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Cardozo HG, Monteiro ER, Correia BS, Victor B Ferronatto J, Almeida-Filho FT, Alievi MM, Valle SF. Influence of intravenous fentanyl or dexmedetomidine infusions, combined with lidocaine and ketamine, on cardiovascular response, sevoflurane requirement and postoperative pain in dogs anesthetized for unilateral mastectomy. Vet Anaesth Analg 2024; 51:381-390. [PMID: 38744657 DOI: 10.1016/j.vaa.2024.04.006] [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: 09/26/2023] [Revised: 04/14/2024] [Accepted: 04/14/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVE To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy. STUDY DESIGN Prospective, randomized, blinded, clinical trial. ANIMALS A total of 29 female dogs with mammary tumors. METHODS Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 μg kg-1 loading dose (LD) and 1 μg kg-1 hour-1; lidocaine 2 mg kg-1 LD and 3 mg kg-1 hour-1; ketamine 1 mg kg-1 LD and 0.6 mg kg-1 hour-1; n = 14] or FLK (fentanyl 5 μg kg-1 LD and 9 μg kg-1 hour-1; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe'Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann-Whitney test. RESULTS More dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe'Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK. CONCLUSIONS AND CLINICAL RELEVANCE Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.
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Affiliation(s)
- Haiumy G Cardozo
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Eduardo R Monteiro
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Bárbara S Correia
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - João Victor B Ferronatto
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fábio Td Almeida-Filho
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Marcelo M Alievi
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Stella F Valle
- Faculty of Veterinary Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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Akashi N, Murahata Y, Tsuno S, Kanazawa A, Hikasa Y, Imagawa T. Nicardipine constant rate infusion alleviates the cardiovascular effects of dexmedetomidine infusions without affecting the minimal alveolar concentration in sevoflurane-anesthetized dogs. Res Vet Sci 2024; 172:105254. [PMID: 38582048 DOI: 10.1016/j.rvsc.2024.105254] [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: 03/02/2024] [Revised: 03/27/2024] [Accepted: 04/01/2024] [Indexed: 04/08/2024]
Abstract
Two randomized crossover trials evaluated the effects of nicardipine constant rate infusion (CRI) on 1) the anesthetic potency of sevoflurane and 2) the ability to attenuate dexmedetomidine-induced cardiovascular depression in anesthetized dogs. First, six healthy Beagle dogs weighing 11.7 ± 0.9 kg were allocated to one of three treatments that administered a CRI of carrier (saline) or dexmedetomidine 0.5 or 3.0 μg/kg/h following a loading dose. The minimum alveolar concentration (MAC) of sevoflurane was determined utilizing electric stimuli before and after the loading dose of nicardipine (20 μg/kg intravenously for 10 min), followed by CRI at 40 μg/kg/h with 60 min of equilibration. Subsequently, cardiovascular and blood gas variables were evaluated in another trial under sevoflurane anesthesia at the individual 1.5 MAC. After baseline measurements, the dogs were assigned to two treatments (dexmedetomidine CRI at 0.5 or 3.0 μg/kg/h following a loading dose) with sevoflurane doses adjusted to 1.5 times of MAC equivalent, and the measurements were repeated every 15 min for 120 min. After 60 min, nicardipine CRI at 40 μg/kg/h with a loading dose was added to the dexmedetomidine CRI. Dexmedetomidine infusions significantly decreased the sevoflurane MAC but nicardipine did not significantly alter the MAC either with or without dexmedetomidine CRI in dogs. Dexmedetomidine dose-dependently decreased the cardiac index and increased the systemic vascular resistance index; these effects were fully counteracted by concomitant nicardipine CRI. Nicardipine CRI can be useful for controlling the cardiovascular depression elicited by dexmedetomidine in anesthetized dogs without affecting the anesthetic potency of sevoflurane.
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Affiliation(s)
- Natsuki Akashi
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, Japan
| | - Yusuke Murahata
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, Japan.
| | - Sayaka Tsuno
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, Japan
| | - Aomi Kanazawa
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, Japan
| | - Yoshiaki Hikasa
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, Japan
| | - Tomohiro Imagawa
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, 4-101 Koyama-Minami, Tottori, Japan
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Marzok M, Almubarak AI, Kandeel M, El-Deeb W, Babiker H, Fathi El-Hawari S. A randomized crossover study of the effect of butorphanol-lidocaine and tramadol-lidocaine on sevoflurane's minimum alveolar concentration in dogs. Front Vet Sci 2023; 9:1057580. [PMID: 36713864 PMCID: PMC9878290 DOI: 10.3389/fvets.2022.1057580] [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: 09/29/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
Inhalational anesthesia is routinely used in small animal surgery. Selecting a suitable drug combination is vital since it may negatively affect the patient's physiological condition. We conducted this study to examine the sparing effect of butorphanol-lidocaine (BUT-LID) and tramadol-lidocaine (TRM-LID) on sevoflurane's minimum alveolar concentration (MAC) in 10 healthy mongrel dogs aged 1-2 years and weighing 11.5 ± 0.8 kg (mean ± SD). Sevoflurane's MAC was measured on three separate occasions. The three dog treatment groups were control (CONT) anesthetized only with sevoflurane, TRM-LID (TRM, i.v. 1.5 mg kg-1, then 1.3 mg kg-1 h-1 and LID, i.v. 2 mg kg-1, then 3 mg kg-1 h-1) or BUT-LID treatment (BUT, i.v. 0.1 mg kg-1 then 0.2 mg kg-1 h-1 and LID, i.v. 2 mg kg-1, then 3 mg kg-1 h-1). We hypothesized that both TRM-LID and BUT-LID would result in a significant MAC sparing effect in healthy dogs. The TRM-LID treatment resulted in a non-significant MAC reduction. MAC was lowered significantly in the BUT-LID group (p = 0.009). The sevoflurane MAC-sparing effects of TRM-LID and BUT-LID treatments were 7.05 ± 22.20 and 19.90 ± 5.91%, respectively, a difference that was not statistically significant (p = 0.13). Bradycardia was observed in the TRM-LID (p < 0.001) treatment. The esophageal temperature was significantly higher for the TRM-LID treatment than the CONT (p < 0.001) treatment. No statistically significant changes were detected between the three groups in f R, Pe'CO2, and MABP. In conclusion, there was a significant sparing effect after adding BUT-LID co-infusion than the control group. No sparing effect was noticed when adding TRM-LID co-infusion. However, no difference in the MAC sparing percentages between the TRM-LID and BUT-LID treatments. The BUT-LID co-infusion resulted in a sevoflurane MAC reduction superior to TRM-LID in addition to minimal cardiorespiratory changes. Both BUT-LID and TRM-LID may be clinically beneficial to dogs during anesthesia. However, BUT-LID produced higher sparing effect and reduction of sevoflurane MAC value.
