Induction and recovery characteristics and cardiopulmonary effects of sevoflurane and isoflurane in bald eagles

OBJECTIVE: To compare induction and recovery characteristics and cardiopulmonary effects of isoflurane and sevoflurane in bald eagles. Animals-17 healthy adult bald eagles. PROCEDURES: Anesthesia was induced with isoflurane or sevoflurane delivered in oxygen via a facemask in a crossover design with 4 weeks between treatments. Eagles were intubated, allowed to breathe spontaneously, and instrumented for cardiopulmonary measurements. Time to induction, extubation, and recovery, as well as smoothness of recovery, were recorded. RESULTS: Administration of sevoflurane resulted in a significantly quicker recovery, compared with isoflurane. Temperature, heart rate, and respiratory rate significantly decreased over time, whereas systolic (SAP), diastolic (DAP), and mean arterial blood pressure (MAP) significantly increased over time with each treatment. Temperature, heart rate, SAP, DAP, and MAP were significantly higher with isoflurane. Blood pH significantly decreased, whereas PaCO(2) significantly increased over time with each treatment. Bicarbonate and total carbon dioxide concentrations significantly increased over time with each treatment; however, there was a significant time-treatment interaction. The PaO(2) and arterial oxygen saturation increased over time with isoflurane and decreased over time with sevoflurane with a significant time-treatment interaction. Six eagles developed cardiac arrhythmias with isoflurane, as did 4 with sevoflurane anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE: Isoflurane and sevoflurane administration resulted in smooth, rapid induction of and recovery from anesthesia similar to other species. Isoflurane administration resulted in tachycardia, hypertension, and more arrhythmias, compared with sevoflurane. Sevoflurane was associated with fewer adverse effects and may be particularly beneficial in compromised bald eagles.     

Effects of intravenous ethyl pyruvate on cardiopulmonary variables and quality of recovery from anesthesia in horses

ObjectiveTo determine the effects of intravenous ethyl pyruvate, an anti-inflammatory with putative benefits in horses with endotoxemia, on cardiopulmonary variables during anesthesia and the quality of anesthetic recovery.Study designRandomized, crossover, blinded experimental design.AnimalsA total of six healthy Standardbred geldings, aged 13 ± 3 years and weighing 507 ± 66 kg (mean ± standard deviation).MethodsHorses were anesthetized for approximately 90 minutes on two occasions with a minimum of 2 weeks apart using xylazine for sedation, ketamine and diazepam for induction, and isoflurane in oxygen for maintenance. Lactated Ringer’s solution (LRS; 10 mL kg^–1 hour^–1) was administered during anesthesia. Treatments were randomized and administered starting approximately 30 minutes after induction of anesthesia and infused over 60 minutes: LRS (1 L) or ethyl pyruvate (150 mg kg^–1 in 1 L LRS). Invasive arterial pressures, heart rate, respiratory rate and end-tidal carbon dioxide tensions were recorded every 5 minutes for the duration of anesthesia. Arterial blood gases, glucose and lactate concentrations were measured every 20 minutes. Anesthetic recovery was video recorded, stored, and subsequently rated by two individuals blinded to treatments. Total recovery time, time to extubation, number of attempts and time to sternal recumbency, number of attempts to stand and time to stand were recorded. Quality of recovery was analyzed. Data between treatments and within a treatment were assessed using two-way repeated-measures anova and a Pearson correlation coefficient, significant at p < 0.05.ResultsAll horses completed the study. No significant differences were detected between the ethyl pyruvate and LRS treatments for either the cardiopulmonary variables or quality of recovery from anesthesia.Conclusions and clinical relevanceThe results suggest that intravenous ethyl pyruvate can be administered to healthy anesthetized horses with minimal impact on the cardiopulmonary variables studied or the quality of recovery from anesthesia.     

