Effects of trazodone and dexmedetomidine on fentanyl-mediated reduction of isoflurane minimum alveolar concentration in cats.

OBJECTIVE: To screen modulators of biogenic amine (BA) neurotransmission for the ability to cause fentanyl to decrease isoflurane minimum alveolar concentration (MAC) in cats, and to test whether fentanyl plus a combination of modulators decreases isoflurane MAC more than fentanyl alone. STUDY DESIGN: Prospective, experimental study. ANIMALS: A total of six adult male Domestic Short Hair cats. METHODS: Each cat was anesthetized in three phases with a 1 week washout between studies. In phase 1, anesthesia was induced and maintained with isoflurane, and MAC was measured in duplicate using a tail clamp stimulus and standard bracketing technique. A 21 ng mL-1 fentanyl target-controlled infusion was then administered and MAC measured again. In phase 2, a single cat was administered a single BA modulator (buspirone, haloperidol, dexmedetomidine, pregabalin, ramelteon or trazodone) in a pilot drug screen, and isoflurane MAC was measured before and after fentanyl administration. In phase 3, isoflurane MAC was measured before and after fentanyl administration in cats co-administered trazodone and dexmedetomidine, the two BA modulator drugs associated with fentanyl MAC-sparing in the screen. Isoflurane MAC-sparing by fentanyl alone, trazodone-dexmedetomidine and trazodone-dexmedetomidine-fentanyl was evaluated using paired t tests with p < 0.05 denoting significant effects. RESULTS: The MAC of isoflurane was 1.87% ± 0.09 and was not significantly affected by fentanyl administration (p = 0.09). In the BA screen, cats administered trazodone or dexmedetomidine exhibited 26% and 22% fentanyl MAC-sparing, respectively. Trazodone-dexmedetomidine co-administration decreased isoflurane MAC to 1.50% ± 0.14 (p < 0.001), and the addition of fentanyl further decreased MAC to 0.95% ± 0.16 (p < 0.001). CONCLUSIONS AND CLINICAL RELEVANCE: Fentanyl alone does not affect isoflurane MAC in cats, but co-administration of trazodone and dexmedetomidine causes fentanyl to significantly decrease isoflurane requirement.

Lower airway ultrasonographic, endoscopic, and cytological changes in horses undergoing inhalation anesthesia with controlled ventilation for minor elective surgeries.

Effects of general anesthesia with controlled ventilation on the respiratory system have had limited evaluation in horses. A prospective observational study was performed with eleven client-owned horses undergoing elective surgery. Physical examination, auscultation with a rebreathing bag, complete blood cell count, lung ultrasound imaging, tracheal endoscopy imaging and transendoscopic tracheal wash were conducted before and 24 hours after anesthesia. Lung ultrasound imaging was also repeated just after recovery. A significant increase in blood neutrophil count between pre- and post-anesthesia (P=0.004) was observed. There was an increase in ultrasonographic score of the lungs at recovery (left P=0.007, right P=0.017). The score of the dependent lung was higher than the independent lung at recovery time (P=0.026) but no difference was observed 24 hours after anesthesia. The tracheal mucus score was higher after anesthesia (P=0.001); severe local inflammation was present in several horses at the site of endotracheal tube cuff. Neutrophil count was significantly higher on tracheal wash fluid cytology after anesthesia (P=0.016), without any significant changes on bacterial load. Increased tracheal mucus score and neutrophil count in tracheal wash samples were observed after general anesthesia in healthy horses without clinical evidence of pneumonia (fever, cough). Tracheal inflammation secondary to endotracheal intubation and cuff inflation was, therefore, suspected. Elective surgery without complications can induce inflammation of the trachea and changes in ultrasound images of the lungs in healthy horses and should be considered when evaluating respiratory system after a general anesthesia.

[Inhalation anesthesia in the cat: Development of cuff pressure when using nitrous oxide]. / Inhalationsanästhesie bei der Katze: Die Entwicklung des Cuffdrucks bei Verwendung von Lachgas.

