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.     

Cardiovascular Effects of a Continuous Two-Hour Propofol Infusion in Dogs Comparison With Isoflurane Anesthesia

The cardiovascular effects during 2 hours of anesthesia with either a continuous propofol infusion or isoflurane were compared in the same six healthy dogs. Dogs were randomly assigned to be anesthetized with either propofol (5 mg/kg, IV administered over 30 seconds, immediately followed by a propofol infusion beginning at 0.4 mg/kg/min), or isoflurane (2.0% end-tidal concentration). The propofol infusion was adjusted to maintain a light plane of anesthesia. Dogs anesthetized with propofol had higher values for systemic arterial pressure due to higher systemic vascular resistance. Dogs anesthetized with isoflurane had higher values for heart rate and mean pulmonary artery pressure. Cardiac index was not different between the two groups. Apnea and cyanosis were observed during induction of anesthesia with propofol. At the end of anesthesia the mean time to extubation for dogs anesthetized with either propofol or isoflurane was 13.5 min and 12.7 min, respectively. A continuous infusion of propofol (0.44 mg/kg/min) provided a light plane of anesthesia. Ventilatory support during continuous propofol infusion is recommended.     

Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cats

OBJECTIVE: To compare cardiovascular effects of equipotent infusion doses of propofol alone and in combination with ketamine administered with and without noxious stimulation in cats. ANIMALS: 6 cats. PROCEDURE: Cats were anesthetized with propofol (loading dose, 6.6 mg/kg; constant rate infusion [CRI], 0.22 mg/kg/min) and instrumented for blood collection and measurement of blood pressures and cardiac output. Cats were maintained at this CRI for a further 60 minutes, and blood samples and measurements were taken. A noxious stimulus was applied for 5 minutes, and blood samples and measurements were obtained. Propofol concentration was decreased to 0.14 mg/kg/min, and ketamine (loading dose, 2 mg/kg; CRI, 23 microg/kg/min) was administered. After a further 60 minutes, blood samples and measurements were taken. A second 5-minute noxious stimulus was applied, and blood samples and measurements were obtained. RESULTS: Mean arterial pressure, central venous pressure, pulmonary arterial occlusion pressure, stroke index, cardiac index, systemic vascular resistance index, pulmonary vascular resistance index, oxygen delivery index, oxygen consumption index, oxygen utilization ratio, partial pressure of oxygen in mixed venous blood, pH of arterial blood, PaCO2, arterial bicarbonate concentration, and base deficit values collected during propofol were not changed by the addition of ketamine and reduction of propofol. Compared with propofol, ketamine and reduction of propofol significantly increased mean pulmonary arterial pressure and venous admixture and significantly decreased PaO2. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of propofol by CRI for maintenance of anesthesia induced stable hemodynamics and could prove to be clinically useful in cats.     

The effects of maternal plasma dobutamine levels on fetal oxygenation in anaesthetized sheep

Objective To measure the effects of dobutamine infusion on fetal oxygenation during isoflurane anaesthesia in pregnant ewes. Study design Prospective randomized experimental study. Animals Seven clinically normal adult pregnant Rambouillet‐Dorset cross ewes with fetuses of 117–122 days gestational age. Methods The ewes were anaesthetized with ketamine (2 mg kg^?1) IM, and isoflurane (F_E′ISO 2.0%) in oxygen. After instrumentation and stabilization, dobutamine was infused at 4 µg kg^?1minute^?1 for 60 minutes and 10 µg kg^?1minute^?1 for 60 minutes in random order, separated by a 20‐minute washout period. Catheters were placed in the maternal and fetal carotid arteries; these were used for continuous blood pressure measurement and intermittent blood sampling. Results Maternal mean systemic carotid arterial pressure was 60 mm Hg prior to dobutamine infusion. After 5 minutes of dobutamine infusion, fetal oxygen saturation increased (p < 0.05) from 0.62 (0.17–0.71, minimum–maximum) to 0.72 (0.28–0.78) at a dose of 4 µg kg^?1minute^?1 and to 0.70 (0.20–0.73) at a dose of 10 µg kg^?1minute^?1. These increases were maintained during the infusion and were not significantly different between doses. Maternal oxygen saturation remained constant at 1.0 before and during all infusions. Although maternal heart rate and blood pressure increased (p < 0.05) by 90% and 25%, respectively, with dobutamine, this stimulant effect was not evident in the corresponding fetal variables. Maternal haemoglobin concentration increased 30% (p < 0.05) with each infusion. Conclusions Dobutamine at 4 µg kg^?1minute^?1 increases fetal oxygenation that is not improved by a dose of 10 µg kg^?1minute^?1. This increase is largely due to an increase in maternal haemoglobin concentration that, in turn, increases oxygen delivery to the placenta. Clinical relevance The use of dobutamine to treat hypotension in pregnant sheep during isoflurane anaesthesia improves fetal oxygenation. This may be true in other species.     

