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Ruíz-López P, Schauvliege S, Gasthuys F, Haspeslagh M. Dobutamine use in horses during romifidine and isoflurane anaesthesia. Res Vet Sci 2024; 167:105119. [PMID: 38154415 DOI: 10.1016/j.rvsc.2023.105119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023]
Abstract
This retrospective study aimed to assess the incidence of hypotension and the subsequent administration of dobutamine in horses anesthetized with isoflurane and romifidine during elective surgery. Time from induction of anaesthesia to administration of dobutamine was registered, as well as the time and dose needed to restore mean arterial pressure (MAP) ≥ 70 mmHg. Additionally, the influence of patient and anaesthesia related parameters on the need for dobutamine supplementation was evaluated. In total, 118 horses were included in this retrospective study. Dobutamine was administered to effect when MAP<70 mmHg. Data registered: patient weight, acepromazine premedication, body position, administration of intraoperative ketamine bolus, locoregional anaesthesia, mechanical ventilation, duration of anaesthesia, dose and duration of dobutamine administration, heart rate, MAP before dobutamine administration, MAP and time required to increase MAP≥70 mmHg. Dobutamine infusion was needed in 54.2% of the horses 30 ± 17 min after isoflurane-romifidine anaesthesia started. Dobutamine 0.55 ± 0.18 μg kg-1 min-1 achieved a MAP≥70 mmHg in 12 ± 8 min. Duration of dobutamine infusion was 56 ± 37 min. An univariable logistic regression showed a significant association between dobutamine and acepromazine administration (p = 0.01; OR = 3.43), anaesthesia time (p = 0.02; OR = 2.41) and dorsal recumbency (p < 0.001; OR = 8.40). In a multivariable logistic regression, only dorsal recumbency significantly increased the need for dobutamine supplementation (p < 0.001; OR = 7.70). There was no significant association between patient weight (p = 0.11; OR = 1), locoregional anaesthesia (p = 0.07; OR = 0.47), administration of a ketamine bolus (p = 0.95; OR = 0.98) or volume controlled ventilation (p = 0.94; OR = 1.04) and dobutamine administration. Low doses of dobutamine were suitable to restore MAP above 70 mmHg within a limited time period. Only dorsal recumbency increased the need of dobutamine administration.
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Affiliation(s)
- Patricia Ruíz-López
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, University of Ghent, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - Stijn Schauvliege
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, University of Ghent, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Frank Gasthuys
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, University of Ghent, Salisburylaan 133, 9820 Merelbeke, Belgium
| | - Maarten Haspeslagh
- Department of Large Animal Surgery, Anaesthesia and Orthopaedics, Faculty of Veterinary Medicine, University of Ghent, Salisburylaan 133, 9820 Merelbeke, Belgium
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Garcia Filho SG, de Andrade FSRM, Dos Santos RST, Gonçalves LA, Pereira MAA, de Souza AF, Ambrósio AM, Fantoni DT. Comparison of Hemodynamic Effects of Dobutamine and Ephedrine Infusions in Isoflurane-Anesthetized Horses. Vet Sci 2023; 10:vetsci10040278. [PMID: 37104433 PMCID: PMC10146723 DOI: 10.3390/vetsci10040278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/28/2023] Open
Abstract
The objective of this study was to compare the hemodynamic effects of dobutamine and ephedrine during the management of anesthesia-related hypotension in healthy horses. Thirteen horses underwent general anesthesia with isoflurane and were randomly divided into two different groups, one of which received a dobutamine constant rate infusion (CRI) (1 µg/kg bwt/min) and the other received an ephedrine CRI (20 µg/kg bwt/min) when hypotension (<60 mmHg) was identified, following up to 15 min after the blood pressure reached 70 mmHg. All horses were equipped with a pulmonary artery catheter and a peripheral artery catheter, and multiparameter monitoring commenced as soon as they were under mechanical ventilation. Hemodynamic parameters were recorded, while tissue perfusion markers (peripheral oxygen saturation, arterial oxygen partial pressure, arterial carbon dioxide partial pressure, arterial pH, arterial plasma bicarbonate concentration, arterial oxygen saturation, mixed venous oxygen saturation, mixed venous oxygen content, arterial oxygen content, arteriovenous oxygen difference, oxygen delivery index, oxygen consumption index, and oxygen extraction ratio), serum lactate concentration, and troponin I concentrations were analyzed before the start of infusions (T0), when the blood pressure reached 70 mmHg (T1), and 15 min after T1 (T2). The time to restore the arterial pressure was similar in both groups (p > 0.05); however, the heart rate was higher in the ephedrine group (p = 0.0098), and sinus bradyarrhythmia occurred in the dobutamine group. Furthermore, both experimental protocols increased cardiac output (p = 0.0012), cardiac index (p = 0.0013), systemic vascular resistance (p = 0.008), systemic vascular resistance index (p < 0.001), and ameliorated perfusion markers. In the dobutamine group, the pulmonary artery wedge pressure (p < 0.001) and systolic index (p = 0.003) were elevated, while the arteriovenous oxygen difference was reduced in the ephedrine group (p = 0.02). Troponin I was used as a myocardial injury indicator, and did not differ between moments or between groups (p > 0.05). We concluded that both drugs were effective and safe to treat anesthetic hypotension under the conditions of this study.
