Effects of Ketamine on the Equine Electroencephalogram During Anesthesia With Halothane in Oxygen

OBJECTIVE: To investigate the effects of ketamine on the electroencephalogram (EEG) of the horse. STUDY DESIGN: Prospective experimental study. ANIMALS: Eight Welsh mountain pony geldings weighing between 280 and 330 kg, 5 to 9 years old. METHODS: During halothane anesthesia at an end-tidal halothane concentration between 0.75 and 0.85%, the EEG frequency power spectrum and the auditory evoked potential were recorded while an infusion of ketamine was given. Ketamine 200 mg was infused over 5 minutes in 8 ponies. The effects of ketamine on the EEG were recorded continuously during the infusion and for a further 55 minutes. RESULTS: The ketamine infusion produced a plasma ketamine concentration that was significantly greater than the baseline until 7 minutes after the start of the infusion. The highest recorded ketamine concentration was 4.2+/-1.1 microg/ml recorded at 5 minutes after the start of the infusion. The spectral edge and median frequency of the EEG and the midlatency of the auditory evoked potential were compared with those recorded before the start of the infusion. The spectral edge, median frequencies and mid-latency of the auditory evoked potential were reduced by 21+/-13%, 31+/-20% and 19+/-36% respectively (mean +/- SD). Only the reduction in spectral edge frequency reached statistical significance. CONCLUSIONS: These results compared with those from other anesthetic and sedative agents suggest that the spectral edge frequency is an indicator of general central nervous system depression whereas the median frequency may be an indicator of antinociception.     

Retrospective analysis of detomidine infusion for standing chemical restraint in 51 horses

Objective To assess the effectiveness of a detomidine infusion technique to provide standing chemical restraint in the horse. Design Retrospective study. Animals Fifty‐one adult horses aged 9.5 ± 6.9 years (range 1–23 years) and weighing 575 ± 290.3 kg. Methods Records of horses presented to our clinic over a 3‐year period in which a detomidine infusion was used to provide standing chemical restraint were reviewed. Information relating to the types of procedure performed, duration of infusion, drug dosages and adjunct drugs administered was retrieved. Results Detomidine was administered as an initial bolus loading dose (mean ± SD) of 7.5 ± 1.87 µg kg^?1. The initial infusion rate was 0.6 µg kg^?1 minute^?1, and this was halved every 15 minutes. The duration of the infusion ranged from 20 to 135 minutes. Twenty horses received additional detomidine or butorphanol during the procedure. All horses undergoing surgery received local anesthesia or epidural analgesia in addition to the detomidine infusion. A wide variety of procedures were performed in these horses. Conclusions Detomidine administered by infusion provides prolonged periods of chemical restraint in standing horses. Supplemental sedatives or analgesics may be needed in horses undergoing surgery. Clinical relevance An effective method that provides prolonged periods of chemical restraint in standing horses is described. The infusion alone did not provide sufficient analgesia for surgery and a significant proportion of animals required supplemental sedatives and analgesics.     

Evaluation of auditory evoked potentials to predict depth of anaesthesia during fentanyl/fluanisone−midazolam anaesthesia in rats

Objectives To assess a method for monitoring depth of anaesthesia using components of middle latency auditory evoked potential (AEP) waveforms during anaesthesia with fentanyl/fluanisone and midazolam. Study design Prospective observational study. Animals Five female Wistar rats weighing between 210 and 250 g. Methods Implanted electrodes were used to record AEPs in animals receiving five doses of anaesthetic. Recordings were made at 5 minutes post‐injection (deep anaesthesia; no pedal withdrawal response, PWR) and then at 25 minutes (light anaesthesia; strong PWR). Responses showed five characteristic peaks occurring at 11, 14, 23, 42 and 68 ms that were measured for latency of occurrence and peak amplitude. Results Auditory evoked potential peaks P14, N23 and P42 were increased significantly in latency with successive anaesthetic injections [avg. F(1,4) = 12.53, p < 0.001; avg. F(1,4) = 10.6, p < 0.001; avg. F(1,4) = 3.9, p = 0.02, respectively]. Peak N23 showed a significant reduction in latency during the 20 minute recovery period following both the first and second anaesthetic injections (t(3) = 7.52, p = 0.005; t(4) = 5.17, p = 0.007, respectively). Peak P42 occurred significantly earlier 20 minutes following the second anaesthetic injection (t(4) = 4.75, p = 0.009). The mean overall depth of anaesthesia assessed using PWR scores was significantly correlated with the mean latency of peak N23, such that as the strength of PWR increased, N23 occurred significantly earlier (r = ?0.99, p = 0.01). The amplitude difference between peaks N23 and P42 increased after the second and third drug administrations [avg. F(1,4) = 10.65, p = 0.031 and avg. F(1,4) = 11.24, p = 0.028, respectively]. Conclusion The characteristics of these peaks, and in particular latency of peak N23, may provide a useful tool for assessing depth of anaesthesia produced by this, and possibly other anaesthetic agents.     