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Affiliation(s)
- Mohamed Marzok
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Surgery, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt,*Correspondence: Mohamed Marzok ✉
| | - Adel I. Almubarak
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Mahmoud Kandeel
- Department of Pharmacology, Faculty of Veterinary Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt,Department of Biomedical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Wael El-Deeb
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Internal Medicine, Infectious Diseases and Fish Diseases, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt
| | - Hussein Babiker
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Sayed Fathi El-Hawari
- Department of Clinical Sciences, College of Veterinary Medicine, King Faisal University, Al-Ahsa, Saudi Arabia,Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Sohag University, Sohag, Egypt
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El-Hawari SF, Oyama N, Koyama Y, Tamura J, Itami T, Sano T, Yamashita K. Sparing effect of tramadol, lidocaine, dexmedetomidine and their combination on the minimum alveolar concentration of sevoflurane in dogs. J Vet Sci 2022; 23:e53. [PMID: 35698808 PMCID: PMC9346531 DOI: 10.4142/jvs.21305] [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] [Received: 12/13/2021] [Revised: 04/02/2022] [Accepted: 04/26/2022] [Indexed: 11/20/2022] Open
Abstract
Background Problems associated with using inhalational anaesthesia are numerous in veterinary anaesthesia practice. Decreasing the amount of used inhalational anaesthetic agents and minimising of cardiorespiratory disorders are the standard goals of anaesthetists. Objective This experimental study was carried out to investigate the sparing effect of intravenous tramadol, lidocaine, dexmedetomidine and their combinations on the minimum alveolar concentration (MAC) of sevoflurane in healthy Beagle dogs. Methods This study was conducted on six beagle dogs. Sevoflurane MAC was determined by the tail clamp method on five separate occasions. The dogs received no treatment (control; CONT), tramadol (TRM: 1.5 mg kg-1 intravenously followed by 1.3 mg kg-1 h-1), lidocaine (LID: 2 mg kg-1 intravenously followed by 3 mg kg-1 h-1), dexmedetomidine (DEX: 2 μg kg-1 intravenously followed by 2 μg kg-1 h-1), and their combination (COMB), respectively. Cardiorespiratory variables were recorded every five minutes and immediately before the application of a noxious stimulus. Results The COMB treatment had the greatest sevoflurane MAC-sparing effect (67.4 ± 13.9%) compared with the other treatments (5.1 ± 25.3, 12.7 ± 14.3, and 40.3 ± 15.1% for TRM, LID, and DEX treatment, respectively). The cardiopulmonary variables remained within the clinically acceptable range following COMB treatment, although the mean arterial pressure was higher and accompanied by bradycardia. Conclusions Tramadol-lidocaine-dexmedetomidine co-infusion produced a remarkable sevoflurane MAC-sparing effect in clinically healthy beagle dogs and could result in the alleviation of cardiorespiratory depression caused by sevoflurane. Cardiorespiratory variables should be monitored carefully to avoid undesirable side effects induced by dexmedetomidine.
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Affiliation(s)
- Sayed Fathi El-Hawari
- Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Sohag University, Sohag 82524, Egypt
| | - Norihiko Oyama
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0819, Japan
| | - Yukako Koyama
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Jun Tamura
- Veterinary Teaching Hospital, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido 060-0819, Japan
| | - Takaharu Itami
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Tadashi Sano
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
| | - Kazuto Yamashita
- Department of Small Animal Clinical Sciences, School of Veterinary Medicine, Rakuno Gakuen University, Ebetsu, Hokkaido 069-8591, Japan
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Bustamante R, Canfrán S, Gómez de Segura IA, Aguado D. Intraoperative effect of low doses of ketamine or dexmedetomidine continuous rate infusions in healthy dogs receiving propofol total intravenous anaesthesia and epidural anaesthesia: A prospective, randomised clinical study. Res Vet Sci 2021; 143:4-12. [PMID: 34953409 DOI: 10.1016/j.rvsc.2021.12.017] [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: 03/16/2021] [Revised: 12/02/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
The present study aimed to determine the effect of either ketamine or dexmedetomidine constant rate infusion (CRI) on intraoperative propofol anaesthetic requirements during total intravenous anaesthesia (TIVA) in healthy dogs undergoing hindlimbs orthopaedic procedures receiving epidural anaesthesia. In this randomised, blinded clinical study, thirty-nine healthy client-owned dogs were premedicated intramuscularly (dexmedetomidine 4 μg/kg and methadone 0.3 mg/kg). General anaesthesia was induced to effect with propofol administered as intravenous bolus, and maintained with propofol TIVA (18 mg/kg/h), adjusted to meet the suitable clinical anaesthetic depth (indicatively±20%) based on clinical judgement. Lumbosacral epidural anaesthesia was performed using bupivacaine (1 mg/kg) and morphine preservative free (0.1 mg/kg). Dogs randomly received either saline (SP; loading dose 1 mL/kg, CRI 1 mL/kg/h), or ketamine (KP; loading dose 1.5 mg/kg, CRI 1.5 mg/kg/h), or dexmedetomidine (DP; loading dose 1 μg/kg/, CRI 1 μg/kg/h). Physiological variables were recorded intraoperatively at 5-min intervals using standard-of-care monitoring. Recovery quality and duration were recorded. Treatment groups were compared with parametric and non-parametric tests as appropriate, p < 0.05. Propofol rates and recovery scores were similar between groups. Overall mean and diastolic blood pressures were higher in group DP compared to group KP (12-14 mmHg, p = 0.016 and p = 0.015, respectively). More dogs required mechanical ventilation in group KP (12 dogs) than in either group SP or DP (7 dogs per group, p = 0.037). Ketamine or dexmedetomidine CRIs, at the studied rates, did not reduce propofol TIVA requirements in dogs undergoing orthopaedic surgery with epidural anaesthesia.