Effects of dobutamine, norepinephrine, and vasopressin on cardiovascular function in anesthetized neonatal foals with induced hypotension

OBJECTIVE: To determine the effects of dobutamine, norepinephrine, and vasopressin on cardiovascular function and gastric mucosal perfusion in anesthetized foals during isoflurane-induced hypotension. ANIMALS: 6 foals that were 1 to 5 days of age. PROCEDURES: 6 foals received 3 vasoactive drugs with at least 24 hours between treatments. Treatments consisted of dobutamine (4 and 8 Sang/kg/min), norepinephrine (0.3 and 1.0 Sang/kg/min), and vasopressin (0.3 and 1.0 mU/kg/min) administered IV. Foals were maintained at a steady hypotensive state induced by a deep level of isoflurane anesthesia for 30 minutes, and baseline cardiorespiratory variables were recorded. Vasoactive drugs were administered at the low infusion rate for 15 minutes, and cardiorespiratory variables were recorded. Drugs were then administered at the high infusion rate for 15 minutes, and cardiorespiratory variables were recorded a third time. Gastric mucosal perfusion was measured by tonometry at the same time points. RESULTS: Dobutamine and norepinephrine administration improved cardiac index. Vascular resistance was increased by norepinephrine and vasopressin administration but decreased by dobutamine at the high infusion rate. Blood pressure was increased by all treatments but was significantly higher during the high infusion rate of norepinephrine. Oxygen delivery was significantly increased by norepinephrine and dobutamine administration; O2 consumption decreased with dobutamine. The O2 extraction ratio was decreased following norepinephrine and dobutamine treatments. The gastric to arterial CO2 gap was significantly increased during administration of vasopressin at the high infusion rate. CONCLUSION AND CLINICAL RELEVANCE: Norepinephrine and dobutamine are better alternatives than vasopressin for restoring cardiovascular function and maintaining splanchnic circulation during isoflurane-induced hypotension in neonatal foals.     

Effects of nitrous oxide on mask induction of anesthesia with sevoflurane or isoflurane in dogs.

OBJECTIVE: To determine the effects of nitrous oxide (N2O) on the speed and quality of mask induction with sevoflurane or isoflurane in dogs. ANIMALS: 7 healthy Beagles. PROCEDURE: Anesthesia was induced with sevoflurane or isoflurane delivered in 100% oxygen or in a 2:1 mixture of N2O and oxygen via a face mask. Each dog received all treatments with at least 1 week between treatments. Initial vaporizer settings were 0.8% for sevoflurane and 0.5% for isoflurane (0.4 times the minimum alveolar concentration [MAC]). Vaporizer settings were increased by 0.4 MAC at 15-second intervals until settings were 4.8% for sevoflurane and 3.0% for isoflurane (2.4 MAC). Times to onset and cessation of involuntary movements, loss of the palpebral reflex, negative response to tail-clamp stimulation, and endotracheal intubation were recorded, and cardiopulmonary variables were measured. RESULTS: Administration of sevoflurane resulted in a more rapid induction, compared with isoflurane. However, N2O had no effect on induction time for either agent. Heart rate, mean arterial blood pressure, cardiac output, and respiratory rate significantly increased and tidal volume significantly decreased from baseline values immediately after onset of induction in all groups. Again, concomitant administration of N2O had no effect on cardiopulmonary variables. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of N2O did not improve the rate or quality of mask induction with sevoflurane or isoflurane. The benefits provided by N2O attributable to concentrating and second gas effects appear minimal in healthy dogs when low solubility inhalation agents such as isoflurane and sevoflurane are used for mask induction.     

Pharmacokinetics of inhaled anesthetics in green iguanas (Iguana iguana)

OBJECTIVE: To test the hypothesis that differences in anesthetic uptake and elimination in iguanas would counter the pharmacokinetic effects of blood:gas solubility and thus serve to minimize kinetic differences among inhaled agents. ANIMALS: 6 green iguanas (Iguana iguana). PROCEDURES: Iguanas were anesthetized with isoflurane, sevoflurane, or desflurane in a Latin-square design. Intervals from initial administration of an anesthetic agent to specific induction events and from cessation of administration of an anesthetic agent to specific recovery events were recorded. End-expired gas concentrations were measured during anesthetic washout. RESULTS: Significant differences were not detected for any induction or recovery events for any inhalation agent in iguanas. Washout curves best fit a 2-compartment model, but slopes for both compartments did not differ significantly among the 3 anesthetics. CONCLUSIONS AND CLINICAL RELEVANCE: Differences in blood:gas solubility for isoflurane, sevoflurane, and desflurane did not significantly influence differences in pharmacokinetics for the inhalation agents in iguanas.     