OBJECTIVE: During inhalation anesthesia with nitrous oxide in oxygen the pressure in the cuff of the endotracheal tube may increase due to diffusion of nitrous oxide into the cuff. The aim of the study was to investigate the development of cuff pressure during nitrous oxide anesthesia under clinical conditions in feline patients and to identify possible influencing factors such as tube size and gas flow rate. MATERIAL AND METHODS: The prospective study included cats scheduled for inhalation anesthesia with nitrous oxide for a minimum duration of 60 minutes at the Department for Small Animals of the University of Leipzig. Cuff pressure was adjusted with a cuff manometer and its development was recorded. RESULTS: In total, the cuff pressure values of 24 cats were recorded. Animals were allocated into groups by tube size (ID 4.0 mm and ID 4.5 mm) and by fresh gas flow rate: low flow rate (0.6 l/min) and high flow rate (3 l/min). During anesthesia, cuff pressure increased over time, with statistical significance occurring from 45 minutes onwards in comparison to the initial cuff pressure (p=0.005). After 60 minutes, there was a mean cuff pressure increase of 3 cmH2O. Despite this moderate mean increase, highly variable pressure values up to 48 cmH2O in individual animals were recorded. No cat reached the termination criterion of 60 cmH2O cuff pressure. Effects of tube size (p=0.63) and flow rate (p=0.334) on the cuff pressure were not evident. CONCLUSION: After a period of 45 minutes of nitrous oxide administration, a significant increase in cuff pressure occurs in the cat. However, tube size and total gas flow rate do not seem to influence the cuff pressure development. CLINICAL RELEVANCE: When using nitrous oxide during inhalation anesthesia, regular cuff pressure evaluation and correction are necessary and hence recommended in feline patients. As individual pressure changes may be highly variable, no fixed recommendations for optimal management are possible.

Effects of alfaxalone on induction quality of inhalation anesthesia in domestic pigeons (Columba livia domestica).

Several studies have documented the effects of anesthesia on pigeons. However, previous studies using pigeons have not examined a combination of injection and inhalation anesthesia. This study aimed to evaluate the effects of intramuscular (IM) administration of alfaxalone in conjunction with mask induction on the quality of isoflurane anesthesia in healthy domestic pigeons (Columba livia domestica). In a randomized, double-blind, crossover study consisting of two phases, six healthy adult pigeons were anesthetized twice with a washout period of 7 days. In each phase, the pigeons were randomly assigned IM administration of either alfaxalone (4 mg/kg) or an equal volume of normal saline. After 20 min, anesthesia was induced with isoflurane through a face mask. Once voluntary movement of the limbs and eyelids ceased, the face mask was removed, and the trachea was intubated. The quality of anesthesia was assessed by scoring sedation prior to anesthetic induction, induction, and recovery. Heart rate, respiratory rate, cloacal temperature, and noninvasive systolic, diastolic, and mean arterial pressure were recorded before the IM injection (baseline) and during the procedure. The minimum anesthetic concentration of isoflurane was determined using the "bracketing" method. Moderate sedation (sedation scores of 2 and 3) was observed only with alfaxalone administration. In the alfaxalone group, the induction score was significantly higher (better induction quality) than in the control group (P=0.041). The combination of alfaxalone and mask induction was effective for inhalation anesthesia in pigeons.

[Evaluation of isoflurane inhalation -anesthesia machines available in Switzerland for on farm piglet -castrations]. / Kritische Evaluation der in der Schweiz zur Verfügung stehenden Inhalations­anästhesiegeräte zur Ferkelkastration ­unter Isoflurananästhesie im Stall.

INTRODUCTION: The present study analyzed piglet castration under isoflurane anesthesia in ten farms. The data of 202 male piglets in the age between three to eleven days and with a body weight of 1 - 4,7 kg were collected. The aim of this study was to compare the PorcAnest®, Pignap® and Pigsleeper® anesthesia machines used in Switzerland. Isoflurane, carbon dioxide (CO2) and oxygen (O2) values were measured in relation to their significance for anesthesia quality. Therefore, preoperative stress level and movements were assessed during skin incision and the dissection of the spermatic cords. Isoflurane, CO2 and O2 values were recorded in the inhaled and exhaled gases next to the nostrils at 30, 60, 75 and 90 seconds after the start of anesthesia. Movements to the skin incisions and dissection of the spermatic cord were observed in 32 % and 37 % respectively. Movements increased with the decrease of measured inspiratory and expiratory isoflurane values (FIIso and ETIso). Significantly lower inspiratory O2 values (FIO2: 12 - 21 volume % vs 21 - 95 volume %) and stronger movements were measured in anesthesia machines using room air compared to machines operated with medical oxygen. Results indicate a potential for improvement in anesthesia deph piglet castration under isoflurane inhalaton anesthesia and THE measured isoflurane, CO2 and O2 values differ significantly between PorcAnest®, Pignap® and Pigsleeper® anesthesia machines. These fluctuations could be recognized and reduced by annual professional maintenance and / or the addition of an anesthetic gas analyzer. In addition, a change to medical oxygen is indicated for all anesthetic machines. Anesthesia machines have to be optimized in consultation with the manufacturers as soon as possible and the farmers have to be trained and sensitized to ensure pain-free castration.

