Isoflurane is a volatile anesthetic agent commonly used in equine veterinary medicine for the induction and maintenance of general anesthesia. It is administered through inhalation and is valued for its rapid onset and recovery characteristics. Isoflurane acts on the central nervous system to produce a reversible loss of consciousness and sensation, facilitating various surgical and diagnostic procedures in horses. The agent is noted for its minimal metabolism by the liver, with the majority being exhaled unchanged, which is beneficial in reducing the burden on the equine liver. This page compiles peer-reviewed research studies and scholarly articles that explore the pharmacokinetics, physiological effects, and clinical applications of isoflurane in equine anesthesia.
Matthews NS, Hartsfield SM, Sanders EA, Light GS, Slater MS.All 43 horses anaesthetised for colic surgery were premedicated with xylazine or diazepam. Anaesthesia was induced with guaifenesin and ketamine, horses were placed in dorsal recumbency and anaesthesia was maintained with isoflurane in oxygen and mechanical ventilation. Haemoglobin saturation readings (SpO2) were taken with a pulse oximeter and compared with computed haemoglobin saturation (SaO2) from arterial blood samples. Readings were taken over a range of SaO2 of 78-100%, mean arterial blood pressure ranged from 24 to 108 mmHg and PaO2 ranged from 53 to 490 mmHg. Analysis of 107 readings ...
Ekström PM, Short CE, Geimer TR.This study was done to compare the electroencephalographic (EEG) response evoked by orthopedic surgery in halothane- and isoflurane-anesthetized horses. Eight horses scheduled for bilateral arthroscopic surgery of the stifle were premedicated with detomidine (20 micrograms/kg) intravenously and five minutes later induced to anesthesia with ketamine (2.2 mg/kg) intravenously. Anesthesia was maintained with either halothane or isoflurane. Assignment of inhalation anesthetic was done randomly. The multiple of minimal alveolar concentration (MAC) of halothane required for anesthesia was significan...
Olson KN, Klein LV, Nann LE, Soma LR.Six horses were administered isoflurane anesthesia by liquid injection into a closed breathing circuit according to the square root of time model. The unit dose (UD) was calculated using Lowe's formula to provide an end-tidal concentration of 1.3%, or the minimum alveolar concentration of isoflurane. The mean UD was 4.2 +/- 0.2 mL. The mean end-tidal isoflurane concentration (ETiso) for each interval after injection, and the peak and minimum concentrations for each injection interval, did not change beginning with the second injection, indicating that the square root of time model accurately p...
Matthews NS, Miller SM, Hartsfield SM, Slater MR.Recovery from isoflurane anesthesia was shorter, with no difference in quality, compared with halothane anesthesia in 2 groups of horses. In 1 group, 12 horses scheduled for elective arthroscopy were randomly assigned to receive halothane or isoflurane for maintenance of anesthesia during surgery. In the other group, 6 horses received anesthesia only, on 2 occasions, with halothane on 1 occasion, and isoflurane on the other. Difference in the quality of recovery was not seen between isoflurane and halothane anesthesia in either group. In the group that had surgery, recovery to sternal position...
Pascoe PJ, Black WD, Claxton JM, Sansom RE.The pharmacokinetics of alfentanil were investigated in the horse. Four doses of alfentanil (4, 10, 20 and 40 micrograms/kg) were given to four horses at different times and their locomotor activity monitored. Doses of 20 and 40 micrograms/kg produced a significant increase in locomotor activity. The plasma concentrations of alfentanil were measured in six standing horses and the pharmacokinetics calculated. It was found that the decay curves were best described by a biexponential equation. The elimination half-life (t1/2 beta) was 21.65 +/- 3.99 min and the clearance (Cl) was 14.1 +/- 0.7 ml/...
Eicker SW, Cuvelliez S.Inhalation anesthesia has three requirements: delivery of oxygen, delivery of an appropriate concentration of a volatile anesthetic agent, and removal of carbon dioxide. Halothane and isoflurane are the most commonly used anesthetic agents. They are usually delivered with a semiclosed circle system using an out-of-the-circuit vaporizer. Carbon dioxide is eliminated by chemical absorption and by flow of excess oxygen and waste anesthetic agent through the pop-off valve. These gases should be scavenged to prevent room contamination. A variety of ancillary equipment is available to assist the ane...