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Affiliation(s)
- Sergio Grandisoli Garcia Filho
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
| | - Felipe Silveira Rego Monteiro de Andrade
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
| | - Rosana Souza Thurler Dos Santos
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
| | - Lucas Alaião Gonçalves
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
| | - Marco Aurélio Amador Pereira
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
| | - Anderson Fernando de Souza
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
| | - Aline Magalhães Ambrósio
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
| | - Denise Tabacchi Fantoni
- Department of Surgery, School of Veterinary Medicine and Animal Science, University of São Paulo, 87 Professor Orlando Marques Paiva Ave., São Paulo 05508-270, SP, Brazil
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Asorey I, Corletto F. Anaesthetic management of a horse with atrial fibrillation undergoing transvenous electrical cardioversion in combination with amiodarone. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Federico Corletto
- Dick White Referrals Six Mile Bottom UK
- Newmarket Equine Hospital Newmarket UK
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Hoeberg E, Haga HA, Lervik A. Cardiovascular effects of intravenous morphine in anesthetized horse. Front Vet Sci 2022; 9:1007345. [PMID: 36225800 PMCID: PMC9549263 DOI: 10.3389/fvets.2022.1007345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/08/2022] [Indexed: 11/23/2022] Open
Abstract
Objectives To investigate whether morphine causes a change in mean arterial blood pressure (MAP) heart rate (HR) and oxygen extraction (OE) rate in healthy horses anesthetized with isoflurane and a dexmedetomidine infusion. Material and methods The study design was prospective clinical, randomized, blinded two groups including 33 horses. All horses were sedated with romifidine IV, and anesthesia was induced with midazolam IV and ketamine IV and maintained with isoflurane in oxygen and medical air and a dexmedetomidine infusion. As a baseline venous and arterial blood, HR and MAP were sampled. Thereafter either morphine 0.1 mg kg−1 IV or an equivalent volume of NaCl 0.9% IV was administered. HR and MAP were then further sampled for 5 min before venous and arterial blood was again sampled. OE was calculated based upon arterial and venous blood gas analysis. To evaluate the change in minimum MAP, mean HR, and OE, the differences between baseline and observation period values were further termed delta MAP, delta HR, and delta OE. Individual delta MAPs were normalized to the minimum baseline value and are reported as a percentage. Alpha was set to 0.05. Confidence intervals 95% (CI) were calculated for delta MAP, delta HR, and delta OE within groups, and for the difference between groups. Results The 95% CIs for delta MAP (%), delta HR (min−1), and delta OE (mL/dL) in the morphine group were −20.5 to −9.0, 0.6 to 3.1, and −0.1 to 0.6 and in the placebo group were −17.4 to −10.1, 0.2 to 2.0, and −0.2 to 0.3, respectively. The 95% CI for the differences in delta MAP (%), delta HR (min−1), and delta OE (mL/dL) were −5.5 to 7.6, −2.3 to 0.7, and −0.7 to 0.2, respectively. The minimum MAP of one horse in the morphine group decreased around 50% between baseline and observation period with almost unchanged OE and HR. Conclusion and clinical relevance The effects of morphine 0.1 mg kg−1 IV on HR, MAP, and OE in healthy horses anesthetized with isoflurane and a CRI of dexmedetomidine are minimal.
