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- Author or Editor: Carolyn L. Kerr x
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Abstract
OBJECTIVE
To determine the cardiopulmonary effects of IV administration of fentanyl to cats anesthetized with isoflurane and during anesthetic recovery with concurrent administration of acepromazine or dexmedetomidine.
ANIMALS
6 healthy adult cats.
PROCEDURES
Cats received an IV bolus (5 μg/kg) followed by an IV infusion (5 μg/kg/h) of fentanyl for 120 minutes during isoflurane anesthesia and for 30 minutes after discontinuing isoflurane. Cats were randomly assigned in a crossover study to receive acepromazine (0.05 mg/kg) or dexmedetomidine (2.5 μg/kg), IV, when isoflurane was discontinued. Cardiopulmonary data were obtained during anesthesia and for 30 minutes during the anesthetic recovery period.
RESULTS
The administration of fentanyl during isoflurane anesthesia resulted in a transient increase in arterial blood pressure, mean pulmonary artery pressure, and oxygen delivery. Compared with values during isoflurane anesthesia, administration of dexmedetomidine during anesthetic recovery resulted in significant decreases in cardiac index, stroke index, and oxygen delivery and significant increases in arterial, central venous, and mean pulmonary artery pressures; systemic vascular resistance index; and oxygen extraction ratio. Administration of acepromazine resulted in increases in heart rate, cardiac index, oxygen uptake, and oxygen extraction ratio. Oxygen extraction ratio did not differ between acepromazine and dexmedetomidine.
CONCLUSIONS AND CLINICAL RELEVANCE
Fentanyl transiently improved indices of cardiopulmonary performance when administered to healthy cats anesthetized with isoflurane. The cardiovascular effects of acepromazine and dexmedetomidine in healthy cats receiving fentanyl during recovery from isoflurane anesthesia differed, but measured cardiopulmonary parameters remained within acceptable limits.
Abstract
Objective—To evaluate cardiopulmonary effects of anesthetic induction with diazepam and ketamine or xylazine and ketamine, with subsequent maintenance of anesthesia with isoflurane, in foals undergoing abdominal surgery.
Animals—17 pony foals.
Procedures—Foals underwent laparotomy at 7 to 15 days of age and laparoscopy 7 to 10 days later. Foals were randomly assigned to receive diazepam, ketamine, and isoflurane (D/K/Iso; n = 8) or xylazine, ketamine, and isoflurane (X/K/Iso; 9) for both procedures.
Results—During anesthesia for laparotomy, cardiac index, and mean arterial blood pressure ranged from 110 to 180 mL/kg/min and 57 to 81 mm Hg, respectively, in the D/K/Iso group and 98 to 171 mL/kg/min and 50 to 66 mm Hg, respectively, in the X/K/Iso group. Cardiac index, heart rate, and arterial blood pressures were significantly higher in the D/K/Iso group, compared with the X/K/Iso group. During anesthesia for laparoscopy, cardiac index and mean arterial blood pressure ranged from 85 to 165 mL/kg/min and 67 to 83 mm Hg, respectively, in the D/K/Iso group, and 98 to 171 mL/kg/min and 48 to 67 mm Hg, respectively, in the X/K/Iso group. Heart rates and arterial blood pressures were significantly higher in the D/K/Iso group, compared with the X/K/Iso group. There were no significant differences between groups during either experimental period for percentage end-tidal isoflurane, arterial blood gas partial pressures, or pH values.
Conclusions and Clinical Relevance—Anesthesia of foals for abdominal surgery with D/K/Iso was associated with less hemodynamic depression than with X/K/Iso.
Abstract
Objective—To determine the effects of meloxicam and butorphanol on minimum alveolar concentration of isoflurane (MACISO) in rabbits.
Animals—10 healthy young adult female rabbits.
