British journal of anaesthesia.
Publisher:
Elsevier. [London] : Elsevier (2018)
Frequency: Monthly
Country: England
Language: English
Start Year:1923 -
ISSN:
0007-0912 (Print)
1471-6771 (Electronic)
0007-0912 (Linking)
1471-6771 (Electronic)
0007-0912 (Linking)
Impact Factor
9.8
2022
| NLM ID: | 0372541 |
| (DNLM): | B34340000(s) |
| (OCoLC): | 01537271 |
| Coden: | BJANAD |
| LCCN: | sc 85001052 |
| Classification: | W1 BR503 |
Voltage changes in the lithium dilution cardiac output sensor after exposure to blood from horses given xylazine. In a previous in vitro study using saline medium, the authors showed that certain drugs changed the voltages of lithium dilution cardiac output (LiDCO) sensors and also influenced their accuracy in measuring lithium concentrations. These two parameters correlated and so we examined whether such drug-sensor interaction exists when LiDCO sensor was exposed to xylazine in blood. Methods: Five healthy adult warm-blood horses were injected with 0.5 mg kg(-1) xylazine i.v. Physiological saline solution and venous blood were consecutively sampled through the same LiDCO sensor at 60, 45, 30, 15, and 0...
Influence of drugs on the response characteristics of the LiDCO sensor: an in vitro study. In a previous study, the authors found a large bias (50%) for lithium (LiDCO) compared with thermodilution cardiac output measurement methods in ponies receiving i.v. infusions of xylazine, ketamine, and midazolam. This prompted the authors to examine the effect of drugs on the LiDCO sensor. Methods: Drugs and lithium were dissolved in 0.9% saline to produce the following solutions: saline, saline-lithium, saline-drug, and saline-drug-lithium. The drug concentrations were overlapping the range of clinical interest as estimated from the published literature. These 38°C solutions were pumped th...
Lithium dilution, pulse power analysis, and continuous thermodilution cardiac output measurements compared with bolus thermodilution in anaesthetized ponies. This study compares cardiac output (CO) measurements obtained by lithium dilution (LiDCO), pulse power analysis (PulseCO), and continuous thermodilution (CTD) with bolus thermodilution (BTD) in ponies. Methods: Eight isoflurane-anaesthetized Shetland ponies received xylazine, ketamine, and midazolam infusions (0.3, 1.2, and 0.018 mg kg(-1) h(-1), respectively). CO was measured with BTD, CTD, LiDCO, and PulseCO. Lithium was injected into the jugular vein and blood was sampled from the facial artery for lithium detection and this artery was also used for PulseCO. Measurements were obtained durin...
Reversal of profound rocuronium block monitored in three muscle groups with sugammadex in ponies. This clinical study evaluated the speed of reversal of profound rocuronium block in ponies using sugammadex and investigated the differences in onset and recovery from block in three different muscle groups. Methods: Anaesthesia was induced and maintained with isoflurane in oxygen 100% in eight ponies. Neuromuscular monitoring was performed at each site using acceleromyography: in the extensor muscles of the pelvic limb (peroneal nerve) and thoracic limb (radial nerve), and in the orbicularis oris muscle (OOM; facial nerve). Rocuronium 0.6 mg kg(-1) i.v. was administered, followed 5 min later ...
Pharmacokinetic profile in relation to anaesthesia characteristics after a 5% micellar microemulsion of propofol in the horse. To define the pharmacokinetic profile of propofol 5% microemulsion formulation in horses. Methods: First, propofol was administered as bolus injection (2 mg kg(-1)) to six xylazine-sedated horses. Secondly, after sedation and bolus injection, propofol was maintained with continuous infusion for 3 h [8.1 (sd 3.2) mg kg(-1) h(-1)] to the same six horses. Thirdly, in two horses, a commercial propofol was used for comparison. Response to noxious stimulation was used to evaluate analgesia. Venous blood samples were obtained to measure propofol plasma concentration using liquid chromatography-mass s...
