Ciência Rural, Santa Electrocardiographic Maria, v.39, n.2, p.

453-459, study on geriatric mar-abr, dogs 2009 undergoing general anesthesia with isoflurane.

453

ISSN 0103-8478

Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane

Estudo eletrocardiográfico em cães geriátricos submetidos à anestesia geral com isofluorano

Andreza Conti-PataraI* Denise Tabacchi FantoniI Silvia Renata Gaido CortopassiI

ABSTRACT The purpose of this study was to clarify the degree of influence of anesthetic agents commonly used during anesthesia on the heart conduction systems of geriatric dogs, with or without the presence of electrocardiographic changes in the pre-anesthetic electrocardiogram and also to determine the possible causes of ST-segment and T-wave changes during anesthesia, by monitoring ventilation and oxygenation. 36 geriatric dogs were evaluated. In addition to electrocardiographic evaluation, the pre-anesthetic study included serum levels of urea, creatinine, total protein, albumin and electrolytes. The pre-anesthetic medication consisted of acepromazine (0.05mg kg -1) in association with meperidine (3.0mg kg -1) by IM injection. Anesthesia was induced with propofol (3.0 to 5.0mg kg-1) by IV injection and maintained with isoflurane in 100% oxygen. During the anesthesia, the animals were monitored by continued computerized electrocardiogram. Systemic blood pressure , heart rate, respiratory rate, end-tidal carbon dioxide, partial pressure of carbon dioxide in arterial blood, arterial oxygen saturation, partial pressure of arterial oxygen and oxygen saturation of hemoglobin were closely monitored. During maintenance anesthesia, normal sinus rhythm was more common (78%). ST-segment and T-wave changes during the anesthetic procedure were quite common and were related to hypoventilation. The use of isoflurane did not result in arrhythmia, being therefore a good choice for this type of animal; Electrocardiographic findings of ST-segment and Twave changes during the maintenance anesthesia were evident in animals with hypercapnia, a disorder that should be promptly corrected with assisted or controlled ventilation to prevent complicated arrhythmias. Key words: anesthesia, dog, electrocardiography, geriatrics.
I

RESUMO Os objetivos deste estudo foram esclarecer a influência dos agentes anestésicos comumente utilizados durante a anestesia no sistema de condução cardíaco em cães idosos, com ou sem alterações eletrocardiográficas prévias, e determinar as possíveis causas de alterações no segmento ST e onda T durante a anestesia, por meio da monitoração da ventilação e da oxigenação. Para tanto, foram avaliados 36 cães idosos. Os exames pré-anestésicos incluíram o eletrocardiograma e os níveis séricos de uréia, creatinina, proteína total, albumina e eletrólitos. A medicação préanestésica foi realizada com acepromazina (0,05mg kg -1 ) associada à meperidina (3,0mg kg-1) por via intramuscular. A indução da anestesia foi realizada com propofol e a manutenção foi feita com isofluorano com oxigênio a 100%. Durante a anestesia, os animais foram monitorados continuamente com um eletrocardiógrafo computadorizado. A pressão arterial sistêmica, a freqüência cardíaca, a freqüência respiratória, o dióxido de carbono expirado, a pressão parcial arterial de dióxido de carbono, a saturação de oxigênio arterial, a pressão parcial de oxigênio arterial e a saturação de oxigênio na hemoglobina também foram monitorados durante a anestesia. Durante a manutenção da anestesia, 78% dos animais apresentaram ritmo sinusal normal. As alterações no segmento ST e onda T foram freqüentes e relacionadas à hipoventilação. O isofluorano não promoveu o aparecimento de arritmias, sendo assim um fármaco indicado em animais idosos. As alterações em segmento ST e onda T foram evidentes em animais com hipercapnia. A correção da hipercapnia deve ser implementada por meio de ventilação controlada e/ou assistida a fim de prevenir arritmias mais complicadas. Palavras-chave: anestesia, cães, geriátricos. eletrocardiografia,

Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia (FMVZ), Universidade de São Paulo (USP). Av. Prof. Dr. Orlando Marques de Paiva, 87, Cidade Universitária, 05508-900, São Paulo, SP, Brasil. E-mail: acontipatara@yahoo.com.br. *Autor para correspondência.
Received 03.19.08 Approved 08.27.08

Ciência Rural, v.39, n.2, mar-abr, 2009.

