Effects of an alveolar recruitment maneuver on cardiovascular and respiratory parameters during total intravenous anesthesia in ponies

OBJECTIVE: To evaluate pulmonary and cardiovascular effects of a recruitment maneuver (RM) combined with positive end-expiratory pressure (PEEP) during total intravenous anesthesia in ponies. ANIMALS: 6 healthy adult Shetland ponies. PROCEDURE: After premedication with detomidine (10 microg/kg, IV), anesthesia was induced with climazolam (0.06 mg/kg, IV) and ketamine (2.2 mg/kg, IV) and maintained with a constant rate infusion of detomidine (0.024 mg/kg/h), climazolam (0.036 mg/kg/h), and ketamine (2.4 mg/kg/h). The RM was preceded by an incremental PEEP titration and followed by a decremental PEEP titration, both at a constant airway pressure difference (deltaP) of 20 cm H2O. The RM consisted of a stepwise increase in deltaP by 25, 30, and 35 cm H2O obtained by increasing peak inspiratory pressure (PIP) to 45, 50, and 55 cm H2O, while maintaining PEEP at 20 cm H2O. Hemodynamic and pulmonary variables were analyzed at every step of the PEEP titration-RM. RESULTS: During the PEEP titration-RM, there was a significant increase in PaO 2 (+12%), dynamic compliance (+ 62%), and heart rate (+17%) and a decrease in shunt (-19%) and mean arterial blood pressure (-21%) was recorded. Cardiac output remained stable. CONCLUSIONS AND CLINICAL RELEVANCE: Although baseline oxygenation was high, Pa(O2) and dynamic compliance further increased during the RM. Despite the use of high PIP and PEEP and a high tidal volume, limited cardiovascular compromise was detected. A PEEP titration-RM may be used to improve oxygenation in anesthetized ponies. During stable hemodynamic conditions, PEEP titration-RM can be performed with acceptable adverse cardiovascular effects.     

Cardiopulmonary effects of sufentanil long acting on sevoflurane anaesthesia in dogs

OBJECTIVE: To evaluate the cardiopulmonary effects of sufentanil long acting (SLA) in sevoflurane-anaesthetized dogs. STUDY DESIGN: Randomized prospective study. Animals Forty female dogs (beagles) aged 1-2 years, weighing 11.97 +/- 1.40 kg. MATERIALS AND METHODS: The dogs were divided into five groups of eight. Two control groups were used: group A received intramuscular (IM), SLA (50 microg kg(-1)) alone, while group B received the SLA vehicle followed by sevoflurane anaesthesia for 90 minutes. In the other groups, SLA (50 microg kg(-1) IM) was given immediately before (group C(0)), 15 minutes before (group D(15)) or 30 minutes (group E(30)) before induction [with intravenous (IV) thiopental] of sevoflurane anaesthesia lasting for 90 minutes. Heart rate, arterial blood pressure, respiratory rate (f(r)), arterial oxygen haemoglobin saturation and end-tidal sevoflurane concentration (Fe'SEVO) were measured every 10 minutes during anaesthesia and at 2, 4 and 24 hours after induction (not Fe'SEVO). Acid-base and blood gas analyses were performed. RESULTS: Sufentanil LA reduced heart rate and increased arterial CO(2) tensions during anaesthesia. Respiratory depression was least in group E(30) compared with groups C(0) and D(15). Bradycardia was present for at least 24 hours. Respiratory rate was least in group B although arterial O(2) and CO(2) tension values were acceptable up to 24 hours after anaesthesia. CONCLUSIONS: Pre-anaesthetic medication with SLA moderately aggravated the cardiopulmonary effects of sevoflurane. CLINICAL RELEVANCE: In spite of a moderate depressant effect on cardiorespiratory parameters, SLA may be of use as pre-anaesthetic medication before sevoflurane anaesthesia in dogs. Intermittent positive pressure ventilation may occasionally be necessary.     

