Perioperative Brain Function Monitoring with Electroencephalography in Horses Anesthetized with Multimodal Balanced Anesthetic Protocol Subjected to Surgeries

Simple Summary

This study aimed to investigate the use of electroencephalography (EEG) and EEG-derived (processed) indices for detecting brain activity changes perioperatively in 12 anesthetized adult horses subjected to various surgery. Frontal electrodes together with Sedline/Root monitor were used on these horses from soon after anesthesia induction and continued until the horse first attempted to stand in recovery. The EEG waves were characterized by low-frequency high amplitude alpha, theta, and alpha waves during the isoflurane maintenance and surgery, which is commonly observed in profound anesthesia. The processed EEG indices including Patient State Index, Burst Suppression Ratio, and 95% Spectral Edge Frequency changed significantly between the stages (induction, surgery, and recovery) of anesthesia. Collectively, the presence of the slow EEG wave activities and the presence of burst suppression implies that these horses were profoundly unconscious during the anesthesia. We concluded that the use of EEG in conjunction with traditional cardiorespiratory monitoring provides clinically relevant information about perioperative brain state changes in the anesthetized horses.

Abstract

This study aimed to investigate the use of electroencephalography (EEG) for detecting brain activity changes perioperatively in anesthetized horses subjected to surgery. Twelve adult horses undergoing various surgeries were evaluated after premedication with xylazine and butorphanol, induction with ketamine, midazolam, and guaifenesin, and maintenance with isoflurane. The frontal EEG electrodes were placed after the horse was intubated and mechanically ventilated. The EEG data were collected continuously from Stage (S)1—transition from induction to isoflurane maintenance, S2—during surgery, S3—early recovery before xylazine sedation (0.2 mg kg IV), and S4—recovery after xylazine sedation. The Patient State Index (PSI), (Burst) Suppression Ratio (SR), and 95% Spectral Edge Frequency (SEF₉₅) were compared across the stages. The PSI was lowest in S2 (20.8 ± 2.6) and increased to 30.0 ± 27.7 (p = 0.005) in S3. The SR increased from S1 (5.5 ± 10.7%) to S3 (32.7 ± 33.8%, p = 0.0001). The spectral power analysis showed that S3 had a significantly higher content of delta wave activity (0.1–4 Hz) in the EEG and lower relative power in the 3 Hz to 15 Hz range when compared to S1 and S2. A similar result was observed in S4, but the lower power was in a narrower range, from 3 Hz to 7 Hz, which indicate profound central nervous system depression potentiated by xylazine, despite the cessation of isoflurane anesthesia. We concluded that the use of EEG provides clinically relevant information about perioperative brain state changes of the isoflurane-anesthetized horse.

Effect of butorphanol administration on cardiovascular parameters in isoflurane-anesthetized horses – a retrospective clinical evaluation

OBJECTIVE

To determine cardiovascular responses to administration of butorphanol in isoflurane-anesthetized horses.

STUDY DESIGN

Retrospective evaluation of anesthetic records.

ANIMALS

Seventy-six horses anesthetized for a variety of clinical surgical procedures.

METHODS

Anesthetic records of clinical equine patients anesthetized between January 1999 and December 2003 were searched. The records were reviewed for horses in which anesthesia was induced with ketamine and a benzodiazepine and maintained with isoflurane, and horses that received butorphanol intraoperatively. Exclusion criteria included horses in which the rate of infusion of an inotrope or end-tidal isoflurane concentration was changed 10 minutes before or after the butorphanol bolus. The horses were separated into two groups: group 1 horses received butorphanol at intervals as part of a balanced protocol, group 2 horses had > or = 10% increase in heart rate (HR) or blood pressure within 10 minutes prior to butorphanol administration.

RESULTS

Eighty-nine butorphanol administration events matched the criteria for inclusion, 49 in group 1 and 40 in group 2. There were no significant changes after butorphanol administration in systolic arterial pressure (SAP), mean arterial pressure (MAP), diastolic arterial pressure (DAP), and heart rate (HR) in group 1, or in end-tidal carbon dioxide concentration or hemoglobin oxygen saturation in either group. There were significant decreases in SAP (p < 0.0001), MAP (p < 0.0005), and DAP (p < 0.0008) after butorphanol administration in group 2.

CONCLUSIONS AND CLINICAL RELEVANCE

The results presented here confirm that butorphanol can be administered to horses during isoflurane anesthesia without adverse effects on HR and arterial blood pressure. The results imply that butorphanol can deepen the plane of anesthesia and obtund sympathetic stimulation from a surgical procedure.

Complications associated with anaesthesia for ocular surgery: a retrospective study 1989-1996

This retrospective study was initiated to identify complications of anaesthesia occurring during ocular surgery. Records of 74 horses anaesthetised for eye enucleation, 65 horses anaesthetised for surgery of the eye and adnexa, and 51 horses anaesthetised for splint bone excision were reviewed. Fifty-three percent of the horses anaesthetised for eye enucleation moved during surgery which was significantly more frequent than in the other groups (P = 0.001). The incidence of moving was significantly reduced by use of an anaesthetic gas analyser for monitoring (P = 0.001). Transient hypertension was measured in 6 horses during removal of the eye. One horse experienced a momentary decrease in heart rate from 36 to 26 beats/min at the start of surgery involving a mass on the third eyelid. The incidence of unsatisfactory recovery from anaesthesia involving multiple attempts to stand was significantly greater after ocular surgery than after splint bone excision (P = 0.036). Our conclusions were 1) the oculocardiac reflex was not active in these horses undergoing ocular surgery, 2) increased attention must be paid to provision of analgesia and adequate depth of anaesthesia, which may be facilitated by use of an anaesthetic gas analyser and 3) horses were at greater risk for unsatisfactory recoveries from anaesthesia after ocular surgery.