Effects of dobutamine on cardiac index and arterial blood pressure in isoflurane-anaesthetized horses under clinical conditions

Volatile agent-induced hypotension may contribute to anaesthetic-related morbidity and mortality in horses. Dobutamine is commonly used to support arterial blood pressure (ABP) but little is known about its cardiovascular effects under clinical conditions. The aim of this clinical study was to elucidate the relationship between cardiovascular function and dobutamine infusion in isoflurane-anaesthetized horses. Forty-four horses anaesthetized for a variety of surgical procedures were studied. Premedication with acepromazine, methadone and detomidine was followed by induction of anaesthesia with ketamine and midazolam. Anaesthesia was maintained with isoflurane vaporized in oxygen. Routine anaesthetic monitoring was applied and cardiac output was measured by lithium dilution. Dobutamine was infused to maintain mean ABP above 70 mmHg. The relationship between dobutamine infusion rate, heart rate (HR), ABP and cardiac index was investigated immediately prior to ( T ₀) and 15 min ( T ₁) after dobutamine infusion started, followed at 30 min intervals ( T ₂, etc.). Arterial blood pressure increased significantly after dobutamine infusion started, HR and cardiac index increased significantly only with dobutamine infusion in combination with surgical stimulus. Although isoflurane decreases blood pressure mainly by vasodilation, dobutamine is an effective treatment for hypotension under clinical conditions in isoflurane-anaesthetized horses. The effect of dobutamine is not directly proportional to dose and surgical stimulus probably contributes to the cardiovascular improvement.     

Effects of propofol-sevoflurane anesthesia on the maternal and fetal hemodynamics blood gases, and uterine activity in pregnant goats

To determine the effects of propofol and sevoflurane on hemodynamics, acid-base balance and uterine activity in pregnant animals, a prospective experimental study was designed by use of ten pregnant goats. Propofol was intravenously administered at a bolus dose of 5 mg/kg and then infused a rate of 0.3 mg/kg/min for 5 min. Following the induction, the animals were incrementally inhaled 2.7 and 4.1% of end-tidal concentration of sevoflurane each for 30 min, and then recovered. The maternal and fetal heart rate (HR), arterial blood pressure (BP) and acid-base balance, the intrauterine pressure (IUP), and the uterine blood flow (UBF) were measured. Following the pre-anesthetic data, the parameters were measured 7 times throughout the anesthetic and recovering periods. The propofol infusion induced 1.37 times of HR increase and produced decrease in PO(2) and a relevant metabolic acidemia in the mother, with no effect in the fetus. Sevoflurane reduced BP in the fetus from 30 (2.7%) to 60 (4.1%) min of inhalation. The uterine contractions disappeared throughout sevoflurane inhalation, and then recurred within 15 min after the cessation of sevoflurane. Propofol injection increases HR, and induces a moderate hypoxemia and metabolic acidemia associated with the suppressed ventilation for pregnant goats, with less effect on the fetal hemodinamics. Sevoflurane causes minimal change in maternal hemodynamics, but induces significant hypotension in the fetus and reduction of uterine activity. These data may be useful in making anesthetic choices combined with analgesia for Caesarian section in goats.     

