Risk of post-anaesthetic colic in horses anaesthetised with two different anaesthetic protocols : single-centre retrospective study

Nukutuksen jälkeinen ähky on yleisimpiä anestesia-komplikaatioita hevosilla. Erilaisten nukutusprotokollien vaikutusta nukutuksen jälkeisen ähkyn esiintyvyyteen hevosilla on tutkittu vain vähän. Kävimme läpi Helsingin Yliopiston Yliopistollisessa eläinsairaalassa 1.1.2013 – 31.12.2016 ortopediseen leikkaukseen, kastraatioon tai penisamputaatioon isofluraanilla ja joko lidokaiini (n = 106)- tai romifidiini-infuusiolla (n = 127) nukutettujen hevosten potilastiedot. Käytimme yhden muuttujan analyysiä sekä monimuuttuja-analyysiä selvittääksemme nukutuksen jälkeisen ähkyn ja seuraavien tekijöiden välistä yhteyttä: lidokaiini- tai romifidiini-infuusio, asepromatsiiniesilääkitys, hevoselle käytetty opioidi, paikallispuudutuksen käyttö, hevoselle käytetty tulehduskipulääke ja antibiootti, ikä, paino, sukupuoli, asento leikkauksen aikana, leikkauksen vuorokaudenaika, sairaalassaolo ennen leikkausta, vuodenaika, toimenpide, anestesian kesto ja leikkauksen jälkeisen sairaalassaoloajan pituus. Nukutuksen jälkeisen ähkyn esiintyvyys oli 6,87 % (n = 16). Esiintyvyys oli 3,77 % (n = 4) lidokaiini-infuusiolla nukutetuilla hevosilla ja 9.44 % (n = 12) romifidiini-infuusiolla nukutetuilla (p = 0,09). Tutkituista tekijöistä ainoastaan hevosen suuri paino tunnistettiin nukutuksen jälkeiselle ähkylle altistavaksi riskitekijäksi (vetosuhde 1,8 jokaiselle 100 kg:n nousulle painossa). Eri opioidit, asepromatsiini-esilääkitys ja sairaalassaoloaika ennen leikkausta olivat mahdollisia sekoittavia tekijöitä. Emme todenneet merkitseviä eroja nukutuksen jälkeisen ähkyn esiintyvyydessä lidokaiini- ja romifidiini-infuusiolla ja isofluraanilla nukutettujen hevosten välillä. Tarvitaan lisää prospektiivisia tutkimuksia, jotta voidaan paremmin selvittää eri nukutusprotokollien vaikutusta nukutuksen jälkeisen ähkyn esiintyvyyteen.Peer reviewe

Canine mammary tumour cells exposure to sevoflurane : effects on cell proliferation and neuroepithelial transforming gene 1 expression

Objective The influence of perioperative factors, such as anaesthetic and analgesic techniques, on metastatic spread following surgery for primary cancer removal is of growing interest. The present study investigated the effects of sevoflurane on canine mammary tumour cell proliferation (MTT colorimetric assay) and on the expression of neuroepithelial transforming gene 1 (NET1). Study design Prospective controlled in vitro trial. Study material Primary (CIPp) and metastatic canine tubular adenocarcinoma (CIPm) cells. Methods To perform MTT tests, cell lines were seeded at a density of 3000 cells per well and incubated with sevoflurane (1, 2.5 or 4 mM) or only with the culture medium (control). Sevoflurane was added to the cell cultures every hour to avoid changes in drug concentration. MTT assays were performed after 6 hours of exposure obtaining absolute values of absorbance. The RNA isolated from the lysates of the same cell lines underwent quantitative polymerase chain reaction to evaluate NET1 gene expression changes compared with controls. One-or two-way analysis of variance was used as appropriate (p <0.05). Results A significant increase in cell proliferation compared with controls was observed in CIPp treated with lower sevoflurane concentrations, whereas a significant decrease in cell proliferation was found in CIPm treated with all the sevoflurane concentrations. All CIPp treatments did not induce changes in gene expression compared with controls, whereas a significant increase in gene expression was observed in CIPm between controls and the higher sevoflurane concentration. Conclusions and clinical relevance Sevoflurane treatments modified the cell proliferation rate in both cell lines showing an increase or decrease when applied to CIPp or CIPm, respectively. Expression of the NET1 gene increased after treatment with sevoflurane 4 mM in metastatic cells. The role of sevoflurane on cancer recurrence should be further investigated.Peer reviewe

