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Bettschart-Wolfensberger R. Sevoflurane versus isoflurane - which agent leads to better recovery from anaesthesia in horses? Vet Rec 2021. [PMID: 34357599 DOI: 10.1002/vetr.801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Yaygingul R. Comparison of the Anesthetic Effects of Isoflurane and Sevoflurane Inhalation on the Cardiovascular System of the Common Buzzard ( Buteo buteo). J Avian Med Surg 2021; 34:237-242. [PMID: 33099976 DOI: 10.1647/1082-6742-34.3.237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The aim of this study was to compare the effects of isoflurane (ISO) and sevoflurane (SEVO) inhalation anesthesia on the cardiovascular system of the common buzzard (Buteo buteo). Fourteen common buzzards of unknown sex and age, weighing 700-900 g each, were used for the study. The buzzards were randomly divided into an ISO group and a SEVO group, each comprising 7 buzzards. The buzzards were then anesthetized by masked induction with either ISO or SEVO. After induction, all buzzards were intubated with a 2.5-mm-diameter uncuffed endotracheal tube. Anesthesia was maintained with 3% ISO or 4% SEVO in a 3 L/min flow of 100% oxygen. Before induction, immediately after induction, and at intervals of 5, 10, 15, 20, 25, and 30 min after the patients were induced, the heart rate, respiratory rate, and body temperature of the buzzards were recorded. In addition, before and during anesthesia, serum electrolytes (sodium, ionized calcium, and potassium), blood gas measurements (arterial pH, arterial partial pressure of carbon dioxide, arterial partial pressure of oxygen, bicarbonate concentration, and oxyhemoglobin saturation), and hematocrit values were evaluated in the blood samples taken from both the ISO and SEVO groups. A statistically significant decrease in body temperature was observed in both groups. A significant decrease in heart rate was observed in the ISO group. The increases in partial pressure of carbon dioxide and bicarbonate concentration were statistically significant in both groups. The effects of ISO and SEVO anesthesia on the cardiovascular and respiratory system in the buzzards were similar based on the results of this study.
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Affiliation(s)
- Rahime Yaygingul
- Aydin Adnan Menderes University, Veterinary Faculty, Department of Surgery, 09016 Isikli, Aydin, Turkey,
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Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021; 11:ani11061777. [PMID: 34198637 PMCID: PMC8232193 DOI: 10.3390/ani11061777] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Recovery is the most dangerous phase of general anaesthesia in horses. Numerous publications have reported about this phase, but structured reviews that try to reduce the risk of bias of narrative reviews/expert opinions, focussing on the topic are missing. Therefore, the aim of the present article was to publish the first structured review as a summary of the literature focussing on the recovery phase after general anaesthesia in horses. The objective was to summarise the available literature, taking into account the scientific evidence of the individual studies. A structured approach was followed with two experts in the field independently deciding on article inclusion and its level of scientific evidence. A total number of 444 articles, sorted by topics and classified based on their levels of evidence, were finally included into the present summary. The most important findings were summarised and discussed. The present structured review can be used as a compilation of the publications that, to date, focus on the recovery phase after general anaesthesia in adult horses. This type of review tries to minimise the risk of bias inherent to narrative reviews/expert opinions. Abstract Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords “recovery anaesthesia horse”, entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 “narrative reviews/expert opinions”, 16 “retrospective outcome studies”, 5 “surveys”, 59 “premedication/sedation and induction drugs”, 27 “maintenance with inhalant agents”, 55 “maintenance with total intravenous anaesthesia (TIVA)”, 3 “TIVA versus inhalants”, 56 “maintenance with partial intravenous anaesthesia (PIVA)”, 27 “other drugs used during maintenance”, 18 “drugs before/during recovery”, 18 “recovery systems”, 21 “respiratory system in recovery”, 41 “other factors”, 51 “case series/reports” and 6 “systems to score recoveries”. Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.
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White KL, Hird JFR, Taylor PM. Sevoflurane or isoflurane anaesthesia? A prospective, randomised blinded clinical trial in horses undergoing elective surgery. Vet Rec 2021; 189:e507. [PMID: 34047371 DOI: 10.1002/vetr.507] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/26/2021] [Accepted: 04/30/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Isoflurane is the only volatile anaesthetic agent licensed for equine use in the United Kingdom, but sevoflurane is also commonly used. The two agents have rarely been compared for use in clinical elective surgery. METHODS This single centre, prospective, randomised, blinded clinical investigation recruited 101 healthy client owned horses undergoing elective surgery. Anaesthesia was standardised and horses randomly assigned to receive isoflurane (I) or sevoflurane (S) for maintenance of anaesthesia in 100% oxygen. Horses were ventilated to normocapnia and received intravenous fluid therapy and haemodynamic support with dobutamine to maintain mean arterial blood pressure above 60 mm Hg. Recovery was timed and video-recorded to allow offline evaluation by two experienced clinicians unaware of the volatile agent used. No post-anaesthetic sedation was administered. RESULTS There was no significant difference between groups in terms of haemodynamic support required during anaesthesia nor in quality or duration of recovery. Inotropic support to maintain MAP above 60 mm Hg was required by 67 of 101 (67%) of horses. Five horses in the I group required additional ketamine or thiopentone to improve the plane of anaesthesia. CONCLUSIONS Haemodynamic support needed during anaesthesia as well as the duration and quality of recovery were similar with isoflurane and sevoflurane.
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Affiliation(s)
- Kate L White
- School of Veterinary Medicine and Science, University of Nottingham, Leicestershire, UK
| | - John F R Hird
- Shelf Equine Hospital, Lower Giles Hill Farm, Halifax, West Yorkshire, UK
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Velázquez-Delgado PI, Gutierrez-Blanco E, Torres-Acosta FDJ, Ortega-Pacheco A, Aguilar-Caballero AJ, Dzikiti BT. Comparison of Propofol or Isoflurane Anesthesia Maintenance, Combined with a Fentanyl-Lidocaine-Ketamine Constant-Rate Infusion in Goats Undergoing Abomasotomy. Animals (Basel) 2021; 11:ani11020492. [PMID: 33668487 PMCID: PMC7918233 DOI: 10.3390/ani11020492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/24/2021] [Accepted: 02/11/2021] [Indexed: 11/16/2022] Open
Abstract
Simple Summary General anesthesia in small ruminants is still a challenge under field conditions. Propofol is an injectable short-acting anesthetic used to provide induction and/or anesthesia maintenance. Isoflurane is the inhaled anesthetic more widely used for providing general anesthesia; however, it requires an expensive equipment for its administration, and high doses may produce environmental pollution. Both anesthetics produce dose-related cardiovascular depressant effects. This study aimed to compare the effects of propofol or isoflurane, combined with a constant-rate infusion of fentanyl–lidocaine–ketamine (total [total intravenous anesthesia (TIVA)] and partial intravenous anesthesia [PIVA], respectively) in goats undergoing abomasotomy. Our results showed that both TIVA and PIVA protocols produced a satisfactory quality of anesthesia during surgery, with minimal changes in cardiopulmonary parameters. However, recovery from anesthesia induced by propofol fentanyl–lidocaine–ketamine might be of poor quality. Abstract This study aimed to compare, first, the anesthetic and cardiopulmonary effects of propofol or isoflurane anesthetic maintenance in goats receiving a fentanyl–lidocaine–ketamine infusion undergoing abomasotomy and, secondly, to compare the quality of the recovery from anesthesia. Two groups were used: propofol (TIVA) and isoflurane (PIVA). Goats were premedicated with fentanyl (10 μg/kg intravenously [IV]), lidocaine (2 mg/kg, IV), and ketamine (1.5 mg/kg, IV). Anesthesia was induced with propofol and maintenance consisted of fentanyl (10 μg/kg/h, IV), lidocaine (50 μg/kg/min, IV), and ketamine (50 μg/kg/min, IV) as constant-rate infusions (CRIs), combined with either CRI of propofol at initial dose of 0.3 mg/kg/min, IV (TIVA), or isoflurane with initial end-tidal (FE’Iso) concentration of 1.2% partial intravenous anesthesia (PIVA). The mean effective propofol dose for maintenance was 0.44 ± 0.07 mg/kg/min, while the mean FE’Iso was 0.81 ± 0.2%. Higher systolic arterial pressure (SAP) values were observed in total intravenous anesthesia (TIVA) during some time points. Recovery was smooth in PIVA, while restlessness, vocalizations, and paddling were observed in TIVA. Both protocols produced a satisfactory quality of anesthesia during surgery, with minimal impact on cardiopulmonary function. Nevertheless, recovery after anesthesia in TIVA might be of poor quality.
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Affiliation(s)
- Perla I. Velázquez-Delgado
- Department of Animal Health and Preventive Medicine, Autonomous University of Yucatan, 97000 Merida, Mexico; (P.I.V.-D.); (F.d.J.T.-A.); (A.O.-P.); (A.J.A.-C.)
| | - Eduardo Gutierrez-Blanco
- Department of Animal Health and Preventive Medicine, Autonomous University of Yucatan, 97000 Merida, Mexico; (P.I.V.-D.); (F.d.J.T.-A.); (A.O.-P.); (A.J.A.-C.)
