45 min after the commencement of mechanical ventilation, and in recovery.

Results

During anaesthesia, the arterial partial pressure of oxygen was adequate in all horses, regardless of position of recumbency or the concentration of oxygen provided. At 10 and 45 min after commencing IPPV, the arterial partial pressure of oxygen was lower in horses in dorsal recumbency compared with those in lateral recumbency, irrespective of the concentration of oxygen supplied. Based on oxygenation indices, pulmonary function during general anaesthesia in horses placed in dorsal recumbency was more compromised than in horses in lateral recumbency, irrespective of the concentration of oxygen provided.

Conclusion

During general anaesthesia, using oxygen at a concentration of 60% instead of 100% maintains adequate arterial oxygenation in horses in dorsal or lateral recumbency. However, it will not reduce pulmonary function abnormalities induced by anaesthesia and recumbency.     

Papers and articles measurement of central venous pressure in horses.

Central venous pressure measurements were made in 74 horses and ponies free from clinical evidence of cardiopulmonary disease. Using the sternal manubrium as the zero reference point, the mean value obtained was 12 cm H2O (S.D. +/- 6). There was a significant correlation with body weight (r=0.6, p less than 0.001) but there was none with age, sex, breed or type. During halothane anaesthesia, using the same reference point, the mean value was 24.5 cm H2O (S.D. +/- 6) in 28 animals in right lateral recumbency, 29 cm H2O (S.D. +/- 8) in 17 animals in left lateral recumbency and -6 cm H20 (S.D. +/- 4) IN 27 supine animals. The use of the sternal manubrium as zero reference point did not allow comparison of values in standing and recumbent animals and it was considered that serial measurements were of more value than isolated determinations in assessing the circulatory state of an animal.     

Cardiopulmonary effects of positive end-expiratory pressure in anesthetized horses.

The cardiopulmonary effects of 0, 5, 10, and 15 cm of H2O positive end-expiratory pressures (PEEP) were determined in anesthetized, spontaneously breathing horses, using a 4 by 4 Latin-square design with one repetition. Cardiac output, alveolar-arterial oxygen tension difference, alveolar ventilation, dead space/tidal volume ratio, and carbon dioxide elimination were not significantly altered by the procedure. As PEEP was increased, alveolar and arterial oxygen tensions, respiratory exchange ratio, and pH decreased, whereas arterial carbon dioxide tension and oxygen consumption increased. These results indicate PEEP is contraindicated in laterally recumbent spontaneously ventilating anesthetized horses breathing air, because it causes alveolar hypoventilation and does not improve pulmonary gas exchange.     

Comparison of sevoflurane and isoflurane in dogs anaesthetised for clinical surgical or diagnostic procedures

OBJECTIVES: To assess attributes of sevoflurane for routine clinical anaesthesia in dogs by comparison with the established volatile anaesthetic isoflurane. METHODS: One hundred and eight dogs requiring anaesthesia for elective surgery or diagnostic procedures were studied. The majority was premedicated with 0.03 mg/kg of acepromazine and 0.01 mg/kg of buprenorphine or 0.3 mg/kg of methadone before induction of anaesthesia with 2 to 4 mg/kg of propofol and 0.5 mg/kg of diazepam. They were randomly assigned to receive either sevoflurane (group S, n=50) or isoflurane (group I, n=58) in oxygen and nitrous oxide for maintenance of anaesthesia. Heart rate, respiratory rate, indirect arterial blood pressure, haemoglobin saturation, vaporiser settings, end-tidal carbon dioxide and anaesthetic concentration and oesophageal temperature were measured. Recovery was timed. Data were analysed using analysis of variance and non-parametric tests. RESULTS: Heart rate (85 to 140/minute), respiratory rate (six to 27/minute) and systolic arterial blood pressure (80 to 150 mmHg) were similar in the two groups. End-tidal carbon dioxide between 30 and 60 minutes (group S 6.4 to 6.6 and group I 5.8 to 5.9 per cent) and vaporiser settings throughout (group S 2.1 to 2.9 and group I 1.5 to 1.5 per cent) were higher in group S. There was no difference in time to head lift (18+/-16 minutes), sternal recumbency (28+/-22 minutes) or standing (48+/-32 minutes). No adverse events occurred. CLINICAL SIGNIFICANCE: Sevoflurane appeared to be a suitable volatile anaesthetic for maintenance of routine clinical anaesthesia in dogs.