The aim of this study was to
determine the effects of lidocaine (LIDO) and dexmedetomidine (DEX) or their combination
(LIDO–DEX), administered by constant-rate infusion (CRI), on the minimum alveolar
concentration (MAC) of sevoflurane in dogs. Seven healthy mongrel dogs were used with a
2-week washout interval between treatments in this study. Anesthesia was induced with
propofol and maintained with sevoflurane in oxygen, and MAC of sevoflurane was determined
after 90 min equilibration period in the dogs (SEV-MACBASAL). Then, sevoflurane
MAC was determined again in the dogs after 45 min equilibration period of one of the
following treatments: an intravenous loading dose of lidocaine 2 mg/kg followed by 6
mg/kg/hr CRI (SEV-MACLIDO); an intravenous loading dose of dexmedetomidine 2
µg/kg followed by 2 µg/kg/hr CRI
(SEV-MACDEX); or their combination (SEV-MACLIDO-DEX). These
SEV-MACs were determined in duplicate. Data were analyzed using ANOVA and post
hoc Tuckey test when appropriate. The SEV-MACBASAL was 1.82 ± 0.06%,
SEV-MACLIDO was 1.38 ± 0.08%, SEV-MACDEX was 1.22 ± 0.10%, and
SEV-MACLIDO-DEX was 0.78 ± 0.06%. The CRI administration of lidocaine,
dexmedetomidine and their combination produced a significant reduction in the MAC of
sevoflurane by 26.1 ± 9.0% (P<0.0001), 43.7 ± 11.8%
(P<0.0002) and 54.4 ± 9.8% (P<0.0001),
respectively. The MAC reduction was significantly greater after the CRI combination of
lidocaine and dexmedetomidine when compared with lidocaine CRI
(P<0.0001) or dexmedetomidine CRI treatments
(P<0.025).
The effects of intravenous (IV) lidocaine, dexmedetomidine and their combination delivered as a bolus followed by a constant rate infusion (CRI) on the minimum alveolar concentration of isoflurane (MACISO) in dogs were evaluated. Seven healthy adult dogs were included. Anaesthesia was induced with propofol and maintained with isoflurane. For each dog, baseline MAC (MACISO/BASAL) was determined after a 90-minute equilibration period. Thereafter, each dog received one of the following treatments (loading dose, CRI): lidocaine 2 mg kg−1, 100 µg kg−1 minute−1; dexmedetomidine 2 µg kg−1, 2 µg kg−1 hour−1; or their combination. MAC was then determined again after 45- minutes of treatment by CRI. At the doses administered, lidocaine, dexmedetomidine and their combination significantly reduced MACISO by 27.3% (range: 12.5–39.2%), 43.4% (33.3–53.3%) and 60.9% (46.1–78.1%), respectively, when compared to MACISO/BASAL. The combination resulted in a greater MACISO reduction than the two drugs alone. Their use, at the doses studied, provides a clinically important reduction in the concentration of ISO during anaesthesia in dogs.
Chagas disease is a lingering Public Health problem in Latin America with ∼5.7 million people infected with Trypanosoma cruzi. Transmission is still taking place in most countries of the Americas, including the United States. Dogs are frequently infected with T. cruzi and its high infection prevalence is associated with increased risk of Chagas disease in humans. The city of Mérida in the Yucatan peninsula is endemic for Chagas disease and canines are frequently infected with T. cruzi. The objective of this study was to evaluate the performance of a qualitative point of care (POC) molecular test (RPA-LF, recombinase polymerase amplification-lateral flow) developed in our laboratory for identifying infected dogs. We used retrospective samples of dogs that came for consultation because of cardiac alterations and proved to be infected with T. cruzi as determined by enzyme-linked immunosorbent assay (ELISA), Western blot, and quantitative PCR (qPCR). The analytical sensitivity indicated that RPA-LF amplified T. cruzi DNA in samples containing almost equal to one to two parasites per reaction. Serial twofold dilutions of T. cruzi epimastigotes showed that the test had 95% (19/20) repeatability at concentrations of two parasites per reaction. The test showed no cross reactivity with human DNA or other protozoan parasites (Trypanosoma rangeli, Leishmania spp., and Plasmodium spp.). RPA-LF had the capacity to amplify all discrete typing units (DTUs I-VI) of T. cruzi that circulate in domestic or extradomestic environments. The RPA-LF had 93.2% (95% confidence interval 87.2-98.1) sensitivity and excellent agreement with qPCR used as gold standard (Cohen's Kappa test = 0.963). ELISA was positive in 96.6% (85/88) of dogs, which together with the molecular tests confirmed the frequent contact with infected triatomine bugs in the city of Mérida. These preliminary results on the diagnostic efficacy of the RPA-LF deserve further large-scale field testing of this POC test for T. cruzi infection in endemic areas.
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