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Di Franco C, Nocera I, Melanie P, Briganti A. Evaluation of the Quality of Recovery from General Anesthesia in Dogs with Two Different Low Doses of Dexmedetomidine. Animals (Basel) 2024; 14:1383. [PMID: 38731387 PMCID: PMC11083314 DOI: 10.3390/ani14091383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 05/01/2024] [Accepted: 05/02/2024] [Indexed: 05/13/2024] Open
Abstract
The purpose of this study was to evaluate the quality of recovery from general anesthesia with the administration of two low doses of dexmedetomidine in canine patients. For this blind randomized clinical trial study, 30 dogs undergoing general anesthesia for diagnostic procedures or elective surgery (ovariectomy/castration) were included. The patients were randomly divided into three groups, and at the end of anesthesia, they received a bolus of dexmedetomidine at 1 mcg/kg IV (D1), or a bolus of dexmedetomidine at 0.5 mcg/kg (D0.5), or a bolus of NaCl, in a total of 0.5 mL of solution for all three groups. After administration of the bolus, the anesthetist monitored the patients every 5 min by measuring heart rate, systolic and mean blood pressure, respiratory rate, and oxygen saturation. The quality of recovery was also assessed using 4 different scales. The extubation time, time of headlift, and standing position were also recorded. Both groups receiving dexmedetomidine had better awakening and a lower incidence of delirium when compared to saline administration. The heart rate was lower, while the systolic pressure was higher in the two groups D1 and D0.5 compared to the NaCl with a low presence of atrioventricular blocks. The extubation time resulted significantly higher in the D1 (17 ± 6 min) compared to the D0.5 (10 ± 4 min) and NaCl (8 ± 3 min) (p < 0.0001); the headlift time D1 (25 ± 10 min) resulted significantly longer than the NaCl group (11 ± 5 min) (p = 0.0023) but not than the D0.5 (18 ± 9 min). No significant differences were found among the three groups for standing positioning (D1 50 ± 18 min, D0.5 39 ± 22 min, NaCl 28 ± 17 min). The preventive administration of a bolus of dexmedetomidine at a dosage of 0.5 mcg/kg or 1 mcg/kg IV during the recovery phase improves the quality of recovery in patients undergoing general anesthesia.
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Affiliation(s)
- Chiara Di Franco
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (P.M.); (A.B.)
| | - Irene Nocera
- Institute of Health Sciences, Sant’Anna School of Advanced Studies, 56127 Pisa, Italy;
| | - Pierre Melanie
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (P.M.); (A.B.)
| | - Angela Briganti
- Department of Veterinary Sciences, University of Pisa, 56124 Pisa, Italy; (P.M.); (A.B.)
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Kästner SB, Amon T, Tünsmeyer J, Noll M, Söbbeler FJ, Laakso S, Saloranta L, Huhtinen M. Effects of tasipimidine premedication with and without methadone and dexmedetomidine on cardiovascular variables during propofol-isoflurane anaesthesia in Beagle dogs. Vet Anaesth Analg 2024; 51:253-265. [PMID: 38580536 DOI: 10.1016/j.vaa.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 02/20/2024] [Accepted: 03/05/2024] [Indexed: 04/07/2024]
Abstract
OBJECTIVE To evaluate cardiovascular effects of oral tasipimidine on propofol-isoflurane anaesthesia with or without methadone and dexmedetomidine at equianaesthetic levels. STUDY DESIGN Prospective, placebo-controlled, blinded, experimental trial. ANIMALS A group of seven adult Beagle dogs weighing (mean ± standard deviation) 12.4 ± 2.6 kg and a mean age of 20.6 ± 1 months. METHODS The dogs underwent four treatments 60 minutes before induction of anaesthesia with propofol. PP: placebo orally and placebo (NaCl 0.9%) intravenously (IV); TP: tasipimidine 30 μg kg-1 orally and placebo IV; TMP: tasipimidine 30 μg kg-1 orally and methadone 0.2 mg kg-1 IV; and TMPD: tasipimidine 30 μg kg-1 orally with methadone 0.2 mg kg-1 and dexmedetomidine 1 μg kg-1 IV followed by 1 μg kg-1 hour-1. Isoflurane in oxygen was maintained for 120 minutes at 1.2 individual minimum alveolar concentration preventing motor movement. Cardiac output (CO), tissue blood flow (tbf), tissue oxygen saturation (stO2) and relative haemoglobin content were determined. Arterial and mixed venous blood gases, arterial and pulmonary artery pressures and heart rate (HR) were measured at baseline; 60 minutes after oral premedication; 5 minutes after IV premedication; 15, 30, 60, 90 and 120 minutes after propofol injection; and 30 minutes after switching the vaporiser off. Data were analysed by two-way anova for repeated measures; p < 0.05. RESULTS Tasipimidine induced a significant 20-30% reduction in HR and CO with decreases in MAP (10-15%), tbf (40%) and stO2 (43%). Blood pressure and oxygenation variables were mainly influenced by propofol-isoflurane-oxygen anaesthesia, preceded by short-lived alterations related to IV methadone and dexmedetomidine. CONCLUSIONS AND CLINICAL RELEVANCE Tasipimidine induced mild to moderate cardiovascular depression. It can be incorporated into a common anaesthetic protocol without detrimental effects in healthy dogs, when anaesthetics are administered to effect and cardiorespiratory function is monitored.
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Affiliation(s)
- Sabine Br Kästner
- Small Animal Clinic, University of Veterinary Medicine, Hannover, Germany.
