Continuous versus intermittent thermodilution for cardiac output measurement during alveolar recruitment manoeuvres in sheep.

OBJECTIVE: To evaluate interchangeability of a thermodilution based STAT mode continuous cardiac output (CCO) measurement method with bolus thermodilution (BTD). STUDY DESIGN: Randomized crossover study. ANIMALS: Ten 9 month old healthy male sheep. METHODS: Each sheep was anaesthetized twice for laparoscopy. On one occasion mechanical ventilation was used immediately after anaesthetic induction (IPPV treatment) and on the other occasion the start of IPPV was delayed and two periods of alveolar recruitment manoeuvres were also performed (RM treatment). Cardiac output (CO) was measured simultaneously with both CCO and BTD at 6 time points. Data were analysed using difference versus mean plots. A priori limits of acceptance were set at ±30% of the mean of every paired measurement. If <5% of the data fell outside of these limits (Chi-square test, p<0.05) the interchangeability of methods was accepted. Proportions of data outside of these limits were also compared between treatments (Fisher's test, p <0.05). Cardiac output data from each treatment and measurement method were also analyzed separately with one-factorial anova and Bonferroni test (p<0.05). RESULTS: A total of 119 measurements were obtained. Cardiac output ranged from 1.9 to 10.4 L minute(-1) (CCO) and from 1.1 to 9.8 L minute(-1) (BTD). The bias and limits of agreement were 0.5±1.9 L minute(-1) . More than 5% of all data fell outside of the limits of acceptance (24/119), and a larger proportion fell outside of these limits in the RM (20/59) compared to the IPPV treatment (4/60). The Bonferroni test detected significant decreases of CO over time in both treatments when measured with BTD but not with CCO. CONCLUSIONS AND CLINICAL RELEVANCE: The STAT mode CCO method is not interchangeable with BTD during acute haemodynamic changes caused by recruitment manoeuvres, thus the results of STAT mode CCO should be interpreted with caution because decreases in CO may not be detected.

A scavenging double mask to reduce workplace contamination during mask induction of inhalation anesthesia in dogs.

BACKGROUND: Workplace contamination by the use of volatile anesthetic agents should be kept to a minimum if a potential health hazard is to be minimised. Mask induction of animals is a common procedure. The present study investigates the efficiency of a novel scavenging double mask in reducing waste gas concentrations in the breathing zone of the anesthetist performing this procedure. METHODS: Twelve beagle dogs (ASA I) undergoing general anesthesia for a dental procedure were intravenously premedicated with medetomidine and butorphanol (10 µg/kg and 0.2 mg/kg). Anesthesia was induced via a custom-made scavenging mask using isoflurane in oxygen. In six dogs (group S), scavenging from the mask was performed whereas in six other dogs (group NS) the scavenging function was disabled. Isoflurane concentration was continuously measured with photoacoustic spectroscopy at the level of the shoulder of the anesthetist before and during mask induction and additionally during intubation. Statistical analysis was performed with a Student t- test and a Mann-Whitney U test (p < 0.05 for significance). RESULTS: The mean isoflurane concentration during baseline (premedication) was 1.8 ± 0.8 ppm and 2.3 ± 0.6 ppm in group S and NS respectively. This increased during mask induction to 2.0 ± 0.8 ppm and 11.2 ± 6.0 ppm respectively (p < 0.01). The maximum isoflurane concentration ranged from 0.7 ppm to 2.8 ppm and from from 8.3 ppm to 43.7 ppm in group S and NS respectively. CONCLUSION: This double mask can be used to induce inhalation anesthesia in dogs. Scavenging from the mask significantly decreases the amount of waste anaesthetic gas concentrations in the breathing zone of the anesthetist. Therefore, such a system can be recommended whenever induction or maintenance of general anesthesia by mask is considered.

Anaesthetic sparing effect of local anaesthesia of the ovarian pedicle during ovariohysterectomy in dogs.

OBJECTIVE: To evaluate the effect of local anaesthesia of the mesovarium on end-tidal isoflurane (Fe'(iso)) concentration and vital parameters during canine ovariohysterectomy. STUDY DESIGN: Prospective, randomized, blinded study. ANIMALS: Twenty client-owned dogs undergoing elective ovariohysterectomy. Mean age 1.7 (+/-0.53, SD) years and mean body weight 21 kg (+/-5.9, SD). METHODS: Pre-medication was with intravenous acepromazine (0.02 mg kg(-1)) and methadone (0.1 mg kg(-1)). Anaesthesia was induced with propofol and maintained with isoflurane in oxygen. One group (n = 10) received local infiltration of the mesovarium with 0.5 mL lidocaine 2% and one group (n = 10) with 0.5 mL NaCl 0.9%. Heart (HR) and respiratory rates (fr), invasive mean arterial blood pressure (MAP) and Fe'(iso)were recorded. The Fe'(iso) was adjusted according to changes in HR, RR and MAP. Time points used for comparison were T1 (after induction of anaesthesia before surgery), T2 (after lidocaine infiltration of the mesovarium) and T3 (surgical manipulation of the ovaries). Data were analysed using a mixed model for repeated measurement anova and the Tukey adjustment. Results are presented as mean +/- SD; p < 0.05 was considered significant. RESULTS: In both groups, HR and fr remained stable at the three time points. Mean values ranged from 84 to 94 beats minute(-1) and from 10 to 14 breaths minute(-1). The Fe'(iso) was significantly lower at T3 compared to T1 and mean values ranged from 0.95% to 1.24%. The mean arterial blood pressure was significantly higher at T3 compared to T1 and mean values ranged from 58 to 96 mm Hg. At none of the time points were there significant differences between the two groups for HR, fr, MAP or Fe'(iso). CONCLUSION: Neither an isoflurane sparing effect nor a difference in autonomic response to surgery was demonstrated following local anaesthesia of the mesovarium. CLINICAL RELEVANCE: There appeared to be minimal benefit from local anaesthesia of the mesovarium during this study.

Laparoscopic-assisted implantation of a urinary catheter in male sheep.

OBJECTIVE-To evaluate a laparoscopic technique for implantation of a urinary catheter in the right paramedian area in male sheep and to determine feasibility, benefits, and risks for this technique. DESIGN-Evaluation study. ANIMALS-6 Healthy male sheep (mean +/- SD body weight, 42.16 +/- 11.95 kg [92.75 +/- 26.29 lb]). PROCEDURES-Each sheep was anesthetized and positioned in dorsal recumbency. A 10-mm laparoscope was inserted in the right paramedian area between the xiphoid and preputial orifice. After creation of capnoperitoneum, grasping forceps were inserted in the left paramedian area at the level of the teats and used to immobilize the urinary bladder. A pigtail balloon catheter was implanted transcutaneously in the right paramedian area between the preputial orifice and teats and directed into the urinary bladder by use of laparoscopic guidance. The catheter was removed 10 days after implantation. Fourteen days after initial surgery, a second laparoscopy was performed to evaluate pathologic changes. RESULTS-Inadvertent insertion of the first trocar into the rumen of 1 sheep was the only intraoperative complication encountered. Laparoscopic-assisted implantation of the urinary catheter was successfully performed in all sheep. No postoperative complications were detected. CONCLUSIONS AND CLINICAL RELEVANCE-Laparoscopic-assisted implantation of a urinary catheter in the right paramedian area was successfully performed and may be a feasible method for use in sheep. This method can be considered as an alternative to tube cystotomy performed by laparotomy.