The effect of two different intra-operative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses

Thompson, Kate R; Bardell, David

doi:10.1111/vaa.12277

Cited by 7 publications

(9 citation statements)

References 20 publications

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“…At T, mean PaCO 2 was 59 mmHg in horses which were to demonstrate apnoea and 65 mmHg in those which resumed breathing immediately. This difference was not statistically significant, but broadly agrees with the threshold of 66 mmHg previously reported for return of spontaneous ventilation following CMV during VAA anaesthesia . Thompson and Bardell reported that horses with PaCO 2 53 mmHg at end anaesthesia took on average 3.5 min and up to 9 min to resume SV compared to an average of 52 s for horses with PaCO 2 67 mmHg.…”

Section: Discussionsupporting

confidence: 89%

“…This difference was not statistically significant, but broadly agrees with the threshold of 66 mmHg previously reported for return of spontaneous ventilation following CMV during VAA anaesthesia . Thompson and Bardell reported that horses with PaCO 2 53 mmHg at end anaesthesia took on average 3.5 min and up to 9 min to resume SV compared to an average of 52 s for horses with PaCO 2 67 mmHg. The difference in mean PaCO 2 values between our apnoeic and non‐apnoeic groups was narrower than in either of these previous studies, and at R0 mean PaCO 2 in apnoeic horses had risen to 73 mmHg, well above the level at which spontaneous ventilation was previously reported to resume.…”

Section: Discussionsupporting

confidence: 89%

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Restoration of arterial oxygen tension in horses recovering from general anaesthesia

Bardell

Mosing

Cripps

2019

Equine Veterinary Journal

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Summary Background Arterial hypoxaemia is common in anaesthetised horses, but little information exists regarding restoration of arterial oxygen tension (PaO2) during recovery from anaesthesia, or if intra‐operative management factors exert any longer‐term effect. Objectives To evaluate PaO2 in horses recovering from general anaesthesia up to 1 h after resuming standing. Study design Prospective observational clinical cohort study. Methods Systemically healthy adult horses undergoing inhalational general anaesthesia for elective surgical procedures were studied. Arterial blood samples were obtained anaerobically prior to pre‐anaesthetic medication, at end of anaesthesia, immediately following positioning in the recovery box, then at 10‐min intervals until standing. Additionally, samples were taken when horses achieved sternal recumbency, at standing (STAND) and 1 h after standing (STAND+1). Data were analysed using ANOVA and mixed‐effects linear regression, with significance set at P<0.05. Results Data from one hundred and two horses were analysed. Forty horses received controlled mandatory ventilation (CMV) throughout anaesthesia, 47 breathed spontaneously (SV) and 15 initially breathed spontaneously before CMV was imposed (S‐CMV). Overall, PaO2, P(A‐a)O2 and PaCO2 remained significantly lower than baseline at STAND+1 (P<0.01). CMV resulted in higher PaO2 at the end of anaesthesia (P = 0.03) and during early recovery (P<0.01) than SV. Only in group S‐CMV did PaO2, P(A‐a)O2 and PaCO2 return to baseline values at STAND+1. Highest PaO2 values associated with CMV were also associated with early recovery apnoea. Main limitations Non‐standardised anaesthetic management, temporal and quantitative variation in oxygen delivery during early recovery and lack of control group where oxygen was electively withheld during recovery. Conclusions Controlled mandatory ventilation results in better pulmonary function in horses as assessed by PaO2, P(A‐a)O2 and PaCO2, an effect enhanced by an initial period of SV and still evident 1 h after standing. High PaO2 values may contribute to early recovery apnoea but this does not adversely affect outcome. The Summary is available in Portuguese – see Supporting Information

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 89%

Restoration of arterial oxygen tension in horses recovering from general anaesthesia

Bardell

Mosing

Cripps

2019

Equine Veterinary Journal

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“…Partial pressure of arterial carbon dioxide (PaCO 2 ) during general anaesthesia does not influence the recovery phase [346]. Hypercapnic hyperpnoea aiming to increase alveolar minute ventilation and, therefore, the speed of elimination of inhalant agents, was successful in shortening recovery times, but did not improve quality [341].…”