INTRODUCTION: La présente étude a analysé la castration de porcelets sous anesthésie à l'isoflurane dans dix exploitations. Les données de 202 porcelets mâles âgés de trois à onze jours et pesant entre 1 et 4,7 kg ont été recueillies. Le but de cette étude était de comparer les appareils d'anesthésie PorcAnest®, Pignap® et Pigsleeper® utilisés en Suisse. Les valeurs d>isoflurane, de dioxyde de carbone (CO2) et d>oxygène (O2) ont été mesurées en fonction de leur importance pour la qualité de l>anesthésie. Pour cela, le niveau de stress préopératoire et les mouvements ont été évalués lors de l'incision cutanée et la dissection des cordons spermatiques. Les valeurs d'isoflurane, de CO2 et d'O2 ont été enregistrées dans les gaz inhalés et expirés à côté des narines à 30, 60, 75 et 90 secondes après le début de l'anesthésie. Des mouvements lors des incisions cutanées et de la dissection du cordon spermatique ont été observés respectivement dans 32 % et 37 % des cas. Les mouvements ont augmenté avec la diminution des valeurs d'isoflurane inspiratoires et expiratoires mesurées (FIIso et ETIso). Des valeurs d'O2 inspiratoire significativement plus faibles (FIO2 : 12 - 21 % du volume contre 21 - 95 % du volume) et des mouvements plus importants ont été constatés avec les appareils d'anesthésie utilisant l'air ambiant par rapport à ceux fonctionnant avec de l'oxygène médical. Les résultats indiquent qu'il existe un potentiel d'amélioration de la profondeur d'anesthésie dans la castration des porcelets sous anesthésie par inhalation d'isoflurane et que les valeurs mesurées d'isoflurane, de CO2 et d'O2 diffèrent significativement entre les appareils d'anesthésie PorcAnest®, Pignap® et Pigsleeper®. Ces fluctuations pourraient être identifiées et réduites par un entretien professionnel annuel et/ou par l'ajout d'un analyseur de gaz anesthésique. De plus, un passage à l'oxygène médical est indiqué pour tous les appareils d'anesthésie. Les appareils d'anesthésie doivent être optimisés en concertation avec les fabricants dans les plus brefs délais et les éleveurs doivent être formés et sensibilisés pour assurer une castration sans douleur.

Transplantation of Pluripotent Stem Cell-Derived Cardiomyocytes into a Myocardial Infarction Model of Cynomolgus Monkey.

Recent evidence has provided exciting proof of concepts for the use of pluripotent stem cell-derived cardiomyocytes (PSC-CMs) for cardiac repair; however, large animal studies, which better reflect human disease, are required for clinical application. Here, we describe how to create myocardial infarction in cynomolgus monkey followed by transplantation of PSC-CMs. This method ensures the establishment of a myocardial infarction model and enables reliable PSC-CM transplantation.

[Investigations on suckling piglets castrated under automated isoflurane anesthesia]. / Untersuchungen zur automatisierten Isoflurannarkose bei der Saugferkelkastration.

OBJECTIVE: Investigation of defensive reactions, piglet losses, post-bleeding and recovery time of suckling piglets castrated under automated isoflurane anesthesia as well as measurements of isoflurane concentrations in ambient air and estimation of the cleaning and disinfection success of anesthesia masks. MATERIAL AND METHODS: A total of 955 suckling piglets (age: 4.0 ± 1.2 days; weight: 2.0 ± 0.5 kg) were castrated under automated isoflurane anesthesia (PorcAnest 3000®) after the administration of a non-steroidal anti-inflammatory drug. Reactions during the procedure were assessed before castration using the interdigital claw reflex and during castration by defensive movements and vocal response. The piglets' recovery time was evaluated in the stable corridor (pass 1) and the farrowing pen (passes 4-5). In 73 animals, the spermatic cord was cut with a scalpel and the post-operative bleeding visually evaluated. In addition, exposure measurements of isoflurane were performed and anesthetic masks were examined for total bacterial contamination and indicator bacteria before and after the anesthetic procedure and following their disinfection. RESULTS: Following insufflation of isoflurane for 90 seconds 94.3 % of the piglets and after prior testing of the interdigital claw reflex and possible extension of the anesthetic supply 95.3 % of the piglets showed no or minimal defensive movements during castration. An anesthetic incident occurred in 0.9 % of the piglets, but no animal died. The recovery time lasted 7.3 ± 4.7 minutes (pass 1) and 6.2 ± 3.3 minutes (passes 4-5). Cutting the spermatic cord with a scalpel led to a higher post-bleeding score (p < 0.001) compared to use of the emasculator. Isoflurane concentrations in ambient air ranged between 4.5 und 28.1 mg/m3. Masks disinfection reduced the total germ count by 99.8 %. Contaminations with Escherichia coli and MRSA were no longer detectable in 4 of 6 cases after disinfection. CONCLUSION: Isoflurane anesthesia led in over 94 % of the piglets to no or minimal defensive reactions during castration. Anesthetic incidents occurred rarely and no piglet losses were recorded. Therefore, automated isoflurane anesthesia is associated with a low risk for suckling piglets. Measurements of isoflurane concentrations on persons involved were below the internationally lowest limit value. Disinfection of the anesthesia masks may prevent germ transmission between animal groups via this potential vector.