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Ruíz-López P, Morgaz J, Quirós-Carmona S, Navarrete-Calvo R, Domínguez JM, Gómez-Villamandos RJ, Granados MM. Parasympathetic Tone Changes in Anesthetized Horses after Surgical Stimulation, and Morphine, Ketamine, and Dobutamine Administration. Animals (Basel) 2022; 12:ani12081038. [PMID: 35454284 PMCID: PMC9027407 DOI: 10.3390/ani12081038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022] Open
Abstract
Simple Summary A parasympathetic tone activity (PTA) monitor has been developed similar to the analgesia nociception index (ANI) used in human medicine to evaluate the changes in the autonomic nervous system based on heart rate variability. The autonomic nervous system acts unconsciously and regulates body functions (autonomic response). Examples of autonomic response are decreases of heart rate or/and blood pressure due to an increase of parasympathetic tone activity. It is important to know how stimuli and medication may affect the autonomic nervous system since they can modify heart rate and blood pressure. This study attempts to find how a surgical nociceptive stimulus, along with the administration of medication frequently used in horses, can affect mean parasympathetic tone activity (PTAm) (one of the values of the PTA monitor), heart rate and blood pressure in clinically anesthetized horses. Values of the PTAm, heart rate, and blood pressure were registered before and after surgical incision and after the administration of morphine, ketamine, and dobutamine at defined time points. No changes were found after the incision or the administration of morphine and dobutamine. It seems that only ketamine affects the autonomic nervous system by decreasing PTAm. Abstract Autonomic nervous system (ANS) activity can modify cardiovascular parameters in response to nociceptive stimuli or drugs in anesthetized animals. The aim of this study was to determine if a surgical nociceptive stimulus and morphine, ketamine, and dobutamine administration would modify ANS activity observed as a change in the mean parasympathetic tone activity (PTAm) in anesthetized horses. In 20 anesthetized horses, heart rate (HR), mean arterial pressure (MAP), and PTAm were monitored before and 1, 3, and 5 min after surgical incision, and before and 10 min after the administration of morphine (0.2 mg/kg IV). If nystagmus or spontaneous ventilation was observed, ketamine (0.5 mg/kg IV) was given, and the three variables were registered before and 3 and 5 min afterward. If MAP reached ≤62 mmHg, a dobutamine infusion was administered, and the three variables were recorded before and 5 min after starting/increasing the infusion (0.25 μg/kg/min IV every 5 min). The three variables were registered before and 1, 3, and 5 min after a PTAm decrease of ≥20%, HR increase of ≥10%, or MAP increase of ≥20%. The PTAm decreased 3 min after the administration of ketamine and 1 min after a PTA event. The surgical incision, dobutamine, and morphine did not modify PTAm. The absence of changes in ANS activity after the nociceptive stimulus and lack of correlation between PTAm and HR or MAP suggest that PTAm is a poor indicator of sympathetic activation under the study conditions. Ketamine seems to affect ANS activity by decreasing PTAm.
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Affiliation(s)
- Patricia Ruíz-López
- Department of Surgery and Anesthesia of Domestic Animals, Faculty of Veterinary Medicine, University of Ghent, 9820 Merelbeke, Belgium
- Correspondence: (P.R.-L.); (J.M.)
| | - Juan Morgaz
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
- Correspondence: (P.R.-L.); (J.M.)
| | - Setefilla Quirós-Carmona
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - Rocío Navarrete-Calvo
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - Juan Manuel Domínguez
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - Rafael Jesús Gómez-Villamandos
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
| | - M. M. Granados
- Animal Medicine and Surgery Department, Faculty of Veterinary Medicine, University of Córdoba, 14014 Cordoba, Spain; (S.Q.-C.); (R.N.-C.); (J.M.D.); (R.J.G.-V.); (M.M.G.)
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Ryan A, Gurney M, Steinbacher R. Suspected vagal reflex and hyperkalaemia inducing asystole in an anaesthetised horse. Equine Vet J 2021; 54:927-933. [PMID: 34738246 PMCID: PMC9543672 DOI: 10.1111/evj.13535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 08/26/2021] [Accepted: 10/18/2021] [Indexed: 12/02/2022]
Abstract
A 10‐year‐old 466 kg mustang gelding presented to an equine referral hospital for surgical repair of nasal, frontal and lacrimal bone fractures from an unknown trauma. Surgical repair was performed under general anaesthesia, including a right‐sided maxillary regional anaesthetic block with mepivacaine hydrochloride. Progressive hyperkalaemia was documented perianaesthetically (T‐3 mins; 134 mins after induction; potassium 6.4 mmol/L (ref 3.5‐5.1 mmol/L). Perianaesthetic bradycardia was attributed to alpha −2 agonist infusion administration, and other characteristic ECG changes (flattened P waves, narrow T waves of increased amplitude, prolonged QRS complex) were not documented. Asystole occurred 137 min after induction of anaesthesia; however, a review of the available literature suggests the degree of hyperkalaemia documented was unlikely to be the primary cause of asystole but may have been a contributing factor. It is hypothesised that a trigeminocardiac reflex was the primary contributory factor to asystole in the described case, and may represent a maxillomandibulocardiac reflex that has not been previously described in the horse.
