Nerve stimulator-guided paravertebral lumbar plexus anaesthesia in dogs

Veterinary Research Communications -     

The influence of anaesthesia on bronchography in dogs

The spread of the contrast medium, Dionosil Aqueous (Glaxo),* in the bronchi of three healthy dogs was investigated under a variety of anaesthetic techniques. The most reliable results were obtained when intermittent positive pressure ventilation (IPPV) was applied following anaesthetic techniques incorporating the use of neuromuscular blocking agents. Good results were also obtained using trichloroethylene anaesthesia. The reliability of results obtained using relaxant techniques was confirmed in clinical cases.     

Propofol infusion anaesthesia in dogs pre-medicated with medetomidine

Ten laboratory beagles pre-medicated with medetomidine (40 μg/kg bodyweight [bwt]) were anaesthetised using a rapid injection of propofol, followed by propofol infusion. A loading dose of 4 mg/kg bwt of propofol was administered intravenously (iv) as a bolus and, immediately after, a 60 min iv propofol infusion (150 μg/kg bwt/min) was initiated. After a transient increase, mean arterial blood pressure decreased significantly below the pre-propofol level. However, the lowest values recorded (115 ± 11 mmHg) remained within the physiological limits. Heart rate increased significantly (from 41 ± 7.3 to 58 ± 11 beats/min) after initiation of the propofol infusion. No significant changes were seen in respiratory frequency; pO₂ decreased transiently; minimum values (10 ± 2.3 kPa) recorded 5 mins after initiation of the propofol infusion differed significantly from the starting level. pCO₂ increased significantly and the highest values recorded were 6.1 ± 0.35 kPa. Accordingly, pH decreased reaching the lowest level (pH 7.29) 15 mins after initiation of the propofol infusion. The analgesic effect of the present combination was not studied, but the absence of the palpebral and pedal reflexes suggested a surgical stage of anaesthesia. Therefore, propofol infusion in beagles pre-medicated with medetomidine proved to be a promising anaesthetic regimen but, if used clinically, oxygen-enriched inspired air should be used.     

Short duration anaesthesia for minor procedures in dogs

Anaesthesia was maintained with 4 different techniques in each of 12 dogs of ASA grades I or 11 undergoing 4 treatment sessions of mega-voltage x-ray therapy at weekly intervals. After induction of anaesthesia with propofol, these dogs received either: i) continiious pi-opofol iv infusion together with nitrous oxide/oxygen by inhalation: ii) halothane in nitrous oxiddoxygen; iii) entluraiie in nitrous oxide/oxygen; or iv) isollurane in nitrous oxide/oxygen. Anaesthesia dways enabled irradiation to be performed but stable anaesthesia was achieved more easily when enflurnne was used. The incidence of undesirable effects during anaesthesia wiis low. Recovery from the end of anaesthesia to swallowing was fastest Lifter enfluraiie (2.2 min median) but the recovery times to walking were similar (medians: halothane 12.5 min; entlurane 12.0 min; isoflurane 12.5 min; propofol I3 min). Personal preferences. local facilities and cost are likely to be the deciding factors in choice of any one of these techniques for dogs undergoing short procedures unussociatcd with surgical stimulation.     

Hyaluronidase shortens levobupivacaine lumbosacral epidural anaesthesia in dogs

Objectives : The aim of this study was to evaluate the effects of hyaluronidase added to levobupivacaine in lumbosacral epidural blockade in dogs. Methods : Six adult mixed breed dogs (two males and four females) weighing 7 to 14 kg (10·5 ±1·5 kg) and aged two to five years were used. Each dog received both treatments in random order: levobupivacaine alone (LBA; n=6) or levobupivacaine plus hyaluronidase (LBH; n=6) administered in the lumbosacral epidural space. Systemic effects, spread and duration of anaesthesia and motor block were determined before treatment and at predetermined intervals. Results : The duration of local anaesthesia was 90 ±10 minutes (P=0·001) for LBH treatment and 150 ±15 minutes for LBA treatment. In the LBH treatment, anaesthesia reached the T12 to T13 dermatome and in the LBA treatment it reached the T11 to T12 dermatome in all animals in 5 and 15 minutes, respectively. Complete motor blockade was 75 ±12 minutes (P=0·01) and 120 ±15 minutes for LBH and LBA treatments, respectively. Clinical Significance : Hyaluronidase added to levobupivacaine significantly shortens the duration of epidural anaesthesia with the same dermatome spread into the epidural space in dogs.     