Evaluation of variables to describe the shape of volumetric capnography curves during bronchoconstriction in dogs

The aim of the study was to investigate changes in volumetric capnography (V(C)) variables during bronchoconstriction in dogs and compare it with total respiratory resistance (R(L)) measured with a Fleisch pneumotachograph. Six dogs were challenged with increasing concentrations of carbachol until obvious signs of bronchoconstriction were seen. All V(C) parameters were obtained before, directly after, 10 and 20 min after maximal bronchoconstriction. The slope of phase III (SIII) and airway and alveolar dead space parameters were significantly different from baseline directly after the challenge. The V(C) curve obtained a typical shape at the time of maximal bronchoconstriction and a trend to return to baseline shape was seen over time. A significant correlation was found for all aforementioned parameters with R(L). We conclude that the shape of the V(C) curve in combination with dead space calculation can be used to verify bronchoconstriction on a breath-to-breath basis.     

Hyperosmolar hyperglycaemic syndrome in a dog resulting from parenteral nutrition overload

Blood glucose reached 44 mmoi/iitre and the plasma osmoiality was estimated to be more than 334 mOsm/iitre. Lipaemia was severe and persisted for several days. The dog developed nausea, infusion o f a p'irenteral nutrition solution.     

The influence of methane on the infrared measurement of halothane in the horse

Using two types of infrared anaesthetic analysers (Capnomac, Datex, Finland and Anaesthetic Gas Monitor [AGM] 1304, Bruel & Kjaer, Denmark) simultaneous measurements were made of halothane and methane concentrations in the expired gases from nine anaesthetised horses. Methane concentrations varied from 232 to 1770 ppm. The Capnomac gave halothane readings 0.35 to 4.5 per cent higher than those given by the other analyser. A highly significant linear relationship (r = 0.87) was found between this difference and the concentration of methane in the anaesthetic circuit. This linear relationship was confirmed by an in vitro study using methane-air mixtures containing approximately 500 to 2,500 ppm of methane and analysed in both the halothane and isoflurane measuring modes of the analysers. The AGM 1304 was totally unaffected by methane. We concluded that monitors with absorption in the upper end of the infrared spectrum are preferable for measuring the concentration of inhalation agents in low-flow anaesthetic systems.     

Potential of Nepalese entomopathogenic nematodes as biocontrol agents against <Emphasis Type="Italic">Holotrichia longipennis</Emphasis> Blanch. (Coleoptera: Scarabaeidae)

Holotrichia longipennis Blanch. (Coleoptera: Scarabaeidae) is a serious pest of commercial crops in Siduwa, Dhankuta, Nepal. Seven indigenous isolates of entomopathogenic nematodes (Steinernema lamjungense LMT5, S. lamjungense SS4, S. everestense DKP4, S. abbasi CS1, S. sp. KL1, Heterorhabditis indica CK2 and H. indica CK6) were used in a series of bioassays against the insect. All isolates showed an increased dispersal in response to H. longipennis. Nematodes were more attracted towards third instar larvae than to second instars. Differences in penetration and multiplication in the insect were observed amongst the seven isolates. Steinernema lamjungense LMT5, S. everestense DKP4 and S. abbasi CS1 caused greater mortality than other isolates to different developmental stages. Pupae and second instar larvae were more susceptible than third instar larvae. Significant differences were observed in LT₅₀ values of the isolates against different stages of H. longipennis. Three isolates (S. lamjungense LMT5, S. everestense DKP4 and S. abbasi CS1) along with a commonly used insecticide (chlorpyrifos) were tested against this insect in pot and field experiments. In pot experiments using maize and cabbage as a host crop, S. lamjungense LMT5 and S. everestense DKP4 performed better than S. abbasi CS1 and yielded a mortality comparable with chlorpyrifos. Similar results were observed in field experiments 3 weeks after nematode application. These experiments overall suggest S. lamjungense LMT5 to be a promising biocontrol agent against H. longipennis followed by S. everestense DKP4 and S. abbasi CS1.     