Maternal and fetal effects of propofol anaesthesia in the pregnant ewe

The objective of this study was to determine the effects of propofol (PRF) on maternal and fetal cardiopulmonary function during the last trimester of pregnancy. Six pregnant 2-3 year-old Ripollesa sheep, each weighing 78+/-8 kg were used in the study and prepared by placing catheters in the maternal jugular vein and carotid artery. A catheter was also placed in the fetal femoral artery. Twenty-four hours later the sheep were anaesthetized with PRF (6 mg/kg intravenous (IV) followed by a continuous infusion at a rate of 0.4 mg/kg/min for 60 min) and cardiopulmonary data collected. Further data were collected for 105 min following termination of the infusion. The maternal mean arterial pressure (MAP) and diastolic arterial pressure (DAP) were significantly decreased (P<0.05) during the first 15 min of the infusion period, while the maternal pH was also significantly decreased. Maternal PaCO(2) and PaO(2) were significantly increased throughout the total infusion period. It was further observed that the fetal pH decreased significantly, throughout the infusion period, whereas the fetal MAP, DAP and PaCO(2) were significantly increased during the first 15 min of the infusion, after which time all parameters returned to control values. No differences in either maternal or fetal parameters were observed between control and recovery times.     

Yohimbine/flumazenil antagonism of hemodynamic alterations induced by a combination of midazolam, xylazine, and butorphanol in dogs.

Reversal of hemodynamic alterations induced by midazolam maleate (1.0 mg/kg of body weight), xylazine hydrochloride (0.44 mg/kg), and butorphanol tartrate (0.1 mg/kg) with yohimbine (0.1 mg/kg) and flumazenil (0.25 mg/kg) was evaluated in 5 dogs. The dogs were anesthetized with isoflurane for instrumentation. With return to consciousness, baseline values were recorded, and the midazolam/xylazine/butorphanol mixture with glycopyrrolate was administered IV. Hemodynamic data were recorded for 60 minutes, and then a reversal mixture of yohimbine and flumazenil was administered IV. All variables were measured 1 minute from beginning of the reversal injection. Mean arterial pressure, pulmonary arterial pressure, systemic vascular resistance, and right ventricular stroke work index increased significantly (P < 0.05) above baseline at 60 minutes. Cardiac index and central venous pressure significantly decreased below baseline at 60 minutes. After reversal, mean arterial pressure and central venous pressure significantly decreased from baseline, whereas cardiac index, pulmonary arterial pressure, and right ventricular stroke work index increased significantly above baseline. Heart rate, cardiac index, and right ventricular stroke work index increased significantly above the 60-minute value after reversal. Mean arterial pressure and systemic vascular resistance decreased significantly (P < 0.05) below the 60-minute value after reversal. The hemodynamic alterations accompanying midazolam/xylazine/butorphanol sedation-anesthesia may be rapidly reversed with a combination of yohimbine and flumazenil.     

A comparison in dogs of medetomidine,with or without MK‐467, and the combination acepromazine‐butorphanol as premedication prior to anaesthesia induced by propofol and maintained with isoflurane

ObjectiveTo compare the haemodynamic effects of three premedicant regimens during propofol-induced isoflurane anaesthesia.Study designProspective, randomized cross-over study.AnimalsEight healthy purpose-bred beagles aged 4 years and weighing mean 13.6 ± SD 1.9 kg.MethodsThe dogs were instrumented whilst under isoflurane anaesthesia prior to each experiment, then allowed to recover for 60 minutes. Each dog was treated with three different premedications given intravenously (IV): medetomidine 10 μg kg^?1 (MED), medetomidine 10 μg kg^?1 with MK-467 250 μg kg^?1 (MMK), or acepromazine 0.01 mg kg^?1 with butorphanol 0.3 mg kg^?1 (AB). Anaesthesia was induced 20 minutes later with propofol and maintained with isoflurane in oxygen for 60 minutes. Heart rate (HR), cardiac output, arterial blood pressures (ABP), central venous pressure (CVP), respiratory rate, inspired oxygen fraction, rectal temperature (RT) and bispectral index (BIS) were measured and arterial and venous blood gases analyzed. Cardiac index (CI), systemic vascular resistance index (SVRI), oxygen delivery index (DO₂I), systemic oxygen consumption index (VO₂I) and oxygen extraction (EO₂) were calculated. Times to extubation, righting, sternal recumbency and walking were recorded. The differences between treatment groups were evaluated with repeated measures analysis of covariance.ResultsHR, CI, DO₂I and BIS were significantly lower with MED than with MMK. ABP, CVP, SVRI, EO₂, RT and arterial lactate were significantly higher with MED than with MMK and AB. HR and ABP were significantly higher with MMK than with AB. However, CVP, CI, SVRI, DO₂I, VO₂I, EO₂, T, BIS and blood lactate did not differ significantly between MMK and AB. The times to extubation, righting, sternal recumbency and walking were significantly shorter with MMK than with MED and AB.Conclusions and clinical relevanceMK-467 attenuates certain cardiovascular effects of medetomidine in dogs anaesthetized with isoflurane. The cardiovascular effects of MMK are very similar to those of AB.     

