RESUMEN
Objectives The aim of the study was to evaluate the cardiorespiratory effects, quality of sedation and recovery of intramuscular alfaxalone-dexmedetomidine-butorphanol (ADB) and ketamine-dexmedetomidine-butorphanol (KDB), in cats. Methods Nine adult, healthy cats (6.63 ± 1.42 kg) were enrolled in a blinded, randomized, crossover experimental design. Cats were sedated twice intramuscularly, once with ADB (alfaxalone 1 mg/kg, dexmedetomidine 0.005 mg/kg, butorphanol 0.2 mg/kg), and once with KDB (ketamine 5 mg/kg, dexmedetomidine 0.005 mg/kg, butorphanol 0.2 mg/kg), in random order. Data collected included heart rate (HR), arterial blood pressure and blood gas analysis, respiratory rate and sedation score. Analysis of variance with Bonferroni post-hoc correction was used for parametric data, and a Wilcoxon signed rank test was used for non-parametric data. Significance was set at P <0.05. Results Total sedation time was shorter for ADB (90.71 ± 15.12 mins vs 147.00 ± 47.75 mins). Peak sedation was observed within 15 mins in both groups. Quality of recovery was excellent in both groups. HR decreased over time in both groups. Diastolic and mean arterial pressure decreased over time for ADB, becoming significant after 30 mins. All cardiovascular variables were within the clinically acceptable range in both groups. Arterial partial pressure of oxygen was significantly decreased from baseline for KDB at all time points (73 ± 2.5 mmHg [9.7 ± 0.3 kPa] vs ADB 83 ± 2.6 mmHg [11 ± 0.3 kPa]). Hypoventilation was not observed. Conclusions and relevance Both protocols produced acceptable cardiovascular stability. Sedation and recovery quality were good, albeit sedation was shorter with ADB. Although oxygenation was better maintained in the ADB group, all sedated cats should receive oxygen supplementation.
Asunto(s)
Anestésicos Combinados/farmacología , Gatos/fisiología , Sedación Consciente/veterinaria , Anestésicos Combinados/administración & dosificación , Animales , Butorfanol/administración & dosificación , Butorfanol/farmacología , Sistema Cardiovascular/efectos de los fármacos , Dexmedetomidina/administración & dosificación , Dexmedetomidina/farmacología , Método Doble Ciego , Quimioterapia Combinada , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Hipnóticos y Sedantes/farmacología , Inyecciones Intramusculares/veterinaria , Ketamina/administración & dosificación , Ketamina/farmacología , Masculino , Pregnanodionas/administración & dosificación , Pregnanodionas/farmacología , Distribución Aleatoria , Resultado del TratamientoRESUMEN
OBJECTIVE: To determine the relationship between tissue oxygen saturation (StO2) and oxygen delivery (DËO2) during hypoxemia and hyperoxemia. STUDY DESIGN: Prospective, randomized study. ANIMALS: Eight purpose-bred Beagle dogs. METHODS: Dogs were anesthetized with isoflurane, ventilated to eucapnia, and instrumented for thermodilution cardiac output, invasive mean arterial pressure (MAP), sartorius muscle StO2 and airway gas monitoring. Dogs were administered rocuronium to facilitate mechanical ventilation and esmolol to minimize anesthetic effects on cardiac output. Instrumentation and baseline data collection were at 0.21 fractional inspired oxygen (FIO2). Dogs were evaluated at high (0.40 then 0.95) and low (0.15 then 0.10) FIO2 sequences in random order with a 60 minute rest period at FIO2 0.21 between sequences. Target FIO2 was achieved by manipulating nitrogen and oxygen flow rates. Data collected at each FIO2, after a 10 minute period of stabilization, included heart rate (HR), MAP, cardiac index (CI) and StO2. Arterial oxygen content (CaO2) and oxygen delivery index (DËO2I) were calculated at each FIO2. Data analysis included Pearson's correlation analysis and mixed-model anova (p < 0.05). RESULTS: There were no significant differences in HR, MAP or CI across all FIO2 values. Significant decreases occurred in mean ± standard deviation StO2 (90 ± 4% to 69 ± 18%; p = 0.0001), DËO2I (458 ± 70 to 281 ± 100 mL minute(-1) m(-2); p = 0.0008) and CaO2 (13.2 ± 1.53 to 8.4 ± 2.05 mL dL(-1); p = 0.0001) from FIO2 0.21 to 0.10, but not at remaining FIO2 values. The correlation between StO2 and DËO2I across all FIO2 values was strong (r = 0.97; p = 0.0013) and linear. CONCLUSIONS AND CLINICAL RELEVANCE: In this model of hypoxemia and hyperoxemia, the strong correlation between StO2 and DËO2I suggests that StO2 can be used to estimate DËO2.
