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Biomedical subjects

J E Ilkiw

Publications and source records attributed to J E Ilkiw.

At least 19 recordsLinked to original sources

Animal dependence of inhaled anaesthetic requirements in cats.

BACKGROUND: The minimum alveolar concentration (MAC) of an inhaled anaesthetic describes its potency as a general anaesthetic. Individuals vary in their sensitivity to anaesthetics and we sought to determine whether an individual animal's sensitivity to inhaled anaesthetics would be maintained across different agents. METHODS: Six female mongrel cats, age 2 yr (range 1.8-2.3) and mean weight 3.5 (SD 0.3) kg, were studied on three separate occasions over a 12-month period to determine the MAC of isoflurane, sevoflurane and desflurane. Induction of anaesthesia in a chamber was followed by orotracheal intubation and maintenance of anaesthesia with the inhaled agent in oxygen delivered via a non-rebreathing circuit. MAC was determined in triplicate using standard tail-clamp technique. RESULTS: Mean MAC values for isoflurane, sevoflurane and desflurane were 1.90 (SD 0.18), 3.41 (0.65) and 10.27 (1.06)%, respectively. Body temperature, systolic pressure and Sp(O(2)) recorded at the time of MAC determinations for isoflurane, sevoflurane and desflurane were 38.3 (0.3), 38.6 (0.1) and 38.3 (0.3) degrees C; 71.2 (8.3), 74.6 (15.9) and 88.0 (12.0) mmHg; 99.2 (1.1), 99.1 (1.3) and 99.4 (0.8)%, respectively. Both the anaesthetic agent and the individual cat had significant effects on MAC. Correlation coefficients for comparisons between desflurane and isoflurane, desflurane and sevoflurane, and sevoflurane and isoflurane were 0.90, 0.89 and 0.97, respectively. CONCLUSIONS: These findings show that an individual has a consistent degree of sensitivity to a variety of inhaled anaesthetics, suggesting a genetic basis for sensitivity to inhaled anaesthetic effects.

Anesthetics, Inhalation↗

The effect of intravenous administration of variable-dose flumazenil after fixed-dose ketamine and midazolam in healthy cats.

The effects of intravenous administration of variable-dose flumazenil (0, 0.001, 0.005, 0.01, and 0.1 mg/kg) after ketamine (3 mg/kg) and midazolam (0.0 and 0.5 mg/kg) were studied in 18 healthy unmedicated cats from time of administration until full recovery. End-points were chosen to determine whether flumazenil shortened the recovery period and/or modified behaviors previously identified and attributed to midazolam. Overall, flumazenil administration had little effect on recovery or behaviors. One minute after flumazenil administration, all cats were recumbent but a greater proportion of cats which received the highest dose assumed sternal recumbency with head up than any other group. Although not significant, those cats that received the highest flumazenil dose also had shorter mean times for each of the initial recovery stages (lateral recumbency with head up, sternal recumbency with head up and walking with ataxia) than any of the other treatment groups that received midazolam. For complete recovery, flumazenil did decrease the proportion of the cats that was sedated, but did not shorten the time to walking without ataxia. Based on this study, the administration of flumazenil in veterinary practice, at the doses studied, to shorten and/or improve the recovery from ketamine and midazolam in healthy cats cannot be recommended.

Anesthetics, Intravenous↗

Balanced anesthetic techniques in dogs and cats.

The term "balanced anesthesia" refers to the use of a mixture of drugs, such that the advantages of small amounts of drugs are used without having to contend with the disadvantages of large doses of any one drug. In veterinary practice, inhalant drugs are usually administered alone to maintain anesthesia, and balanced anesthetic techniques are rare. Unfortunately, cardiopulmonary function is reduced in dose-dependent fashion by inhalant drugs and deepening the level of anesthesia in order to modify autonomic responses to noxious stimuli may increase morbidity and mortality. This article justifies the use of balanced anesthetic techniques in veterinary practice and describes the advantages gained by the use of nitrous oxide, continuous opioid infusion, epidural/spinal opioid administration, and transdermal opioid administration. These techniques, described in detail in the article, are easy to learn, relatively inexpensive, may decrease patient morbidity and mortality, and will provide the veterinarian with smoother operating conditions.