Procedure—Rabbits were anesthetized with isoflurane on 3 occasions in a blinded, randomized complete block design to determine the MACISO associated with administration of meloxicam (0, 0.3, or 1.5 mg/kg, PO) and butorphanol (0.4 mg/kg, IV). The MACISO was determined by use of a paw clamp technique as the end-tidal concentration of isoflurane halfway between the values that allowed or inhibited purposeful movement. Rectal temperature, end-tidal CO2 concentration, heart rate, oxygen saturation, and arterial blood pressure were measured to evaluate cardiopulmonary function.
Results—Mean ± SE MACISO in saline (0.9% NaCl) solution–treated rabbits was 2.49 ± 0.07% and was not significantly different from that associated with administration of meloxicam at 0.3 mg/kg (2.56 ± 0.07%) or 1.5 mg/kg (2.66 ± 0.07%). Butorphanol significantly reduced the MACISO to 2.30 ± 0.07% when administered with saline solution alone, 2.27 ± 0.07% when administered with 0.3 mg of meloxicam/kg, and 2.33 ± 0.07% when administered with 1.5 mg of meloxicam/kg. The percentage reduction in MACISO was significantly greater for rabbits that received butorphanol and meloxicam at either dose, compared with butorphanol and saline solution.
Conclusions and Clinical Relevance—Results indicated that meloxicam does not have a direct isoflurane-sparing effect and does not interfere with the anesthetic-sparing effect of butorphanol in rabbits.
Abstract
Objective—To evaluate the use of a lithium dilution cardiac output (LiDCO) technique for measurement of CO and determine the agreement between LiDCO and thermodilution CO (TDCO) values in anesthetized cats.
Animals—6 mature cats.
Procedure—Cardiac output in isoflurane-anesthetized cats was measured via each technique. To induce different rates of CO in each cat, anesthesia was maintained at > 1.5X end-tidal minimum alveolar concentration (MAC) of isoflurane and at 1.3X endtidal isoflurane MAC with or without administration of dobutamine (1 to 3 µg/kg/min, IV). At least 2 comparisons between LiDCO and TDCO values were made at each CO rate. The TDCO indicator was 1.5 mL of 5% dextrose at room temperature; with the LiDCO technique, each cat received 0.005 mmol of lithium/kg (concentration, 0.015 mmol/mL). Serum lithium concentrations were measured prior to the first and following the last CO determination.
Results—35 of 47 recorded comparisons were analyzed; via linear regression analysis (LiDCO vs TDCO values), the coefficient of determination was 0.91. The mean bias (TDCO-LiDCO) was –4 mL/kg/min (limits of agreement, –35.8 to +27.2 mL/kg/min). The concordance coefficient was 0.94. After the last CO determination, serum lithium concentration was < 0.1 mmol/L in each cat.
Conclusions and Clinical Relevance—Results indicated a strong relationship and good agreement between LiDCO and TDCO values; the LiDCO method appears to be a practical, relatively noninvasive method for measurement of CO in anesthetized cats. (Am J Vet Res 2005;66:1639–1645).
Abstract
Objective—To assess the sedative and cardiopulmonary effects of medetomidine and xylazine and their reversal with atipamezole in calves.
Animals—25 calves.
Procedures—A 2-phase (7-day interval) study was performed. Sedative characteristics (phase I) and cardiopulmonary effects (phase II) of medetomidine hydrochloride and xylazine hydrochloride administration followed by atipamezole hydrochloride administration were evaluated. In both phases, calves were randomly allocated to receive 1 of 4 treatments IV: medetomidine (0.03 mg/kg) followed by atipamezole (0.1 mg/kg; n = 6), xylazine (0.3 mg/kg) followed by atipamezole (0.04 mg/kg; 7), medetomidine (0.03 mg/kg) followed by saline (0.9% NaCl; 6) solution (10 mL), and xylazine (0.3 mg/kg) followed by saline solution (10 mL; 6). Atipamezole or saline solution was administered 20 minutes after the first injection. Cardiopulmonary variables were recorded at intervals for 35 minutes after medetomidine or xylazine administration.