Circulatory, respiratory and behavioral responses in isoflurane anesthetized llamas

Objectives To evaluate the circulatory, respiratory and behavioral effects of isoflurane (ISO) anesthesia in llamas during mechanical ventilation and spontaneous breathing. Design Prospective randomised study. Animals Six adult, neutered male llamas (10 ± 1 years [mean ± SD], 179 ± 32 kg). Materials and methods Animals in which the minimum alveolar concentration (MAC) had been previously determined were anesthetized with ISO in oxygen. Inspired and end‐tidal (ET) ISO were sampled continuously. Arterial blood pH, respiratory and circulatory variables, and clinical signs of anesthesia were recorded at three doses (1.0, 1.5 and 2.0 times the individual animal's MAC; mean MAC value 1.13%) of ISO during spontaneous and controlled ventilation. A series of Latin squares was used to determine order of dose. Controlled ventilation (CV) (target PaCO₂ 38 ± 5 mm Hg [5.0 ± 0.6 kPa]) preceded spontaneous ventilation (SV) at each dose. Animals breathed spontaneously for approximately 10 minutes prior to data collection. Body temperature was maintained at 37 ± 0.6 °C. Circulatory and respiratory data were analysed with a mixed model, least squares analysis of variance, for repeated measures taken at equally spaced intervals. p < 0.05. Results Dose and mode of ventilation had significant influences on measured variables. For example, heart rate increased as dose increased; 67 ± 14 beats minute^?1 at 1.0 MAC‐CV versus 77 ± 6 beats minute^?1 at 2 MAC‐CV. Conversely, mean arterial pressure decreased with increasing dose; 82 ± 13 mm Hg at MAC‐CV versus 52 ± 15 mm Hg at 2 MAC‐CV. Arterial CO₂ increased with increasing dose during SV; 45 ± 5 mm Hg [6 ± 0.6 kPa] at MAC versus 53 ± 4 mmHg [7 ± 0.5 kPa] at 2 MAC. Reflex activity (e.g. palpebral reflex) and muscle tone (e.g. jaw tone) decreased while eyelid aperture increased with increasing anesthetic dose. Conclusions and Clinical Relevance The influence of ISO dose and mode of ventilation on circulatory and respiratory variables in llamas is qualitatively similar to that reported in other species. Changes in reflex activity and muscle tone may be used to guide appropriate anesthetic delivery in ISO‐induced llamas.     

Analgesic, hemodynamic and respiratory effects of caudal epidurally administered ropivacaine hydrochloride in mares