Trim CM, Adams JG, Cowgill LM, Ward SL.The purpose of this survey was to identify complications occurring in horses with colic during anaesthesia and recovery from anaesthesia; and to determine any relationships between these complications and drugs used for induction or maintenance of anaesthesia. Two hundred and thirty nine horses were anaesthetised on a total of 250 occasions for colic surgery between January 1985 and May 1987. Of these, 189 recovered from 200 anaesthetic episodes. Most horses received xylazine and guaifenesin with either thiobarbiturate (68 per cent) or ketamine (24 per cent) and anaesthesia was maintained with...
Cribb PH.Forty-five horses were maintained on halothane or isoflurane anesthesia for at least 90 minutes and received positive pressure ventilation after the first 30 minutes of anesthesia. Parameters monitored included end-tidal partial pressure of carbon dioxide (ETPCO2), arterial blood pressure, and arterial blood gases and pH. There was a statistically significant correlation between end-tidal carbon dioxide and arterial partial pressure of carbon dioxide (PaCO2) for both halothane and isoflurane anesthesia. There was no significant correlation between end-tidal carbon dioxide and either body weigh...
Serteyn D, Coppens P, Mottart E, Michelet S, Micheels J, Philippart C, Lamy M.The cardiovascular function of horses was less depressed during anaesthesia with isoflurane than during anaesthesia with halothane. Muscular microcirculation measured by laser Doppler flowmetry was significantly greater in horses anaesthetised with isoflurane.
Jones RS, Seymour CJ.The inhalational anaesthetic agent isoflurane was administered to 22 dogs and 21 horses undergoing a variety of surgical procedures. Satisfactory anaesthesia was produced in all the animals. The cardiopulmonary changes were similar to those observed with halothane. Rapid changes in the depth of anaesthesia were achieved and recovery from anaesthesia was rapid in both dogs and horses, which was a reflection of the relative insolubility of isoflurane. Recovery from anaesthesia in the horses was particularly smooth and rapid with the animals spending a greater part of their recumbency in the ster...
Meyer RE, Short CE.The correlation between end-tidal partial pressure of CO2 (PETCO2) and arterial (PaCO2) was determined for spontaneously breathing ponies under halothane or isoflurane anesthesia. The PETCO2 was useful as a trend indicator of PaCO2 during the first 60 minutes of halothane or isoflurane anesthesia when PaCO2 values were less than 60 to 70 mm of Hg. Halothane anesthesia lasting greater than 90 minutes was associated with PaCO2 values in excess of 60 to 70 mm of Hg, a large arterial- to end-tidal PCO2 difference (PaCO2-PETCO2) and a significant increase in alveolar dead space. These effects were ...
Engelking LR, Dodman NH, Hartman G, Valdez H.The acute 2-hour effects of isoflurane anesthesia on liver function and biliary excretion were examined in 2 ponies prepared surgically with chronic external biliary fistulas (T-tubes). Studies were conducted 2 to 8 months postoperatively with the enterohepatic circulation held intact between studies. Bile acid infusion IV (8.1 to 8.8 mumol/min) helped maintain bile flow and bile acid and bilirubin excretion during complete biliary diversion throughout each study. Following 3-hour control periods, anesthesia was induced and maintained at 1.3 to 1.5 minimal alveolar concentration plus O2 (spont...
Steffey EP, Zinkl J, Howland D.The potential toxicity to horses of 7.33 +/- 0.87 SD minimal alveolar concentration hours of isoflurane anesthesia was evaluated by sequential determination of blood cell counts, electrolyte concentrations, and certain blood chemical values. Minimal or no serious toxicosis was observed for up to 7 days after anesthesia was terminated.
Auer JA, Garner HE, Amend JF, Hutcheson DP, Salem CA.The duration and quality of recovery after separate 2 hour anaesthetic periods with equipotent alveolar concentrations of isoflurane, enflurane, halothane and methoxyflurane were evaluated in experimental ponies. Recovery was shortest after isoflurane anaesthesia, followed by enflurane, halothane and finally methoxyflurane, although standing was achieved more rapidly after enflurane than after isoflurane. This sequence of recovery times was compatible with the respective solubilities of the 4 agents. The smoothest recovery was obtained after isoflurane anaesthesia, followed by methoxyflurane, ...
Olson KN, Klein LV, Nann LE, Soma LR.Six horses were administered isoflurane anesthesia by liquid injection into a closed breathing circuit according to the square root of time model. The unit dose (UD) was calculated using Lowe's formula to provide an end-tidal concentration of 1.3%, or the minimum alveolar concentration of isoflurane. The mean UD was 4.2 +/- 0.2 mL. The mean end-tidal isoflurane concentration (ETiso) for each interval after injection, and the peak and minimum concentrations for each injection interval, did not change beginning with the second injection, indicating that the square root of time model accurately p...