Anesthesia↗

Assessment of isoflurane-induced anesthesia in ferrets and rats.

OBJECTIVE: To characterize isoflurane (ISO)-induced anesthesia in ferrets and rats. ANIMALS: 8 ferrets (Mustela putorius furo) and 8 Sprague-Dawley rats. PROCEDURE: Ferrets and rats were anesthetized in a similar manner, using ISO in oxygen. Minimum alveolar concentration (MAC) was determined, using the tail-clamp method. Immediately thereafter, assessments were recorded for 0.8, 1.0, 1.5, and 2.0 MAC (order randomized) of ISO. RESULTS: MAC of ISO was (mean +/- SEM) 1.74 +/- 0.03 and 1.58 +/- 0.05% for ferrets and rats, respectively. Mean arterial blood pressure (MAP) was 75.0 +/- 4.3 and 107.9 +/- 2.7 mm Hg at 0.8 MAC for ferrets and rats, respectively, and decreased in a parallel dose-dependent manner. Respiratory frequency decreased in rats as ISO dose increased; however, respiratory frequency increased in ferrets as ISO dose increased from 0.8 to 1.5 MAC but then decreased at 2.0 MAC. At 0.8 MAC, hypoventilation was much greater in ferrets (PaCO2 = 71.4 +/- 3.5 mm Hg), compared with rats (PaCO2 = 57.7 +/- 1.9 mm Hg). In both species, PaCO2 progressively increased as anesthetic dose increased. Eyelid aperture of ferrets increased in a dose-dependent manner. Pupil diameter in ferrets and rats increased as ISO dose increased. CONCLUSIONS AND CLINICAL RELEVANCE: The MAP and PaCO2 in ferrets and rats and eyelid aperture in ferrets consistently and predictably changed in response to changes in anesthetic dose of ISO. Magnitude of respiratory depression was greater in ferrets than rats. Changes in MAP and PaCO2 in ferrets and rats and eyelid aperture in ferrets are consistent guides to changes in depth of ISO-induced anesthesia.

Anesthetics, Inhalation↗

Comparison of clinical signs and hemodynamic variables used to monitor rabbits during halothane- and isoflurane-induced anesthesia.

OBJECTIVE: To characterize variables used to monitor rabbits during inhalation anesthesia. ANIMALS: 8 male New Zealand White rabbits. PROCEDURE: Rabbits were similarly anesthetized with halothane (HAL) or isoflurane (ISO) in a crossover study; half received HAL followed by ISO, and the protocol was reversed for the remaining rabbits. After induction, minimum alveolar concentration (MAC) was determined for each agent, using the tail-clamp method, and variables were recorded at 0.8, 1.0, 1.5, and 2.0 MAC (order randomized). RESULTS: Mean +/- SEM MAC was 1.42 +/- 0.05 and 2.07 +/- 0.09% for HAL and ISO, respectively. Directly measured auricular mean arterial blood pressure was 52.8 +/- 5.6 and 54.8 +/- 6.1 mm Hg at 0.8 MAC for HAL and ISO, respectively, and decreased from these values in a parallel dose-dependent manner. Respiratory frequency remained constant (range, 69 to 78 breaths/min) over the range of HAL doses but incrementally decreased from a mean of 53 (at 0.8 MAC) to 32 breaths/min (at 2.0 MAC) for ISO. The PaCO2 was similar at 0.8 MAC for HAL and ISO and progressively increased with increasing doses of both agents; PaCO2 at 2.0 MAC for ISO was significantly greater than that at 2.0 MAC for HAL (79.8 +/- 13.7 vs 54.9 +/- 4.0 mm Hg, respectively). Eyelid aperture consistently increased in a dose-dependent manner for both anesthetics. CONCLUSIONS: Arterial blood pressure, PaCO2, and eyelid aperture consistently and predictably changed in rabbits in response to changes in anesthetic doses. The magnitude of respiratory depression was greater for ISO than for HAL.

Anesthesia, Inhalation↗

The optimal intravenous dose of midazolam after intravenous ketamine in healthy awake cats.