| | - Thomas Amon
- Small Animal Clinic, University of Veterinary Medicine, Hannover, Germany
| | - Julia Tünsmeyer
- Small Animal Clinic, University of Veterinary Medicine, Hannover, Germany
| | - Mike Noll
- Evidensia, Small Animal Clinic, Norderstedt, Germany
| | | | - Sirpa Laakso
- Department of Research and Development, Orion Pharma, Orion Corporation, Espoo, Finland
| | - Lasse Saloranta
- Department of Research and Development, Orion Pharma, Orion Corporation, Espoo, Finland
| | - Mirja Huhtinen
- Department of Research and Development, Orion Pharma, Orion Corporation, Espoo, Finland
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Effects of ketamine, propofol and isoflurane on electrocardiographic variables in clinically healthy dogs premedicated with medetomidine and midazolam. VETERINARY RESEARCH FORUM : AN INTERNATIONAL QUARTERLY JOURNAL 2024; 15:187-194. [PMID: 38770200 PMCID: PMC11102798 DOI: 10.30466/vrf.2024.2008055.3954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/08/2024] [Indexed: 05/22/2024]
Abstract
The purpose of this study was to investigate the effects of three anesthetic agents, with premedication of medetomidine and midazolam, on electrocardiographic variables in dogs. Ten adult mixed breed dogs were used in a crossover design study, where they received ketamine, propofol and isoflurane treatments with a one-week washout period between them. In all three groups, medetomidine was administered first followed by midazolam after 15 min. Then, after 20 min, group 1 received ketamine intravenously (IV), group 2 received propofol (IV), and group 3 received isoflurane (inhalation). In all dogs, electrocardiographs were taken before and after premedication's, as well as every 15 min during anesthesia. Medetomidine significantly decreased heart rate and P wave amplitude and increased PR interval, R wave amplitude, QT interval, and T wave amplitude. Midazolam increased the amplitude of the R and T waves. Ketamine increased the heart rate and PR interval. Propofol increased the heart rate for up to 15 min, decreased the PR interval for up to 30 min, and the QT interval for up to 45 min. Isoflurane increased the heart rate and decreased the amplitude of R and T waves. The results showed that the drugs used in this study did not have many side effects on electrocardiographic variables and could be used without serious concern. The most important side effects observed were a severe reduction in heart rate and 1st degree atrioventricular (AV) block and, to a lesser extent, 2nd degree AV block caused by medetomidine and midazolam which were masked by the anesthetics.
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Sández I, Martín-Flores M, Portela DA, Márquez-Grados F, Monge-García MI. Haemodynamic effects of labetalol in isoflurane-anaesthetized dogs that received dexmedetomidine: A randomized clinical trial. Vet Anaesth Analg 2024; 51:126-134. [PMID: 38114389 DOI: 10.1016/j.vaa.2023.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 09/06/2023] [Accepted: 10/11/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE To test whether labetalol improved cardiovascular function in anaesthetized dogs injected with dexmedetomidine. STUDY DESIGN Prospective, randomized, blinded, clinical trial. ANIMALS A group of 20 healthy client-owned dogs undergoing ovariohysterectomy. METHODS Each dog received dexmedetomidine (5 μg kg-1) and methadone (0.2 mg kg-1) intramuscularly. General anaesthesia was induced with propofol and maintained with isoflurane in oxygen. All dogs were mechanically ventilated, and epidural anaesthesia with lidocaine was performed. Standard anaesthetic monitoring, invasive blood pressure, oesophageal Doppler and near-infrared tissue perfusion/oxygenation were applied. Peak velocity (PV), mean acceleration and stroke distance (SD) from the oesophageal Doppler were recorded. Arterial elastance (Ea) was calculated. Tissue oxygenation (rStO2) was also recorded. Prior to surgery, animals received either 0.1 mg kg-1 of labetalol intravenously (IV) over 60 seconds or the equivalent volume of saline. Data were recorded for 20 minutes. Age, weight and propofol dose were compared with a Wilcoxon rank-sum test. The effects of time, treatment and their interaction with haemodynamic and perfusion variables were analysed with mixed-effect models and Tukey's post hoc tests. RESULTS Significant effects of the interaction between treatment and time were observed whereby heart rate (HR) was higher in dogs given labetalol (p = 0.01), whereas arterial blood pressure and Ea were lower (p < 0.01). Similarly, PV, SD and rStO2 were higher in the labetalol group, and significant effects were detected for the interaction between treatment and time (p < 0.01). CONCLUSIONS AND CLINICAL RELEVANCE Labetalol at a dose of 0.1 mg kg-1 IV in dogs under general anaesthesia and administered a pre-anaesthetic medication of dexmedetomidine produced mild vasodilation (reduction of Ea), resulting in an increase in HR and left ventricular outflow. Although labetalol could be an effective option to achieve haemodynamic optimization after dexmedetomidine-induced vasoconstriction, future studies are needed to assess long-term effects.
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Affiliation(s)
- Ignacio Sández
- Department of Anesthesiology and Pain Management, Hospital Veterinario AniCura-Vetsia, Madrid, Spain.
| | - Manuel Martín-Flores
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, University of Florida College of Veterinary Medicine, Gainesville, FL, USA
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Vettorato E, Mylniczenko ND, Portela DA. Use of an esophageal Doppler monitor to guide goal-directed cardiovascular optimization in two anesthetized Western lowland gorillas (Gorilla gorilla). Vet Anaesth Analg 2024; 51:192-194. [PMID: 38296767 DOI: 10.1016/j.vaa.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/06/2024] [Accepted: 01/07/2024] [Indexed: 02/02/2024]
Affiliation(s)
- Enzo Vettorato
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA.
| | - Natalie D Mylniczenko
- Disney's Animals, Science and Environment, Disney's Animal Kingdom, Lake Buena Vista, FL, USA
| | - Diego A Portela
- Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
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Khaleghi M, Sarchahi AA, Kazemi Mehrjerdi H, Rasekh M, Saadati D. Influence of ketamine, propofol or isoflurane on intraocular pressure, heart rate and blood pressure in healthy dogs premedicated with medetomidine and midazolam. Vet Med Sci 2024; 10:e1330. [PMID: 38009426 PMCID: PMC10766053 DOI: 10.1002/vms3.1330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 10/23/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND According to the findings of several studies, sedatives and anaesthetics have different effects on the functioning of the cardiovascular system and intraocular pressure (IOP). For accurate diagnosis, treatment and surgery with minimal complications, it is necessary to be aware of the effects of sedatives and anaesthetics on the cardiovascular system and IOP. OBJECTIVES The aim of this study was to evaluate the effects of sedatives (medetomidine and midazolam) and anaesthetics (ketamine, propofol and isoflurane) on IOP, heart rate (HR) and blood pressure in dogs. METHODS In this study, 10 dogs participated in three treatments using a randomised cross-over design, with a 1-week washout period between each treatment. Dogs in all treatments were premedicated with medetomidine and midazolam. Anaesthesia was induced using ketamine, propofol, or isoflurane and maintained for 60 min with the appropriate doses of each drug. The cardiovascular variables (heart rate, and systolic, diastolic and mean arterial pressures) and IOP were measured at different timepoints: before premedication (baseline values, T-Bas), 15 min after medetomidine administration (T-Med), 20 min after midazolam administration (T-Mid) and at 15 (T-15), 30 (T-30), 45 (T-45) and 60 (T-60) min after anaesthesia induction. RESULTS Medetomidine significantly reduced the IOP and HR and did not significantly change the mean arterial pressure (MAP). Midazolam significantly reduced the IOP while did not significantly change the HR and MAP. Ketamine and isoflurane significantly increased the IOP and HR while did not significantly change the MAP. Propofol significantly increased the HR, but did not cause significant changes in IOP and MAP. CONCLUSIONS Considering that anaesthetics are typically administered in conjunction with pre-anaesthetic drugs, the increases in IOP induced by ketamine and isoflurane are not important, as the IOP did not exceed the baseline values. However, further studies are required to investigate these effects in patients with elevated IOP.
