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1.
Four hundred and ninety horses were anaesthetised with halothane for clinical surgical or diagnostic procedures following induction with either detomidine/keta-mine, detomidine/thiopentone, xylazine/ketamine or guaiphenesin/thiopentone. Routine clinical monitoring was performed during anaesthesia. All horses developed hypotension (mean arterial pressures below 80 mm Hg) and respiratory depression (significant fall in respiratory rate and arterial carbon dioxide tension above 7 kPa (53 mm Hg)) consistent with the recognised effects of halothane. All anaesthetic procedures incorporating xylazine or detomidine resulted in lower pulse rates (28–35 per min) than after guaiphenesin/thiopentone (36–44 per min) and there was greater respiratory depression after techniques employing thiopentone rather than keta-mine. Development of hypotension was delayed after techniques using the α2 adrenoceptor agonist agents (xylazine and detomidine), particularly detomidine. Prernedication with acepromazine did not affect any of the physiological variables measured after techniques employing detomidine. Recovery to standing was fastest after xylazine/ketamine (31±1 min) and slowest after detomidine/thiopentone (53±2 min). Recovery quality was best after detomidine/thiopentone and all techniques employing an α2 adrenoceptor agonist agent resulted in smoother recovery than after guaiphenesin/thiopentone. This study demonstrates that most of the physiological effects of individual induction agents are overridden by the cardiovascular and respiratory depressant effects of halothane. The study also shows that detomidine is an acceptable sedative for use before general anaesthesia with halothane in horses.  相似文献   

2.
Objective To determine the effects of surgery, hypoxia, hypercapnia and flunixin administration on plasma β‐endorphin immunoreactivity (BEI) in anaesthetized horses. Study design Prospective crossover study. Animals Six healthy adult Welsh Mountain ponies and seven healthy adult Thoroughbreds. Methods Ponies were anaesthetized with thiopentone and halothane or with pentobarbitone and the horses with guaiphenesin, thiopentone and halothane. Ponies were anaesthetized for 2 hours and on separate occasions underwent a period of hypoxia, hypercapnia, anaesthesia only, or were given flunixin at induction. The horses were anaesthetized for 2 hours and on separate occasions underwent surgery to relocate one carotid artery subcutaneously or anaesthesia only. Plasma samples were taken pre‐anaesthesia, at 20 minute intervals during, and after anaesthesia for BEI assay using radio‐immunoassay. Analysis of variance of the concentration‐time curve was used for statistical analysis. Results Pre‐anaesthetic β‐endorphin immunoreactivity (BEI) values ranged between 5.7 and 20.4 pmol L?1. Induction of anaesthesia caused a five to 10 fold increase in mean plasma BEI in all cases except the hypercapnia group. Halothane anaesthesia increased BEI in ponies and horses but there were no significant changes during pentobarbitone anaesthesia. The increase in BEI in the hypoxic group was greater (peak value 136.8 ± 32.2 pmol L?1) and sustained for a longer period compared with levels in those given halothane alone or in those which became hypercapnic. There was marked individual variation in the flunixin group and changes were not significant. Surgery in the horses resulted in the highest peak values in the study (182.5 ± 153.0 pmol L?1) but the AUC was not significantly higher than in the same animals without surgery, where the peak value was 102.9 ± 42.1 pmol L?1. Conclusions Beta‐endorphin appeared to be a sensitive marker of an endocrine stress response but its physiological role during equine anaesthesia is unknown. Clinical relevance Unknown.  相似文献   

3.
Halothane produces a concentration related depression of cardiopulmonary function in horses ( Steffey & Howland 1978 ). This study evaluated an infusion of ketamine and guaiphenesin in horses to reduce halothane requirements during surgical anaesthesia.  相似文献   