Analgesia from a veterinary perspective. The last decade has seen continued progress in both the recognition and management of animal pain. This upsurge in the use of analgesics in animals is welcome, but the main areas of use continue to be the control of postoperative or post-trauma pain, and the management of musculoskeletal pain, in companion animals and horses. The management of pain associated with other conditions, such as soft-tissue inflammation or cancer, is still relatively neglected. Pain management in farm animals, and in animals used in biomedical research could also be improved further. Apart from providing some intere...
Stereoselective pharmacokinetics of ketamine and norketamine after racemic ketamine or S-ketamine administration during isoflurane anaesthesia in Shetland ponies. The arterial pharmacokinetics of ketamine and norketamine enantiomers after racemic ketamine or S-ketamine i.v. administration were evaluated in seven gelding ponies in a crossover study (2-month interval). Methods: Anaesthesia was induced with isoflurane in oxygen via a face-mask and then maintained at each pony's individual MAC. Racemic ketamine (2.2 mg kg(-1)) or S-ketamine (1.1 mg kg(-1)) was injected in the right jugular vein. Blood samples were collected from the right carotid artery before and at 1, 2, 4, 8, 16, 32, 64, and 128 min after ketamine administration. Ketamine and norketamine...
The effects of i.v. fentanyl administration on the minimum alveolar concentration of isoflurane in horses. Fentanyl decreases the minimum alveolar concentration (MAC) of inhaled anaesthetics and has been used clinically to reduce the requirements of other anaesthetic drugs in humans and small animals. We hypothesized that i.v. fentanyl would decrease the MAC of isoflurane in horses in a dose-dependent manner. Methods: Following determination of baseline MAC of isoflurane, fentanyl was administered i.v. to target plasma concentrations of 1, 8 and 16 ng ml(-1). Each horse was randomly assigned two of three target concentrations administered in ascending order. Loading and infusion doses for each hors...
The effects of halothane and isoflurane on cardiovascular function in laterally recumbent horses. Experimental studies in adult horses have shown that general anaesthesia maintained with isoflurane is associated with less depression of cardiovascular function compared with halothane anaesthesia. Adverse effects of intermittent positive-pressure ventilation (IPPV) have also been demonstrated. Nevertheless, the haemodynamic effects of these agents and the effects of differing modes of ventilation have not been assessed during clinical anaesthesia in horses undergoing surgery. Methods: The haemodynamic effects of isoflurane or halothane anaesthesia during spontaneous or IPPV were studied non-...
Blood/gas partition coefficients of halothane, isoflurane and sevoflurane in horse blood. Blood/gas partition coefficients (lambda(b/g)) for volatile agents in horse blood are reported for halothane but not for isoflurane and sevoflurane. We measured the lambda(b/g) of halothane, isoflurane and sevoflurane in the blood of fasted horses. The correlation with age, weight and some haematological and biochemical variables was studied. The temperature correction factor for isoflurane solubility was calculated. Methods: Twenty-four horses were randomly allocated to halothane (n=8), isoflurane (n=8) or sevoflurane (n=8). Blood samples were taken after 10 h' fasting. Calculation of lambda(...
Effect of different pulses of nitric oxide on venous admixture in the anaesthetized horse. Dependent atelectatic lung areas open towards the end of inspiration when the lung opening pressure increases, and recollapse during expiration. We hypothesized that inhaled nitric oxide (NO) counteracts hypoxic vasoconstriction in these collapsing lung areas, resulting in increased pulmonary shunt perfusion. Methods: We administered NO as a pulse and varied the pulse timing during inspiration in equine anaesthesia, where atelectasis develops regularly. Six spontaneously breathing standard breed trotters were studied under isoflurane anaesthesia in lateral recumbency. NO pulsed into the first ...