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Affiliation(s)
| | - Ali Asghar Sarchahi
- Faculty of Veterinary MedicineDepartment of Clinical SciencesFerdowsi University of MashhadMashhadIran
| | - Hossein Kazemi Mehrjerdi
- Faculty of Veterinary MedicineDepartment of Clinical SciencesFerdowsi University of MashhadMashhadIran
| | - Mehdi Rasekh
- Faculty of Veterinary MedicineDepartment of Clinical SciencesUniversity of ZabolZabolIran
| | - Dariush Saadati
- Faculty of Veterinary MedicineDepartment of Food HygieneUniversity of ZabolZabolIran
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Marangoni S, Ubiali M, Ambrosini F, Jahnel L, Vilani JM, Steagall PV, Vilani RGDDC. Effects of different rates of propofol with or without S-ketamine on ventricular function in healthy cats - a randomized study. Front Vet Sci 2023; 10:1272949. [PMID: 38152595 PMCID: PMC10752607 DOI: 10.3389/fvets.2023.1272949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/24/2023] [Indexed: 12/29/2023] Open
Abstract
Propofol is used for anesthetic induction in cats and procedural sedation in countries where alfaxalone is not available. Studies have reported propofol-related effects in echocardiography variables in dogs and humans. However, there is a lack of echocardiography studies investigating propofol-related effects on cats. This study aimed to use echocardiography to investigate echocardiographic changes in three protocols using propofol: propofol-slow (2 mg/kg/min, PS); propofol-fast (8 mg/kg/min, PF); propofol-ketamine (S-ketamine 2 mg/kg bolus followed by propofol 2 mg/kg/min; PK) in healthy premedicated (gabapentin-buprenorphine-acepromazine; 200 mg/cat, 0.4, and 0.1 mg/kg, respectively), non-intubated cats. Echocardiographic measurements were obtained at three time points: baseline (before the administration of propofol), end of propofol titration (end-point, T0), and 15 min after T0 (T15). Propofol at a lower rate continued from T0 to T15. Echocardiographic and physiological variables included fractional shortening (FS%), ejection fraction (EF%), HR, BP, and others. Propofol requirements at T0 for PF, PS, and PK groups were 5.0 ± 0.9, 3.8 ± 0.7, and 2.4 ± 0.5 mg/kg, respectively. EF% neither change over time nor between groups. PF and PK showed a reduction in FS% at T0 (47 ± 6 to 34 ± 6 and 42 ± 6 to 36 ± 5, respectively). BP reduced significantly in PF and PS groups (136 ± 26 to 105 ± 13 and 137 ± 22 to 115 ± 15 mmHg, respectively). It is unclear whether changes in echocardiography variables were of clinical relevance related to treatment groups or a result of within-group individual responses.
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Affiliation(s)
- Sabrine Marangoni
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Matheus Ubiali
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Francieli Ambrosini
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Larissa Jahnel
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Julia M. Vilani
- Department of Veterinary Medicine, Federal University of Paraná, Juvevê, Curitiba, PR, Brazil
| | - Paulo V. Steagall
- Department of Veterinary Clinical Sciences and Centre for Companion Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada
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Pinheiro AV, Petrucci GN, Dourado A, Pires I. Anaesthesia in Veterinary Oncology: The Effects of Surgery, Volatile and Intravenous Anaesthetics on the Immune System and Tumour Spread. Animals (Basel) 2023; 13:3392. [PMID: 37958147 PMCID: PMC10648213 DOI: 10.3390/ani13213392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/11/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
Throughout the course of oncological disease, the majority of patients require surgical, anaesthetic and analgesic intervention. However, during the perioperative period, anaesthetic agents and techniques, surgical tissue trauma, adjuvant drugs for local pain and inflammation and other non-pharmacological factors, such as blood transfusions, hydration, temperature and nutrition, may influence the prognosis of the disease. These factors significantly impact the oncologic patient's immune response, which is the primary barrier to tumour progress, promoting a window of vulnerability for its dissemination and recurrence. More research is required to ascertain which anaesthetics and techniques have immunoprotective and anti-tumour effects, which will contribute to developing novel anaesthetic strategies in veterinary medicine.
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Affiliation(s)
- Ana Vidal Pinheiro
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
| | - Gonçalo N. Petrucci
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal;
- Center for Investigation Vasco da Gama (CIVG), Department of Veterinary Sciences, Vasco da Gama University School (EUVG), 3020-210 Coimbra, Portugal
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
| | - Amândio Dourado
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- Onevetgroup Hospital Veterinário do Porto (HVP), 4250-475 Porto, Portugal;
| | - Isabel Pires
- Department of Veterinary Sciences, School of Agricultural and Veterinary Sciences (ECAV), University of Trás-os-Montes e Alto Douro (UTAD), 5000-801 Vila Real, Portugal; (A.D.); (I.P.)