Evaluation of induction characteristics and hypnotic potency of isoflurane and sevoflurane in healthy dogs

OBJECTIVE: To determine induction characteristics and the minimum alveolar concentration (MAC) at which consciousness returned (MACawake) in dogs anesthetized with isoflurane or sevoflurane. ANIMALS: 20 sexually intact male Beagles. PROCEDURES: In experiment 1, 20 dogs were randomly assigned to have anesthesia induced and maintained with isoflurane or sevoflurane. The MAC at which each dog awoke in response to auditory stimulation (MACawake-noise) was determined by decreasing the end-tidal concentration by 0.1 volume (vol %) every 15 minutes and delivering a standard audible stimulus at each concentration until the dog awoke. In experiment 2, 12 dogs received the same anesthetic agent they were administered in experiment 1. After duplicate MAC determination, the end-tidal concentration was continually decreased by 10% every 15 minutes until the dog awoke from anesthesia (MACawake). RESULTS: Mean induction time was significantly greater for isoflurane-anesthetized dogs (212 seconds), compared with the sevoflurane-anesthetized dogs (154 seconds). Mean+/-SD MACawake-noise was 1.1+/-0.1 vol % for isoflurane and 2.0+/-0.2 vol % for sevoflurane. Mean MAC was 1.3+/-0.2 vol % for isoflurane and 2.1+/-0.6 vol % for sevoflurane, and mean MACawake was 1.0+/-0.1 vol % for isoflurane and 1.3+/-0.3 vol % for sevoflurane. CONCLUSIONS AND CLINICAL RELEVANCE: Sevoflurane resulted in a more rapid induction than did isoflurane. The MACawake for dogs was higher than values reported for both agents in humans. Care should be taken to ensure that dogs are at an appropriate anesthetic depth to prevent consciousness, particularly when single-agent inhalant anesthesia is used.     

Clinical investigations of halothane and isoflurane for induction and maintenance of foal anesthesia

Fifty-eight foals were divided into two groups for study of aspects of the clinical anesthetic management of foals and to characterize effects of halothane (n = 30) and isoflurane (n = 28) in foals. There were no significant differences (P greater than 0.05) in the demographics of the two groups. Results of hemograms and biochemical analysis of venous blood samples before and after anesthesia were either not influenced or only mildly (clinically unimportant) affected by either agent. Like adult horses, foals have an increased PaCO2 when anesthetized with inhaled anesthetics. We could detect no difference in the magnitude of increase in PaCO2 with either anesthetic. Anesthetic induction and recovery was most rapid with isoflurane. The quality of induction and recovery was similarly acceptable with either agent. Heart rate during isoflurane was not significantly different from conscious conditions but during halothane, heart rate was significantly less than control except at 91-120 min when statistical significance was not detected. These results support the clinical impression that foals can be safely and reliably anesthetized with either agent.     

Anesthetic indices of sevoflurane and isoflurane in unpremedicated dogs

OBJECTIVE: To compare the anesthetic index of sevoflurane with that of isoflurane in unpremedicated dogs. DESIGN: Randomized complete-block crossover design. ANIMALS: 8 healthy adult dogs. PROCEDURE: Anesthesia was induced by administering sevoflurane or isoflurane through a face mask. Time to intubation was recorded. After induction of anesthesia, minimal alveolar concentration (MAC) was determined with a tail clamp method while dogs were mechanically ventilated. Apneic concentration was determined while dogs were breathing spontaneously by increasing the anesthetic concentration until dogs became apneic. Anesthetic index was calculated as apneic concentration divided by MAC. RESULTS: Anesthetic index of sevoflurane (mean +/- SEM, 3.45 +/- 0.22) was significantly higher than that of isoflurane (2.61 +/- 0.14). No clinically important differences in heart rate; systolic, mean, and diastolic blood pressures; oxygen saturation; and respiratory rate were detected when dogs were anesthetized with sevoflurane versus isoflurane. There was a significant linear trend toward lower values for end-tidal partial pressure of carbon dioxide during anesthesia with sevoflurane, compared with isoflurane, at increasing equipotent anesthetic doses. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that sevoflurane has a higher anesthetic index in dogs than isoflurane. Sevoflurane and isoflurane caused similar dose-related cardiovascular depression, but although both agents caused dose-related respiratory depression, sevoflurane caused less respiratory depression at higher equipotent anesthetic doses.     

