Abstract
This article describes the anaesthetic management and use of total intravenous anaesthesia (TIVA) for neurosurgery in 4 dogs. Propofol in conjunction with morphine was used for the maintenance of anaesthesia. Anaesthesia was induced with either thiopentone or propofol. The program Stelpump (a target-controlled infusion program) was run on a laptop and connected to a syringe driver via an RS 232 cable. The program was found to be reliable and safe for the administration of TIVA in dogs. Invasive monitoring was required in order to monitor cardiovascular changes during surgery. Ventilation was controlled to maintain the end-tidal carbon dioxide below 40 mm Hg. The anaesthesia was characterised by haemodynamic stability. The haemodynamic stability was probably the result of the choice of TIVA and balanced anaesthesia. Intracranial pressure and oedema was controlled with dexamethasone, mannitol and ventilatory management either in combination or alone. Three dogs survived to hospital discharge and 1 dog was euthanased 2 weeks later due to tumour metastasis. The development and characterisation of the anaesthetic effects of TIVA needs to be elucidated in order to provide clinicians with rational guidelines for the appropriate use of TIVA in veterinary medicine.
Highlights
Much debate has occurred in the human medical literature concerning the optimal anaesthetic technique for patients undergoing neurosurgical procedures
DISCUSSION no conclusive decisions can be made from this small study about the use of total intravenous anaesthesia (TIVA) for patients undergoing neurosurgery, a number of important differences between inhalational anaesthesia and TIVA are evident
It is evident that blood pressure was well maintained and at times tended towards hypertension
Summary
Much debate has occurred in the human medical literature concerning the optimal anaesthetic technique for patients undergoing neurosurgical procedures. Volatile anaesthetics alone are not considered optimal as they increase cerebral blood flow and increase intracranial pressure[7]. Volatile anaesthetic agents used in combination with opioids, sedatives and low doses of intravenous anaesthetic agents are acceptable for most neurosurgical procedures[7]. Intravenous anaesthetic agents offer the advantage of reducing cerebral oxygen consumption and cerebral blood flow but do not alter intracranial compliance[7]. Blood flow metabolism coupling and carbon dioxide responsiveaAnaesthesiology, bSmall Animal Medicine, cSmall Animal Surgery: Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Private Bag X04, Onderstepoort, 0110 South Africa
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