Section: Respiratory System In Recoverymentioning

confidence: 99%

“…Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia[343] (10) Comparison of cardiorespiratory variables in dorsally recumbent horses anesthetized with guaifenesin-ketamine-xylazine spontaneously breathing 50% or maximal oxygen concentrations[344] (11) Impact of low inspired oxygen fraction on oxygenation in clinical horses under general anesthesia[345] (12) The effect of two different intra-operative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses[346] (13) Controlled mechanical ventilation with constant positive end-expiratory pressure and alveolar recruitment manoeuvres during anaesthesia in laterally or dorsally recumbent horses[347] (14) Effect of reducing inspired oxygen concentration on oxygenation parameters during general anaesthesia in horses in lateral or dorsal recumbency[348] (15) Effects of 12 and 17 cm H 2 O positive end-expiratory pressure applied after alveolar recruitment maneuver on pulmonary gas exchange and compliance in isoflurane-anesthetized horses[349] Arterial blood gas tensions in the horse during recovery from anesthesia[350] (17) Alleviation of postanesthetic hypoxemia in the horse[351] (18) Restoration of arterial oxygen tension in horses recovering from general anaesthesia[352] 3 Evaluation of a modification of the Hudson demand valve in ventilated and spontaneously breathing horses[353] (20) Effects of sedation, anesthesia, and endotracheal intubation on respiratory mechanics in adult horses[354] (21) Use of nasotracheal intubation during general anesthesia in two ponies with tracheal collapse[355] Total respiratory system in recovery publications = 21LoE: level of evidence.…”

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confidence: 99%

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

Gozalo-Marcilla

Ringer

2021

Animals

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Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords “recovery anaesthesia horse”, entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 “narrative reviews/expert opinions”, 16 “retrospective outcome studies”, 5 “surveys”, 59 “premedication/sedation and induction drugs”, 27 “maintenance with inhalant agents”, 55 “maintenance with total intravenous anaesthesia (TIVA)”, 3 “TIVA versus inhalants”, 56 “maintenance with partial intravenous anaesthesia (PIVA)”, 27 “other drugs used during maintenance”, 18 “drugs before/during recovery”, 18 “recovery systems”, 21 “respiratory system in recovery”, 41 “other factors”, 51 “case series/reports” and 6 “systems to score recoveries”. Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.

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“…Pomiar PaCO 2 służy głównie do oceny jakości oddychania (hiperwentylacja, hipowentylacja), co daje informację o równowadze pomiędzy metabolizowanym dwutlenkiem węgla a jego wydalaniem przez płuca. Pomimo ustalonych zakresów bezpieczeństwa tego parametru istnieją hipotezy, że podwyższony poziom dwutlenku węgla może wpływać korzystnie na wybudzanie koni (55). Prawidłowa kontrola wentylacji wpływa również na prawidłowe wysycenie organizmu zwierzęcia w anestetyki wziewne.…”

Section: Monitoring Rutynowyunclassified

Equine general anesthesia monitoring – review of the methods and current knowledge

Drewnowska¹,

Lisowska²,

Turek³

2018

Medycyna Weterynaryjna

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The high anesthetic mortality rate and high number of the postanesthetic side effects in horses generates the need for precise assessment of Central Nervous System depression caused by the anesthetic agents. The factors which influence the degree of CNS depression can be human-dependent (i.e. veterinarian level of education), conditionally human-dependent (i.e. type of surgery performed) or not human-dependent (i.e. breed, individual susceptibility to anesthetics). In order to monitor and assess the level of equine anesthesia, the modified Guedel scale is used currently. There are 3 types of monitoring according to its accuracy: basic, routine and used in special cases. The monitored vital parameters can give either direct or indirect measurement on the cardiovascular and respiratory system during anesthesia. In this paper the types of measurement techniques and the practical use of ECG, pulse, eye signs, arterial blood pressure, body temperature, pulse oximetry, capnography, end tidal anesthetics concentration and blood gases were described. More parameters can be measured, but not all of them can be used in everyday practice, because of the complicated invasive technique. Currently the research are led on direct monitoring of CNS through intraanesthetic EEG analysis..

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The effect of two different intra-operative end-tidal carbon dioxide tensions on apnoeic duration in the recovery period in horses

Cited by 7 publications

References 20 publications

Restoration of arterial oxygen tension in horses recovering from general anaesthesia

Restoration of arterial oxygen tension in horses recovering from general anaesthesia

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

Equine general anesthesia monitoring – review of the methods and current knowledge

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