CV6LU.0mg kg-1 by IM injection. CV5RL. When necessary. Additionally. respiratory rate. color of the mucosae. In the pre-anesthetic evaluation. Arterial blood samples were obtained every 30 minutes. The animals were evaluated by the Cardiology Service. Following the assessment. obtained from the Surgery Service of the Veterinary Hospital of the Veterinary Medicine and Zootechny School of São Paulo University were included in the study. in addition to the close assessment of electrolytic balance and oxygenation of the patient (COHEN & TILLEY. the ST-segment. Following intubation. V10). where the pre-anesthetic electrocardiogram was measured. parameters were statistically evaluated up to 75 minutes of anesthesia. intravenous fentanyl h 5 μ g kg -1 by intravenous injection was administered in order to enhance trans-operative analgesia. and degree of hydration were measured. ST-segment. The purpose of this study was to clarify the degree of influence of anesthetic agents commonly used during anesthesia on the heart conduction systems of geriatric dogs. Oxygenation was assessed by pulse oximetryl.0mg kg-1 by IV injection. Pre-anesthetic exams included after cardiac assessment. T-wave and cardiac rhythm were assessed by the frequency of abnormalities of occurrence in the group. by monitoring ventilation and oxygenation. the animals were pretreated with acepromazinec 0. the animal was kept on inhaled anesthesiaf with isofluraneg in 100% oxygen. mean. 1979). v.05mg kg -1 and meperidined 3. starting immediately after the administration of the pre-anesthetic medication. hemogram. 1989). Cardiac rhythm.05). The level of significance established was 5% (P<0. color of the mucosae. and degree of hydration. capillary filling time. serum levels of creatinine and urea. Anesthesia was induced with intravenous propofole 3. using a sensor attached to the tongue of the animal or to glabrous non-pigmented skin. aVF. systolic. heart rate.454 INTRODUCTION Conti-Patara et al. DII. total protein and albumin. the animal was continuously monitored using a computerized electrocardiographi simultaneously showing the 10 leads used in the assessment of dogs (DI. These changes make the geriatric patient more prone to developing arrhythmia during the anesthetic procedure (PADDLEFORD. CV6LL. range and polarity of the T-wave were measured.0 to 5. Ciência Rural. After 15 minutes. 1999). during the anesthesia. 2009. and gasometrical assessment was performed using a pH and blood gas analyzerm. aVR. regardless of the type of surgery performed. blood pressure. with or without the presence of electrocardiographic changes in the pre-anesthetic electrocardiogram and also to determine the possible causes of ST-segment and T-wave changes during anesthesia. systolic and non-invasive diastolic blood pressure. Respiratory rate was assessed by observation of the thoracic movements. total plasma proteins. and ventilation by observation of the expired carbon dioxide levels. constantly being displayed by a gas analyzerk connected to the “T” outlet. Electrocardiographic assessment during the anesthesia is very important in order to monitor heart rate and rhythm. . albumin. small-size dogs. and magnesium was measured by spectrophotometryb. potassium and ionized calcium were measured by means of a multi-parametric analyzera using an appropriate kit. mar-abr. During the trans-operative period.39. Dogs with altered values for renal function. MATERIAL AND METHODS Thirty-six geriatric. PR interval. n. aVL. and reduce the concentration of the inhaled anesthetic agent. a postmedication. temperature. Therefore. The animals selected were those included in risk category 2 and they underwent surgical procedure lasting at least 60 minutes. with the aid of a circular circuit. and electrolytes and the dogs that received any medication for the heart were not included in the study. electrocardiographic assessment during the anesthesia is of fundamental importance to prevent more complicated arrhythmias in geriatric animals which undergo a stressful situation such as a surgical and anesthetic procedure (PADDLEFORD. The results obtained were statistically confronted by parametric testing. time zero being the moment when anesthesia was induced. the heart rate and respiratory rate. Aging is responsible for the degenerative changes seen in the heart conduction systems. pre-anesthetic assessment was conducted and included heart rate. serum levels of sodium. range and morphology of the QRS complex. capillary filling time. temperature. 1999). Only the values obtained every 15-minute time points were considered for evaluation. using variance analysis for repeated measures followed by Tukey’s test to compare the different evaluation time points throughout the anesthesia. and diastolic blood pressure were also assessed using a non-invasive blood pressure monitorj. complete blood count. Small size was defined as animals of up to 10kg and geriatric was defined as those which had reached at least 75% of the expected life span for that particular breed and size: 9 to 13 years (GOLDSTON. 15 females and 21 males of different breeds (Table 1). Mean. and morphology.2. DIII.

