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  • Author or Editor: Philip A. March x
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Abstract

Objective—To compare the minimum alveolar concentration (MAC) of isoflurane required to prevent corticocerebral activation, autonomic responses, and purposeful movements after somatic or visceral stimulation in cats anesthetized with isoflurane.

Animals—17 healthy spayed female cats.

Procedure—Bispectral index (BIS), autonomic parameters, and purposeful movements were monitored before and after somatic or visceral stimuli in cats anesthetized with isoflurane. End-tidal (ET) isoflurane concentration was varied to determine MAC values for cortical arousal (MACBIS), autonomic responsiveness (MACBAR), and purposeful movement (MAC). Bispectral index values ≥ 60 were considered to represent corticocerebral activation.

Results—Minimum alveolar concentration for purposeful movement was significantly less than MACBIS and MACBAR for both somatic and visceral stimulation. Individual MAC values for somatic stimulation were not significantly different from respective MAC values for visceral stimulation. The percentage of cats that had a BIS response ≥ 60 was inversely related to the end-tidal isoflurane concentration.

Conclusions and Clinical Relevance—Corticocerebral arousal and subcortical autonomic reflexes occured at isoflurane anesthetic concentrations at which reflexive or purposeful movements were absent. These results suggested that isoflurane had a preferential effect on voluntary motor output at low end-tidal isoflurane concentrations, and that sensory pathways, subcortical sympathetic output, and cortical responsiveness are less susceptible to the anesthetic effects of isoflurane. Bispectral index values obtained after somatic or visceral stimulation were sensitive for the detection of early changes in cortical excitability. (Am J Vet Res 2003; 64:1528–1533)

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in American Journal of Veterinary Research

Abstract

Objective—To determine whether the prestimulation bispectral index (BIS) value or relative change in BIS after noxious stimulation can be used to assess the depth of isoflurane anesthesia in cats.

Animals—17 healthy female cats.

Procedure—Electroencephalogram (EEG) patterns and BIS values were examined in cats that received increasing end-tidal (ET) isoflurane concentrations. Subsequently, BIS values were determined before and after either a noxious somatic or visceral stimulus in cats that received ET isoflurane concentrations ranging from 1.8% to 2.4%. Electrical stimuli of the tail base and bladder distension to 50 cm of water were the somatic and visceral stimuli, respectively.

Results—The resting BIS at ET isoflurane concentrations from 1.4% to 1.9% steadily decreased concurrently with increasing degrees of EEG suppression. Prestimulation BIS values, however, were not related to 1.8% to 2.4% ET isoflurane concentrations and not useful for prediction of BIS values or hemodynamic and movement responses after a noxious stimulus. The poststimulation BIS value and the difference between mean BIS values before and after stimulation were inversely correlated with increasing ET isoflurane concentrations. Poststimulation BIS values > 60 were observed at ET isoflurane concentrations greater than those associated with a movement response after a stimulus.

Conclusions and Clinical Relevance—The prestimulation BIS value has limited use in assessing anesthetic depth in cats during isoflurane anesthesia. The change in BIS values after a noxious somatic or visceral stimulus was a reliable measure of anesthetic depth and may be a useful measure of early arousal from the hypnotic state. (Am J Vet Res 2003;64:1534–1541)

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in American Journal of Veterinary Research

Abstract

Case Description—A 9-year-old 19.7-kg (43.3-lb) spayed female Australian Shepherd was examined for an increase in frequency of episodic neurologic signs, often occurring upon exercise.

Clinical Findings—Between episodes of neurologic signs, the dog was considered clinically normal on the basis of findings on physical and neurologic examinations. An episode of ataxia with central vestibular signs was induced by exercising the patient in the hospital. All clinicopathologic values were within reference ranges, as were findings on magnetic resonance imaging of the brain and peripheral vestibular system. Systolic blood pressures of 180 to 200 mm Hg were recorded, and systemic hypertension was diagnosed.