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Affiliation(s)
- Aoife Ryan
- University of Veterinary Medicine, Vienna, Austria.,Anderson Moores Veterinary Specialists, Winchester, UK
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Loomes K. The use of hyoscine N‐butylbromide to treat intraoperative bradycardia during isoflurane anaesthesia in three horses. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- K. Loomes
- Rainbow Equine Hospital Old Malton, North Yorkshire UK
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Duggan M, Schofield W, Vermedal H. Successful cardiopulmonary resuscitation in an adult horse following cardiovascular collapse on recovery from general anaesthesia in the Trendelenburg position. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- M. Duggan
- Lisadell Equine Hospital Co. Meath Ireland
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La Rosa L, Schauvliege S. Transient radial paralysis occurring in a Belgian White Blue bull undergoing general anaesthesia for claw amputation. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Lavinia La Rosa
- Large Animal Department of Surgery and AnaestesiologyGhent UniversityMerelbekeBelgium
| | - Stijn Schauvliege
- Large Animal Department of Surgery and AnaestesiologyGhent UniversityMerelbekeBelgium
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Ranninger E, Bettschart‐Wolfensberger R. Polymorphic tachycardia in an anaesthetised horse with an undiagnosed pheochromocytoma undergoing emergency coeliotomy. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2019-001000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Elisabeth Ranninger
- Department of Clinical Diagnostics and ServicesSection of AnaesthesiologyVetsuisse FacultyUniversity of ZurichZurichSwitzerland
| | - Regula Bettschart‐Wolfensberger
- Department of Clinical Diagnostics and ServicesSection of AnaesthesiologyVetsuisse FacultyUniversity of ZurichZurichSwitzerland
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Auckburally A, Petruccione I, Voss S. Providing fluid therapy to equine colic patients. Part 2. IN PRACTICE 2019. [DOI: 10.1136/inp.l6432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Auckburally A, Grubb TL, Wiklund M, Nyman G. Effects of ventilation mode and blood flow on arterial oxygenation during pulse-delivered inhaled nitric oxide in anesthetized horses. Am J Vet Res 2019; 80:275-283. [PMID: 30801218 DOI: 10.2460/ajvr.80.3.275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the impact of mechanical ventilation (MV) and perfusion conditions on the efficacy of pulse-delivered inhaled nitric oxide (PiNO) in anesthetized horses. ANIMALS 27 healthy adult horses. PROCEDURES Anesthetized horses were allocated into 4 groups: spontaneous breathing (SB) with low (< 70 mm Hg) mean arterial blood pressure (MAP; group SB-L; n = 7), SB with physiologically normal (≥ 70 mm Hg) MAP (group SB-N; 8), MV with low MAP (group MV-L; 6), and MV with physiologically normal MAP (group MV-N; 6). Dobutamine was used to maintain MAP > 70 mm Hg. Data were collected after a 60-minute equilibration period and at 15 and 30 minutes during PiNO administration. Variables included Pao2, arterial oxygen saturation and content, oxygen delivery, and physiologic dead space-to-tidal volume ratio. Data were analyzed with Shapiro-Wilk, Mann-Whitney U, and Friedman ANOVA tests. RESULTS Pao2, arterial oxygen saturation, arterial oxygen content, and oxygen delivery increased significantly with PiNO in the SB-L, SB-N, and MV-N groups; were significantly lower in group MV-L than in group MV-N; and were lower in MV-N than in both SB groups during PiNO. Physiologic dead space-to-tidal volume ratio was highest in the MV-L group. CONCLUSIONS AND CLINICAL RELEVANCE Pulmonary perfusion impacted PiNO efficacy during MV but not during SB. Use of PiNO failed to increase oxygenation in the MV-L group, likely because of profound ventilation-perfusion mismatching. During SB, PiNO improved oxygenation irrespective of the magnitude of blood flow, but hypoventilation and hypercarbia persisted. Use of PiNO was most effective in horses with adequate perfusion.
