Cardiovascular effects of constant rate infusions of lidocaine, lidocaine and dexmedetomidine, and dexmedetomidine in dogs anesthetized at equipotent doses of sevoflurane.

This study evaluated the cardiovascular effects of a constant rate infusion (CRI) of lidocaine, lidocaine and dexmedetomidine, and dexmedetomidine in dogs anesthetized with sevoflurane at equipotent doses. Treatments consisted of T1-Lidocaine [loading dose 2 mg/kg body weight (BW), IV, and CRI of 100 µg/kg BW per min] at 1.4% end-tidal of sevoflurane (FESEV); T2-Dexmedetomidine (loading dose 2 µg/kg BW, IV, and CRI of 2 µg/kg BW per hour) and FESEV 1.1%; and T3-Lidocaine-Dexmedetomidine using the same doses of T1 and T2 and FESEV 0.8%. Constant rate infusion of lidocaine did not induce any cardiovascular changes; lidocaine and dexmedetomidine resulted in cardiovascular effects similar to dexmedetomidine alone. These effects were characterized by a significant (P < 0.001) decrease in heart rate, cardiac output, cardiac index, oxygen delivery, and pulmonary vascular resistance index, and a significant (P < 0.001) increase in mean and diastolic arterial pressure, systemic vascular resistance index, pulmonary arterial occlusion pressure and oxygen extraction ratio, compared with baseline values. In conclusion, a CRI of lidocaine combined with dexmedetomidine produces significant cardiovascular changes similar to those observed with dexmedetomidine alone.

Effets cardiovasculaires des infusions constante de taux de lidocaïne, lidocaïne et dexmédétomidine, et dexmédétomidine chez chiens anesthésier at équipotent doses de sevoflurane. L'objet de cette etude a été la evaluation des effets cardo-vasculaires de la perfusion à debit continue (CRI) de lidocaïne, lidocaïene et dexmédétomidine, et dexmédétomidine en chiens anesthésiés avec sévoflurane dans équipotentiel dose. Les traitemets consistèrent á T1-Lidocaïne [dose de charge de 2 mg/kg, IV, et perfusion à debit continue (CRI) de 100 µg/kg/min] en 1,4 % en fin d'expiration du sévoflurane (FESEV); T2-Déxmédetomidine (dose de charge de 2 µg/kg, IV, et perfusion à debit continue (CRI) de 2 µg/kg/h) et FESEV 1,1 % et T3-Lidocaïne-Dexmédétomidine en utilisant la même dose de T1 et T2 et FESEV 0,8 %. Perfusion à debit continue (CRI) de lidocaïne ne induit pas aucun échange cardio-vasculaire; lidocaïne et dexmédétomidine resulta dans effets cardio-vasculaires similaires a dexmédétomidine seule. Ces effets caracterices par significative décroissance (P < 0,001) en fréquence cardiaque, le débit cardiaque, index cardiaque, la libération de l'oxygène, pulmonaire indice de résistance vasculaire, et significative accroissement de la moyenne a la pression artériele diastolique (P < 0,001), indice de résistance vasculaire systémique, et l'extraction d'oxygène. En somme, la perfusion à debit continue (CRI) de lidocaïne produit significative échange cardio-vasculaire similaire à ceux observe en itilisant seulement dexmédétomidine.(Traduit par les auteurs).

Effects of lidocaine, dexmedetomidine or their combination on the minimum alveolar concentration of sevoflurane in dogs.

The aim of this study was to determine the effects of lidocaine (LIDO) and dexmedetomidine (DEX) or their combination (LIDO-DEX), administered by constant-rate infusion (CRI), on the minimum alveolar concentration (MAC) of sevoflurane in dogs. Seven healthy mongrel dogs were used with a 2-week washout interval between treatments in this study. Anesthesia was induced with propofol and maintained with sevoflurane in oxygen, and MAC of sevoflurane was determined after 90 min equilibration period in the dogs (SEV-MACBASAL). Then, sevoflurane MAC was determined again in the dogs after 45 min equilibration period of one of the following treatments: an intravenous loading dose of lidocaine 2 mg/kg followed by 6 mg/kg/hr CRI (SEV-MACLIDO); an intravenous loading dose of dexmedetomidine 2 µg/kg followed by 2 µg/kg/hr CRI (SEV-MACDEX); or their combination (SEV-MACLIDO-DEX). These SEV-MACs were determined in duplicate. Data were analyzed using ANOVA and post hoc Tuckey test when appropriate. The SEV-MACBASAL was 1.82 ± 0.06%, SEV-MACLIDO was 1.38 ± 0.08%, SEV-MACDEX was 1.22 ± 0.10%, and SEV-MACLIDO-DEX was 0.78 ± 0.06%. The CRI administration of lidocaine, dexmedetomidine and their combination produced a significant reduction in the MAC of sevoflurane by 26.1 ± 9.0% (P<0.0001), 43.7 ± 11.8% (P<0.0002) and 54.4 ± 9.8% (P<0.0001), respectively. The MAC reduction was significantly greater after the CRI combination of lidocaine and dexmedetomidine when compared with lidocaine CRI (P<0.0001) or dexmedetomidine CRI treatments (P<0.025).