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Affiliation(s)
- Rocío Bustamante
- Anaesthesiology Service, Vetsia Veterinary Hospital, Calle Galileo 3, 28914, Leganés, Madrid, Spain.
| | - Susana Canfrán
- Anaesthesiology Service, Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain.
| | - Ignacio A Gómez de Segura
- Anaesthesiology Service, Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain.
| | - Delia Aguado
- Anaesthesiology Service, Department of Animal Medicine and Surgery, Veterinary Teaching Hospital, Veterinary Faculty, Complutense University of Madrid, Avda. Puerta de Hierro s/n, 28040 Madrid, Spain.
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Kalamaras AB, Aarnes TK, Moore SA, Jones SC, Pereira CR, Peng J, Kieves NR. Effects of perioperative saphenous and sciatic nerve blocks, lumbosacral epidural or morphine-lidocaine-ketamine infusion on postoperative pain and sedation in dogs undergoing tibial plateau leveling osteotomy. Vet Anaesth Analg 2021; 48:415-421. [PMID: 33814330 DOI: 10.1016/j.vaa.2021.02.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 01/29/2021] [Accepted: 02/10/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare the quality of postoperative analgesia and sedation after preoperative saphenous and sciatic nerve blockade, preoperative lumbosacral epidural injection and perioperative intravenous (IV) morphine, lidocaine and ketamine infusions in dogs undergoing stifle arthroscopy and tibial plateau leveling osteotomy (TPLO) under general anesthesia. STUDY DESIGN Prospective, blinded, randomized, clinical comparison study. ANIMALS A total of 45 dogs weighing 33.9 (15.9-56.7) kg and aged 5.2 (1.0-12.0) years, mean (range), undergoing elective unilateral TPLO for spontaneous cranial cruciate ligament rupture. METHODS Client-owned dogs were enrolled. Dogs were randomly assigned to one of three groups: group MLK, perioperative IV morphine, lidocaine and ketamine infusion; group EPID, lumbosacral epidural with ropivacaine and morphine; or group SSNB, saphenous and sciatic nerve blockade with ropivacaine. Routine stifle arthroscopy followed by TPLO surgery was performed. Sedation and pain scores were assessed at 0, 2, 4, 8 and 24 hours following extubation. Rescue analgesia was administered as prescribed by Glasgow composite pain score-short form score >5. RESULTS Sedation scores for MLK were higher than EPID and SSNB. Pain scores for SSNB were lower than those for EPID and MLK. No significant differences were found in anesthesia duration or surgery duration among groups. No dogs required rescue analgesia. CONCLUSIONS AND CLINICAL RELEVANCE Although analgesia was adequate in all groups, the best combination of analgesia without increased sedation was recorded for SSNB.
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Affiliation(s)
- Alexandra B Kalamaras
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Turi K Aarnes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Stephen C Jones
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Carolina Ricco Pereira
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Juan Peng
- Department of Biomedical Informatics, Center for Biostatistics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Nina R Kieves
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
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Hartnack AK, Niehaus AJ, Lakritz J, Coetzee JF, Kleinhenz MD. Pharmacokinetics of an intravenous constant rate infusion of a morphine-lidocaine-ketamine combination in Holstein calves undergoing umbilical herniorrhaphy. Am J Vet Res 2020; 81:17-24. [PMID: 31887082 DOI: 10.2460/ajvr.81.1.17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To describe the pharmacokinetics of morphine, lidocaine, and ketamine associated with IV administration of a constant rate infusion (CRI) of a morphine-lidocaine-ketamine (MLK) combination to calves undergoing umbilical herniorrhaphy. ANIMALS 20 weaned Holstein calves with umbilical hernias. PROCEDURES Calves were randomly assigned to receive a CRI of an MLK solution (0.11 mL/kg/h; morphine, 4.8 μg/kg/h; lidocaine, 2.1 mg/kg/h; and ketamine, 0.42 mg/kg/h) for 24 hours (MLK group) or 2 doses of flunixin meglumine (1.1 mg/kg, IV, q 24 h) and a CRI of saline (0.9% NaCl) solution (0.11 mL/kg/h) for 24 hours (control group). For all calves, the CRI was begun after anesthesia induction. Blood samples were obtained immediately before and at predetermined times for 120 hours after initiation of the assigned treatment. Noncompartmental analysis was used to estimate pharmacokinetic parameters for the MLK group. RESULTS During the CRI, steady-state serum concentrations were achieved for lidocaine and ketamine, but not morphine. Mean terminal half-life was 4.1, 0.98, and 1.55 hours and area under the concentration-time curve was 41, 14,494, and 7,426 h•μg/mL for morphine, lidocaine, and ketamine, respectively. After the CRI, the mean serum drug concentration at steady state was 6.3, 616.7, and 328 ng/mL for morphine, lidocaine, and ketamine, respectively. CONCLUSIONS AND CLINICAL RELEVANCE During the CRI of the MLK solution, steady-state serum concentrations were achieved for lidocaine and ketamine, but not morphine, likely owing to the fairly long half-life of morphine. Kinetic analyses of MLK infusions in cattle are necessary to establish optimal dosing protocols.
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Hartnack AK, Niehaus AJ, Lakritz J, Coetzee JF, Kleinhenz MD. Analgesic efficacy of an intravenous constant rate infusion of a morphine-lidocaine-ketamine combination in Holstein calves undergoing umbilical herniorrhaphy. Am J Vet Res 2020; 81:25-32. [PMID: 31887083 DOI: 10.2460/ajvr.81.1.25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To assess the analgesic efficacy of an IV constant rate infusion (CRI) of a morphine-lidocaine-ketamine (MLK) combination in calves undergoing umbilical herniorrhaphy. ANIMALS 20 weaned Holstein calves with umbilical hernias. PROCEDURES Calves were randomly assigned to receive a CRI of an MLK solution (0.11 mL/kg/h; morphine, 4.8 μg/kg/h; lidocaine, 2.1 mg/kg/h; and ketamine, 0.42 mg/kg/h) for 24 hours (MLK group) or 2 doses of flunixin meglumine (1.1 mg/kg, IV, q 24 h) and a CRI of saline (0.9% NaCl) solution (0.11 mL/kg/h) for 24 hours (control group). The assigned CRI was begun after anesthesia induction. A pain-scoring system and incisional algometry were used to assess pain, and blood samples were obtained to measure serum cortisol concentration at predetermined times for 120 hours after CRI initiation. RESULTS Mean pain scores did not differ significantly between the MLK and control groups at any time. Mean algometry score for the MLK group was significantly greater (calves were less responsive to pressure) than that for the control group at 4 hours after CRI initiation. Mean cortisol concentration decreased over time for both groups and was significantly greater for the MLK group than the control group at 1, 4, and 18 hours after CRI initiation. CONCLUSIONS AND CLINICAL RELEVANCE A CRI of MLK provided adequate postoperative analgesia to calves that underwent umbilical herniorrhaphy. However, the technical support required for CRI administration limits its use to hospital settings. Kinetic analyses of MLK infusions in cattle are necessary to establish optimal dosing protocols and withdrawal intervals.