- Correspondence: ; Tel.: +52-99-9942-3200
| | - Felipe de J. Torres-Acosta
- Department of Animal Health and Preventive Medicine, Autonomous University of Yucatan, 97000 Merida, Mexico; (P.I.V.-D.); (F.d.J.T.-A.); (A.O.-P.); (A.J.A.-C.)
| | - Antonio Ortega-Pacheco
- Department of Animal Health and Preventive Medicine, Autonomous University of Yucatan, 97000 Merida, Mexico; (P.I.V.-D.); (F.d.J.T.-A.); (A.O.-P.); (A.J.A.-C.)
| | - Armando J. Aguilar-Caballero
- Department of Animal Health and Preventive Medicine, Autonomous University of Yucatan, 97000 Merida, Mexico; (P.I.V.-D.); (F.d.J.T.-A.); (A.O.-P.); (A.J.A.-C.)
| | - Brighton T. Dzikiti
- Department of Large Animal Clinical Science, School of Veterinary Medicine, Ross University, KN0111 Basseterre, Saint Kitts and Nevis;
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Tokushige H, Araki M, Kusano K, Arima D, Ito H, Yamazaki Y, Urayama S, Kambayashi Y, Tateno O, Ohta M. A retrospective comparison of induction with thiopental/guaifenesin and propofol/ketamine in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine during arthroscopic surgery. J Equine Sci 2019; 30:25-31. [PMID: 31285690 PMCID: PMC6606449 DOI: 10.1294/jes.30.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Accepted: 04/23/2019] [Indexed: 11/01/2022] Open
Abstract
This study compares clinical characteristics between induction with thiopental/guaifenesin and propofol/ketamine in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine. Clinical records of 214 horses that underwent arthroscopic surgery between 2015 and 2016 were retrospectively retrieved. Horses were premedicated with medetomidine and midazolam to sedate at the adequate level for smooth induction, and then induced with either thiopental (4.0 mg/kg) and guaifenesin (100 mg/kg) in Group TG (n=91) or propofol (1.0 mg/kg) and ketamine (1.0 mg/kg) in Group PK (n=123). Anesthesia was maintained using sevoflurane with constant rate infusion of medetomidine. Quality of induction/recovery, sevoflurane requirement, cardiovascular function and recovery characteristics were evaluated. Anesthetic induction scores (median, range) for Group TG (5, 2-5) and Group PK (5, 2-5) were not significantly different. There were no significant differences in end-tidal sevoflurane concentration (mean ± standard deviation) between Group TG and Group PK (both 2.4 ± 0.2%). Dobutamine infusion rate (µg/kg/min) required for keeping mean arterial blood pressure (MAP) above 70 mmHg in Group PK (0.43, 0.10-1.40) was significantly lower than in Group TG (0.67, 0.08-1.56). Recovery score in Group PK (5, 2-5) was significantly higher than in Group TG (4, 2-5). Both propofol/ketamine and thiopental/guaifenesin provided a smooth induction of anesthesia. Moreover, induction with propofol/ketamine resulted in lower dobutamine requirements for keeping MAP above 70 mmHg during maintenance, and better quality of recovery. Induction with propofol/ketamine would be preferable to thiopental/guaifenesin in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine during arthroscopic surgery.
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Affiliation(s)
- Hirotaka Tokushige
- Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
| | - Masanari Araki
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Kanichi Kusano
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Daisuke Arima
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Hideki Ito
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Yosuke Yamazaki
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Shuntaro Urayama
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Yoshinori Kambayashi
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Oki Tateno
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Minoru Ohta
- Equine Research Institute, Japan Racing Association, Tochigi 329-0412, Japan
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Tokushige H, Okano A, Arima D, Ito H, Kambayashi Y, Minamijima Y, Ohta M. Clinical effects of constant rate infusions of medetomidine-propofol combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. Acta Vet Scand 2018; 60:71. [PMID: 30396363 PMCID: PMC6217774 DOI: 10.1186/s13028-018-0426-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/29/2018] [Indexed: 11/29/2022] Open
Abstract
Background The aim of the present study was to evaluate clinical efficacy of constant rate infusions (CRIs) of medetomidine–propofol combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. Thirty horses were sedated intravenously (IV) with medetomidine (6.0 μg/kg) and midazolam (0.02 mg/kg) and induced IV with ketamine (1.0 mg/kg) and propofol (1.0 mg/kg). These horses were randomly allocated to three groups and maintained with sevoflurane and CRI of either medetomidine (3.0 μg/kg/h) (Group M; n = 10); or medetomidine (3.0 μg/kg/h) and propofol (3.0 mg/kg/h) (Group MP3; n = 10); or medetomidine (3.0 μg/kg/h) and propofol (6.0 mg/kg/h) (Group MP6; n = 10). End-tidal sevoflurane concentration (ETSEVO), cardiovascular parameters, plasma propofol concentration, and recovery time and quality were compared among groups. Data were analyzed by using ANOVA with Tukey’s multiple comparison test, considering P < 0.05 significant. Results ETSEVO (%) was 2.4 ± 0.1 in Group M, 1.7 ± 0.2 in Group MP3, and 1.4 ± 0.2 in Group MP6; ETSEVO declined significantly in a propofol-dose-dependent manner. The rates of dobutamine infusion (μg/kg/min) required to keep the mean arterial blood pressure over 70 mmHg were significantly lower in Group MP3 (0.20 ± 0.10) and Group MP6 (0.15 ± 0.06) than in Group M (0.37 ± 0.18). Recovery time and quality did not differ among groups. All horses in Group MP3 required only one attempt to stand, and recovery quality was excellent. Plasma propofol concentrations were stable throughout maintenance of anesthesia in Group MP3, whereas those in Group MP6 increased significantly with increasing duration of maintenance. Conclusions CRIs of medetomidine–propofol reduced the sevoflurane requirement for surgical anesthesia as the propofol dose increased, compared with a CRI of medetomidine alone. Additionally, the two propofol protocols provided good maintenance of cardiovascular function. CRIs of medetomidine (3.0 μg/kg/h) and propofol (3.0 mg/kg/h) resulted in excellent-quality recovery. This protocol could therefore be an especially useful additive to sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery.
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Tokushige H, Kushiro A, Okano A, Maeda T, Ito H, Wakuno A, Nagata SI, Ohta M. Clinical evaluation of constant rate infusion of alfaxalone-medetomidine combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. Acta Vet Scand 2018; 60:50. [PMID: 30180855 PMCID: PMC6123962 DOI: 10.1186/s13028-018-0406-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 08/30/2018] [Indexed: 11/10/2022] Open
Abstract
Background Alfaxalone has a number of pharmacological properties which are desirable for constant rate infusion (CRI). Previously, the co-administration of alfaxalone and medetomidine is shown to be suitable for short-term anesthesia in horses. However, the use of alfaxalone–medetomidine CRI with inhalational anesthesia under surgical procedures have not been investigated in clinical cases. The aim of the present study was to evaluate the clinical efficacy of alfaxalone–medetomidine CRI in sevoflurane-anesthetized Thoroughbred racehorses undergoing arthroscopic surgery. Sevoflurane requirement, cardiovascular function, and induction/recovery quality were compared between horses maintained with sevoflurane in combination with medetomidine CRI (3 µg/kg/h) (Group M; n = 25) and those maintained with sevoflurane in combination with alfaxalone–medetomidine CRI (0.5 mg/kg/h and 3 µg/kg/h, respectively) (Group AM; n = 25). Results The mean end-tidal sevoflurane concentrations were significantly lower in Group AM (1.8 ± 0.2%) than in Group M (2.4 ± 0.1%). The mean dobutamine infusion rate required for maintaining mean arterial blood pressure within the target values (60–80 mmHg) was significantly lower in Group AM (0.53 ± 0.20 µg/kg/min) than in Group M (0.85 ± 0.32 µg/kg/min). Induction and recovery scores were not significantly different between two groups. However, excitatory response during recovery were observed in five horses in Group AM. The mean plasma alfaxalone concentrations were stable throughout the maintenance period (0.77 ± 0.12 to 0.85 ± 0.13 µg/mL), and decreased significantly immediately after standing (0.32 ± 0.07 µg/mL). Conclusions Alfaxalone–medetomidine CRI reduced sevoflurane requirement by approximately 26% with good maintenance of cardiopulmonary function in Thoroughbred racehorses undergoing arthroscopic surgery. Sevoflurane in combination with alfaxalone–medetomidine CRI may be a clinically effective anesthetic technique for Thoroughbred racehorses. However, 20% of horses administered alfaxalone showed remarkable excitatory response during recovery. Greater attention to excitatory response may be advisable if alfaxalone is used for induction or maintenance of anesthesia. A larger study is needed to explore the clinical relevance of these findings.
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Mizobe F, Wakuno A, Okada J, Otsuka T, Ishikawa Y, Kurimoto S. Clinical usefulness of intravenous constant rate infusion of fentanyl and medetomidine under sevoflurane anesthesia in Thoroughbred racehorses undergoing internal fixation surgery. J Equine Sci 2017; 28:143-147. [PMID: 29270071 PMCID: PMC5735311 DOI: 10.1294/jes.28.143] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/18/2017] [Indexed: 11/30/2022] Open
Abstract
A total of 20 racehorses with longitudinal fractures underwent internal fixation surgery under sevoflurane anesthesia combined with infusion of medetomidine (3 µg/kg/hr) alone (10 horses, group M) or medetomidine and
fentanyl (7 µg/kg/hr) (10 horses, group FM). In group FM, the end-tidal sevoflurane concentration during surgery was maintained significantly lower than in group M (2.8–2.9% for group M vs. 2.2–2.6% for group FM,
P<0.01). The mean arterial blood pressure was maintained over 70 mmHg using dobutamine infusion (group M, 0.36–0.54 µg/kg/min; group FM, 0.27–0.65 µg/kg/min), and the recovery qualities were clinically acceptable in
both groups. In conclusion, co-administration of fentanyl and medetomidine by constant rate infusion may be a clinically useful intraoperative anesthetic adjunct for horses to reduce the requirement of sevoflurane when
they undergo orthopedic surgery.