4.
Objective To compare the anaesthetic and cardiopulmonary effects of a diazepam–ketamine combination with thiopentone for induction of anaesthesia in dogs. Animal population Twenty healthy dogs of various breeds weighing between 3.8 and 42.6 kg undergoing major orthopaedic or soft tissue surgery. Materials and methods Pre‐anaesthetic medication in all cases was intramuscular acepromazine and methadone given 30 minutes before induction of anaesthesia. Each animal was then randomly assigned to receive either thiopentone or diazepam and ketamine. Quality of conditions for, and time to tracheal intubation were recorded. Anaesthesia was maintained with halothane in oxygen and nitrous oxide. Heart rate, respiratory rate, systolic blood pressure, end tidal carbon dioxide tensions and oxygen saturation were recorded at 10 minute intervals throughout surgery. The quality of recovery from anaesthesia was assessed. Results The quality of induction in both groups was satisfactory. The total mean time (± SD) to tracheal intubation (162 ± 84 seconds) was significantly longer in dogs receiving diazepam and ketamine compared to dogs receiving thiopentone (62 ± 28 seconds). Heart rate, systolic blood pressure and end tidal carbon dioxide concentration were not significantly different between groups. Respiratory rate was significantly higher in the diazepam–ketamine group between 0 and 30 minutes. The quality of recovery was similar in each group. Conclusions There appear to be fewer differences between the induction agents examined in this study than was previously believed. No pressor, or other cardiovascular stimulating effects were detected in the dogs that received diazepam and ketamine. Clinical relevance The absence of obvious differences between groups suggests that pre‐anaesthetic medication, inhaled anaesthetics and the physiological effects of surgery itself probably had a greater effect on the variables studied than the induction agent used. Further studies are required to determine whether diazepam and ketamine offers significant advantages over other induction agents in the unhealthy dog.  相似文献   

5.
Anaesthesia using propofol alone and in combination with guaiphenesin, after detomidine premedication, was evaluated for performance of minor surgical procedures (castration and tenotomy) in horses. Twelve male horses were premedicated with 0.015 mg/kg of detomidine intravenously (iv) and divided into two groups of six. One group of horses received 2 mg/kg of propofol iv and the other group received 0.5 mg/kg of propofol mixed with 100 mg/kg of a 7.5% solution of guaiphenesin in saline iv. Induction of anaesthesia was fast and smooth in both groups. All horses were easily intubated immediately afterwards but intubation was easier in the horses which received propofol and guaiphenesin. Heart rate fell by 20% in both groups after detomidine injection, stabilising between 45 and 53 beats/minute during anaesthesia with no difference between the groups. Respiratory depression developed after detomidine injection and was slightly intensified after induction of anaesthesia. Respiratory rate was significantly lower in the propofol group (14 ± 3 breaths/minute) than with propofol/guaiphenesin (19 ± 4 breaths/minute) at five minutes after induction. Anaesthesia induced respiratory acidosis in both groups and hypoxaemia also occurred, but once the horses stood up the arterial blood oxygen partial pressure returned to basal values. Surgical time ranged between 8 and 16 minutes and with the exception of one horse in the propofol/guaiphenesin group the horses did not show signs of pain or discomfort during surgery. Recovery to standing was fast and took 26 ± 2 minutes in the propofol and 29 ± 5 minutes in the propofol/ guaiphenesin group. Most horses stood up at the first attempt with minimal ataxia. These two anaesthetic techniques appear to be useful for minor surgical procedures performed within 16 minutes of induction of anaesthesia.  相似文献   

6.
Objective To identify the incidence of adverse effects caused by morphine 100–170 µg kg?1 administration during surgery in horses. Design Retrospective case record analysis (1996–2000). Animals Eighty‐four healthy (ASA 1 or 2) horses, mean age 5.5 ± 3.1 (SD) years (2 months to 16 years), mean weight 524 ± 14 kg (100–950). Methods Physiological data and evidence of complications were collected from the anaesthetic records of all animals anaesthetized with romifidine, ketamine, diazepam and halothane and undergoing laryngeal surgery or orchiectomy at the Royal (Dick) School of Veterinary Studies. Cases were divided into those receiving (group M+; n = 18) and those not receiving morphine (M?; n = 29), and the data compared. Values for heart and respiratory rate and mean arterial pressure were compared at 15‐minute intervals between 30 and 120 minutes after induction using anova for repeated measures. The incidence of intraoperative problems was compared using Fisher's exact test. Recovery scores were compared using Student's unpaired t‐test. The records of a further 37 horses undergoing umbilical herniorrhaphy (n = 5), arthroscopy (n = 29) or tarsal arthrodesis (n = 3) were also studied but not analysed statistically due to disparate treatment distribution. Results There were no significant differences between the M+ and M? groups. The incidence of post‐operative complications such as box‐walking and colic were similar in each group. Conclusions Morphine doses of 100–170 µg kg?1 do not increase the risk of problems when used to provide perioperative analgesia in horses anaesthetized with romifidine, ketamine, diazepam and halothane. Clinical relevance Morphine provides an acceptable and relatively inexpensive way to provide perioperative analgesia in horses.  相似文献   

