Influence of Vaporizer Setting on Mask Induction of Dogs With Isoflurane Using an In-circuit Vaporizer

The speed of mask induction using an in-circuit vaporizer may be influenced by vaporizer setting. To investigate this in clinical patients, 18 dogs were randomly assigned to one of three groups. Each dog was premedicated and then mask induced with isoflurane using a Stephen's in-circuit vaporizer set at 1/2, 3/4, or full ON. We determined inspired isoflurane and oxygen concentrations at the level of the mask, respiratory rate, resistance to mask induction, and time to intubation. No significant differences were found between groups in resistance to induction or in time to intubation. At settings of 3/4 and full ON, inspired isoflurane concentrations at time of intubation ranged from 3.3% to 8.25%, and were significantly higher than those resulting from the 1/2 setting (range 2.1% to 4.6%). We conclude that it may be preferable to avoid settings greater than 1/2 when using the Stephen's vaporizer for mask induction because of the potential adverse effects of high inspired inhalant anesthetic concentrations. In addition, use of higher vaporizer settings may not significantly speed induction.     

Comparison of diazepam–ketamine and thiopentone for induction of anaesthesia in healthy dogs

Objective To compare the anaesthetic and cardiopulmonary effects of a diazepam–ketamine combination with thiopentone for induction of anaesthesia in dogs. Animal population Twenty healthy dogs of various breeds weighing between 3.8 and 42.6 kg undergoing major orthopaedic or soft tissue surgery. Materials and methods Pre‐anaesthetic medication in all cases was intramuscular acepromazine and methadone given 30 minutes before induction of anaesthesia. Each animal was then randomly assigned to receive either thiopentone or diazepam and ketamine. Quality of conditions for, and time to tracheal intubation were recorded. Anaesthesia was maintained with halothane in oxygen and nitrous oxide. Heart rate, respiratory rate, systolic blood pressure, end tidal carbon dioxide tensions and oxygen saturation were recorded at 10 minute intervals throughout surgery. The quality of recovery from anaesthesia was assessed. Results The quality of induction in both groups was satisfactory. The total mean time (± SD) to tracheal intubation (162 ± 84 seconds) was significantly longer in dogs receiving diazepam and ketamine compared to dogs receiving thiopentone (62 ± 28 seconds). Heart rate, systolic blood pressure and end tidal carbon dioxide concentration were not significantly different between groups. Respiratory rate was significantly higher in the diazepam–ketamine group between 0 and 30 minutes. The quality of recovery was similar in each group. Conclusions There appear to be fewer differences between the induction agents examined in this study than was previously believed. No pressor, or other cardiovascular stimulating effects were detected in the dogs that received diazepam and ketamine. Clinical relevance The absence of obvious differences between groups suggests that pre‐anaesthetic medication, inhaled anaesthetics and the physiological effects of surgery itself probably had a greater effect on the variables studied than the induction agent used. Further studies are required to determine whether diazepam and ketamine offers significant advantages over other induction agents in the unhealthy dog.     