Sustainable veterinary anaesthesia: single centre audit of oxygen and inhaled anaesthetic consumption and comparisons to a hypothetical model.

OBJECTIVES: Single centre carbon footprint audit of oxygen and inhaled anaesthetic agent consumption. STUDY DESIGN: Retrospective audit with hypothetical intervention. MATERIALS AND METHODS: Records of 100 consecutive anaesthetics were examined. Consumption of oxygen and inhaled anaesthetic agent were estimated from oxygen flowmeter and vaporiser settings. Carbon dioxide equivalents (kg CO2 e) were calculated. Records were reassessed to identify potential reductions in oxygen flow. Animals >5 kg were assigned to use circle systems set at a maintenance flow of 1 L/min following a short transitional period of higher flow. Animals <5 kg were assigned to Mapleson-A breathing systems at a flow of 1 L/min. Potential reductions in oxygen and inhaled anaesthetic agent consumption and CO2 e were calculated. RESULTS: A total of 14,370 minutes of anaesthesia were audited. Median bodyweight of the animals was 12.1 (interquartile range 5 to 25.8) kg. Median anaesthetic time was 110 (interquartile range 73.8 to 205) minutes. It was estimated 43,132 L of oxygen were used to vaporise 2605 mL of liquid sevoflurane and 1654 mL of liquid isoflurane. Potential oxygen consumption was 16,798 L, lowering sevoflurane consumption to 1123 mL and isoflurane to 589 mL. Using the suggested technique, oxygen and inhaled anaesthetic agent could have been reduced in 97% of anaesthetics with a median inhaled anaesthetic agent reduction of 59% (interquartile range 43 to 71%). Carbon footprint of the inhaled anaesthetic agent used was calculated as 1.82 metric tonnes of CO2 e. This could have been lowered to 0.67 metric tonnes (63% reduction). CLINICAL SIGNIFICANCE: Large reductions in oxygen and inhaled anaesthetic agent consumption and therefore greenhouse gas emission and financial expenditure can be made if we audit and adapt our practices.

EVALUATION OF A LARYNGEAL MASK AIRWAY AS AN ALTERNATIVE TO OROTRACHEAL INTUBATION FOR MAINTAINING AIRWAY PATENCY DURING INHALANT ANESTHESIA UNDER SPONTANEOUS VENTILATION IN CAPYBARAS (HYDROCHOERUS HYDROCHAERIS).

Orotracheal intubation carries greater difficulty in rodents than in most domestic species. The human laryngeal mask airway (LMA) was compared with an endotracheal tube (ETtube) for maintaining airway patency in anesthetized capybaras (Hydrochoerus hydrochaeris). Six capybaras (24-52 kg) were remotely darted with intramuscular ketamine, midazolam, and acepromazine on two occasions (≥7-day intervals). After isoflurane mask induction for random placement of an ETtube or a LMA during each episode, anesthesia was maintained with isoflurane in oxygen under spontaneous ventilation for 90-120 min. Computed tomography of the pharynx and larynx was performed in two of six animals and three of six animals with the ETtube and LMA, respectively. End-tidal isoflurane [median (range)] was not significantly different between ETtube [0.6% (0.5-1.5%)] and LMA [0.6% (0.4-0.9%)]. Heart rate [67 ± 11 beats/min (ETtube) and 67 ± 18 beats/min (LMA)], mean arterial pressure [74 ± 13 mm Hg (ETtube) and 74 ± 14 mm Hg (LMA)], arterial CO2 tension [41 ± 2 mm Hg (ETtube) and 43 ± 4 mm Hg (LMA)], and arterial O2 tension [360 ± 59 mm Hg (ETtube) and 360 ± 63 mm Hg (LMA)] were not significantly different between treatment groups. Computed tomography showed gas in the esophagus with the LMA (three of three animals); the fit of the LMA to the larynx was adequate in two of three animals and fair in one of three animals. Recovery from anesthesia was uneventful. The LMA is a feasible alternative to the ETtube for maintaining airway patency during inhalant anesthesia in spontaneously breathing capybaras. However, the LMA may be dislodged during movement of the animal.