7.
Objective To identify changes in the amplitude spectrum of the electroencephalogram (EEG) during a standardized surgical model of nociception in horses. Animals Thirteen entire male horses and ponies referred to Division of Clinical Veterinary Science, Bristol (n = 9) and Department of Clinical Veterinary Medicine (n = 4) for castration. Materials and methods Following pre‐anaesthetic medication with acepromazine, anaesthesia was induced with guaiphenesin and thiopental and maintained with halothane in oxygen. The EEG was recorded continuously using subcutaneous needle electrodes. Additional monitoring comprised ECG, arterial blood pressure, blood gas analysis, airway gases, and body temperature. All animals were castrated using a closed technique. The raw EEG was analysed after completion of each investigation and the EEG variables median frequency (F50), spectral edge frequency (SEF) 95% and total amplitude were derived from the spectra using standard techniques. The mean values of EEG variables recorded during a baseline time period (recorded before the start of surgery) and castration of each testicle were compared using analysis of variance for repeated measures. Results Total amplitude (Atot) decreased and F50 increased during castration of each testicle compared to the baseline time period [(89.0 ± 7.8% testicle 1, 87.0 ± 7.8% testicle 2) and (110.0 ± 15.0% testicle 1, 109.0 ± 15.0% testicle 2), respectively]. Changes in SEF 95% were not significant. Conclusions De‐synchronization was identified in the EEG during the nociceptive stimulus of castration. The results suggest that an increase in F50 may be a specific marker for nociception in the horse. Clinical relevance Studies investigating the efficacy of analgesic agents in horses are limited by difficulties in peri‐operative pain assessment. This model, using EEG changes associated with nociceptive stimulation, can be used to investigate the anti‐nociceptive efficacy of different anaesthetic agents in the horse.  相似文献   

8.
Objective To evaluate the effects of a constant rate infusion (CRI) of romifidine on the requirement of isoflurane, cardiovascular performance and recovery in anaesthetized horses undergoing arthroscopic surgery. Study design Randomized blinded prospective clinical trial. Animals Thirty horses scheduled for routine arthroscopy. Methods After premedication (acepromazine 0.02 mg kg?1, romifidine 80 μg kg?1, methadone 0.1 mg kg?1) and induction (midazolam 0.06 mg kg?1 ketamine 2.2 mg kg?1), anaesthesia was maintained with isoflurane in oxygen. Horses were assigned randomly to receive a CRI of saline (group S) or 40 μg kg?1 hour?1 romifidine (group R). The influences of time and treatment on anaesthetic and cardiovascular parameters were evaluated using an analysis of variance. Body weight (t‐test), duration of anaesthesia (t‐test) and recovery score (Wilcoxon Rank Sum Test) were compared between groups. Significance was set at p < 0.05. Results All but one horse were positioned in the dorsal recumbent position and ventilated from the start of anaesthesia. End tidal isoflurane concentrations were similar in both groups at similar time points and over the whole anaesthetic period. Cardiac output was significantly lower in horses of the R group, but there were no significant differences between groups in cardiac index, body weight or age. All other cardiovascular parameters were similar in both groups. Quality of recovery did not differ significantly between groups, but more horses in group R stood without ataxia at the first attempt. One horse from group S had a problematic recovery. Conclusions and clinical relevance No inhalation anaesthetic sparing effect or side effects were observed by using a 40 μg kg?1 hour?1 romifidine CRI in isoflurane anaesthetized horses under clinical conditions. Cardiovascular performance remained acceptable. Further studies are needed to identify the effective dose of romifidine that will induce an inhalation anaesthetic sparing effect in anaesthetized horses.  相似文献   

9.
Objective To determine, in mildly hypercapnic horses under isoflurane–medetomidine balanced anaesthesia, whether there is a difference in cardiovascular function between spontaneous ventilation (SV) and intermittent positive pressure ventilation (IPPV). Study design Prospective randomized clinical study. Animals Sixty horses, undergoing elective surgical procedures under general anaesthesia: ASA classification I or II. Methods Horses were sedated with medetomidine and anaesthesia was induced with ketamine and diazepam. Anaesthesia was maintained with isoflurane and a constant rate infusion of medetomidine. Horses were assigned to either SV or IPPV for the duration of anaesthesia. Horses in group IPPV were maintained mildly hypercapnic (arterial partial pressure of carbon dioxide (PaCO2) 50–60 mmHg, 6.7–8 kPa). Mean arterial blood pressure (MAP) was maintained above 70 mmHg by an infusion of dobutamine administered to effect. Heart rate (HR), respiratory rate (fR), arterial blood pressure and inspiratory and expiratory gases were monitored continuously. A bolus of ketamine was administered when horses showed nystagmus. Cardiac output was measured using lithium dilution. Arterial blood‐gas analysis was performed regularly. Recovery time was noted and recovery quality scored. Results There were no differences between groups concerning age, weight, body position during anaesthesia and anaesthetic duration. Respiratory rate was significantly higher in group IPPV. Significantly more horses in group IPPV received supplemental ketamine. There were no other significant differences between groups. All horses recovered from anaesthesia without complications. Conclusions There was no difference in cardiovascular function in horses undergoing elective surgery during isoflurane–medetomidine anaesthesia with SV in comparison with IPPV, provided the horses are maintained slightly hypercapnic. Clinical relevance In horses with health status ASA I and II, cardiovascular function under general anaesthesia is equal with or without IPPV if the PaCO2 is maintained at 50–60 mmHg.  相似文献   

