The cardiovascular status of isoflurane-anaesthetized horses with and without dexmedetomidine constant rate infusion evaluated at equivalent depths of anaesthesia

Abstract

ObjectiveTo compare cardiac index and oxygen extraction at equivalent depths of anaesthesia between isoflurane-anaesthetized horses and horses anesthetized with isoflurane and dexmedetomidine CRI. Study designSequential, blinded, randomized, balanced, crossover study. AnimalsEight horses weighing a mean ± standard deviation of 478 ± 58 kg. MethodsHorses were premedicated with 0.03 mg kg−1 acepromazine intramuscularly (IM) and 8 μg kg−1 dexmedetomidine intravenously (IV). Anaesthesia was induced with 2.5 mg kg−1 ketamine and 0.1 mg kg−1 midazolam IV and maintained with isoflurane in oxygen and air. Horses were mechanically ventilated. Fractional concentration of end-tidal isoflurane (Fe’Iso) was stabilized at 1.7% with a CRI of 0.9% NaCl (IsoNaCl), or at 1.1% with 1.75 μg kg−1 hour−1 dexmedetomidine (IsoDex). Mean arterial blood pressure was maintained above 60 mmHg by dobutamine infusion. Following nociceptive electrical stimulation, Fe’Iso was stabilized at a 0.1% lower concentration and nociceptive stimulation was repeated. This procedure was continued until the horse moved. Fe’Iso values prior to the concentration at which movement occurred were considered to indicate equivalent depths of anaesthesia between treatments. Cardiac index and oxygen extraction were compared at equivalent depths of anaesthesia using a paired Student’s t-test. ResultsCardiac index differed between IsoNaCl at 61 ± 12 mL kg−1 minute−1 and IsoDex at 48 ± 10 mL kg−1 minute−1 (p = 0.047). In addition, oxygen extraction differed between IsoNaCl at 3.4 ± 0.8 mL kg−1 minute−1 and IsoDex at 4.5 ± 0.5 mL kg−1 minute−1 (p = 0.0042). Two horses receiving IsoNaCl were administered dobutamine at equivalent depths of anaesthesia (7.0 and 28.8 μg kg−1 hour−1, respectively). Conclusions and clinical relevanceCardiovascular function in horses receiving isoflurane and 1.75 μg kg−1 minute−1 dexmedetomidine is more compromised than in horses receiving a higher concentration of isoflurane and 0.9% NaCl CRI.