Results—At the doses evaluated, xylazine and medetomidine induced a similar degree of sedation in calves; however, the duration of medetomidine-associated sedation was longer. Compared with pretreatment values, heart rate, cardiac index, and PaO2 decreased, whereas central venous pressure, PaCO2 , and pulmonary artery pressures increased with medetomidine or xylazine. Systemic arterial blood pressures and vascular resistance increased with medetomidine and decreased with xylazine. Atipamezole reversed the sedative and most of the cardiopulmonary effects of both drugs.
Conclusions and Clinical Relevance—At these doses, xylazine and medetomidine induced similar degrees of sedation and cardiopulmonary depression in calves, although medetomidine administration resulted in increases in systemic arterial blood pressures. Atipamezole effectively reversed medetomidine- and xylazine-associated sedative and cardiopulmonary effects in calves.
Abstract
Objective—To evaluate the cardiopulmonary and sedative effects of the peripheral α2-adrenoceptor antagonist MK 0467 when administered IM or IV concurrently with medetomidine in dogs.
Animals—8 adult dogs.
Procedures—Dogs received 20 μg of medetomidine/kg, IM, alone or concurrently with MK 0467 (0.4 mg/kg, IM), and 10 μg of medetomidine/kg, IV, alone or concurrently with MK 0467 (0.2 mg/kg, IV), in a randomized crossover study. Sedation characteristics were scored and hemodynamic measurements and arterial and mixed-venous blood samples for blood gas analysis were obtained before (time 0; baseline) and for 90 minutes after treatment.
Results—Heart rate (HR), mixed-venous partial pressure of oxygen (P
Conclusions and Clinical Relevance—In dogs, MK 0467 administered concurrently with medetomidine IV or IM reduced the cardiovascular effects of medetomidine but had no detectable effect on sedation scores.
Abstract
Objective—To determine the cardiovascular effects of 60 minutes of abdominal insufflation with CO2 to an intra-abdominal pressure of 15 mm Hg in standing horses receiving a constant rate infusion of detomidine.
Animals—5 horses.
Procedure—Horses were randomly allocated into treatment or control groups. A washout period of a minimum of 7 days separated the 2 experimental periods of the crossover study. Catheters were placed into the right atrium, pulmonary artery, jugular vein, and right transverse facial artery after lidocaine infiltration. All horses were sedated with detomidine (8.54 µg/kg/h, IV). Horses in the treatment group received abdominal insufflation with CO2 via a laparoscopic cannula to a final and constant intraabdominal pressure of 15 mm Hg for 60 minutes. Systemic arterial pressure, right atrial pressure, heart rate, cardiac output, core body temperature, and the pH and gas tensions of arterial and mixed venous blood were obtained. Cardiac index and systemic vascular resistance were calculated. Data were collected in 3 stages: preinsufflation (–10 and –5 minutes), insufflation (0, 15, 30, 45, and 60 minutes), and postinsufflation (70 and 80 minutes). The quality of sedation and level of analgesia were determined.
Results—The PaO2 of horses in the treatment group was significantly higher after 60 minutes of pneumoperitoneum than in the control group. Core body temperature decreased significantly from baseline in both groups.
Conclusions and Clinical Relevance—A 60-minute period of abdominal insufflation to an intra-abdominal pressure of 15 mm Hg did not induce significant cardiovascular abnormalities in healthy horses. ( Am J Vet Res 2004;65:357–362)
Abstract
Objective—To compare laparoscopic dissection withlaparoscopic dissection combined with abdominal instillation of ferric hyaluronate gel for the treatment of experimentally induced adhesions in pony foals.
Animals—12 healthy pony foals.
Procedure—A serosal abrasion method was used to create adhesions at 4 sites on the jejunum (day 0). At day 7, laparoscopy was performed and the adhesions observed in each foal were recorded. In group-1 foals (n = 6), the adhesions were separated laparoscopically (treatment 1). In group-2 foals (n = 6), 300 mL of 0.5% ferric hyaluronate gel was infused into the abdomen after the adhesions were separated laparoscopically (treatment 2). At day 24, terminal laparoscopy was performed and the adhesions observed were recorded. Total number of adhesions within each group was compared between day 7 and 24. Data were analyzed to determine whether an association existed between the number of adhesions on day 24 and treatment type.
