Clinical comparison of the effects of isoflurane or propofol anaesthesia on mean arterial blood pressure and ventilation in dogs undergoing orthopaedic surgery receiving epidural anaesthesia.

Bustamante et al., Vet J. 2018 Mar;233:49-54. Epub 2018 Jan 11.

The aim of this study was to compare the effects on mean arterial pressure (MAP) and ventilation of propofol total IV anaesthesia (TIVA) and isoflurane as anaesthetic maintenance in healthy dogs undergoing orthopaedic surgery, with epidural anaesthesia.

Dogs were premedicated IM with dexmedetomidine (4μg/kg) and methadone (0.3mg/kg), induced with IV propofol (0.65-5mg/kg) and randomly assigned to be maintained with isoflurane (group I) or propofol (group P). Isoflurane end-tidal concentration (EtISO) and propofol infusion rate were adjusted during the surgery to maintain a suitable anaesthetic depth.

All dogs received bupivacaine (1mg/kg) and morphine (0.1mg/kg) in the lumbosacral epidural space (total volume 0.2mL/kg).

MAP was recorded every 5min during the procedure. Statistical analysis was performed using parametric (Student's t test) and nonparametric (Mann-Whitney U-test, chi-square) tests, as appropriate.

Anaesthetic maintenance in groups I and P was accomplished by providing a mean EtISO of 1.12±0.15% and a mean propofol infusion rate of 15.0±4.7mg/kg/h, respectively. MAP was significantly higher in group P than in group I (92±17mmHg versus 78±10mmHg; P=0.021).

Eleven dogs in group P and two dogs in group I reached an EtCO2>7.3kPa, requiring mechanical ventilation (P=0.001).

In combination with epidural anaesthesia, propofol TIVA improved MAP and is a suitable alternative to isoflurane in orthopaedic surgery of the hind limb in healthy dogs. Nevertheless, since it was associated with increased respiratory depression, mechanical ventilation should be available.