Objective To determine the analgesic, hemodynamic and respiratory effects, sedation and ataxia in mares of caudal epidural administration of ropivacaine hydrochloride solution. Study design Prospective, single‐dose trial. Animals Ten healthy mares weighing from 475 to 565 kg. Methods Intravascular catheters and an epidural needle were placed after infiltration of the skin and subcutaneous tissues with 2% lidocaine. Ropivacaine (0.5%, 8 or 9 mL) was then injected epidurally at the fifth sacral or sacrococcygeal vertebrae, respectively. Analgesia was determined by lack of sensory perception to electrical stimulation (> 40 milliamps) and absence of response to needle pricks extending from coccyx to S2 dermatomes. Electrocardiogram, heart and respiratory rates, rectal temperature, arterial blood pressure, arterial acid‐base (pH, standard bicarbonate and base excess), gas tensions (PO₂, PCO₂), PCV, oxyhemoglobin and total solids concentrations, and numerical scores of perineal analgesia, sedation (head drop), and ataxia (position of pelvic limbs) were determined before and during a 5‐hour testing period. Analysis of variance (anova ) with repeated measures was used to detect significant (p < 0.05) differences of mean values from baseline. Results Epidurally administered ropivacaine induced variable analgesia extending bilaterally from coccyx to S2 (three mares), coccyx to S3 (four mares), and coccyx to S4 (three mares), with minimal sedation, ataxia, and cardiovascular and respiratory disturbances of mares. Perineal analgesia was attained at 10 ± 4 minutes and lasted for 196 ±42 minutes (mean ± SD). Five mares demonstrated inadequate perineal analgesia, probably attributable to deviation of the spinal needle from the midline. They were successfully blocked with ropivacaine on another occasion. Epidural ropivacaine significantly reduced repiratory rates of mares and did not change other variables from baseline. Conclusions and clinical relevance Ropivacaine (0.5%, 8 mL 500 kg^?1) can be administered caudal epidurally to produce prolonged (> 2.5 hours) bilateral perineal analgesia with minimal sedation, ataxia, and circulatory and respiratory disturbances in standing mares.     

Glomerular filtration rate after tramadol, parecoxib and pindolol following anaesthesia and analgesia in comparison with morphine in dogs

ObjectiveTo compare the effects of morphine, parecoxib, tramadol and a combination of parecoxib, tramadol and pindolol on nociceptive thresholds in awake animals and their effect on glomerular filtration rate (GFR) in dogs subjected to 30 minutes of anesthesia.AnimalsEight adult mixed breed experimental dogs.Study designRandomized, controlled trial.MethodsDogs received 0.05 mg kg^?1 acepromazine subcutaneously (SC) as anaesthetic pre-medication. Thirty to sixty minutes later, they received either tramadol 3 mg kg^?1 intravenously, (IV), parecoxib (1 mg kg^?1 IV), a combination of tramadol 3 mg kg^?1 (IV), parecoxib 1 mg kg^?1 (IV) and pindolol 5 μg kg^?1 (SC), morphine (0.1 mg kg^?1 (IV) or 0.9% saline (2 mL). Anaesthesia was then induced with IV propofol to effect (2.9 ± 0.8 mg kg^?1) and maintained with halothane in oxygen for 30 minutes. Systolic arterial blood pressure was maintained above 90 mmHg with IV fluids and by adjusting the inspired halothane concentration. Post-treatment nociceptive thresholds to mechanical stimuli, expressed as percent of pre-treatment values, were compared between the treatments to assess the analgesic efficacy of the drugs. Plasma iohexol clearance (ICL), a measure of GFR, was estimated both before and 24 hours after induction of anaesthesia to study the drugs’ effects on renal perfusion. Nociceptive threshold and GFR data were compared using mixed model analysis in sas^®9.1.ResultsBoth tramadol and parecoxib produced similar analgesia, which was less than that of morphine. Their combination with pindolol produced analgesia comparable with morphine. None of the test drugs, either alone or in combination, reduced GFR.ConclusionTramadol and parecoxib (either alone or in combination) can increase nociceptive thresholds in awake dogs and have minimal effects on renal perfusion in normotensive dogs subjected to anaesthesia.     

Mandibular Osteodistraction for Correction of Deep Bite Class II Malocclusion in a Horse

Objective— To describe a technique for, and outcome after, mandibular osteodistraction in the horse.
Study Design— Clinical report.
Animals— Warmblood horse.
Methods— A half ring external fixator was applied on both sides of an osteotomy site performed on the mandible of a colt. A bite plate was placed on the upper incisors creating occlusion between lower and upper jaw. After a 5-day latency period, distraction was applied (1 mm/day) until the overjet was judged normal.
Results— Mandibular elongation and correction of brachygnathia was obtained without major complications. Six months after the procedure the overjet reduction was considered stable.
Conclusions— Mandibular osteodistraction can be considered for treatment of severe brachygnathia in yearlings.
Clinical Relevance— Distraction osteogenesis has the advantage of progressive elongation of the mandible, allowing concurrent bone remodeling and soft tissue adaptation. Severe mandibular incisor malocclusion in horses outside the maximal growth phase can be corrected using this technique.     