The clinical use of the neuromuscular blocking agent rocuronium in dogs

Objective The aim of this study was to characterize the onset and duration of action of the aminosteroid muscle relaxant rocuronium in dogs under clinical conditions. Study design Prospective single dose trial. Animals Twenty‐three dogs aged between 6 months and 12 years, weighing between 5.5 and 61.5 kg admitted to the University of Liverpool Small Animal Hospital between January and March 2000, and undergoing elective surgical procedures under general anaesthesia. Materials and methods Following induction of general anaesthesia, neuromuscular function was evaluated using train‐of‐four (TOF) stimulation. An initial dose of 0.4 mg kg^?1 rocuronium was administered intravenously (IV) and neuromuscular blockade was monitored by visually assessing the number of responses (twitches) to TOF stimulation (train‐of‐four count: TOFC). Incremental doses of 0.16 mg kg^?1 rocuronium were administered as indicated, when at least two twitches of the TOFC had returned. Results Rocuronium (0.4 mg kg^?1) abolished all responses to TOF stimulation in all dogs. The mean time to onset of neuromuscular blockade (complete abolition of all twitches) was 98 ± 52 seconds. Neuromuscular blockade (absence of all twitches to return of all four) lasted 32.3 ± 8.2 minutes. Incremental doses of 0.16 mg kg^?1 had a mean duration of action of 20.8 ± 4.9 minutes and up to seven increments were shown to be noncumulative. The effects of rocuronium were readily antagonized with neostigmine and atropine. Small transient increases in arterial blood pressure, which occurred in three dogs after the administration of rocuronium, were the only cardiovascular side‐effects observed. Conclusions Rocuronium is an effective nondepolarizing neuromuscular blocking agent in the dog, with a rapid onset of neuromuscular block after intravenous administration and an intermediate duration of action. Clinical relevance Rocuronium produced a neuromuscular block with similar characteristics to those obtained with vecuronium, thus apparently offering little advantage over vecuronium. However, its availability in aqueous solution and a longer shelf‐life increases convenience.     

Propofol anaesthesia for surgery in late gestation pony mares

Objective To characterize propofol anaesthesia in pregnant ponies. Animals Fourteen pony mares, at 256 ± 49 days gestation, undergoing abdominal surgery to implant fetal and maternal vascular catheters. Materials and methods Pre‐anaesthetic medication with intravenous (IV) acepromazine (20 µg kg^?1), butorphanol (20 µg kg^?1) and detomidine (10 µg kg^?1) was given 30 minutes before induction of anaesthesia with detomidine (10 µg kg^?1) and ketamine (2 mg kg^?1) IV Maternal arterial blood pressure was recorded (facial artery) throughout anaesthesia. Arterial blood gas values and plasma concentrations of glucose, lactate, cortisol and propofol were measured at 20‐minute intervals. Anaesthesia was maintained with propofol infused initially at 200 µg kg^?1 minute^?1, and at 130–180 µg kg^?1 minute^?1 after 60 minutes, ventilation was controlled with oxygen and nitrous oxide to maintain PaCO₂ between 5.0 and 6.0 kPa (37.6 and 45.1 mm Hg) and PaO₂ between 13.3 and 20.0 kPa (100 and 150.4 mm Hg). During anaesthesia flunixin (1 mg kg^?1), procaine penicillin (6 IU) and butorphanol 80 µg kg^?1 were given. Lactated Ringer's solution was infused at 10 mL kg^?1 hour^?1. Simultaneous fetal and maternal blood samples were withdrawn at 85–95 minutes. Recovery from anaesthesia was assisted. Results Arterial blood gas values remained within intended limits. Plasma propofol levels stabilized after 20 minutes (range 3.5–9.1 µg kg^?1); disposition estimates were clearance 6.13 ± 1.51 L minute^?1 (mean ± SD) and volume of distribution 117.1 ± 38.9 L (mean ± SD). Plasma cortisol increased from 193 ± 43 nmol L^?1 before anaesthesia to 421 ± 96 nmol L^?1 60 minutes after anaesthesia. Surgical conditions were excellent. Fetal umbilical venous pH, PO₂ and PCO₂ were 7.35 ± 0.04, 6.5 ± 0.5 kPa (49 ± 4 mm Hg) and 6.9 ± 0.5 kPa (52 ± 4 mm Hg); fetal arterial pH, PO₂ and PCO₂ were 7.29 ± 0.06, 3.3 ± 0.8 kPa (25 ± 6 mm Hg) and 8.7 ± 0.9 kPa (65 ± 7 mm Hg), respectively. Recovery to standing occurred at 46 ± 17 minutes, and was generally smooth. Ponies regained normal behaviour patterns immediately. Conclusions and clinical relevance Propofol anaesthesia was smooth with satisfactory cardiovascular function in both mare and fetus; we believe this to be a suitable anaesthetic technique for pregnant ponies.     

