Electroencephalogram of Healthy Horses During Inhaled Anesthesia.

BackgroundPrevious study of the diagnostic validity of electroencephalography (EEG) to detect abnormalities in equine cerebral cortical function relied on the administration of various drugs for sedation, induction, and maintenance of general anesthesia but used identical criteria to interpret recordings.ObjectivesTo determine the effects of 2 inhalation anesthetics on the EEG of healthy horses.AnimalsSix healthy horses.MethodsProspective study. After the sole administration of one of either isoflurane or halothane at 1.2, 1.4, and 1.6 times the minimum alveolar concentration, EEG was recorded during controlled ventilation, spontaneous ventilation, and nerve stimulation.ResultsBurst suppression was observed with isoflurane, along with EEG events that resembled epileptiform discharges. Halothane results were variable between horses, with epileptiform-like discharges and bursts of theta, alpha, and beta recorded intermittently. One horse died and 2 were euthanized as the result of anesthesia-related complications.Conclusions and clinical importanceThe results of this study indicate that the effects of halothane and isoflurane on EEG activity in the normal horse can be quite variable, even when used in the absence of other drugs. It is recommended that equine EEG be performed without the use of these inhalation anesthetics and that general anesthesia be induced and maintained by other contemporary means

Desflurane Selectively Suppresses Long-latency Cortical Neuronal Response to Flash in the Rat

Background—The effect of inhalational anesthetics on sensory-evoked unit activity in the cerebral cortex has been controversial. Desflurane has desirable properties for in vivo neurophysiologic studies but its effect on cortical neuronal activity and neuronal responsiveness is not known. We studied the effect of desflurane on resting and visual evoked unit activity in rat visual cortex in vivo. Methods—Desflurane was administered to adult albino rats at steady-state concentrations at 2%, 4%, 6% and 8%. Flashes from a light emitting diode were delivered to the left eye at 5-second intervals. Extracellular unit activity within the right visual cortex was recorded using a 49-electrode array. Individual units were identified using principal components analysis. Results—At 2% desflurane 578 active units were found. Of these, 75% increased their firing rate in response to flash. Most responses contained early (0–100ms) and late (150–1000ms) components. With increasing desflurane concentration, the number of units active at baseline decreased (−13%), the number of early responding units increased (+31%), and number of late responding units decreased (−15%). Simultaneously, baseline firing rate decreased (−77%), the early response was unchanged, and the late response decreased (−60%). Conclusions—The results indicate that visual cortex neurons remain responsive to flash stimulation under desflurane anesthesia but the long-latency component of their response is attenuated in a concentration-dependent manner. Suppression of the long-latency response may be related to a loss of cortico-cortical feedback and loss of consciousness

USE OF INHALANT ANESTHETICS IN THREE SNAKE SPECIES

Different snake species respond differently to various anesthetic agents. Hence, an anesthetic procedure developed for one species cannot necessarily be safely transferred to another species. The goal of this paper is to summarize our experience using inhalant anesthetics on three snake species, including both procedures that were successful and those we found to be less satisfactory. We found isoflurane delivered with a precision vaporizer to be the best agent to anesthetize black rat snakes (Elaphe o. obsoleta). Sex and mass did not seem to affect induction times in black rat snakes, but larger female rat snakes recovered faster from anesthesia than smaller females. Halothane delivered in the open method provided consistent anesthesia in northern water snakes (Nerodia s. sipedon), although it caused some mortality and should not be used on debilitated patients. Halothane delivered with a precision vaporizer may be used to anesthetize eastern massasauga rattlesnakes (Sistrurus c. catenatus). However, care must be taken to prevent mortality resulting from anesthetic overdose. Sex and mass had no effect on induction and recovery times in the rattlesnakes, but stressed animals require longer induction and recovery times

Review of hypoxaemia in the anaesthetized horse: predisposing factors, consequences and management

Objectives: To discuss how hypoxaemia might be harmful and why the horse is particularly predisposed to developing it. To review the strategies that are used to manage hypoxaemia in anaesthetised horses, to describe how successful these strategies are and the adverse events associated with them. Databases used: Google Scholar and PubMed using the search terms – horse; pony; exercise; anaesthesia; hypoxaemia; oxygen; mortality; morbidity; ventilation perfusion mismatch. Conclusions: Although there is no evidence that hypoxaemia is associated with increased morbidity and mortality in anaesthetised horses, most anaesthetists would agree that it is important to recognise and prevent or treat it. The favourable anatomical and physiological adaptations of the horse for exercise, adversely affect gas exchange once the animal is recumbent. Hypoxaemia is recognised more frequently than in other domestic species during general anaesthesia, although its incidence in healthy horses remains unreported. The management of hypoxaemia in anaesthetised horses is challenging and often unsuccessful. Positive pressure ventilation strategies to address alveolar atelectasis in humans have been modified for implementation in the recumbent anaesthetised horse, but are often accompanied by unpredictable and unacceptable cardiopulmonary adverse effects, and some strategies are difficult or impossible to achieve in adult horses. Furthermore, the anticipated beneficial effects of these techniques are inconsistent. Increasing the inspired fraction of oxygen during anaesthesia is often unsuccessful since much of the impairment in gas exchange is a direct result of shunt. Alternative approaches to the problem involve the manipulation of pulmonary blood away from atelectatic regions of lung to better ventilated areas. However, further work is essential, with particular focus upon survival associated with general anaesthesia in the horse, before any technique can be accepted into widespread clinical use