Bispectral index,spectral edge frequency 95%, and median frequency recorded for various concentrations of isoflurane and sevoflurane in pigs

OBJECTIVE: To evaluate bispectral index (BIS), spectral edge frequency 95% (SEF), and median frequency (MED) in relation to a visual analogue scale (VAS) as indicators of anesthetic depth for various concentrations of sevoflurane and isoflurane in pigs. ANIMALS: 32 pigs. PROCEDURE: Pigs were randomly allocated to 8 groups (4 pigs/group). An electroencephalogram (EEG) was recorded in each conscious pig. Pigs were then anesthetized by use of sevoflurane (n = 16) or isoflurane (16). Agents were administered in oxygen at minimum alveolar concentrations (MACs) of 1, 1.25, 1.5, and 1.75 MAC in a randomized order. End-tidal sevoflurane and isoflurane concentrations were maintained for 30 minutes, after which an EEG was recorded for 5 minutes; BIS, SEF, and MED were then calculated. Anesthetic depth was evaluated by use of the VAS. Cardiovascular and EEG responses to nociceptive stimuli were evaluated for each anesthetic agent. RESULTS: BIS decreased significantly for the various concentrations of each anesthetic. At equivalent MACs, BIS values were significantly higher during sevoflurane-induced anesthesia than during isoflurane-induced anesthesia. Values of MED and SEF decreased significantly from basal values to 1 MAC of sevoflurane and isoflurane. For both agents, there was good correlation between VAS scores and BIS values and between VAS scores and SEF values. CONCLUSIONS AND CLINICAL RELEVANCE: BIS was useful for predicting changes in anesthetic depth at clinical dosages of inhalant anesthetics. Values of BIS, SEF, and MED were significantly higher during anesthesia induced by administration of sevoflurane than during anesthesia induced by administration of isoflurance at equivalent MACs.     

Comparison of the arterial blood gas,arterial oxyhaemoglobin saturation and end-tidal carbon dioxide tension during sevoflurane or isoflurane anaesthesia in rabbits

The effects of sevoflurane or isoflurane on arterial blood gas, arterial oxyhaemoglobin saturation and end-tidal CO2 tension were monitored during induction and maintenance of anaesthesia in 10 premedicated New Zealand White (NZW) rabbits.For induction, the anaesthetic agents were delivered via a face-mask. After induction was completed, an endotracheal tube was introduced for maintenance of anaesthesia for a period of 90 minutes. Changes in heart rate, respiratory rate, arterial blood gas, arterial oxyhaemoglobin saturation, blood pH and end-tidal CO2 tension were recorded. Although sevoflurane and isoflurane produce similar cardiopulmonary effects in premedicated rabbits, sevoflurane provides a smoother and faster induction because of its lower blood/gas partition coefficient. Thus sevoflurane is probably a more suitable agent than isoflurane for mask induction and maintenance. Its lower blood solubility also makes sevoflurane more satisfactory than isoflurane for maintenance of anaesthesia because it allows the anaesthetist to change the depth of anaesthesia more rapidly.     

Comparison of three different inhalant anesthetic agents (isoflurane, sevoflurane, desflurane) in red-tailed hawks (Buteo jamaicensis)

