Minimum alveolar anesthetic concentrations for airway occlusion in cats: a new concept of minimum alveolar anesthetic concentration-airway occlusion response

Anesthetic potency of sevoflurane with and without nitrous oxide in mechanically ventilated Dumeril monitors

OBJECTIVE

To determine the minimum alveolar concentration (MAC) of sevoflurane and assess the sevoflurane-sparing effect of coadministration of nitrous oxide in mechanically ventilated Dumeril monitors (Varanus dumerili).

DESIGN

Prospective crossover study.

ANIMALS

10 healthy adult Dumeril monitors.

PROCEDURE

Anesthesia was induced with sevoflurane in 100% oxygen or sevoflurane in 66% nitrous oxide (N2O) with 34% oxygen, delivered through a face mask. Monitors were endotracheally intubated, and end-tidal and inspired isoflurane concentrations were measured continuously; MAC was determined by use of a standard bracketing technique. An electrical stimulus (50 Hz, 50 V) was delivered to the ventral aspect of the tail as the supramaximal stimulus. A blood sample for blood gas analyses was collected from the ventral coccygeal vessels at the beginning and end of the anesthetic period. An interval of at least 7 days was allowed to elapse between treatments.

RESULTS

The MAC +/- SDs of sevoflurane in oxygen and with N2O were 2.51 +/- 0.46% and 1.83 +/- 0.33%, respectively. There was a significant difference between the 2 treatments, and the mean MAC-reducing effect of N2O was 26.4 +/- 11.4%. Assuming simple linear additivity of sevoflurane and N2O, the MAC for N2O was estimated to be 244%. No significant differences in blood gas values--with the predictable exception of oxygen pressure--were detected between the 2 groups.

CONCLUSIONS AND CLINICAL RELEVANCE

The MAC of sevoflurane in Dumeril monitors is similar to that reported for other species. The addition of N2O significantly decreased the MAC of sevoflurane in this species.

Minimum alveolar concentration of isoflurane in mechanically ventilated Dumeril monitors

OBJECTIVE

To determine minimum alveolar concentration (MAC) of isoflurane in mechanically ventilated Dumeril monitors (Varanus dumerili).

DESIGN

Prospective study.

ANIMALS

10 healthy adult Dumeril monitors.

PROCEDURE

Anesthesia was induced with isoflurane in oxygen delivered through a face mask. Monitors were endotracheally intubated, and end-tidal and inspired isoflurane concentrations were continuously measured. After equilibration at an end-tidal-to-inspired isoflurane concentration ratio of >0.9 for 20 minutes, an electrical stimulus (50 Hz, 50 V) was delivered to the ventral aspect of the tail for up to 1 minute and the monitor was observed for purposeful movement. End-tidal isoflurane concentration was then decreased by 10%, and equilibration and stimulation were repeated. The MAC was calculated as the mean of the lowest end-tidal isoflurane concentration that prevented positive response and the highest concentration that allowed response. A blood sample for blood gas analysis was collected from the tail vein at the beginning and end of the anesthetic period.

RESULTS

Mean +/- SD MAC of isoflurane was 1.54 +/- 0.17%. Mean heart rates at the upper and lower MAC values were 32.4 +/- 3 beats/min and 34 +/- 4.5 beats/min, respectively. During the experiment, PaCo2 decreased significantly from 43.1 mm Hg to 279 mm Hg and blood pH and HCO3 concentration increased significantly from 7.33 to 7.64 and from 25.3 to 32.9 mmol/L, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

The MAC of isoflurane in Dumeril monitors was similar to that reported in mammals but lower than values reported in other reptiles. This difference may be reflective of the more advanced cardiovascular physiologic features of monitor lizards.

Relationship of bispectral index to minimum alveolar concentration multiples of sevoflurane in cats

OBJECTIVE

To determine the relationship between bispectral index (BIS) and minimum alveolar concentration (MAC) multiples of sevoflurane in cats.

ANIMALS

8 domestic cats.

PROCEDURE

Each cat was anesthetized twice with sevoflurane. First, the MAC of sevoflurane for each cat was determined by use of the tail clamp method. Second, cats were anesthetized with sevoflurane at each of 5 MAC multiples administered in random order. Ventilation was controlled, and after a 15-minute equilibration period at each MAC multiple of sevoflurane, BIS data were collected for 5 minutes and the median value of BIS calculated.

RESULTS

The mean (+/- SD) MAC of sevoflurane was 3.3 +/- 0.2%. The BIS values at 0.5 MAC could not be recorded as a result of spontaneous movement in all 8 cats. The BIS values at 2.0 MAC were confounded by burst suppression in all 8 cats. Over the range of 0.8 to 1.5 MAC, BIS values decreased significantly with increasing end-tidal sevoflurane concentrations. Mean (+/- SD) BIS measurements were 30 +/- 3, 21 +/- 3, and 5 +/- 2 at 0.8, 1.0, and 1.5 MAC, respectively.

CONCLUSIONS AND CLINICAL RELEVANCE

Values of BIS are inversely and linearly related to end-tidal sevoflurane concentrations in anesthetized cats, and BIS may be a useful predictor of CNS depression in this species. The consistently low BIS values recorded in this study suggest that clinical BIS end points used to titrate anesthetic agents in humans may not be applicable to cats.

Minimum alveolar concentration measures of central nervous system activation in cats anesthetized with isoflurane

OBJECTIVE

To compare the minimum alveolar concentration (MAC) of isoflurane required to prevent corticocerebral activation, autonomic responses, and purposeful movements after somatic or visceral stimulation in cats anesthetized with isoflurane.

ANIMALS

17 healthy spayed female cats.

PROCEDURE

Bispectral index (BIS), autonomic parameters, and purposeful movements were monitored before and after somatic or visceral stimuli in cats anesthetized with isoflurane. End-tidal (ET) isoflurane concentration was varied to determine MAC values for cortical arousal (MAC(BIS)), autonomic responsiveness (MAC(BAR)), and purposeful movement (MAC). Bispectral index values > or = 60 were considered to represent corticocerebral activation.

RESULTS

Minimum alveolar concentration for purposeful movement was significantly less than MAC(BIS) and MAC(BAR) for both somatic and visceral stimulation. Individual MAC values for somatic stimulation were not significantly different from respective MAC values for visceral stimulation. The percentage of cats that had a BIS response > or = 60 was inversely related to the end-tidal isoflurane concentration.

CONCLUSIONS AND CLINICAL RELEVANCE

Corticocerebral arousal and subcortical autonomic reflexes occured at isoflurane anesthetic concentrations at which reflexive or purposeful movements were absent. These results suggested that isoflurane had a preferential effect on voluntary motor output at low end-tidal isoflurane concentrations, and that sensory pathways, subcortical sympathetic output, and cortical responsiveness are less susceptible to the anesthetic effects of isoflurane. Bispectral index values obtained after somatic or visceral stimulation were sensitive for the detection of early changes in cortical excitability.