10.
The pharmacodynamics and pharmacokinetics of ketamine, when administered by infusion as an adjunct to halothane anaesthesia in horses, were investigated in 5 equine patients presented for routine castration. Anaesthesia was induced with detomidine, 20 μg/kg, followed by ketamine, 2.2 mg/kg bwt, the trachea intubated and the horses allowed to breathe halothane in oxygen. Five minutes later, a constant rate infusion of ketamine, 40 μg/kg min, was commenced and the halothane vaporiser concentration adjusted to maintain a light plane of anaesthesia. The mean infusion duration was 62 min (range 40–103). The ketamine was switched off approximately 15 min before the halothane. Plasma ketamine and norketamine levels, determined by high performance liquid chromatography, ranged from 0.74–2.04 μg/ml and 0.15–0.75 μg/ml, respectively, during the infusion period. The harmonic mean elimination half-life of ketamine was 46.1 min, mean volume of distribution at steady state (Vdss) was 1365 (271) ml/kg, mean body clearance (Cl) was 32.3 (9.1) ml/min.kg, and average mean residence time for the infusion (MRTinf) was 105.9 (20.4) min, respectively. Following termination of halothane, mean times to sternal recumbency and standing were 21.1 (6.9) and 41.6 (17.0) min, respectively. Surgical conditions were considered highly satisfactory, and physiological parameters were well preserved in most animals.  相似文献   

11.
Objective To characterize intravenous anaesthesia with detomidine, ketamine and guaiphenesin in pregnant ponies. Animals Twelve pony mares, at 260–320 days gestation undergoing abdominal surgery to implant fetal and maternal vascular catheters. Materials and methods Pre‐anaesthetic medication with intravenous (IV) acepromazine (30 µg kg?1), butorphanol (20 µg kg?1) and detomidine (10 µg kg?1) preceded induction of anaesthesia with detomidine (10 µg kg?1) and ketamine (2 mg kg?1) IV Maternal arterial blood pressure was measured directly throughout anaesthesia and arterial blood samples were taken at 20‐minute intervals for measurement of blood gases and plasma concentrations of cortisol, glucose and lactate. Anaesthesia was maintained with an IV infusion of detomidine (0.04 mg mL?1), ketamine (4 mg mL?1) and guaiphenesin (100 mg mL?1) (DKG) for 140 minutes. Oxygen was supplied by intermittent positive pressure ventilation (IPPV) adjusted to maintain PaCO2 between 5.0 and 6.0 kPa (38 and 45 mm Hg), while PaO2 was kept close to 20.0 kPa (150 mm Hg) by adding nitrous oxide. Simultaneous fetal and maternal blood samples were withdrawn at 90 minutes. Recovery quality was assessed. Results DKG was infused at 0.67 ± 0.17 mL kg?1 hour?1 for 1 hour then reduced, reaching 0.28 ± 0.14 mL kg?1 hour?1 at 140 minutes. Arterial blood gas values and pH remained within intended limits. During anaesthesia there was no change in heart rate, but arterial blood pressure decreased by 10%. Plasma glucose and lactate increased (10‐fold and 2‐fold, respectively) and cortisol decreased by 50% during anaesthesia. Fetal umbilical venous pH, PO2 and PCO2 were 7.34 ± 0.06, 5.8 ± 0.9 kPa (44 ± 7 mm Hg) and 6.7 ± 0.8 kPa (50 ± 6 mm Hg); and fetal arterial pH, PO2 and PCO2 were 7.29 ± 0.06, 4.0 ± 0.7 kPa (30 ± 5 mm Hg) and 7.8 ± 1.7 kPa (59 ± 13 mm Hg), respectively. Surgical conditions were good but four ponies required a single additional dose of ketamine. Ponies took 60 ± 28 minutes to stand and recovery was good. Conclusions and clinical relevance Anaesthesia produced with DKG was smooth while cardiovascular function in mare and fetus was well preserved. This indicates that DKG infusion is suitable for maintenance of anaesthesia in pregnant equidae.  相似文献   

