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

Casoni, Daniela; Spadavecchia, Claudia; Adami, Chiara

doi:10.1186/s13028-014-0049-z

Acta Veterinaria Scandinavica

Table 1 Details of anaesthetic protocol for each patient

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

Case details	Patient	Procedure	Premedication	Induction	Maintenance	Ventilation	Time of salbutamol inhalation	Et Isoflurane%	Dobutamine dose μg kg-¹ min⁻¹
Case 1¥	14 year old, gelding Swiss Warm Blood 760 kg	Emergency explorative laparotomy	Romifidine¹ 40 μg kg⁻¹ IV	Ketamine³ 2.2 mg kg⁻¹ IV	Isoflurane in oxygen	IPPV fr = 8–10 min⁻¹ TV = 10 ml kg⁻¹ I:E ratio: 1:2 Peak PAW =30 cmH₂0 PEEP =5 cmH₂O	T₀ = 45	Et Iso 1.1%	Minimum0.22
			Butorphanol² 50 μg kg⁻¹ IV	Diazepam⁴ 100 mcg kg⁻¹ IV	Lidocaine 2% (30 μg kg⁻¹ min⁻¹) CRI		T₁ = 35		Maximum 0.5
			Butorphanol² 50 μg kg⁻¹ IV	Diazepam⁴ 100 mcg kg⁻¹ IV	Lidocaine 2% (30 μg kg⁻¹ min⁻¹) CRI		T₁ = 35		At salbutamol inhalation 0.5
Case 2¥	12 year old, mare Island horse 350 kg	Emergency explorative laparotomy	Romifidine¹ 50 μg Kg⁻¹ IV	Ketamine³ 2.2 mg Kg⁻¹ IV	Isoflurane in oxygen and air	IPPV fr = 5 min⁻¹ TV = 11.5 ml kg⁻¹ I:E ratio: 1:2 Peak PAW =20 cmH₂0	T₀ = 55	Et Iso 1%	Minimum 0.5
			Butorphanol² 50 μg kg⁻¹ IV	Diazepam⁴ 50 mcg kg⁻¹ IV	Lidocaine 2% (25 μg kg⁻¹ min⁻¹), ketamine³( 10 μg kg⁻¹ min⁻¹) and guafenesin⁵ (0.4 mg⁻¹ kg⁻¹ min⁻1) CRI		T₁ = 40		Maximum 1.5
				Diazepam⁴ 50 mcg kg⁻¹ IV					At salbutamol inhalation 0.75
				Guaifenesine to effect IV					At salbutamol inhalation 0.75
Case 3*	6 month old, male Swiss warm blood 265 kg	Elective scrotal herniorraphy and castration	Acepromazine⁶ 30 μg Kg⁻¹ IM	Ketamine³ 2.2 mg Kg⁻¹ IV	Isoflurane in oxygen	Spontaneous breathing IPPV (after salbutamol administration) fr = 6 min⁻¹ TV = 15 ml kg⁻¹ I:E ratio: 1:2 Peak PAW =25 cmH₂0	T₁ = 45	Et Iso 1.1%	Minimum 0.6
			Romifidine¹ 50 μg Kg⁻¹ IV	Diazepam⁴ 100 mcg kg⁻¹ IV	Romifidine (0.6 μg kg⁻¹ min⁻¹) CRI		T₀ = 55		Maximum 1.6
			L- Methadone⁷ 50 μg Kg⁻¹ IV	Guaifenesine to effect IV			T₀ = 55		At salbutamol inhalation 0.6
Case 4*	4 month old, male Polo Pony 200 kg	Elective humbelical herniorraphy	Acepromazine 30 μg kg⁻¹ IM	Ketamine³ 2.2 mg kg⁻¹IV	Isoflurane in oxygen and air	Spontaneous breathing; IPPV (before salbutamol administration) TV = 2200 ml fr = 7 min⁻¹ TV = 13 ml kg⁻¹ (2550 ml) I:E ratio: 1:2 Peak PAW =30 cmH₂0	T₀ = 35	Et Iso 1.3%	Minimum 0.8
			Romifidine¹ 60 μg kg⁻¹	Diazepam⁴ 100 mcg kg⁻¹ IV			T₁ = 28		Maximum 1.6
			Butorphanol² 40 μg kg⁻¹				T₁ = 28		At salbutamol inhalation 1.6
Case 5†	10 year old, gelding male Swiss warm blood 670 kg	Emergency carpus arthroscopy	Romifidine¹ 60 μg kg⁻¹ IV	Ketamine³ 2.2 mg Kg⁻¹ IV	Isoflurane in oxygen and air	Spontaneous breathing TV =5600 ml	T₀ = 85	Et Iso 1.1%	Minimum 0.12
			L- Methadone⁷ 50 μg kg⁻¹ IV	Diazepam⁴ 100 mcg kg⁻¹ IV	Romifidine (0.6 μg kg⁻¹ min⁻¹) CRI		T₁ = 70		Maximum 0.5
			L- Methadone⁷ 50 μg kg⁻¹ IV	Diazepam⁴ 100 mcg kg⁻¹ IV	Romifidine (0.6 μg kg⁻¹ min⁻¹) CRI		T₁ = 70		At salbutamol inhalation 0.12

*This patient was ventilated after hypoxia and hypercapnia were detected; ¥ these patients underwent mechanical ventilation from the beginning of inhalational anesthesia;† this patient was allowed to breath spontaneously during anesthesia; ¹Romifidine, Sedivet ®, 10 mg/ml, Boehringer Ingelheim, Switzerland; ²Butorphanol, Morphasol ®10 mg/ml Graeub AGE, Switzerland; ³Ketamine, Narketan ®, 100 mg/ml, Vetoquinol Suisse; ⁴Diazepam, Valium® 5 mg/ml, Roche, Basel, Switzerland; ⁵Guaifenesine 12.5% solution (currently out of the market); ⁶Acetilpromazine, Prequillan ®10 mg/ml Arovet AG; ⁷ L-methadone/fenpipramide 50/2.5 μg kg⁻¹ IV Polamivet ®, Intervet, Switzerland.
T0 = Time between romifidine injection at the sedation and salbutamol inhalation. T1 = Time between ketamine injection at the injection and salbutamol inhalation expressed in minutes.

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