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Conde Ruiz C, Junot S. Successful Cardiopulmonary Resuscitation in a Sevoflurane Anaesthetized Horse That Suffered Cardiac Arrest at Recovery. Front Vet Sci 2018; 5:138. [PMID: 29988384 PMCID: PMC6024005 DOI: 10.3389/fvets.2018.00138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 06/04/2018] [Indexed: 12/04/2022] Open
Abstract
A 17-year-old mare undergoing dental surgery suffered a cardiac arrest while being transferred from the surgical theatre to the recovery box. This complication was diagnosed early, thus allowing a prompt start to the cardiopulmonary resuscitation maneuvers. External thoracic compressions, intermittent positive pressure ventilation, and adrenaline administration were at the core of this successful resuscitation. Although it was not possible to confirm the cause of cardiac arrest in this horse, a Bezold-Jarisch reflex due to potential decrease on venous return because of postural change and drug interactions was hypothesized. Based on this report, it appears advisable to smoothly change the position of anaesthetized patient; furthermore, the administration of drugs affecting cardiovascular hemodynamics or sympatho-vagal balance to animals while changing their recumbency should be avoided.
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Affiliation(s)
- Clara Conde Ruiz
- Service d'Anesthésie, VetAgro Sup, Université de Lyon, Marcy L'Etoile, France
| | - Stéphane Junot
- Service d'Anesthésie, VetAgro Sup, Université de Lyon, Marcy L'Etoile, France.,Unité APCSe, Agressions Pulmonaires et Circulatoires dans le sepsis, VetAgro Sup, Université de Lyon, Marcy L'Etoile, France
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Mirra A, Klopfenstein Bregger MD, Levionnois OL. Suspicion of Postanesthetic Femoral Paralysis of the Non-Dependent Limb in a Horse. Front Vet Sci 2018; 5:12. [PMID: 29468166 PMCID: PMC5808350 DOI: 10.3389/fvets.2018.00012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 01/19/2018] [Indexed: 11/13/2022] Open
Abstract
A 15-year-old Selle Francais gelding was presented to the equine referral hospital for treatment of a left guttural pouch mycosis previously diagnosed. After induction, the horse was shortly hoisted by all four feet, moved on a padded surgical table, and positioned in right lateral recumbency. In order to reduce the risk of bleeding during surgical manipulation of the carotid and maxillary arteries, a mean arterial pressure between 60 and 70 mmHg was targeted. After surgery, the horse was moved in a padded recovery box keeping the same lateral recumbency. Four unsuccessful attempts were performed, with the horse always returning to sternal recumbency keeping the left hind limb up. At the fifth attempt, performed 120 min after the end of the general anesthesia, the horse stood up correctly but moderate ataxia and absence of weight bearing on the left hind limb were shown. Both the stifle and the fetlock joint were held in a flexed position and could not be extended properly in order to set the foot on the ground, resulting in a very short step. The horse was calm, not sweating, and willing to move; the muscles of the affected limb were relaxed, and the limb was neither warm nor painful at palpation. Occasionally, the horse flexed the affected hind limb in an exaggerated motion with marked abduction. No additional laboratory analyses were performed. Due to a strong suspicion of neuropathy, a sling support was initiated and a supportive bandage associated with flunixine administration was performed until resolution of the symptoms. The horse fully recovered after 3 days. This case report does not clarify the pathogenesis of the possible postanesthetic neuropathy accounted on the non-dependent limb, highlighting the need for future research in this field. Non-dependent limb neuropathy should be an expected problem even after having ruled out the most commonly known causes predisposing to postanesthetic lameness.