4 4.Description of the dogs included in the study: age. 17% of the animals could have degenerative alterations in the conduction system as a result of aging.1 Sex male female male female female female female female female male male male male male male female male female male male male male male female female male male female female male female male male male female male Surgery arthroplasty Excision of skin cancer Excision of skin cancer Ablation of conduct hearing Excision of skin cancer hemimandibulectomy Excision of skin cancer Excision of skin cancer Excision of skin cancer Perineum herniorrhaphy Perineum herniorrhaphy Limb Amputation Hemimandibulectomy Perineum herniorrhaphy Osteosynthesis Excision of skin cancer Ablation of conduct hearing Cystotomy Cystotomy e orchiectomy orchiectomy orchiectomy Ablation of conduct hearing Excision of perineum cancer Facectomy Excision of skin cancer Excision of skin cancer Facectomy Rhinoscopy Excision of skin cancer Excision of skin cancer Mastectomy Perineum herniorrhaphy Limb amputation Hemimandibulectomy Excision of perineum cancerão de Osteosynthesisosteossíntese RESULTS AND DISCUSSION In the study group. however.6 7.2 8.39. atrioventricular and sinoatrial Ciência Rural.4 5 7..2.3 10 10. An increase of collagen between the tissue cells of the atrioventricular node and common His bundle may also occur. weight.3 6 7 10 3.5 7.0 3. Dogs 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 Breed pinscher mongrel mongrel teckel poodle mongrel pinscher Brazilian terrier poodle mongrel Poodle poodle Brazilian terrier yorkshire poodle mongrel pinscher schinauzer poodle mongrel poodle pinscher poodle pinscher poodle poodle Lhasa-apso mongrel teckel poodle mongrel Lhasa-apso poodle Lhasa-apso pinscher mongrel Age (years) 9 9 10 10 10 10 6 11 9 13 14 9 13 15 9 12 10 9 9 15 12 10 9 10 12 12 10 13 14 10 11 11 12 11 9 11 Weight (kg) 7 11 7 7 10 10 3.3 7 6 4. 1999). the prolonged PR interval observed is important from the biological point of view since 8% of the animals with normal PR interval and sinus rhythm evolved to firstdegree atrioventricular block (AVB) (Figure 1).0 7.4 5. the elderly have multiple pathophysiological conditions (PADDLEFORD.5 4. Type I Mobitz second-degree atrioventricular block in 3% of the animals. Aging is associated with the structural and functional changes in the cardiac pacemaker and in its conduction system. 455 Table 1 . During the trans-anesthetic period.3 2. . mar-abr.0 8.2 9. the pre-anesthetic electrocardiogram revealed a first-degree atrioventricular block in 3% of the animals. n. sex and surgery. v. 2009. 1992).2 10. 39% of the dogs had normal sinus rhythm and 3% had sinus tachycardia.Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane. and sinus pauses in 11% of the animals showing that overall. 41% of the animals had sinus arrhythmia.0 10.0 9. When compared to young animals. breed.0 4.1 4.3 6. During the trans-operative period. without hemodynamic impairment. thus reducing the velocity of impulse conduction in these segments (SCHMIDLIN et al.5 9.