Asunto(s)
Enfermedades de los Perros/metabolismo , Hemoglobinas/metabolismo , Hiperoxia/veterinaria , Hipoxia/veterinaria , Oxígeno/metabolismo , Animales , Perros , Femenino , Hiperoxia/metabolismo , Hipoxia/metabolismo , Masculino , Monitoreo Fisiológico/veterinaria , Espectroscopía Infrarroja Corta/veterinariaRESUMEN
OBJECTIVE: To compare the hemodynamic responses to orotracheal intubation following induction of anesthesia with propofol, ketamine-propofol, and ketamine-diazepam in premedicated dogs. DESIGN: Prospective, randomized, masked study. ANIMALS: 10 healthy adult Beagles. PROCEDURES: Dogs were randomly allocated to be anesthetized twice, with a 1-week wash-out interval, by means of 2 of 3 possible protocols (propofol [4 mg/kg {1.8 mg/lb}, n = 6 dogs], ketamine [2 mg/kg {0.9 mg/lb}] and propofol [2 mg/kg; 7], or ketamine [5 mg/kg {2.3 mg/lb}] and diazepam [0.2 mg/kg {0.09 mg/lb}; 6]). After instrumentation, continuous heart rate, systolic arterial blood pressure, mean arterial blood pressure, diastolic arterial blood pressure, cardiac index, stroke volume index, and systemic vascular resistance were recorded. Fifteen minutes after premedication, dogs were anesthetized; all anesthetics were administered IV. After 5 minutes, orotracheal intubation was performed without the use of a laryngoscope. Data were collected prior to intubation (baseline), at intubation, and 30, 60, 90, 120, 150, and 180 seconds thereafter. Results were compared among the 3 groups and over time. RESULTS: No differences among groups were observed for any variables studied. In all groups, arterial blood pressures were significantly decreased at various time points after intubation. A significant increase in systolic arterial blood pressure was observed between baseline and the 30-second time point in the ketamine-diazepam group. No significant differences were detected over time for the other variables in any group. CONCLUSIONS AND CLINICAL RELEVANCE: Intubation after anesthetic induction with ketamine-diazepam caused transitory hypertension, whereas intubation after induction with propofol or ketamine-propofol did not cause cardiovascular stimulation. In dogs in which hypertension is a concern, propofol or ketamine-propofol may be a better choice for induction prior to orotracheal intubation.
Asunto(s)
Presión Sanguínea/efectos de los fármacos , Diazepam/farmacología , Perros , Intubación/veterinaria , Ketamina/farmacología , Propofol/farmacología , Anestésicos Disociativos/administración & dosificación , Anestésicos Disociativos/farmacología , Anestésicos Intravenosos/administración & dosificación , Anestésicos Intravenosos/farmacología , Animales , Estudios Cruzados , Diazepam/administración & dosificación , Método Doble Ciego , Ketamina/administración & dosificación , Propofol/administración & dosificaciónRESUMEN
OBJECTIVE: To evaluate the cardiorespiratory effects of IV administration of propofol (4 mg/kg), ketamine hydrochloride and propofol (2 mg/kg each; K-P), or ketamine hydrochloride (5 mg/kg) and diazepam (0.2 mg/kg; K-D) before and after induction of anesthesia (IoA) in dogs sedated with acepromazine maleate and oxymorphone hydrochloride. ANIMALS: 10 healthy adult Beagles. PROCEDURES: Each dog was randomly allocated to receive 2 of 3 treatments (1-week interval). For instrumentation prior to each treatment, each dog was anesthetized with isoflurane. After full recovery, acepromazine (0.02 mg/kg) and oxymorphone (0.05 mg/kg) were administered IV. Fifteen minutes later (before IoA), each dog received treatment IV with propofol, K-P, or K-D. Cardiorespiratory and arterial blood gas variables were assessed before, immediately after, and 5 minutes after IoA. RESULTS: Compared with findings before IoA, dogs receiving the K-P or K-D treatment had increased cardiac output, oxygen delivery, and heart rate 5 minutes after IoA; K-P administration did not change mean arterial blood pressure or stroke volume and decreased systemic vascular resistance. Propofol decreased mean arterial blood pressure and systemic vascular resistance immediately after IoA but did not change heart rate, cardiac output, or oxygen delivery. All treatments caused some degree of apnea, hypoventilation, and hypoxemia (Pao2 < 80 mm Hg). CONCLUSIONS AND CLINICAL RELEVANCE: In dogs, K-P treatment maintained mean arterial blood pressure better than propofol alone and increased heart rate, cardiac output, or oxygen delivery, as did the K-D treatment. Supplemental 100% oxygen should be provided during IoA with all 3 treatments.
