Cardiovascular Effects of Adding Adrenaline to Arthroscopic Knee Irrigation Fluid in Canine Diagnostic Procedures
by
, , , , and
Ana Zapata
1,2,*
,
Claudio Iván Serra Aguado
1,3,*,
José Ignacio Redondo
4,
José Román Soto Muñoz
5,
José Sansano-Maestre
6 and
Rocío Fernández-Parra
1,3 1
Hospital Veterinario de Referencia UCV, Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, 46018 Valencia, Spain
2
Programa de Doctorado en Ciencias de la Vida y del Medio Natural, Escuela de Doctorado, Universidad Católica de Valencia San Vicente el Mártir, 46002 Valencia, Spain
3
Departamento Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, 46002 Valencia, Spain
4
Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria, Universidad Cardenal Herrera-CEU, CEU Universities, C/Tirant lo Blanch, 7, Alfara del Patriarca, 46115 Valencia, Spain
5
Veterinary Specialist Ireland, A83 EV27 Summerhill, Ireland
6
Departamento de Producción Animal y Salud Pública. Universidad Católica de Valencia San Vicente Mártir, 46002 Valencia, Spain
*
Authors to whom correspondence should be addressed.
Animals 2025, 15(11), 1544; https://doi.org/10.3390/ani15111544 (registering DOI)
Submission received: 29 March 2025
/
Revised: 21 May 2025
/
Accepted: 22 May 2025
/
Published: 25 May 2025
(This article belongs to the Special Issue Diagnostic Approach and Treatment of Orthopedic Disease in Dogs and Cats: Second Edition)
Simple Summary
Intra-articular bleeding resulting from the creation of the arthroscopic portal and manipulation of joint tissues can significantly impair visual clarity during the procedure. In human medicine, adrenaline is commonly added to the irrigation fluid to enhance visibility. However, this practice carries a minimal risk of inducing hypertension and/or tachycardia (with or without arrhythmias). This study aims to assess whether the use of adrenaline at a concentration of 0.33 mg L−1 in the arthroscopic irrigation fluid would cause hemodynamic alterations in dogs. In half of the dogs, advanced hemodynamic parameters were monitored using the pressure recording analytical method (PRAM) with the MostCare® system. No significant differences were observed in cardiovascular parameters between groups at different time points or within the same group over time. In conclusion, the use of adrenaline at 0.33 mg L−1 as a haemostatic agent in arthroscopic irrigation fluid does not produce significant cardiovascular alterations in dogs. Similarly, advanced monitoring appears to show consistent results, with no alterations in hemodynamic parameters.
Abstract
Background: Adrenaline is used as a local haemostatic in human arthroscopy, due to its peripheral vasoconstrictive properties, which enhance image quality with minimal cardiovascular side effects. This study aims to evaluate the effects of adrenaline in arthroscopic irrigation fluid and asses its impact on image visibility. Methods: A prospective, double-blind, randomised clinical trial was conducted on 20 knees from 18 dogs undergoing diagnostic arthroscopies. Dogs were randomly assigned to two groups: group A (received lactate Ringer (LR) with adrenaline 0.33 mg L−1) and group C (received LR with 0.33 mL of saline solution). Cardiovascular parameters were recorded using a multiparametric monitor, with advanced hemodynamic parameters assessed using the PRAM method (MostCare®) in half of the dogs, and glucose, cortisol, and adrenaline levels were measured at various time points. Hemoglobin concentration was calculated based on the residual fluid and image quality was evaluated by a blinded surgeon using a visual analog scale (VAS). Results: No significant differences between groups in cardiovascular parameters, glucose, cortisol, adrenaline, hemoglobin, or VAS scores; only time differences for cortisol and adrenaline. Conclusions: The use of adrenaline at 0.33 mg L−1 in arthroscopic irrigation fluid does not cause significant cardiovascular changes or improve image quality, confirming it is safe at this concentration.
