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Objective: To examine the influence of a detomidine constant rate infusion (CRI) on cardiovascular function, isoflurane requirements and recovery quality in horses undergoing elective surgery., Study Design: Prospective, randomized, blinded, clinical trial., Animals: Twenty adult healthy horses., Methods: After sedation (detomidine, 10 μg kg(-1) intravenously [IV]) and induction of anaesthesia (midazolam 0.06 mg kg(-1) , ketamine 2.2 mg kg(-1) IV), anaesthesia was maintained with isoflurane in oxygen/air (inspiratory oxygen fraction 55%). When indicated, the lungs were mechanically ventilated. Dobutamine was administered when MAP<70 mmHg. The horses were randomly allocated to one of two groups and throughout anaesthesia, received either a detomidine (5 μg kg(-1)  hour(-1) ) (D) or saline (S) CRI, with the anaesthetist unaware of the treatment. Monitoring included end-tidal isoflurane concentration, arterial pH, PaCO(2) , PaO(2) , dobutamine administration rate, heart rate (HR), arterial pressure, cardiac index (CI), systemic vascular resistance (SVR), stroke index and oxygen delivery index (ḊO(2) I). For recovery from anaesthesia, all horses received 2.5 μg kg(-1) detomidine IV. Recovery quality and duration were recorded in each horse. For statistical analysis, anova, Pearson chi-square and Wilcoxon rank sum tests were used as relevant., Results: Heart rate (p=0.0176) and ḊO(2) I (p= 0.0084) were lower and SVR higher (p=0.0126) in group D, compared to group S. Heart rate (p=0.0011) and pH (p=0.0187) increased over time. Significant differences in isoflurane requirements were not detected. Recovery quality and duration were comparable between treatments., Conclusions and Clinical Relevance: A detomidine CRI produced cardiovascular effects typical for α(2) -agonists, without affecting isoflurane requirements, recovery duration or recovery quality., (© 2011 The Authors. Veterinary Anaesthesia and Analgesia. © 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists.)

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 microg 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 microg 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 microg 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.

Objective: To examine the influence of direct current shock application in anaesthetized horses with atrial fibrillation (AF) and to study the effects of cardioversion to sinus rhythm (SR)., Study Design: Prospective clinical study., Animals: Eight horses successfully treated for AF (transvenous electrical cardioversion after amiodarone pre-treatment)., Methods: Cardioversion catheters and a pacing catheter were placed under sedation [detomidine 10 microg kg(-1) intravenously (IV)]. After additional sedation (5-10 microg kg(-1) detomidine, 0.1 mg kg(-1) methadone IV), anaesthesia was induced with ketamine, 2.2 mg kg(-1) and midazolam, 0.06 mg kg(-1) (IV) in a sling and maintained with isoflurane in oxygen. Flunixin meglumine, 1.1 mg kg(-1), was administered IV. Shocks were delivered as biphasic truncated exponential waves, synchronized with the R-wave of the electrocardiogram. Monitoring included pulse oximetry, electrocardiography, capnography, inhalational anaesthetic agent concentration, arterial blood pressure, LiDCO and PulseCO cardiac index (CI) and arterial blood gases. Values before and after the first unsuccessful shock and before and after cardioversion to SR were compared., Results: Values before the first shock were comparable to reported values in healthy, isoflurane anaesthetized horses. Reliable CI measurements could not be obtained using the PulseCO technique. Intermittent positive pressure ventilation was required in most horses (bradypnea and/or PaCO(2) >8 kPa, 60 mmHg), while dobutamine was administered in two horses (0.3-0.5 microg kg(-1) minute(-1)). After the 1st unsuccessful shock application, systolic arterial pressure (SAP) was decreased (p = 0.025), other recorded values were not influenced (CI measurements not available for this analysis). SR was associated with increases in CI (p = 0.039) and stroke index (p = 0.002) and a decrease in SAP (p = 0.030)., Conclusions and Clinical Relevance: Despite the presence of AF, cardiovascular function was well maintained during anaesthesia and was not affected by shock application. Cardiac index and stroke index increased and SAP decreased after cardioversion.

Objective: To investigate the influence of two ventilation modes on the performance of an anaesthetic conserving device (AnaConDa) in piglets., Study Design: Prospective randomized experimental trial., Animals: Eight female piglets weighing 24.7 +/- 2.2 kg., Methods: Anaesthesia was maintained with sevoflurane (in 60% oxygen) delivered from the AnaConDa placed between endotracheal tube (ETT) and Y-piece. Anaesthetic depth was guided using standard clinical parameters. Ventilation mode was volume controlled (VC) during the first and pressure support (PS) during the second period of anaesthesia in four piglets (group 1); the order was reversed in group 2. Anaesthetic gases were sampled before (at the proximal end of the ETT) and after the AnaConDa (Y-piece). Data were analysed using a model I anova, with treatment and group as fixed categorical effects. Using a paired t-test, partial pressures of carbon dioxide (Pe'CO(2)) on both sides of the device were compared., Results: Although the mean administration rate of sevoflurane was comparable in both groups (3.8 +/- 1.8 mL hour(-1)), E'Sevo was higher in group 1, more specifically during the first period (p = 0.035). Less sevoflurane escaped during VC (14.0 +/- 3.4%) compared with PS ventilation (17.2 +/- 5.7%) (p = 0.001). Pe'CO(2) was lower at the Y-piece (6.4 +/- 0.8 kPa, 48 +/- 6 mmHg) compared with the ETT (9.3 +/- 1.4 kPa, 70 +/- 11 mmHg) in both groups and ventilation modes. On average, inspiratory CO(2) tension was 2.0 +/-1.0 kPa (15 +/- 8 mmHg). Respiration rate was comparable in all piglets while tidal volume () and peak inspiratory pressure were lower during VC compared with PS (p < 0.001, p = 0.015 respectively)., Conclusions and Clinical Relevance: The observed differences in E'Sevo concentration and sevoflurane breakthrough were probably related to differences in . The observed high FiCO(2) indicated an excessive dead space with the AnaConDa for these piglets.