Oxygenation and plasma endothelin-1 concentrations in healthy horses recovering from isoflurane anaesthesia administered with or without pulse-delivered inhaled nitric oxide

Abstract

Objective To assess oxygenation, ventilation-perfusion (V/Q) matching and plasma endothelin (ET-1) concentrations in healthy horses recovering from isoflurane anaesthesia administered with or without pulse-delivered inhaled nitric oxide (iNO). Study Design Prospective experimental trial. Animals Healthy adult Standardbred horses. Methods Horses were anaesthetized with isoflurane in oxygen and placed in lateral recumbency. Six control (C group) horses were anaesthetized without iNO delivery and six horses received pulse-delivered iNO (NO group). After 2.5hours of anaesthesia isoflurane and iNO were abruptly discontinued, inhaled oxygen was reduced from 100% to approximately 30%, and the horses were moved to the recovery stall. At intervals during a 30-minute period following the discontinuation of anaesthesia, arterial and mixed venous blood gas values, shunt fraction (Q̇s/Q̇t), plasma ET-1 concentration, pulse rate and respiratory rate were measured or calculated. Repeated measures anova and a Bonferroni post hoc test was used to analyze data with significance set at p<0.05. Results At all time points in the recovery period, NO horses maintained better arterial oxygenation (oxygen partial pressure: NO 13.2±2.7-11.1±2.7 versus C 6.7±1.1-7.1±1.1kPa) and better V/Q matching (Q̇s/Q̇t NO 0.23±0.05-0.14±0.06 versus C 0.48±0.03-0.32±0.08%) than C horses. Mixed venous oxygenation was higher in NO for 25minutes following the discontinuation of anaesthesia (NO 6.3±0.2-4.5±0.07 versus C 4.7±0.6-3.7±0.3kPa). In both groups of horses arterial oxygenation remained fairly stable; venous oxygenation declined over this time period in the NO group but still remained higher than venous oxygen in the C group. ET-1 concentrations were higher at most time points in C than NO. Changes in other parameters were either minor or absent. Conclusions and Clinical Relevance Delivery of iNO to healthy horses during anaesthesia results in better arterial and venous oxygenation and V/Q matching (as determined by lower Q̇s/Q̇t) and lower ET-1 concentrations throughout a 30-minute anaesthetic recovery period. © 2012 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.