mar-abr. The elderly individuals have reduced baroreflex activity. limbic structures and diffuse thalamic-cortical projections. 5% of the study animals had sinus tachycardia associated with the superficial plane of anesthesia. the tachycardia increases the workload of the cardiac pump and the consumption of oxygen by the cardiac muscle. Figure 1 . During the trans-anesthetic period. or result from the use of vagolytic drugs or catecholamine (NUNES. isoflurane is the inhalation anesthetic of choice for animals with cardiac diseases (STEFFEY. the activity of acepromazine. vasodilatation and ataxia produced (SPINOSA & GÓRNIAK. As a result of the increased consumption of oxygen and inadequate supply. 1999). blood pressure measures revealed no significant difference between pre and post pre-anesthetic medication (Table 1). which already cause higher myocardial oxygen consumption (PADDLEFORD. confirming that the intramuscular dose of acepromazine used (0. This may be aggravated by degenerative cardiac diseases that are commonly found in geriatric animals (DODMAN et al. Thus it reduces vasomotor tonus. sedation. seven animals (19%) had hypotension and four of these (11%). In this study. Introduction of vasoactive medication was required in only two animals. the cardiac muscle becomes prone to hypoxia. Therefore. thus reducing myocardial perfusion (CHAGAS. Sinus tachycardia promotes shortening of diastolic time. at 15min of the inalatory anesthesia. 1996). 2009. As regards pre-anesthetic medication. although slightly higher than after the administration of the preanesthetic medication (Post MPA) probably due to the effect of isoflurane.05mg kg -1) results in adequate level of tranquilization without promoting hypotension.2. 1993). 2002). In concentrations of up to 2 MAC. blocks may be caused by drugs such as phenothiazines that promote increased vagal tonus (MUIR.. During the trans-anesthetic period. 1984). v. Isoflurane induces significant hypotension as a result of reduced peripheral vascular resistance. had their blood pressure normalized solely by reducing isoflurane concentration in 10%. B-After 30 minutes of general anesthesia. Simultaneously. n. a period during which coronary flow predominates. 2000). the animal had first degree atrioventricular block. 1999).A-Sinus Rhythm with 15 minutes of general anesthesia. This reduction results in a reduced response to blood loss during the trans-operative Ciência Rural.39. considering that two animals had second-degree AVB prior to the induction of the anesthesia. As regards changes in cardiac rhythm. shows specificity for the afferent sensorial routes to reticular formation.456 Conti-Patara et al. During inhaled anesthesia. 1996). 1999). the phenothiazinic used in this study. heart rate remained stable. justifying the tranquility. The likelihood of the phenothiazinic agent causing the atrioventricular blocks cannot be discarded. the isoflurane helps to maintain cardiac output. not necessarily related to the superficial plane of anesthesia but may be compensatory to severe hypotension. increasing heart rate baseline values up to 20% (AMARAL. . we must mention the occurrence of sinus tachycardia – a frequent rhythm during anesthesia. it should be used with caution in animals in shock or suffering from hypotension (STOELTING. Therefore.