A comparison of the 'Maxima' and the modified Ayre's T-piece breathing systems in spontaneously breathing cats

Objective To compare the fresh gas flow requirements of the ‘Maxima’ and Jackson‐Rees modified Ayre's T‐piece (JRMATP) in spontaneously breathing anaesthetized in cats. Study design Prospective randomized clinical study. Animals or sample population Fifteen adult cats (6 male, 9 female, 3.1 ± 0.4 kg [x? ± SD]). Materials & methods After pre‐anaesthetic medication with acepromazine and pethidine, anaesthesia was induced using thiopentone and the trachea was intubated with a cuffed endotracheal tube. This was attached to either a ‘Maxima’ or a JRMATP breathing system; allocation was randomized. Anaesthesia was maintained with halothane delivered in a 1 : 1 oxygen : nitrous oxide mixture. Initial total fresh gas flow (FGF) was set at 600 mL kg^?1 min^?1. After 20 minutes, FGF was reduced in increments of 200 mL min^?1 until rebreathing (inspired CO₂ concentration >0.2%) occurred. At this point, FGF was increased to 600 mL kg^?1 and the process was repeated with the other breathing system. The respiratory rate and airway pressure at the endotracheal tube connector were monitored throughout anaesthesia. Results The mean fresh gas flow that prevented rebreathing with the Maxima system (164 ± 39 mL kg^?1) was significantly less (p < 0.0001) than that required in the modified T‐piece (455 ± 0.77 mL kg^?1). Respiratory rates and airway pressures at the endotracheal tube connector were not significantly affected by breathing system employed. Conclusions In terms of the gas flow requirements that prevent rebreathing, the ‘Maxima’ breathing system is more efficient than the modified Ayre's T‐piece in spontaneously breathing cats anaesthetised with halothane.     

β-endorphin immunoreactivity during anaesthesia in equidae

Objective To determine the effects of surgery, hypoxia, hypercapnia and flunixin administration on plasma β‐endorphin immunoreactivity (BEI) in anaesthetized horses. Study design Prospective crossover study. Animals Six healthy adult Welsh Mountain ponies and seven healthy adult Thoroughbreds. Methods Ponies were anaesthetized with thiopentone and halothane or with pentobarbitone and the horses with guaiphenesin, thiopentone and halothane. Ponies were anaesthetized for 2 hours and on separate occasions underwent a period of hypoxia, hypercapnia, anaesthesia only, or were given flunixin at induction. The horses were anaesthetized for 2 hours and on separate occasions underwent surgery to relocate one carotid artery subcutaneously or anaesthesia only. Plasma samples were taken pre‐anaesthesia, at 20 minute intervals during, and after anaesthesia for BEI assay using radio‐immunoassay. Analysis of variance of the concentration‐time curve was used for statistical analysis. Results Pre‐anaesthetic β‐endorphin immunoreactivity (BEI) values ranged between 5.7 and 20.4 pmol L^?1. Induction of anaesthesia caused a five to 10 fold increase in mean plasma BEI in all cases except the hypercapnia group. Halothane anaesthesia increased BEI in ponies and horses but there were no significant changes during pentobarbitone anaesthesia. The increase in BEI in the hypoxic group was greater (peak value 136.8 ± 32.2 pmol L^?1) and sustained for a longer period compared with levels in those given halothane alone or in those which became hypercapnic. There was marked individual variation in the flunixin group and changes were not significant. Surgery in the horses resulted in the highest peak values in the study (182.5 ± 153.0 pmol L^?1) but the AUC was not significantly higher than in the same animals without surgery, where the peak value was 102.9 ± 42.1 pmol L^?1. Conclusions Beta‐endorphin appeared to be a sensitive marker of an endocrine stress response but its physiological role during equine anaesthesia is unknown. Clinical relevance Unknown.