Suitability of lingual venous blood to determine the acid-base and blood gas status of dogs under anesthesia

Pre-print file deposited according to publisher conditions in SHERPA/RoMEO, January 4, 2011.Ye

A study of cardiovascular function under controlled and spontaneous ventilation in isoflurane-medetomidine anaesthetized horses

OBJECTIVE: To determine, in mildly hypercapnic horses under isoflurane-medetomidine balanced anaesthesia, whether there is a difference in cardiovascular function between spontaneous ventilation (SV) and intermittent positive pressure ventilation (IPPV). STUDY DESIGN: Prospective randomized clinical study. ANIMALS: Sixty horses, undergoing elective surgical procedures under general anaesthesia: ASA classification I or II. METHODS: Horses were sedated with medetomidine and anaesthesia was induced with ketamine and diazepam. Anaesthesia was maintained with isoflurane and a constant rate infusion of medetomidine. Horses were assigned to either SV or IPPV for the duration of anaesthesia. Horses in group IPPV were maintained mildly hypercapnic (arterial partial pressure of carbon dioxide (PaCO(2)) 50-60 mmHg, 6.7-8 kPa). Mean arterial blood pressure (MAP) was maintained above 70 mmHg by an infusion of dobutamine administered to effect. Heart rate (HR), respiratory rate (f(R)), arterial blood pressure and inspiratory and expiratory gases were monitored continuously. A bolus of ketamine was administered when horses showed nystagmus. Cardiac output was measured using lithium dilution. Arterial blood-gas analysis was performed regularly. Recovery time was noted and recovery quality scored. RESULTS: There were no differences between groups concerning age, weight, body position during anaesthesia and anaesthetic duration. Respiratory rate was significantly higher in group IPPV. Significantly more horses in group IPPV received supplemental ketamine. There were no other significant differences between groups. All horses recovered from anaesthesia without complications. CONCLUSIONS: There was no difference in cardiovascular function in horses undergoing elective surgery during isoflurane-medetomidine anaesthesia with SV in comparison with IPPV, provided the horses are maintained slightly hypercapnic. CLINICAL RELEVANCE: In horses with health status ASA I and II, cardiovascular function under general anaesthesia is equal with or without IPPV if the PaCO(2) is maintained at 50-60 mmHg

Hemodynamic effects of an intravenous infusion of medetomidine at six different dose regimens in isoflurane-anesthetized dogs

abstract: This study investigated the dose dependency of the hemodynamic effects of IV medetomidine (MED) constant-rate infusion (CRI) during isoflurane anesthesia. Twenty-four healthy beagles randomly received one of six MED CRI regimens. A loading dose of MED was administered IV at 0.2, 0.5, 1.0, 1.7, 4.0, or 12.0 µg.kg-1 for 10 minutes, followed by a maintenance CRI providing identical dose amounts over 60 minutes. Heart rate and mean arterial blood pressure were recorded, blood gases were analyzed, and cardiac index (CI) was determined. Statistical analysis involved a repeated measures linear model. Baseline CI demonstrated a dose-dependent decrease as the MED dose increased, with decreases of 14.9% (SD, 12.7%), 21.7% (17.9%), 27.1% (13.2%), 44.2% (9.7%), 47.9% (8.1%), and 61.2% (14.1%) at doses of 0.2, 0.5, 1.0, 1.7, 4.0, and 12.0 µg.kg-1, respectively. The four lowest doses induced limited and transient changes in heart rate, mean arterial pressure, and CI. Further investigation into potential perioperative uses of MED CRI is warranted