Use of adrenaline continuous infusion to treat hypotension during general anaesthesia in a cow and a calf

Abstract

Background: Hypotension is one of the most common complications observed during inhalation anaesthesia in veterinary patients. Treatment of hypotension in cattle is more challenging than in other species, owing to the limited number of drugs licensed in food producing animals. The use of adrenaline as an infusion to support blood pressure has not been described previously in bovines. Case presentation: A cow and a calf presented to University College Dublin Veterinary Hospital for bilateral mandibular fracture repair and bladder rupture repair respectively, developed severe anaesthetic related hypotension unresponsive to conventional treatments. In both cases an adrenaline infusion was started and slowly increased to effect, with infusion rates ranging from 0.01 to 0.25 μg/kg/min. Blood pressure increased as the adrenaline infusion rate increased, but clinically significant improvements in blood pressure were only observed with infusion rates exceeding 0.05 μg/kg/min. The side effect observed with adrenaline infusion was an increase in plasma lactate levels in both cases. Both animals were euthanised due to non-anaesthetic related complications. Conclusions: Maintenance of normotension is important during bovine anaesthesia to prevent the development of postanaesthetic complications. In the cases described here, adrenaline was effective as an additional treatment of anaesthetic related hypotension. Further research is required to establish the recommended infusion rates, cardiovascular effects and possible side effects of adrenaline infusion administration as a treatment for hypotension in bovines.

Variable‐rate infusion of adrenaline to manage hypotension in an anaesthetised goat

“…However, considering the chronicity of the condition, catecholamine depletion was possible, and ketamine was not considered as a suitable treatment option. The use of loco‐regional anaesthetic techniques have long been considered adjuncts to general anaesthesia, 29 and are an important part of anaesthetic protocols in food animal species 20 . In this case, the skin of the abdomen and subcutaneous tissues were desensitised by infiltration of procaine and added to the balanced anaesthetic technique.…”

“…The use of loco-regional anaesthetic techniques have long been considered adjuncts to general anaesthesia, 29 and are an important part of anaesthetic protocols in food animal species. 20 In this case, the skin of the abdomen and subcutaneous tissues were desensitised by infiltration of procaine and added to the balanced anaesthetic technique. Despite this, a reduction of the inhaled isoflurane concentration alone was unsuccessful at managing the hypotension observed.…”

“…9,18 Adrenaline has been used as an intravenous bolus of 30 μg/kg to resuscitate a calf after cardiac arrest, 19 and as a constant-rate infusion as treatment of anaesthetic-related hypotension in a cow and a calf. 20 To the authors' knowledge, this is the first description of the use of adrenaline as a variable-rate infusion to support the blood pressure in an anaesthetised goat.…”

“…Data describing the detailed cardiovascular effects of adrenaline in different species are sparse; β1 and β2 adrenergic agonist effects predominate at low doses, whereas at higher doses, α1 adrenergic effects are evident, causing a marked rise of systemic vascular resistance 9,18 . Adrenaline has been used as an intravenous bolus of 30 µg/kg to resuscitate a calf after cardiac arrest, 19 and as a constant‐rate infusion as treatment of anaesthetic‐related hypotension in a cow and a calf 20 . To the authors’ knowledge, this is the first description of the use of adrenaline as a variable‐rate infusion to support the blood pressure in an anaesthetised goat.…”

Influencia del estrés calórico en las reacciones adversas postinmunización en becerras Holstein-Friesian

“…Las becerras sospechosas de reacción adversa fueron los que presentaron alguno de los siguientes signos: disnea, hiperpnea, tos, incoordinación, postración, diaforesis, secreción espumosa de la boca, fosas nasales o secreción anal (Adams 2022). Una vez que se identificaba una becerra positiva, se administraba el siguiente tratamiento en el menor tiempo posible: epinefrina (15 µg kg −1 IV), difenhidramina (0.7 mg kg −1 IV), sulfato de atropina (0.2 mg kg −1 IV), flumetasona (0.1 mg kg −1 IM) y cafeína (5 mg kg −1 IV) (Ring et al 2014, Fernández et al 2020.…”