ISOFLURANE RESPIRATORY ANESTHETIC INDEX IN CHICKENS (GALLUS GALLUS DOMESTICUS).

Respiratory depression from isoflurane seems to be greater in birds than in mammals. Isoflurane respiratory anesthetic index (AI) has only been evaluated in ducks (Anas platyrhynchos), which indeed showed a lower AI compared to mammals, but the isoflurane AI for other avian species is not known. The aim of this study was to evaluate the isoflurane AI in chickens (Gallus gallus domesticus). Six adult hens were anesthetized with isoflurane for determination of the minimum anesthetic concentration (MAC) using the bracketing method. During a second anesthetic event, the isoflurane AI was determined by progressively increasing the expired fraction of isoflurane by 0.5 times MAC until apnea was achieved (ETiso-apnea). The isoflurane AI was considered the ratio between the ETiso-apnea and the MAC. Heart rate, systolic arterial pressure, respiratory rate, and end-tidal carbon dioxide were continuously monitored throughout both anesthetic events. Data were analyzed using a mixed-effect model with Greenhouse-Geisser correction, followed by Tukey's test. The MAC for isoflurane was 1.18% ± 0.09% (mean ± SD). The ETiso-apnea was 3.31% ± 0.34% and the isoflurane AI was 2.80 ± 0.26. In chickens, isoflurane AI is similar to that measured in mammals, which is in contrast with published data in other avian species.

Evaluation of supraglottic airway device use during inhalation anesthesia in healthy African pygmy hedgehogs (Atelerix albiventris).

OBJECTIVE: To evaluate a supraglottic airway device (SGAD) designed for rabbits in African pygmy hedgehogs (Atelerix albiventris) during inhalation anesthesia. STUDY DESIGN: Prospective, randomized, blinded experimental study. ANIMALS: A total of 12 adult African pygmy hedgehogs (seven male, five female). METHODS: Hedgehogs were placed in a chamber and anesthesia was induced using isoflurane in oxygen. Oropharyngeal endoscopy was performed and video recorded. The SGAD (v-gel R1) was inserted and connected to a Mapleson D circuit. Capnography, pulse oximetry and physiologic variables were measured during anesthesia, and lung inflation was tested at 10 and 20 cmH2O. With the SGAD temporarily disconnected, anesthetized hedgehogs were randomly positioned into right and left lateral, dorsal and sternal recumbency to evaluate the effect of a change in body position on SGAD placement. Oropharyngeal endoscopy was repeated at the end of anesthesia, and recovery time was recorded. Pre- and post-SGAD placement endoscopy videos were retrospectively reviewed and scored for gross trauma. RESULTS: The median [interquartile range (IQR)] time to successful SGAD placement was 38 (16-68) seconds. The time to SGAD placement decreased as the study progressed. SGAD required repositioning in six hedgehogs, median 2.5 (IQR, 1-3.5) adjustments each, to successfully perform lung inflation or maintain capnography readings. Lung inflation at 10 cmH2O was successfully performed without leakage in nine animals, and in the other three animals after adjusting the SGAD at 1-2 time points. Inflation at 20 cmH2O was rarely achieved without an air leak. Changes in heart and respiratory rates during anesthesia were not clinically relevant. Median endoscopic scores were 0 (no lesions) for both pre-and postplacement. CONCLUSIONS AND CLINICAL RELEVANCE: The SGAD was relatively quickly and easily placed, permitted lung inflation and caused no significant oropharyngeal damage. The SGAD is a practical option for airway management in African pygmy hedgehogs.

Comparison of the Anesthetic Effects of Isoflurane and Sevoflurane Inhalation on the Cardiovascular System of the Common Buzzard (Buteo buteo).