12.
A combination of 0.5 mg/kg of methotrimeprazine, 0.1 mg/kg of midazolam and 100 mg/kg of a 10 per cent guaiphenesin solution was investigated for the induction of recumbency in 15 horses; the addition of 1.6 mg/kg of ketamine was also evaluated in 15 horses and anaesthesia was maintained with halothane in oxygen. The horses became recumbent quickly and smoothly and they recovered quietly, with little ataxia. Tachycardia occurred after induction, but no other changes from pre-operative values were observed until halothane in oxygen had been given, when hypothermia, hypotension, bradypnoea, hyperoxaemia, respiratory acidosis and decreased respiratory minute volume developed. Horses given ketamine in addition to methotrimeprazine, midazolam and guaiphenesin were easier to intubate and recovered more quickly than horses receiving only methotrimeprazine, midazolam and guaiphenesin.  相似文献   

13.
Six ponies were anaesthetised for two hours with intermittent injections of a combination of guaiphenesin (72 mg/kg/hr), ketamine (1.4 mg/kg/hr) and detomidine (0.015 mg/kg/hr) after premedication with detomidine 0.01 mg/kg and induction of anaesthesia with guaiphenesin 50 mg/kg and ketamine 2 mg/kg. Induction of anaesthesia was smooth, the ponies were easily intubated and after intubation breathed 100% oxygen spontaneously. During anaesthesia mean pulse rate ranged between 31–44 beats per minute and mean respiratory rate between 12–23 breaths per minute. Mean arterial blood pressure remained between 110–130 mm Hg, mean arterial carbon dioxide tension between 6.1–6.9 kPa and pH between 737–7.42. Arterial oxygen tension was over 23 kPa throughout anaesthesia. Plasma glucose increased to more than 25 mmol per litre during anaesthesia; there was no change in lactate or ACTH concentration and plasma cortisol concentration decreased. Recovery was rapid and smooth. A guaiphenesin, ketamine and detomidine combination appeared to offer potential as a total intravenous technique for maintenance of anaesthesia in horses.  相似文献   

14.
Objective To identify and characterize the effects of guaiphenesin (GGE) on the electroencephalogram during halothane anaesthesia. Study design Prospective controlled study. Animals Eight healthy Welsh mountain pony geldings between 5 and 9 years old and weighing between 270 and 330 kg (mean 301 kg). Methods Anaesthesia was induced with thiopentone and maintained using halothane in oxygen. End tidal halothane was maintained above 0.75 and below 0.85%. The EEG was recorded continuously and a binaural broad band click stimulus was provided throughout the experiment at 6.1224 Hz. An infusion of 1500 mg GGE was given over 5 minutes. Samples were taken for blood gas analysis and plasma GGE assay (HPLC) 5 minutes prior to the start of the infusion and at 3, 5, 7, 10, 15, 20, 30, 45 and 60 minutes thereafter. The median and 95th percentile of the EEG were calculated using standard statistical techniques and the mid‐latency of the auditory evoked response was generated. The values of EEG variables at each time point were compared to the average value for the 15 minute period before the infusion was started. Arterial blood gas values and plasma GGE concentration were compared to the baseline sample taken prior to the start of the infusion. Comparisons were made using analysis of variance for repeated measures followed by Dunnett's test if a significant difference was detected. Results The peak serum plasma concentration was 49.6 ± 7.8 μg mL?1 (mean ± SD) occurring five minutes after the start of the infusion. The 95% spectral edge frequency (F95) of the EEG decreased by a maximum of 5.2 ± 14.3% 5 minutes after the start of the GGE infusion. This change did not reach statistical significance (p= 0.07). When three nonresponders were excluded, the depression in F95 at 5 minutes in the remaining five animals became 13.0 ± 12.0% and was statistically significant (p= 0.02). No changes were seen in median frequency of the EEG or the second differential of the middle latency auditory evoked potential. Conclusions These results did not demonstrate any statistically significant GGE‐induced changes in the EEG. However, there was some visible depression of F95 in five of the animals studied even though the dose of GGE used was considerably less than that used in most clinical circumstances. Clinical relevance The EEG effects seen in this study concur with the commonly held view that while GGE has some sedative effects, it is not a reliable anaesthetic agent.  相似文献   

