Effects of midazolam and nitrous oxide on the minimum anesthetic concentration of isoflurane in the ball python (Python regius)

Abstract

ObjectiveTo evaluate the effects of midazolam and nitrous oxide (N2O) on the minimum anesthetic concentration of isoflurane (MACISO) in ball pythons. Study designProspective, crossover, randomized, semi-blinded study. AnimalsA total of nine healthy adult female ball pythons (Python regius) weighing 2.76 ± 0.73 kg. MethodsIn each snake, three protocols were evaluated with 2 week washouts: treatment MID–O2, midazolam (1 mg kg−1) administered intramuscularly (IM) and anesthesia induced with isoflurane–oxygen; treatment SAL–O2, saline (0.2 mL kg−1) IM and anesthesia with isoflurane–oxygen; and treatment SAL–N2O, saline IM and anesthesia with isoflurane and 50% nitrous oxide (N2O):50% oxygen. In each treatment, isoflurane was administered by face mask immediately after premedication. Snakes were endotracheally intubated and inspired and end-tidal isoflurane concentrations were monitored. The study design followed a standard bracketing technique, and the MACISO was determined using logistic regression. Electrical stimulation using a Grass stimulator connected to the base of the tail (50 V, 50 Hz, 6.5 ms pulse−1) was used as the supramaximal stimulus. Blood-gas analysis was performed on cardiac blood collected immediately following intubation and after the last stimulation. Blood-gas variables were compared over time and between treatments using linear mixed models. ResultsMACISO at a body temperature of 30.1 ± 0.4 °C was 1.11% (95% confidence interval, 0.94–1.28%) in SAL–O2 and was significantly decreased to 0.48% (0.29–0.67%) in MID–O2 (p < 0.001) and to 0.92% (0.74–1.09%) in SAL–N2O (p = 0.016). PO2 was significantly lower in MID–O2 and SAL–N2O than in SAL–O2. Conclusions and clinical relevanceMidazolam significantly decreased the MACISO by 57% in ball pythons, whereas addition of N2O resulted in a modest, although significant, decrease (17%). MACISO in ball pythons was lower than those previously reported in reptiles.