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Akashi N, Murahata Y, Kishida H, Hikasa Y, Azuma K, Imagawa T. Effects of constant rate infusions of dexmedetomidine, remifentanil and their combination on minimum alveolar concentration of sevoflurane in dogs. Vet Anaesth Analg 2020; 47:490-498. [PMID: 32471632 DOI: 10.1016/j.vaa.2020.04.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To evaluate the effects of constant rate infusions (CRIs) of dexmedetomidine and remifentanil alone and their combination on minimum alveolar concentration (MAC) of sevoflurane in dogs. STUDY DESIGN Randomized crossover experimental study. ANIMALS A total of six (three males, three females) healthy, adult neutered Beagle dogs weighing 12.6 ± 1.4 kg. METHODS Anesthesia was induced with sevoflurane in oxygen until endotracheal intubation was possible and anesthesia maintained with sevoflurane using positive-pressure ventilation. Each dog was anesthetized five times and was administered each of the following treatments: saline (1 mL kg-1 hour-1) or dexmedetomidine at 0.1, 0.5, 1.0 or 5.0 μg kg-1 loading dose intravenously over 10 minutes followed by CRI at 0.1, 0.5, 1.0 or 5.0 μg kg-1 hour-1, respectively. Following 60 minutes of CRI, sevoflurane MAC was determined in duplicate using an electrical stimulus (50 V, 50 Hz, 10 ms). Then, CRI of successively increasing doses of remifentanil (0.15, 0.60 and 2.40 μg kg-1 minute-1) was added to each treatment. MAC was also determined after 30 minutes equilibration at each remifentanil dose. Isobolographic analysis determined interaction from the predicted doses required for a 50% MAC reduction (ED50) with remifentanil, dexmedetomidine and remifentanil combined with dexmedetomidine, with the exception of dexmedetomidine 5.0 μg kg-1 hour-1, obtained using log-linear regression analysis. RESULTS The sevoflurane MAC decreased dose-dependently with increasing infusion rates of dexmedetomidine and remifentanil. Remifentanil ED50 values were lower when combined with dexmedetomidine than those obtained during saline-remifentanil. Synergistic interactions between dexmedetomidine and remifentanil for MAC reduction occurred with dexmedetomidine at 0.5 and 1.0 μg kg-1 hour-1. CONCLUSIONS AND CLINICAL RELEVANCE Combined CRIs of dexmedetomidine and remifentanil synergistically resulted in sevoflurane MAC reduction. The combination of dexmedetomidine and remifentanil effectively reduced the requirement of sevoflurane during anesthesia in dogs.
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Affiliation(s)
- Natsuki Akashi
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Yusuke Murahata
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori, Japan.
| | - Hikaru Kishida
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Yoshiaki Hikasa
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Kazuo Azuma
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori, Japan
| | - Tomohiro Imagawa
- Joint Department of Veterinary Medicine, Faculty of Agriculture, Tottori University, Tottori, Japan
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Johnson BA, Aarnes TK, Wanstrath AW, Ricco Pereira CH, Bednarski RM, Lerche P, McLoughlin MA. Effect of oral administration of gabapentin on the minimum alveolar concentration of isoflurane in dogs. Am J Vet Res 2019; 80:1007-1009. [PMID: 31644338 DOI: 10.2460/ajvr.80.11.1007] [Citation(s) in RCA: 2] [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 determine the effect of oral administration of gabapentin (20 mg/kg) on the minimum alveolar concentration (MAC) of isoflurane in dogs. ANIMALS 6 healthy adult dogs (3 males and 3 females with a mean ± SD body weight of 24.8 ± 1.3 kg). PROCEDURES Each dog was anesthetized twice. Dogs were initially assigned to 1 of 2 treatments (gabapentin [20 mg/kg, PO] followed 2 hours later by anesthesia maintained with isoflurane or anesthesia maintained with isoflurane alone). A minimum of 7 days later, dogs received the other treatment. The MAC of isoflurane was determined by use of an iterative bracketing technique with stimulating electrodes placed in the maxillary buccal mucosa. Hemodynamic variables and vital parameters were recorded at the lowest end-tidal isoflurane concentration at which dogs did not respond to the stimulus. Effect of treatment on outcome variables was analyzed by use of a paired t test. RESULTS Mean ± SD MAC of isoflurane was significantly lower when dogs received gabapentin and isoflurane (0.71 ± 0.12%) than when dogs received isoflurane alone (0.91 ± 0.26%). Mean reduction in MAC of isoflurane was 20 ± 14%. Hemodynamic variables did not differ significantly between treatments. Mean time to extubation was significantly less when dogs received gabapentin and isoflurane (6 ± 4 minutes) than when dogs received isoflurane alone (23 ± 15 minutes). CONCLUSIONS AND CLINICAL RELEVANCE Oral administration of gabapentin 2 hours before anesthesia maintained with isoflurane had a MAC-sparing effect with no effect on hemodynamic variables or vital parameters of dogs.
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Valverde A, Skelding AM. Alternatives to Opioid Analgesia in Small Animal Anesthesia: Alpha-2 Agonists. Vet Clin North Am Small Anim Pract 2019; 49:1013-1027. [PMID: 31481257 DOI: 10.1016/j.cvsm.2019.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Alpha-2 agonists have potent analgesic effects, in addition to their sedative actions. Alpha-2 agonists provide analgesia through any of several routes of administration, including parenteral, oral, epidural or intrathecal and intraarticular, because of spinal and supraspinal actions. Systemic doses are short acting, whereas local administration at the site of action result in longer analgesic effects. The potent cardiovascular and respiratory effects of alpha-2 agonists should be considered when used as analgesics.
