Cardiovascular changes after administration of aerosolized salbutamol in horses: five cases

Abstract

Prevention and treatment of intraoperative hypoxemia in horses is difficult and both efficacy and safety of therapeutic maneuvers have to be taken into account. Inhaled salbutamol has been suggested as treatment of hypoxia in horses during general anesthesia, due to safety and ease of the technique. The present report describes the occurrence of clinically relevant unwanted cardiovascular effects (i.e. tachycardia and blood pressure modifications) in 5 horses undergoing general anesthesia in dorsal recumbency after salbutamol inhalation. Balanced anesthesia based on inhalation of isoflurane in oxygen or oxygen and air and continuous rate infusion (CRI) of lidocaine, romifidine, or combination of lidocaine and guaifenesine and ketamine was provided. Supportive measures were necessary to restore normal cardiovascular function in all horses but no long-term adverse effects were noticed in any of the cases.

Maternal and fetal arterial blood gas data during general anaesthesia for caesarean delivery of preterm twin lambs

“…In horses the risk of occurrence of clinically relevant unwanted cardiovascular side-effects (tachycardia and major alterations in arterial blood pressure) is significant so medical bronchodilation may not be appropriate in pregnant sheep. 18 The anaesthetic management of the ewes in this study ensured that arterial blood pressure was measured and managed to maintain normotension. Uterine arteries have minimal autoregulation to maintain uterine perfusion pressure and uterine blood flow so it is essential to avoid maternal hypotension, minimize the duration of supine positioning and prevent frequent uterine contractions.…”

“…In horses the risk of occurrence of clinically relevant unwanted cardiovascular side-effects (tachycardia and major alterations in arterial blood pressure) is significant so medical bronchodilation may not be appropriate in pregnant sheep. 18…”

Successful management of hypoxaemia in a mule during general anaesthesia

“…20 While salbutamol is primarily a bronchodilator, the mechanism of action of this intervention is uncertain with variable results on improving PaO 2 reported in anaesthetised horses. 20,21 A study has shown increased heart rate and cardiac output after administration of salbutamol which might indicate a change in pulmonary perfusion besides putative bronchodilation. 22 Its application appears worth trying as undesirable effects are seldom and limited.…”

“…2,3 Pulmonary administration of nebulized salbutamol (β -adrenergic agonist) has been reported to reduce hypoxaemia. [20][21][22] In most cases, different modalities of mechanical ventilation are required to recruit lung areas where alveolar ventilation is insufficient. For example, the open lung concept (OLC) describes the application of high inspiratory pressure in combination with positive endexpiratory pressure (PEEP).…”

Hypoxaemia and bradyarrhythmia in a foal undergoing surgical bladder repair

“…Hyponatremia can result from loss of sodium or gain of free water and it can occur in the presence of normovolaemia, dehydration or hypovolaemia. As a consequence of decreased serum sodium concentration, an osmotic gradient across the blood‐brain barrier could provoke the movement of free water into brain cells causing cerebral oedema 32 . The use of 3% saline has been described as a treatment approach for hyponatraemia 33 .…”