The aim of this study was to compare the effects of isoflurane (ISO) and sevoflurane (SEVO) inhalation anesthesia on the cardiovascular system of the common buzzard (Buteo buteo). Fourteen common buzzards of unknown sex and age, weighing 700-900 g each, were used for the study. The buzzards were randomly divided into an ISO group and a SEVO group, each comprising 7 buzzards. The buzzards were then anesthetized by masked induction with either ISO or SEVO. After induction, all buzzards were intubated with a 2.5-mm-diameter uncuffed endotracheal tube. Anesthesia was maintained with 3% ISO or 4% SEVO in a 3 L/min flow of 100% oxygen. Before induction, immediately after induction, and at intervals of 5, 10, 15, 20, 25, and 30 min after the patients were induced, the heart rate, respiratory rate, and body temperature of the buzzards were recorded. In addition, before and during anesthesia, serum electrolytes (sodium, ionized calcium, and potassium), blood gas measurements (arterial pH, arterial partial pressure of carbon dioxide, arterial partial pressure of oxygen, bicarbonate concentration, and oxyhemoglobin saturation), and hematocrit values were evaluated in the blood samples taken from both the ISO and SEVO groups. A statistically significant decrease in body temperature was observed in both groups. A significant decrease in heart rate was observed in the ISO group. The increases in partial pressure of carbon dioxide and bicarbonate concentration were statistically significant in both groups. The effects of ISO and SEVO anesthesia on the cardiovascular and respiratory system in the buzzards were similar based on the results of this study.

Comparison of isoflurane, sevoflurane, and desflurane as inhalant anesthetics in prairie rattlesnakes (Crotalus viridis).

OBJECTIVE: To characterize induction and recovery characteristics of 3 commonly used inhalant anesthetics in prairie rattlesnakes (Crotalus viridis): isoflurane, sevoflurane, and desflurane. ANIMALS: 12 healthy adult prairie rattlesnakes. PROCEDURES: In a randomized crossover design, snakes underwent anesthetic induction with 5% isoflurane, 8% sevoflurane, or 18% desflurane, with a washout period of ≥ 7 days between anesthetic events. Anesthetic depth parameters were recorded throughout induction and recovery, including time to loss and return of righting reflex, muscle tone, ability to intubate, response to pressure, and time to return to spontaneous respiration. Every 5 minutes throughout the anesthetic procedures, heart rate, respiratory rate, and percentage expired anesthetic gas were recorded. RESULTS: No snakes died during the study. Sevoflurane anesthesia resulted in anesthetic gas avoidance behavior in snakes during induction and had the significantly longest recovery time to extubation and time to return of pressure response, compared with the other inhalant anesthetics. Anesthesia with isoflurane resulted in a significantly longer time to return of righting reflex, compared with sevoflurane or desflurane. No significant difference was noted in time to loss of pressure response among the 3 anesthetic gases. Desflurane anesthesia resulted in the significantly quickest loss of righting reflex among the anesthetic protocols; despite this, 4 of 12 desflurane anesthetized snakes did not achieve an anesthetic plane deep enough for intubation. CONCLUSIONS AND CLINICAL RELEVANCE: Isoflurane and sevoflurane, but not desflurane, inhalation anesthesia resulted in consistent and predictable loss of righting reflex and induction of anesthesia deep enough to allow intubation in snakes.

Effects of isoflurane, remifentanil and dexmedetomidine on selected EEG parameters derived from a Narcotrend Monitor before and after nociceptive stimulation at different MAC multiples in cats.

BACKGROUND: The aim of this prospective and complete cross-over study was to evaluate the effects of isoflurane, remifentanil and dexmedetomidine on EEG parameters derived from the Narcotrend® Monitor before and after nociceptive stimulation at different isoflurane MAC (minimal alveolar concentration) multiples. Seven adult European Domestic Short Hair cats were used. Each cat went through 3 experimental treatments. Group I received isoflurane, group IR received isoflurane and a constant rate infusion (CRI) of remifentanil (18 µg/kg/h IV), and group ID received isoflurane and a CRI of dexmedetomidine (3 µg/kg/h IV). The isoflurane MAC in each group was determined via supramaximal electrical stimulation. The EEG parameters were derived by a Narcotrend Monitor at specific time points before and after nociceptive stimulation at 0.75, 1.0 and 1.5 MAC. The depth of anaesthesia was also assessed by a clinical score. RESULTS: The mean MAC sparing effects in group IR and group ID were 9.8 and 55.2%, respectively. The best correlation of EEG and MAC multiples was found for the Narcotrend Index (NI) in group I (r = - 0.67). The NI was also able to differentiate between 0.75 MAC and 1.5 MAC in group IR. Spectral edge frequency had a lower correlation with MAC multiples in group I (r = - 0.62) but was able to differentiate between 0.75 MAC and 1.5 MAC in groups I and IR, and between 1.0 MAC and 1.5 MAC in group IR. Narcotrend Index, SEF 95 and MF increased significantly after nociceptive stimulation at 1.0 MAC in group I, and SEF 95 increased significantly at 0.75 MAC in group ID. The clinical score correlated closer than any of the EEG parameters with MAC in all groups, with highest correlation values in group I (r = - 0.89). Noxious stimulation led to a significant increase of the clinical score at 0.75 MAC and 1.0 MAC in group I. CONCLUSIONS: The EEG parameters derived from the Narcotrend Monitor show correlation to isoflurane MAC multiples in cats, but the anaesthetic protocol and especially the addition of dexmedetomidine have great influence on the reliability. The Narcotrend Monitor can be used as an additional tool to assess anesthetic depth in cats.