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Affiliation(s)
- Fumiaki Mizobe
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Ai Wakuno
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Jun Okada
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Tasuku Otsuka
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Yuhiro Ishikawa
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
| | - Shinjiro Kurimoto
- Racehorse Hospital, Ritto Training Center, Japan Racing Association, Shiga 520-3085, Japan
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Wakuno A, Maeda T, Kodaira K, Kikuchi T, Ohta M. Anesthetic management with sevoflurane combined with alfaxalone-medetomidine constant rate infusion in a Thoroughbred racehorse undergoing a long-time orthopedic surgery. J Equine Sci 2017; 28:111-115. [PMID: 28955163 PMCID: PMC5608964 DOI: 10.1294/jes.28.111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Accepted: 06/15/2017] [Indexed: 11/17/2022] Open
Abstract
A three-year old Thoroughbred racehorse was anesthetized with sevoflurane and oxygen inhalation anesthesia combined with constant rate infusion (CRI) of alfaxalone-medetomidine for internal fixation of a third metacarpal bone
fracture. After premedication with intravenous (IV) injections of medetomidine (6.0 µg/kg IV), butorphanol (25 µg/kg IV), and midazolam (20 µg/kg IV), anesthesia was induced with 5% guaifenesin (500 ml/head IV) followed
immediately by alfaxalone (1.0 mg/kg IV). Anesthesia was maintained with sevoflurane and CRIs of alfaxalone (1.0 mg/kg/hr) and medetomidine (3.0 µg/kg/hr). The total surgical time was 180 min, and the total inhalation anesthesia
time was 230 min. The average end-tidal sevoflurane concentration during surgery was 1.8%. The mean arterial blood pressure was maintained above 70 mmHg throughout anesthesia, and the recovery time was 65 min. In conclusion, this
anesthetic technique may be clinically applicable for Thoroughbred racehorses undergoing a long-time orthopedic surgery.
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Affiliation(s)
- Ai Wakuno
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Tatsuya Maeda
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Kazumichi Kodaira
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Takuya Kikuchi
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
| | - Minoru Ohta
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Ibaraki 300-0493, Japan
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Tokushige H, Ohta M, Okano A, Kuroda T, Kakizaki M, Ode H, Aoki M, Wakuno A, Kawasaki K. Effects of Medetomidine Constant Rate Infusion on Sevoflurane Requirement, Cardiopulmonary Function, and Recovery Quality in Thoroughbred Racehorses Undergoing Arthroscopic Surgery. J Equine Vet Sci 2015. [DOI: 10.1016/j.jevs.2014.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Ohta M, Kurimoto S, Ishikawa Y, Tokushige H, Mae N, Nagata SI, Mamada M. Cardiovascular effects of dobutamine and phenylephrine infusion in sevoflurane-anesthetized Thoroughbred horses. J Vet Med Sci 2013; 75:1443-8. [PMID: 23832627 PMCID: PMC3942978 DOI: 10.1292/jvms.13-0104] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To determine dose-dependent cardiovascular effects of dobutamine and phenylephrine during
anesthesia in horses, increasing doses of dobutamine and phenylephrine were infused to 6
healthy Thoroughbred horses. Anesthesia was induced with xylazine, guaifenesin and
thiopental and maintained with sevoflurane at 2.8% of end-tidal concentration in all
horses. The horses were positioned in right lateral recumbency and infused 3 increasing
doses of dobutamine (0.5, 1.0 and 2.0 µg/kg/min) for 15 min each dose.
Following to 30 min of reversal period, 3 increasing doses of phenylephrine (0.25, 0.5 and
1.0 µg/kg/min) were infused. Cardiovascular parameters were measured
before and at the end of each 15-min infusion period for each drug. Blood samples were
collected every 5 min during phenylephrine infusion period. There were no significant
changes in heart rate throughout the infusion period. Both dobutamine and phenylephrine
reversed sevoflurane-induced hypotension. Dobutamine increased both mean arterial blood
pressure (MAP) and cardiac output (CO) as the result of the increase in stroke volume,
whereas phenylephrine increased MAP but decreased CO as the result of the increase in
systemic vascular resistance. Plasma phenylephrine concentration increased
dose-dependently, and these values at 15, 30 and 45 min were 6.2 ± 1.2, 17.0 ± 4.8 and
37.9 ± 7.3 ng/ml, respectively.
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Affiliation(s)
- Minoru Ohta
- Racehorse Clinic, Ritto Training Center, Japan Racing Association (JRA), 1028 Misono, Ritto-shi, Shiga 520-3085, Japan
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Wagner AE, Mama KR, Steffey EP, Ferreira TH, Rezende ML. Comparison of the cardiovascular effects of equipotent anesthetic doses of sevoflurane alone and sevoflurane plus an intravenous infusion of lidocaine in horses. Am J Vet Res 2011; 72:452-60. [DOI: 10.2460/ajvr.72.4.452] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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The effect of preanesthetic administration of lactated Ringer solution on blood pressure in isoflurane-anesthetized horses. ACTA VET-BEOGRAD 2011. [DOI: 10.2298/avb1103175b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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HUBBELL JAE, SAVILLE WJA, BEDNARSKI RM. The use of sedatives, analgesic and anaesthetic drugs in the horse: An electronic survey of members of the American Association of Equine Practitioners (AAEP). Equine Vet J 2010; 42:487-93. [DOI: 10.1111/j.2042-3306.2010.00104.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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OHTA M, WAKUNO A, OKADA J, KODAIRA K, NAGATA SI, ITO M, OKU K. Effects of Intravenous Fentanyl Administration on End-Tidal Sevoflurane Concentrations in Thoroughbred Racehorses undergoing Orthopedic Surgery. J Vet Med Sci 2010; 72:1107-11. [DOI: 10.1292/jvms.09-0285] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Minoru OHTA
- Racehorse Clinic, Ritto Training Center, Japan Racing Association (JRA)
| | - Ai WAKUNO
- Racehorse Clinic, Ritto Training Center, Japan Racing Association (JRA)
| | - Jun OKADA
- Racehorse Clinic, Ritto Training Center, Japan Racing Association (JRA)
| | - Kazumichi KODAIRA
- Racehorse Clinic, Ritto Training Center, Japan Racing Association (JRA)
| | | | - Motoki ITO
- Racehorse Clinic, Ritto Training Center, Japan Racing Association (JRA)
| | - Kazuomi OKU
- Racehorse Clinic, Ritto Training Center, Japan Racing Association (JRA)
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Bidwell LA, Bramlage LR, Rood WA. Equine perioperative fatalities associated with general anaesthesia at a private practice – a retrospective case series. Vet Anaesth Analg 2007; 34:23-30. [PMID: 17238959 DOI: 10.1111/j.1467-2995.2005.00283.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To determine the fatality rate of horses undergoing general anaesthesia at a private equine referral practice using a limited number of anaesthetic protocols. METHODS A retrospective analysis of records (n = 17 961) from all horses undergoing general anaesthesia for surgical procedures from 1997 to 2001 at Rood and Riddle Equine Hospital, Lexington, Kentucky, USA. Results were reported as percentage of the population, and as crude mortality rates for each procedure (deaths per 1000). RESULTS The prevalence of equine fatalities directly related to anaesthesia was 0.12% (n = 21) and this rose to 0.24% (n = 42) with the inclusion of horses killed or dying within 7 days post general anaesthesia. Causes of death directly related to anaesthesia were cardiac arrest (n = 10), fracture in recovery stall (n = 8), neuropathy and myopathy necessitating euthanasia (n = 3). Crude mortality rates per procedure were < or =7 deaths per 1000 cases, except arthrodesis/osteotomy cases were 66.7 deaths per 1000 cases. CONCLUSIONS The anaesthetic fatality rate at this practice is lower than has been reported previously. CLINICAL RELEVANCE Familiarity with an anaesthetic protocol in combination with reduced anaesthetic time, emergencies of shorter duration between diagnosis and surgery, and adequate preoperative examination appear to minimize the risks associated with general anaesthesia in horses.
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Affiliation(s)
- Lori A Bidwell
- Rood and Riddle Equine Hospital, Lexington, KY 40511, USA.
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Driessen B, Nann L, Benton R, Boston R. Differences in need for hemodynamic support in horses anesthetized with sevoflurane as compared to isoflurane. Vet Anaesth Analg 2006; 33:356-67. [PMID: 17083608 DOI: 10.1111/j.1467-2995.2005.00279.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To study whether hemodynamic function in horses, particularly mean arterial blood pressure (MAP), is better maintained with sevoflurane than isoflurane, thus requiring less pharmacological support. STUDY DESIGN Prospective randomized clinical investigation. Animals Thirty-nine racehorses undergoing arthroscopy in lateral recumbency. METHODS Horses were assigned to receive either isoflurane (n = 20) or sevoflurane (n = 19) at 0.9-1.0 minimum alveolar concentration (MAC) for maintenance of anesthesia. Besides routine clinical monitoring, cardiac output (CO) was measured by lithium dilution. Hemodynamic support was prescribed as follows: when MAP decreased to <70 mmHg, patients were to receive infusion of 0.1% dobutamine, which was to be discontinued at MAP >85 mmHg or heart rate >60 beats minute(-1). Statistical analysis of results, given as mean +/- SD, included a clustered regression approach. RESULTS Average inhalant anesthetic time [91 +/- 35 (isoflurane group) versus 97 +/- 26 minutes (sevoflurane group)] and dose (in MAC multiples), volume of crystalloid solution infused, and cardiopulmonary parameters including CO were similar in the two groups, except heart rate was 8% higher in isoflurane than sevoflurane horses (p < 0.05). To maintain MAP >70 mmHg, isoflurane horses received dobutamine over a significantly longer period (55 +/- 26 versus 28 +/- 21% of total anesthetic time, p < 0.01) and at a 51% higher dose than sevoflurane horses (41 +/- 19 versus 27 +/- 23 microg kg(-1) MAC hour(-1); p = 0.058), with 14/20 isoflurane animals and only 9/19 sevoflurane horses being infused with dobutamine at >30 microg kg(-1) MAC hour(-1) (p < 0.05). Dobutamine infusion rates were consistently lower in the sevoflurane as compared to the isoflurane group, with differences reaching significance level during the 0-30 minutes (p < 0.01) and 61-90 minutes periods (p < 0.05). CONCLUSIONS AND CLINICAL RELEVANCE Horses under sevoflurane anesthesia may require less pharmacological support in the form of dobutamine than isoflurane-anesthetized horses. This could be due to less suppression of vasomotor tone.
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Affiliation(s)
- Bernd Driessen
- Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, Section of Critical Care/Anesthesia, University of Pennsylvania, PA 19348, USA.