Dexmedetomidine or medetomidine premedication before propofol-desflurane anaesthesia in dogs

The objective of this study was to evaluate dexmedetomidine as a premedicant in dogs prior to propofol-desflurane anaesthesia, and to compare it with medetomidine. Six healthy dogs were anaesthetized. Each dog received intravenously (i.v.) five preanaesthetic protocols: D1 (dexmedetomidine, 1 microg/kg, i.v.), D2 (dexmedetomidine, 2 microg/kg, i.v.), M1 (medetomidine, 1 microg/kg, i.v.), M2 (medetomidine, 2 microg/kg, i.v.), or M4 (medetomidine, 4 microg/kg, i.v.). Anaesthesia was induced with propofol (2.3-3.3 mg/kg) and maintained with desflurane. The following variables were studied: heart rate (HR), mean arterial pressure, systolic arterial pressure, diastolic arterial pressure, respiratory rate (RR), arterial oxygen saturation, end-tidal CO2, end-tidal concentration of desflurane (EtDES) required for maintenance of anaesthesia and tidal volume. Arterial blood pH (pHa) and arterial blood gas tensions (PaO2, PaCO2) were measured during anaesthesia. Time to extubation, time to sternal recumbency and time to standing were also recorded. HR and RR decreased significantly during sedation in all protocols. Cardiorespiratory variables during anaesthesia were statistically similar for all protocols. EtDES was significantly different between D1 (8.1%) and D2 (7.5%), and between all doses of medetomidine. Desflurane requirements were similar for D1 and M2, and for D2 and M4 protocols. No statistical differences were observed in recovery times. The combination of dexmedetomidine, propofol and desflurane appears to be effective for induction and maintenance of general anaesthesia in healthy dogs.     

Medetomidine/propofol anaesthesia for gastroduodenal endoscopy in dogs

This study was performed to evaluate clinically the level of analgesia obtained during fibre optic gastroduodenal examination with an anaesthetic regimen consisting of 1000 μg/m²b.s.a. medetomidine premedica-tion (equivalent to 30–50 μg/kg b.w, IM) followed by induction and maintenance of anaesthesia with propofol (1–2 mg/kg, IV), with spontaneous respiration of room air. Following premedication, all the dogs (n=20) were connected to an E.C.G. monitor (lead II) and a femoral artery catheter was placed for continuous recording of blood pressure and to allow sampling for arterial blood gas analysis. The mean values for heart rate and arterial blood pressure following medetomidine administration were 55 b.p.m. and 121 mm Hg, respectively, and these values remained unchanged during the procedure. Blood gas data all remained within physiological limits. Fibre optic gastroduodenoscopy could be performed without the occurrence of “pain” responses. In all but one dog, the pyloric sphincter was relaxed and it was easy to pass the endoscope into the duodenum. All the dogs recovered rapidly and smoothly from anaesthesia, following administration of atipamezole 2500 μg/m² b.s.a. (equivalent to 75–125 μg/kg b.w.) IM to reverse the effects of the medetomidine.     

A clinical trial of propofol infusion anaesthesia in dogs

Studies were carried out on 40 dogs premedicated with acepromazine (0·05 mg. kg^-1) and atropine (0·02 mg. kg^-1) to determine the minimum infusion rate of propofol needed to maintain anaesthesia and to compare the quality of the anaesthesia with that produced by halothane/nitrous oxide/oxygen. In 30 dogs anaesthesia was induced with propofol and maintained with a continuous infusion and in the other ten dogs anaesthesia was induced with thiopentone and maintained with the inhalation agents. An infusion rate of 0·4 mg. kg^-1 min^-1 of propofol produced surgical anaesthesia in dogs breathing oxygen or oxygen-enriched air. Cardiovascular and respiratory effects were similar to those in dogs anaesthetized with halothane/nitrous oxide and with both anaesthetic regimens myocardial oxygen consumption appeared to increase with increasing duration of anaesthesia. A possible familial susceptibility resulting in a more prolonged recovery was revealed and propofol infusion was associated with a 16 per cent incidence of vomiting in the recovery period. It was concluded that in canine anaesthesia the continuous infusion of propofol to maintain anaesthesia in healthy dogs was safe but less satisfactory than the use of halothane/nitrous oxide.     

