An anaesthetic protocol in the young domestic pig allowing neuromuscular blockade for studies of cardiac function following cardioplegic arrest and cardiopulmonary bypass

• Published in: Acta anaesthesiologica Scandinavica Vol. 48; no. 9; pp. 1144 - 1154
• Main Authors: Fanneløp, T., Dahle, G. O., Matre, K., Segadal, L., Grong, K.
• Format: Journal Article
• Language: English
• Published: Oxford, UK; Malden, USA Blackwell Publishing Ltd/Inc 01.10.2004; Blackwell
• Subjects: Adjuvants, Anesthesia; Anaesthesia; Anesthesia; Anesthesia, Inhalation; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Anesthetics, Intravenous; Animals; Biological and medical sciences; cardiac function; Cardioplegic Solutions; Cardiopulmonary Bypass; Fentanyl; Heart - physiopathology; Heart Arrest, Induced; Hemodynamics - drug effects; Hydrocortisone - blood; Medical sciences; Midazolam; Monitoring, Intraoperative; muscular paralysis; Myocardial Contraction - drug effects; Myocardial Reperfusion; Neuromuscular Blockade; Nitrous Oxide; Pentobarbital; Research Design; Swine; Ventricular Function, Left - drug effects; Nervous system diseases; Cardiocirculatory arrest; muscular paralysis; Motor system disorder; Cardiovascular disease; Pig; Cardiopulmonary bypass; Anaesthesia; swine; Vertebrata; Mammalia; Anesthesia; cardiac function; Artiodactyla; Paralysis; Neurological disorder; Ungulata
• ISSN: 0001-5172; 1399-6576
• DOI: 10.1111/j.1399-6576.2004.00464.x

Background:  Neuromuscular blockade should, for ethical reasons, not be allowed in animal experiments unless the use is strongly motivated. Beforehand, the anaesthetic protocol must be documented without muscle relaxation in the species studied. Documentation is difficult to obtain from the scientific literature. When focusing on cardiac function over time, in particular, the ideal anaesthetic protocol should cause no or minor alterations in cardiac variables. Methods:  We intended to document an anaesthetic protocol involving ventilation with N2O combined with loading doses and continuous infusions of pentobarbital, fentanyl and midazolam in seven pigs by applying potentially painful stimuli every 15 min for 7 h. Subsequently, left ventricular global and regional function was studied with conductance catheter and strain rate imaging by echocardiography in eight pigs with pancuronium included. Results:  Pigs without pancuronium were completely immobilized and unresponsive to potentially painful stimuli and sternotomy, with no accumulation or degradation of anaesthetic agents. With pancuronium included, left ventricular preload gradually decreased together with reduction of cardiac index from 3.52 ± 0.14 at 2 h to 2.84 ± 0.11 L min−1 · m−2 (±SEM) after 7 h of observation. Preload recruitable stroke work decreased after 7 h, whereas peak systolic strain in the anterior left ventricular wall and load‐independent indices of diastolic function were not significantly altered. Conclusion:  In specific experimental protocols, the anaesthetic protocol described could allow the use of muscular paralysis in young domestic pigs, for instance when involving hypothermic cardiopulmonary bypass, cardioplegic arrest and reperfusion.