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Pypendop BH, Ilkiw JE. Comparison of variability in cardiorespiratory measurements following desflurane anesthesia at a multiple of the minimum alveolar concentration for each dog versus a multiple of a single predetermined minimum alveolar concentration for all dogs in a group. Am J Vet Res 2006; 67:1956-61. [PMID: 17144793 DOI: 10.2460/ajvr.67.12.1956] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether the variability of cardiorespiratory measurements is smaller when administering desflurane at a multiple of the individual's minimum alveolar concentration (MAC) or at a predetermined, identical concentration in all subjects. ANIMALS 10 dogs. PROCEDURES Desflurane was administered at 1.5 times the individual's MAC (iMAC) and 1.5 times the group's MAC (gMAC). The order of concentrations was randomly selected. Heart rate, respiratory rate, arterial blood pressure, central venous pressure, mean pulmonary artery pressure, pulmonary artery occlusion pressure, arterial and mixed-venous blood gas tensions and pH, and cardiac output were measured. The desflurane concentration required to achieve a mean arterial pressure (MAP) of 60 mm Hg was then determined. Finally, the desflurane concentration required to achieve an end-tidal PCO(2) of 55 mm Hg was measured. RESULTS Variances when administering 1.5 iMAC or 1.5 gMAC were not significantly different for any variable studied. Differences between the MAC multiples needed to reach an MAP of 60 mm Hg and the mean of the sample were significantly larger when gMAC was used, compared with iMAC, indicating that a multiple of iMAC better predicted the concentration resulting in a MAP of 60 mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that, in a small group of dogs, variability in cardiorespiratory measurements among dogs is unlikely to differ whether an inhalant anesthetic is administered at a multiple of the iMAC in each dog or at an identical gMAC in all dogs.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Feary DJ, Mama KR, Thomasy SM, Wagner AE, Enns RM. Influence of gastrointestinal tract disease on pharmacokinetics of lidocaine after intravenous infusion in anesthetized horses. Am J Vet Res 2006; 67:317-22. [PMID: 16454639 DOI: 10.2460/ajvr.67.2.317] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the disposition of lidocaine after IV infusion in anesthetized horses undergoing exploratory laparotomy because of gastrointestinal tract disease. ANIMALS 11 horses (mean +/- SD, 10.3 +/- 7.4 years; 526 +/- 40 kg). PROCEDURE Lidocaine hydrochloride (loading infusion, 1.3 mg/kg during a 15-minute period [87.5 microg/kg/min]; maintenance infusion, 50 microg/kg/min for 60 to 90 minutes) was administered IV to dorsally recumbent anesthetized horses. Blood samples were collected before and at fixed time points during and after lidocaine infusion for analysis of serum drug concentrations by use of liquid chromatography-mass spectrometry. Serum lidocaine concentrations were evaluated by use of standard noncompartmental analysis. Selected cardiopulmonary variables, including heart rate (HR), mean arterial pressure (MAP), arterial pH, PaCO2, and PaO2, were recorded. Recovery quality was assessed and recorded. RESULTS Serum lidocaine concentrations paralleled administration, increasing rapidly with the initiation of the loading infusion and decreasing rapidly following discontinuation of the maintenance infusion. Mean +/- SD volume of distribution at steady state, total body clearance, and terminal half-life were 0.70 +/- 0.39 L/kg, 25 +/- 3 mL/kg/min, and 65 +/- 33 minutes, respectively. Cardiopulmonary variables were within reference ranges for horses anesthetized with inhalation anesthetics. Mean HR ranged from 36 +/- 1 beats/min to 43 +/- 9 beats/min, and mean MAP ranged from 74 +/- 18 mm Hg to 89 +/- 10 mm Hg. Recovery quality ranged from poor to excellent. CONCLUSIONS AND CLINICAL RELEVANCE Availability of pharmacokinetic data for horses with gastrointestinal tract disease will facilitate appropriate clinical dosing of lidocaine.
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Affiliation(s)
- Darien J Feary
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
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Oku K, Ohta M, Katoh T, Moriyama H, Kusano K, Fujinaga T. Cardiovascular Effects of Continuous Propofol Infusion in Horses. J Vet Med Sci 2006; 68:773-8. [PMID: 16953074 DOI: 10.1292/jvms.68.773] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
We examined the influence of propofol infusion on cardiovascular system at the rate of 0.14, 0.20 and 0.30 mg/kg/min in six adult Thoroughbred horses. The cardiovascular parameters were heart rate (HR), mean arterial pressure (MAP), mean right atrial pressure (MRAP), stroke volume (SV), cardiac output (CO), systemic vascular resistance (SVR), pre-ejection period (PEP) and ejection time (ET). In order to keep the ventilation conditions constantly, intermittent positive pressure ventilation was performed, and the partial arterial CO(2) pressure was maintained at 45 to 55 mmHg during maintenance anesthesia. SV showed a significant dose-dependent decrease however, CO did not show significant change. SVR decreased significantly at higher dose. PEP was prolonged and PEP/ET increased significantly at the highest dose. From these results, it became clear that SV decreases dose-dependently due to decrease of cardiac contractility during anesthesia with continuous propofol infusion in horses. On the other hand, since MAP and CO did not show significant changes, total intravenous anesthesia with propofol was suggested to be suitable for long-term anesthesia in horses.
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Affiliation(s)
- Kazuomi Oku
- Racehorse Clinic, Miho Training Center, Japan Racing Association, Shiga, Japan
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Steffey EP, Mama KR, Galey FD, Puschner B, Woliner MJ. Effects of sevoflurane dose and mode of ventilation on cardiopulmonary function and blood biochemical variables in horses. Am J Vet Res 2005; 66:606-14. [PMID: 15900940 DOI: 10.2460/ajvr.2005.66.606] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To quantitate effects of dose of sevoflurane and mode of ventilation on cardiovascular and respiratory function in horses and identify changes in serum biochemical values associated with sevoflurane anesthesia. ANIMALS 6 healthy adult horses. PROCEDURE Horses were anesthetized twice: first, to determine the minimum alveolar concentration (MAC) of sevoflurane and second, to characterize cardiopulmonary and serum biochemical responses of horses to 1.0, 1.5, and 1.75 MAC multiples of sevoflurane during controlled and spontaneous ventilation. Results-Mean (+/- SEM) MAC of sevoflurane was 2.84 +/- 0.16%. Cardiovascular performance during anesthesia decreased as sevoflurane increased; the magnitude of cardiovascular depression was more severe during mechanical ventilation, compared with spontaneous ventilation. Serum inorganic fluoride concentration increased to a peak of 50.8 +/- 7.1 micromol/L at the end of anesthesia. Serum creatinine concentration and sorbitol dehydrogenase activity reached their greatest values (2.0 +/- 0.8 mg/dL and 10.2 +/- 1.8 U/L, respectively) at 1 hour after anesthesia and then returned to baseline by 1 day after anesthesia. Serum creatine kinase, aspartate aminotransferase, and alkaline phosphatase activities reached peak values by the first (ie, creatine kinase) or second (ie, aspartate aminotransferase and alkaline phosphatase) day after anesthesia. CONCLUSIONS AND CLINICAL RELEVANCE Sevoflurane causes dose-related cardiopulmonary depression, and mode of ventilation further impacts the magnitude of this depression. Except for serum inorganic fluoride concentration, quantitative alterations in serum biochemical indices of liver- and muscle-cell disruption and kidney function were considered clinically unremarkable and similar to results from comparable studies of other inhalation anesthetics.
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Affiliation(s)
- Eugene P Steffey
- Department of Surgical and Radiological Science, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Mama KR, Wagner AE, Steffey EP, Kollias-Baker C, Hellyer PW, Golden AE, Brevard LF. Evaluation of xylazine and ketamine for total intravenous anesthesia in horses. Am J Vet Res 2005; 66:1002-7. [PMID: 16008223 DOI: 10.2460/ajvr.2005.66.1002] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the use of xylazine and ketamine for total i.v. anesthesia in horses. ANIMALS 8 horses. PROCEDURE Anesthetic induction was performed on 4 occasions in each horse with xylazine (0.75 mg/kg, i.v.), guaifenesin (75 mg/kg, i.v.), and ketamine (2 mg/kg, i.v.). Intravenous infusions of xylazine and ketamine were then started by use of 1 of 6 treatments as follows for which 35, 90, 120, and 150 represent infusion dosages (microg/kg/min) and X and K represent xylazine and ketamine, respectively: X35 + K90 with 100% inspired oxygen (O2), X35 + K120-(O2), X35 + K150-(O2), X70 + K90-(O2), K150-(O2), and X35 + K120 with a 21% fraction of inspired oxygen (ie, air). Cardiopulmonary measurements were performed. Response to a noxious electrical stimulus was observed at 20, 40, and 60 minutes after induction. Times to achieve sternal recumbency and standing were recorded. Quality of sedation, induction, and recovery to sternal recumbency and standing were subjectively evaluated. RESULTS Heart rate and cardiac index were higher and total peripheral resistance lower in K150-(O2) and X35 + K120-air groups. The mean arterial pressure was highest in the X35 + K120-air group and lowest in the K150-(O2) group (125 +/- 6 vs 85 +/- 8 at 20 minutes, respectively). Mean Pa(O2) was lowest in the X35 + K120-air group. Times to sternal recumbency and standing were shortest for horses receiving K150-(O2) (23 +/- 6 minutes and 33 +/- 8 minutes, respectively) and longest for those receiving X70 + K90-(O2) (58 +/- 28 minutes and 69 +/- 27 minutes, respectively). CONCLUSIONS AND CLINICAL RELEVANCE Infusions of xylazine and ketamine may be used with oxygen supplementation to maintain 60 minutes of anesthesia in healthy adult horses.
