General Anesthesia in Geriatric Dogs with Propofol-Isoflurane, PropofolSevoflurane, Alphaxalone-Isoflurane, Alphaxalone-Sevoflurane and Their Comparison of Biochemical, Hemodynamic and Cardiopulmonary Effects

Zeynep Bilgen Şen, Nuh Kiliç

Abstract


Background: Geriatric is defined as the life-cycle in which the physical state, organ functions, sensory functions, mental function and immunity progressively regress. Aging causes progressive and irreversible changes in the functional capacities of organ systems, which in turn alter the response to stress and anesthetic drugs. Propofol is an anesthetic agent with sedative and hypnotic effects. Anesthesia induction with propofol is fast and smooth. Alphaxalone (3α-hydroxy-5α-pregnane11,20-dione) is a central nervous system depressant in the form of synthetic neuroactive steroids. This allows anesthesia and muscle relaxation by increasing the inhibition of gamma amino butyric acid type A (GABA) receptors. The aim of this study is to compare effects of propofol-isoflurane and propofol-sevoflurane with relatively a new anesthetic combination alphaxalone-isoflurane and alphaxalone-sevoflurane on hematological, biochemical and physiological parameters.

Materials, Methods & Results: Dogs were randomly divided into 4 groups and anesthesia protocols were applied. After induction of anesthesia with 6 mg/kg propofol in groups 1 and 2, isoflurane anesthesia was continued in group 1 and sevoflurane in group 2. After induction of 3 mg/kg alphaxalone anesthesia in groups 3 and 4, isoflurane anesthesia was continued in group 3 whereas sevoflurane in group 4. Vena cephalica was catheterized for blood collection. At the preanesthetic period, 15, 30, 45, 60 min and 60 min after the anesthesia, complete blood counts were performed. Serum ALT, AST, urea, creatinine values were measured during preanesthesia, perianesthesia 15-30 min and 60 min after anesthesia. Cardiopulmonary parameters and reflexes were evaluated before anesthesia and recorded at perianesthetic 5, 10, 15, 30, 45, 60 min and 60 min after full recovery. Patients were monitored during anesthesia. The average age of the dogs in the study was 10.83. All of the dogs were anesthetized in a few seconds with intravenous injection of propofol or alphaxalone. During anesthesia the respiratory rate (fR) was recorded by counting the movements of the reservoir bag. A pulse oximeter was used to monitor pulse rate (fH) and haemoglobin oxygen saturation (SpO2). Body temperature was measured from rectum with a thermometer. Geriatric dogs were anesthetized for a variety of clinical reasons, concerning laparatomy (12.5%), orthopedic (7.5%), soft tissue (60%),  dental (10%) and ophthalmologic surgery (10%). Duration of anesthesia was 94.44 (± 12.6) for group I, 81(± 10.54) for group II, 93.88 (± 11.6) for group III and 64.5 (± 3.97) min for group IV. Serum urea and creatinine concentrations were not significantly different in the four groups.

Discussion: The mean duration of anesthesia recovery was 6.0 ± 2.0 in group 1, 4.6 ± 1.45 in group 2, 3.7 ± 1.23 in group 3 and 9.7 ± 3.09 min in group 4. In group 4 recovery was longer than other groups and statistically significant (P < 0.05). In our research, the recovery is shorter in the isoflurane treated groups than in the sevoflurane treated groups. When the effect of different groups on heart rate was examined, the difference between them was not significant.  Duration and depth of the anesthesia with propofol-isoflurane, propofol-sevoflurane, alphaxalone–isoflurane and alphaxalone-sevoflurane were found to be satisfactory for surgery. Four anesthetic agents applied in geriatric dogs did not adversely affected the hematological and biochemical parameters. In conclusion anesthesia on geriatric dogs after induction of propofol and alphaxalone maintained with isoflurane or sevoflurane found to be safe. However, they did not provide analgesia in painful operations, so it would be appropriate to use analgesics in the pre or intraoperative period.


