Two anaesthetic protocols and perioperative monitoring in a dog with asymptomatic right bundle branch block.


ES Flouraki
https://orcid.org/0000-0002-0127-9432
C Koutinas
T Anagnostou
https://orcid.org/0000-0002-4547-626X
I Savvas
https://orcid.org/0000-0001-5575-7244
G Kazakos
Resumen

A 16-year-old mixed breed dog was presented for skin mass excision. During initial evaluation, a right bundle branch block and a mitral valve insufficiency were detected, while concentration of cardiac troponin-I (cTnI) was slightly elevated at 0.653ng/ml. The dog was anesthetized with fentanyl and propofol, maintained with isoflurane and a ring block of lidocaine was also performed. Anaesthesia and peri-operative monitoring was uneventful, while post-operative concentration of cTnI was elevated at 1.34 ng/ml. The following day a partial urethral obstruction was noted, and the dog was rescheduled for cysteotomy and urethrostomy to avoid complete obstruction. The second anaesthetic protocol consisted of fentanyl, midazolam and etomidate for induction and isoflurane for maintenance with the addition of fentanyl as a constant rate infusion. Anaesthesia and perioperative monitoring were also uneventful. Post-anaesthetic evaluation revealed an increased cTnI plasma concentration at 2.57 ng/ml. Ten days later, during re-examination, the plasma concentration of cTnI had returned to normal and no deterioration was noted on ECG examination. Four months later, the patient’s physical status and ECG examination indicated no further dysfunction of the heart.

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Brodbelt, D.C., et al., The risk of death: the Confidential Enquiry into
Perioperative Small Animal Fatalities. Vet Anaesth Analg, 2008.
(5): p. 365-373.
Egenvall, A., B.N. Bonnett, and J. Häggström, Heart Disease as a Cause
of Death in Insured Swedish Dogs Younger Than 10 Years of Age. J
Vet Inter Med, 2006. 20(4): p. 894-903.
Harvey, R.C. and S.J. Ettinger, Cardiovascular Disease, in Lumb and
Jones’ Veterinary Anaesthesia and Analgesia W.J. Tranquilli, J.C.
Thurmon, and K.A. Grimm, Editors. 2007, Blackwell Publishing:
Iowa, USA. p. 891-897.
Kittleson, M., Electrocardiography: Basic consepts, Diagnosis of chamber
enlargement and intraventricular conduction disturbances, in Small
Animal Cardiovascular Medicine, M. Kittleson and R. Kienle, Editors.
, Mosby Inc: St Luis, USA. p. 72-94.
Martin, M., Intraventricular conduction defects, in Small Animal ECGs;
An introductory guide, M. Martin, Editor. 2007, Blackwell Publishing:
Oxford. p. 64-69.
Fantoni, C., et al., Right and Left Ventricular Activation Sequence in Patients
with Heart Failure and Right Bundle Branch Block: A Detailed
Analysis Using Three-Dimensional Non-Fluoroscopic Electroanatomic
Mapping System. J Cardiovasc Electrophysiol, 2005. 16(2): p.
-119.
Hesse, B., et al., Complete bundle branch block as an independent predictor
of all-cause mortality: report of 7,073 patients referred for nuclear
exercise testing. Am J Med, 2001. 110(4): p. 253-259.
Cordery, R., et al., Brugada syndrome and anesthetic management. J Cardiothorac
Vasc Anesth, 2006. 20(3): p. 407-13.
Inamura, M., et al., General anesthesia for patients with Brugada syndrome.
A report of six cases. Can J Anesth, 2005. 52(4): p. 409-412.
Hall, L.W. and K.W. Clarke, Principles of sedation, analgesia and premedication,
in Veterinary Anaesthesia, L.W. Hall and K.W. Clarke,
Editors. 2001, W.B. Saunders: England. p. 75-112.
McClain, D.A. and C.C. Hug Jr, Intravenous fentanyl kinetics. Clinl Pharmacol
Ther, 1980. 28(1): p. 106-114.
Lamont, L.A. and K.A. Mathews, Opioids, nonsteroidal anti-inflammatories
and analgesic adjuvants, in Lumb and Jones Veterinary Anaesthesia
and Analgesia, W.J. Tranquilli, J.C. Thurmon, and K.A. Grimm,
Editors. 2007, Blackwell Publishing: New York. p. 241-271.
Brussel, T., et al., Hemodynamic and cardiodynamic effects of propofol
and etomidate: negative inotropic properties of propofol. Anesth Analg,
69(1): p. 35-40.
Williams, G.D., et al., The Hemodynamic Effects of Propofol in Children
with Congenital Heart Disease. Anesth Analg, 1999. 89(6): p. 1411.
Sherry, K.M., et al., Comparison of the use of a propofol infusion in cardiac
surgical patients with normal and low cardiac output states. J
Cardiothorac Vasc Anesth, 1995. 9(4): p. 368-72.
Goodchild, C.S. and J.M. Serrao, Cardiovascular effects of propofol in the
anaesthetized dog. Br J Anaesth, 1989. 63(1): p. 87-92.
Perk, C., O. Guzel, and E.G. Gulanber, Etomidate/Alfentanil anaesthesia
in dogs and its effects on pulse oxymeter, electrocardiography and
haematological parameters. Turkish J Vet Anim Sci, 2022. 26: p.
-1024.
Schou, J., Etomidate for Prehospital Emergency Anesthesia. Emerg Med,
39(6): p. 592-8.
Schou, J. Etomidate; State of the art. 2004 [cited 2012; Available from:
_Etomidate/links/00b4952bf997a98236000000/Etomidate.
pdf.
Galloway, D.S., et al., Anesthetic indices of sevoflurane and isoflurane in
unpremedicated dogs. J Am Vet Med Assoc, 2004. 225(5): p. 700-
Sousa, M.G., et al., Effects of isoflurane on echocardiographic parameters
in healthy dogs. Vet Anaesth Analg, 2008. 35(3): p. 185-190.
Hall, L.W. and K.W. Clarke, Genaral pharmacology of the inhalation
anaesthetics, in Veterinary Anaesthesia, L.W. Hall and K.W. Clarke,
Editors. 2001, W.B. Saunders: England. p. 133-147.
Cilli, F., et al., Incidence of elevation of cardiac troponin I prior to and following
routine general anaesthesia in dogs. Vet Anaesth Analg, 2010.
(5): p. 409-16.
O’Brien, P.J., et al., Cardiac troponin T is a sensitive, specific biomarker
of cardiac injury in laboratory animals. Lab Anim Sci, 1997. 47(5):
p. 486-95.
Tarducci, A., et al., Serum values of cardiac troponin-T in normal and
cardiomyopathic dogs. Vet Res Commun, 2004. 28 Suppl 1: p. 385-8.
Porciello, F., et al., Cardiac troponin I is elevated in dogs and cats with
azotaemia renal failure and in dogs with non-cardiac systemic disease.
Aust Vet J, 2008. 86(10): p. 390-4.
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