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Affiliation(s)
- Alexander Valverde
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1, Canada.
| | - Alicia M Skelding
- Toronto Animal Health Partners Emergency and Specialty Hospital, Toronto, Ontario M3B 2R2, Canada
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Hoffman EA, Aarnes TK, Ricco Pereira CH, Lerche P, Bednarski RM, McLoughlin MA. Effect of oral trazodone on the minimum alveolar concentration of isoflurane in dogs. Vet Anaesth Analg 2018; 45:754-759. [PMID: 30297130 DOI: 10.1016/j.vaa.2018.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/08/2018] [Accepted: 08/14/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the effect of oral trazodone on the minimum alveolar concentration (MAC) of isoflurane in dogs. STUDY DESIGN Prospective blinded, single-observer, randomized crossover experimental study. ANIMALS Six adult (age 6.8 ± 1.6 months) healthy dogs (three males and three females), weighing 24.8 ± 3.4 kg (mean ± standard deviation). METHODS Each dog was anesthetized twice with a minimum of 7 days between anesthetic episodes. Dogs were randomly assigned to be administered two treatments in a crossover design: premedication with trazodone (8 mg kg-1; TRAZ-ISO) orally 2 hours prior to an anesthetic episode or no (ISO). Dogs were anesthetized with intravenous propofol (6 mg kg-1) and isoflurane in >95% oxygen. Isoflurane MAC was determined using an iterative bracketing technique with electrodes placed in the buccal mucosa. Hemodynamic variables were compared at the lowest end-tidal isoflurane concentration at which each dog did not respond. A paired t test was used to assess the effect of treatment on outcome variables with significance set to a value of p < 0.05. RESULTS The MAC concentration (mean ± standard deviation) in dogs administered TRAZ-ISO was 0.85 ± 0.17% compared with 1.02 ± 0.11% in those administered ISO (p = 0.01, 95% confidence interval -0.25 to -0.05), resulting in a mean MAC reduction of 17 ± 12%. There were no differences in hemodynamic variables between treatments. CONCLUSIONS AND CLINICAL RELEVANCE Premedication of dogs with oral trazodone (8 mg kg-1) 2 hours prior to anesthetic induction has a significant isoflurane MAC sparing effect with no significant observed hemodynamic benefit.
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Affiliation(s)
- Elizabeth A Hoffman
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Turi K Aarnes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
| | - Carolina H Ricco Pereira
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Phillip Lerche
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Richard M Bednarski
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Mary A McLoughlin
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
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Simon B, Scallan E, Coursey C, Kiehl W, Moore E. The clinical effects of a low dose dexmedetomidine constant rate infusion in isoflurane anesthetized cats. Vet J 2018; 234:55-60. [DOI: 10.1016/j.tvjl.2018.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 02/10/2018] [Accepted: 02/13/2018] [Indexed: 11/25/2022]
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Reed R, Doherty T. Minimum alveolar concentration: Key concepts and a review of its pharmacological reduction in dogs. Part 2. Res Vet Sci 2018; 118:27-33. [PMID: 29421482 DOI: 10.1016/j.rvsc.2018.01.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 01/09/2018] [Accepted: 01/13/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To outline the major components of the minimum alveolar concentration (MAC) and review the literature regarding pharmacological manipulation of the MAC of halothane, isoflurane, sevoflurane, enflurane, and desflurane in dogs. The pharmacological agents included are alpha-2 agonists, benzodiazepines, propofol, opioids, lidocaine, acepromazine, non-steroidal anti-inflammatory agents (NSAIDs), maropitant, and NMDA antagonists. Part 2 of this review will focus on the effect of opioids, lidocaine, NSAIDs, maropitant, acepromazine, and NMDA antagonists on MAC. DATABASES USED PubMed, Google Scholar, CAB Abstracts. Search terms used: minimum alveolar concentration, MAC, dog, canine, inhaled anesthetic potency, isoflurane, sevoflurane, desflurane, enflurane, and halothane. CONCLUSIONS Opioids, lidocaine, NSAIDs, maropitant, acepromazine, and NMDA antagonists have been shown to reduce the MAC of inhaled anesthetics in dogs and allow for clinically important decreases in inhalant anesthetic use. Thus, the use of these agents potentially decrease the adverse cardiovascular and pulmonary effects associated with the use of high concentrations of inhaled anesthetics.
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Affiliation(s)
- Rachel Reed
- University of Georgia College of Veterinary Medicine, 2200 College Station Rd., Athens, GA 30605, USA.
| | - Thomas Doherty
- University of Tennessee College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996, USA.
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Reed R, Doherty T. Minimum alveolar concentration: Key concepts and a review of its pharmacological reduction in dogs. Part 1. Res Vet Sci 2018; 117:266-270. [PMID: 29331922 DOI: 10.1016/j.rvsc.2018.01.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 11/25/2017] [Accepted: 01/08/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To outline the major components of the minimum alveolar concentration (MAC) and review the literature in regard to pharmacological manipulation of the MAC of halothane, isoflurane, sevoflurane, enflurane, and desflurane in dogs. The pharmacologic agents included are alpha-2 agonists, benzodiazepines, propofol, maropitant, opioids, lidocaine, acepromazine, non-steroidal anti-inflammatory agents, and NMDA antagonists. Part 1 will focus on summarizing the relevance, measurement, and mechanisms of MAC and review the effects of alpha-2 agonists, benzodiazepines, and propofol on MAC. DATABASES USED PubMed, Google Scholar, CAB Abstracts. Search terms used: minimum alveolar concentration, MAC, dog, canine, inhaled anesthetic potency, isoflurane, sevoflurane, desflurane, enflurane, and halothane. CONCLUSIONS Many drugs reduce the MAC of inhaled anesthetics in dogs, and allow for a clinically important decrease in inhalant anesthetic use. A decrease in MAC may decrease the adverse cardiovascular and pulmonary effects associated with the use of high concentrations of inhaled anesthetics.
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Affiliation(s)
- Rachel Reed
- University of Georgia College of Veterinary Medicine, 2200 College Station Rd., Athens, GA 30605, USA.
| | - Thomas Doherty
- University of Tennessee College of Veterinary Medicine, 2407 River Dr., Knoxville, TN 37996, USA.