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Affiliation(s)
- Alessandro Mirra
- Division of Anesthesiology and Pain Therapy, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | | | - Olivier Louis Levionnois
- Division of Anesthesiology and Pain Therapy, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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Hopster K, Ambrisko TD, Kästner SBR. Influence of catecholamines at different dosages on the function of the LiDCO sensor in isoflurane anesthetized horses. J Vet Emerg Crit Care (San Antonio) 2017; 27:651-657. [PMID: 29064159 DOI: 10.1111/vec.12672] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 03/11/2016] [Accepted: 04/18/2016] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the lithium dilution method for cardiac output (LiDCO) and bolus-thermo-dilution (BTD) measurements before and during infusion of dobutamine, dopamine, phenylephrine, or noradrenaline at 2 different doses in anesthetized horses and to examine the correlation between sensor voltages (saline-blood exposed) and possible measurement errors. DESIGN Prospective experimental study. SETTING University teaching hospital. ANIMALS Nine Warmblood horses. INTERVENTIONS Following 90 minutes of equilibration, 3 different doses of dobutamine (0.5-3 μg/kg/min), dopamine (1-5 μg/kg/min), phenylephrine (0.5-3 μg/kg/min), or noradrenaline (0.1-0.5 μg/kg/min) were administered for 15 minutes in anesthetized horses, and measurements using the LiDCO were performed at the lowest and highest doses. Pairs of LiDCO and BTD measurements were collected and sensor voltages exposed to blood and saline were measured before and at the end of each infusion period. Agreement between LiDCO and BTD was assessed with the Bland-Altman method. MEASUREMENT AND MAIN RESULTS The biases (2 standard deviations) before infusion of dobutamine, dopamine, phenylephrine, and noradrenaline were 1.1 (5.7), 1.6 (7.3), 0.2 (6.6), and 1.5 (4.1) L/min, respectively, and minimally and nonsignificantly changed following low-dose catecholamine infusions. Following infusion of higher doses, biases were significantly higher compared to baseline with 10.7 (7.8), 11.2 (11.9), 6.9 (11.7), and 3.5 (3.8) L/min, respectively. The difference between saline- and blood-exposed sensor voltage decreased during infusion of high doses of catecholamines with correlations (rs = 0.62) between cardiac output differences and sensor voltage differences (saline-blood). CONCLUSIONS This study demonstrated that catecholamines could lead to overestimation in a dose-dependent fashion in LiDCO measurements. Monitoring changes in sensor voltage differences (saline-blood) is a valuable and clinically applicable tool to predict errors in LiDCO measurements.
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Affiliation(s)
- Klaus Hopster
- Equine Clinic, University of Veterinary Medicine Hanover, Hanover, Germany
| | - Tamas D Ambrisko
- The Section of Anaesthesiology and Perioperative Intensive-Care Medicine, Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
| | - Sabine B R Kästner
- Equine Clinic, University of Veterinary Medicine Hanover, Hanover, Germany
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Schier MF, Raisis AL, Secombe CJ, Hosgood G, Musk GC, Lester GD. Effects of dobutamine hydrochloride on cardiovascular function in horses anesthetized with isoflurane with or without acepromazine maleate premedication. Am J Vet Res 2017; 77:1318-1324. [PMID: 27901396 DOI: 10.2460/ajvr.77.12.1318] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the effects of acepromazine maleate premedication on cardiovascular function before and after infusion of dobutamine hydrochloride for 30 minutes in isoflurane-anesthetized horses. ANIMALS 6 healthy adult horses. PROCEDURES Each horse was anesthetized once following premedication with acepromazine (0.02 mg/kg, IV) administered 30 minutes prior to anesthetic induction (ACP+ treatment) and once without premedication (ACP- treatment). Anesthesia was induced with IV administration of xylazine hydrochloride (0.8 mg/kg), ketamine hydrochloride (2.2 mg/kg), and diazepam (0.08 mg/kg). Horses were positioned in right lateral recumbency, and anesthesia was maintained via inhalation of isoflurane delivered in oxygen. End-tidal isoflurane concentration was adjusted to achieve a target mean arterial blood pressure of 60 mm Hg (interquartile range [25th to 75th percentile], 57 to 63 mm Hg) for at least 15 minutes. Cardiac index, oxygen delivery index, and femoral arterial blood flow indices were determined 60 minutes after anesthetic induction (baseline). Dobutamine was then infused to achieve a target mean arterial blood pressure of 80 mm Hg (interquartile range, 76 to 80 mm Hg). Data collection was repeated 30 minutes after the start of dobutamine infusion for comparison with baseline values. RESULTS Complete data sets were available from 5 of the 6 horses. Dobutamine administration resulted in significant increases in oxygen delivery and femoral arterial blood flow indices but no significant change in cardiac index for each treatment. However, at baseline or 30 minutes after the start of dobutamine infusion, findings for the ACP+ and ACP- treatments did not differ. CONCLUSIONS AND CLINICAL RELEVANCE In isoflurane-anesthetized horses, dobutamine administration increased oxygen delivery and femoral arterial blood flow indices, but these changes were unaffected by premedication with acepromazine.