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References


Albertson T.E., Walby W.F. & Joy R.M. 1992. Modification of GABA-mediated inhibition by various injectable anesthetics. Anesthesiology. 77: 488-499.

Ambros B., Duke-Novakovski T. & Pasloske K.S. 2008. Comparison of the anesthetic efficacy and cardiopulmonary effects of continuous rate infusions of alfaxalone-2-hydroxypropyl-β- cyclodextrin and propofol in dogs. American Journal of Veterinary Research. 69(11): 1391-1398.

Apaydın N. & Kibar M. 2008. Deneysel laparatomi uygulanan köpeklerde sevofluran ve isofluran anestezisinin kardiyovasküler sistem üzerine etkileri. Sağlık Bilimleri Dergisi. 17(3): 162-167.

Boulestin A.S.M. 2004. L’anesthésie du chien au sevoflurane étude comparée avec l’isoflurane. 66p. Ecole Nationale Vétérinaire de Toulouse. Thèse d’exercice, Université Paul Sabatier - Toulouse III. Toulouse, France.

Brodbelt D.C., Blissitt K.J., Hammond R.A., Neath P.J., Young L.E., Pfeiffer D.U. & Wood J.L.N. 2008. The risk of death: the confidential enquiry into perioperative small animal fatalities. Veterinary Anaesthesia and Analgesia. 35: 365-373.

Carpenter R.E., Pettifer G.R. & Tranquilli W.J. 2005. Anesthesia for geriatric patients. Veterinary Clinics Small Animal Practice. 35: 571-580.

Conzen P.F., Kharasch E.D., Czerner S.F.A., Artru A.A., Reichle F.M., Michalowski P., Rooke A., Weiss B.M. & Ebert T.J. 2002. Low-flow sevoflurane compared with isoflurane anesthesia in patients with stable renal insufficiency. Anesthesiology. 97(3): 578-584.

Dowling P.M. 2005. Geriatric pharmacology. Veterinary Clinics of Small Animal Practice. 35: 557-569.

Ferré P.J., Pasloske K., Whittem T., Ranasinghe M.G., Li Q. & Lefebvre H.P. 2006. Plasma pharmacokinetics of alfaxalone in dogs after an intravenous bolus of Alfaxan-CD RTU. Veterinary Anaesthesia and Analgesia. 33: 229-236.

Fortney W.D. 2011. Geriatri ve Yaşlanma. In: Hoskins J.D. (Ed). Kedi ve köpeklerde Geriatri ve Gerontoloji. 2nd edn. Turkey: Medipress, pp.1-6.

Goodchild C.S. & Serrao J.M. 1989. Cardiovascular effects of propofol in the anaesthetized dog. British Journal of Anaesthesiology. 63: 87-92.

Güzel Ö. & Perk E.C. 2002. Köpeklerde genel anestezi prosedürü ve intraoperatif periyotta rastlanan kardiyak ritm bozukluklarının tanı ve sağaltımı. İstanbul Üniversitesi Veteriner Fakültesi Dergisi. 28(2): 381-401.

Hanley P.J., Ray J., Brandt U. & Daut J. 2002. Halothane, isoflurane and sevoflurane inhibit NADH: ubiquinone oxidoreductase (complex I) of cardiac mitochondria. Journal of Physiology. 544(3): 687-693.

Harrison N.L. & Simmonds M.A. 1984. Modulation of the GABA receptor complex by a steroid anaesthetic. Brain Research. 323: 287-292.

Hosgood G. & Scholl D.T. 1998. Evaluation of age as a risk factor for perianesthetic morbidity and mortality in the dog. The Journal of Veterinary Emergency and Critical Care. 8(3): 222-236.

Joubert K.E. 2007. Pre-anaesthetic screening of geriatric dogs. Journal of the South African Veterinary Association. 78(1): 31-35.

Keates H. & Whittem T. 2012. Effect of intravenous dose escalation with alfaxalone and propofol on occurrence of apnoea in the dog. Research in Veterinary Science.93: 904-906.