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Smith CK, Seddighi R, Cox SK, Sun X, Knych HK, Doherty TJ. Effect of dexmedetomidine on the minimum infusion rate of propofol preventing movement in dogs. Vet Anaesth Analg 2017; 44:1287-1295. [PMID: 29074303 DOI: 10.1016/j.vaa.2017.07.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 07/17/2017] [Accepted: 07/19/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the effect of dexmedetomidine on induction dose and minimum infusion rate of propofol preventing movement (MIRNM). STUDY DESIGN Randomized crossover, unmasked, experimental design. ANIMALS Three male and three female healthy Beagle dogs weighing 10.2 ± 2.8 kg. METHODS Dogs were studied on three occasions at weekly intervals. Premedications were 0.9% saline (treatment P) or dexmedetomidine (1 μg kg-1, treatment PLD; 2 μg kg-1, treatment PHD) intravenously. Anesthesia was induced with propofol (2 mg kg-1 and then 1 mg kg-1 every 15 seconds) until intubation. Anesthesia was maintained for 90 minutes in P with propofol (0.5 mg kg-1 minute-1) and saline, in PLD with propofol (0.35 mg kg-1 minute-1) and dexmedetomidine (1 μg kg-1 hour-1), and in PHD with propofol (0.3 mg kg-1 minute-1) and dexmedetomidine (2 μg kg-1 hour-1). The stimulus (50 V, 50 Hz, 10 ms) was applied to the antebrachium, and propofol infusion was increased or decreased by 0.025 mg kg-1 minute-1 based on a positive or negative response, respectively. Data were analyzed using a mixed-model anova and presented as mean ± standard error. RESULTS Propofol induction doses were 8.68 ± 0.57 (P), 6.13 ± 0.67 (PLD) and 4.78 ± 0.39 (PHD) mg kg-1 and differed among treatments (p < 0.05). Propofol MIRNM values were 0.68 ± 0.13, 0.49 ± 0.16 and 0.26 ± 0.05 mg kg-1 minute-1 for P, PLD and PHD, respectively. Propofol MIRNM decreased 59% in PHD (p < 0.05). Plasma propofol concentrations were 14.04 ± 2.30 (P), 11.30 ± 4.30 (PLD) and 7.96 ± 0.72 (PHD) μg mL-1 and dexmedetomidine concentrations were 0.68 ± 0.12 (PLD) and 0.89 ± 0.08 (PHD) ng mL-1 at MIRNM determination. CONCLUSIONS AND CLINICAL RELEVANCE Dexmedetomidine (1 and 2 μg kg-1) decreased propofol induction dose. Dexmedetomidine (2 μg kg-1 hour-1) resulted in a significant decrease in propofol MIRNM.
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Affiliation(s)
- Christopher K Smith
- Department of Small Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA.
| | - Reza Seddighi
- Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA
| | - Sherry K Cox
- Department of Biological and Diagnostic Sciences, University of Tennessee, Knoxville, TN, USA
| | - Xiaocun Sun
- Office of Information and Technology, University of Tennessee, Knoxville, TN, USA
| | - Heather K Knych
- KL Maddy Equine Analytical Chemistry Laboratory, University of California Davis, Davis, CA, USA
| | - Thomas J Doherty
- Department of Large Animal Clinical Sciences, University of Tennessee, Knoxville, TN, USA
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Navarrete R, Quirós-Carmona S, Granados MDM, Gómez-Villamandos RJ, Domínguez JM, Férnandez-Sarmiento JA, Muñoz-Rascón P, Funes FJ, Morgaz J. Effect of dexmedetomidine constant rate infusion on the bispectral index during alfaxalone anaesthesia in dogs. Vet Anaesth Analg 2016; 43:397-404. [DOI: 10.1111/vaa.12323] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 05/25/2015] [Indexed: 12/31/2022]
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18
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Drees R, Johnson RA, Stepien RL, Munoz Del Rio A, Saunders JH, François CJ. QUANTITATIVE PLANAR AND VOLUMETRIC CARDIAC MEASUREMENTS USING 64 MDCT AND 3T MRI VS. STANDARD 2D AND M-MODE ECHOCARDIOGRAPHY: DOES ANESTHETIC PROTOCOL MATTER? Vet Radiol Ultrasound 2015; 56:638-57. [PMID: 26082285 PMCID: PMC5006684 DOI: 10.1111/vru.12269] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Accepted: 04/28/2015] [Indexed: 12/17/2022] Open
Abstract
Cross-sectional imaging of the heart utilizing computed tomography and magnetic resonance imaging (MRI) has been shown to be superior for the evaluation of cardiac morphology and systolic function in humans compared to echocardiography. The purpose of this prospective study was to test the effects of two different anesthetic protocols on cardiac measurements in 10 healthy beagle dogs using 64-multidetector row computed tomographic angiography (64-MDCTA), 3T magnetic resonance (MRI) and standard awake echocardiography. Both anesthetic protocols used propofol for induction and isoflourane for anesthetic maintenance. In addition, protocol A used midazolam/fentanyl and protocol B used dexmedetomedine as premedication and constant rate infusion during the procedure. Significant elevations in systolic and mean blood pressure were present when using protocol B. There was overall good agreement between the variables of cardiac size and systolic function generated from the MDCTA and MRI exams and no significant difference was found when comparing the variables acquired using either anesthetic protocol within each modality. Systolic function variables generated using 64-MDCTA and 3T MRI were only able to predict the left ventricular end diastolic volume as measured during awake echocardiogram when using protocol B and 64-MDCTA. For all other systolic function variables, prediction of awake echocardiographic results was not possible (P = 1). Planar variables acquired using MDCTA or MRI did not allow prediction of the corresponding measurements generated using echocardiography in the awake patients (P = 1). Future studies are needed to validate this approach in a more varied population and clinically affected dogs.