Effect of two anaesthetic regimens on airway nitric oxide production in horses. There is evidence that halothane inhibits nitric oxide synthase in vitro, but the effect of intravenous anaesthetic agents is less clear. This study was undertaken to compare the rate of exhaled nitric oxide production (VNO) in spontaneously breathing horses anaesthetized with halothane or an intravenous regimen. Seven adult horses were studied twice in random order. After premedication with romifidine 100 microg kg(-1), anaesthesia was induced with ketamine 2.2 mg kg(-1) and maintained with halothane in oxygen (HA) or by an intravenous infusion of ketamine, guaiphenesin and romifidine (IV). I...
Effects of inhaled nitric oxide 10 ppm in spontaneously breathing horses anaesthetized with halothane. Inhaled nitric oxide, a selective pulmonary vasodilator, is known to improve arterial oxygenation after cardiopulmonary bypass and during acute respiratory distress syndrome in humans. During general anaesthesia with spontaneous ventilation, healthy adult horses develop large alveolar-arterial oxygen tension differences. In this study, we have determined the effects of inhaled nitric oxide (10 parts per million (ppm)) on venous admixture and pulmonary haemodynamics in horses anaesthetized with halothane. Seven adult horses were studied twice in random sequence. After premedication with romifid...
Comparison of the effects of halothane, isoflurane and methoxyflurane on the electroencephalogram of the horse. We have investigated in eight ponies the effects of three different end-tidal concentrations of halothane, isoflurane and methoxyflurane on median (F50) and 95% spectral edge (F95) frequencies of the EEG and the second differential (DD) of the middle latency auditory evoked potential (MLAEP). The three concentrations of each agent were chosen to represent approximately the minimum alveolar concentration (MAC), 1.25 MAC and 1.5 MAC for each agent. During halothane anaesthesia, F95 decreased progressively as halothane concentration increased, from mean 13.9 (SD 2.6) at 0.8% to 11.9 (1.1) at 1.2%...
Measurement of cardiac output by transoesophageal Doppler echocardiography in anaesthetized horses: comparison with thermodilution. In order to determine if transoesophageal Doppler echocardiography could be used to estimate cardiac output in anaesthetized horses, we have compared the technique with estimations of cardiac output by thermodilution in eight healthy adult thoroughbreds. Measurements of aortic blood flow velocity were made by high pulse repetition frequency (HPRF) and continuous wave (CW) Doppler echocardiography from a 3.5-MHz transoesophageal probe. Cardiac output was increased during the study by administration of dobutamine, providing a range of cardiac output measurements by thermodilution from 15.0 to 64...
Effect of xylazine and ketamine on the pharmacokinetics of alfentanil during halothane anaesthesia. We measured plasma concentrations of alfentanil in two horses after three different randomly ordered treatments. Each horse received halothane in oxygen by mask followed by a bolus dose of alfentanil 60 micrograms kg-1 i.v., halothane in oxygen by mask followed by an i.v. alfentanil infusion for 120 min and xylazine and ketamine followed by halothane and a bolus dose of alfentanil 60 micrograms kg-1 i.v. Halothane was maintained at 1.05-1.07% end-tidal concentration with a PaCO2 of 6-7.3 kPa. The plasma concentration-time curves were similar after bolus and infusion doses of alfentanil with ha...
Flow reversal through a Mark III halothane vaporizer. A fault in the assembly of a Matrix Large Animal Circle anaesthetic machine resulted in reversal of fresh gas flow through the vaporizer. The fault was discovered only after the sudden development of excessive depth of anaesthesia in two equine patients. Laboratory investigations were conducted to determine the effect of flow reversal on vaporizer output. Results indicated that output concentration was approximately doubled under these conditions.
Equine stress responses to anaesthesia. Information on equine stress responses to anaesthesia and surgery is sparse. Six ponies were anaesthetized for 2 h with halothane and no surgery was performed. Plasma concentrations of glucose, lactate, non-esterified fatty acids, cortisol, insulin, catecholamines and adrenocorticotropic hormone (ACTH) were measured. The results were compared with those obtained in the same group of ponies over the same time period on a different day with the animals conscious. Anaesthesia induced an increase in plasma concentrations of glucose, lactate, cortisol and ACTH and a decrease in plasma concentration...