Phenylpiperidine opioid effects on isoflurane minimum alveolar concentration in cats.

Different structurally related phenylpiperidine opioids exhibit different isoflurane-sparing effects in cats. Because minimum alveolar concentration (MAC) in cats is affected only by very high plasma concentrations of some phenylpiperidine opioids, we hypothesized these effects are caused by actions on nonopioid receptors. Using a prospective, randomized, crossover design, six cats were anesthetized with isoflurane, intubated, ventilated, and instrumented. Isoflurane MAC was measured in triplicate using a tail-clamp and bracketing technique. A computer-controlled intravenous infusion using prior pharmacokinetic models targeted plasma concentrations of 60 ng/ml fentanyl, 10 ng/ml sufentanil, or 500 ng/ml alfentanil, and isoflurane MAC was measured in duplicate. Next, naltrexone 0.6 mg/kg was administered to cats hourly during the opioid infusion, and isoflurane MAC was measured in duplicate. Blood was collected during MAC determinations to measure opioid concentrations. Responses were analyzed using repeated measures ANOVA with significance at p < .05. Alfentanil and sufentanil decreased isoflurane MAC by 16.4% and 6.4%, respectively, and these effects were completely reversed by naltrexone. Fentanyl had no significant effect on isoflurane MAC. Alfentanil and sufentanil modestly reduce isoflurane MAC via agonist effects on opioid receptors. However, these effects are too small to justify clinical use of phenylpiperidine opioids as single agents to reduce MAC in cats.

The effect of inspired oxygen concentration on oxidative stress biomarkers in dogs under inhalation anesthesia.

This study investigated oxidative stress biomarkers at 3 different oxygen concentrations in dogs under general anesthesia to determine whether high-concentration oxygen increases oxidative stress. Six healthy beagles were randomly assigned to receive 3 anesthesia protocols (inhalation of 40%, 60%, and 100% oxygen) during 3 hours of general anesthesia with sevoflurane, with at least one week in between each protocol. For each experiment, blood samples were collected at 0, 3, 6, and 24 hours after inhalation of oxygen. Derivatives of reactive oxygen metabolites, biochemical antioxidant potential, superoxide dismutase, and 8-hydroxydeoxyguanosine in the blood did not significantly differ among the 3 groups at any time point. This study is the first comparing high concentrations of oxygen with low concentrations of oxygen for anesthesia in dogs. According to our findings, 100% oxygen may not alter the oxidative stress level in dogs during general anesthesia with sevoflurane for 3 hours.

La présente étude a examiné les biomarqueurs oxydatifs de stress à trois concentrations différentes en oxygène chez des chiens sous anesthésie générale afin de déterminer si des concentrations élevées en oxygène augmentent le stress oxydatif. Six chiens beagles en santé ont été assignés de manière aléatoire pour recevoir trois protocoles d'anesthésie (inhalation de 40 %, 60 % et 100 % d'oxygène) pendant 3 heures d'anesthésie générale avec du sévoflurane, avec au moins une semaine entre chaque protocole. Pour chaque essai, des échantillons sanguins furent prélevés à 0, 3, 6 et 24 heures après l'inhalation d'oxygène. Des dérivés de métabolites oxygène réactif, le potentiel anti-oxydant biochimique, la superoxyde dismutase et le 8-hydroxydéoxyguanosine dans le sang n'ont pas différé significativement parmi les trois groupes à n'importe quel moment. Cette étude est la première à comparer des concentrations élevées en oxygène avec des concentrations faibles en oxygène lors d'anesthésie chez des chiens. Selon nos trouvailles, 100 % d'oxygène ne modifierait pas le niveau de stress oxydatif chez les chiens durant une anesthésie générale avec du sévoflurane pendant 3 heures.(Traduit par Docteur Serge Messier).