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Affiliation(s)
- Khursheed R Mama
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA
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Steffey EP, Woliner MJ, Puschner B, Galey FD. Effects of desflurane and mode of ventilation on cardiovascular and respiratory functions and clinicopathologic variables in horses. Am J Vet Res 2005; 66:669-77. [PMID: 15900949 DOI: 10.2460/ajvr.2005.66.669] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To quantitate the effects of desflurane and mode of ventilation on cardiovascular and respiratory functions and identify changes in selected clinicopathologic variables and serum fluoride values associated with desflurane anesthesia in horses. ANIMALS 6 healthy adult horses. PROCEDURE Horses were anesthetized on 2 occasions: first, to determine the minimum alveolar concentration (MAC) of desflurane in O2 and second, to characterize cardiopulmonary and clinicopathologic responses to 1X, 1.5X, and 1.75X desflurane MAC during both controlled and spontaneous ventilation. RESULTS Mean +/- SEM MAC of desflurane in horses was 8.06 +/- 0.41 %; inhalation of desflurane did not appear to cause airway irritation. During spontaneous ventilation, mean PaCO2 was 69 mm Hg. Arterial blood pressure, stroke volume, and cardiac output decreased as the dose of desflurane increased. Conditions of intermittent positive pressure ventilation and eucapnia resulted in further cardiovascular depression. Horses recovered quickly from anesthesia with little transient or no clinicopathologic evidence of adverse effects. Serum fluoride concentration before and after administration of desflurane was below the limit of detection of 0.05 ppm (2.63microM/L). CONCLUSIONS AND CLINICAL RELEVANCE Results indicate that desflurane, like other inhalation anesthetics, causes profound hypoventilation in horses. The magnitude of cardiovascular depression is related to dose and mode of ventilation; cardiovascular depression is less severe at doses of 1X to 1.5X MAC, compared with known effects of other inhalation anesthetics under similar conditions. Desflurane is not metabolized to an important degree and does not appear to prominently influence renal function or hepatic cellular integrity or function.
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Affiliation(s)
- Eugene P Steffey
- Department of Surgical and Radiological Science, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Pypendop BH, Ilkiw JE. Assessment of the hemodynamic effects of lidocaine administered IV in isofluraneanesthetized cats. Am J Vet Res 2005; 66:661-8. [PMID: 15900948 DOI: 10.2460/ajvr.2005.66.661] [Citation(s) in RCA: 88] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the hemodynamic effects of lidocaine (administered IV to achieve 6 plasma concentrations) in isoflurane-anesthetized cats. ANIMALS 6 cats. PROCEDURE Cats were anesthetized with isoflurane in oxygen (end-tidal isoflurane concentration set at 1.25 times the predetermined individual minimum alveolar concentration). Lidocaine was administered IV to each cat to achieve target pseudo-steady-state plasma concentrations of 0, 3, 5, 7 9, and 11 microg/mL, and isoflurane concentration was reduced to an equipotent concentration. At each plasma lidocaine concentration, cardiovascular and blood gas variables; PCV; and plasma total protein, lactate, lidocaine, and monoethylglycinexylidide concentrations were measured in cats before and during noxious stimulation. Derived variables were calculated. RESULTS n isoflurane-anesthetized cats, heart rate, cardiac index, stroke index, right ventricular stroke work index, plasma total protein concentration, mixed-venous PO2 and hemoglobin oxygen saturation, arterial and mixed-venous bicarbonate concentrations, and oxygen delivery were significantly lower during lidocaine administration, compared with values determined without lidocaine administration. Mean arterial pressure, central venous pressure, pulmonary artery pressure, systemic and pulmonary vascular resistance indices, PCV, arterial and mixed-venous hemoglobin concentrations, plasma lactate concentration, arterial oxygen concentration, and oxygen extraction ratio were significantly higher during administration of lidocaine, compared with values determined without lidocaine administration. Noxious stimulation did not significantly affect most variables. CONCLUSIONS AND CLINICAL RELEVANCE In isoflurane-anesthetized cats, although IV administration of lidocaine significantly decreased inhalant requirements, it appeared to be associated with greater cardiovascular depression than an equipotent dose of isoflurane alone. Administration of lidocaine to reduce isoflurane requirements is not recommended in cats.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Feary DJ, Mama KR, Wagner AE, Thomasy S. Influence of general anesthesia on pharmacokinetics of intravenous lidocaine infusion in horses. Am J Vet Res 2005; 66:574-80. [PMID: 15900935 DOI: 10.2460/ajvr.2005.66.574] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare the disposition of lidocaine administered IV in awake and anesthetized horses. ANIMALS 16 horses. PROCEDURE After instrumentation and collection of baseline data, lidocaine (loading infusion, 1.3 mg/kg administered during 15 minutes (87 microg/kg/min); constant rate infusion, 50 microg/kg/min) was administered IV to awake or anesthetized horses for a total of 105 minutes. Blood samples were collected at fixed times during the loading and maintenance infusion periods and after the infusion period for analysis of serum lidocaine concentrations by use of liquid chromatography with mass spectral detection. Selected cardiopulmonary parameters including heart rate (HR), mean arterial pressure (MAP), arterial pH, PaCO2, and PaO2 were also recorded at fixed time points during lidocaine administration. Serum lidocaine concentrations were evaluated by use of standard noncompartmental analysis. RESULTS Serum lidocaine concentrations were higher in anesthetized than awake horses at all time points during lidocaine administration. Serum lidocaine concentrations reached peak values during the loading infusion in both groups (1,849 +/- 385 ng/mL and 3,348 +/- 602 ng/mL in awake and anesthetized horses, respectively). Most lidocaine pharmacokinetic variables also differed between groups. Differences in cardiopulmonary variables were predictable; for example, HR and MAP were lower and PaO2 was higher in anesthetized than awake horses but within reference ranges reported for horses under similar conditions. CONCLUSIONS AND CLINICAL RELEVANCE Anesthesia has an influence on the disposition of lidocaine in horses, and a change in dosing during anesthesia should be considered.
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Affiliation(s)
- Darien J Feary
- Veterinary Medical Teaching Hospital, University of California, Davis, CA 95616, USA
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Kushiro T, Yamashita K, Umar MA, Maehara S, Wakaiki S, Abe R, Seno T, Tsuzuki K, Izumisawa Y, Muir WW. Anesthetic and Cardiovascular Effects of Balanced Anesthesia Using Constant Rate Infusion of Midazolam-Ketamine-Medetomidine with Inhalation of Oxygen-Sevoflurane (MKM-OS Anesthesia) in Horses. J Vet Med Sci 2005; 67:379-84. [PMID: 15876787 DOI: 10.1292/jvms.67.379] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The anesthetic sparring and cardiovascular effects produced by midazolam 0.8 mg/ml-ketamine 40 mg/ml-medetomidine 0.05 mg/ml (0.025 ml/kg/hr) drug infusion during sevoflurane in oxygen (MKM-OS) anesthesia was determined in healthy horses. The anesthetic sparring effects of MKM-OS were assessed in 6 healthy thoroughbred horses in which the right carotid artery was surgically relocated to a subcutaneous position. All horses were intubated and ventilated with oxygen using intermittent positive pressure ventilation (IPPV). The end-tidal concentration of sevoflurane (ET(SEV)) required to maintain surgical anesthesia was approximately 1.7%. Heart rate and mean arterial blood pressure averaged 23-41 beats/min and 70-112 mmHg, respectively. All horses stood between 23-44 min after the cessation of all anesthetic drugs. The cardiovascular effects of MKM-OS anesthesia were evaluated in 5 healthy thoroughbred horses ventilated using IPPV. Anesthesia was maintained for 4 hr at an ET(SEV) of 1.7%. Each horse was studied during left lateral (LR) and dorsal recumbency (DR) with a minimum interval between evaluations of 1 month. Cardiac output and cardiac index were maintained between 70-80% of baseline values during LR and 65-70% of baseline values during DR. Stroke volume was maintained between 75-85% of baseline values during LR and 60-70% of baseline values during DR. Systemic vascular resistance was not different from baseline values regardless of position. MKM-OS anesthesia may be useful for prolonged equine surgery because of its minimal cardiovascular depression in both of lateral and dorsal recumbency.
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Affiliation(s)
- Tokiko Kushiro
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido, Japan
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Abstract
There is a plethora of information regarding anesthetic management of horses; however, controlled studies of the critically ill equine patient are few. These patients should be managed like any equine anesthetic candidate but much more stringently:I. Preoperative evaluation and appropriate therapy may represent the difference between life and death during the intraoperative and recovery periods. 2. The anesthetic induction and maintenance protocol should be based on the individual situation of the veterinary facility and personnel("comfort zone"). 3. Appropriate monitoring and intraoperative supportive measures are essential. 4. The anesthetic period is a significant perturbation to homeostasis. Even if the horse seems to have done well (ie, as indicated by the cardiopulmonary values), a problem-free anesthetic period does not guarantee a successful recovery, and close monitoring should continue until the horse is ambulatory. 5. Critically ill patients are often in a negative energy balance. Supportive measures to ensure an adequate caloric intake, such as enteral or parenteral nutrition, facilitate healing and return of homeostasis.
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Matthews NS, Hartsfield SM. Arrhythmogenic dose of epinephrine in isoflurane- or sevoflurane-anesthetized horses. J Equine Vet Sci 2004. [DOI: 10.1016/j.jevs.2004.02.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Abstract
OBJECTIVE To determine hemodynamic effects of 3 concentrations of sevoflurane in cats. ANIMALS 6 cats. PROCEDURE Cats were anesthetized with sevoflurane in oxygen. After instruments were inserted, end-tidal sevoflurane concentration was set at 1.25, 1.5, or 1.75 times the individual minimum alveolar concentration (MAC), which was determined in another study. Twenty-five minutes were allowed after each change of concentration. Heart rate; systemic and pulmonary arterial pressures; central venous pressure; pulmonary artery occlusion pressure; cardiac output; body temperature; arterial and mixed-venous pH, PCO2, PO2, oxygen saturation, and hemoglobin concentrations; PCV; and total protein and lactate concentrations were measured for each sevoflurane concentration before and during noxious stimulation. Arterial and mixed-venous bicarbonate concentrations, cardiac index, stroke index, rate-pressure product, systemic and pulmonary vascular resistance indices, left and right ventricular stroke work indices, PaO2, mixed-venous partial pressure of oxygen (PVO2), oxygen delivery, oxygen consumption, oxygen-extraction ratio, alveolar-to-arterial oxygen difference, and venous admixture were calculated. Spontaneous and mechanical ventilations were studied during separate experiments. RESULTS Mode of ventilation did not significantly influence any of the variables examined. Therefore, data from both ventilation modes were pooled for analysis. Mean arterial pressure, cardiac index, stroke index, rate-pressure product, left ventricular stroke work index, arterial and mixed-venous pH, PaO2, and oxygen delivery decreased, whereas PaCO2, PVO2, and mixed-venous partial pressure of CO2 increased significantly with increasing doses of sevoflurane. Noxious stimulation caused a significant increase in most cardiovascular variables. CONCLUSIONS AND CLINICAL RELEVANCE Sevoflurane induces dose-dependent cardiovascular depression in cats that is mainly attributable to myocardial depression.