Objective To compare isoflurane, sevoflurane and desflurane for inhalant anesthesia in red‐tailed hawks (Buteo jamaicensis) in terms of the speed and characteristics of induction; cardiovascular and respiratory parameters while anesthetized; and speed and quality of recovery. Study design Prospective, cross over, randomized experimental study. Animals 12 healthy adult red‐tailed hawks. Methods Anesthesia was induced with isoflurane, sevoflurane or desflurane in oxygen via face mask in a crossover, randomized design with a 1 week washout period between each treatment. Hawks were tracheally intubated, allowed to breathe spontaneously, and instrumented for cardiopulmonary monitoring. Data collected included heart rate, respiratory rate, end‐tidal CO₂, inspired and expired agent, SpO_2, temperature, systolic blood pressure, time to intubation and time to recovery (tracking). Recovery was subjectively scored on a 4 point scale as well as a summary evaluation, by a single blinded observer. Results No significant difference in time to induction and time to extubation was noted with the administration of isoflurane, sevoflurane or desflurane. Time to the ability of the bird to follow a moving object with its eyes (tracking) was significantly faster with the administration of sevoflurane and desflurane. All recoveries were scored 1 or 2 and were assessed as good to excellent. No significant difference was noted in heart rate, blood pressure and temperature among the three inhalants. Administration of isoflurane resulted in lower respiratory rates. Conclusions and clinical relevance Overall, although isoflurane remains the most common inhaled anesthetic in avian practice, sevoflurane and desflurane both offer faster time to tracking, while similar changes in cardiopulmonary function were observed with each agent during anesthesia of healthy red‐tailed hawks.     

Comparison of sevoflurane and isoflurane in domestic ferrets (Mustela putorius furo)

Isoflurane anesthesia is commonly used in ferrets for routine examinations and diagnostics. Sevoflurane is now being used as well, but there have been no studies to date directly comparing these agents in domestic ferrets. A prospective study was designed to evaluate the quality and speed of anesthetic induction and recovery using isoflurane and sevoflurane in ferrets. In addition effects on heart rate, blood pressure and packed cell volume were also recorded. No significant differences were noted between anesthetic agents.     

Recovery From Sevoflurane Anesthesia in Horses: Comparison to Isoflurane and Effect of Postmedication With Xylazine

Objective—To compare recovery from sevoflurane or isoflurane anesthesia in horses. Study Design—Prospective, randomized cross-over design. Animals—Nine Arabian horses (3 mares, 3 geldings, and 3 stallions) weighing 318 to 409 kg, 4 to 20 years old. Methods—Horses were anesthetized on three occasions with xylazine (1.1 mg/kg), Diazepam (0.03 mg/kg intravenously [IV]), and ketamine (2.2 mg/kg IV). After intubation, they were maintained with isoflurane or sevoflurane for 90 minutes. On a third occasion, horses were maintained with sevoflurane and given xylazine (0.1 mg/kg IV) when the vaporizer was turned off. Horses were not assisted in recovery and all recoveries were videotaped. Time to extubation, first movement, sternal, and standing were recorded as was the number of attempts required to stand. Recoveries were scored on a 1 to 6 scoring system (1 = best, 6 = worst) by the investigators, and by three evaluators who were blinded to the treatments the horses received. These blinded evaluators assessed the degree of ataxia present at 10 minutes after each horse stood, and recorded the time at which they judged the horse to be ready to leave the recovery stall. Results—Mean times (± SD) to extubation, first movement, sternal, and standing were 4.1 (1.7), 6.7 (1.9), 12.6 (4.6), and 17.4 (7.2) minutes with isoflurane; 3.4 (0.8), 6.6 (3.1), 10.3 (3.1), and 13.9 (3.0) minutes with sevoflurane; and 4.0 (1.2), 9.1 (3.3), 13.8 (6.5), and 18.0 (7.1) with sevoflurane followed by xylazine. Horses required a mean number of 4 (2.3), 2 (0.9), and 2 (1.6) attempts to stand with isoflurane, sevoflurane, and sevoflurane followed by xylazine respectively. The mean recovery score (SD) for isoflurane was 2.9 (1.2) from investigators and 2.4 (1.1) from blinded evaluators. For sevoflurane, the mean recovery score was 1.7 (0.9) from investigators and 1.9 (1.1) from evaluators, whereas the recoveries from sevoflurane with xylazine treatment were scored as 1.7 (1.2) from investigators and 1.7 (1.0) from blinded evaluators. Conclusions—Recoveries appeared to vary widely from horse to horse, but were significantly shorter with sevoflurane than isoflurane, although sevoflurane followed by xylazine was no different from isoflurane. Under the conditions of the study, recoveries from sevoflurane and sevoflurane followed by xylazine were of better quality than those from isoflurane. Clinical Relevance—Sevoflurane anesthesia in horses may contribute to a shorter, safer recovery from anesthesia.     