Muir W., Lerche P., Wiese A., Nelson L., Pasloske K. & Whittem T. 2008. Cardiorespiratory and anesthetic effects of clinical and supreclinical doses of alfaxalone in dogs. Veterinary Anaesthesia and Analgesia. 35: 451-462.

Paddleford R.R. 2011. Anestezi. In: Hoskins J.D. (Ed). Kedi ve Köpeklerde Geriatri ve Gerontoloji. 2nd edn. Turkey: Medipress, pp.73-85.

Picker O., Scheeren T.W.L. & Arndt O. 2001. Inhalation anaesthetics increase heart rate by decreasing cardiac vagal activity in dogs. British Journal of Anaesthesia. 87(5): 748-754.

Polis I., Gasthuys F., Ham Van L. & Laevens H. 2001. Recovery times and evaluation of clinical hemodynamic parameters of sevoflurane, isoflurane and halothane anaesthesia in mongrel dogs. Journal of Veterinary Medicine. A48: 401-411.

Poumeyrol S.M.S. 2012. Etude clinique des effets de l’alfaxalone en injection intra-musculaire chez le lapin. 64p. Ecole Nationale Vétérinaire d’ Alfort, Maisons-Alfort. Thèse de Doctorat Vétérinaire. Faculté de Médécine Université de Créteil, Université Paris-Est-Créteil (UPEC), Créteil, France.

Pride N.B. 2005. Agening and changes in lung mechanics. European Respiratory Journal. 26: 563-565.

Reid J. & Nolan A.M. 1996. Pharmacokinetics of propofol as an induction agent in geriatric dogs. Research in Veterinary Science. 61: 169-171.

Rodriguez J.M., Munoz-Rascon P., Navarette-Calvo R., Gomez-Villamandos R.J., Perez J.M.D., Sarmiento J.A.F., Carmona S.Q. & Machuca M.M.G. 2012. Comparison of the cardiopulmonary parameters after induction of anaesthesia with alphaxalone or etomidate in dogs. Veterinary Anaesthesia and Analgesia. 39: 357-365.

Sadean M.R. & Glass P.S.A. 2003. Pharmacokinetics in the elderly. Best Practice & Research Clinical Anaesthesiology. 17(2): 191-205.

Seeler D.C., Dodman N.H., Norman W. & Court M. 1988. Recommended techniques in small animal anaesthesia IV anaesthesia and cardiac disease. British Veterinary Journal. 144: 108-122.

Suarez M.A., Dzikiti B.T., Stegmann F.G.& Hartman M. 2012. Comparison of alfaxalone and propofol administered as total intravenous anaesthesia for ovariohysterectomy in dogs. Veterinary Anaesthesia and Analgesia. 39: 236-244.

Symons J.A. & Myles P.S. 2006. Myocardial protection with volatile anaesthetic agents during coronary artery bypass surgery: a meta-analysis. British Journal of Anaesthesia. 97(2): 127-136.

Taboada F.M. & Murison P.J. 2010. Induction of anaesthesia with alfaxalone or propofol before isoflurane maintenance in cats. Veterinary Record. 167: 85-89.

Tanaka K., Ludwig L.M., Kersten J.R., Pagel P.S. & Warltier D.C. 2004. Mechanisms of cardioprotection by volatile anesthetics. Anesthesiology. 100(3): 707-721.

Warne L.N., Beths T., Whittem T., Carter J.E. & Bauquier S.H. 2015. A review of the pharmacology and clinical application of alfaxalone in cats. The Veterinary Journal. 203: 141-148.

Warpechowski P., Santos A.T.L., Pereire P.J.I. & Lima G.G. 2010. Effects of propofol on the cardiac conduction system. Revista Brasileira de Anestesiologia. 60(4): 438-444.




DOI: https://doi.org/10.22456/1679-9216.81800

Copyright (c) 2018 Zeynep Bilgen Şen, Nuh Kiliç

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