15.
ObjectiveTo compare isoflurane alone or in combination with systemic ketamine and lidocaine for general anaesthesia in horses.Study designProspective, randomized, blinded clinical trial.AnimalsForty horses (ASA I-III) undergoing elective surgery.MethodsHorses were assigned to receive isoflurane anaesthesia alone (ISO) or with ketamine and lidocaine (LKI). After receiving romifidine, diazepam, and ketamine, the isoflurane end-tidal concentration was set at 1.3% and subsequently adjusted by the anaesthetist (unaware of treatments) to maintain a light plane of surgical anaesthesia. Animals in the LKI group received lidocaine (1.5 mg kg−1 over 10 minutes, followed by 40 μg kg−1 minute−1) and ketamine (60 μg kg−1 minute−1), both reduced to 65% of the initial dose after 50 minutes, and stopped 15 minutes before the end of anaesthesia. Standard clinical cardiovascular and respiratory parameters were monitored. Recovery quality was scored from one (very good) to five (very poor). Differences between ISO and LKI groups were analysed with a two-sample t-test for parametric data or a Fischer's exact test for proportions (p < 0.05 for significance). Results are mean ± SD.ResultsHeart rate was lower (p = 0.001) for LKI (29 ± 4) than for ISO (34 ± 6). End-tidal concentrations of isoflurane (ISO: 1.57% ± 0.22; LKI: 0.97% ± 0.33), the number of horses requiring thiopental (ISO: 10; LKI: 2) or dobutamine (ISO:8; LKI:3), and dobutamine infusion rates (ISO:0.26 ± 0.09; LKI:0.18 ± 0.06 μg kg−1 minute−1) were significantly lower in LKI compared to the ISO group (p < 0.001). No other significant differences were found, including recovery scores.Conclusions and clinical relevanceThese results support the use of lidocaine and ketamine to improve anaesthetic and cardiovascular stability during isoflurane anaesthesia lasting up to 2 hours in mechanically ventilated horses, with comparable quality of recovery.  相似文献   

16.
A combination of detomidine, guaiphenesin and ketamine was used to maintain anaesthesia for surgery in 38 horses and ponies. Cardiovascular and respiratory depression were minimal and surgical conditions were excellent. Recovery was smooth in most cases but prolonged and ataxic in some pregnant pony mares. Plasma cortisol concentration decreased during anaesthesia, even when major surgery was performed. This suggests that the anaesthetic technique does not itself induce a stress response and may suppress it. Anaesthesia was straightforward in all cases and the technique appears to have potential as an alternative to anaesthetic maintenance with volatile agents. The pharmacokinetics of the infusion are unknown and require investigation, particularly in pregnant animals.  相似文献   

17.
Objective To compare isoflurane and sevoflurane in lambs undergoing prolonged anaesthesia for spinal surgery. Study design Prospective randomised clinical study. Animals Eighteen Scottish blackface lambs 3–6 weeks of age and weighing 10–17 kg. Methods After intramuscular medetomidine, anaesthesia was induced and maintained with either isoflurane (group I) or sevoflurane (group S) delivered in oxygen. Meloxicam, morphine, a constant rate infusion of ketamine and atracurium were given intravenously (IV) during surgery. Lungs were ventilated to maintain normocapnia. with peak inspiratory pressures of 20–25 cmH2O. Ephedrine or dextran 40% was administered when mean arterial pressure (MAP) was <55 mmHg. Intrathecal morphine, and IV meloxicam and edrophonium were injected before recovery. Time to loss of palpebral reflex (TLPR) upon induction, cardiorespiratory variables, time at first swallowing and other movement, tracheal extubation, vocalisation, spontaneous head lifting (>1 minute), reunion with the ewe, and the number of MAP treatments were recorded. Statistical analysis utilised anova , Mann–Whitney, t‐test or Pearson’s correlation test as relevant. p < 0.05 was considered significant. Results End‐tidal carbon dioxide (mean ± SD) was significantly lower in group S (5.5 ± 0.6 kPa) than in group I (5.8 ± 0.5 kPa) while MAP (70 ± 11 mmHg) and diastolic arterial blood pressure (60 ± 11 mmHg) were higher in group S than in group I (65 ± 12 and 54 ± 11 mmHg, respectively). No differences were found with TLPR and MAP treatments. Time (median, range) from end of anaesthesia to ewe‐lamb reunion was briefer (p = 0.018) in group S (48, 20–63 minutes). Conclusion Isoflurane and sevoflurane are both suitable for maintaining general anaesthesia in lambs although sevoflurane, as used in this study, allows a more rapid reunion with the ewe. Clinical relevance The principal advantage of sevoflurane over isoflurane during prolonged anaesthesia in lambs is a more rapid recovery.  相似文献   