Inhalation anesthesia in Dumeril's monitor (Varanus dumerili) with isoflurane, sevoflurane, and nitrous oxide: effects of inspired gases on induction and recovery.

Induction and recovery from inhalation anesthesia of Dumeril's monitors (Varanus dumerili) using isoflurane, sevoflurane, and nitrous oxide (N2O) were characterized using a randomized crossover design. Mean times to induction for isoflurane in 100% oxygen (O2), sevoflurane in 100% O2, sevoflurane in 21% O2:79% nitrogen (N2; room air), and sevoflurane in 66% N2O:34% O2 were 13.00 +/- 4.55, 11.20 +/- 3.77, 10.40 +/- 2.50, and 9.40 +/- 2.80 min, respectively, at 26 degrees C (n = 10). Mask induction with sevoflurane was significantly faster than with isoflurane. There was no significant difference between the induction time for sevoflurane in O2 or in room air, but sevoflurane combined with N2O resulted in significantly faster inductions than were obtained with sevoflurane in 100% O2. All treatments resulted in a significantly higher respiratory rate than in undisturbed animals. There were no significant differences in respiratory rate among lizards receiving O2, isoflurane in 100% O2, sevoflurane in room air, and sevoflurane combined with N2O, but animals receiving sevoflurane in O2 had a lower respiratory rate than those receiving pure O2. The sequence of complete muscle relaxation during induction was consistent and not significantly different among the four treatments: front limbs lost tone first, followed by the neck and the hind limbs; then the righting reflex was lost and finally tail tone. There were no significant differences in recovery times between isoflurane and sevoflurane or between sevoflurane in 100% O2 and sevoflurane combined with N2O. Similar recovery times were observed in animals recovering in 100 and 21% O2.     

Comparisons of Sevoflurane, Isoflurane, and Halothane Anesthesia in Spontaneously Breathing Cats

The clinical effects of sevoflurane, isoflurane, and halothane anesthesia with or without nitrous oxide, were compared in healthy, premedicated cats breathing spontaneously during 90 minutes of anesthesia. The effect of nitrous oxide in accelerating the induction of and recovery from anesthesia was more evident for halothane than for sevoflurane or isoflurane. The cats recovered more rapidly from sevoflurane-oxygen than from either halothane- or isoflurane-oxygen. Heart rates did not significantly change during anesthesia with any of the anesthetics. Arterial blood pressures during sevoflurane-oxygen anesthesia were somewhat higher than those with either isoflurane- or halothane-oxygen. There were no significant differences in arterial blood pressures among sevoflurane, isoflurane, and halothane anesthesia when combined with nitrous oxide. The respiration rate during sevoflurane-oxygen was similar to that during halothane-oxygen. There were no significant differences in respiration rate among sevoflurane, isoflurane, and halothane anesthesia when combined with nitrous oxide. The degree of hypercapnia and acidosis during sevoflurane anesthesia was similar to that observed during isoflurane anesthesia and less than during halothane anesthesia. The three anesthetic regimens, with or without nitrous oxide, induced a similar degree of hyperglycemia and hemodilution during anesthesia. Serum biochemical examination did not reveal any hepatic or renal injuries after each anesthesia.     

A comparison of equine recovery characteristics after isoflurane or isoflurane followed by a xylazine-ketamine infusion.

OBJECTIVE: To determine whether infusion of xylazine (XYL) and ketamine (KET) for 30 minutes after isoflurane administration in horses would result in improved quality of recovery from anesthesia, without detrimental cardiopulmonary changes. STUDY DESIGN: Randomized, blinded experimental trial. ANIMALS: Seven healthy adult horses aged 6.4 +/- 1.9 years and weighing 506 +/- 30 kg. METHODS: Horses were anesthetized twice, at least 1 week apart. On both occasions, anesthesia was induced by the administration of XYL, diazepam, and KET, and maintained with isoflurane for approximately 90 minutes, the last 60 minutes of which were under steady-state conditions (1.2 times the minimum alveolar concentration isoflurane). On one occasion, horses were allowed to recover from isoflurane anesthesia, while on the other, XYL and KET were infused for 30 minutes after termination of isoflurane administration. Heart rate, respiratory rate, arterial blood pressure, pH, and blood-gases were measured and recorded at set intervals during steady-state isoflurane anesthesia and XYL-KET infusion. Recovery events were timed and subjectively scored by one nonblinded and two blinded observers. Data were analyzed using a restricted maximum likelihood-based mixed effect model repeated measures analysis. RESULTS: Infusion of XYL and KET resulted in longer recovery times, but there was no significant improvement in recovery quality score. CONCLUSIONS: Under the conditions of this study, infusion of XYL and KET does not positively influence recovery from isoflurane anesthesia in horses. CLINICAL RELEVANCE: This study does not support the routine use of XYL and KET infusions in horses during the transition from isoflurane anesthesia to recovery.     

