Effects of diazepam and flumazenil on minimum alveolar concentrations for dogs anesthetized with isoflurane or a combination of isoflurane and fentanyl
Pw. Hellyer et al., Effects of diazepam and flumazenil on minimum alveolar concentrations for dogs anesthetized with isoflurane or a combination of isoflurane and fentanyl, AM J VET RE, 62(4), 2001, pp. 555-560
Objective-To determine the effect of a constant-rate infusion of fentanyl o
n minimum alveolar concentration (MAC) of isoflurane and to determine the i
nteraction between fentanyl and a benzodiazepine agonist (diazepam) and ant
agonist (flumazenil) in isoflurane-anesthetized dogs.
Animals-8 mixed-breed adult dogs. Procedure-Dogs were anesthetized with iso
flurane 3 times during a 6-week period. After a 30-minute equilibration per
iod, each MAC determination was performed in triplicate, using standard tec
hniques. Fentanyl was administered as a bolus 110 mug/kg of body weight, IV
) that was followed by a constant infusion (0.3 mug/kg per min, IV) through
out the remainder of the experiment. After determining isoflurane-fentanyl
MAC in triplicate, each dog received saline (0.9% NaCl) solution, diazepam,
or flumazenil. After 30 minutes, MAC was determined again.
Results-Fentanyl significantly decreased isoflurane MAC (corrected to a bar
ometric pressure of 760 mm Hg) from 1.80 +/- 0.21 to 0.85 +/- 0.14%, a redu
ction of 53%. Isoflurane-fentanyl-diazepam MAC (0.48 +/- 0.29%) was signifi
cantly less than isoflurane-fentanyl-saline MAC (0.79 +/- 0.21%). Percentag
e reduction in isoflurane MAC was significantly greater for fentanyl-diazep
am (74%), compared with fentanyl-saline (54%) or fentanyl-flumazenil (61%).
Mean fentanyl concentrations for the entire experiment were increased over
time and were higher in the diazepam group than the saline or flumazenil g
roups.
Conclusions and Clinical Relevance-Fentanyl markedly decreased isoflurane M
AC in dogs. Diazepam, but not flumazenil, further decreased isoflurane-fent
anyl MAC. Our results indicate that diazepam enhances, whereas flumazenil d
oes not affect, opioid-induced CNS depression and, possibly, analgesia in d
ogs.