In the present study.07 328. arterial pH.4 1. The STsegment should not be assessed exclusively in lead DII. Hypoxia and hypercapnia promote cardiac arrhythmias triggered indirectly by catecholamines.7±9.0 20.0 20. P<0. PaCO2 levels were higher or equal to 45mmHg.8±22. .4 24.44±0. the values obtained at 30min were lower compared to those obtained at the post-MPA and extubation time points (Table 2).9 99.5±21..7 57.3±15.33±0.15±0. peripheral saturation of oxihemoglobin (PSO2) in per cent (%).39±0.5±0.1 80.4 20.7±18.3±21. a significant reduction in respiratory rate values was observed at 15.7±0.5±7.07±0.4±0.4 1.4 1.6±22. Parameter HR SBP MBP DBP RR ETCO2 SpO2 PH PaO2 PaCO2 HCO3_ SaO2 Fi Iso ET Iso Pre-MPA 128.37 60min 101.3±5.4 87.1 353.9±18.4±18.9±23.39 1. Geriatric individuals may develop respiratory system impairment.91±14.5±3.8±15.3 99.8±0.21±0. Ciência Rural.0 65.41±0.1±16.3±23.MPA 98.54 1.76±0.8 70.2 61.1 42. 2000).4±0.21 99.46 1. and isofluorane expiratory concentration (ET Iso) at different evaluation time points.4* 31. v. there is a qualitative deterioration of pulmonary elastin and reduced complacency of the thoracic walls that promotes deterioration of ventilation and of efficient gas interchange (TOLDO et al. with decreased volume/minute and increased levels of carbon dioxide in the arterial blood (PaCO2) (AMARAL.001.6 110. 2002). 1996).0±19.3±15.1 101. sodium.0±8.69±30.4±0.9 76.35±0.2* 34. partial pressure of oxygen in arterial blood (PaO2) in millimeters of mercury (mmHg).9±9.4±3. 30.2±11.0 99.1 80.9 102. Two animals (6%) showed ST segment Table 2 .8±17.2 119.Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane. potassium and magnesium were within normal limits.segment changes are not necessarily visible in this lead. hypercapnia.9 73.0 79.6 27.5±10.7 19.62±37. oxygen saturation in arterial blood (SaO2).7 102. as observed in four animals (11%).53±31.3 62.1±128.3 1.3 18. P<0.Mean and Standard deviation of heart rate (beats per minute).92±25. in the group studied.8±6.6 extubation 123.3 99. 1993). isoflurane also promotes intense respiratory depression.4±17. therefore.8 99. 1985).6 60.6 86.19±26.3±0. n. with a tendency to respiratory acidosis as a result of hypoventilation. and cardiac hypertrophy (ETTINGER.35±0.09 * A significant reduction in respiratory rate values was observed at 15. The analysis of ST-segment in lead DII and in the precordial leads showed ST changes during the trans-anesthetic period associated with hypercapnia (Figure 2). 2001). mar-abr.6±8.8±0.5 15min 105. In addition to the physiological changes in the respiratory system of geriatric individuals.67±26. geriatric animals undergoing anesthesia and spontaneous ventilation are more prone to developing hypoxia when compared to younger animals (ROBINSON.6±7. respiratory rate (movements per minute).0 28.9±20.2 93.8 75min 97. the electrocardiographic changes observed were not associated with the electrolytic disorders.4±18. The serum levels of calcium. These dogs underwent controlled and/or assisted ventilation.5±18.4 99. we observed they easily recovered the systemic blood pressure after the reduction of the concentration of the inhaled anesthetic agent. partial pressure of carbon dioxide in arterial blood (PaCO2) (mmHg).001.9 45min 105.9 17.60±0.7 7.6±8. systolic.6±14. Likewise.1 29. 45 and 60min compared to preanesthetic values.5 98.9 7. since after 15 minutes of inhalatory anesthesia at the time point of the first arterial blood samples for gasometry.3±0.0 59.1±18. 457 period. 1984).39. 2009. since mild ST.8±25. As a result.8±0. changes in the STsegment (elevation or depression) and in the morphology of the T-wave may be associated with myocardial hypoxia.2.2 Post. With age.8±25.2 114. Clearly. mean and diastolic blood pressure (mmHg).53 1.6±7.0* 34. end-tidal carbon dioxide [concentration] (ETCO2) (mmHg). and directly by cardiac cell depression and by stimulation of the vasomotor centers of the brain (HUBBEL et al.16 0. From the electrocardiographic viewpoint.5±9. isofuorane inspiratory concentration (Fi Iso).38 33.1 74. 30. Although the geriatrics are more sensitive to cardiovascular depression and hypotension caused by the majority of anesthetic agents.1 24.01 and P<0. 45 and 60min compared to pre-anesthetic values (respectively P<0. requiring the assessment of this segment in the precordial leads (NUNES.4±132.63±0.3±12..05±22.37 1.6* 30.7±10.4 30min 104.44 0. electrolytic abnormalities.4 99.1 99.2 38.48 1.7±16.75±31. the ability to adapt to hypotension and to the self-regulation of the cardiovascular system is reduced in geriatric individuals who become more sensitive to cardiovascular depression and hypotension caused by the majority of anesthetic agents (OWENS.01). plasma bicarbonate (HCO3-) (mmol l-1).