Eicker SW, Cuvelliez S.Inhalation anesthesia has three requirements: delivery of oxygen, delivery of an appropriate concentration of a volatile anesthetic agent, and removal of carbon dioxide. Halothane and isoflurane are the most commonly used anesthetic agents. They are usually delivered with a semiclosed circle system using an out-of-the-circuit vaporizer. Carbon dioxide is eliminated by chemical absorption and by flow of excess oxygen and waste anesthetic agent through the pop-off valve. These gases should be scavenged to prevent room contamination. A variety of ancillary equipment is available to assist the ane...
Rankin DC, Greene SA, Keegan RD, Weil AB, Schneider RK, Bayly WM.To evaluate effects of strenuous exercise in adult horses immediately before anesthesia and to determine whether prior exercise affects anesthesia induction, recovery, or both. Methods: 6 healthy Thoroughbreds in good condition and trained to run on a treadmill, each horse serving as its own control. Methods: Horses ran on a treadmill until fatigued, then were sedated immediately with detomidine hydrochloride and anesthetized with a zolazepam hydrochloride-tiletamine combination. Anesthesia was maintained with isoflurane in oxygen for another 90 minutes. Blood samples were taken before, during...
Franci P, Bertamini A, Bertamini O, Pilla T, Busetto R.A new volatile anaesthetic agent delivery system was tested in 15 horses undergoing scheduled surgical procedures. The delivery system consisted of a laptop computer (with dedicated software), a computer-controlled syringe driver (loaded with liquid isoflurane) connected to the inspiratory arm of a large-animal circle breathing system and a respiratory gas monitor, providing isoflurane end-tidal concentrations (ET(measured)) every 20 s to the computer. Following induction and connection to the breathing system, mechanical ventilation was started. The bodyweight (BW), fresh gas flow, breathing ...
Schauvliege S, Gozalo Marcilla M, Duchateau L, Martens A, Vlaminck L, Pille F, Declercq J, Levet T, Gasthuys F.No studies have been reported on the effects of enoximone in anaesthetised colic horses. Objective: To examine whether enoximone improves cardiovascular function and reduces dobutamine requirement in anaesthetised colic horses. Methods: Forty-eight mature colic horses were enrolled in this prospective, randomised clinical trial. After sedation (xylazine 0.7 mg/kg bwt) and induction (midazolam 0.06 mg/kg bwt, ketamine 2.2 mg/kg bwt), anaesthesia was maintained with isoflurane in oxygen and a lidocaine constant rate infusion (15 mg/kg bwt, 2 mg/kg/h). Horses were ventilated (PaCO2 < 8.00 kPa)...
Midon M, Yamada DI, Zangirolami Filho D, Natalini CC, Escobar A, Clark-Price SC.This randomized double-blinded study evaluated the recovery from isoflurane anesthesia in horses receiving doxapram and xylazine. 6 horses were anesthetized 4 times (minimum of 2-week washout period). Anesthesia was performed with xylazine (0.6 mg/kg), ketamine (2.2 mg/kg), midazolam (0.1 mg/kg), and maintained with isoflurane for 90 minutes. At recovery, horses received one of the following randomized treatments: RX: xylazine (0.2 mg/kg), RXD1: xylazine (0.2 mg/kg) and doxapram (0.1 mg/kg), RXD2: xylazine (0.2 mg/kg) and doxapram (0.2 mg/kg), or RS: saline. Recoveries were rope-assisted and e...
Fisher K, Dodam J, Bailey J, Thombs L, Hodgson D, Bukoski A.To compare PaO2 and PaCO2 in horses recovering from general anesthesia maintained with either apneustic anesthesia ventilation (AAV) or conventional mechanical ventilation (CMV). Methods: Randomized, crossover design. Methods: A total of 10 healthy adult horses from a university-owned herd. Methods: Dorsally recumbent horses were anesthetized with isoflurane in oxygen [inspired oxygen fraction = 0.3 initially, with subsequent titration to maintain PaO2 ≥ 85 mmHg (11.3 kPa)] and ventilated with AAV or CMV according to predefined criteria [10 mL kg-1 tidal volume, PaCO2 40-45 mmHg (5.3-6.0 kP...