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Affiliation(s)
- Bruno H Pypendop
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA
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Setoyama K, Shinzato T, Misumi K, Fujiki M, Sakamoto H. Effects of Propofol-Sevoflurane Anesthesia on the Maternal and Fetal Hemodynamics Blood Gases, and Uterine Activity in Pregnant Goats. J Vet Med Sci 2003; 65:1075-81. [PMID: 14600344 DOI: 10.1292/jvms.65.1075] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To determine the effects of propofol and sevoflurane on hemodynamics, acid-base balance and uterine activity in pregnant animals, a prospective experimental study was designed by use of ten pregnant goats. Propofol was intravenously administered at a bolus dose of 5 mg/kg and then infused a rate of 0.3 mg/kg/min for 5 min. Following the induction, the animals were incrementally inhaled 2.7 and 4.1% of end-tidal concentration of sevoflurane each for 30 min, and then recovered. The maternal and fetal heart rate (HR), arterial blood pressure (BP) and acid-base balance, the intrauterine pressure (IUP), and the uterine blood flow (UBF) were measured. Following the pre-anesthetic data, the parameters were measured 7 times throughout the anesthetic and recovering periods. The propofol infusion induced 1.37 times of HR increase and produced decrease in PO(2) and a relevant metabolic acidemia in the mother, with no effect in the fetus. Sevoflurane reduced BP in the fetus from 30 (2.7%) to 60 (4.1%) min of inhalation. The uterine contractions disappeared throughout sevoflurane inhalation, and then recurred within 15 min after the cessation of sevoflurane. Propofol injection increases HR, and induces a moderate hypoxemia and metabolic acidemia associated with the suppressed ventilation for pregnant goats, with less effect on the fetal hemodinamics. Sevoflurane causes minimal change in maternal hemodynamics, but induces significant hypotension in the fetus and reduction of uterine activity. These data may be useful in making anesthetic choices combined with analgesia for Caesarian section in goats.
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Yamashita K, Muir WW, Tsubakishita S, Abrahamsen E, Lerch P, Izumisawa Y, Kotani T. Infusion of guaifenesin, ketamine, and medetomidine in combination with inhalation of sevoflurane versus inhalation of sevoflurane alone for anesthesia of horses. J Am Vet Med Assoc 2002; 221:1150-5. [PMID: 12387385 DOI: 10.2460/javma.2002.221.1150] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate effects of infusion of guaifenesin, ketamine, and medetomidine in combination with inhalation of sevoflurane versus inhalation of sevoflurane alone for anesthesia of horses. DESIGN Randomized clinical trial. ANIMALS 40 horses. PROCEDURE Horses were premedicated with xylazine and anesthetized with diazepam and ketamine. Anesthesia was maintained by infusion of guaifenesin, ketamine, and medetomidine and inhalation of sevoflurane (20 horses) or by inhalation of sevoflurane (20 horses). A surgical plane of anesthesia was maintained by controlling the inhaled concentration of sevoflurane. Sodium pentothal was administered as necessary to prevent movement in response to surgical stimulation. Hypotension was treated with dobutamine; hypoxemia and hypercarbia were treated with intermittent positive-pressure ventilation. The quality of anesthetic induction, maintenance, and recovery and the quality of the transition to inhalation anesthesia were scored. RESULTS The delivered concentration of sevoflurane (ie, the vaporizer dial setting) was significantly lower and the quality of transition to inhalation anesthesia and of anesthetic maintenance were significantly better in horses that received the guaifenesin-ketamine-medetomidine infusion than in horses that did not. Five horses, all of which received sevoflurane alone, required administration of pentothal. Recovery time and quality of recovery were not significantly different between groups, but horses that received the guaifenesin-ketamine-medetomidine infusion required fewer attempts to stand. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that in horses, the combination of a guaifenesin-ketamine-medetomidine infusion and inhalation of sevoflurane resulted in better transition and maintenance phases while improving cardiovascular function and reducing the number of attempts needed to stand after the completion of anesthesia, compared with inhalation of sevoflurane.
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Affiliation(s)
- Kazuto Yamashita
- Department of Veterinary Surgery 1, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido, Japan
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Driessen B, Zarucco L, Steffey EP, McCullough C, Del Piero F, Melton L, Puschner B, Stover SM. Serum fluoride concentrations, biochemical and histopathological changes associated with prolonged sevoflurane anaesthesia in horses. JOURNAL OF VETERINARY MEDICINE. A, PHYSIOLOGY, PATHOLOGY, CLINICAL MEDICINE 2002; 49:337-47. [PMID: 12440788 DOI: 10.1046/j.1439-0442.2002.00462.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The volatile anaesthetic sevoflurane is degraded to fluoride (F-) and a vinyl ether (Compound A), which have the potential to harm kidney and liver. Whether renal and hepatic injuries can occur in horses is unknown. Cardiopulmonary, biochemical and histopathological changes were studied in six healthy thoroughbred horses undergoing 18 h of low-flow sevoflurane anaesthesia. Serum F- concentrations were measured and clinical laboratory tests performed to assess hepatic and renal function before and during anaesthesia. Necropsy specimens of kidney and liver were harvested for microscopic examination and compared to pre-experimental needle biopsies. Cardiopulmonary parameters were maintained at clinically acceptable levels throughout anaesthesia. Immediately after initiation of sevoflurane inhalation, serum F- levels began to rise, reaching an ongoing 38-45 micromol 1(-1) plateau at 8 h of anaesthesia. Serum biochemical analysis revealed only mild increases in glucose and creatinine kinase and a decrease in total calcium. Beyond 10 h of anaesthesia mild, time-related changes in urine included increased volume, glucosuria and enzymuria. Histological examination revealed mild microscopic changes in the kidney involving mainly the distal tubule, but no remarkable alterations in liver tissue. These results indicate that horses can be maintained in a systemically healthy state during unusually prolonged sevoflurane anaesthesia with minimal risk of hepatocellular damage from this anaesthetic. Furthermore, changes in renal function and morphology observed after sevoflurane inhalation are judged minimal and appear to be clinically irrelevant; they may be the result of anaesthetic duration, physiological stressors, sevoflurane (or its degradation products) or other unkown factors associated with these animals and study conditions.
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Affiliation(s)
- B Driessen
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, 95616, USA.
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35
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Read MR, Read EK, Duke T, Wilson DG. Cardiopulmonary effects and induction and recovery characteristics of isoflurane and sevoflurane in foals. J Am Vet Med Assoc 2002; 221:393-8. [PMID: 12164537 DOI: 10.2460/javma.2002.221.393] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare induction and recovery characteristics and cardiopulmonary effects of isoflurane and sevoflurane in foals. DESIGN Prospective crossover study. ANIMALS 6 healthy foals. PROCEDURE Foals were anesthetized twice (once at 1 month of age and again at 3 months of age). Anesthesia was induced by administration of the agent in oxygen through a nasotracheal tube. During maintenance of anesthesia, foals were positioned in dorsal recumbency; intermittent positive-pressure ventilation was performed. Characteristics of induction and recovery were recorded. Cardiopulmonary variables were recorded 10 minutes after anesthetic induction and 15, 30, 45, and 60 minutes later. RESULTS All 6 foals were successfully anesthetized with isoflurane and sevoflurane. There were no significant differences between the 2 drugs in regard to characteristics of induction or recovery, and induction and recovery were generally smooth and unremarkable. There were no significant differences between drugs in regard to measured cardiopulmonary variables; however, both drugs caused initial hypotension that resolved over time. CONCLUSIONS AND CLINICAL RELEVANCE Results suggest that isoflurane and sevoflurane can both be used for general anesthesia of 1- to 3-month-old foals. Significant differences between the 2 agents were not detected for any of the variables measured, suggesting that quality of anesthesia with these 2 agents was comparable.
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Affiliation(s)
- Matt R Read
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
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Abstract
Both desflurane and sevoflurane offer theoretical and practical advantages over other inhalation anesthetics for horses. The lower solubility of both agents provides improved control of delivery and helps to counteract the confounding influence of the voluminous patient breathing circuit commonly used for anesthetizing horses. The lower solubility should account for faster rates of recovery compared with the older agents; whether or not the quality of recovery differs remains to be objectively evaluated in a broad range of circumstances. The pharmacodynamic effects are, in large part, similar to those of isoflurane (e.g., low arrhythmogenicity) but with some differences. For example, desflurane may be overall more sparing to cardiovascular function (especially during controlled ventilation) compared with isoflurane and sevoflurane, which are roughly similar. Respiratory depression with both new agents is equal to or more depressing than isoflurane, suggesting the use of mechanical ventilation, especially in circumstances of prolonged management (i.e., hours of anesthesia). Both new anesthetics, not surprisingly, are expensive. From this point there are some agent-unique considerations. The anesthetic potency of both agents is less than that of isoflurane, which influences the cost of anesthesia, but also places an upper limit on inspired oxygen concentration (of particular concern with desflurane). Both agents require new vaporizers, but because of the high boiling point and steep vapor-pressure curve of desflurane, new technology was required. This translates into more costly equipment, adding to the cost of desflurane use. In addition, electricity is necessary for the new desflurane vaporizer to function, which limits its portability and adds additional practical considerations in its clinical use. On the other hand, desflurane strongly resists degradation both in vitro and in vivo, but in vitro degradation of sevoflurane by CO2 absorbents may produce renal injury. This may be true especially in association with low fresh-gas inflow rates (used to reduce the cost of using the new agent), and university based practices, where prolonged anesthesia is common.
