Objective: To investigate the cardiopulmonary effects of a xylazine-guaiphenesin-ketamine infusion combined with inter-coccygeal extradural (lidocaine) anaesthesia in calves.
Study design: Prospective study.
Animals: Five Holstein Friesian calves (one steer, four heifers) aged 6 weeks weighing 65.2 +/- 2.7 kg.
Materials and methods: Calves were anaesthetized with isoflurane in oxygen for instrumentation. At least 12 hours later, xylazine (0.2 mg kg(-1) i.m.) was given. After 15 minutes, an infusion of xylazine hydrochloride (0.1 mg mL(-1)), guaiphenesin (50 mg mL(-1)) and ketamine (1 mg mL(-1)) (X-G-K) was infused at a rate of 1.1 mL kg(-1) hour-1 i.v. Oxygen (4 L minute(-1)) was delivered by nasotracheal tube 30 minutes later. Inter-coccygeal (Co1-Co2) extradural anaesthesia (lidocaine 2%, 0.18 mL kg(-1)) was administered 30 minutes later. Cardiopulmonary variables were obtained in the unsedated standing calves 10 minutes after xylazine, 15 and 30 minutes after X-G-K without O2, 15 and 30 minutes after X-G-K with O2 and 5, 15, 30, 45 and 60 minutes after extradural anaesthesia. Data were analysed using a repeated measurement analysis of variance including an autoregressive covariance structure of order 1 (correlations at different time intervals).
Results: Xylazine caused significant (p<0.05) decreases in heart rate (HR), cardiac output (Qt) and index (CI), stroke volume and stroke index, mean, systolic and diastolic arterial blood pressure (MAP, SAP, DAP), left (LVWSI) and right ventricular stroke work index (RVWSI), mean, systolic and diastolic pulmonary arterial pressure (MPAP, SPAP, DPAP), arterial pH, arterial oxygen tension (PaO2), arterial base excess, arterial HCO3- concentration, arterial saturation, packed cell volume, arterial and venous oxygen content (CaO2, CvO2), O2 consumption and O2 delivery (VO2, DO2). Increases in systemic vascular resistance (SVR) and pulmonary vascular resistance (PVR) were observed. During X-G-K infusion without O2, HR, Qt and CI increased gradually while SVR, PVR and MAP decreased. Left ventricular stroke work index and PaO2 remained constant, while O2 supplementation improved PaO2. Coccygeal extradural anaesthesia had little effect on cardiopulmonary variables. Respiratory rate (f) and PaCO2 significantly increased over the experiment.
Conclusions and clinical relevance: Xylazine caused adverse cardiopulmonary effects in calves. Improvement occurred during xylazine-guaiphenesin-ketamine infusion. Cardiac index and arterial blood pressure remained below baseline values while sustained increases in respiration rate and PaCO2 were observed. Inter-coccygeal extradural anaesthesia had only minor effects. Oxygen supplementation proved advantageous during guaiphenesin, ketamine and xylazine infusion in healthy calves in combination with coccygeal extradural anaesthesia induced persistent cardiopulmonary depression.