Results—At day 24, the number of adhesions was significantly decreased within each group, compared with the number of adhesions at day 7 (group-1 foals, 10 vs 22 adhesions; group-2 foals, 3 vs 20 adhesions). Treatment 1 was associated with a significantly higher number of adhesions at day 24, compared with treatment 2 (odds ratio, 4.54; 95% confidence interval, 1.03 to 23.02).
Conclusions and Clinical Relevance—Abdominal instillation of 0.5% ferric hyaluronate gel after laparoscopic dissection was a more effective technique than laparoscopic dissection alone to treat experimentally induced adhesions in pony foals. Laparoscopic adhesiolysis following abdominal surgery in foals is a safe and effective technique. ( Am J Vet Res 2004;65:681–686)
Abstract
Objective—To determine the relationship between epidural cranial migration and injectate volume of an isotonic solution containing dye in laterally recumbent foal cadavers and evaluate the cranial migration and dermatome analgesia of an epidural dye solution during conditions of laparoscopy in foals.
Animals—19 foal cadavers and 8 pony foals.
Procedure—Foal cadavers received an epidural injection of dye solution (0.05, 0.1, 0.15, or 0.2 mL/kg) containing 1.2 mg of new methylene blue (NMB)/mL of saline (0.9% NaCl) solution. Length of the dye column and number of intervertebral spaces cranial and caudal to the injection site were measured. Anesthetized foals received an epidural injection of dye solution (0.2 mL/kg) containing saline solution or 2% mepivacaine. Foals were placed in a 10o headdown position, and pneumoperitoneum was induced. Dermatome analgesia was determined by use of a described electrical stimulus technique. Foals were euthanatized, and length of the dye column was measured.
Results—Epidural cranial migration of dye solution in foal cadavers increased with increasing volume injected. No significant difference was found in epidural cranial migration of a dye solution (0.2 mL/kg) between anesthetized foals undergoing conditions of laparoscopy and foal cadavers in lateral recumbency. Further craniad migration of the dye column occurred than indicated by dermatome analgesia.
Conclusions and Clinical Relevance—Epidural cranial migration increases with volume of injectate. On the basis of dermatome analgesia, an epidural injection of 2% mepivacaine (0.2 mL/kg) alone provides analgesia up to at least the caudal thoracic dermatome and could permit caudal laparoscopic surgical procedures in foals. ( Am J Vet Res 2005; 66:1324–1329)
Abstract
Objective—To determine reasons for epidural catheter placement among horses examined at a veterinary teaching hospital, efficacy of epidural administration of analgesics, duration of catheter placement, reasons for catheter removal, and complications encountered.
Design—Retrospective study.
Animals—43 horses.
Procedure—Medical records were reviewed.
Results—A total of 50 epidural catheters were placed in the 43 horses. Underlying conditions included fractures, lacerations, septic arthritis, myositis, perineal injuries, and cellulitis. Horses ranged from 2 to 21 years old and weighed between 365 and 795 kg (803 and 1,749 lb). Median duration of catheter placement was 96 hours (range, 1.5 to 480 hours). The response to epidural drug administration was reported as positive in 34 horses and negative in 4. There was no apparent response in 2 horses, and response could not be determined in 3. Three temporary patient-related complications associated with epidural catheter administration were observed. Technical problems associated with the epidural catheters included dislodgement of the catheter itself (7 catheters) or of the adapter or filter (5), obstruction (5), and leakage (5). Twenty-two catheters were removed because of resolution of the underlying condition, and 10 were removed because of complications. For 6 catheters, the reason for catheter removal was not recorded. The remaining 12 catheters were in place when the horses were euthanatized .
Conclusions and Clinical Relevance—Results suggest that epidural catheterization can be used successfully for repeated epidural delivery of analgesics and anesthetics in horses with various clinical conditions. Complications associated with epidural catheters or epidural drug administration were infrequent and transient. (J Am Vet Med Assoc 2003;222:1394–1398)