Induction of anaesthesia in dogs and cats with propofol

Propofol was used to induce anaesthesia in 89 dogs and 13 cats of either sex, various breeds and of widely different ages and weights; they varied considerably in physical condition and were anaesthetised for a variety of investigations and surgical procedures. They were premedicated with acepromazine, papaveretum, diazepam, pethidine, atropine and scopolamine in different combinations. After induction with propofol, anaesthesia was maintained with halothane, isoflurane, methoxyflurane and enflurane and, or, nitrous oxide. The mean (+/- sd) induction doses of propofol in unpremedicated and premedicated animals were 5.2 +/- 2.3 mg/kg and 3.6 +/- 1.4 mg/kg respectively for dogs, and 5.0 +/- 2.8 mg/kg and 5.3 +/- 4.3 mg/kg for cats. There were no differences between the sexes. Premedication did not affect recovery times. The incidence of side effects was very low. One dog showed evidence of pain when propofol was injected. No incompatibility was observed between propofol and the premedicants and other anaesthetic agents used.     

Prevalence of laryngeal paresis in dogs undergoing general anaesthesia

OBJECTIVE: To estimate the prevalence of laryngeal paresis within a selected population of dogs and identify some of the distinguishing characteristics of affected dogs. DESIGN: A prospective study involving laryngoscopic examination of 250 dogs. PROCEDURE: The laryngeal movements of 250 dogs undergoing general anaesthesia were observed. The severity of laryngeal paresis in these dogs was graded (0 = normal laryngeal movements, 4 = bilateral laryngeal paralysis). The following information was also recorded for each dog: age, sex, weight, breed, condition score, anaesthetic protocol, clinical suspicion of disease and observer. RESULTS: Twenty five percent of the dogs examined had some degree of laryngeal paresis. Affected dogs were significantly older than unaffected dogs (P < 0.001). There was a trend for the severity of laryngeal paresis to increase with age. There was no difference between the sexes. Dogs with laryngeal paresis were significantly heavier than normal animals (P < 0.02). Overweight animals had a significantly higher laryngeal grade than those with a normal condition score (P < 0.05). Labrador Retrievers and Rottweilers had a significantly higher risk of having laryngeal paresis (P < 0.05). Clinical suspicion was found to have high diagnostic value. An intra-class correlation coefficient for inter-rater reliability between the two observers was 0.95. CONCLUSIONS: Laryngeal paresis had a high prevalence in the animals surveyed and was strongly associated with age and breed. The results of this study are consistent with the concept of a progressive degenerative disease with a breed susceptibility. Clinical suspicion for the presence of the disease was a reliable indicator. The grading system used had a high degree of inter-observer agreement.     

Effects of medetomidine premedication on propofol infusion anaesthesia in dogs

Observations of cardiovascular and respiratory parameters were made on six dogs anaesthetized on two separate occasions for 120 minutes with a propofol infusion, once without premedication and once following premedication with 10 μg kg-¹ of intramuscular medetomidine. During anaesthesia the heart rate and cardiac index tended to be lower following medetomidine premedication, while the mean arterial pressure was significantly greater (p<0.05). Although the differences were not statistically significant, the systemic vascular resistance, pulmonary vascular resistance and stroke volume index were also greater in dogs given medetomidine. The mean arterial oxygen and carbon dioxide tensions were similar under both regimens, but in 2 dogs supplementary oxygen had to be administered during anaesthesia to alleviate severe hypoxaemia on both occasions they were anaesthetized. Minute and tidal volumes of respiration tended to be greater in dogs not given medetomidine but medetomidine premedication appeared to have no effect on venous admixture. Dogs given medetomidine received intramuscular atipamezole at the end of the 120 min. propofol infusion; the mean time from induction of anaesthesia to walking without ataxia was 174. min in the unpremedicated dogs and 160 min. in the dogs given atipamezole. The mean blood propofol concentration at which the dogs walked without ataxia was higher in the unpremedicated animals (2.12 ± 0.077 μg. ml-¹ compared with 1.27 ± 0.518 μg. ml-¹ in the premedicated dogs). The oxygen delivery to the tissues was lower after medetomidine premedication (p = 0.03) and the oxygen consumption was generally lower after medetomidine premedication but the difference did not achieve statistical significance. No correlation could be demonstrated between blood propofol concentration and cardiac index, systemic or pulmonary vascular resistance indices, systolic, diastolic or mean arterial blood pressures.     