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Affiliation(s)
| | | | | | | | - Jimmy H Saunders
- Faculty of Veterinary Medicine, UGent, Salisburylaan 133, 9820, Merelbeke, Belgium
| | - Christopher J François
- Department of Radiology, School of Medicine and Public Health, UW-Madison, 600 Highland Avenue, Madison, WI, 53792
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Drees R, Johnson RA, Stepien RL, Munoz Del Rio A, François CJ. Effects of two different anesthetic protocols on cardiac flow measured by two dimensional phase contrast magnetic resonance imaging. Vet Radiol Ultrasound 2015; 56:168-75. [PMID: 25124271 PMCID: PMC4329287 DOI: 10.1111/vru.12200] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 05/04/2014] [Indexed: 01/01/2023] Open
Abstract
Companion animals are routinely anesthetized or heavily sedated for cardiac MRI studies, however effects of varying anesthetic protocols on cardiac function measurements are incompletely understood. The purpose of this prospective study was to compare effects of two anesthetic protocols (Protocol A: Midazolam, fentanyl; Protocol B: Dexmedetomidine) on quantitative and qualitative blood flow values measured through the aortic, pulmonic, mitral, and tricuspid valves using two-dimensional phase contrast magnetic resonance imaging (2D PC MRI) in healthy dogs. Mean flow per heartbeat values through the pulmonary artery (Qp) and aorta (Qs) were compared to right and left ventricular stroke volumes (RVSV, LVSV) measured using a reference standard of 2D Cine balanced steady-state free precession MRI. Pulmonary to systemic flow ratio (Qp/Qs) was also calculated. Differences in flow and Qp/Qs values generated using 2D PC MRI did not differ between the two anesthetic protocols (P = 1). Mean differences between Qp and RVSV were 3.82 ml/beat (95% limits of agreement: 3.62, -11.26) and 1.9 ml/beat (-7.86, 11.66) for anesthesia protocols A and B, respectively. Mean differences between Qs and LVSV were 1.65 ml/beat (-5.04, 8.34) and 0.03 ml/beat (-4.65, 4.72) for anesthesia protocols A and B, respectively. Mild tricuspid or mitral reflux was seen in 2/10 dogs using 2D PC MRI. No aortic or pulmonic insufficiency was observed. Findings from the current study indicated that these two anesthetic protocols yield similar functional measures of cardiac blood flow using 2D PC MRI in healthy dogs. Future studies in clinically affected patients are needed.
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Affiliation(s)
- Randi Drees
- VMTH DSS, UW-Madison, Madison, WI, 53726, USA
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Abstract
This paper is the thirty-sixth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2013 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior, and the roles of these opioid peptides and receptors in pain and analgesia; stress and social status; tolerance and dependence; learning and memory; eating and drinking; alcohol and drugs of abuse; sexual activity and hormones, pregnancy, development and endocrinology; mental illness and mood; seizures and neurologic disorders; electrical-related activity and neurophysiology; general activity and locomotion; gastrointestinal, renal and hepatic functions; cardiovascular responses; respiration and thermoregulation; and immunological responses.
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Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
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Pascoe PJ. The cardiopulmonary effects of dexmedetomidine infusions in dogs during isoflurane anesthesia. Vet Anaesth Analg 2014; 42:360-8. [PMID: 25082327 DOI: 10.1111/vaa.12220] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Accepted: 06/26/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the cardiopulmonary changes associated with intravenous (IV) infusions of dexmedetomidine at equipotent isoflurane-dexmedetomidine concentrations compared with isoflurane alone. STUDY DESIGN Prospective, randomized, crossover experiment. ANIMALS Six adult intact female mixed-breed dogs weighing (mean ± SD [range]) 23.3 ± 3.8 (17.8-29.4) kg. METHODS Anesthesia was induced and maintained with isoflurane in oxygen. Measurements of respiratory rate (fR), heart rate (HR), systemic and pulmonary arterial pressures (SAP, DAP, MAP, MPAP), central venous pressure (CVP), pulmonary arterial occlusion pressure (PAOP), cardiac index (CI), left and right ventricular stroke work index (LVSWI, RVSWI), systemic and pulmonary vascular resistance index (SVRI, PVRI), arteriovenous shunt (Q˙s/Q˙t), oxygen delivery (D˙O2), oxygen extraction ratio (O2 ER), oxygen consumption, arterial and mixed venous blood gases, and arterial packed cell volume (PCV) were obtained 30 minutes after instrumentation at an end-tidal isoflurane concentration (Fe'Iso) of 1.73 ± 0.02% (1.3 MAC). Dexmedetomidine was administered IV at 0.5 or 3 μg kg(-1) over 6 minutes followed by an infusion at 0.5 (LD) or 3 μg kg(-1) hour(-1) (HD), respectively, with Fe'Iso at 1.41 ± 0.02 (LD) or 0.72 ± 0.09% (HD). Measurements were taken at 10, 30, 60, 90, 120, 150 and 180 minutes after the start of the infusion. RESULTS The low dose produced significant decreases in HR, increases in SAP, DAP, CVP, MPAP, PAOP and LVSWI, but no change in CI. HD produced significant increases in SAP, MAP, DAP, CVP, PAOP, SVRI, LVSWI, O2 ER and PCV and significant decreases in CI and D˙O2. There were significant differences between treatments in HR, MAP, DAP, CVP, MPAP, PAOP, CI, SVRI, HCO3-, SBE, D˙O2, O2 ER and Q˙s/Q˙t. CONCLUSIONS AND CLINICAL RELEVANCE Cardiopulmonary changes associated with LD were within clinically accepted normal ranges whereas HD produced clinically significant changes. The LD may be useful as an anesthetic adjunct in healthy dogs.
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Affiliation(s)
- Peter J Pascoe
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA, USA
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Drees R, Johnson RA, Pinkerton M, Del Rio AM, Saunders JH, François CJ. Effects of two different anesthetic protocols on 64-MDCT coronary angiography in dogs. Vet Radiol Ultrasound 2014; 56:46-54. [PMID: 25065815 DOI: 10.1111/vru.12185] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Accepted: 04/24/2014] [Indexed: 11/26/2022] Open
Abstract
Heart rate is a major factor influencing diagnostic image quality in computed tomographic coronary artery angiography (MDCT-CA), with an ideal heart rate of 60-65 beats/min in humans. The purpose of this prospective study was to compare effects of two different clinically applicable anesthetic protocols on cardiovascular parameters and 64-MDCT-CA quality in 10 healthy dogs. Scan protocols and bolus volumes were standardized. Image evaluations were performed in random order by a board-certified veterinary radiologist who was unaware of anesthetic protocols used. Heart rate during image acquisition did not differ between protocols (P = 1), with 80.6 ± 7.5 bpm for protocol A and 79.2 ± 14.2 bpm for protocol B. Mean blood pressure was significantly higher (P > 0.05) using protocol B (protocol A 62.9 ± 9.1 vs. protocol B 72.4 ± 15.9 mmHg). The R-R intervals allowing for best depiction of individual coronary artery segments were found in the end diastolic period and varied between the 70% and 95% interval. Diagnostic quality was rated excellent, good, and moderate in the majority of the segments evaluated, with higher scores given for more proximal segments and lower for more distal segments, respectively. Blur was the most commonly observed artifact and mainly affected the distal segments. No significant differences were identified between the two protocols for optimal reconstruction interval, diagnostic quality and measured length individual segments, or proximal diameter of the coronary arteries (P = 1). Findings indicated that, when used with a standardized bolus volume, both of these anesthetic protocols yielded diagnostic quality coronary 64-MDCT-CA exams in healthy dogs.