The effects of intravenous administration of variable-dose midazolam (0, 0.05, 0.075, 0.1, 0.3 and 0.5 mg/kg) and ketamine (3 mg/kg) were studied in twenty-four healthy unmedicated cats from time of administration until full recovery. End-points were chosen to determine the optimal dose to allow a short period of restraint without noxious stimuli, a short period of restraint with noxious stimuli and endotracheal intubation. Recovery characteristics, as well as undesirable behaviours observed during recovery, were also recorded. The dose of midazolam to achieve lateral recumbency with head down was found to be 0.016 mg/kg in 50% of the population (ED50) and 0.054 mg/kg in 95% (ED95) of the population. A midazolam dose of 0.286 mg/kg was required to prevent conscious perception of a stimulus to the ulnar nerve in 50% of the population and 0.652 mg/kg in 95% of the population. The ED50 and ED95 of midazolam required to prevent swallowing in response to a laryngoscope placed on the back of the tongue were found to be 0.265 mg/kg and 0.583 mg/kg, respectively. The ED50 doses of 0.265 mg/kg for intubation and 0.286 mg/kg for restraint with noxious stimulation were close to the tested dose of 0.3 mg/kg. At that dose, the lack of responses lasted 3.67 +/- 2.27 min for laryngoscope and 2.50 +/- 2.20 min for ulnar nerve stimulation, with recovery to walking with ataxia taking 41.50 +/- 15.18 min and complete recovery taking 3.6 +/- 1.3 h. The predominant behavioural pattern during recovery was found to be normal, but some cats also exhibited abnormal behavioural patterns. Nine of the twelve cats exhibited an abnormal arousal state, with 4 being restless and 5 being sedated. Seven of the twelve cats exhibited an abnormal behaviour when approached, with three of the cats being more difficult to approach and four of the cats being easier to approach. Eight of the twelve cats exhibited an abnormal behavioural pattern when restrained, with the cats equally divided between more difficult and easier to restrain. Five of the twelve cats vocalized more during the recovery. The ED50 of 0.042 mg/kg to induce chemical restraint without a noxious stimulus is close to the tested dose of 0.05 mg/kg. At that dose, cats remained lateral with head down for 5.49 +/- 4.02 min, took 25.96 +/- 5.77 min to walk with ataxia and 1.7 +/- 0.4 h for complete recovery. The predominant behavioural patterns during recovery were normal, with several cats exhibiting some abnormal patterns. Two cats were sedated, one cat was more difficult to approach, one cat was easier to restrain and three cats were more vocal.

Anesthetics, Dissociative↗

Cardiovascular effects of equipotent isoflurane and alfentanil/isoflurane minimum alveolar concentration multiple in cats.

OBJECTIVE: To determine whether administration of opioids to anesthetized cats induced less cardiovascular depression than that induced by an equivalent amount of anesthetic alone, and to measure endocrine responses to a noxious stimulus. ANIMALS: 6 healthy female cats. PROCEDURE: Anesthesia was induced with isoflurane and was maintained for 60 minutes at 1.3 isoflurane MAC. Blood gas tensions, pH, and plasma alfentanil and hormone concentrations, blood pressures, and cardiac output were measured. A noxious stimulus was applied for 5 minutes, while blood acquisition and measurements were repeated. Alfentanil was administered i.v. to achieve estimated plasma concentration of 500 ng/ml, and end-tidal isoflurane concentration was reduced by 35%. After another 60 minutes, blood was obtained and measurements were taken, then a second 5-minute noxious stimulus was applied while blood acquisition and measurements were retaken. RESULTS: Alfentanil administration and reduction of isoflurane concentration significantly increased body temperature, heart rate, mean arterial pressure, mean pulmonary arterial pressure, stroke index, cardiac index, hemoglobin, oxygen delivery index, PvO2 and PvCO2, dopamine, epinephrine (EPI), norepinephrine (NOREPI), and cortisol values, and significantly decreased arterial and venous pH. Application of a noxious stimulus significantly increased heart rate, stroke index, cardiac index, PaO2, oxygen delivery index, arterial and venous pH, and NOREPI values, and decreased bicarbonate, PaCO2, PvCO2, and EPI values. Alfentanil administration blunted cardiac index, PaCO2, oxygen delivery index, arterial pH, PaO2, and EPI, and NOREPI responses to a noxious stimulus. CONCLUSIONS: Compared with isoflurane alone, alfentanil administration and reduction of isoflurane MAC improved cardiovascular variables, and blunted respiratory, hormonal, and most hemodynamic responses to a noxious stimulus in cats. CLINICAL RELEVANCE: Use of the balanced opioid anesthesia regimen induced some beneficial effects in healthy cats; effects were similar to, although greater in nature, than effects induced by a noxious stimulus.