- CECAV—Veterinary and Animal Research Center, University of Trás-os-Montes and Alto Douro, 5001-801 Vila Real, Portugal
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Kook Kang J, Kalra A, Ameen Ahmad S, Kumar Menta A, Rando HJ, Chinedozi I, Darby Z, Spann M, Keller SP, J. R. Whitman G, Cho SM. A recommended preclinical extracorporeal cardiopulmonary resuscitation model for neurological outcomes: A scoping review. Resusc Plus 2023; 15:100424. [PMID: 37719942 PMCID: PMC10500026 DOI: 10.1016/j.resplu.2023.100424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/14/2023] [Accepted: 06/19/2023] [Indexed: 09/19/2023] Open
Abstract
Background Despite the high prevalence of neurological complications and mortality associated with extracorporeal cardiopulmonary resuscitation (ECPR), neurologically-focused animal models are scarce. Our objective is to review current ECPR models investigating neurological outcomes and identify key elements for a recommended model. Methods We searched PubMed and four other engines for animal ECPR studies examining neurological outcomes. Inclusion criteria were: animals experiencing cardiac arrest, ECPR/ECMO interventions, comparisons of short versus long cardiac arrest times, and neurological outcomes. Results Among 20 identified ECPR animal studies (n = 442), 13 pigs, 4 dogs, and 3 rats were used. Only 10% (2/20) included both sexes. Significant heterogeneity was observed in experimental protocols. 90% (18/20) employed peripheral VA-ECMO cannulation and 55% (11/20) were survival models (median survival = 168 hours; ECMO duration = 60 minutes). Ventricular fibrillation (18/20, 90%) was the most common method for inducing cardiac arrest with a median duration of 15 minutes (IQR = 6-20). In two studies, cardiac arrests exceeding 15 minutes led to considerable mortality and neurological impairment. Among seven studies utilizing neuromonitoring tools, only four employed multimodal devices to evaluate cerebral blood flow using Transcranial Doppler ultrasound and near-infrared spectroscopy, brain tissue oxygenation, and intracranial pressure. None examined cerebral autoregulation or neurovascular coupling. Conclusions The substantial heterogeneity in ECPR preclinical model protocols leads to limited reproducibility and multiple challenges. The recommended model includes large animals with both sexes, standardized pre-operative protocols, a cardiac arrest time between 10-15 minutes, use of multimodal methods to evaluate neurological outcomes, and the ability to survive animals after conducting experiments.
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Affiliation(s)
- Jin Kook Kang
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
| | - Andrew Kalra
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Syed Ameen Ahmad
- Division of Neurosciences Critical Care, Department of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, USA
| | - Arjun Kumar Menta
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
| | - Hannah J. Rando
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
| | - Ifeanyi Chinedozi
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
| | - Zachary Darby
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
| | - Marcus Spann
- Informationist Services, Johns Hopkins School of Medicine, Baltimore, USA
| | - Steven P. Keller
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, USA
| | - Glenn J. R. Whitman
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
| | - Sung-Min Cho
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins Hospital, Baltimore, USA
- Division of Neurosciences Critical Care, Department of Neurology, Neurosurgery, Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, USA
- Division of Pulmonary and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, USA
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Sández I, Redondo JI, Donati PA, Gómez J. Haemodynamic Effects of Pimobendan during General Anaesthesia in Healthy Senior Dogs: A Prospective, Randomised, Triple-Blinded, Placebo-Controlled Clinical Study. Animals (Basel) 2023; 13:2110. [PMID: 37443908 DOI: 10.3390/ani13132110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/10/2023] [Accepted: 06/24/2023] [Indexed: 07/15/2023] Open
Abstract
Pimobendan is an inotropic and vasodilator drug with no sympathomimetic effects. This study aimed to evaluate the haemodynamic effects of pimobendan during anaesthesia in healthy senior dogs. A prospective, randomised, triple-blinded, placebo-controlled clinical study was conducted. Thirty-three dogs (median [range]: 9 [7, 12] years) were anaesthetised for surgical procedures. The dogs were randomly allocated into two groups: eighteen dogs received intravenous pimobendan at a dose of 0.15 mg/kg (PIMOBENDAN), and fifteen dogs received intravenous saline solutions at a dose of 0.2 mL/kg (PLACEBO). Data were recorded before, 1 min, 10 min, and 20 min after injection. Velocity-time integral (VTI), peak-velocity (PV), and mean-acceleration (MA) were measured using an oesophageal Doppler monitor (ODM). Heart rate and mean arterial pressure were also registered. The data were analysed using a two-way ANOVA for trimmed means. Statistical differences were considered if p < 0.05. Twenty minutes after injection, the VTI (13.0 cm [10.4, 22.3]), PV (95.0 [83.0, 160] m/s), and MA (12.6 [9.40, 17.0] m/s2) were significantly higher in the PIMOBENDAN group compared to the PLACEBO group (VTI: 10.5 [6.50, 17.4] cm, PV: 80.0 [62.0, 103] m/s and MA: 10.2 [7.00, 16.0] ms2). No significant differences were observed in the rest of the variables. Using pimobendan during anaesthesia increases VTI, PV, and MA, as measured by an ODM.
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Affiliation(s)
- Ignacio Sández
- Department of Anesthesiology and Pain Management, Hospital Veterinario AniCura-Vetsia, Leganés, 28914 Madrid, Spain
| | - José I Redondo
- Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain
| | - Pablo A Donati
- Department of Anaesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires 1427, Argentina
| | - José Gómez
- AniCura Iberia Medical Department, 28006 Madrid, Spain
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11
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Layton R, Layton D, Beggs D, Fisher A, Mansell P, Stanger KJ. The impact of stress and anesthesia on animal models of infectious disease. Front Vet Sci 2023; 10:1086003. [PMID: 36816193 PMCID: PMC9933909 DOI: 10.3389/fvets.2023.1086003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/09/2023] [Indexed: 02/05/2023] Open
Abstract
Stress and general anesthesia have an impact on the functional response of the organism due to the detrimental effects on cardiovascular, immunological, and metabolic function, which could limit the organism's response to an infectious event. Animal studies have formed an essential step in understanding and mitigating infectious diseases, as the complexities of physiology and immunity cannot yet be replicated in vivo. Using animals in research continues to come under increasing societal scrutiny, and it is therefore crucial that the welfare of animals used in disease research is optimized to meet both societal expectations and improve scientific outcomes. Everyday management and procedures in animal studies are known to cause stress, which can not only cause poorer welfare outcomes, but also introduces variables in disease studies. Whilst general anesthesia is necessary at times to reduce stress and enhance animal welfare in disease research, evidence of physiological and immunological disruption caused by general anesthesia is increasing. To better understand and quantify the effects of stress and anesthesia on disease study and welfare outcomes, utilizing the most appropriate animal monitoring strategies is imperative. This article aims to analyze recent scientific evidence about the impact of stress and anesthesia as uncontrolled variables, as well as reviewing monitoring strategies and technologies in animal models during infectious diseases.
