The use of dexmedetomidine during pulmonic balloon valvuloplasty in dogs

Abstract

Background: Information regarding the anaesthetic management for pulmonic balloon valvuloplasty (PBV) in dogs is scarce. We present data from dogs receiving dexmedetomidine combined with inhalational anaesthesia during PBV. Methods: Anaesthetic records from dogs receiving dexmedetomidine (n = 11) and a control group (n = 29) anaesthetised for PBV between 2012 and 2020 were analysed. Intraoperative variables potentially affected by dexmedetomidine administration were compared between groups. Results: Demographic characteristic and anaesthetic agents administered were similar between groups. The incidence of hypotension (mean arterial pressure (MAP) < 60 mm Hg) was 25% for dexmedetomidine and 29% for control (p = 0.8); however, dexmedetomidine group received vasopressors for a shorter time (p = 0.02). The incidence of bradycardia was 100% and 96% for dexmedetomidine and control (p = 0.5), but antimuscarinic agents were administered more frequently to the latter (p = 0.014). Conclusion: Dexmedetomidine may be a useful adjuvant to general anaesthesia during PBV in dogs and reduced the use of vasopressors and antimuscarinics.

Propofol‐dexmedetomidine continuous infusion in a dog with pulmonic stenosis undergoing balloon valvuloplasty

“…For these reasons, their administration has been traditionally limited only to healthy adult animals 40 . However, the intensity and duration of these effects are dose dependent; therefore, if used judiciously, alpha 2 ‐adrenoreceptor agonists might also be administered in presence of a specific cardiac disease 15,36–39,41,42 . In healthy dogs anaesthetised with isoflurane, the administration of dexmedetomidine (0.5 μg/kg loading bolus + 0.5 μg/kg/h), as used in the case described here, decreased CI by 1%–17% 39 .…”

“…38 In dogs with PS, dexmedetomidine infusion could be helpful to avoid tachycardia and to maintain SVR and arterial blood pressure; thereby, dexmedetomidine could reduce the myocardial oxygen demand and the risk of developing myocardial ischaemia. 15,43 The infusion of dexmedetomidine (0.56 [0.13-1.36 μg/kg/h]) in dogs with PS undergoing BV did not significantly increase the incidence of bradycardia, but reduced the need for sympathomimetic and antimuscarinic administration. 15 In our dog, neither sympathomimetic nor antimuscarinic drugs were administered as arterial blood pressure and CI were well maintained.…”

“…7 Atenolol could contribute to lower HR under general anaesthesia, as β-blockers can potentiate bradycardia and have hypotensive effects. 15,23 On the other hand, tachycardia is also counterproductive as it increases myocardial work and oxygen consumption, potentially leading to tachyarrhythmias. Moreover, reducing the diastolic time, tachycardia might decrease the RV preload and RV output further.…”

“…15,43 The infusion of dexmedetomidine (0.56 [0.13-1.36 μg/kg/h]) in dogs with PS undergoing BV did not significantly increase the incidence of bradycardia, but reduced the need for sympathomimetic and antimuscarinic administration. 15 In our dog, neither sympathomimetic nor antimuscarinic drugs were administered as arterial blood pressure and CI were well maintained.…”

“…A limited number of reports describing the anaesthetic management of dogs with PS undergoing BV have been published: volatile anaesthetic agents combined with opioids and/or lidocaine and/or benzodiazepine were generally administered 6–14 . Moreover, the use of dexmedetomidine infusion combined with a volatile anaesthetic has been reported to reduce the need of intraoperative vasopressors and antimuscarinics 15 . Compared to isoflurane, propofol infusion maintained higher systemic vascular resistance (SVR) and arterial blood pressure, but without affecting cardiac index, in dogs 16–18 .…”