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.