Evaluation of the isoflurane-sparing effects of lidocaine and fentanyl during surgery in dogs

Objective - To evaluate the isoflurane-sparing effects of lidocaine and fentanyl administered by constant rate infusion (CRI) during surgery in dogs. Design-Randomized prospective study. Animals - 24 female dogs undergoing unilateral mastectomy because of mammary neoplasia. Procedures - After premedication with acepromazine and morphine and anesthetic induction with ketamine and diazepam, anesthesia in dogs (n = 8/group) was maintained with isoflurane combined with either saline (0.9% NaCl) solution (control), lidocaine (1.5 mg/kg [0.68 mg/lb], IV bolus, followed by 250 μg/kg/min [113 μg/lb/min], CRI), or fentanyl (5 μg/kg [2.27 μg/lb], IV bolus, followed by 0.5 μg/kg/min [0.23 μg/lb/min], CRI). Positive-pressure ventilation was used to maintain eucapnia. An anesthetist unaware of treatment, end-tidal isoflurane (ETiso) concentration, and vaporizer concentrations adjusted a nonprecision vaporizer to maintain surgical depth of anesthesia. Cardiopulmonary variables and ETiso values were monitored before and after beginning surgery. Results - Heart rate was lower in the fentanyl group. Mean arterial pressure did not differ among groups after surgery commenced. In the control group, mean ± SD ETiso values ranged from 1.16 ± 0.35% to 1.94 ± 0.96%. Fentanyl significantly reduced isoflurane requirements during surgical stimulation by 54% to 66%, whereas the reduction in ETiso concentration (34% to 44%) observed in the lidocaine group was not significant. Conclusions and Clinical Relevance - Administration of fentanyl resulted in greater isoflurane sparing effect than did lidocaine. However, it appeared that the low heart rate induced by fentanyl may partially offset the improvement in mean arterial pressure that would be expected with reduced isoflurane requirements.