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Olsen E, Pedersen TLS, Robinson R, Haubro Andersen P. Accuracy and precision of oscillometric blood pressure in standing conscious horses. J Vet Emerg Crit Care (San Antonio) 2015; 26:85-92. [DOI: 10.1111/vec.12411] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 03/11/2014] [Accepted: 03/20/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Emil Olsen
- Department of Large Animal Sciences, Faculty of Health and Medical sciences; University of Copenhagen
| | | | - Rebecca Robinson
- Department of Clinical Science and Services, The Royal Veterinary College; University of London
| | - Pia Haubro Andersen
- Department of Clinical Sciences; Swedish University of Agricultural Sciences
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Kutter APN, Bettschart-Wolfensberger R, Schwarzwald CC, Portier KG, Ringer SK. Evaluation of the non-calibrated pulse contour cardiac output monitor FloTrac/Vigileo against thermodilution in standing horses. Vet Anaesth Analg 2015; 43:153-62. [PMID: 26095722 DOI: 10.1111/vaa.12281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2014] [Accepted: 02/10/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To evaluate the non-calibrated, minimally invasive cardiac output (CO) monitor FloTrac/Vigileo (FloTrac) against thermodilution (TD) CO in standing horses. STUDY DESIGN Prospective, experimental trial. ANIMALS Nine adult horses weighing a median (range) of 535 (470-602) kg. METHODS Catheters were placed in the right atrium, pulmonary artery and carotid artery under local anaesthesia. CO was measured 147 times by TD and FloTrac and indexed to body weight. Changes in CO were achieved with romifidine or xylazine and dobutamine constant rate infusions. Bland-Altman analysis, concordance and polar plot analysis were used to assess agreement and ability to track changes in CO. RESULTS Mean ± standard deviation COTD of 48 ± 16 mL kg(-1) minute(-1) (range: 19-93 mL kg(-1) minute(-1) ) and mean COF loTrac of 9 ± 3 mL kg(-1) minute(-1) (range: 5-21 mL kg(-1) minute(-1) ) were measured. Low agreement with a large mean bias of 39 mL kg(-1) minute(-1) and wide limits of agreement of 8-70 mL kg(-1) minute(-1) were found. The percentage error of 108% and precision of TD of ± 18% resulted in an estimated precision of FloTrac of ± 106%. Comparison of changes in COF loTrac with changes in COTD gave a concordance rate of 52% in the four-quadrant plot, and a mean polar angle of -11° with radial limits of agreement of ± 61 ° in the polar plot. Mean arterial pressure (MAP) and COF loTrac were positively correlated (r = 0.5, p < 0.0001). No correlation of MAP with COTD was observed. CONCLUSIONS AND CLINICAL RELEVANCE The FloTrac system, originally designed for use in humans, neither measured absolute CO in standing horses accurately nor tracked relative changes in CO measured by TD correctly. The false dependence of COF loTrac on arterial blood pressure further discourages the use of this technique in horses.
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Affiliation(s)
- Annette P N Kutter
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | | | - Colin C Schwarzwald
- Clinic for Equine Internal Medicine, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Karine G Portier
- Section of Anaesthesiology, VetAgro Sup (Veterinary Campus), University of Lyon, Marcy L'Étoile, France.,INSERM (Institut National de la Santé et de la Recherche Médicale), UMR-1060, CarMeN (Cardiovasculaire, Métabolisme, Diabétologie et Nutrition), Lyon, France
| | - Simone K Ringer
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Briganti A, Portela D, Grasso S, Sgorbini M, Tayari H, Bassini JF, Vitale V, Romano M, Crovace A, Breghi G, Staffieri F. Accuracy of different oxygenation indices in estimating intrapulmonary shunting at increasing infusion rates of dobutamine in horses under general anaesthesia. Vet J 2015; 204:351-6. [DOI: 10.1016/j.tvjl.2015.04.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 03/10/2015] [Accepted: 04/06/2015] [Indexed: 11/25/2022]
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Canola PA, Valadão CA, Borges JHS, Canola JC. Evaluation of Cardiovascular Function During S(+)-Ketamine Constant Rate Infusion in Dorsally Recumbent Halothane-Anesthetized Horses. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2014.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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