Sevoflurane Anaesthesia in Dogs PDF
Preview Sevoflurane Anaesthesia in Dogs
Sevoflurane Anaesthesia in Dogs : Clinical Implications and Applications Ingeborgh Polis Proefschrift ter verkrijging van de graad van Doctor in de Diergeneeskundige Wetenschappen (PhD) aan de Faculteit Diergeneeskunde, Universiteit Gent Promotor: Prof. Dr. F. Gasthuys Co-promotors: Prof. Dr. L. Van Ham Prof. Dr. Y. Moens Department of Small Animal Medicine and Clinical Biology Faculty of Veterinary Medicine Ghent University ISBN 90-5864-019-1 1 2 DEDICATION To my parents, for their lifelong love and encouragement. To Geert, my support in bad days. To Bram, the twinkle in my eyes. Ingeborgh 3 4 CONTENTS List of abbreviations GENERAL INTRODUCTION 1 SCIENTIFIC AIMS 5 CHAPTER 1 SEVOFLURANE: PHYSICO-CHEMICAL PROPERTIES 9 AND MAC Introduction 11 History of inhalant anaesthetic agents 11 Molecular structure and physical properties of sevoflurane 15 Anaesthetic properties of sevoflurane 18 Minimum alveolar concentration (MAC) 24 References 27 CHAPTER 2 SEVOFLURANE: INFLUENCES ON BODY 35 SYSTEMS AND ECONOMIC CONSIDERATIONS Summary 37 Introduction 37 Effects on central nervous system 38 Effects on cardiovascular system 42 Effects on respiratory system 45 Hepatic effects 47 Renal effects 50 Economic considerations 55 Conclusion 58 References 59 INTRODUCTION TO CHAPTERS 3 AND 4 75 CHAPTER 3 RECOVERY TIMES AND EVALUATION OF CLINICAL 79 HEMODYNAMIC PARAMETERS OF SEVOFLURANE, ISOFLURANE AND HALOTHANE ANAESTHESIA IN MONGREL DOGS. Summary 81 Introduction 82 Materials and Methods 83 5 Results 86 Discussion 91 References 99 CHAPTER 4 THE INFLUENCE OF VENTILATION MODE 103 (SPONTANEOUS VENTILATION, IPPV AND PEEP) ON CARDIOPULMONARY PARAMETERS IN SEVOFLURANE ANAESTHETIZED DOGS. Summary 105 Introduction 106 Materials and Methods 107 Results 113 Discussion 119 References 126 INTRODUCTION TO CHAPTER 5 131 CHAPTER 5 THE EFFECTS OF INTRATHORACIC PRESSURE DURING 135 CONTINUOUS TWO-LUNG VENTILATION FOR THORACOSCOPY ON THE CARDIORESPIRATORY PARAMETERS IN SEVOFLURANE ANAESTHETIZED DOGS. Summary 137 Introduction 138 Materials and Methods 140 Results 146 Discussion 154 References 161 INTRODUCTION TO CHAPTERS 6, 7 AND 8 165 CHAPTER 6 ARTERIAL CATHETERISATION AND VASCULAR 169 ACCESS PORT IMPLANTATION FOR BLOOD SAMPLING AND CONTINUOUS BLOOD PRESSURE MEASUREMENT IN DOGS. Summary 171 Introduction 171 Materials and Methods 173 Results 180 Discussion 181 References 185 6 CHAPTER 7 PERIANAESTHETIC CARDIOPULMONARY, SEDATIVE 187 AND ANTINOCICEPTIVE EFFECTS OF A LONG ACTING FORMULATION OF SUFENTANIL ADMINISTERED BEFORE SEVOFLURANE ANAESTHESIA IN DOGS. PART I. CARDIOPULMONARY EFFECTS 187 Summary 189 Introduction 190 Materials and Methods 193 Results 199 Discussion 210 References 215 CHAPTER 8 PERIANAESTHETIC CARDIOPULMONARY, SEDATIVE 221 AND ANTINOCICEPTIVE EFFECTS OF A LONG ACTING FORMULATION OF SUFENTANIL ADMINISTERED BEFORE SEVOFLURANE ANAESTHESIA IN DOGS. PART II. SEDATIVE AND ANTINOCICEPTIVE EFFECTS 221 Summary 223 Introduction 224 Materials and Methods 225 Results 231 Discussion 237 References 242 GENERAL DISCUSSION 247 References 260 SUMMARY 265 SAMENVATTING 271 DANKWOORD 277 CURRICULUM VITAE 281 PUBLICATIONS 283 7 8 L IST OF ABBREVIATIONS AA % end tidal anaesthetic agent percentage AR artificial respiration ASA american society of anaesthesiologists BSA body surface area BWT body weight CBF cerebral blood flow CI cardiac index CO cardiac output COET end tidal carbon dioxide percentage 2 CPAP continuous positive airway pressure CV controlled ventilation DAP diastolic arterial blood pressure DPAP diastolic pulmonary artery pressure F alveolar anaesthetic concentration A F inspired concentration i FiAA % inspiratory anaesthetic agent concentration FiO inspiratory oxygen fraction 2 Halo halothane HCO- plasma bicarbonate concentration 3 HPV hypoxic pulmonary vasoconstriction HR heart rate ID internal diameter IM intramuscular IPPV intermittent positive pressure ventilation Iso isoflurane ITP intrathoracic pressure IV intravenous LA long acting LVSWI left ventricular stroke work index MAC minimum alveolar concentration MAP mean arterial blood pressure Min-max minimum and maximum MPAP mean pulmonary artery pressure MVV minute ventilation volume OLV one lung ventilation P alveolar partial pressure A PAP pulmonary artery pressure PaCO arterial carbon dioxide tension 2 PCV packed cell volume PCWP pulmonary capillary wedge pressure 9 LIST OF ABBREVIATIONS PEEP positive end expiratory pressure Pinsp inspiratory pressure PO per os PO arterial oxygen tension 2 PVR pulmonary vascular resistance RAP right atrial pressure RR respiratory rate RVSWI right ventricular stroke work index SAP systolic arterial blood pressure SBC standard bicarbonate concentration SBE standard base excess SC subcutaneous Sevo sevoflurane SI stroke index SPAP systolic pulmonary artery pressure SpO % peripheral haemoglobin saturation 2 SpV spontaneous ventilation SV stroke volume SVR systemic vascular resistance TLV two lung ventilation TV tidal volume VAP vascular access port 10
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