Baggs ewes adapt to maternal undernutrition and maintain conceptus growth by maintaining fetal plasma concentrations of amino acids

Adequate delivery of AA is essential for normal fetal growth and development. Recently, we reported that when ewes from the University of Wyoming flock (farm flock with adequate nutrition) were fed 50% (nutrient-restricted) or 100% (control-fed) of the NRC-recommended nutrient requirements between d 28 and 78 of gestation, fetal weights as well as concentrations of most AA in maternal and fetal blood were substantially reduced in nutrient-restricted vs. control-fed pregnancies. The current study utilized Baggs ewes, which were selected under a markedly different production system (range flock with limited nutrition), to test the hypothesis that adaptation of ewes to nutritional and environmental changes may alter placental efficiency and conceptus nutrient availability in the face of maternal nutrient restriction. Baggs ewes received 50 or 100% of the NRC nutrient requirements between d 28 and 78 of pregnancy. On d 78, maternal uterine arterial and fetal umbilical venous blood samples were obtained, and the ewes were euthanized. Amino acids and their metabolites (ammonia, urea, and polyamines) in plasma were analyzed using enzymatic and HPLC methods. The results showed that maternal plasma concentrations of 9 AA (Asp, Ile, Leu, Lys, Orn, Phe, Thr, Trp, and Val) as well as maternal and fetal plasma concentrations of ammonia and urea were reduced (P < 0.05) in nutrient-restricted compared with control-fed Baggs ewes. However, fetal plasma concentrations of all AA and polyamines did not differ (P = 0.842) between the 2 groups of ewes. Collectively, these findings suggest that Baggs ewes, by adapting to the harsh conditions and limited nutrition under which they were selected, were able to maintain fetal concentrations of AA in the face of a maternal nutrient restriction through augmenting placental efficiency.     

Uterine blood flow during early pregnancy in ewes: interaction between the conceptus and the ovary bearing the corpus luteum

To determine if a transient increase in uterine blood flow (BF) and estradiol-17 beta (E2 beta) secretion occurs during maternal recognition of pregnancy in ewes (as previously observed for sows and cows), 40 nonpregnant (NP) ewes were assigned in equal numbers to surgery on d 9, 11, 13 or 15 postestrus (d 0 = day of estrus). For 20 NP ewes (five/day), each uterine horn (UH) was flushed with saline and uterine flushings (UF) collected. For the remaining 20 ewes, BF was determined for each UH using electromagnetic transducers, and samples of uterine arterial (UA) and uterine venous (UV) blood were obtained from each UH. After an intervening cycle, each ewe was mated, subjected to surgery on the same day postmating as during her previous nonmated cycle, and BF measurements and UA and UV samples were obtained. In addition, each UH of pregnant (P) ewes was flushed and the location of conceptuses was determined. Concentrations of E2 beta and progesterone (P4) in UA and E2 beta in UV and UF were determined by radioimmunoassay. For NP ewes, BF (ml/min) was not different for UH ipsilateral or contralateral to the ovary bearing the corpus luteum (CL), and did not differ across days, averaging 6.5 +/- .4. For P ewes, BF to UH contralateral to the ovary bearing the CL on all days and BF to UH ipsilateral to ovaries bearing CL on d 9 was similar to BF of either UH of NP ewes, averaging 6.8 +/- .6. On d 11, 13 and 15 of pregnancy, BF to UH ipsilateral to the ovary bearing CL was elevated (P less than .01) twofold (13.3 +/- .9).(ABSTRACT TRUNCATED AT 250 WORDS)     

