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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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] [What about the content of this article? (0)] [Affiliation(s)] [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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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. Can Vet J 2022; 63:722-726. [PMID: 35784775 PMCID: PMC9207967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Sández I, Soto M, Torralbo D, Rioja E. Effect of different analgesic techniques on hemodynamic variables recorded with an esophageal Doppler monitor during ovariohysterectomy in dogs. Can Vet J 2018; 59:419-424. [PMID: 29606730 PMCID: PMC5855226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study compared the efficacy of intravenous (IV) fentanyl and ketamine with lumbosacral epidural lidocaine in dogs undergoing ovariohysterectomy. Dogs with esophageal Doppler monitoring (n = 112) were included in this retrospective study. All dogs were premedicated with dexmedetomidine and methadone, induced with IV propofol or alfaxalone and maintained using isoflurane and IV fentanyl, IV ketamine, or epidural lidocaine. Heart rate (HR), mean arterial pressure (MAP), expired fraction of isoflurane (ETIso), stroke distance (SD), minute distance (MD), peak velocity (PV) and mean acceleration (MA) were recorded before and after ligation of the ovarian pedicle (OvP). There were no differences for ETIso, HR, and MAP among fentanyl, ketamine, and control groups. Minute Distance, SD, MA and PV significantly decreased after OvP in fentanyl, ketamine, and control groups, but remained stable in the epidural group. Lumbosacral epidural lidocaine prevented hemodynamic depression changes caused by OvP ligation, whereas fentanyl and ketamine failed to do so.
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Affiliation(s)
- Ignacio Sández
- Mobile Anaesthesia Service, Sinergia Veterinaria, Madrid, Spain (Sández, Soto, Torralbo); School of Veterinary Science, University of Liverpool, Liverpool, Merseyside, United Kingdom (Rioja)
| | - María Soto
- Mobile Anaesthesia Service, Sinergia Veterinaria, Madrid, Spain (Sández, Soto, Torralbo); School of Veterinary Science, University of Liverpool, Liverpool, Merseyside, United Kingdom (Rioja)
| | - Daniel Torralbo
- Mobile Anaesthesia Service, Sinergia Veterinaria, Madrid, Spain (Sández, Soto, Torralbo); School of Veterinary Science, University of Liverpool, Liverpool, Merseyside, United Kingdom (Rioja)
| | - Eva Rioja
- Mobile Anaesthesia Service, Sinergia Veterinaria, Madrid, Spain (Sández, Soto, Torralbo); School of Veterinary Science, University of Liverpool, Liverpool, Merseyside, United Kingdom (Rioja)
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