Neuromuscular blockade with rocuronium bromide for ophthalmic surgery in horses

Purpose The production of a central eye to ease surgical access for intraocular surgery is generally dependent on the depth of anesthesia. The aim of this study was to evaluate the eyeball position under muscle relaxation with rocuronium during general anesthesia. Material and methods Twenty horses, body weight 480 ± 62 kg; age 12.6 ± 6.2 years (mean ± SD) were anesthetised for various ophthalmic surgeries. Horses were premedicated with acepromazine, xylazine, and butorphanol intravenously and anesthesia induced with ketamine and diazepam. Anesthesia was maintained with isoflurane in 100% oxygen and 0.6 mL/kg/h of an infusion containing midazolam, ketamine, and xylazine diluted in 500 mL 0.9% NaCl. Horses were mechanically ventilated. Neuromuscular function was assessed with an acceleromyograph (TOF‐Guard^®) and the N. peroneus superficialis was stimulated every 15 s with a train‐of‐four stimulation pattern. A dose of 0.3 mg/kg rocuronium was administered intravenously. The changes in the eyeball position were recorded. Results The dose of 0.3 mg/kg rocuronium produced a 100% neuromuscular block in all horses. Onset time and clinical duration of block was 2.38 ± 2.02 min (range 0.5–8) and 32 ± 18.6 min (range 7.7–76.2), respectively. The globe rotated to central position within 31 ± 2.8 s. The whole iris was visible after 42 ± 7.7 s in all horses. No additional bolus of rocuronium was necessary for any surgery. Conclusion Neuromuscular blockade with rocuronium bromide can be used safely to facilitate ophthalmic surgery in equines.     

Pressure profile in the caudal extradural space of standing horses before and after extradural drug administration

The objectives of this study were to measure the pressure in the caudal extradural space of standing horses and to evaluate the usefulness of pressure waves to identify correct needle placement. Caudal extradural pressure was measured in 12 healthy horses. The pressure and any extradural pressure waves were recorded for 3min after puncture, for 1min after testing for lack of resistance (LOR), and for 10min after lidocaine injection. Successful extradural drug administration was confirmed in all horses. The median extradural pressure findings after puncture, after LOR, immediately after injection and 10min after needle placement were -1.60kPa (range -2.27 to 1.33kPa), -0.67kPa (-2.27 to 5.73kPa), 5.00kPa (0.93 to 9.87kPa) and 0.13kPa (-0.67 to 4.53kPa), respectively. Extradural pressure waves were not always present. Extradural space pressure was sub-atmospheric in most horses and extradural injection significantly increased this pressure for up to 10min. Extradural pressure waves had limited usefulness in the confirmation of the correct placement of the needle.     

Isoflurane measurement error using short wavelength infrared techniques in horses: influence of fresh gas flow and pre-anaesthetic food deprivation

OBJECTIVE: To quantify the isoflurane measurement error arising from the use of short wavelength infrared (IR) anaesthetic gas analysis during low flow anaesthesia in horses. STUDY DESIGN: Prospective clinical study. ANIMAL POPULATION: Sixty-four client-owned horses referred for elective or emergency surgery (age 1-16 years, body mass 400-650 kg). MATERIALS AND METHODS: Horses were divided into four groups based on duration of pre-anaesthetic food deprivation period (FDP) and fresh gas flow during anaesthesia: a high flow group with normal FDP (n = 16) and three groups with low flow and normal (n = 29), long (n = 5) or no (n = 14) FDP, respectively. Circuit isoflurane concentrations were measured simultaneously using a short wavelength (methane-sensitive) analyser (Datex Capnomac Ultima) and a long wavelength (methane-insensitive) analyser (Hewlett Packard M 1025 B) for at least 60 minutes. The difference between the readings of both analysers gave the isoflurane measurement error of short wavelength IR analysis, from which the circuit methane concentration was calculated. RESULTS: In the low flow groups, isoflurane measurement error increased over time, whereas in the high flow group, error remained constant after an initial rise in the first 15 minutes. The isoflurane measurement error was significantly lower (p < 0.005) in the high flow group compared with the low flow-normal FDP group from 15 to 60 minutes. Compared to the low flow - normal FDP group, isoflurane measurement error was significantly smaller (p < 0.001, from 15 to 60 minutes) in the low flow-long FDP group and significantly larger (p = 0.016, at 60 minutes) in the low flow-no FDP group. Within the low flow-no FDP group, values in colic cases did not differ from those in noncolic cases (p > 0.7). CONCLUSIONS: Isoflurane measurement using short wavelength IR absorption is inaccurate. The fresh gas flow and duration of pre-anaesthetic food deprivation influence the isoflurane measurement error during anaesthesia in horses. CLINICAL RELEVANCE: Short wavelength IR analysers are not reliable for isoflurane measurement during (low flow) anaesthesia in horses.