Influence of halothane, isoflurane, and sevoflurane on gastroesophageal reflux during anesthesia in dogs

OBJECTIVE: To determine whether maintenance of anesthesia with halothane or sevoflurane is associated with a lower incidence of gastroesophageal reflux (GER) than the use of isoflurane in dogs undergoing orthopedic surgery. ANIMALS: 90 dogs. PROCEDURES: Dogs were evaluated during elective orthopedic surgery. Dogs with a history of vomiting or that had received any drugs that would alter gastrointestinal tract function were excluded from the study. The anesthetic protocol used was standardized to include administration of acepromazine maleate and morphine prior to induction of anesthesia with thiopental. Dogs were allocated to receive halothane, isoflurane, or sevoflurane to maintain anesthesia. A sensor-tipped catheter was placed to measure esophageal pH during anesthesia. Gastroesophageal reflux was defined as an esophageal pH < 4 or > 7.5. RESULTS: 51 dogs had 1 or more episodes of acidic GER during anesthesia. Reflux was detected in 14 dogs receiving isoflurane, 19 dogs receiving halothane, and 18 dogs receiving sevoflurane. In dogs with GER, mean +/- SD time from probe placement to onset of GER was 36 +/- 65 minutes and esophageal pH remained < 4 for a mean of 64% of the measurement period. There was no significant association between GER and start of surgery or moving a dog on or off the surgery table. Dogs that developed GER soon after induction of anesthesia were more likely to regurgitate. CONCLUSIONS AND CLINICAL RELEVANCE: Maintenance of anesthesia with any of the 3 commonly used inhalant agents is associated with a similar risk for development of GER in dogs.     

Cardiopulmonary effects of diazepam/ketamine/isoflurane or xylazine/ketamine/isoflurane in foals undergoing abdominal surgery

The purpose of this study was to evaluate the cardiopulmonary effects of anesthetic induction with diazepam/ketamine or xylazine/ketamine with subsequent maintenance of anesthesia using isoflurane in foals undergoing abdominal surgery. Seventeen foals underwent laparotomy at 7–10 days of age and a laparoscopy 7–10 days later. Foals were randomly assigned to receive xylazine (0.8 mg kg^?1)/ketamine (2 mg kg^?1) (X/K)(n = 9) or diazepam (0.2 mg kg^?1)/ketamine (2 mg kg^?1) (D/K)(n = 8) for induction of anesthesia for both procedures. In all foals, anesthesia was maintained with isoflurane in oxygen with the inspired concentration adjusted to achieve adequate depth of anesthesia as assessed by an individual blinded to the treatments. IPPV was employed throughout using a tidal volume of 10 mL kg^?1 adjusting the frequency to maintain eucapnia (PaCO₂ 35–45 mm Hg, 4.7–6.0 kPa). Cardiopulmonary variables were measured after induction of anesthesia prior to, during, and following surgery. To compare the measured cardiopulmonary variables between the two anesthetic regimes for both surgical procedures, results were analyzed using a three‐way factorial anova for repeated measures (p < 0.05). During anesthesia for laparotomy, mean CI and MAP ranged from 110 to 180 mL kg^?1 minute^?1 and 57–81 mm Hg, respectively, in the D/K foals and 98–171 mL kg^?1 minute^?1 and 50–66 mm Hg in the X/K foals. Overall, CI, HR, SAP, DAP, and MAP were significantly higher in foals in the D/K group versus the X/K group during this anesthetic period. During anesthesia for laparoscopy, mean CI and MBP ranged from 85 to 165 mL kg^?1 minute^?1 and 67–83 mm Hg, respectively, in the D/K group, and 98–171 mL kg^?1 minute^?1 and 48–67 mm Hg in the X/K group. Only HR, SAP, DAP, and MAP were significantly higher in the D/K group versus X/K group during this latter anesthetic period. There were no significant differences between groups during either surgical procedure for end‐tidal isoflurane, PaO₂, PaCO₂, or pH. In conclusion, anesthesia of foals for laparotomy and laparoscopy with diazepam/ketamine/isoflurane is associated with less hemodynamic depression than with xylazine/ketamine/isoflurane.     