Propofol-halothane-nitrous oxide/oxygen anaesthesia for mega-voltage radiotherapy in dogs

Observations were made on 49 dogs aged 3–13 years, of ASA Grades I and 11, during 83 periods of mega-voltage radiotherapy. The dogs weighed 5.847.0 kg and the total duration of anaesthesia ranged from 12–52 min (mean ± sem, 22 ± 8). No premedication was given. Anaesthesia was induced with iv propofol and, following endotracheal intubation, maintained with halothane/nitrous oxide/oxygen and intermittent injections of propofol. The dose of propofol needed to induce jaw relaxation sufficient for intubation was 3.5–10.8 mgkg bwt (5.67 ± 0.15) administered over 7–137 s (36 ± 2). On 91 occasions in 54 periods of anaesthesia, supplementary doses of propofol ranging from 0.2–4.9 mg/kg bwt (1.42 ± 0.14) were needed during positioning for irradiation. The times elapsing from extubation to swallowing, response to voice, spontaneous head lifting and walking were 3, 6, 7 and 13 min, respectively. A 12% incidence of tonic-clonic movements indicated that the method of anaesthesia cannot be regarded as entirely satisfactory for mega-voltage radiotherapy.     

Effects of general anaesthesia on static respiratory compliance in dogs

The effect of anaesthesia on total, pulmonary and chest wall static respiratory compliance was investigated in healthy spontaneously breathing dogs undergoing orthopaedic surgery. Total compliance fell by 26 per cent from the baseline measurement within 25 minutes of the first measurement (P less than 0.01), while pulmonary and chest wall compliances fell by 34 per cent and 40 per cent, respectively (P less than 0.01). Pulmonary compliance ceased to fall after 50 minutes, but chest wall compliance was still declining after 70 minutes. The decline in compliance could be prevented by periodic full lung inflation, with a significant difference being found between inflated and uninflated dogs (P less than 0.01). The reduction in compliance during anaesthesia is believed to be a consequence of reduced functional residual capacity and the development of lung tissue atelectasis.     

The effect of omeprazole on oesophageal pH in dogs during anaesthesia

O bjectives : Intra-operative, gastro-oesophageal reflux may be associated with post-anaesthestic complications such as oesophagitis and oesophageal stricture in dogs. The aim of this study was to investigate the effect of preoperative administration of omeprazole, a proton pump inhibitor, on oesophageal pH in anaesthetised dogs.
M ethods : Forty-seven dogs undergoing elective pelvic limb orthopaedic surgery were enrolled into the study. These were randomly allocated to treatment group (n=22) or control group (n=25). The treatment group received one dose of omeprazole (1 mg/kg po) at least 4 h before anaesthesia. All dogs were anaesthetised by the same standardised protocol. A pH probe was inserted into the distal oesophagus after induction of anaesthesia and oesophageal pH was continuously monitored.
R esults : In the treatment group, four animals (18 per cent) showed a sudden decrease in oesophageal pH (<4). In the control group the same phenomenon was detected in 13 animals (52 per cent). Gastro-oesophageal reflux occurred more frequently in the control group compared with the omeprazole group (odds ratio 4·7, 95 per cent C.I. 1.1 to 24.7, P=0.032).
C linical S ignificance : This study suggests that the preoperative administration of omeprazole is effective in reducing the incidence of gastro-oesophageal reflux during anaesthesia in dogs.     

Dopamine‐induced bradycardia in two dogs under isoflurane anaesthesia

Dopamine is a commonly used positive inotropic agent for the treatment of hypotension in small animals. Two dogs that had undergone surgery, under isoflurane anaesthesia, developed a sudden and profound bradycardia when a dopamine infusion was administered. Bradycardia was attributed to the activation of the Bezold‐Jarisch reflex, an inhibitory reflex, characterised by bradycardia and hypotension.