Anaesthetic and cardiorespiratory effects of a constant rate infusion of fentanyl in isoflurane‐anaesthetized sheep

ObjectiveTo determine the anaesthetic and cardiorespiratory effects of a constant rate infusion of fentanyl in sheep anaesthetized with isoflurane and undergoing orthopaedic surgery.Study designProspective, randomised, ‘blinded’ controlled study.AnimalsTwenty healthy sheep (weight mean 41.1 ± SD 4.5 kg).MethodsSheep were sedated with intravenous (IV) dexmedetomidine (4 μg kg⁻¹) and morphine (0.2 mg kg⁻¹). Anaesthesia was induced with propofol (1 mg kg⁻¹ minute⁻¹ to effect IV) and maintained with isoflurane in oxygen and a continuous rate infusion (CRI) of fentanyl 10 μg kg⁻¹ hour⁻¹ (group F) or saline (group P) for 100 minutes. The anaesthetic induction dose of propofol, isoflurane expiratory fraction (Fe’iso) required for maintenance and cardiorespiratory measurements were recorded and blood gases analyzed at predetermined intervals. The quality of recovery was assessed. Results were compared between groups using t-tests or Mann–Whitney as relevant.ResultsThe propofol induction dose was 4.7 ± 2.4 mg kg⁻¹. Fe’iso was significantly lower (by 22.6%) in group F sheep than group P (p = 0). Cardiac index (mean ± SD mL kg⁻¹ minute⁻¹) was significantly (p = 0.012) lower in group F (90 ± 15) than group P (102 ± 35). Other measured cardiorespiratory parameters did not differ statistically significantly between groups. Recovery times and recovery quality were statistically similar in both groups.Conclusions and clinical relevanceFentanyl reduced isoflurane requirements without clinically affecting the cardiorespiratory stability or post-operative recovery in anaesthetized sheep undergoing orthopaedic surgery.     

Cardiac output and other hemodynamic variables in anesthetized dogs undergoing laparotomy because of abdominal neoplasia

OBJECTIVE: To measure cardiac output and other hemodynamic variables in anesthetized dogs undergoing laparotomy because of abdominal neoplasia. DESIGN: Prospective case series. ANIMALS: 8 dogs with splenic or hepatic tumors. PROCEDURES: Dogs were anesthetized and underwent abdominal laparotomy. End-tidal isoflurane concentration, heart rate, arterial blood pressures, cardiac output, arterial pH, blood gas partial pressures, PCV, and plasma total protein concentration were measured at set intervals before, during, and after surgery. Cardiac index, stroke index, and systemic vascular resistance index were calculated. RESULTS: End-tidal isoflurane concentration was lowest before and after surgery. Heart rate did not change significantly throughout the anesthetic period. Arterial blood pressures and systemic vascular resistance index were highest shortly after surgery began; cardiac index and stroke volume index did not change significantly during surgery but increased significantly after surgery ended. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that in dogs undergoing laparotomy because of abdominal neoplasia, changes in arterial blood pressures were not necessarily indicative of qualitatively similar changes in cardiac index.     

Hemodynamic effects of target-controlled infusion of propofol alone or in combination with a constant-rate infusion of remifentanil in dogs

The objective of this study was to evaluate the hemodynamic effects of target-controlled infusion (TCI) of propofol alone or in combination with a constant-rate infusion (CRI) of remifentanil. Six adult dogs were given 2 treatments in a randomized crossover study with a 7-day interval between treatments. Treatment 1 was propofol (P) and treatment 2 was propofol and remifentanil (P-Rem), without any premedication. Propofol was induced using a TCI system with a predicted plasma concentration (Cp) of 6.0 μg/mL. Anesthesia was maintained within the Cp range (0.65 to 3.0 μg/mL) for 120 min and remifentanil was administered at a rate of 0.3 μg/kg body weight (BW) per minute, CRI. Cardiopulmonary variables were recorded before (baseline), during, and 120 min after drug administration. Heart rate (HR) decreased significantly in the P-Rem group (46%) compared with baseline values. In the P-Rem group, the cardiac index (CI) decreased significantly (49% to 58%) and the stroke volume (SV) decreased compared with baseline values. The systemic vascular resistance index (SVRI) increased significantly in the P-Rem group compared with baseline values. There was no difference in mean arterial pressure (MAP) between the groups. Central venous pressure (CVP) and pulmonary artery occlusion pressure (PAOP) significantly increased in the P-Rem group compared with baseline values. In conclusion, the hemodynamic changes observed in this study indicate a compromise of the cardiovascular system, although the dogs in this study were healthy/euvolemic and there was no change in preload. More studies are required in order to evaluate the actual safety of the combination of propofol and remifentanil in patients with reduced cardiac reserve.     