18.
This clinical study analysed the anaesthetic sparing effect of a medetomidine constant rate infusion (CRI) during isoflurane anaesthesia in horses. Forty healthy horses undergoing different types of orthopaedic and soft tissue surgeries were studied in a randomized trial. Orthopaedic surgeries were primarily arthroscopies and splint bone extractions. Soft tissue surgeries were principally castrations with one ovariectomy. All horses received 0.03 mg kg?1 acepromazine IM 1 hour prior to sedation. Group A (11 orthopaedic and nine soft tissue surgeries), was sedated with 1.1 mg kg?1 xylazine IV, group B (13 orthopaedic and seven soft tissue surgeries) with 7 µg kg?1 medetomidine IV. Anaesthesia was induced in both groups with 2.2 mg kg?1 ketamine and diazepam 0.02 mg kg?1 IV. Maintenance of anaesthesia was with isoflurane (ISO) in 100% oxygen, depth of anaesthesia was always adjusted by the first author. Group B received an additional CRI of 3.5 µg kg?1 hour?1 medetomidine. Respiratory rate (RR), heart rate (HR), mean arterial blood pressure (MAP), Fe ′ISO and Fe ′CO2 were monitored with a methane insensitive monitor (Cardiocap 5, Ohmeda, Anandic, Diessenhofen) and noted every 5 minutes. Arterial blood was withdrawn for gas analysis (PaO2, PaCO2) 5 minutes after the induction of anaesthesia and every 30 minutes thereafter. Dobutamine (DOB) was given as a CRI to maintain mean arterial blood pressure above 70 mm Hg. Data were averaged over time (sum of measurements/number of measurements) and tested for differences between groups by unpaired t‐tests. There were no significant differences between the groups in terms of body mass (group A, 508 ± 73.7 kg; group B, 529.25 ± 78.4 kg) or duration of anaesthesia (group A, 125.5 ± 36 minutes; group B, 121.5 ± 48.4 minutes). The mean Fe ′ISO required to maintain a surgical plane of anaesthesia was significantly higher in group A (1.33 ± 0.13%) than in group B (1.07 ± 0.19%; p = 2.78 × 10?5). Heart rate was different between the two groups (group A, 42.2 ± 8.3; group B, 32.6 ± 3.5; p = 8.8 × 10?5). Dobutamine requirements were higher in group A (group A, 0.72 ± 0.24 μg kg?1 minute?1; group B, 0.53 ± 0.23 μg kg?1 minute?1; p = 0.023). Respiratory rate, Fe ′CO2, PaO2, PaCO2 were not different between the groups. Adjustment of anaesthetic depth subjectively was easier with the medetomidine infusion and isoflurane (group B) than with isoflurane as a sole agent (group A). In group A 12 horses and in group B five horses showed purposeful movements on 27 (A) and 12 (B) occasions. They were given thiopental (group A, 0.0114 mg kg?1 minute?1; group B, 0.0023 mg kg?1 minute?1). In group A, a further 17 horses were given ketamine to deepen anaesthesia (52 occasions, 0.00426 mg kg?1 minute?1) whereas in group B only nine horses needed ketamine (34 occasions, 0.00179 mg kg?1 minute?1). An infusion of 3.5 µg kg?1 MED during ISO anaesthesia resulted in a significantly reduced ISO requirement.  相似文献   