Increases in heart rate and systolic blood pressure in anaesthetized dogs affected with X-linked muscular dystrophy after cisatracurium administration: a retrospective study.

International audienceBackground: Most patients affected with Duchenne muscular dystrophy (DMD) present with arrhythmias and cardiomyopathies. Drugs which potentially may induce tachycardia or hypertension could precipitate acute cardiac failure in these patients and should be avoided. Methods: Thirty anesthesia records of 5 experimental male golden retriever cross-bred dogs affected with X-linked muscular dystrophy (GRDM) a model of DMD, were retrospectively reviewed (DMD group). Anesthesia records were compared with those of 10 golden retriever dogs not affected with muscular dystrophy (control group). Records were excluded if dogs received anticholinergics or vasoactive amines. Anesthesia was induced with fentanyl followed by propofol, both intravenously. After orotracheal intubation all dogs' lungs were mechanically ventilated. Anesthesia was maintained with an infusion of fentanyl and propofol (DMD group) or isoflurane in oxygen (control group). Pure O2 was provided to the DMD group. Cisatracurium (0.1 mg kg-1) was administered intravenously to all dogs. Five-min interval recordings of HR and SAP were obtained. Results: Immediately after the administration of cisatracurium, absolute values for HR and SAP significantly increased by 78.3±37.0 beats minute-1 (115.4±64.9%) and 33.0±28.3 mmHg (33.5±31.2%), respectively, in all DMD dogs, and remained significantly increased for 10 and 30 minutes, respectively. Dogs in the control group did not show significant increases of HR or SAP after cisatracurium administration. All dogs recovered from anesthesia without complications. Conclusion: In this report, increases in HR and SAP could be associated with the administration of cisatracurium in individuals affected with X-linked muscular dystrophy. These cardiovascular changes deserve further investigation

Stereoselective methadone disposition after administration of racemic methadone to anesthetized Shetland ponies assessed by capillary electrophoresis.

The enantioselectivity of the pharmacokinetics of methadone was investigated in anesthetized Shetland ponies after a single intravenous (0.5 mg/kg methadone hydrochloride; n = 6) or constant rate infusion (0.25 mg/kg bolus followed by 0.25 mg/kg/h methadone hydrochloride; n = 3) administration of racemic methadone. Plasma concentrations of l-methadone and d-methadone and their major metabolites, l- and d-2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), respectively, were analyzed by CE with highly sulfated γ-cyclodextrin as chiral selector and electrokinetic analyte injection from liquid/liquid extracts prepared at alkaline pH. In both trials, the d-methadone concentrations were lower than those of l-methadone and the d-EDDP levels were lower than those of L-EDDP. For the case of a single intravenous bolus injection, the plasma concentration versus time profile of methadone enantiomers was analyzed with a two-compartment pharmacokinetic model. l-methadone showed a slower elimination rate constant, a lower body clearance, and a smaller steady-state volume of distribution than d-methadone. d-methadone and d-EDDP were eliminated faster than their respective l-enantiomers. This is the first study that outlines that the disposition of racemic methadone administered to anesthetized equines is enantioselective

Trending ability and limitations of transpulmonary thermodilution and pulse contour cardiac output measurement in cats as a model for pediatric patients