Some cardiopulmonary effects of midazolam premedication in clenbuterol-treated bitches during surgical endoscopic examination of the uterus and ovariohysterectomy

Midazolam was administered intravenously to 8 bitches in a randomised, placebo-controlled clinical trial before propofol induction of surgical anaesthesia. Anaesthesia was maintained with isoflurane-in-oxygen during surgical endoscopic examination of the uterus and ovariohysterectomy. Clenbuterol was administered at the start of surgery to improve uterine muscle relaxation, and to facilitate endoscopic examination of the uterus. Ventilation was controlled. Induction of anaesthesia with propofol to obtain loss of the pedal reflex resulted in a statistically significant (P < 0.05) decrease in minute volume and arterial oxygen partial pressure in the midazolam group. Apnoea also occurred in 50% of dogs in the midazolam group. The dose for propofol in the midazolam group was 7.4 mg/kg compared to 9.5 mg/kg in the control. Minute volume was significantly (P < 0.05) higher in both groups during isoflurane maintenance, compared to the value after incremental propofol to obtain loss of the pedal reflex. Propofol induction resulted in a 25-26% reduction in the mean arterial blood pressure in both groups, and the administration of clenbuterol at the start of surgery resulted in a transient, but statistically significant (P < 0.05), decrease in mean arterial blood pressure in the midazolam group during isoflurane anaesthesia. It is concluded that intravenous midazolam premedication did not adversely affect cardiovascular function during propofol induction, but intra-operative clenbuterol during isoflurane maintenance of anaesthesia may result in transient hypotension. Midazolam premedication may increase adverse respiratory effects when administered before propofol induction of anaesthesia.     

Hemodynamic effects of intravenous lidocaine in isoflurane anesthetized cats

Lidocaine dose‐dependently decreases the minimum alveolar concentration (MAC) of isoflurane in cats. The purpose of this study was to determine the hemodynamic effects of six lidocaine plasma concentrations in isoflurane anesthetized cats. Six cats were studied. After instrumentation, end‐tidal isoflurane concentration was set at 1.25 times the individual minimum alveolar concentration (MAC), which was determined in a previous study. Lidocaine was administered intravenously to target pseudo‐steady state plasma concentrations of 0, 3, 5, 7, 9, and 11 μg ml^–1, and isoflurane concentration was reduced to an equipotent concentration, determined in a previous study. Cardiovascular variables; blood gases; PCV; total protein and lactate concentrations; and lidocaine and monoethylglycinexylidide concentrations were measured at each lidocaine target concentration, before and during noxious stimulation. Derived variables were calculated. Data were analyzed using a repeated measures anova , followed by a Tukey test for pairwise comparisons where appropriate. One cat was excluded from analysis because the study was aborted at 7 μg ml^–1 due to severe cardiorespiratory depression. Heart rate, cardiac index, stroke index, right ventricular stroke work index, total protein concentration, mixed‐venous PO₂ and hemoglobin oxygen saturation, arterial and mixed‐venous bicarbonate concentrations, and oxygen delivery were significantly lower during lidocaine administration than when no lidocaine was administered. Mean arterial pressure, central venous pressure, pulmonary artery pressure, systemic and pulmonary vascular resistance indices, PCV, arterial and mixed‐venous hemoglobin concentrations, lactate concentration, arterial oxygen concentration, and oxygen extraction ratio were significantly higher during administration of lidocaine than when no lidocaine was administered. Most changes were significant at lidocaine target plasma concentrations of 7 μg ml^–1 and above. Noxious stimulation did not significantly affect most variables. Despite significantly decreasing in inhalant requirements, when combined with isoflurane, lidocaine produces greater cardiovascular depression than an equipotent dose of isoflurane alone. The use of lidocaine to reduce isoflurane requirements is not recommended in cats.     

