The effect of hypovolemia due to hemorrhage on the minimum alveolar concentration of isoflurane in the dog

Abstract

ObjectiveTo determine the effect of hypovolemia on the minimum alveolar concentration (MAC) of isoflurane in the dog. Study designRandomized, cross-over trial. Animal populationSix healthy intact mixed breed female dogs weighing 18.2–29.0 kg. MethodsDogs were randomly assigned to determine the MAC of isoflurane in a normovolemic or hypovolemic state with a minimum of 18 days between trials. On both occasions, anesthesia was initially induced and maintained for 40 minutes with isoflurane delivered in oxygen while vascular catheters were placed in the cephalic vein and dorsal metatarsal artery. In dogs assigned to the hypovolemic group, 30 mL kg−1 of blood was removed at 1 mL kg−1 minute−1 from the arterial catheter. All dogs were allowed to recover from anesthesia. Thirty minutes after the discontinuation of isoflurane, anesthesia was re-induced with isoflurane in oxygen delivered by face mask. The tracheas were intubated, and connected to an anesthetic machine with a Bain anesthetic circuit. Mechanical ventilation was instituted at a rate of 10 breaths minute−1 with the tidal volume set to deliver 10–15 mL kg−1. Airway gases were monitored continuously and tidal volume was adjusted to maintain an end-tidal carbon dioxide level of 35–40 mmHg (4.67–5.33 kPa). Body temperature was maintained at 37–38 °C (98.6–100.4 °F). The MAC determination was performed using an electrical stimulus applied to the toe web and MAC was defined as the mean value of end-tidal isoflurane between the concentrations at which a purposeful movement did and did not occur in response to the electrical stimulus. The MAC values were compared between groups using a Student's t-test. ResultsThe MAC of isoflurane was significantly less in hypovolemic dogs (0.97 ± 0.03%) compared with normovolemic dogs (1.15 ± 0.02%) (p < 0.0079). Conclusions and clinical relevanceThe MAC of isoflurane is reduced in dogs with hypovolemia resulting from hemorrhage. Veterinarians should be prepared to deliver a lower percentage of isoflurane to maintain anesthesia in hypovolemic dogs during diagnostic and therapeutic procedures.