two animals (5%) showed TWave morphological changes concomitant with hypercapnia and hypotension.ST –segment and T wave changes that were observed in the electrocardiogram of the animals which presented hypercapnia. 1975). however. range and polarity also showed alterations: nine animals (25%) showed T-wave morphological changes at 15min and 30min of anesthesia that were related with hypercapnia. causing circulatory alterations that could jeopardize the physical integrity of the animals. the first degree atrioventricular block observed in geriatric animals is likely to occur as a result of the administration of acepromazine without. Figure 2 . and enhanced hemodynamic stability. In the study group. 1993). the use of isoflurane in concentrations around the 1 CAM and a half did not promote arrhythmia. v. and four animals (11%) showed ST segment changes concomitant only with hypotension at 45min of anesthesia. 2009. geriatric animals have a great tendency to develop hypoventilation and hypercapnia. An evaluation of T-wave morphology.An electrocardiogram with normal ST-segment and T-wave (DII. fibrillation and asystolia (NUNES. Myocardial hypoxia must be identified and treated immediately. there is a depression of the ST-segment and changes in the morphology of the T wave when compared to electrocardiogram A. In this electrocardiogram. 25mm s-1).39. 16% of the animals showed T-wave polarity inversion related to hypoventilation and hypercapnia. or by correction of ventilation or even by the use of coronary vasodilators. and four animals (11%) showed T-wave morphological changes concomitant only with hypotension at 15min and 30min of anesthesia. through the use of assisted or controlled ventilation is highly important in order to prevent more complicated arrhythmias. N. Identification of this disorder through continued electrocardiographic monitoring and its correction. Failure to identify this abnormality occasionally results in worsening of the symptoms that may evolve to sustained ventricular arrhythmia. n.A. if the heart rate is high.458 Conti-Patara et al. the intervention of the anesthesiologist is paramount to prevent cardiovascular collapse (ZAIDAN. either by correction of the heart rate. 2002). mar-abr. therefore. being a good choice for this type of animals. B. T-wave polarity inversion during the anesthetic procedure suggests myocardial hypoxia and the ventilation and oxygenation status of the patient must be evaluated (BOLTON. close monitoring is required in addition to ventilation if necessary. ACKNOWLEDGEMENTS The authors thank the FAPESP (Foundation of Support to Research of the State of São Paulo) for financial support. . changes concomitant with hypercapnia and hypotension. CONCLUSIONS From the results obtained it was possible to conclude that from the electrocardiographic viewpoint. If the arrhythmia is causing major hemodynamic changes. The decision to treat electrocardiographic alterations during the transanesthetic period will depend on the global cardiac status of the patient.2. Ciência Rural.