Asunto(s)
Anestésicos Intravenosos/farmacología , Presión Sanguínea/efectos de los fármacos , Gasto Cardíaco/efectos de los fármacos , Perros/fisiología , Frecuencia Cardíaca/efectos de los fármacos , Acepromazina/administración & dosificación , Acepromazina/efectos adversos , Acepromazina/farmacología , Anestesia/veterinaria , Anestésicos Intravenosos/administración & dosificación , Anestésicos Intravenosos/efectos adversos , Animales , Estudios Cruzados , Diazepam/administración & dosificación , Diazepam/efectos adversos , Diazepam/farmacología , Isoflurano/administración & dosificación , Ketamina/administración & dosificación , Ketamina/efectos adversos , Ketamina/farmacología , Oximorfona/administración & dosificación , Oximorfona/efectos adversos , Oximorfona/farmacología , Propofol/administración & dosificación , Propofol/efectos adversos , Propofol/farmacología , Volumen Sistólico/efectos de los fármacos , Resistencia Vascular/efectos de los fármacosRESUMEN
OBJECTIVE: To evaluate the feasibility and functionality of intra-carotid wireless device implantation in ponies, and to investigate its short-term complications. STUDY DESIGN: Prospective preliminary study. ANIMALS: Five mixed breed, adult, intact male ponies weighing 104 +/- 28.8 kg (mean +/- SD) underwent surgery. Arterial blood pressure data were continuously collected from four animals. METHODS: General anesthesia was induced on two consecutive days. On the first day, an intra-arterial wireless device was implanted in the right carotid artery. On the next day, a transcutaneous intra-arterial catheter was placed in the left facial artery. Data from both sources were collected. Post-mortem examination was performed. RESULTS: Surgical time was 27.1 +/- 11.85 minutes. All catheters remained in place with some extra vascular migration. Complications included mild seroma and hematoma. CONCLUSION: The wireless system allowed continuous monitoring in ponies throughout anesthesia and at rest and may allow for the recording of arterial blood pressure and heart rate when it would be difficult to achieve with a conventional system (e.g. during recovery from anesthesia). CLINICAL RELEVANCE: The wireless invasive blood pressure monitor may allow continuous measurements when only intermittent measurements would be feasible with a wired system.
Asunto(s)
Monitores de Presión Sanguínea/veterinaria , Presión Sanguínea/fisiología , Caballos/fisiología , Monitoreo Intraoperatorio/veterinaria , Animales , Tecnología Biomédica , Masculino , Monitoreo Intraoperatorio/instrumentaciónRESUMEN
OBJECTIVE: To assess the brachial plexus block in chickens by an axillary approach and using a peripheral nerve stimulator. STUDY DESIGN: Prospective, randomized, double-blinded study. ANIMALS: Six, 84-week old, female chickens. METHODS: Midazolam (1 mg kg(-1)) and butorphanol (1 mg kg(-1)) were administered into the pectoralis muscle. Fifteen minutes later, the birds were positioned in lateral recumbency and following palpation of the anatomic landmarks, a catheter was inserted using an axillary approach to the brachial plexus. Lidocaine or bupivacaine (1 mL kg(-1)) was injected after plexus localization by the nerve stimulator. Sensory function was tested before and after blockade (carpus, radius/ulna, humerus and pectoralis muscle) in the blocked and unblocked wings. The latency to onset of motor and sensory block and the duration of sensory block were recorded. A Friedman nonparametric one-way repeated-measures ANOVA was used to compare scores from baseline values over time and to compare the differences between wings at each time point. RESULTS: A total of 18 blocks were performed with a success rate of 66.6% (12/18). The latency for motor block was 2.8 +/- 1.1 and 3.2 +/- 0.4 minutes for lidocaine and bupivacaine, respectively. The latencies for and durations of the sensory block were 6.0 +/- 2.5 and 64.0 +/- 18.0 and 7.8 +/- 5.8 and 91.6 +/- 61.7 minutes for lidocaine and bupivacaine, respectively. There was no statistical difference between these times for lidocaine or bupivacaine. Sensory function was not abolished in nonblocked wings. CONCLUSIONS AND CLINICAL RELEVANCE: The brachial plexus block was an easy technique to perform but had a high failure rate. It might be useful for providing anesthesia or postoperative analgesia of the wing in chickens and exotic avian species that have similar wing anatomy.
Asunto(s)
Plexo Braquial/efectos de los fármacos , Butorfanol/farmacología , Pollos , Midazolam/farmacología , Bloqueo Nervioso/veterinaria , Adyuvantes Anestésicos/administración & dosificación , Adyuvantes Anestésicos/farmacología , Analgesia/veterinaria , Analgésicos Opioides/administración & dosificación , Analgésicos Opioides/farmacología , Animales , Butorfanol/administración & dosificación , Femenino , Midazolam/administración & dosificación , Bloqueo Nervioso/métodosRESUMEN
A 6-year-old, neutered male, Pembroke Welsh corgi was presented for hind limb paralysis. After anesthetic induction, marked cyanosis and hypotension were noted. Diaphragmatic hernia was diagnosed based upon radiographic findings. Risks and complications associated with undiagnosed diaphragmatic hernia and the importance of thorough physical examination and patient assessment are discussed.