Effects of single hyperinflation using a sustained high pressure manoeuvre during inhalation anaesthesia in horses.

The effect of a single hyperinflation using a sustained high-pressure manoeuvre (SHPM) during inhalation anaesthesia was evaluated in horses. Twenty-eight client-owned male horses were recruited; 14 were operated on in dorsal recumbency and 14 in lateral recumbency. For each category, horses were randomly allocated to either the 'breathing spontaneously' or 'mechanically ventilated' group. After 30 min of anaesthesia, baseline cardiorespiratory parameters were collected and a SHPM of 50 cmH2O during 50s was undertaken. In the group of horses breathing spontaneously and positioned in dorsal recumbency, venous admixture developed significantly more than in other groups and a single SHPM only partially and transiently improved arterial oxygenation. No benefit of the respiratory manoeuvre was observed in the other groups.

Isoflurane but not halothane minimum alveolar concentration-sparing response of dexmedetomidine is enhanced in rats chronically treated with selective α2-adrenoceptor agonist.

Halothane minimum alveolar concentration (MAC)-sparing response is preserved in rats rendered tolerant to the action of dexmedetomidine. It has been shown that halothane and isoflurane act at different sites to produce immobility. The authors studied whether there was any difference between halothane and isoflurane MAC-sparing effects of dexmedetomidine in rats after chronic administration of a low dose of this drug. Twenty-four female Wistar rats were randomly allocated into four groups of six animals: two groups received 10 µg/kg intraperitoneal dexmedetomidine for five days (treated groups) and the other two groups received intraperitoneal saline solution for five days (naive groups) prior to halothane or isoflurane MAC determination (one treated and one naive group of halothane and one treated and one naive group of isoflurane). Halothane or isoflurane MAC determination was performed before (basal) and 30 min after an intraperitoneal dose of 30 µg/kg of dexmedetomidine (post-dex) from alveolar gas samples at the time of tail clamp. Administration of an acute dose of dexmedetomidine to animals that had chronically received dexmedetomidine resulted in a MAC-sparing effect that was similar to that seen in naive animals for halothane; however, the same treatment increased the MAC-sparing response of dexmedetomidine for isoflurane. Isoflurane but not halothane MAC-sparing response of acutely administered dexmedetomidine is enhanced in rats chronically treated with this drug.

Cardiorespiratory and minimum alveolar concentration sparing effects of a continuous intravenous infusion of dexmedetomidine in halothane or isoflurane-anaesthetized rats.

Dexmedetomidine (DEX) is a highly selective alpha(2)-adrenoceptor agonist in both the central and peripheral nervous systems. Its cardiorespiratory effects have been described; however, these effects have not been reported when it is used in combination with volatile anaesthetics in rats. The cardiovascular and respiratory actions of a continuous intravenous infusion of 0.25 microg/kg/min of DEX administered to rats anaesthetized at 1 minimum alveolar concentration (MAC) of either halothane (HAL) or isoflurane (ISO) were studied. Twenty-eight rats were grouped into four treatment groups: HAL alone, ISO alone, DEX + HAL and DEX + ISO. The MAC(HAL) or MAC(ISO) was determined in each rat from alveolar gas samples at the time of tail clamping. Control MAC values, expressed as mean +/- standard deviation, were 1.31 +/- 0.1% for HAL and 1.46 +/- 0.05% for ISO. DEX reduced HAL MAC from 1.31 +/- 0.1% to 0.36 +/- 0.22% (72 +/- 17% MAC reduction) and ISO MAC from 1.46 +/- 0.05% to 0.83 +/- 0.2% (43 +/- 14% MAC reduction). Heart rate (HR) was decreased in both DEX groups at 1 MAC, with no differences between HAL and ISO. The mean arterial pressure was significantly depressed in the DEX + ISO group compared with the ISO only group. This difference in mean arterial blood pressure (MABP) was not seen between the DEX + HAL and HAL only groups. Respiratory depression was minor at 1 MAC with both inhalant anaesthetics. DEX reduced the MAC of HAL to a degree greater than it decreased the MAC of ISO. The effects of DEX on HR and ventilation were similar in rats anaesthetized with HAL or ISO at 1 MAC; however, hypotension was more pronounced when DEX was combined with ISO at 1 MAC.