Objective—To evaluate the isoflurane-sparing effects of lidocaine and fentanyl administered by constant rate infusion (CRI) during surgery in dogs.
Design—Randomized prospective study.
Animals—24 female dogs undergoing unilateral mastectomy because of mammary neoplasia.
Procedures—After premedication with acepromazine and morphine and anesthetic induction with ketamine and diazepam, anesthesia in dogs (n = 8/group) was maintained with isoflurane combined with either saline (0.9% NaCl) solution (control), lidocaine (1.5 mg/kg [0.68 mg/lb], IV bolus, followed by 250 μg/kg/min [113 μg/lb/min], CRI), or fentanyl (5 μg/kg [2.27 μg/lb], IV bolus, followed by 0.5 μg/kg/min [0.23 μg/lb/min], CRI). Positive-pressure ventilation was used to maintain eucapnia. An anesthetist unaware of treatment, endtidal isoflurane (ETiso) concentration, and vaporizer concentrations adjusted a nonprecision vaporizer to maintain surgical depth of anesthesia. Cardiopulmonary variables and ETiso values were monitored before and after beginning surgery.
Results—Heart rate was lower in the fentanyl group. Mean arterial pressure did not differ among groups after surgery commenced. In the control group, mean ± SD ETiso values ranged from 1.16 ± 0.35% to 1.94 ± 0.96%. Fentanyl significantly reduced isoflurane requirements during surgical stimulation by 54% to 66%, whereas the reduction in ETiso concentration (34% to 44%) observed in the lidocaine group was not significant.
Conclusions and Clinical Relevance—Administration of fentanyl resulted in greater isoflurane sparing effect than did lidocaine. However, it appeared that the low heart rate induced by fentanyl may partially offset the improvement in mean arterial pressure that would be expected with reduced isoflurane requirements.
Objective—To evaluate analgesic effects of epidurally administered neostigmine alone or in combination with morphine in dogs after ovariohysterectomy.
Animals—40 healthy bitches.
Procedures—After acepromazine premedication, anesthesia was induced. Dogs randomly received 1 of the following 4 epidural treatments 30 minutes before ovariohysterectomy (n = 10/group): saline (0.9% NaCl) solution (control), morphine (0.1 mg/kg), neostigmine (10 μg/kg), or morphine-neostigmine (0.1 mg/kg and 10 μg/kg, respectively). Analgesia was assessed for 24 hours after surgery by use of a visual analogue scale (VAS; scale of 0 to 10) or numeric descriptive scale (NDS; scale of 0 to 24) and by the need for supplemental analgesia (morphine [0.5 mg/kg, IM] administered when VAS was ≥ 4 or NDS was ≥ 8).
Results—Significantly more control dogs (n = 8) received supplemental analgesia, compared with the number of neostigmine-treated dogs (1); no dogs in the remaining groups received supplemental analgesia. Compared with values for the control dogs, the NDS scores were lower for morphine-neostigmine–treated dogs (from 2 to 6 hours and at 12 hours) and for morphine-treated dogs (all time points). The NDS scores were lower for morphine-treated dogs at 3, 12, and 24 hours, compared with values for neostigmine-treated dogs. The VAS was less sensitive than the NDS for detecting differences among groups.
Conclusions and Clinical Relevance—Epidurally administered neostigmine reduced the use of supplemental analgesia after ovariohysterectomy in dogs. However, analgesic effects were less pronounced than for epidurally administered morphine or morphine-neostigmine. Adding neostigmine to epidurally administered morphine did not potentiate opioid-induced analgesia.