Minimum anesthetic concentration of isoflurane and sparing effect of midazolam in Quaker parrots (Myiopsitta monachus).

OBJECTIVE: To determine the effects of midazolam on the minimum anesthetic concentration (MAC) reduction of end-tidal isoflurane concentration (Fe'Iso) measured using an electrical stimulus in Quaker parrots (Myiopsitta monachus). STUDY DESIGN: Randomized crossover experimental study. ANIMALS: A group of six adult Quaker parrots, weighing 98-124 g. METHODS: Birds were anesthetized with isoflurane in oxygen delivered by mask, then tracheally intubated and mechanically ventilated. Three treatments were applied with a 4 day interval between anesthetic events. Each anesthetized bird was administered midazolam (1 mg kg-1; treatment MID1), midazolam (2 mg kg-1; treatment MID2) or electrolyte solution (control) intramuscularly. The treatments were administered using a replicated Latin square design and the observers were blinded. Based on a pilot bird, the starting Fe'Iso was 1.8%. After equilibration for 10 minutes, a supramaximal stimulus was delivered using an electrical current (20 V and 50 Hz for 10 ms) and birds were observed for non-reflex movement. The Fe'Iso was titrated by 0.1% until a crossover event was observed. The MAC was estimated using logistic regression. RESULTS: The MAC of isoflurane (MACISO) was estimated at 2.52% [95% confidence interval (CI), 2.19-2.85] with a range of 1.85-2.65%. MACISO in MID1 was 2.04% (95% CI, 1.71-2.37) and in MID2 was 1.81% (95% CI, 1.48-2.14); reductions in MACISO from control of 19% (p = 0.001) and 28% (p < 0.001), respectively. Heart rate, temperature, sex and anesthetic time were not different among treatments. CONCLUSIONS: Midazolam (1-2 mg kg-1) intramuscularly resulted in a significant isoflurane-sparing effect in response to a noxious stimulus in Quaker parrots without observable adverse effects. CLINICAL RELEVANCE: Midazolam can be used as part of a balanced anesthetic approach using isoflurane in Quaker parrots, and potentially in other psittacine species.

The effect of intravenous maropitant on blood pressure in healthy awake and anesthetized dogs.

OBJECTIVE: To evaluate the effects of intravenous maropitant on arterial blood pressure in healthy dogs while awake and under general anesthesia. DESIGN: Experimental crossover study. ANIMALS: Eight healthy adult Beagle dogs. PROCEDURE: All dogs received maropitant (1 mg kg-1) intravenously under the following conditions: 1) awake with non-invasive blood pressure monitoring (AwNIBP), 2) awake with invasive blood pressure monitoring (AwIBP), 3) premedication with acepromazine (0.005 mg kg-1) and butorphanol (0.2 mg kg-1) intramuscularly followed by propofol induction and isoflurane anesthesia (GaAB), and 4) premedication with dexmedetomidine (0.005 mg kg-1) and butorphanol (0.2 mg kg-1) intramuscularly followed by propofol induction and isoflurane anesthesia (GaDB). Heart rate (HR), systolic (SAP), diastolic (DAP), and mean blood pressures (MAP) were recorded before injection of maropitant (baseline), during the first 60 seconds of injection, during the second 60 seconds of injection, at the completion of injection and every 2 minutes post injection for 18 minutes. The data were compared over time using a Generalized Linear Model with mixed effects and then with simple effect comparison with Bonferroni adjustments (p <0.05). RESULTS: There were significant decreases from baseline in SAP in the GaAB group (p < 0.01) and in MAP and DAP in the AwIBP and GaAB (p < 0.001) groups during injection. A significant decrease in SAP (p < 0.05), DAP (p < 0.05), and MAP (p < 0.05) occurred at 16 minutes post injection in GaDB group. There was also a significant increase in HR in the AwIBP group (p < 0.01) during injection. Clinically significant hypotension occurred in the GaAB group with a mean MAP at 54 ± 6 mmHg during injection. CONCLUSION: Intravenous maropitant administration significantly decreases arterial blood pressure during inhalant anesthesia. Patients premedicated with acepromazine prior to isoflurane anesthesia may develop clinically significant hypotension.