Key result
Individualized vs group-based desflurane dosing fails to reduce cardiorespiratory measurement variability in dogs.
Why the study?
It was uncertain whether variability in cardiorespiratory measurements is smaller when desflurane is administered at a multiple of the individual's MAC versus a predetermined group MAC.
RCT (n=10)
Randomly selected order
Answers are grounded in this paper and cite their sources.
No difference in cardiorespiratory variability with iMAC versus gMAC in dogs; leaves open whether individual titration aids predictability in veterinary anesthesia.
OBJECTIVE: To determine whether the variability of cardiorespiratory measurements is smaller when administering desflurane at a multiple of the individual's minimum alveolar concentration (MAC) or at a predetermined, identical concentration in all subjects. ANIMALS: 10 dogs. PROCEDURES: Desflurane was administered at 1.5 times the individual's MAC (iMAC) and 1.5 times the group's MAC (gMAC). The order of concentrations was randomly selected. Heart rate, respiratory rate, arterial blood pressure, central venous pressure, mean pulmonary artery pressure, pulmonary artery occlusion pressure, arterial and mixed-venous blood gas tensions and pH, and cardiac output were measured. The desflurane concentration required to achieve a mean arterial pressure (MAP) of 60 mm Hg was then determined. Finally, the desflurane concentration required to achieve an end-tidal PCO(2) of 55 mm Hg was measured. RESULTS: Variances when administering 1.5 iMAC or 1.5 gMAC were not significantly different for any variable studied. Differences between the MAC multiples needed to reach an MAP of 60 mm Hg and the mean of the sample were significantly larger when gMAC was used, compared with iMAC, indicating that a multiple of iMAC better predicted the concentration resulting in a MAP of 60 mm Hg. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that, in a small group of dogs, variability in cardiorespiratory measurements among dogs is unlikely to differ whether an inhalant anesthetic is administered at a multiple of the iMAC in each dog or at an identical gMAC in all dogs.
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Pypendop et al. (2006) conducted an RCT in Anesthesia (n=10). Desflurane based on individual MAC vs. Desflurane at 1.5 times the group's MAC (gMAC) was evaluated on Variability of cardiorespiratory measurements. Administering desflurane at 1.5 times the individual's MAC compared to 1.5 times the group's MAC did not significantly alter the variance of cardiorespiratory measurements in dogs.
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