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Affiliation(s)
- Eugene P Steffey
- Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.
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Polis I, Gasthuys F, Gielen I, Van Ryssen B, Van Bree H, Laevens H, De Rijcke L. The effects of intrathoracic pressure during continuous two-lung ventilation for thoracoscopy on the cardiorespiratory parameters in sevoflurane anaesthetized dogs. JOURNAL OF VETERINARY MEDICINE. A, PHYSIOLOGY, PATHOLOGY, CLINICAL MEDICINE 2002; 49:113-20. [PMID: 12019950 DOI: 10.1046/j.1439-0442.2002.00404.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The cardiopulmonary effects of different levels of carbon dioxide insufflation (3, 5 and 2 mm Hg) under two-lung ventilation were studied in six sevoflurane (1.5 minimum alveolar concentration; MAC) anaesthetized dogs during left-sided thoracoscopy. An arterial catheter, Swan-Ganz catheter and multianaesthetic gas analyser were used to monitor the cardiopulmonary parameters during the experiment. Baseline data were obtained before intrathoracic pressure elevation and the measurements were repeated at intervals after left lung collapse induced by insufflation with carbon dioxide gas. The intrapleural pressure levels used were 3, 5 and 2 mm Hg. Arterial blood pressures, cardiac index, stroke index, left and right ventricular stroke work index, arterial haemoglobin saturation, arterial oxygen tension and systemic vascular resistance decreased significantly during hemithorax insufflation, whereas heart rate, right atrial pressure, mean, systolic and diastolic pulmonary arterial pressure, pulmonary capillary wedge pressure, pulmonary vascular resistance and arterial carbon dioxide tension significantly increased during intrapleural pressure elevation. Although carbon dioxide insufflation into the left hemithorax with an intrapleural pressure of 2-5 mm Hg compromises cardiac functioning in 1.5 MAC sevoflurane anaesthetized dogs, it can be an efficacious adjunct for thoracoscopic procedures. Intrathoracic view was satisfactory with an intrapleural pressure of 2 mm Hg. Therefore, the intrathoracic pressure rise during thoracoscopy with two-lung ventilation should be kept as low as possible. Additional insufflation periods should be avoided, since a more rapid and more severe cardiopulmonary depression can occur.
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Affiliation(s)
- I Polis
- Department of Small Animal Medicine and Clinical Biology, Ghent University, Belgium.
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Polis I, Gasthuys F, Laevens H, Van Ham L, De Rick A. The influence of ventilation mode (spontaneous ventilation, IPPV and PEEP) on cardiopulmonary parameters in sevoflurane anaesthetized dogs. JOURNAL OF VETERINARY MEDICINE. A, PHYSIOLOGY, PATHOLOGY, CLINICAL MEDICINE 2001; 48:619-30. [PMID: 11848255 DOI: 10.1046/j.1439-0442.2001.00394.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The purpose of this study was to investigate the cardiopulmonary influences of sevoflurane in oxygen at two anaesthetic concentrations (1.5 and 2 MAC) during spontaneous and controlled ventilation in dogs. After premedication with fentany-droperidol (5 microg/kg and 0.25 mg/kg intramuscularly) and induction with propofol (6 mg/kg intravenously) six dogs were anaesthetized for 3 h. Three types of ventilation were compared: spontaneous ventilation (SpV), intermittent positive pressure ventilation (IPPV), and positive end expiratory pressure ventilation (PEEP, 5 cm H2O). Heart rate, haemoglobin oxygen saturation, arterial blood pressures, right atrial and pulmonary arterial pressures, pulmonary capillary wedge pressure and cardiac output were measured. End tidal CO2%, inspiratory oxygen fraction, respiration rate and tidal volume were recorded using a multi-gas analyser and a respirometer. Acid-base and blood gas analyses were performed. Cardiac index, stroke volume, stroke index, systemic and pulmonary vascular resistance, left and right ventricular stroke work index were calculated. Increasing the MAC value during sevoflurane anaesthesia with spontaneous ventilation induced a marked cardiopulmonary depression; on the other hand, heart rate increased significantly, but the increases were not clinically relevant. The influences of artificial respiration on cardiopulmonary parameters during 1.5 MAC sevoflurane anaesthesia were minimal. In contrast, PEEP ventilation during 2 MAC concentration had more pronounced negative influences, especially on right cardiac parameters. In conclusion, at 1.5 MAC, a surgical anaesthesia level, sevoflurane can be used safely in healthy dogs during spontaneous and controlled ventilation (IPPV and PEEP of 5 cm H2O).
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Affiliation(s)
- I Polis
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Belgium.
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Yamanaka T, Oku K, Koyama H, Mizuno Y. Time-related changes of the cardiovascular system during maintenance anesthesia with sevoflurane and isoflurane in horses. J Vet Med Sci 2001; 63:527-32. [PMID: 11411498 DOI: 10.1292/jvms.63.527] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
To clarify time-related changes in equine cardiovascular system during maintenance anesthesia (180 min, 1.2 minimum alveolar concentration) with sevoflurane (Sev-group) compared to isoflurane (Iso-group) as the basis for clinical use of Sev, horses were examined for the heart rate (HR), mean arterial pressure (MAP), cardiac index (CI), systemic vascular resistance (SVR) and pre-ejection period (PEP)/ejection time (ET) that is an index of the cardiac contractility. The HR was almost 30 beats/min in both groups without significant temporal change. MAP was significantly elevated with time but there was no significant difference between the groups. In the Sev-group, CI remained unchanged but the significant increase of CI with time was observed in the Iso-group. In the Sev-group SVR was significantly higher than that of the Iso-group and increased with time. No significant difference of PEP/ET was seen between the groups, but PEP/ET lowered with time in the Iso-group in association with prolonged ET. The results indicated that the time-dependent elevation of MAP in the Sev-group reflected increased SVR without increase of CI and that it reflected increased CI resulting from increased stroke volume in the Iso-group in association with lowered PEP/ET, that is, increased cardiac contractility.
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Affiliation(s)
- T Yamanaka
- Racehorse Clinic, Japan Racing Association Miho Training Center, Ibaraki
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HASEGAWA T, SATO F, NAMBO Y, ISHIDA N. Expression of Steroidogenic Enzyme Genes in the Equine Feto-Placental Unit. J Equine Sci 2001. [DOI: 10.1294/jes.12.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Telhisa HASEGAWA
- Laboratory of Molecular and Cellular Biology, Equine Research Institute
| | - Fumio SATO
- Laboratory of Molecular and Cellular Biology, Equine Research Institute
| | - Yasuo NAMBO
- Laboratory of Molecular and Cellular Biology, Equine Research Institute
| | - Nobushige ISHIDA
- Laboratory of Molecular and Cellular Biology, Equine Research Institute
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41
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Aida H, Steffey EP, Pascoe JR, Yarbrough TB, Takahashi T, Hiraga A, Hobo S, Smith BL, Steffey MA, Jones JH. Use of sevoflurane for anesthetic management of horses during thoracotomy. Am J Vet Res 2000; 61:1430-7. [PMID: 11108193 DOI: 10.2460/ajvr.2000.61.1430] [Citation(s) in RCA: 17] [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 evaluate sevoflurane as an inhalation anesthetic for thoracotomy in horses. ANIMALS 18 horses between 2 and 15 years old. PROCEDURE 4 horses were used to develop surgical techniques and were euthanatized at the end of the procedure. The remaining 14 horses were selected, because they had an episode of bleeding from their lungs during strenuous exercise. General anesthesia was induced with xylazine (1.0 mg/kg of body weight, IV) followed by ketamine (2.0 mg/kg, IV). Anesthesia was maintained with sevoflurane in oxygen delivered via a circle anesthetic breathing circuit. Ventilation was controlled to maintain PaCO2 at approximately 45 mm Hg. Neuromuscular blocking drugs (succinylcholine or atracurium) were administered to eliminate spontaneous breathing efforts and to facilitate surgery. Cardiovascular performance was monitored and supported as indicated. RESULTS 2 of the 14 horses not euthanatized died as a result of ventricular fibrillation. Mean (+/- SD) duration of anesthesia was 304.9 +/- 64.1 minutes for horses that survived and 216.7 +/- 85.5 minutes for horses that were euthanatized or died. Our subjective opinion was that sevoflurane afforded good control of anesthetic depth during induction, maintenance, and recovery. CONCLUSIONS AND CLINICAL RELEVANCE Administration of sevoflurane together with neuromuscular blocking drugs provides stable and easily controllable anesthetic management of horses for elective thoracotomy and cardiac manipulation.
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Affiliation(s)
- H Aida
- Equine Research Institute, Japan Racing Association, Utsunomiya, Tochigi
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42
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Ohta M, Oku K, Yamanaka T, Mizuno Y. Anesthetic management with sevoflurane and oxygen for orthopedic surgeries in racehorses. J Vet Med Sci 2000; 62:1017-20. [PMID: 11039602 DOI: 10.1292/jvms.62.1017] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Eighty-five thoroughbred racehorses with various types of fracture were subjected to arthroscopic surgery (44 horses) or internal fixation (41 horses) under sevoflurane anesthesia. The mean end-tidal sevoflurane concentration during anesthesia ranged from 2.5 to 2.8%. PaCO2 was maintained between 50 and 65 mmHg by controlled ventilation. The mean arterial blood pressure was maintained above 65 mmHg by infusion of dobutamine and fluids, however, heart rate significantly increased with time. Recovery from anesthesia was calm and smooth in almost all cases. No apparent complication was observed during and after anesthesia in all cases. Therefore, sevoflurane anesthesia is considered to be safe and useful for orthopedic surgery in racehorses.