Molecular genetic analysis for malignant hyperthermia : a thesis presented to Massey University in partial fulfilment of the requirements for the degree of Master of Science in Biochemistry

Malignant hyperthermia (MH) is a rare pharmacogenetic disorder in humans caused by inhalational general anaesthetics and depolarising muscle relaxants. An MH reaction shows abnormal calcium homeostasis in skeletal muscle leading to a hypermetabolic state and increased muscle contracture. A mutation within the calcium release channel ryanodine receptor of skeletal muscle (RYR1) is one of the causes of MH leading to the abnormally high release of calcium ions into the cytosol during MH reactions. The MH reaction can also be triggered by excess exercise, heat and stress. A New Zealand male, identified as M818, showed a fulminant MH reaction which resulted in death. The reaction was caused by exercise, and he did not have a family history of MH. As this individual did not have any of the mutations within RYR1 found to date in New Zealand families, the entire RYR1 cDNA was screened for a novel mutation that may result in susceptibility to exercise-induced MH. This patient may have had a novel RYRl mutation because exercise-induced MH is quite rare. Screening of this gene, however did not identify any mutations within RYR1 suggesting that the M818 patient may have a mutation in another gene because MH is a heterogeneous disorder with 40-50% of families showing linkage to alternative loci. Heterogeneity of MH can result in discordance between genotype and phenotype. Some MH susceptible patients do not have a RYR1 mutation that is found in other individuals with the same kindred. One or more other genes could be associated with MH for these individuals although alternative loci have not been studied in New Zealand families. A genome-wide scan was performed to search for other candidate loci using a large MH kindred known as the CH family within which discordance has been observed. Non-parametric linkage analysis across all chromosomes identified five weak linkages from one branch, and two strong linkages from another branch of the CH family. Secondary linkage analysis was performed on one candidate locus identified in the genome-wide scan, and a weak linkage and recombination was observed within the shorter region. No candidate genes with obvious relevance to calcium homeostasis or signalling were identified within this region. The existence of alternative causative loci in this family cannot be ruled out however, because the loci identified from the genome-wide scan are very large and contain many genes of unknown function

Halothane hepatitis with renal failure treated with hemodialysis and exchange transfusion

A 38-year-old white female, hepatitis B antigen negative, developed fluminating hepatic failure associated with oliguria and severe azotemia after two halothane anesthesia and without exposure to other hepatotoxic drugs or blood transfusions. She was treated with multiple hemodialysis and exchange blood transfusion. The combined treatment corrected the uremic abnormalities and improved her level of consciousness. The liver and kidney function gradually improved, and she made a complete recovery, the first recorded with hepatic and renal failure under these post-anesthetic conditions. Further evaluation of this combined treatment used for this patient is warranted. © 1974 The Japan Surgical Society

Mechanisms of Volatile Anesthetic-Induced Myocardial Protection

Volatile anesthetics protect myocardium against reversible and irreversible ischemic injury. Experimental evidence from several in vitro and in vivo animal models demonstrates that volatile agents enhance the recovery of stunned myocardium and reduce the size of myocardial infarction after brief or prolonged coronary artery occlusion and reperfusion, respectively. This protective effect persists after the anesthetic has been discontinued, a phenomenon known as anesthetic-induced preconditioning (APC). Recent clinical data also demonstrates evidence of APC in patients during cardiac surgery. Thus, administration of volatile anesthetics may represent a novel therapeutic approach that reduces morbidity and mortality associated with perioperative myocardial ischemia and infarction. The mechanisms responsible for APC appear to be similar to those implicated in ischemic preconditioning, but nonetheless have subtle differences. Accumulating evidence indicates that APC is characterized by complex signal transduction pathways that may include adenosine receptors, G proteins, protein kinase C, reactive oxygen species, and sarcolemmal or mitochondrial KATP channels. Opioid analgesics may further enhance APC as well. This article will review recent advances in the understanding of mechanisms responsible for volatile anesthetic-induced myocardial protection

Cardiac arrest in a child during a combined general epidural anesthesia procedure

An increased risk of perioperative cardiac arrest in children, in comparison to adults, has been recognized. A number of factors associated with perioperative cardiac arrest have been identified, including young age, comorbidities, and emergency surgery. Since anesthesia-related cardiac arrest is uncommon, a multi-related database is required to understand the mechanisms of cardiac arrest and to develop preventive strategies. Most cardiac arrests occur during induction (37%) or maintenance (45%) of anesthesia, usually following one or more of the following antecedent events, i.e., bradycardia (54%), hypotension (49%), abnormality of oxygen saturation as measured by pulse oximetry (48%), inability to measure blood pressure (25%), abnormality of endtidal CO2 (21%), cyanosis (21%), or arrhythmia (18%). In 11% of cases, cardiac arrest occurred without recognized warning.1 There are only few reports in the literature, and in Kariadi Hospital, none has ever been reported. The aim of this report is to identify and discuss possible causes of cardiac arrest and to anticipate its complications

The possibility of positive selection for both F18(+) Escherichia coli and stress resistant pigs opens new perspectives for pig breeding

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