Comparison of hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of anesthesia with isoflurane and halothane in horses undergoing arthroscopic surgery

OBJECTIVE: To compare hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of halothane and isoflurane in horses undergoing arthroscopic surgery. ANIMALS: 8 healthy adult horses. PROCEDURE: Anesthesia was maintained with isoflurane or halothane (crossover study). At 6 intervals during anesthesia and surgery, cardiopulmonary variables and related derived values were recorded. Recovery from anesthesia was assessed; gastrointestinal tract motility was subjectively monitored for 72 hours after anesthesia. Horses were administered chromium, and fecal chromium concentration was used to assess intestinal transit time. Venous blood samples were collected for clinicopathologic analyses before and 2, 24, and 48 hours after anesthesia. RESULTS: Compared with halothane-anesthetized horses, cardiac index, oxygen delivery, and heart rate were higher and systemic vascular resistance was lower in isoflurane-anesthetized horses. Mean arterial blood pressure and the dobutamine dose required to maintain blood pressure were similar for both treatments. Duration and quality of recovery from anesthesia did not differ between treatments, although the recovery periods were somewhat shorter with isoflurane. After isoflurane anesthesia, gastrointestinal motility normalized earlier and intestinal transit time of chromium was shorter than that detected after halothane anesthesia. Compared with isoflurane, halothane was associated with increases in serum aspartate transaminase and glutamate dehydrogenase activities, but there were no other important differences in clinicopathologic variables between treatments. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with halothane, isoflurane appears to be associated with better hemodynamic stability during anesthesia, less hepatic and muscle damage, and more rapid return of normal intestinal motility after anesthesia in horses undergoing arthroscopic procedures.     

A comparison of recovery times and characteristics with sevoflurane and isoflurane anaesthesia in horses undergoing magnetic resonance imaging

Objective To compare recovery times and quality following maintenance of anaesthesia with sevoflurane or isoflurane after a standard intravenous induction technique in horses undergoing magnetic resonance imaging (MRI). Study design Prospective, randomised, blinded clinical study. Animals One hundred ASA I/II horses undergoing MRI. Materials and methods Pre‐anaesthetic medication with intravenous acepromazine and romifidine was followed by induction of anaesthesia with diazepam and ketamine. The animals were randomised into two groups to receive either sevoflurane or isoflurane in oxygen. Horses were subjectively scored (0–5) for temperament before sedation, for quality of sedation, induction and maintenance and anaesthetic depth on entering the recovery area. Recoveries were videotaped and scored by an observer, unaware of the treatment, using two scoring systems. Times to the first movement, head lift, sternal recumbency and standing were recorded along with the number of attempts to achieve sternal and standing positions. Variables were compared using a Student t‐test or Mann–Whitney U‐test (p < 0.05), while the correlation between subjective recovery score and other relevant variables was tested calculating the Spearman Rank correlation coefficient and linear regression modelling performed when significant. Results Seventy‐seven horses entered the final analysis, 38 received isoflurane and 39 sevoflurane. Body mass, age and duration of anaesthesia were similar for both groups. There were no differences in recovery times, scoring or number of attempts to achieve sternal recumbency and standing between groups. Weak, but significant, correlations were found between the subjective recovery score for the pooled data from both groups and both temperament and time in sternal recumbency. Conclusions No differences in recovery times or quality were detected following isoflurane or sevoflurane anaesthesia after intravenous induction. Clinical relevance Sevoflurane affords no obvious advantage in recovery over isoflurane following a standard intravenous induction technique in horses not undergoing surgery.