Hemodynamic effects of nitrous oxide in isoflurane-anesthetized cats

OBJECTIVE: To determine the hemodynamic effects of nitrous oxide in isoflurane-anesthetized cats. ANIMALS: 12 healthy adult domestic shorthair cats. PROCEDURE: Cats were anesthetized by administration of isoflurane in oxygen. After instruments were inserted, end-tidal isoflurane concentration was set at 1.25 times the individual minimum alveolar concentration, and nitrous oxide was administered in a Latin-square design at 0, 30, 50, and 70%. Each concentration was administered for 25 minutes before measurements were obtained to allow for stabilization. Heart rate; systemic and pulmonary arterial pressures; central venous pressure; pulmonary artery occlusion pressure; cardiac output; body temperature; arterial and mixed-venous pH, PCO2, PO2, and hemoglobin concentrations; PCV; and total protein and lactate concentrations were measured before and during noxious stimulation for each nitrous oxide concentration. Arterial and mixed-venous bicarbonate concentrations and oxygen saturation, cardiac index, stroke index, rate-pressure product, systemic and pulmonary vascular resistance indices, left and right ventricular stroke work indices, arterial and mixed-venous oxygen contents, oxygen delivery, oxygen consumption, oxygen extraction ratio, alveolar-to-arterial oxygen difference, and venous admixture were calculated. RESULTS: Arterial pressure, central venous pressure, pulmonary arterial pressure, rate-pressure product, systemic and pulmonary vascular resistance indices, arterial PCO2, and PCV increased during administration of 70% nitrous oxide. Arterial and mixed-venous pH, mixed-venous PO2, and alveolar-to-arterial oxygen difference decreased during administration of 70% nitrous oxide. Results before and during noxious stimulation were similar. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of 70% nitrous oxide to isoflurane-anesthetized cats resulted in improved arterial pressure, which was related to a vasoconstrictive effect.     

Comparison of isoflurane and propofol for maintenance of anesthesia in dogs with intracranial disease undergoing magnetic resonance imaging

ObjectiveTo compare isoflurane and propofol for maintenance of anesthesia and quality of recovery in client-owned dogs with intracranial disease undergoing magnetic resonance imaging (MRI).Study designProspective, randomized, clinical trial.AnimalsTwenty-five client-owned dogs with intracranial pathology, 13 females and 12 males, ages 11 months to 13 years, weighing between 3.0 and 48.0 kg.MethodsEach dog was randomly assigned to receive propofol or isoflurane for maintenance of anesthesia. All dogs were not premedicated, were administered propofol intravenously to effect for induction, intubated and mechanically ventilated to maintain an end-tidal carbon dioxide tension 30–35 mmHg (4.0–4.7 kPa). Temperature and cardiac output were measured pre- and post-MRI. Scores for mentation, neurological status, ease of maintenance, and recovery were obtained pre- and post-anesthesia. Pulse oximetry, end-tidal gases, arterial blood pressure, heart rate (HR) and requirements for dopamine administration to maintain mean arterial pressure (MAP) >60 mmHg were recorded throughout anesthesia.ResultsEnd-tidal isoflurane concentration was 0.73 ± 0.35% and propofol infusion rate was 292 ± 119 μg kg^?1 minute^?1. Cardiac index was higher, while HR was lower, with propofol than isoflurane in dogs younger than 5 years, but not in older dogs. Dogs maintained with isoflurane were 14.7 times more likely to require dopamine than propofol dogs. Mentation and maintenance scores and temperature were not different. MAP and diastolic arterial pressure were higher in the propofol group. Recovery scores were better with propofol, although times to extubation were similar. Change in neurological score from pre- to post-anesthesia was not different between treatments.ConclusionsDogs maintained with propofol during MRI had higher arterial pressures, decreased requirements for dopamine, and better recovery scores, compared to dogs maintained with isoflurane.Clinical relevancePropofol anesthesia offered cardiovascular and recovery advantages over isoflurane during MRI in dogs with intracranial disease in this study.     