The present study evaluated transpulmonary thermodilution (TPTD) and pulse contour cardiac output (PCCO) both measured by the PiCCO Plus™ monitor (Pulsion Medical Systems, Munich, Germany) against pulmonary artery thermodilution (PATD) in cats as a hemodynamic model for small children. A wide range of cardiac outputs (CO) was simultaneously measured. Accuracy and trending abilities were critically evaluated. Three cats were studied under isoflurane anesthesia and 160 CO measurements were performed with 3 mL ice-cold 5 % dextrose with PATD and TPTD. The results were compared with the PCCO measurement before the bolus measurement. Cardiac output was manipulated from 32 to 224 mL/kg/min by dobutamine, dopamine, phenylephrine, medetomidine and increased concentrations of isoflurane. Bland–Altman analysis, concordance and polar plot analysis were performed to assess accuracy and trending ability. TPTD was measuring constantly higher than PATD with a mean bias of 73 mL/kg/min and limits of agreement of 34–112 mL/kg/min, a concordance rate of 94 % and a mean polar angle of −5° with radial limits of agreement (RLOA) of 33°. Concordance rate of the PCCO versus PATD was 82 % with a mean polar angle of −10° and RLOA of 46° and versus TPTD 90 % with a mean polar angle of −6° and RLOA of 46°. Both tested methods constantly overestimated simultaneous PATD measurements. The small size, low flows and the relative short catheter not reaching the abdominal aorta may explain that. However TPTD tracked changes accurately opposed to a poor trending ability of the PCCO measurement

Development of a method for analysis of ketamine and norketamine enantiomers in equine brain and cerebrospinal fluid by capillary electrophoresis

Ketamine and norketamine are being transported across the blood brain barrier and are also entering from blood into cerebrospinal fluid (CSF). Enantioselective distributions of these compounds in brain and CSF have never been determined. The enantioselective CE based assay previously developed for equine plasma was adapted to the analysis of these compounds in equine brain via use of an acidic pre-extraction of interferences prior to liquid/liquid extraction at alkaline pH. CSF can be treated as plasma. With 100 mg of brain tissue and 0.5 mL of CSF or plasma, assay conditions for up to 30 nmol/g and 6 μM, respectively, of each enantiomer with LOQs of 0.5 nmol/g and 0.1 μM, respectively, were established and the assays were applied to equine samples. CSF and plasma samples analyzed stemmed from anesthetized patient horses and brain, CSF and plasma were obtained from anesthetized horses that were euthanized with an overdose of pentobarbital. Data obtained indicate that ketamine and norketamine enantiomers are penetrating into brain and CSF with those of ketamine being more favorably transported than norketamine, whereas metabolites of norketamine are hindered. More work is required to properly investigate possible stereoselectivities of the ketamine metabolism and transport of metabolites from blood into brain tissue and CSF

Influence of pre-anaesthetic thoracic radiographs on ASA physical status classification and anaesthetic protocols in traumatized dogs and cats

The purpose of this study was to evaluate if pre-anaesthetic thoracic radiographs contribute to the anaesthetic management of trauma patients by comparing American Society of Anesthesiologists Physical Status Classification (ASA grade) with and without information from thoracic radiography findings. Case records of 157 dogs and cats being anaesthetized with or without post-traumatic, pre-anaesthetic chest radiographs were retrospectively evaluated for clinical parameters, radiographic abnormalities and anaesthetic protocol. Animals were retrospectively assigned an ASA grade. ASA grades, clinical signs of respiratory abnormalities and anaesthesia protocols were compared between animals with and without chest radiographs. The group of animals without pre-anaesthetic radiographs was anaesthetized earlier after trauma and showed less respiratory abnormalities at presentation. The retrospectively evaluated ASA grade significantly increased with the information from thoracic radiography. Animals with a higher ASA grade were less frequently mechanically ventilated. Pre-anaesthetic radiographs may provide important information to assess the ASA grade in traumatized patients and may therefore influence the anesthesia protocol