São Paulo. Inhalation anesthetics. NUNES. 1984. Anestesiologia . Fisiopatologia da circulação coronariana.2%. Change of inhalation anesthetic agents for management of ventricular premature despolarizations in anesthetized cats and dogs. 2000.643-646. TOLDO. 2001. S.800-833. São Paulo. W.9. D. h Fentanyl: Cristália Produtos Químicos Farmacêuticos Ltda. a ETTINGER. USA. O. Pharmacology and physiology in anesthetic practice .SAESP. D. MUIR.. Philadelphia: Saunders. P. CORTOPASSI. p.ed. Brasil. Brasil. et al. São Paulo: Manole. TILLEY. J. H. FELDMAN. Brasil.6. PADDLEFORD.1993. J. SPINOSA. p. p. D. N. n.R. 2000. In: BRAZ. v. k Gas analyzer: Anesthetic Gas Analyzer and Oxi-capnograph. Brasil. v. 1996.R. p. Andover. p. S. R. In: SPINOSA.G. vaporkettle mod 1415 microprocessado.C. Radiometer.L. 1975. 1993.Electrocardiographic study on geriatric dogs undergoing general anesthesia with isoflurane. In: BARASH. In: YAMASHITA. p.R.T.77-88. São Paulo. p. v. J.1-202. S.185. São Paulo: Atheneu. 2. c Acepromazine: 0. Datascope.H. São Paulo: Atheneu.275.P.T. 1999.R. J. São Paulo. al. et al.1106-1113. São Paulo.E. Baltimore: Williams & Wilkins. Takaoka g Isoflurane: Abbott Produtos Hospitalares. et al. In: ______. In: THURMON.64-81. 2002. New Jersey. Manual of small animal anesthesia. v. Copenhagen.. Lumb and Jones veterinary anesthesia. et.K.97. p. p.C. DODMAN. Datascope. R. Inhaled anesthetics. In: SLATTER.P. Eletrocardiografia. Itapira. W. Brasil. v. p. The geriatric patient .39.267-317. j Non-invasive blood pressure monitor: Criticare Systems. p. STOELTING.A. BOLTON. ROBINSON. Philadelphia: Saunders. In: FANTONI.51-54. R.155-167. 1984. Saõa Paulo. USA. BIOETHICS AND BIOSSECURITY COMMITTEE APPROVAL This study was approved by Bioethic Committee of Veterinary Medicine and Zootechny School of São Paulo University (FMVZ-USP). Philadelphia: Lippencott-Raven.J. Ciência Rural. Handbook of canine eletrocardiography.S. In: BONAGURA. 3.. Textbook of small animal surgery. 1979. HUBBEL.262. GOLDSTON. v. v.M.2245-2250.al. In: SLATTER. W. N. O sistema cardiovascular e a anestesia. Brasil. Tratado de anestesiologia clínica. G.2295-2300.. 5.709-748. Electrocardiography. Rio de Janeiro: Guanabara Koogan.ed. Textbook of veterinary internal medicine. São Paulo: Unesp. i Computerized electrocardiograph: Agilent Technologies. et. d Meperidine (Dolosal): 50mg/ml.G.R. Efeitos cardiovasculares dos anestésicos inalatórios.ed. Effects of physiological aging on cardiac electrophysiology in perfused Fischer 344 rat hearts.971-980.P..P.G. Brasil. Fisiopatologia cardiovascular. SCHMIDLIN. Denmark. et al. 459 SOURCES AND MANUFACTURES Multi-parametric analyzer: i-STAT Corporation. m pH and blood gas analyzer: ABL-5. p. STEFFEY. et al. J Am Vet Med Assoc .ed. Brasil. COHEN.A. 2. Vet Clin North Am. l Oximetry: Anesthetic Gas Analyzer and Oxi-capnograph. Vet Clin North Am Small Anim Pract. Brasil. REFERENCES AMARAL. et. 1993. 2009.S.36-76. São Paulo: Roca. E. 1996.. E. GÓRNIAK.L. e Propofol: Cristália Produtos Químicos Farmacêuticos Ltda. Anestesia em cães e gatos.C. Textbook of small animal surgery. L. E. Anesthetics and techniques. p.physiology of aging. Farmacologia aplicada à medicina veterinária. Aging changes in the geriatric dog and their impact on anesthesia. Philadelphia: Saunders.J. p. Pediatric and geriatric anesthetic techniques.297. Philadelphia: Saunders. ZAIDAN. p. The eletrocardiogram.19. São Paulo. Compend Contin Educ Pract Vet. 3. A. al.A1-A4. 1992. CHAGAS. Anestesia em geriatria. São Paulo. São Paulo. Takaoka.. Cristália Produtos Químicos Farmacêuticos Ltda..C. b Spectrophotometry: kit – Quimimag-Ebran.39-88. Tranqüilizantes e relaxantes de ação central.D. p. MUIR. p.. Univet S. A. J. 1999.ed.W. Am J Physiol. p.140-149.B. Cardiac arrhythmias in the anesthetized patient. Philadelphia: Saunders. 1985. Monitoração da anestesia. 1989. f Aparelho de Anestesia – Samurai III. In: ______.6. In: ETTINGER. 5.W. et al. OWENS. A. 1999. J. p. . Geriatrics and gerontology. mar-abr. R.2.ed. Proc Am Soc Anesthesiol . H. Cap. S.