Acid-Base Equilibrium↗

Effect of alfentanil on the minimum alveolar concentration of isoflurane in cats.

OBJECTIVE: To evaluate effect of incremental doses of alfentanil on isoflurane minimum alveolar concentration (MAC) in cats to determine whether alfentanil reduces isoflurane MAC and, if so, maximal isoflurane MAC reduction. ANIMALS: 6 healthy spayed female cats. PROCEDURE: Cats were anesthetized with isoflurane and instrumented to allow collection of arterial blood for measurement of gas tensions, pH, and plasma alfentanil concentration and to measure arterial blood pressure. Isoflurane MAC was determined in triplicate, and alfentanil was administered i.v., using a computer-driven syringe pump to achieve estimated plasma alfentanil concentrations of 50, 100, 250, 500, 750, and 1,000 ng/ml; isoflurane MAC was determined at each alfentanil concentration. Cats were allowed to recover, and the process was graded as poor, good, or excellent. RESULTS: Alfentanil had a significant dose effect on isoflurane MAC reduction. Significant regression was found for normalized isoflurane MAC versus estimated plasma alfentanil concentration. A quadratic term was necessary to fit the model and, using this curve, MAC reduction (35.0 +/- 6.6%) was estimated to be maximal at a plasma alfentanil concentration of 500 ng/ml. Significant differences were evident in rectal temperature, bicarbonate concentration, base deficit, arterial carbon dioxide and oxygen tensions, and arterial pH between isoflurane alone and some plasma alfentanil concentration and the corresponding reduction in isoflurane concentration. CONCLUSIONS: Infusion of alfentanil resulted in maximal MAC reduction midway between that reported for horses and dogs. At such plasma alfentanil concentration, adverse effects were minimal, but included increase in rectal temperature, metabolic acidosis, and decrease in PaO2. Provided cats were not handled during the recovery period, recovery was smooth and quiet. CLINICAL RELEVANCE: Infusion of alfentanil decreases the need for potent inhalant anesthetics in cats and could potentially be a clinically useful anesthetic regimen in sick cats.

Acid-Base Equilibrium↗

Case-control study of the association between intraoperative administration of nafcillin and acute postoperative development of azotemia.

OBJECTIVE: To describe 7 cases of acute postoperative azotemia in dogs and to examine by use of a case-control study the possible association between this complication and administration of nafcillin. DESIGN: Retrospective and case-control study. ANIMALS: 7 case dogs and 28 matched control dogs. PROCEDURE: Cases of acute renal failure or acute renal insufficiency were identified by retrospective study of records of dogs treated between July 1, 1992, and Feb 28, 1995, and from information received from a practitioner. A random sample of records of dogs undergoing invasive procedures between Dec 1, 1992, and Nov 30, 1993, was examined to determine the prevalence of nafcillin use. Each case dog was matched with 4 control dogs, and data were subjected to logistic regression analysis, employing exact conditional inference on the parameter estimates. RESULTS: Case dogs were between 1 and 9 years old and weighed between 21 and 60 kg. Preoperatively, none of the dogs had a history of renal disease, and BUN concentrations, hematocrit, and plasma protein concentrations were within reference ranges. Postoperatively, each dog became azotemic and had clinical signs consistent with uremia. Hyponatremia was recorded in 6 case dogs. One dog did not respond to treatment and was euthanatized. Two dogs had persistent isosthenuria, and 4 dogs recovered. Nafcillin was used in approximately 502 of 2,184 (23%) dogs that underwent invasive procedures between Dec 1, 1992, and Nov 30, 1993. The use of nafcillin ceased on Nov 30, 1993, and no further cases were recorded in the following 15 months. In the case-control study, the only factor that was significantly associated with the occurrence of acute postoperative azotemia was administration of nafcillin. CLINICAL IMPLICATIONS: Intraoperative use of nafcillin maybe associated with development of acute postoperative azotemia in dogs.