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Affiliation(s)
- Rachel Layton
- Australian Centre for Disease Preparedness, CSIRO, Geelong, VIC, Australia,*Correspondence: Rachel Layton ✉
| | - Daniel Layton
- Australian Centre for Disease Preparedness, CSIRO, Geelong, VIC, Australia
| | - David Beggs
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, VIC, Australia
| | - Andrew Fisher
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, VIC, Australia
| | - Peter Mansell
- Faculty of Veterinary and Agricultural Sciences, Melbourne Veterinary School, University of Melbourne, Melbourne, VIC, Australia
| | - Kelly J. Stanger
- Australian Centre for Disease Preparedness, CSIRO, Geelong, VIC, Australia
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Heart rate, arterial pressure and propofol-sparing effects of guaifenesin in dogs. Vet Anaesth Analg 2023; 50:50-56. [PMID: 36344374 DOI: 10.1016/j.vaa.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/05/2022] [Accepted: 10/06/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To evaluate the heart rate (HR) and systemic arterial pressure (sAP) effects, and propofol induction dose requirements in healthy dogs administered propofol with or without guaifenesin for the induction of anesthesia. STUDY DESIGN Prospective blinded crossover experimental study. ANIMALS A total of 10 healthy adult female Beagle dogs. METHODS Dogs were premedicated with intravenous (IV) butorphanol (0.4 mg kg-1) and administered guaifenesin 5% at 50 mg kg-1 (treatment G50), 100 mg kg-1 (treatment G100) or saline (treatment saline) IV prior to anesthetic induction with propofol. HR, invasive sAP and respiratory rate (fR) were recorded after butorphanol administration, after guaifenesin administration and after propofol and endotracheal intubation. Propofol doses for intubation were recorded. Repeated measures analysis of variance (anova) was used to determine differences in propofol dose requirements among treatments, and differences in cardiopulmonary values over time and among treatments with p < 0.05 considered statistically significant. RESULTS Propofol doses (mean ± standard deviation) for treatments saline, G50 and G100 were 3.3 ± 1.0, 2.7 ± 0.7 and 2.1 ± 0.8 mg kg-1, respectively. Propofol administered was significantly lower in treatment G100 than in treatment saline (p = 0.04). In treatments G50 and G100, HR increased following induction of anesthesia and intubation compared with baseline measurements. HR was higher in treatment G100 than in treatments G50 and saline following induction of anesthesia. In all treatments, sAP decreased following intubation compared with baseline values. There were no significant differences in sAP among treatments. fR was lower following intubation than baseline and post co-induction values and did not differ significantly among treatments. CONCLUSIONS AND CLINICAL RELEVANCE When administered as a co-induction agent in dogs, guaifenesin reduced propofol requirements for tracheal intubation. HR increased and sAP and fR decreased, but mean values remained clinically acceptable.
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13
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Parra Martínez C, Charlesworth TM, Francis A. Anaesthetic management in a dog with constrictive pericarditis complicated with bi‐atrial enlargement and atrial fibrillation undergoing subtotal pericardiectomy. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | | | - Andrew Francis
- Cardiology Department Eastcott Veterinary Referrals Swindon UK
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Sández I, Verdier N, Redondo JI, Tarragona L, Donati PA, Serrano S, Otero PE. Agreement between transthoracic echocardiography and esophageal Doppler on aortic flow variables in anesthetized mechanically ventilated dogs. THE CANADIAN VETERINARY JOURNAL = LA REVUE VETERINAIRE CANADIENNE 2022; 63:722-726. [PMID: 35784775 PMCID: PMC9207967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The use of transthoracic echocardiography (TTE) and esophageal Doppler (ED) for the measurement of hemodynamic variables in anesthetized dogs was studied. Fourteen mixed-breed dogs, without cardiac disease, undergoing general anesthesia for diagnostic or therapeutic procedures were included in this prospective preliminary study. Dogs were premedicated with dexmedetomidine (3 μg/kg) and methadone (0.3 mg/kg), intramuscularly. General anesthesia was induced with propofol intravenously titrated to effect and maintained with isoflurane in oxygen. Animals were positioned in dorsal recumbency. Transthoracic echocardiography was performed using a 5-2 MHz cardiac ultrasound probe placed in the subcostal window, whereas esophageal Doppler was performed using a CardioQ probe (MP50; Deltex Medical, Chichester, UK). Once an appropriate view of the aortic flow was obtained, the variables peak velocity (PV) and velocity-time integral (VTI) were measured. Agreement between methods was evaluated using the Bland-Altman method with single observation per individual. The bias and the limits of agreement (LOA) between the two methods were determined. Mean (± SD) PV was 99.46 cm/s (± 42.73 cm/s) and 110.29 cm/s (± 35.86 cm/s), and VTI was 13.24 cm (± 4.33 cm) and 13.05 cm (± 4.47 cm), for TTE and ED, respectively. Mean differences and LOA were 10.83 cm/s (range: -20.50 to 42.16 cm/s) and -0.19 cm (range: -3.32 to 2.95 cm) for PV and VTI, respectively. No statistically significant differences were determined in the variables measured between TTE and ED in anesthetized dogs without cardiac disease, positioned in dorsal recumbency. This could be of clinical relevance when an evaluation of the intraoperative hemodynamic status of anesthetized dogs is desired.