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Affiliation(s)
- M Ohta
- Racehorse Clinic, Japan Racing Association Miho Training Center, Ibaraki-ken
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43
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Yamashita K, Satoh M, Umikawa A, Tsuda A, Yajima Y, Tsubakishita S, Seno T, Katoh S, Izumisawa Y, Kotani T. Combination of continuous intravenous infusion using a mixture of guaifenesin-ketamine-medetomidine and sevoflurane anesthesia in horses. J Vet Med Sci 2000; 62:229-35. [PMID: 10770592 DOI: 10.1292/jvms.62.229] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The anesthetic and cardiovascular effects of a combination of continuous intravenous infusion using a mixture of 100 g/L guaifenesin-4 g/L ketamine-5 mg/L medetomidine (0.25 ml/kg/hr) and oxygen-sevoflurane (OS) anesthesia (GKM-OS anesthesia) in horses were evaluated. The right carotid artery of each of 12 horses was raised surgically into a subcutaneous position under GKM-OS anesthesia (n=6) or OS anesthesia (n=6). The end-tidal concentration of sevoflurane (EtSEV) required to maintain surgical anesthesia was around 1.5% in GKM-OS and 3.0% in OS anesthesia. Mean arterial blood pressure (MABP) was maintained at around 80 mmHg under GKM-OS anesthesia, while infusion of dobutamine (0.39+/-0.10 microg/kg/min) was necessary to maintain MABP at 60 mmHg under OS anesthesia. The horses were able to stand at 36+/-26 min after cessation of GKM-OS anesthesia and at 48+/-19 minutes after OS anesthesia. The cardiovascular effects were evaluated in 12 horses anesthetized with GKM-OS anesthesia using 1.5% of EtSEV (n=6) or OS anesthesia using 3.0% of EtSEV (n=6). During GKM-OS anesthesia, cardiac output and peripheral vascular resistance was maintained at about 70% of the baseline value before anesthesia, and MABP was maintained over 70 mmHg. During OS anesthesia, infusion of dobutamine (0.59+/-0.24 microg/kg/min) was necessary to maintain MABP at 70 mmHg. Infusion of dobutamine enabled to maintaine cardiac output at about 80% of the baseline value; however, it induced the development of severe tachycardia in a horse anesthetized with sevoflurane. GKM-OS anesthesia may be useful for prolonged equine surgery because of its minimal cardiovascular effect and good recovery.
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Affiliation(s)
- K Yamashita
- Department of Veterinary Surgery I, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido, Japan
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44
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Matthews N, Hartsfield S, Carroll G, Martinez E. Sevoflurane anaesthesia in clinical equine cases: maintenance and recovery. ACTA ACUST UNITED AC 1999. [DOI: 10.1111/j.1467-2995.1999.tb00177.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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45
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Abstract
Desflurane and sevoflurane, recently licensed for use in humans, have kinetics that result in rapid induction and easy maintenance of a stable level of anesthesia. Recovery is also rapid. Cardiopulmonary effects are similar to those of isoflurane. In humans, desflurane can cause airway irritation and sympathetic stimulation, but these side effects have not caused problems in animal trials. Metabolites of sevoflurane and breakdown products from its reaction with carbon dioxide absorbents theoretically could result in hepatic and renal damage, but such toxicity has not occurred despite extensive medical use. Clinical trials in animals are now in progress.
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Affiliation(s)
- K W Clarke
- Royal Veterinary College, University of London, North Mymms, Hatfield, United Kingdom
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Carroll GL, Hooper RN, Rains CB, Martinez EA, Matthews NS, Hartsfield SM, Beleau MH. Maintenance of anaesthesia with sevoflurane and oxygen in mechanically-ventilated horses subjected to exploratory laparotomy treated with intra- and post operative anaesthetic adjuncts. Equine Vet J 1998; 30:402-7. [PMID: 9758097 DOI: 10.1111/j.2042-3306.1998.tb04509.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Eight healthy horses premedicated with xylazine and induced with ketamine were used to evaluate sevoflurane in oxygen for maintenance of anaesthesia during elective exploratory laparotomy. After orotracheal intubation, horses were hoisted, placed in dorsal recumbency on a padded surgery table, and received sevoflurane in oxygen for maintenance of anaesthesia. The horses were allowed to breathe spontaneously until instrumented; then, they were mechanically ventilated to maintain the PaCO2 between 35 and 45 mmHg. Systolic (SAP), diastolic (DAP), and mean (MAP) arterial blood pressures, heart rate (HR), ECG, respiratory rate, an estimation of the saturation of haemoglobin with oxygen in peripheral arterial blood (S(p)O2), nasal temperature, end-tidal CO2(ET(CO2)), end-tidal sevoflurane (ET(SEVO)), and vaporiser concentration were recorded every 5 min post induction; arterial blood samples were obtained soon after induction, at 30 min after induction, and every hour thereafter until surgery was completed. Recovery data including times from the sevoflurane vaporiser being turned off to first movement, to sternal recumbency, and to standing, number of attempts to stand, and recovery score (between 1 = safe, smooth and 6 = stormy, major injury to horse) were collected. Analysis of variance was performed using physiological data collected over 195 min of anaesthesia, the longest time period during which all 8 horses were instrumented. Time effects (P<0.05) for HR, SAP, DAP, MAP, and nasal temperature were identified. Heart rate peaked at 45 min and declined over the course of the procedure. Arterial blood pressure generally decreased over time. Body temperature decreased over time. From 15 to 195 min mean ET(SEVO)concentration ranged from 2.0 to 3.3%, while mean vaporiser settings ranged from 3.7 to 5.5%. Three horses received intra-operative ketamine; all horses received dobutamine infusions; and 2 horses received intra-operative calcium-dextrose. Total anaesthesia time was 222-316 min (mean+/-s.d.269+/-31 min). Time from turning the sevoflurane vaporiser off to first movement was mean +/-s.d.18+/-15 min; to sternal recumbency was 54+/-22 min; to standing was 65+/-27 min; and to returning the horse to the stall in the ward was 78+/-24 min. Six horses stood on the first attempt; 2 horses stood on the second attempt. The median recovery score was one (1-3). In conclusion, sevoflurane provided a stable, easily controllable anaesthetic plane during prolonged exploratory laparotomies; horses experienced smooth, safe recoveries after maintenance of anaesthesia with sevoflurane following routine anaesthetic induction and post operative xyalzine administration.
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Affiliation(s)
- G L Carroll
- Texas A & M University, College Station 77843-4474, USA
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Matthews NS, Hartsfield SM, Mercer D, Beleau MH, MacKenthun A. Recovery from sevoflurane anesthesia in horses: comparison to isoflurane and effect of postmedication with xylazine. Vet Surg 1998; 27:480-5. [PMID: 9749520 DOI: 10.1111/j.1532-950x.1998.tb00160.x] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare recovery from sevoflurane or isoflurane anesthesia in horses. STUDY DESIGN Prospective, randomized cross-over design. ANIMALS Nine Arabian horses (3 mares, 3 geldings, and 3 stallions) weighing 318 to 409 kg, 4 to 20 years old. METHODS Horses were anesthetized on three occasions with xylazine (1.1 mg/kg), Diazepam (0.03 mg/kg intravenously [i.v.]), and ketamine (2.2 mg/kg i.v.). After intubation, they were maintained with isoflurane or sevoflurane for 90 minutes. On a third occasion, horses were maintained with sevoflurane and given xylazine (0.1 mg/kg i.v.) when the vaporizer was turned off. Horses were not assisted in recovery and all recoveries were videotaped. Time to extubation, first movement, sternal, and standing were recorded as was the number of attempts required to stand. Recoveries were scored on a 1 to 6 scoring system (1 = best, 6 = worst) by the investigators, and by three evaluators who were blinded to the treatments the horses received. These blinded evaluators assessed the degree of ataxia present at 10 minutes after each horse stood, and recorded the time at which they judged the horse to be ready to leave the recovery stall. RESULTS Mean times (+/- SD) to extubation, first movement, sternal, and standing were 4.1 (1.7), 6.7 (1.9), 12.6 (4.6), and 17.4 (7.2) minutes with isoflurane; 3.4 (0.8), 6.6 (3.1), 10.3 (3.1), and 13.9 (3.0) minutes with sevoflurane; and 4.0 (1.2), 9.1 (3.3), 13.8 (6.5), and 18.0 (7.1) with sevoflurane followed by xylazine. Horses required a mean number of 4 (2.3), 2 (0.9), and 2 ( 1.6) attempts to stand with isoflurane, sevoflurane, and sevoflurane followed by xylazine respectively. The mean recovery score (SD) for isoflurane was 2.9 (1.2) from investigators and 2.4 (1.1) from blinded evaluators. For sevoflurane, the mean recovery score was 1.7 (0.9) from investigators and 1.9 (1.1) from evaluators, whereas the recoveries from sevoflurane with xylazine treatment were scored as 1.7 (1.2) from investigators and 1.7 (1.0) from blinded evaluators. CONCLUSIONS Recoveries appeared to vary widely from horse to horse, but were significantly shorter with sevoflurane than isoflurane, although sevoflurane followed by xylazine was no different from isoflurane. Under the conditions of the study, recoveries from sevoflurane and sevoflurane followed by xylazine were of better quality than those from isoflurane. CLINICAL RELEVANCE Sevoflurane anesthesia in horses may contribute to a shorter, safer recovery from anesthesia.
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Affiliation(s)
- N S Matthews
- Department of Small Animal Medicine and Surgery, Texas A&M University, College Station 77843-4474, USA
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MIZUNO Y, OHASHI N, AIDA H. Anesthetic Management with Sevoflurane for Internal Fixation of Long Bone Fracture in a Horse. J Equine Sci 1996. [DOI: 10.1294/jes.7.47] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Yutaka MIZUNO
- Miho Training Center, Equine Veterinary Clinic, Japan Racing Association, 2500-2 Oaza-Mikoma, Miho-Mura, Inashiki-Gun, Ibaraki, Japan
| | - Norio OHASHI
- Miho Training Center, Equine Veterinary Clinic, Japan Racing Association, 2500-2 Oaza-Mikoma, Miho-Mura, Inashiki-Gun, Ibaraki, Japan
| | - Hiroko AIDA
- Equine Research Institute, Japan Racing Association, 27-7 Tsurumaki 5-chome, Setagaya-ku, Tokyo 154, Japan
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