Acute Disease↗

The behaviour of healthy awake cats following intravenous and intramuscular administration of midazolam.

The onset of action and behavioural effects following intravenous (i.v.) and intramuscular (i.m.) administration of 0.05, 0.5, 1.0, 2.0 and 5.0 mg/kg of midazolam were studied for 2 h in 20 awake, healthy cats. All cats, except one that received 0.05 mg/kg i.m., showed effects of the drug, whereas no effects were observed in cats administered only the vehicle in which midazolam was dissolved. The onset of action was rapid following both i.v. and i.m. administration, some cats became ataxic, while others assumed positions of sternal or lateral recumbency. Even after administration of the highest dose (5.0 mg/kg), anaesthesia was not induced, with swallowing reflexes and conscious perception of a clamp placed on the tail still present in all cats. An abnormal arousal state was observed in many cats after administration of midazolam. During the first hour, restlessness was more commonly observed, while from 1 to 2 h, sedation was more prominent in cats that received the highest dose. Ataxia occurred in all but one cat, was short-lived in cats that received the lower doses, but still present at 2 h in all cats that received 2.0 and 5.0 mg/kg. Midazolam caused some of the cats to behave differently when approached and restrained compared with behavioural patterns identified prior to administration of the drug. The cats were more likely to behave abnormally following i.v. administration rather than i.m. administration and, for the most part, abnormal behaviour was equally distributed between the two extremes; cats being easier to approach and restrain and cats being more difficult to approach and restrain. Food consumption increased significantly, during the 2 h period, following all i.m. doses and all but the highest (5.0 mg/kg) i.v. dose, with most of the food being consumed in the first hour after administration.

Animals↗

The effect of intravenous administration of variable-dose midazolam after fixed-dose ketamine in healthy awake cats.

The effects of intravenous administration of variable-dose midazolam and ketamine (3 mg/kg) were studied in twelve healthy unmedicated cats from time of administration until full recovery. A range of midazolam doses (0.0, 0.05, 0.5, 1.0, 2.0 and 5.0 mg/kg) was chosen, so that beneficial and/or detrimental effects could be documented and the therapeutic window for further study determined. One minute after administration of ketamine, all cats had assumed a lateral position, mostly with head up. Muscle tone was increased (100%), apneustic breathing pattern evident in 92% of cats, chewing without stimulation of the oropharyngeal area was observed in most cats (97%), but most cats did not salivate (87%). At 2.5 min after completion of ketamine injection and 1 min after administration of saline, a similar picture was observed, except that salivation was evident. All cats chewed or swallowed in response to a finger or laryngoscope placed in the oropharyngeal area and, while most cats were not aware of a noxious stimulus to the tail, some cats were aware of a noxious stimulus to the paw. Recovery from ketamine alone was rapid and smooth with cats rolling into sternal recumbency and then cautiously walking with ataxia. Recovery to walking without incoordination was also rapid (< 2 h) and no abnormal behavioural patterns were observed during recovery. Administration of midazolam after ketamine, had beneficial effects and the therapeutic window for midazolam was found to lie between 0.05 mg/kg and 0.5 mg/kg. Administration of any dose of midazolam after ketamine caused a greater proportion of cats to assume a laterally recumbent position with head down compared with ketamine alone, however, the time period of recumbency was only significantly longer with a midazolam dose of 2.0 mg/kg or above. Doses of midazolam of 0.5 mg/kg or above decreased muscle rigidity but did not affect salivation or respiratory pattern observed in cats which received ketamine alone. A significantly greater proportion of cats which received ketamine and midazolam 0.5 mg/kg or above did not swallow in response to a finger or a laryngoscope placed in the mouth compared with that which received ketamine alone. The length of time in which cats did not swallow was only significantly longer at midazolam doses of 1.0 mg/kg and above. At midazolam doses of 0.5 mg/kg or above, the proportion of cats without a nociceptive response to a tail or paw clamp was significantly greater than cats which received ketamine alone. The time period without nociceptive response, however, was not influenced by midazolam administration. The time taken for cats which received ketamine and midazolam 0.05 mg/kg or 0.5 mg/kg to assume sternal position, walk with ataxia, walk without ataxia, behave normally when approached or restrained and recover normal arousal state was not significantly different from cats which received ketamine alone. Ketamine and midazolam 5.0 mg/kg significantly prolonged all recovery times compared with ketamine alone. Unfortunately, a greater proportion of cats which received ketamine and midazolam 0.5 or 5.0 mg/kg exhibited detrimental behavioural effects. These were more likely to be adverse and included restlessness, vocalization and difficulty approaching and restraining cats. In this study, an effect of sex of the cats was found, with male cats taking a significantly longer to recover to sternal recumbency and walk with ataxia, while female cats took longer to recover to a normal arousal state.