Comparative analgesic and cardiopulmonary effects of bupivacaine and ropivacaine in the epidural space of the conscious dog

Objective To compare the cardiopulmonary effects and sensory blockade of epidural bupivacaine and ropivacaine. Study Design Prospective randomized study. Animals Six young adult medium‐sized crossbred dogs weighing 25.7 ± 7.1 kg. Method Dogs were chronically implanted with a lumbosacral epidural catheter. Acepromazine sedated dogs received all treatments: 0.5% bupivacaine at 0.14 mL kg^?1 (LB5) or 0.22 mL kg^?1 (HB5); 0.5% ropivacaine at 0.14 mL kg^?1 (LR5) or 0.22 mL kg^?1 (HR5); 0.75% bupivacaine at 0.22 mL kg^?1 (HB7.5) or 0.75% ropivacaine at 0.22 mL kg^?1 (HR7.5). Loss of sensation was tested at the level of the perineum, hind toe webs, flank, and caudodorsal rib areas before injection, and post‐injection (PI) up to 150 minutes PI. Systemic arterial blood pressure and heart rate were recorded before injection, and every 10 minutes PI until 150 minutes PI. Arterial blood gas analyses were performed prior to injection, and at 30, 60 and 150 minutes PI. Results No statistical differences existed between groups for the cardiopulmonary data or time to onset of block. Group HR7.5 had lower systolic (10–70 minutes PI) and diastolic (10–70 minutes PI) blood pressures and group HR5 had lower mean (10–90 minutes PI) and diastolic (10–90 minutes PI) blood pressures compared to baseline. Heart rate was lower compared to baseline in groups LR5 and HB7.5. A significant, but mild metabolic acidosis developed in groups LR5 and HB7.5 (150 minutes PI). No differences were present for the duration of block between groups, but duration of block in the dorsocaudal rib area was shorter in group HR5 compared to HR7.5. Conclusion Epidural ropivacaine and bupivacaine at the doses used have mild effects on the cardiopulmonary system, and extent of block are similar. Clinical Relevance The 0.75% concentration of bupivacaine and ropivacaine at 0.22 mL kg^?1 appeared to contribute to greater success of block (>80%) at dermatomes L₅–L₇.     

Anesthetic Potency of Desflurane in the Horse: Determination of the Minimum Alveolar Concentration

Objective — To determine the minimum alveolar concentration (MAC) of desflurane (DES) in the horse.
Study Design — Prospective study.
Animals — Six healthy adult horses (three males and three females) weighing 370 ±16 kg and aged 9 ±2 years old.
Methods — Anesthesia was induced with DES vaporized in oxygen via a face mask connected to a large-animal, semiclosed anesthetic circle system. The horses were endotracheally intubated and positioned in right lateral recumbency. Inspired and end-tidal DES were monitored using a calibrated Ohmeda RGM 5250 multigas analyzer (Ohmeda-BOC, Spain). The MAC of desflurane that prevented gross purposeful movement in response to 60 seconds of noxious electrical stimulation of oral mucous membranes was determined.
Results — The time from the start of DES administration to lateral recumbency was 6.1 ±0.9 min. The MAC of DES in these horses was 7.6 ±0.4%. Time required for the animal to regain sternal recumbency after 98 ±4 minutes of anesthesia was 6.6 ±0.5 minutes and the time to standing was 14.3 ±2.7 minutes.
Conclusions — The MAC of desflurane in these horses was 7.6 ±0.4%. DES provided a rapid induction to, and recovery from, anesthesia.
Clinical Relevance — Desflurane offers the potential for more precise control during anesthesia, and may allow a faster and uneventful recovery. It is important to know the MAC of an inhalant to use it clinically.