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Effects of orally administered enalapril on blood pressure and hemodynamic response to vasopressors during isoflurane anesthesia in healthy dogs

      Abstract

      Objective

      To examine whether preanesthetic administration of enalapril, compared with placebo, results in a greater decline in blood pressure (BP) or decreased responsiveness of BP to isotonic fluids or vasopressors in healthy dogs during isoflurane anesthesia.

      Study design

      Randomized, experimental, placebo-controlled, blinded, crossover study.

      Animals

      Twelve healthy, female, purpose-bred beagles.

      Methods

      Dogs underwent the following week-long treatment protocols, each preceded by a 1 week washout period: oral placebo twice daily (PLA); oral enalapril, 0.5 mg kg−1 twice daily, with the 15th dose withheld on the day of anesthesia (ENA-W), and oral enalapril, 0.5 mg kg−1 twice daily, with the 15th dose administered 90 minutes prior to anesthetic induction (ENA). On day 8 of each treatment period, dogs were anesthetized in random order utilizing a standard protocol. Following stabilization at an end-tidal isoflurane concentration (Fe′Iso) of 1.3%, invasively measured systolic (SAP), diastolic (DAP) and mean (MAP) arterial blood pressure were continuously recorded via telemetry. Hypotension (SAP < 85 mmHg) was treated with the following sequential interventions: lactated Ringer's solution (LRS) bolus (10 mL kg−1); repeated LRS bolus; dopamine (7 μg kg−1 min−1); and dopamine (10 μg kg−1 min−1) first without and then with vasopressin (1 mU kg−1 hour−1).

      Results

      Compared with the PLA but not the ENA-W group, the ENA group had significantly lower average SAP, DAP and MAP at an Fe′Iso of 1.3%, spent more minutes in hypotension, and required a greater number of interventions to correct moderate-to-severe mean arterial hypotension.

      Conclusions

      In healthy dogs, enalapril administered 90 minutes prior to isoflurane anesthesia increases the degree of intra-anesthetic hypotension and the number of interventions required to correct moderate-to-severe hypotension.

      Clinical relevance

      Dogs receiving angiotensin-converting enzyme inhibitors on the day of anesthesia may exhibit clinically significant intra-anesthetic hypotension.

      Keywords

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