Anesthetics, Dissociative↗

Arterial hypertension associated with topical ocular use of phenylephrine in dogs.

In 3 dogs scheduled for surgical removal of cataracts, systemic and topical treatment with antibiotics and topical ocular treatment with prednisolone, atropine, flurbiprofen, and phenylephrine were used to achieve maximal mydriasis, with minimal risk of pupillary constriction in response to surgery. Each dog developed arterial hypertension, with systolic, diastolic, and mean arterial pressures ranging from 170 to 205, 90 to 112, and 123 to 148 mm of Hg, respectively. Hypertension was treated with acepromazine maleate (0.001 to 0.005 mg/kg of body weight) i.v., decreasing arterial pressures to reference values. Phenylephrine dosages for topical use ranged from 50 to 367 times greater than the i.v. dose required to increase arterial pressure by 50% in anesthetized dogs. Although adverse sequelae to these episodes of hypertension were not noticed, this report documents the uptake of phenylephrine from topical ocular application and suggests the need for dose-response measurements for this adjunct to mydriatic treatment in dogs.

Acepromazine↗

Effect of non-adrenal illness, anaesthesia and surgery on plasma cortisol concentrations in dogs.

Basal plasma cortisol concentrations in 25 dogs with non-adrenal illness were two to three times higher than in 25 normal dogs (158 +/- 25 nmol litre-1 compared with 65 +/- 22; mean +/- SD). In addition, plasma cortisol concentrations were measured in 12 animals undergoing major abdominal, thoracic or orthopaedic surgery and compared to a group of six anaesthetised dogs. Anaesthesia alone failed to significantly alter plasma cortisol levels, however, all forms of surgery produced a significant increase in plasma cortisol concentration which returned to normal 24 hours after completion of surgery.

Anesthesia, General↗

The cardiovascular sparing effect of fentanyl and atropine, administered to enflurane anesthetized dogs.

Cardiovascular effects of high dose opioid together with low dose inhalant were compared with inhalant alone to determine whether opioid/inhalant techniques were less depressant on the cardiovascular system. The effects of positive pressure ventilation and increasing heart rate to a more physiological level were also studied. Cardiovascular measurements recorded during administration of enflurane at 1.3 minimum alveolar concentration (MAC; 2.89 +/- 0.02%) to spontaneously breathing dogs (time 1) and during controlled ventilation [arterial carbon dioxide tension at 40 +/- 3 mmHg (time 2)] were similar. At time 2, mixed venous oxygen tension and arterial and mixed venous carbon dioxide tensions were significantly decreased, while arterial and mixed venous pH were significantly increased compared to measurements at time 1. After administration of fentanyl to achieve plasma fentanyl concentration of 71.7 +/- 14.4 ng/mL and reduction of enflurane concentration to yield 1.3 MAC multiple (0.99 +/- 0.01%), heart rate significantly decreased, while mean arterial pressure, central venous pressure, stroke index, and systemic vascular resistance index increased compared to measurements taken at times 1 and 2. Pulmonary arterial occlusion pressure was significantly increased compared to measurements taken at time 2. After administration of atropine until heart rate was 93 +/- 5 beats/min (plasma fentanyl concentration 64.5 +/- 13.5 ng/mL) heart rate, mean arterial pressure, cardiac index, oxygen delivery index, and venous admixture increased significantly compared to values obtained at all other times.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗

Cardiopulmonary effects of halothane in hypovolemic dogs.