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Affiliation(s)
- Ignacio Sández
- Hospital Veterinario Vetsia, Leganés, Madrid, Spain (Sández, Serrano); Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina (Verdier, Tarragona, Donati, Otero); Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria (Verdier); Universidad Cardenal Herrera-CEU, CEU Universities, Medicina y Cirugía Animal, Alfara del Patriarca, Valencia, Spain (Redondo)
| | - Natalí Verdier
- Hospital Veterinario Vetsia, Leganés, Madrid, Spain (Sández, Serrano); Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina (Verdier, Tarragona, Donati, Otero); Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria (Verdier); Universidad Cardenal Herrera-CEU, CEU Universities, Medicina y Cirugía Animal, Alfara del Patriarca, Valencia, Spain (Redondo)
| | - J Ignacio Redondo
- Hospital Veterinario Vetsia, Leganés, Madrid, Spain (Sández, Serrano); Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina (Verdier, Tarragona, Donati, Otero); Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria (Verdier); Universidad Cardenal Herrera-CEU, CEU Universities, Medicina y Cirugía Animal, Alfara del Patriarca, Valencia, Spain (Redondo)
| | - Lisa Tarragona
- Hospital Veterinario Vetsia, Leganés, Madrid, Spain (Sández, Serrano); Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina (Verdier, Tarragona, Donati, Otero); Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria (Verdier); Universidad Cardenal Herrera-CEU, CEU Universities, Medicina y Cirugía Animal, Alfara del Patriarca, Valencia, Spain (Redondo)
| | - Pablo A Donati
- Hospital Veterinario Vetsia, Leganés, Madrid, Spain (Sández, Serrano); Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina (Verdier, Tarragona, Donati, Otero); Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria (Verdier); Universidad Cardenal Herrera-CEU, CEU Universities, Medicina y Cirugía Animal, Alfara del Patriarca, Valencia, Spain (Redondo)
| | - Susana Serrano
- Hospital Veterinario Vetsia, Leganés, Madrid, Spain (Sández, Serrano); Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina (Verdier, Tarragona, Donati, Otero); Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria (Verdier); Universidad Cardenal Herrera-CEU, CEU Universities, Medicina y Cirugía Animal, Alfara del Patriarca, Valencia, Spain (Redondo)
| | - Pablo E Otero
- Hospital Veterinario Vetsia, Leganés, Madrid, Spain (Sández, Serrano); Department of Anesthesiology and Pain Management, Facultad de Ciencias Veterinarias, Universidad de Buenos Aires, Buenos Aires, Argentina (Verdier, Tarragona, Donati, Otero); Department of Anesthesiology and Perioperative Intensive Care, University of Veterinary Medicine, Vienna, Austria (Verdier); Universidad Cardenal Herrera-CEU, CEU Universities, Medicina y Cirugía Animal, Alfara del Patriarca, Valencia, Spain (Redondo)
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15
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Puccinelli C, Pelligra T, Briganti A, Citi S. Two-dimensional shear wave elastography of liver in healthy dogs: anaesthesia as a source of variability. Int J Vet Sci Med 2022; 10:46-51. [PMID: 35677323 PMCID: PMC9132446 DOI: 10.1080/23144599.2022.2073138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Two-dimensional shear wave elastography (2D-SWE) is a non-invasive method to quantitatively evaluate the liver stiffness (LS), allowing the detection of hepatic pathological changes in both dogs and humans. In dogs, some factors such as patient movement and respiration can cause artefacts and potential errors of measurements. Therefore, anaesthesia has been suggested to reduce the effect of the movement on 2D-SWE in dogs. This study was performed to evaluate the influence of an anaesthetic protocol on 2D-SWE measurements for assessment of LS in healthy dogs. Forty-five dogs were included and subjected to anaesthesia: in 11 dogs, the 2D-SWE was performed both before and under anaesthesia, in 19 dogs, the 2D-SWE was performed only when they were awake and in 15 dogs, the examination was carried out only under anaesthesia. The anaesthetic protocol was composed of intramuscular injection of a combination of dexmedetomidine, methadone and ketamine and intravenous administration of propofol for induction and isoflurane for maintenance. The variability of 2D-SWE values according to anaesthesia was evaluated. Median 2D-SWE values were significantly higher in anesthetized dogs compared to awake dogs either by considering separately the dogs in which the examination was performed both awake and under anaesthesia and by considering all dogs included. According to our study, anaesthesia helped to avoid challenges related to patient movement and respiration; however, it was a source of variability on 2D-SWE values, and this factor should be considered before performing 2D-SWE under anaesthesia.
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Affiliation(s)
| | - Tina Pelligra
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Angela Briganti
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
| | - Simonetta Citi
- Department of Veterinary Sciences, University of Pisa, Pisa, Italy
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16
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Carlsen MF, Christoffersen BØ, Lindgaard R, Pedersen HD, Olsen LH. Implantation of telemetric blood pressure transmitters in Göttingen Minipigs: Validation of 24-h systemic blood pressure and heart rate monitoring and influence of anaesthesia. J Pharmacol Toxicol Methods 2022; 115:107168. [DOI: 10.1016/j.vascn.2022.107168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 10/18/2022]
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17
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Liao J, Li M, Huang C, Yu Y, Chen Y, Gan J, Xiao J, Xiang G, Ding X, Jiang R, Li P, Yang M. Pharmacodynamics and Pharmacokinetics of HSK3486, a Novel 2,6-Disubstituted Phenol Derivative as a General Anesthetic. Front Pharmacol 2022; 13:830791. [PMID: 35185584 PMCID: PMC8851058 DOI: 10.3389/fphar.2022.830791] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Background: The purpose of this study was to characterize the novel sedative/hypnotic agent HSK3486, a 2,6-disubstituted alkylphenol analogue. Methods: The mechanism of action of HSK3486 was studied in competitive binding assays and whole-cell patch clamp assays. HSK3486 was administered by bolus intravenous injection to dogs and rats, and the loss of righting reflex as well as effects on the cardiovascular and respiratory systems were assessed. The in vitro metabolism of HSK3486 was analyzed by CYP450 genotyping and enzyme inhibition. Results: HSK3486 competed with t-butylbicycloorthobenzoate (TBOB) and t-butylbicyclophosphorothionate (TBPS) for binding to the gamma-aminobutyric acid type A (GABAA) receptor. HSK3486 potentiated GABA-evoked chloride currents at lower concentrations while activating GABAA receptor at higher concentrations. HSK3486 induced hypnosis in rats and dogs, and had a higher therapeutic index than propofol in rats. The hypnotic potency of HSK3486 was approximately 4-5 fold higher than that of propofol. HSK3486 exerted minimal effects on the cardiovascular system. Conclusions: HSK3486 is a positive allosteric regulator and direct agonist of GABAA receptor. It has a promising sedative/hypnotic effect and good in vivo pharmacokinetic properties, which justify further studies towards its clinical application.
