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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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Tünsmeyer J, Hopster K, Kästner SB. Clinical Use of a Multivariate Electroencephalogram (Narcotrend) for Assessment of Anesthetic Depth in Horses during Isoflurane-Xylazine Anesthesia. Front Vet Sci 2016; 3:25. [PMID: 27014707 PMCID: PMC4794479 DOI: 10.3389/fvets.2016.00025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 03/04/2016] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the use of the Narcotrend electroencephalogram (EEG) monitor for the assessment of anesthetic depth in horses undergoing xylazine balanced isoflurane anesthesia. Study design Blinded experimental study. Animals Seven healthy warm-blooded horses, aged 10.6 ± 5.9 years, weighing 535 ± 55 kg. Methods Horses were anesthetized for a terminal surgical trial with xylazine, thiopentone, and guaiphenesin for induction and isoflurane and xylazine continuous rate infusion for maintenance. After surgery, an EEG was recorded and processed by the Narcotrend monitor. It displays an index [Narcotrend index (NI)] between 0 and 100, which is supposed to indicate anesthetic depth. This index was recorded and correlated with eight different end tidal (ET) isoflurane concentrations between 0.8 and 2.2 vol%. In addition, anesthetic depth was numerically scored based on common clinical signs with a score of 1 (plane “too deep”) to 4 (plane “too light”). After testing for normal distribution, both clinical scores and NI were correlated with different ET isoflurane concentrations using Spearman rank correlation. Results Correlation of NI with ET isoflurane concentrations was poor (rs = 0.24). The NI ranged between maximal 48 and minimal 13 in the horses. The clinical scores decreased with increasing ET isoflurane concentrations (rs = 0.80). They ranged from 1 to 4 in different horses at the concentrations investigated. Conclusion In this study, the NI did not seem to be useful for assessment of anesthetic depth in horses receiving isoflurane anesthesia balanced with a xylazine constant rate infusion.
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Affiliation(s)
- Julia Tünsmeyer
- Small Animal Clinic, University of Veterinary Medicine Hannover Foundation , Hannover , Germany
| | - Klaus Hopster
- Equine Clinic, University of Veterinary Medicine Hannover Foundation , Hannover , Germany
| | - Sabine B Kästner
- Small Animal Clinic, University of Veterinary Medicine Hannover Foundation, Hannover, Germany; Equine Clinic, University of Veterinary Medicine Hannover Foundation, Hannover, Germany
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Dugdale AHA, Taylor PM. Equine anaesthesia-associated mortality: where are we now? Vet Anaesth Analg 2016; 43:242-55. [PMID: 26970940 DOI: 10.1111/vaa.12372] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 01/12/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To review the literature concerning mortality associated with general anaesthesia in horses and to assess whether there is evidence for a reduction in mortality over the 20 years since the Confidential Enquiry into Perioperative Equine Fatalities (CEPEF). DATABASES USED PubMed, Scopus, Google Scholar. Search terms used: horse; pony; equine; anaesthesia; anesthesia; recovery; morbidity, and mortality. CONCLUSIONS The most recent studies, in which isoflurane and sevoflurane have been more commonly used for anaesthesia maintenance, report fewer intraoperative cardiac arrests than older studies in which halothane was favoured. Catastrophic fractures, however, have become the greatest cause of recovery-associated mortality.
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Affiliation(s)
- Alexandra H A Dugdale
- Faculty of Health and Life Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
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Portier K, Crouzier D, Guichardant M, Prost M, Debouzy JC, Kirschvink N, Fellmann N, Lekeux P, Coudert J. Effects of high and low inspired fractions of oxygen on horse erythrocyte membrane properties, blood viscosity and muscle oxygenation during anaesthesia. Vet Anaesth Analg 2009; 36:287-98. [DOI: 10.1111/j.1467-2995.2009.00459.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Zhu T, Pang Q, McCluskey SA, Luo C. Effect of propofol on hepatic blood flow and oxygen balance in rabbits. Can J Anaesth 2008; 55:364-70. [PMID: 18566200 DOI: 10.1007/bf03021492] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Propofol has been reported to alter hepatic blood flow and to increase hepatic oxygen consumption. This study was designed to determine the effect of propofol on hepatic blood flow and oxygenation in rabbits, in order to establish its net effect on hepatic oxygen balance. METHODS Twenty, adult male, New Zealand white rabbits were randomly divided into two groups: Group P (propofol, 0.6 mg.kg(-1).min(-1)) or Group C (10% intralipid, 0.6 mg.kg(-1).min(-1)). An electromagnetic flowmeter was used to measure hepatic blood flow, and blood, from the carotid artery, the portal vein, and the hepatic vein, was used to determine hepatic oxygenation. After we obtained baseline values, we repeated measurements ten, 30, and 60 min after initiating the infusion. RESULTS Intralipid did not affect systemic hemodynamics, hepatic blood flow, or oxygenation during the 60 min infusion; however, propofol caused a time-dependent decrease in mean arterial blood pressures and an increase in portal venous flow and total hepatic blood flow. In contrast, hepatic arterial blood flow remained unchanged during the propofol infusion. Hepatic oxygen delivery and consumption increased in a time-dependent manner to maximums of 25% and 21.4% (both, P < 0.05) above baseline, respectively. Hepatic venous oxygen saturation and extraction was unchanged throughout the study period. CONCLUSION Propofol increases total hepatic blood flow, primarily by increasing hepatic portal venous flow. The increase in liver oxygen consumption was fully compensated by an increase in oxygen supply to the liver, resulting in a preserved, hepatic oxygen balance.
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Affiliation(s)
- Tao Zhu
- Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu Sichuan Province, China.
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