Cardiopulmonary effects of halothane administration were studied in hypovolemic dogs. Baseline cardiopulmonary data were recorded from conscious dogs after instrumentation. Hypovolemia was induced by withdrawal of blood from dogs until mean arterial pressure of 60 mm of Hg was achieved. Blood pressure was maintained at 60 mm of Hg for 1 hour, by further removal or replacement of blood. Halothane was delivered by face mask, dogs were intubated, then halothane end-tidal concentration of 1.13 +/- 0.02% was maintained, and cardiopulmonary effects were measured 3, 15, 30, and 60 minutes later. After blood withdrawal and prior to halothane administration, systemic vascular resistance index, oxygen extraction, and base deficit increased. Compared with baseline values, these variables were decreased: mean arterial pressure, mean pulmonary arterial pressure, pulmonary arterial occlusion pressure, cardiac index, oxygen delivery index, oxygen consumption index, mixed venous oxygen tension, mixed venous oxygen content, venous admixture, arterial bicarbonate concentration, and mixed venous pH. At all times after intubation, arterial and venous oxygen tensions and mixed venous carbon dioxide tensions were increased. Three minutes after intubation, base deficit and mixed venous carbon dioxide tension increased, and mean arterial pressure and arterial and venous pH decreased, compared with values measured immediately prior to halothane administration. Fifteen minutes after intubation, systemic vascular resistance index decreased and, at 15 and 30 minutes, mean arterial pressure and arterial and venous pH remained decreased. At 60 minutes, mean pulmonary arterial pressure and pulmonary arterial occlusion pressure were increased and mixed venous pH was decreased, compared with values measured before halothane administration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Surface-induced hypothermia in dogs: 19 cases (1987-1989).

Surface-induced hypothermia is used to protect tissues from ischemic events during surgery. In a review of 19 clinical cases in dogs, the technique was used to enable intracardiac surgery (4 dogs) and to facilitate removal of extensive thoracic or abdominal masses (15 dogs). For 16 dogs (84%), anesthesia was induced with an opioid/benzodiazepine combination and maintained with a balanced technique by use of an opioid, a neuromuscular blocking agent, and isoflurane in oxygen. Dogs were cooled in an ice bath to a mean esophageal temperature of 27.8 +/- 1.4 C. Mean anesthesia time was 4.04 +/- 1.37 hours. Hypothermic-induced adverse effects, such as increased blood viscosity, increased myocardial irritability, and shivering, were managed by hemodilution, manipulation of acid-base balance, and administration of opioid and neuromuscular blocking agents. Complications requiring treatment included severe hypotension (74%), arrhythmias (47%), hypoxemia (42%), and acidemia (58%). Six dogs (32%) went into cardiac arrest and all were successfully resuscitated once the surgical procedure was completed. One dog was euthanatized during surgery, another died after surgery, and the 17 remaining dogs (90%) were discharged from the hospital to their owners. The technique appears beneficial in selected cases to decrease the morbidity and mortality associated with the risk of prolonged ischemia and life-threatening hemorrhage.

Animals↗

Advantages and guidelines for using ultrashort barbiturates for induction of anesthesia.

Despite the introduction of a number of new injectable agents, ultrashort barbiturates continue to be popular. Some of the reasons include rapid, smooth onset of action; predictable hypnotic effects; relatively rapid, smooth recovery; and inexpensiveness. Ultrashort barbiturates also possess some pharmacodynamic properties that make them ideal agents for use in patients with certain diseases or undergoing certain procedures. These include patients with raised intracranial pressure, patients with a history of seizures, patients with corneal lacerations or glaucoma, patients for examination of vocal cord and arytenoid cartilage function, patients with hyperthyroidism, and patients thought to be susceptible to malignant hyperthermia.

Anesthesia↗