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Affiliation(s)
- Randi Drees
- Department of Surgical Sciences, UW-Madison VMTH, 2015 Linden Drive, Madison, WI 53706
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MORAN-MUÑOZ R, IBANCOVICHI JA, Gutierrez-BLANCO E, ACEVEDO-ARCIQUE CM, Victoria MORA JM, TENDILLO FJ, SANTOS-GONZALEZ M, YAMASHITA K. Effects of lidocaine, dexmedetomidine or their combination on the minimum alveolar concentration of sevoflurane in dogs. J Vet Med Sci 2014; 76:847-53. [PMID: 24572631 PMCID: PMC4108768 DOI: 10.1292/jvms.13-0407] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Accepted: 02/12/2014] [Indexed: 11/23/2022] Open
Abstract
The aim of this study was to determine the effects of lidocaine (LIDO) and dexmedetomidine (DEX) or their combination (LIDO-DEX), administered by constant-rate infusion (CRI), on the minimum alveolar concentration (MAC) of sevoflurane in dogs. Seven healthy mongrel dogs were used with a 2-week washout interval between treatments in this study. Anesthesia was induced with propofol and maintained with sevoflurane in oxygen, and MAC of sevoflurane was determined after 90 min equilibration period in the dogs (SEV-MACBASAL). Then, sevoflurane MAC was determined again in the dogs after 45 min equilibration period of one of the following treatments: an intravenous loading dose of lidocaine 2 mg/kg followed by 6 mg/kg/hr CRI (SEV-MACLIDO); an intravenous loading dose of dexmedetomidine 2 µg/kg followed by 2 µg/kg/hr CRI (SEV-MACDEX); or their combination (SEV-MACLIDO-DEX). These SEV-MACs were determined in duplicate. Data were analyzed using ANOVA and post hoc Tuckey test when appropriate. The SEV-MACBASAL was 1.82 ± 0.06%, SEV-MACLIDO was 1.38 ± 0.08%, SEV-MACDEX was 1.22 ± 0.10%, and SEV-MACLIDO-DEX was 0.78 ± 0.06%. The CRI administration of lidocaine, dexmedetomidine and their combination produced a significant reduction in the MAC of sevoflurane by 26.1 ± 9.0% (P<0.0001), 43.7 ± 11.8% (P<0.0002) and 54.4 ± 9.8% (P<0.0001), respectively. The MAC reduction was significantly greater after the CRI combination of lidocaine and dexmedetomidine when compared with lidocaine CRI (P<0.0001) or dexmedetomidine CRI treatments (P<0.025).
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Affiliation(s)
- Rafael MORAN-MUÑOZ
- Department of Veterinary Anesthesiology, Faculty of
Veterinary Medicine, Universidad Autónoma del Estado de México, Toluca, México
| | - J. A. IBANCOVICHI
- Department of Veterinary Anesthesiology, Faculty of
Veterinary Medicine, Universidad Autónoma del Estado de México, Toluca, México
| | - Eduardo Gutierrez-BLANCO
- Department of Preventive Medicine and Animal Health, Faculty
of Veterinary Medicine, Universidad Autonoma de Yucatan, Merida, México
| | - Carlos M. ACEVEDO-ARCIQUE
- Department of Veterinary Anesthesiology, Faculty of
Veterinary Medicine, Universidad Autónoma del Estado de México, Toluca, México
| | - J. Mauro Victoria MORA
- Department of Veterinary Anesthesiology, Faculty of
Veterinary Medicine, Universidad Autónoma del Estado de México, Toluca, México
| | - Francisco J. TENDILLO
- Medical and Surgical Research Unit, Hospital Universitario
Puerta de Hierro Majadahonda, Manuel de Falla 1, Madrid Spain
| | - Martin SANTOS-GONZALEZ
- Medical and Surgical Research Unit, Hospital Universitario
Puerta de Hierro Majadahonda, Manuel de Falla 1, Madrid Spain
| | - Kazuto YAMASHITA
- Department of Small Animal Clinical Seiences, School of
Veterinary Medecine Rakuno Gakuen University, Ebetsu, Hokkaido Japan
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De Monte V, Staffieri F, Birettoni F, Bufalari A. Ketamine as a part of anaesthetic management in a dog with twiddler's syndrome. J Small Anim Pract 2013; 55:116-20. [PMID: 24117717 DOI: 10.1111/jsap.12139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
An 11-year-old male German shepherd dog was referred for possible pacemaker implantation. A routine 6-lead electrocardiogram revealed a third-degree atrio-ventricular block with a heart rate of 40 to 45 beats/minute. A transvenous pacemaker implantation procedure was scheduled. The dog was premedicated with 10 µg/kg acepromazine and 5 mg/kg pethidine. A dose of 5 mg/kg ketamine and 0·2 mg/kg diazepam were used for induction and isoflurane in O2 and a constant rate infusion of ketamine (20 to 30 µg/kg/minute) were administered for maintenance of general anaesthesia. Due to a twiddler's syndrome, the pacemaker had to be repositioned. For the second procedure, the same protocol was employed except for a lower dose of ketamine both for induction (3 mg/kg) and constant rate infusion (10 to 15 µg/kg/minute). Ketamine appeared to be useful for both management of anaesthesia and cardiac pacemaker implantation in the absence of a temporary pacemaker.
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Affiliation(s)
- V De Monte
- Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Chirurgica e Radiodiagnostica, Via S. Costanzo, 4 - 06126, Perugia, Italy
| | - F Staffieri
- Università degli Studi di Bari "Aldo Moro" Dipartimento delle Emergenze e dei Trapianti di Organi Sezione di Cliniche Veterinarie e Produzioni Animali, SP per Casamassima km 3-70010, Valenzano (Bari), Italy
| | - F Birettoni
- Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Medica, Via S. Costanzo, 4 - 06126, Perugia, Italy
| | - A Bufalari
- Università degli studi di Perugia, Dipartimento di Patologia, Diagnostica e Clinica Veterinaria, Sezione di Clinica Chirurgica e Radiodiagnostica, Via S. Costanzo, 4 - 06126, Perugia, Italy
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