Sevoflurane or isoflurane anaesthesia? A prospective, randomised blinded clinical trial in horses undergoing elective surgery.
anaesthesia
horse
isoflurane
recovery
sevoflurane
Journal
The Veterinary record
ISSN: 2042-7670
Titre abrégé: Vet Rec
Pays: England
ID NLM: 0031164
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
26
02
2021
received:
05
01
2021
accepted:
30
04
2021
pubmed:
29
5
2021
medline:
26
10
2021
entrez:
28
5
2021
Statut:
ppublish
Résumé
Isoflurane is the only volatile anaesthetic agent licensed for equine use in the United Kingdom, but sevoflurane is also commonly used. The two agents have rarely been compared for use in clinical elective surgery. This single centre, prospective, randomised, blinded clinical investigation recruited 101 healthy client owned horses undergoing elective surgery. Anaesthesia was standardised and horses randomly assigned to receive isoflurane (I) or sevoflurane (S) for maintenance of anaesthesia in 100% oxygen. Horses were ventilated to normocapnia and received intravenous fluid therapy and haemodynamic support with dobutamine to maintain mean arterial blood pressure above 60 mm Hg. Recovery was timed and video-recorded to allow offline evaluation by two experienced clinicians unaware of the volatile agent used. No post-anaesthetic sedation was administered. There was no significant difference between groups in terms of haemodynamic support required during anaesthesia nor in quality or duration of recovery. Inotropic support to maintain MAP above 60 mm Hg was required by 67 of 101 (67%) of horses. Five horses in the I group required additional ketamine or thiopentone to improve the plane of anaesthesia. Haemodynamic support needed during anaesthesia as well as the duration and quality of recovery were similar with isoflurane and sevoflurane.
Sections du résumé
BACKGROUND
BACKGROUND
Isoflurane is the only volatile anaesthetic agent licensed for equine use in the United Kingdom, but sevoflurane is also commonly used. The two agents have rarely been compared for use in clinical elective surgery.
METHODS
METHODS
This single centre, prospective, randomised, blinded clinical investigation recruited 101 healthy client owned horses undergoing elective surgery. Anaesthesia was standardised and horses randomly assigned to receive isoflurane (I) or sevoflurane (S) for maintenance of anaesthesia in 100% oxygen. Horses were ventilated to normocapnia and received intravenous fluid therapy and haemodynamic support with dobutamine to maintain mean arterial blood pressure above 60 mm Hg. Recovery was timed and video-recorded to allow offline evaluation by two experienced clinicians unaware of the volatile agent used. No post-anaesthetic sedation was administered.
RESULTS
RESULTS
There was no significant difference between groups in terms of haemodynamic support required during anaesthesia nor in quality or duration of recovery. Inotropic support to maintain MAP above 60 mm Hg was required by 67 of 101 (67%) of horses. Five horses in the I group required additional ketamine or thiopentone to improve the plane of anaesthesia.
CONCLUSIONS
CONCLUSIONS
Haemodynamic support needed during anaesthesia as well as the duration and quality of recovery were similar with isoflurane and sevoflurane.
Substances chimiques
Anesthetics, Inhalation
0
Sevoflurane
38LVP0K73A
Isoflurane
CYS9AKD70P
Types de publication
Journal Article
Randomized Controlled Trial, Veterinary
Langues
eng
Sous-ensembles de citation
IM
Pagination
e507Informations de copyright
© 2021 The Authors. Veterinary Record published by John Wiley & Sons Ltd on behalf of British Veterinary Association.
Références
Matthews NS, Hartsfield SM, Carroll GL, Martinez EA. Sevoflurane anaesthesia in clinical equine cases: Maintenance and recovery. Vet Anaesth Analg. 1999;26:13-7.
De Benedictis GM, Mathis A, Palacios C. An experimental comparison of the characteristics of recovery from anaesthesia maintained with isoflurane, sevoflurane or desflurane in horses. Vet Anaesth Analg. 2010;37(3):2-3.
Carroll GL, Hooper RN, Rains CB, Martinez EA, Matthews NS, Hartsfield SM, et al. Maintenance of anaesthesia with sevoflurane and oxygen in mechanically-ventilated horses subjected to exploratory laparotomy treated with intra- and post operative anaesthetic adjuncts. Equine Vet J. 1998;30:402-7.
Grosenbaugh DA, Muir W. Cardiorespiratory effects of sevoflurane, isoflurane, and halothane anesthesia in horses. Am J Vet Res. 1998;59:101-6.
Matthews NS, Hartsfield SM, Mercer D, Beleau MH, MacKenthun A. Recovery from sevoflurane anesthesia in horses: comparison to isoflurane and effect of postmedication with xylazine. Vet Surg. 1998;27:480-5.
Aida H, Mizuno Y, Hobo S, Yoshida K, Fujinaga T. Determination of the minimum alveolar concentration (MAC) and physical response to sevoflurane inhalation in horses. J Vet Med Sci. 1994;56:1161-5.
Steffey EP, Mama KR, Galey FD, Puschner B, Woliner MJ. Effects of sevoflurane dose and mode of ventilation on cardiopulmonary function and blood biochemical variables in horses. Am J Vet Res. 2005;66:606-14.
Aida H, Mizuno Y, Hobo S, Yoshida K, Fujinaga T. Cardiovascular and pulmonary effects of sevoflurane anesthesia in horses. Vet Surg. 1996;25:164-70.