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Affiliation(s)
- Juan Liao
- Department of Stomatology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Meiting Li
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Chaoli Huang
- East Hospital, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Yan Yu
- Haisco Pharmaceutical Group Co. Ltd., Chengdu, China
| | - Yashu Chen
- Haisco Pharmaceutical Group Co. Ltd., Chengdu, China
| | - Jiaqi Gan
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Jie Xiao
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Guilin Xiang
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xizhi Ding
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Rong Jiang
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Peng Li
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Peng Li, ; Mengchang Yang,
| | - Mengchang Yang
- Department of Anesthesiology, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu, China
- *Correspondence: Peng Li, ; Mengchang Yang,
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18
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Walters K, Lehnus K, Liu NC, Bigby SE. Determining an optimum propofol infusion rate for induction of anaesthesia in healthy dogs: a randomized clinical trial. Vet Anaesth Analg 2022; 49:243-250. [DOI: 10.1016/j.vaa.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 05/26/2021] [Accepted: 07/21/2021] [Indexed: 11/28/2022]
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19
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Martín Bellido V, Vettorato E. Clinical review of the pharmacological and anaesthetic effects of alfaxalone in dogs. J Small Anim Pract 2021; 63:341-361. [PMID: 34893985 DOI: 10.1111/jsap.13454] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/11/2021] [Accepted: 11/16/2021] [Indexed: 01/02/2023]
Abstract
This clinical review summarises the pharmacological and anaesthetic properties of alfaxalone in the dog. Available pharmacokinetic-pharmacodynamic data and factors affecting the induction dose have been reported. Furthermore, quality of induction and recovery after alfaxalone administration, the use of alfaxalone for total intravenous anaesthesia, and its effects on the cardio-respiratory system, on laryngeal motion, on intraocular pressure and tear production have been evaluated. Finally, the use of alfaxalone in dogs undergoing caesarean section and the effect of intramuscular alfaxalone administration have been considered.
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Affiliation(s)
- V Martín Bellido
- Dick White Referrals, Station Farm - London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
| | - E Vettorato
- Dick White Referrals, Station Farm - London Road, Six Mile Bottom, Cambridgeshire, CB8 0UH, UK
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20
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Iseri T, Nakamori M, Fujimoto Y. Effects of thoracolumbar epidural anesthesia with lidocaine on the systemic hemodynamics and hepatic blood flow in propofol anesthetized dogs. J Vet Med Sci 2021; 83:1877-1884. [PMID: 34645723 PMCID: PMC8762409 DOI: 10.1292/jvms.20-0611] [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] [Indexed: 11/22/2022] Open
Abstract
General anesthesia reduces hepatic blood flow (HBF) from circulatory depression. Total intravenous anesthesia (TIVA) is associated with decreased circulatory depression compared to inhalation anesthesia, and epidural anesthesia using local anesthetics increases blood flow by blocking the sympathetic nerves and expanding blood vessels. We investigated the effects of thoracolumbar epidural anesthesia with TIVA on HBF in dogs. Six Beagle dogs had epidural catheters placed between T13 and L1 and were anesthetized with propofol and vecuronium. Physiological saline (control) or 2% lidocaine (0.2 ml/kg, followed by 0.2 ml/kg/hr) was administered at 1-2 weeks intervals. Heart rate (HR), cardiac index (CI), mean arterial pressure (MAP), and systemic vascular resistance index (SVRI) were recorded at 10-min intervals from before epidural injections (T0) to 110 min. Indocyanine green test was used to measure HBF during the awake state and until 90 min after epidural injections. HR and CI did not differ between treatments. MAP and SVRI after lidocaine were significantly lower than those of controls, and the lowest MAP value was 65 ± 11 mmHg at T10. Compared to T0, after lidocaine treatment, HBF was significantly higher at T30, T60 and T90 (P<0.05); while, after control treatment, no significant change was evident at any time point. Despite a decrease in MAP by this technique, HBF was either maintained at pre-anesthetic levels or increased in comparison to controls, probably due to vasodilation of the hepatic artery induced by the selective blockade sympathetic ganglia.
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Affiliation(s)
- Toshie Iseri
- Department of Clinical Veterinary Science, Joint Faculty of Veterinary Medicine, Yamaguchi University, 1677-1 Yoshida, Yamaguchi-shi, Yamaguchi 753-8515, Japan
| | - Masaya Nakamori
- Otokuni Animal Hospital, 26 Shimokaiinji, Nagaokakyo-shi, Kyoto 617-0845, Japan
| | - Yuka Fujimoto
- Department of Advanced Clinical Medicine, Graduate School of Life and Environmental Sciences, Osaka Prefecture University, 1-58 Rinku-Oraikita, Izumisano-shi, Osaka 598-8531, Japan
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Efficacy and Safety of Dexmedetomidine Premedication in Balanced Anesthesia: A Systematic Review and Meta-Analysis in Dogs. Animals (Basel) 2021; 11:ani11113254. [PMID: 34827988 PMCID: PMC8614454 DOI: 10.3390/ani11113254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/11/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Dexmedetomidine, on account of its potent sedative and analgesic properties, is commonly used in balanced anesthesia of small animal anesthesia; however, concerns regarding its cardiovascular effects prevent its full adoption into veterinary clinical practice. We conducted this meta-analysis to determine the effects of dexmedetomidine on sedation, analgesia, cardiovascular and adverse reactions in dogs compared to other premedications. The outcomes included sedation score, pain score, heart rate, systolic arterial blood pressure, mean arterial blood pressure and the incidence of adverse effects. Thirteen studies were included in this meta-analysis. The results showed that dexmedetomidine provides a satisfactory sedative and analgesic effect in balanced anesthesia of dogs. After dexmedetomidine premedication, dogs experienced lower heart rate and higher blood pressure within an acceptable range. The combinations in balanced anesthesia and routes of delivering drugs would affect heart rate, systolic arterial blood pressure, and mean arterial blood pressure of dogs. Before using dexmedetomidine, an animal’s cardiovascular status should be fully considered. Abstract Dexmedetomidine is commonly used in small animal anesthesia for its potent sedative and analgesic properties; however, concerns regarding its cardiovascular effects prevent its full adoption into veterinary clinical practice. This meta-analysis was to determine the effects of dexmedetomidine on sedation, analgesia, cardiovascular and adverse reactions in dogs compared to other premedications. Following the study protocol based on the Cochrane Review Methods, thirteen studies were included in this meta-analysis ultimately, involving a total of 576 dogs. Dexmedetomidine administration probably improved in sedation and analgesia in comparison to acepromazine, ketamine and lidocaine (MD: 1.96, 95% CI: [−0.08, 4.00], p = 0.06; MD: −0.95, 95% CI: [−1.52, −0.37] p = 0.001; respectively). Hemodynamic outcomes showed that dogs probably experienced lower heart rate and higher systolic arterial blood pressure and mean arterial blood pressure with dexmedetomidine at 30 min after premedication (MD: −13.25, 95% CI: [−19.67, −6.81], p < 0.0001; MD: 7.78, 95% CI: [1.83, 13.74], p = 0.01; MD: 8.32, 95% CI: [3.95, 12.70], p = 0.0002; respectively). The incidence of adverse effects was comparable between dexmedetomidine and other premedications (RR = 0.86, 95% CI [0.58, 1.29], p = 0.47). In summary, dexmedetomidine provides satisfactory sedative and analgesic effects, and its safety is proved despite its significant hemodynamic effects as part of balanced anesthesia of dogs.
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Parra Martínez C, Ronaldson HL, Blake R. Balloon dilation of a perforated cor triatriatum dexter in a Springer Spaniel: anaesthetic management. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | | | - Rachel Blake
- Department of CardiologyPride Veterinary CentreDerbyUK
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23
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Vézina-Audette R. Anesthesia Case of the Month. J Am Vet Med Assoc 2020; 256:176-178. [PMID: 31910081 DOI: 10.2460/javma.256.2.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Conventional Echocardiography and Two-Dimensional Speckle Tracking in Healthy Sevoflurane-Anesthetized Dogs Undergoing Continuous Rate Infusion of Nalbuphine. Vet Med Int 2020; 2020:9278751. [PMID: 32566120 PMCID: PMC7298342 DOI: 10.1155/2020/9278751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/29/2020] [Accepted: 05/20/2020] [Indexed: 11/17/2022] Open
Abstract
Nalbuphine is an agonist-antagonist opioid with adequate analgesic properties and few depressant effects on the respiratory system. However, there are no detailed reports available on cardiovascular effects of nalbuphine in dogs. The aim of this study was to assess the effects of a continuous rate infusion (CRI) of nalbuphine on left ventricular systolic and diastolic function of healthy sevoflurane-anesthetized dogs. Eighteen mixed-breed bitches aged 1-4 years and weighing 9.9 ± 3.8 kg were used. Dogs were randomly assigned to one of two groups: nalbuphine (GN, n = 9) and control (GC, n = 9). Anesthesia was induced and maintained with sevoflurane (2V%) followed by an intravenous (IV) bolus of nalbuphine (0.3 mg/kg) or 0.9% NaCl at equal volume and then CRI of nalbuphine (0.4 mg/kg/h) or 0.9% NaCl at an equal infusion rate. Echocardiographic and hemodynamic variables were determined at baseline and 20, 40, 60, and 80 minutes following start of CRI. No differences were found between groups for left ventricular systolic and diastolic variables obtained through conventional echocardiography and two-dimensional speckle tracking. Likewise, hemodynamic variables did not differ between groups. The E'/A' ratio significantly increased at 20 minutes compared to baseline only in GN. Nalbuphine given at a CRI does not influence left ventricular systolic and diastolic function in healthy sevoflurane-anesthetized dogs.
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Hypoxia - Reoxygenation in neonatal cardiac arrest: Results from experimental models. Semin Fetal Neonatal Med 2020; 25:101085. [PMID: 32014367 DOI: 10.1016/j.siny.2020.101085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In this review, we summarize the results of studies that investigated the effects of hypoxia and reoxygenation in cardiac arrest, including the use of different fractions of inspired oxygen, in neonatal animals. The studies were heterogenous in terms of anaesthetic regimens, and definitions of cardiac arrest and circulatory recovery. Cardiopulmonary resuscitation with 100% oxygen increased oxidative stress in maturing rats. Studies in fetal/neonatal lambs and post-transitional neonatal piglets indicate no consistent differences between ventilation with 21% vs. 100% oxygen with regards to recovery times, oxygen damage or adverse events. If 21% oxygen is as effective as 100% oxygen in newborn infants with cardiac arrest requiring chest compression, the use of 21% instead of 100% oxygen could reduce morbidity and mortality in asphyxiated infants. Unanswered questions include what is the most optimal cerebral oxygen delivery during reperfusion, as well as oxygenation targets after return of spontaneous circulation.
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Djuric M, Nikolic Turnic T, Kostic S, Radonjic K, Jeremic J, Petkovic A, Bradic J, Milosavljevic I, Srejovic I, Zivkovic V, Djuric D, Jakovljevic V, Stevanovic P. Inhibition of gasotransmitters production and calcium influx affect cardiodynamic variables and cardiac oxidative stress in propofol-anesthetized male Wistar rats. Can J Physiol Pharmacol 2019; 97:850-856. [DOI: 10.1139/cjpp-2018-0719] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It has been assumed that the cardioprotective effects of propofol are due to its non-anesthetic pleiotropic cardiac and vasodilator effects, in which gasotransmitters (NO, H2S, and CO) as well as calcium influx could be involved. The study on isolated rat heart was performed using 4 experimental groups (n = 7 in each): (1) bolus injection of propofol (100 mg/kg body mass, i.p.); (2) L-NAME (NO synthase inhibitor, 60 mg/kg body mass, i.p.) + propofol; (3) DL-PAG (H2S synthase inhibitor, 50 mg/kg body mass, i.p.) + propofol; (4) ZnPPIX (CO synthase inhibitor, 50 μmol/kg body mass, i.p.) + propofol. Before and after the verapamil (3 μmol/L) administration, cardiodynamic parameters were recorded (dp/dtmax, dp/dtmin, systolic left ventricular pressure, diastolic left ventricular pressure, heart rate, coronary flow), as well as coronary and cardiac oxidative stress parameters. The results showed significant increases of diastolic left ventricular pressure following NO and CO inhibition, but also increases of coronary flow following H2S and CO inhibition. Following verapamil administration, significant decreases of dp/dtmax were noted after NO and CO inhibition, then increase of diastolic left ventricular pressure following CO inhibition, and increase of coronary flow following NO, H2S, or CO inhibition. Oxidative stress markers were increased but catalase activity was significantly decreased in cardiac tissue. Gasotransmitters and calcium influx are involved in pleiotropic cardiovascular effects of propofol in male Wistar rats.
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Affiliation(s)
- M. Djuric
- Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Clinical Hospital Center “Dr. Dragisa Misovic - Dedinje”, Belgrade, Serbia
| | - T. Nikolic Turnic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - S. Kostic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - K. Radonjic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - J. Jeremic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - A. Petkovic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - J. Bradic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - I. Milosavljevic
- Department of Pharmacy, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - I. Srejovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - V. Zivkovic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
| | - D. Djuric
- Institute of Medical Physiology “Richard Burian”, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - V. Jakovljevic
- Department of Physiology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Department of Human Pathology, 1st Moscow State Medical, University IM Sechenov, Moscow, Russian Federation
| | - P. Stevanovic
- Department of Anesthesiology, Reanimatology and Intensive Care Medicine, University Clinical Hospital Center “Dr. Dragisa Misovic - Dedinje”, Belgrade, Serbia
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