A 1-month-old Nubian goat presented for sialocyst resection. Physical examination and bloodwork were unremarkable. While pre-oxygenating, the goat was sedated with
midazolam and
morphine (0.1 mg kg(-1) each) intravenously (IV).
General anesthesia was induced 5 minutes later with 1.7 mg kg(-1)
propofol.
Sevoflurane was administered in
oxygen without assisted ventilation via a cuffed orotracheal tube. Throughout the first 85 minutes of
anesthesia, the goat was well-oxygenated (SpO(2), > or =97%), ventilating adequately (Pe'CO(2), 36-48 mmHg), and had normal mean arterial blood pressure (MAP, 60-85 mmHg). Blood-gas values at 45 minutes were consistent with adequate ventilation on
oxygen. At 75 minutes, the goat moved in response to surgical stimulation, requiring additional
propofol (0.4 mg kg(-1)). After 10 minutes, MAP dropped precipitously to 40 mmHg and frequent multiform
premature ventricular contractions (PVCs) were observed. Crystalloids,
hetastarch, and
dopamine (5 mug kg(-1) minute(-1)) were administered to correct the
hypotension. Arterial blood-gas analysis revealed that the goat had become hypoxemic (PaO(2), 50 mmHg).
Intermittent positive pressure ventilation (
IPPV) was initiated. Subsequent blood-gas analysis did not show significant improvement in PaO(2) (53 and 56 mmHg, respectively). Occasional PVCs were observed thereafter. Surgery ended, and
sevoflurane and
IPPV were discontinued. The goat was extubated within 7 minutes and received 100%
oxygen by mask. Diffuse
crackles were ausculted over both hemithoraces. Suspecting
pulmonary edema,
furosemide (1 mg kg(-1)) was administered IV. Radiographs taken immediately post-operatively revealed a severe, caudodorsal airspace (alveolar) pattern, confirming the diagnosis. Respiration improved considerably within an hour with nasal
oxygen and two additional doses of
furosemide.
CONCLUSIONS: