Comparison of isoflurane and halothane as inhalation anaesthetics in the dog

Summary

A number of clinically important features of isoflurane anaesthesia were studied in comparison to those of halothane. Two groups of dogs were used. After light premedication, anaesthesia was induced by mask, and both groups of dogs were maintained for 30 minutes at 1.5 × MAC value of either halothane or isoflurane in a combination of oxygen and nitrous oxide (50:50). All animals were ventilating spontaneously.

There was no difference in the speed of induction of the halothane and isoflurane groups. Blood pressure in both groups dropped to approximately 7.5 kPa (56 mm Hg) during maintenance anesthesia (1.5 MAC), while the heart rate was significantly higher in the isoflurane group. Individual respiratory variables were not significantly different between the two groups, however the differences between the trends of the mean values were significant (Sign‐test). In general, with isoflurane, respiration rates were lower, with the tidal volume and end tidal CO₂ being greater.

The trends in pH and arterial pCO₂ showed a slightly more severe respiratory acidosis in the isoflurane group. However, neither group showed values corresponding to any expected clinical problems. Speed of recovery (determined by times to head‐lift and righting‐reflex) was greater in the isoflurane group. Previously known important features of isoflurane are low biodegradability, low blood: gas partition coefficient, and decreased myocardial sensitivity to catecholamines. It is concluded from this study that isoflurane deserves a place in canine anesthesia whenever these specific pharmacologic properties are desired.     

Comparison of recoveries from halothane vs isoflurane anesthesia in horses.

Recovery from isoflurane anesthesia was shorter, with no difference in quality, compared with halothane anesthesia in 2 groups of horses. In 1 group, 12 horses scheduled for elective arthroscopy were randomly assigned to receive halothane or isoflurane for maintenance of anesthesia during surgery. In the other group, 6 horses received anesthesia only, on 2 occasions, with halothane on 1 occasion, and isoflurane on the other. Difference in the quality of recovery was not seen between isoflurane and halothane anesthesia in either group. In the group that had surgery, recovery to sternal position was significantly shorter when isoflurane was used. In the group not treated surgically, recovery to sternal and standing positions was significantly shorter with isoflurane.     

Use of halothane and isoflurane in the horse

When compared with halothane, isoflurane has several distinct characteristics. Vaporizer settings are higher because of its lower potency. Respiratory rates will be slower, and intraoperative changes in depth and recovery from surgical depth of anesthesia will be more rapid, although total recovery times frequently will not be different. Halothane and isoflurane appear similar in their effects on ocular reflexes and mean arterial blood pressure. Recovery from isoflurane should be managed to provide added sedation or physical support if the horse attempts to stand prematurely.     

Comparison of electroencephalogram activity and auditory evoked responses during isoflurane and halothane anaesthesia in the rat

Objectives To compare the second differential index (SDI) calculated from the auditory evoked potential (AEP) and electroencephalogram (EEG) parameters: median frequency (MF), spectral edge frequency (SEF) and burst suppression rate (BSR) determined at four equivalent minimum alveolar concentrations (MAC) of isoflurane or halothane. Animals Twelve male Wistar rats weighing 418 g (SD ± 18.4 g). Methods Auditory evoked potentials and EEG responses were recorded in animals implanted with electrodes at established anaesthetic concentrations. Depth of anaesthesia was assessed using the strength of the pedal withdrawal reflex (PWR), and data were analysed using repeated measures anova and paired t‐tests. Results The SEF tended to decrease with increasing depth of halothane anaesthesia (F = 4.198, p = 0.05), but not with isoflurane. The MF and SDI were significantly higher during halothane than with isoflurane (F = 5.82, p = 0.036 and F = 5.263, p = 0.045, respectively) at equivalent depths of anaesthesia, and EEG burst suppression occurred at deeper planes of isoflurane but not halothane anaesthesia. Conclusions The study demonstrated that EEG and AEP characteristics recorded at MAC equivalent concentrations were suppressed to a greater degree by isoflurane than by halothane. These findings have strong implications for research projects where EEG recordings are collected, and also cast more general doubts upon the value of such parameters for evaluating depth of isoflurane anaesthesia in rats.     

A study of the effect of hemorrhage on the cardiorespiratory actions of halothane, isoflurane and sevoflurane in the dog

OBJECTIVE: To compare the cardiorespiratory changes induced by equipotent concentrations of halothane (HAL), isoflurane (ISO) and sevoflurane (SEVO) before and after hemorrhage. STUDY DESIGN: Prospective, randomized clinical trial. ANIMALS: Twenty-four healthy adult dogs weighing 15.4 +/- 3.4 kg (mean +/- SD). METHODS: Animals were randomly allocated to one of three groups (n = 8 per group). In each group, anesthesia was maintained with 1.5 minimum alveolar concentration of HAL (1.3%), ISO (1.9%) and SEVO (3.5%) in oxygen. Controlled ventilation was performed to maintain eucapnia. Cardiorespiratory variables were evaluated at baseline (between 60 and 90 minutes after induction), immediately after and 30 minutes after the withdrawal of 32 mL kg(-1) of blood (40% of the estimated blood volume) over a 30-minute period. RESULTS: During baseline conditions, ISO and SEVO resulted in higher cardiac index (CI) than HAL. Heart rates were higher with SEVO at baseline, while mean arterial pressure (MAP) and mean pulmonary arterial pressure did not differ between groups. Although heart rate values were higher for ISO and SEVO after hemorrhage, only ISO resulted in a higher CI when compared with HAL. In ISO-anesthetized dogs, MAP was higher immediately after hemorrhage, and this was related to better maintenance of CI and to an increase in systemic vascular resistance index from baseline. CONCLUSIONS: Although the hemodynamic responses of ISO and SEVO are similar in normovolaemic dogs, ISO results in better maintenance of circulatory function during the early period following a massive blood loss. CLINICAL RELEVANCE: Inhaled anesthetics should be used judiciously in animals presented with blood loss. However, if an inhalational agent is to be used under these circumstances, ISO may provide better hemodynamic stability than SEVO or HAL.     

Comparison of cardiopulmonary effects of isoflurane and halothane after atropine-guaifenesin-thiamylal anesthesia for rumenotomy in steers

Cardiopulmonary effects were assessed in 12 yearling steers anesthetized with guaifenesin and thiamylal sodium, intubated, and allowed to breathe isoflurane or halothane in oxygen spontaneously. Light surgical anesthesia, determined using eye position as a clinical indication of anesthetic depth, was maintained during surgical placement of a rumen cannula. Heart rate and respiratory rate were measured while the steers were standing quietly (baseline). Atropine (0.06 mg/kg of body weight, IM) was given after baseline measurements were taken. Heart rate, respiratory rate, arterial blood pressures, pHa, PaCO2, PaO2, arterial [HCO3-], esophageal temperature, and end-tidal anesthetic concentration were measured every 15 minutes for 90 minutes after induction of anesthesia. Mean heart rate increased significantly (P less than 0.05) above baseline in the isoflurane group at 15 and 30 minutes. Mean respiratory rate increased significantly (P less than 0.05) above baseline in the halothane group at 45 minutes. At 45 minutes, mean respiratory rate was lower (P less than 0.05) in the isoflurane group, compared with that in the halothane group. Mean values for arterial blood pressures and arterial gases were similar for both agents at comparable times. Mean end-tidal isoflurane concentrations were less than mean end-tidal halothane concentrations at each comparable time during maintenance of similar anesthetic depth. Maintenance of anesthesia with isoflurane resulted in higher heart rates and lower respiratory rates, compared with maintenance of anesthesia with halothane in these steers.     

Hepatic effects of halothane and isoflurane anesthesia in goats

OBJECTIVE: To determine hepatic effects of halothane and isoflurane anesthesia in young healthy goats. DESIGN: Randomized prospective clinical trial. ANIMALS: 24 healthy 9-month-old female goats. PROCEDURE: Goats were sedated with xylazine hydrochloride and ketamine hydrochloride and anesthetized with halothane (n = 12) or isoflurane (12) while undergoing tendon surgery. End-tidal halothane and isoflurane concentrations were maintained at 0.9 and 1.2 times the minimal alveolar concentrations, respectively, and ventilation was controlled. Venous blood samples were collected approximately 15 minutes after xylazine was administered and 24 and 48 hours after anesthesia, and serum aspartate aminotransferase (AST), sorbitol dehydrogenase (SDH), alkaline phosphatase (ALP), and gamma-glutamyltransferase (GGT) activities and bilirubin concentration were measured. Goats were euthanatized 25 or 62 days after anesthesia, and postmortem liver specimens were submitted for histologic examination. RESULTS: All goats recovered from anesthesia and survived until euthanasia. Serum SDH, GGT, and ALP activities and bilirubin concentration did not increase after anesthesia, but serum AST activity was significantly increased. However, serum hepatic enzyme activities were within reference limits at all times in all except 1 goat in which serum AST activity was high 24 and 48 hours after anesthesia. This goat had been anesthetized with halothane and had the longest duration of anesthesia. No clinically important abnormalities were seen on histologic examination of liver specimens. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that use of halothane or isoflurane for anesthesia in young healthy goats is unlikely to cause hepatic injury.     

Actions of isoflurane and halothane in pregnant mares.

Eighteen healthy, pregnant mares scheduled for laparotomy and uterine manipulation were randomly allotted to 2 equal groups. After IV administration of xylazine hydrochloride and thiamylal sodium, general anesthesia was maintained with halothane (HALO) or isoflurane (ISO) in oxygen. Results of cardiovascular measurements were similar with both inhalant anesthetics; mean arterial blood pressure was 79 and 82 mm of Hg with HALO and ISO, respectively. Respiratory rate decreased most with ISO (mean frequency was 4 and 9 breaths/min with ISO and HALO, respectively). Partial pressure of arterial CO2 was increased similarly with HALO and ISO. Partial pressure of arterial O2 varied greatly among mares and decreased with duration of use of both anesthetics. Recovery time from anesthesia was significantly (P < 0.05) shorter after use of ISO vs HALO. Minor superficial injuries were associated with recovery from both anesthetics (in 5 mares with ISO and in 1 mare with HALO). Physical signs of postanesthetic myopathy or vital-organ dysfunction were not associated with either agent.     

Effects of halothane and isoflurane on baroreflex sensitivity in horses

Baroreflex sensitivity (BS) was used to quantitatively assess the effects of halothane and isoflurane on the heart rate/arterial pressure relationship during steady-state (10 minutes) and dynamic pressure changes in adult horses. Arterial pressure was decreased in response to nitroglycerin or sodium nitroprusside and increased in response to phenylephrine HCl. Mean (+/- SEM) BS in awake horses was 28.9 +/- 2.6 and 13.2 +/- 2.0 ms/mm of Hg during steady-state decreases and increases in systolic arterial pressure (SAP), respectively. Halothane and isoflurane either significantly (P less than 0.05) decreased or eliminated BS during steady-state decreases in SAP, with no significant differences detected between anesthetic agents. During steady-state decreases in SAP, significant (P less than 0.05) correlation between R-R interval and arterial pressure was not observed for 6 of 10 and 4 of 11 halothane and isoflurane anesthesia periods, respectively. Halothane significantly (P less than 0.05) decreased BS during steady-state increases in SAP to 7.9 +/- 0.6 and 6.5 +/- 1.1 ms/mm of Hg during low and high minimal alveolar concentration (MAC) multiples, respectively. Isoflurane decreased BS during steady-state increases in SAP to 9.6 +/- 1.5 and 6.6 +/- 1.1 ms/mm of Hg during low and high MAC anesthesia, respectively, with high MAC of isoflurane decreasing BS significantly (P less than 0.05), compared with awake and low MAC values. Plasma catecholamine (epinephrine and norepinephrine) concentrations increased significantly (P less than 0.05), compared with baseline values during steady-state vasodilator infusions in halothane- and isoflurane-anesthetized horses.(ABSTRACT TRUNCATED AT 250 WORDS)     

Potency of enflurane in dogs: comparison with halothane and isoflurane

Circulatory and respiratory responses to graded increases in alveolar concentrations of enflurane were investigated in unpremedicated healthy dogs during conditions of spontaneous and controlled ventilation. The minimal alveolar concentration (MAC) of enflurane that prevented movement in response to a standard painful stimulus was determined for each dog and averaged 2.06 vol%. In these studies, enflurane produced cardiopulmonary depression in proportion to the alveolar dose. The average end-tidal enflurane concentration that produced at least 60 s of apnea was 5.29 vol% (ie, MAC 2.57). A comparison of these data with previous studies in dogs indicates that equipotent concentrations of enflurane are at least as depressant to the cardiopulmonary system as halothane and isoflurane.     

A comparison of the haemodynamic effects of isoflurane and halothane anaesthesia in horses

The purpose of this study was to compare the haemodynamic effects of equipotent isoflurane and halothane anaesthesia. Six adult horses were investigated on two separate occasions at least 4 weeks apart. On both occasions anaesthesia was induced by ketamine 2.2 mg/kg bwt given 5 min after i.v. administration 100 microg/kg bwt romifidine. Anaesthesia was maintained either by halothane or isoflurane (end-tidal concentrations 0.9-1.0% and 1.3-1.4%, respectively). Horses were ventilated by intermittent positive pressure to maintain PaCO2 between 40-50 mmHg. Haemodynamic variables were measured using catheter-mounted strain gauge transducers in the left and right ventricle, aorta, and right atrium. Cardiac output (CO), velocity time integral (VTI), maximal aortic blood flow velocity (Vmax) and acceleration (dv/dt(max)), left ventricular pre-ejection period (PEP) and ejection time (ET) were measured from aortic blood flow velocity waveforms obtained by transoesophageal Doppler echocardiography. Flow velocity waveforms were recorded from the femoral arteries and veins using low pulse repetition frequency Doppler ultrasound. Time-averaged mean velocity (TAV), velocity of component a (TaVa), velocity of component b (TaVb) and early diastolic deceleration slope (EDDS) were measured. Pulsatility index (PI) and volumetric flow were calculated. Microvascular blood flow was measured in the left and right semimembranosus muscles by laser Doppler flowmetry. Maximal rate of rise of LV pressure (LVdp/dt(max)), CO, Vmax, dv/dt(max), ET, VTI were significantly higher at all time points during isoflurane anaesthesia compared to halothane anaesthesia. Pre-ejection period and diastolic aortic blood pressure were significantly less throughout isoflurane anaesthesia compared to halothane. Isoflurane anaesthesia was associated with significantly lower systemic vascular resistance than halothane anaesthesia. Femoral arterial and venous blood flow were significantly higher and EDDS and PI were significantly lower during isoflurane anaesthesia compared to halothane anaesthesia. In addition during both halothane and isoflurane anaesthesia, femoral arterial flow was higher and EDDS and PI lower in the left (dependent) artery compared to the right (nondependent) artery. This study supports previous work demonstrating improved left ventricular systolic function during isoflurane compared to halothane anaesthesia. This improvement was still evident after premedication with a potent-long acting alpha2-adrenoreceptor agonist, romifidine, and induction of anaesthesia with ketamine. There was also evidence of increased hindlimb blood flow during isoflurane anaesthesia. However, there were differences observed in flow between the left and right hindlimb during maintenance of anaesthesia with each agent, suggesting that there were differences in regional perfusion in anaesthetised horses caused by factors unrelated to agents administered.     

Cardiopulmonary effects of enflurane and isoflurane in the dog.

The cardiopulmonary effects of 2 new inhalant anesthetics, enflurane and isoflurane, were studied in nonsedated, previously instrumented, awake dogs. Base line values were determined, and anesthesia was induced and maintained with the drug being studied. Enflurane depressed cardiopulmonary function to a greater extent than isoflurane. The depression of cardiopulmonary function from both agents increased with increasing depth of anesthesia. Enflurance produced muslce twitching, but isoflurane did not.     

Low flow anaesthesia with isoflurane in the dog

The aim of the present study was to compare the safety of two low flow (LF) regimes [fresh gas flow (FGF) 20 ml/kg/min (group 2) and 14 ml/kg/min (group 3)] with the high flow (HF) technique (FGF 50 ml/kg/min; group 1) of isoflurane anaesthesia. Data were gathered from ninety dogs assigned for surgery under general anaesthesia with an expected duration of 75 minutes or longer. All dogs had an anaesthetic induction with 0,6 mg/kg I-methadone (maximum 25 mg) and 1 mg/kg diazepam (maximum 25 mg) i.v. Anaesthesia was maintained with isoflurane in a mixture of 50% O2 and 50% N2O as carrier gases, with controlled ventilation. The Monitoring included electrocardiogramm, body temperature, the temperature of in- and exspired gases, arterial oxygen saturation, arterial blood pressure as well as a continuous monitoring of inhaled and exhaled gas concentrations (O2, N2O, CO2, isoflurane). The consumption of isoflurane and carrier gases as well as the recovery times were evaluated for the three groups. The inspired oxygen concentrations always ranged above the minimum value of 30 Vol.-% during low flow anaesthesia. The arterial oxygen saturation ranged between 92-98%, the end tidal concentration of CO2 between 35 and 45 mmHg. Heart rate and arterial blood pressure were within normal limits. Recovery time was significantly shorter after LF than after HF anaesthesia. The highest decrease in body temperature occurred in the HF group 1 because of a significantly lower anaesthetic gas temperature. Despite this, LF anaesthesia resulted in a reduced consumption of carrier gases and volatiles. In conclusion, low flow anaesthesia with isoflurane is a safe technique and offers substantial economic advantages over high flow techniques and is moreover better tolerated by the patients.     

Ketamine and the arrhythmogenic dose of epinephrine in cats anesthetized with halothane and isoflurane

Epinephrine-induced arrhythmias were studied in 4 cats (group A), using a 4 X 4 Latin square design. Each cat was anesthetized 4 times, 1 week apart, with halothane (1.5% end expired), isoflurane (2.0% end expired), and halothane or isoflurane preceded by ketamine administered IM (8.8 mg/kg). Lead II of the ECG and femoral artery pressure were recorded. Epinephrine was infused in progressively doubled rates (initial rate = 0.125 micrograms/kg/min) for a maximum of 2.5 minutes or until at least 4 ventricular premature depolarizations occurred within 15 s of each other. The arrhythmogenic dose of epinephrine (ADE; micrograms/kg) was calculated as the product of infusion rate and time to arrhythmia. The ADE (means +/- SD) during anesthesia with halothane alone and with ketamine-halothane anesthesia were 1.33 +/- 0.65 and 1.37 +/- 0.59 micrograms/kg, respectively; during anesthesia with isoflurane alone and ketamine-isoflurane anesthesia, the ADE were 9.34 +/- 1.29 and 16.16 +/- 3.63 micrograms/kg, respectively. The ADE was significantly greater (P less than 0.05) during isoflurane anesthesia and ketamine-isoflurane anesthesia than during halothane anesthesia. The percentages of change in systolic blood pressure (means +/- SD) at the ADE during halothane, ketamine-halothane, isoflurane, and ketamine-isoflurane were 31 +/- 34, 41 +/- 17, 127 +/- 27, and 148 +/- 57, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)     

Minimal alveolar concentrations for halothane, enflurane, and isoflurane in the cat

The minimal alveolar concentrations for halothane, enflurane, and isoflurane in the domestic cat were found to be 1.19 +/- 0.05 (SEM)%, 2.37 +/- 0.06%, and 1.61 +/- 0.04%, respectively. During the potency studies, it was observed that enflurane and isoflurane resulted in shorter wake-up times, compared with halothane. However, enflurane and isoflurane produced electroencephalographic (EEG) and clinical signs of CNS irritability (EEG spiking, myoclonus) in normocapnic or mildly hypocapnic cats. In addition, enflurane and isoflurane caused greater airway irritability (coughing, salivation) than did halothane.     

Temporal effects of halothane and isoflurane in laterally recumbent ventilated male horses

Cardiopulmonary function was monitored in 6 non-medicated, healthy male horses, anesthetized with halothane or isoflurane in O2 at a constant dose (1.2 times the minimum alveolar concentration). Horses were exposed once to each anesthetic agent, and a minimum of 2 weeks separated anesthetic exposures. All horses were studied in left lateral recumbency, and ventilation was mechanically controlled to induce a PaCO2 of 35 to 45 mm of Hg and an inspiratory peak airway pressure of 18 to 22 cm of H2O. After 1 hour of horse preparation, constant conditions were begun. With duration of anesthesia, cardiac output increased (P less than 0.05) with both anesthetic agents, because of an increase in stroke volume (P less than 0.05). Heart rate did not change from initial values with either agent. Mean arterial blood pressure also increased (P less than 0.05) with both agents. With both anesthetics, respiratory rate (P less than 0.05) was increased progressively to maintain acceptable PaCO2 values. Arterial O2 tension did not change with time.     

Low flow anaesthesia with isoflurane and sevoflurane in the dog

The aim of the present study was to compare the safety and efficacy of sevoflurane and isoflurane during low flow anaesthesia (fresh gas flow (FGF) 14 ml/kg/min) as well as to compare the consumption of both anaesthetics. Data were gathered from 60 dogs assigned for surgery under general anaesthesia with an expected duration of 75 minutes or longer. All dogs were induced with 0.6 mg/kg (maximum 25 mg) l-methadone and 1 mg/kg (maximum 25 mg) diazepam i.v.. Anaesthesia was maintained with isoflurane (group 1) or sevoflurane (group 2) in a mixture with 50% O2 and 50% N2O as carrier gases, under controlled ventilation. Monitoring included electrocardiogram, body temperature, the temperature of in- and exspired gases, arterial oxygen saturation, arterial blood pressure as well as a continuous monitoring of inhaled and exhaled gas concentrations (O2, N2O, CO2, isoflurane, sevoflurane). The consumption of isoflurane and sevoflurane as well as the dogs' recovery times were evaluated for both groups. In all groups the inspired oxygen concentrations ranged above the minimum value of 30 Vol% during low flow anaesthesia, with an arterial oxygen saturation above 97%. End tidal concentration of CO2, heart rate and arterial blood pressure were within the physiological ranges and showed no differences between the two groups. Recovery time was significantly shorter after sevoflurane compared to isoflurane anaesthesia, whilst the consumption of sevoflurane was higher than that of isoflurane. Sevoflurane appears to be as clinically safe as isoflurane in low flow anaesthesia. Even considering that sevoflurane is more expensive than isoflurane, the use of the low flow technique decreases the cost of anaesthesia due to the reduced volatile anaesthetic consumption.     

Hepatic effects of halothane, isoflurane or sevoflurane anaesthesia in dogs

The effects of halothane, isoflurane and sevoflurane anaesthesia on hepatic function and hepatocellular damage were investigated in dogs, comparing the activity of hepatic enzymes and bilirubin concentration in serum. An experimental study was designed. Twenty-one clinically normal mongrel dogs were divided into three groups and accordingly anaesthetized with halothane (n = 7), isoflurane (n = 7) and sevoflurane (n = 7). The dogs were 1-4 years old, and weighed between 13.5 and 27 kg (18.4 +/- 3.9). Xylazine HCI (1-2 mg/kg) i.m. was used as pre-anaesthetic medication. Anaesthesia was induced with propofol 2 mg/kg i.v. The trachea was intubated and anaesthesia maintained with halothane, isoflurane or sevoflurane in oxygen at concentrations of 1.35, 2 and 3%, respectively. Intermittent positive pressure ventilation (tidal volume, 15 ml/kg; respiration rate, 12-14/min) was started immediately after intubation and the anaesthesia lasted for 60 min. Venous blood samples were collected before pre-medication, 24 and 48 h, and 7 and 14 days after anaesthesia. Serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH GGT) activities and bilirubin concentration were measured. Serum AST, ALT and GGT activities increased after anaesthesia in all groups. In the halothane group, serum AST and ALT activities significantly increased all the time after anaesthesia compared with baseline activities. But in the isoflurane group AST and ALT activities increased only between 2 and 7 days, and in the sevoflurane group 7 days after anaesthesia. GGT activity was increased in the halothane group between 2 and 7 days, and in the isoflurane and sevoflurane groups 7 days after anaesthesia. All dogs recovered from anaesthesia without complications and none developed clinical signs of hepatic damage within 14 days. The results suggest that the use of halothane anaesthesia induces an elevation of serum activities of liver enzymes more frequently than isoflurane or sevoflurane from 2 to 14 days after anaesthesia in dogs. The effects of isoflurane or sevoflurane anaesthesia on the liver in dogs is safer than halothane anaesthesia in dogs.