Taylor SN, Colbath AC, Manfredi JM, Yob CJ, Muñoz KA.To investigate the effect of isoflurane anesthesia on thermoregulation and peripheral heat loss in dorsally recumbent horses. Methods: Prospective, clinical study. Methods: Seven adult horses (2.6 ± 1.5 years old, 455 ± 70.2 kg). Methods: Horses underwent elective surgical procedures in dorsal recumbency under general anesthesia (GA) maintained with isoflurane in oxygen. Rectal (TR), intranasal (TN) and fetlock surface temperatures (TF) were measured every 10 minutes for the first 80 minutes following induction of GA. Room temperature (TRO) was monitored during the study. Statistical analysi...
Parra Martínez C, Rico Pérez B, Kaartinen J.To evaluate the agreement between noninvasive arterial blood pressure (NIBP) measured from the tongue and thoracic limb with invasive blood pressure (IBP), and to compare NIBP measured from the tongue and thoracic limb in anaesthetized horses. Methods: Prospective clinical study. Methods: A group of eight client-owned healthy horses anaesthetized for scheduled procedures, American Society of Anesthesiologists classification I-II, weighing (mean ± standard deviation) 498 ± 91 kg and aged 7.8 ± 6.75 years. Methods: Animals were premedicated with intravenous (IV) romifidine (0.04-0.08 mg kg-1)...
Ruíz-López P, Schauvliege S, Gasthuys F, Haspeslagh M.This retrospective study aimed to assess the incidence of hypotension and the subsequent administration of dobutamine in horses anesthetized with isoflurane and romifidine during elective surgery. Time from induction of anaesthesia to administration of dobutamine was registered, as well as the time and dose needed to restore mean arterial pressure (MAP) ≥ 70 mmHg. Additionally, the influence of patient and anaesthesia related parameters on the need for dobutamine supplementation was evaluated. In total, 118 horses were included in this retrospective study. Dobutamine was administered to e...
Lambertini C, Spaccini F, Mazzanti A, Spadari A, Lanci A, Romagnoli N.In horses, lidocaine infusion is administered intraoperatively for analgesia and for a reduction of inhalant anaesthetic requirement. The objective of the study was to describe the anaesthetic effects of lidocaine infusion in isoflurane anaesthetised foals. Unassigned: Twelve foals (<3 weeks old) undergoing surgery were included in the study (LIDO group). Foals were premedicated with midazolam and butorphanol IV, anaesthesia was induced with ketamine and propofol IV and maintained with isoflurane. Lidocaine was administered intraoperatively at 0.05 mg/kg/min. Also, the anaesthetic records o...
Reed RA, Carroll AT, Dantino SC, Quandt JE, Barletta M, Sakai DM.To determine the influence of xylazine infusion on survival to discharge and describe the associated intraoperative requirement for isoflurane, use of positive inotropes and vasopressors, and recovery time in horses undergoing exploratory laparotomy. Methods: Retrospective cohort study. Methods: A total of 352 horses. Methods: Medical records of horses undergoing anesthesia for exploratory laparotomy from January 2018 to December 2023 were reviewed. Data collected included survival to discharge, results of diagnostic tests, end tidal isoflurane concentration (FE'Iso), use of vasopressors/inotr...
Ishihara T, Nieves E, Reed R, Hofmeister E.Dobutamine is used to treat hypotension in isoflurane-anaesthetised horses but may produce arrhythmias. Halothane is a volatile anaesthetic that was, historically, widely used in horses, but in one study, 56 of 200 halothane-anaesthetised horses (28%) developed arrhythmias after dobutamine administration. Although isoflurane has largely replaced halothane, it is unknown how isoflurane and dobutamine interact in the development of arrhythmias. Methods: The medical records of horses undergoing general anaesthesia at the University of Georgia Veterinary Teaching Hospital in 2015 were reviewed ret...
Hordle T, Ranninger E, Bettschart-Wolfensberger R.A 24 year old warmblood mare (case 1) and a 12 year old Holsteiner gelding (case 2) were anaesthetized for bursoscopy and phacoemulsification, respectively. Both were premedicated with intramuscular acepromazine (30 μg kg-1). The horses were sedated with intravenous (IV) medetomidine (7-9 μg kg-1 to effect), before anaesthetic induction with ketamine-diazepam. Anaesthesia was maintained with isoflurane in a mixture of oxygen and medical air, alongside a medetomidine constant rate infusion at 3.5 μg kg-1 hour-1. In recovery, 3 and 5 μg kg-1 of medetomidine were administered IV to cases 1 an...