Assessment of the hemodynamic effects of lidocaine administered IV in isoflurane-anesthetized cats

OBJECTIVE:To determine the hemodynamic effects of lidocaine (administered IV to achieve 6 plasma concentrations) in isoflurane-anesthetized cats. ANIMALS: 6 cats. PROCEDURE: Cats were anesthetized with isoflurane in oxygen (end-tidal isoflurane concentration set at 1.25 times the predetermined individual minimum alveolar concentration). Lidocaine was administered IV to each cat to achieve target pseudo-steady-state plasma concentrations of 0, 3, 5, 7 9, and 11 microg/mL, and isoflurane concentration was reduced to an equipotent concentration. At each plasma lidocaine concentration, cardiovascular and blood gas variables; PCV; and plasma total protein, lactate, lidocaine, and monoethylglycinexylidide concentrations were measured in cats before and during noxious stimulation. Derived variables were calculated. RESULTS: n isoflurane-anesthetized cats, heart rate, cardiac index, stroke index, right ventricular stroke work index, plasma total protein concentration, mixed-venous PO2 and hemoglobin oxygen saturation, arterial and mixed-venous bicarbonate concentrations, and oxygen delivery were significantly lower during lidocaine administration, compared with values determined without lidocaine administration. Mean arterial pressure, central venous pressure, pulmonary artery pressure, systemic and pulmonary vascular resistance indices, PCV, arterial and mixed-venous hemoglobin concentrations, plasma lactate concentration, arterial oxygen concentration, and oxygen extraction ratio were significantly higher during administration of lidocaine, compared with values determined without lidocaine administration. Noxious stimulation did not significantly affect most variables. CONCLUSIONS AND CLINICAL RELEVANCE: In isoflurane-anesthetized cats, although IV administration of lidocaine significantly decreased inhalant requirements, it appeared to be associated with greater cardiovascular depression than an equipotent dose of isoflurane alone. Administration of lidocaine to reduce isoflurane requirements is not recommended in cats.     

Influence of a constant rate infusion of dexmedetomidine on cardiopulmonary function and recovery quality in isoflurane anaesthetized horses

ObjectiveTo investigate the influence of a dexmedetomidine constant rate infusion (CRI) in horses anaesthetized with isoflurane.Study designProspective, randomized, blinded, clinical study.AnimalsForty adult healthy horses (weight mean 491 ± SD 102 kg) undergoing elective surgery.MethodsAfter sedation [dexmedetomidine, 3.5 μg kg^?1 intravenously (IV)] and induction IV (midazolam 0.06 mg kg^?1, ketamine 2.2 mg kg^?1), anaesthesia was maintained with isoflurane in oxygen/air (FiO₂ 55–60%). Horses were ventilated and dobutamine was administered when hypoventilation [arterial partial pressure of CO₂ > 8.00 kPa (60 mmHg)] and hypotension [arterial pressure 70 mmHg] occurred respectively. During anaesthesia, horses were randomly allocated to receive a CRI of dexmedetomidine (1.75 μg kg^?1 hour^?1) (D) or saline (S). Monitoring included end-tidal isoflurane concentration, cardiopulmonary parameters, and need for dobutamine and additional ketamine. All horses received 0.875 μg kg^?1 dexmedetomidine IV for the recovery period. Age and weight of the horses, duration of anaesthesia, additional ketamine and dobutamine, cardiopulmonary data (anova), recovery scores (Wilcoxon Rank Sum Test), duration of recovery (t-test) and attempts to stand (Mann–Whitney test) were compared between groups. Significance was set at p < 0.05.ResultsHeart rate and arterial partial pressure of oxygen were significantly lower in group D compared to group S. An interaction between treatment and time was present for cardiac index, oxygen delivery index and systemic vascular resistance. End-tidal isoflurane concentration and heart rate significantly increased over time. Packed cell volume, systolic, diastolic and mean arterial pressure, arterial oxygen content, stroke volume index and systemic vascular resistance significantly decreased over time. Recovery scores were significantly better in group D, with fewer attempts to stand and significantly longer times to sternal position and first attempt to stand.Conclusions and clinical relevance A dexmedetomidine CRI produced limited cardiopulmonary effects, but significantly improved recovery quality.