Anaesthesia of the patient with cardiovascular disease part 2: anaesthesia for specific disorders

Scarabelli, Stefania; Bradbrook, Carl

doi:10.12968/coan.2016.21.6.337

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…Medetomidine produced a significative reduction of heart rate and cardiac index when compared with acepromazine (Saponaro et al 2013). Therefore, acepromazine has been recommended for sedation of patients with degenerative mitral valve disease (Keene et al 2019) and its judicial use can be beneficial in cases of dilated cardiomyopathy, as mild vasodilation reduces afterload and increases myocardial contractility (Scarabelli & Bradbrook 2016).…”

Section: Discussionmentioning

confidence: 99%

Pre‐anaesthetic clinical examination influences anaesthetic protocol in dogs undergoing general anaesthesia and sedation

Louro

Maddox

Robson

et al. 2021

J of Small Animal Practice

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Identify whether pre-anaesthetic clinical examination influences anaesthetic and analgesic agents and techniques protocol in dogs presented for general anaesthesia and sedation at a large referral hospital. Materials and MethOds:In this prospective clinical audit, 554 dogs, undergoing general anaesthesia or sedation for surgical, diagnostic or imaging procedures were included. Multiple attending anaesthetists completed a questionnaire divided into four sections (American Society of Anesthesiologists physical status classification, anaesthetic and analgesic agents and techniques protocol, pre-anaesthetic clinical examination findings and changes made to the anaesthetic protocol). The attending anaesthetist was able to review the patient's history before planning the anaesthetic and analgesic agents and techniques protocol. The patients were examined and changes in American Society of Anesthesiologists physical status classification or anaesthetic protocol were recorded. results:The initial anaesthetic and analgesic agents and techniques protocol was altered in 23.3% (n=129/554) of cases following a pre-anaesthetic clinical examination, but American Society of Anesthesiologists physical status reclassification occurred in only 8.0% (n=37/464) of cases. Multivariable logistic regression analysis showed that pre-anaesthetic clinical examination performed by European College of Veterinary Anaesthesia and Analgesia diplomates (odds ratio 5.8, 95% confidence interval 2.0 to 17.2), compared to anaesthesia interns, and the presence of an audible heart murmur (odds ratio 2.4, 95% confidence interval 1.4 to 4.4) were factors linked to changes in anaesthetic and analgesic agents and techniques protocol, whereas for each one kilogram increase in patient's weight, the odds of a change in anaesthetic and analgesic agents and techniques protocol to occur decreased by 1.7% (odds ratio 0.98, 95% confidence interval 0.97 to 1.0). clinical significance: Pre-anaesthetic clinical examination has impact on American Society of Anesthesiologists physical status classification, therefore estimation of patient's anaesthetic risk, and influences anaesthetic and analgesic agents and techniques protocol choice.

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Section: Discussionmentioning

confidence: 99%

Pre‐anaesthetic clinical examination influences anaesthetic protocol in dogs undergoing general anaesthesia and sedation

Louro

Maddox

Robson

et al. 2021

J of Small Animal Practice

View full text Add to dashboard Cite

show abstract

“…SAS is the most common form of aortic stenosis in the dog and Boxer is one of the breeds predominantly affected (O'Grady et al ., 1989; Kienle et al ., 1994; Hollmer et al ., 2008). In this case, the CO is highly dependent on HR because the outflow obstruction in the aorta impedes stroke volume (SV) to increase (Scarabelli and Bradbrook, 2016). The prognosis is based on the pressure gradient along the valve and common drugs used to treat the clinical signs are beta-adrenergic receptor blockers.…”

Section: Discussionmentioning

confidence: 99%

“…Although midazolam may reduce systolic blood pressure during co-induction with propofol in healthy dogs, values remained within an acceptable range (Hopkins et al ., 2014). Additionally, propofol or alfaxalone could have been chosen to induce anesthesia but they might affect negatively systemic vascular resistance (SVR) (Scarabelli and Bradbrook, 2016), while etomidate has a better cardiovascular profile (Sams et al ., 2008; Rodriguez et al ., 2012).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, the inotropic effect counteracted the cardiovascular effect without increasing afterload. The use of vasoconstrictors (e.g., phenylephrine and norepinephrine) increases SVR, which therefore would increase left atrial pressure (Scarabelli and Bradbrook, 2016) and, for that reason they were not considered in this case. Intravenous infusion of fentanyl was not only administered to enhance intraoperative analgesia but also further reduce Et SEVO (Reilly et al ., 2013; Suarez et al ., 2017).…”

Section: Discussionmentioning

confidence: 99%

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Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy

2019

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The anesthetic management in patients with subaortic stenosis and mitral valve disease should involve intensive monitoring and the anesthesiologist’s main concern is to ensure oxygen delivery and tissue perfusion. Since anesthetic procedures in such patients are rare, there is no previous report about the anesthetic management. A 5.5-year old, 32-kg Boxer, suffering a severe heart disease due to a final stage subaortic stenosis and mitral insufficiency, was anesthetized for an ovariohysterectomy to remove an ovarian tumor that was producing high-volume ascites. Methadone (0.3 mg kg −1 ) was administered intramuscularly (IM) for pre-anesthetic medication, etomidate (1.3 mg kg −1 ) and midazolam (0.2 mg kg −1 ) were used for the induction of anesthesia and after endotracheal intubation, anesthesia was maintained with sevoflurane vaporized in oxygen and air. Fentanyl (5–10 μg kg −1 h −1 ) and paracetamol (15 mg kg −1 ) were administered to improve analgesia. Previous persistent atrial fibrillation was refractory to medication (digoxin, diltiazem, and pimobendan) and continued during the anesthetic procedure. Dobutamine (1.5–5 μg kg −1 minute −1 ) helped to maintain mean arterial blood pressure above 60 mmHg. Epidural morphine (0.1 mg kg −1 ) and incisional bupivacaine (2 mg kg −1 ) were administered at the end of surgery to provide postoperative analgesia. Anesthesia was otherwise uneventful, and recovery was considered excellent.

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Dose-dependent effects of isoflurane and dobutamine on cardiovascular function in dogs with experimental mitral regurgitation

Goya

Wada

Shimada

et al. 2018

Veterinary Anaesthesia and Analgesia

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Anaesthesia of the patient with cardiovascular disease part 2: anaesthesia for specific disorders

Cited by 4 publications

References 25 publications

Pre‐anaesthetic clinical examination influences anaesthetic protocol in dogs undergoing general anaesthesia and sedation

Pre‐anaesthetic clinical examination influences anaesthetic protocol in dogs undergoing general anaesthesia and sedation

Anesthetic management of a dog with severe subaortic stenosis and mitral valve disease complicated with atrial fibrillation undergoing ovariohysterectomy

Dose-dependent effects of isoflurane and dobutamine on cardiovascular function in dogs with experimental mitral regurgitation

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