Selective mechanical ventilation of dependent lung regions in the anaesthetized horse in dorsal recumbency. The effect of selective mechanical ventilation of dependent lung regions were studied in anaesthetized horses (mean weight 486 kg) in dorsal recumbency. Blood-gas measurements were performed with the horse in the lateral position during spontaneous breathing (before selective intubation) and in dorsal recumbency during spontaneous breathing, general mechanical ventilation, and spontaneous breathing + selective mechanical ventilation. Arterial oxygen tension (PaO2) was 32.3 kPa in the lateral position during spontaneous breathing with a high inspired oxygen fraction (FlO2 greater than 92%). In ...
Effect of halothane, enflurane and isoflurane on bronchomotor tone in anaesthetized ponies. The effects of halothane, enflurane and isoflurane on bronchial calibre were investigated in five anaesthetized ponies using a computer-aided forced airflow oscillation technique to derive specific lower airways conductance (s.Glaw) and expiratory reserve volume (ERV). All the agents tended to increase s.Glaw (indicating bronchodilatation), but ERV was reduced by halothane and enflurane, and increased by isoflurane. It was concluded that the effects of these agents on bronchomotor tone were similar to those which occur in man. However, the reasons for the differences in their effects on ERV co...
Solubility of halothane in equine tissues at 37 degrees C. The solubilities of halothane at a concentration of 0.77% v/v in 5% carbon dioxide in air at 37 degrees C were determined for a variety of equine tissues. The mean values for the tissue/gas partition coefficients for visceral tissue taken from 36 horses were 5.42 for whole brain, 4.82 for grey matter, 7.41 for white matter, 4.18 for myocardium, 2.76 for lung, 8.51 for liver, 3.21 for kidneys, 2.66 for gastrointestinal tract, 1.77 for blood and 2.45 for spleen. The mean coefficients for eight different muscles taken from 23 horses ranged from 2.43 for extensor carpi radialis to 4.91 for psoas m...
Tissue composition and halothane solubility in the horse. The halothane muscle/gas partition coefficients at 37 degrees C for 26 samples of eight different muscles from four horses were found to depend significantly on the fat content of the muscle sample with a regression coefficient of 1.913 (SEM 0.109) per per cent ether-extractable fat content. The blood/gas partition coefficients in 24 horses showed a significant dependence on plasma triglyceride concentration (regression coefficient 0.00084 (SEM 0.00033) per mg dl-1), an insignificant positive dependence on plasma free and total cholesterol concentration and, in a multiple regression analysis, ...
Positive end-expiratory pressure in anaesthetized spontaneously breathing horses. Horses breathing spontaneously under halothane anaesthesia were subjected to expiratory resistance by the introduction of a water-trap into the expiratory limb of a circle absorber. Resistances of 10 and 20 cm H2O produced no significant increase in PaO2 (P greater than 0.05) during halothane/air and halothane/oxygen anaesthesia. The imposition of resistance was associated with an increase in PaCO2 and a significant increase in mixed venous PCO2. In three animals subjected to 20 cm H2O resistance under halothane/air anaesthesia, the cardiac output was reduced (P less than 0.01). It was conclud...
The use of ultrasonic energy to vaporize anaesthetic liquids. Ultrasonic energy, provided by a commercially available water vaporizer, was used to vaporize methoxyflurane, halothane, and chloroform. The vaporizer was placed directly in the respiratory line, and the anaesthetic liquid was vaporized one drop at a time. Anaesthesia was maintained for periods up to 6 hr in horses, ponies, calves, sheep, dogs, and one pig. This method of vaporizing liquids is applicable to a wide variety of anaesthetics. It is easily controlled, and the same vaporizer can be used with a wide range of sizes of subjects. The vaporizer can be placed directly in the respiratory c...