19.
Spontaneous EEG changes during castration have been identified in horses anaesthetized with halothane ( Murrell et al. 1999 ). This study, using the same model, investigated the effect of thiopentone on the response of the equine EEG to surgical stimulation. Six yearling ponies, mean weight 210 ± 36 kg, were studied. Following pre‐anaesthetic medication with acetylpromazine, general anaesthesia was induced with guaiphenesin and thiopentone. Anaesthesia was maintained with halothane, F É hal 1.2%, vaporized in oxygen and an infusion of thiopentone IV. The infusion was started 30 minutes after the induction of anaesthesia to achieve a target plasma concentration of 10 µg ml?1. Ventilation was controlled to maintain normocapnia (PaCO2 was measured by arterial blood gas analysis) and the EEG was recorded continuously. Baseline measurements were recorded over 5 minutes at least 10 minutes after the infusion began but before the start of surgery. Castration was defined as section of the spermatic cord. Six blood samples were taken during the baseline and castration time periods for analysis of serum thiopentone concentration by high performance liquid chromatography. The derived EEG variables median (F50) and spectral edge (F95) frequencies and total power (Atot) were examined. For each horse, the EEG data were averaged to produce a single value for F50, F95 and Atot every 30 seconds. These values, recorded during the five minutes baseline and two castration time periods were compared using repeated measures anova . Data are presented as mean ± SD The mean serum concentration of thiopentone during the infusion (23 ± 10.5 µg ml?1) varied widely between individual animals. The F50 was significantly higher (p = 0.0001) during castration compared to the baseline period [104.4 ± 8.8% (testicle 1); 105.8 ± 13.4% (testicle 2)]. Atot decreased significantly (p < 0.0001) during castration [98.8 ± 4.4% (testicle 1); 93.7 ± 6.5% (testicle 2)]. The measured serum thiopentone concentrations were larger than the target concentration, which made the results more difficult to interpret. The ponies appeared to be divided into two groups. In four animals F50, F95 and Atot changed very little during castration compared to the baseline time period. Three of these animals had the largest serum thiopentone concentrations. In the two other animals F50 increased and Atot decreased, the changes were particularly marked in one animal. These animals had lower serum thiopentone concentrations than the first group. Compared to the previous study ( Murrell et al. 1999 ), in the two ponies which responded with EEG changes during castration, the decrease in Atot was smaller in magnitude, the increase in F50 was similar. Changes in Atot may indicate changes in the adequacy of anaesthesia ( Hall & Clarke 1991 ). An infusion of thiopentone IV did not obtund an increase in F50 but minimized changes in adequacy of anaesthesia during castration. These results support an anti‐analgesic action of thiopentone on the equine central nervous system ( Hall & Clarke 1991 ). Acknowledgements: JM is a Horserace Betting Levy Board Scholar.  相似文献   

20.
Objective To compare the arterial pH and blood gas values, heart rate and mean arterial blood pressure, in hypoxaemic anaesthetized horses, before and after treatment, with a salbutamol (albuterol) aerosol. Animal population Eighty‐one client‐owned horses weighing between 114 and 925 kg. Fifty‐seven underwent emergency abdominal surgery and 24 were anaesthetized for elective procedures. Materials and methods Pre‐anaesthetic medication included xylazine, detomidine, butorphanol and morphine, alone or in various combinations. Induction of anaesthesia was achieved with guaifenesin and ketamine, diazepam and ketamine, or guaifenesin and thiopental. The trachea of all animals was intubated and anaesthesia maintained with either halothane (33 horses) or isoflurane (48 horses) in oxygen. Heart rate and rhythm were monitored continuously. Arterial blood pressure was monitored directly, and arterial blood collected for pH and blood gas analyses. When arterial PaO2 fell below 9.3 kPa (70 mm Hg) and failed to respond to corrective measures including positive pressure ventilation and treatment of hypotension (mean arterial blood pressures <70 mm Hg), a salbutamol aerosol (2 µg kg?1) was delivered via the endotracheal tube. Twenty minutes later, a second arterial blood sample was analysed. Results There were no significant differences in mean arterial blood pressure, heart rate, arterial pH, base excess and bicarbonate before and after treatment. Arterial O2 tension increased significantly from a mean ± SD of 8.3 ± 1.7 kPa (62.4 ± 13.1 mm Hg) before administration to 15.9 ± 9.8 kPa (119.4 ± 57.7 mm Hg) after treatment. There was a small but significant decrease in PaCO2 from 7.4 ± 1.5 kPa (55.2 ± 11.2 mm Hg) to 7.0 ± 1.3 kPa (52.9 ± 9.8 mm Hg) between sample times. No changes in heart rhythm were observed. A high percentage (approximately 70%) of animals sweated following treatment. Conclusions Salbutamol administered at a dose of 2 µg kg?1 via the endotracheal tube of anaesthetized horses with PaO2 values less than 9.3 kPa (70 mm Hg) resulted in an almost two‐fold increase in PaO2 values within 20 minutes of treatment. No changes in heart rate or mean arterial blood pressure were associated with the use of salbutamol in this study. The improvement in PaO2 may be a result of bronchodilatation and improved ventilation, increased perfusion secondary to an increase in cardiac output, or a combination of these two factors. Cardiac output and ventilation–perfusion distribution were not measured in this study; therefore, the reason for the increase in PaO2 values cannot be conclusively determined. Clinical relevance Administration of a salbutamol aerosol is a simple but effective technique that can be used to improve PaO2 values in hypoxaemic horses during inhalant anaesthesia with no apparent detrimental side effects.  相似文献   

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