Hikasa Y, Takase K, Ogasawara S. Sevoflurane and oxygen anaesthesia following administration of atropine-xylazine-guaifenesin-thiopental in spontaneously breathing horses. J Vet Med Ser A. 1994;41:700-08.
Driessen B, Nann L, Benton R, Boston R. Differences in need for hemodynamic support in horses anesthetized with sevoflurane as compared to isoflurane. Vet Anaesth Analg. 2006;33:356-67.
Khan KS, Hayes I, Buggy DJ. Pharmacology of anaesthetic agents II: Inhalation anaesthetic agents. Contin Educ Anaesth Crit Care Pain. 2014;14:106-11.
Leece EA, Corletto F, Brearley JC. A comparison of recovery times and characteristics with sevoflurane and isoflurane anaesthesia in horses undergoing magnetic resonance imaging. Vet Anaesth Analg. 2008;35:383-91.
Faul F, Erdfelder E, Lang A-GAG, Buchner A. G ∗ Power 3 : a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175-91.
Young S, Taylor P. Factors influencing the outcome of equine anaesthesia: a review of 1,314 cases. Equine Vet J. 1993;25:147-51.
Steffey EP, Howland D, Giri S, Eger EI. Enflurane, halothane, and isoflurane potency in horses. Am J Vet Res. 1977;38:1037-9.
Grandy J, Steffey E, Hodgson D, Woliner MJ. Arterial hypotension and the development of postanesthetic myopathy in halothane-anesthetized horses. Am J Vet Res. 1987;48:192-7.
Duke T, Filzek U, Read MR, Read EK, Ferguson JG. Clinical observations surrounding an increased incidence of postanesthetic myopathy in halothane-anesthetized horses. Vet Anaesth Analg. 2006;33:122-7.
Yamanaka T, Oku K, Koyama H, Mizuno Y. Time-related changes of the cardiovascular system during maintenance anesthesia with sevoflurane and isoflurane in horses. J Vet Med Sci. 2001;63:527-32.
Mosing M, Senior JM. Maintenance of equine anaesthesia over the last 50 years: controlled inhalation of volatile anaesthetics and pulmonary ventilation. Equine Vet J. 2018;50:282-91.
Dugdale AH, Obhrai J, Cripps PJ. Twenty years later: a single-centre, repeat retrospective analysis of equine perioperative mortality and investigation of recovery quality. Vet Anaesth Analg. 2016;43:171-8.
Johnston GM, Steffey E. Confidential enquiry into perioperative equine fatalities (CEPEF). Vet Surg. 1995;24:518-9.
Ragle C, Baetge C, Yiannikouris S, Dunigan C, Schneider R, Keegan R. Development of equine post anaesthetic myelopathy: Thirty cases (1979-2010). Equine Vet Educ. 2011;23:630-5.
Hall LW, Gillespie JR, Tyler WS. Alveolar-arterial oxygen tension differences in anaesthetized horses. Br J Anaesth. 1968;60:560-8.
Steffey EP, Howland D. Cardiovascular effects of halothane in the horse. Am J Vet Res. 1978;39:611-5.
Lees P, Mullen PA, Tavernor WD. Influence of anaesthesia with volatile agents on the equine liver. Br J Anaesth. 1973;45:570-8.
Engelking LR, Dodman NH, Hartman G, Valdez H, Spivak W. Effects of halothane anesthesia on equine liver function. Am J Vet Res. 1984;45:607-15.
Palanca BJA, Avidan MS, Mashour GA. Human neural correlates of sevoflurane-induced unconsciousness. Br J Anaesth. 2017;119:573-82.
Brosnan RJ, Steffey EP, Escobar A. Effects of hypercapnic hyperpnea on recovery from isoflurane or sevoflurane anesthesia in horses. Vet Anaesth Analg. 2012;39:335-44.
Steffey EP, Kelly AB, Farver TB, Woliner MJ. Cardiovascular and respiratory effects of acetylpromazine and xylazine on halothaneanesthetized horses. J Vet Pharmacol Ther. 1985;8:290-302.
Bergadano A, Lauber R, Zbinden A, Schatzmann U, Moens Y. Blood/gas partition coefficients of halothane, isoflurane and sevoflurane in horse blood. Br J Anaesth. 2003;91:276-8.
Steffey EP. Recent advances in inhalation anesthesia. Vet Clin North Am Equine Pract. 2002;18:159-68.
Barter LS, Carstens EE, Jinks SL, Antognini JF. Rat dorsal horn nociceptive-specific neurons are more sensitive than wide dynamic range neurons to depression by immobilizing doses of volatile anesthetics: An effect partially reversed by the opioid receptor antagonist naloxone. Anesth Analg. 2009;109:641-7.
Barter LS, Mark LO, Antognini JF. Proprioceptive function is more sensitive than motor function to desflurane anesthesia. Anesth Analg. 2009;108:867-72.
Santos M, Fuente M, Garcia-Iturralde R, Herran R, Lopez-Sanroman J, Tendillo FJ. Effects of alpha-2 adrenoceptor agonists during recovery from isoflurane anaesthesia in horses. Equine Vet J. 2003;35:170-5.
Murrell JC, Waters D, Johnson CB. Comparative effects of halothane, isoflurane, sevoflurane and desflurane on the electroencephalogram of the rat. Lab Anim. 2008;42:161-70.