Treatment and Outcome—While the dog received amlodipine and enalapril, blood pressure returned to within reference range, and episodes of neurologic signs no longer occurred. When clinical signs later recurred, systolic blood pressure was again found to be high. Following an increase in medication dosage, blood pressure normalized, and only 4 further episodes of neurologic signs were observed during a follow-up period totaling 30 months.

Clinical Relevance—Transient ischemic attack is a common diagnosis in humans but has not been described for dogs. In humans, it is defined as focal brain dysfunction caused by vascular disease that resolves completely in less than 24 hours and is often recurrent. Systemic hypertension is one of the most common preexisting conditions. We propose that the dog in the present report had clinical signs and diagnostic test results supportive of a diagnosis of transient ischemic attack.

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in Journal of the American Veterinary Medical Association

Abstract

Objective—To determine the effects of constant rate infusion of morphine, lidocaine, ketamine, and morphine- lidocaine-ketamine (MLK) combination on endtidal isoflurane concentration (ET-Iso) and minimum alveolar concentration (MAC) in dogs anesthetized with isoflurane and monitor depth of anesthesia by use of the bispectral index (BIS).

Animals—6 adult dogs.

Procedure—Each dog was anesthetized with isoflurane on 5 occasions, separated by a minimum of 7 to 10 days. Individual isoflurane MAC values were determined for each dog. Reduction in isoflurane MAC, induced by administration of morphine (3.3 µg/kg/min), lidocaine (50 µg/kg/min), ketamine (10 µg/kg/min), and MLK, was determined. Heart rate, mean arterial blood pressure, oxygen saturation as measured by pulse oximetry (SpO2), core body temperature, and BIS were monitored.

Results—Mean ± SD isoflurane MAC was 1.38 ± 0.08%. Morphine, lidocaine, ketamine, and MLK significantly lowered isoflurane MAC by 48, 29, 25, and 45%, respectively. The percentage reductions in isoflurane MAC for morphine and MLK were not significantly different but were significantly greater than for lidocaine and ketamine. The SpO2, mean arterial pressure, and core body temperature were not different among groups. Heart rate was significantly decreased at isoflurane MAC during infusion of morphine and MLK. The BIS was inversely related to the ET-Iso and was significantly increased at isoflurane MAC during infusions of morphine and ketamine, compared with isoflurane alone.

Conclusions and Clinical Relevance—Low infusion doses of morphine, lidocaine, ketamine, and MLK decreased isoflurane MAC in dogs and were not associated with adverse hemodynamic effects. The BIS can be used to monitor depth of anesthesia. (Am J Vet Res 2003;64:1155–1160)

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in American Journal of Veterinary Research

Abstract

Objective—To compare the effects of propofol and sevoflurane on the urethral pressure profile in female dogs.

Animals—10 healthy female dogs.

Procedure—Urethral pressure profilometry was performed in awake dogs, during anesthesia with sevoflurane at 1.5, 2.0, and 3.0% end-tidal concentration, and during infusion of propofol at rates of 0.4, 0.8, and 1.2 mg/kg/min. A consistent plane of anesthesia was maintained for each anesthetic protocol. Maximum urethral pressure, maximum urethral closure pressure, functional profile length, and functional area were measured.

Results—Mean maximum urethral closure pressure of awake dogs was not significantly different than that of dogs anesthetized with propofol at all infusion rates or with sevoflurane at 1.5 and 2.0% end-tidal concentration. Functional area in awake dogs was significantly higher than in anesthetized dogs. Functional area of dogs during anesthesia with sevoflurane at 3.0% end-tidal concentration was significantly lower than functional area for other anesthetic protocols. Individual differences in the magnitude of effects of propofol and sevoflurane on urethral pressures were observed.

Conclusions and Clinical Relevance—Sevoflurane is an alternative to propofol for anesthesia in female dogs undergoing urethral pressure profilometry. Use of these anesthetics at appropriate administration rates should reliably distinguish normal from abnormal maximum urethral closure pressures and functional areas. Titration of anesthetic depth is a critical component of urodynamic testing. (Am J Vet Res 2003;64:1288–1292)

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in American Journal of Veterinary Research