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Vet Anaesth Analg [journal]
- Perioperative physiology and pharmacology in the obese small animal patient. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Aug 6.
To review the available literature concerning the physiologic and pharmacologic alterations induced by obesity in canine and feline patients and their relevance to perioperative care.Literature review.Pubmed, CAB, Web of Science.Obesity of cats and dogs is a chronic inflammatory condition that is increasingly prevalent. Similar to the situation in humans, small animal obesity may be associated with changes in endocrine, respiratory, and cardiovascular function. In addition, alteration of body composition in obesity can affect pharmacokinetic variables. Modifications in perioperative care may need to be made for obese dogs and cats, including attention to respiratory and cardiovascular supportive care and drug dose adjustments.
- A tribute to dr. Steve haskins. [Journal Article]
- Vet Anaesth Analg 2014 Sep; 41(5):550-1.
- Cardiopulmonary and anesthetic effects of the combination of butorphanol, midazolam and alfaxalone in Beagle dogs. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Aug 12.
To evaluate the physiological variables, arterial blood gas values, induction of anesthesia quality, and recovery quality using the combination of butorphanol, midazolam and alfaxalone in dogs.Ten healthy adult Beagle dogs weighing 8.3 ± 3.1 kg.Rectal temperature (T), pulse rate (PR), respiratory rate (fR ), mean arterial pressure (MAP), and arterial blood gases were measured and recorded prior to intravenous (IV) administration of butorphanol, prior to administration of both midazolam and alfaxalone IV 10 minutes later, then every 5 minutes for 20 minutes. M-mode echocardiographic left ventricular (LV) indices were measured before and 5 minutes after administration of alfaxalone. Qualitative scores for induction of anesthesia and recovery were allocated, duration of anesthesia and recovery were calculated, and adverse events were recorded.Scores for induction and recovery quality were excellent. No significant adverse events were observed. Mean ± SD time from induction to extubation and to standing (full recovery) was 29 ± 6 and 36 ± 8 minutes, respectively. There were statistically significant changes in PR, fR and MAP after drug administration. Transient hypercarbia developed after alfaxalone injection. The echocardiographic LV indices were reduced after alfaxalone injection, although those changes were not statistically significant.The combination of butorphanol, midazolam and alfaxalone provided excellent quality of induction of anesthesia and exerted minimal cardiopulmonary effects in healthy dogs.
- Comparison of respiratory function during TIVA (romifidine, ketamine, midazolam) and isoflurane anaesthesia in spontaneously breathing ponies Part I: blood gas analysis and cardiorespiratory variables. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Aug 7.
To compare pulmonary function and gas exchange in ponies during maintenance of anaesthesia with isoflurane or by a total intravenous anaesthesia (TIVA) technique.Experimental, cross-over study.Six healthy ponies weighing mean 286 (range 233-388) ± SD 61 kg, age 13 (9-16) ± 3 years.The ponies were anaesthetized twice, a minimum of two weeks apart. Following sedation with romifidine [80 μg kg(-1) intravenously (IV)], anaesthesia was induced IV with midazolam (0.06 mg kg(-1) ) and ketamine (2.5 mg kg(-1) ), then maintained either with inhaled isoflurane (Fe'Iso = 1.1 vol%) (T-ISO) or an IV infusion of romifidine (120 μg kg(-1) hour(-1) ), midazolam (0.09 mg kg(-1) hour(-1) IV) and ketamine (3.3 mg kg(-1) hour(-1) ) (T-TIVA). Ponies were placed in lateral recumbency. Breathing was spontaneous and Fi'O2 60%. After an instrumentation/stabilisation period of 30 minutes, arterial and mixed venous blood samples were taken simultaneously every 10 minutes for 60 minutes and analysed immediately. Oxygen extraction ratio (O2 ER) and venous admixture were calculated. Tidal volume (TV), minute volume (MV), respiratory rate (fR ), packed cell volume (PCV), arterial blood pressure and heart rate (HR) were measured and recorded. Data were analysed with mixed model anova (α = 0.05). Treatments were compared overall and at two selected time points (T30 and T60) using Bonferroni correction.Arterial and mixed venous partial pressures of O2 and CO2 , and TV were significantly lower and MV and fR were higher in T-TIVA compared to T-ISO. Venous admixture did not differ between treatments. O2 ER was significantly higher in T-TIVA. Mean arterial pressure was higher and HR was lower in T-TIVA compared to T-ISO.Whilst arterial CO2 was within an acceptable range during both protocols, the impairment of oxygenation was more pronounced with the T-TIVA evidenced by lower arterial and venous oxygen partial pressures.
- The cardiopulmonary effects of dexmedetomidine infusions in dogs during isoflurane anesthesia. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Jul 31.
To determine the cardiopulmonary changes associated with intravenous (IV) infusions of dexmedetomidine at equipotent isoflurane-dexmedetomidine concentrations compared with isoflurane alone.Prospective, randomized, crossover experiment.Six adult intact female mixed-breed dogs weighing (mean ± SD [range]) 23.3 ± 3.8 (17.8-29.4) kg.Anesthesia was induced and maintained with isoflurane in oxygen. Measurements of respiratory rate (fR ), heart rate (HR), systemic and pulmonary arterial pressures (SAP, DAP, MAP, MPAP), central venous pressure (CVP), pulmonary arterial occlusion pressure (PAOP), cardiac index (CI), left and right ventricular stroke work index (LVSWI, RVSWI), systemic and pulmonary vascular resistance index (SVRI, PVRI), arteriovenous shunt (Q˙s/Q˙t), oxygen delivery (D˙O2), oxygen extraction ratio (O2 ER), oxygen consumption, arterial and mixed venous blood gases, and arterial packed cell volume (PCV) were obtained 30 minutes after instrumentation at an end-tidal isoflurane concentration (Fe'Iso) of 1.73 ± 0.02% (1.3 MAC). Dexmedetomidine was administered IV at 0.5 or 3 μg kg(-1) over 6 minutes followed by an infusion at 0.5 (LD) or 3 μg kg(-1) hour(-1) (HD), respectively, with Fe'Iso at 1.41 ± 0.02 (LD) or 0.72 ± 0.09% (HD). Measurements were taken at 10, 30, 60, 90, 120, 150 and 180 minutes after the start of the infusion.The low dose produced significant decreases in HR, increases in SAP, DAP, CVP, MPAP, PAOP and LVSWI, but no change in CI. HD produced significant increases in SAP, MAP, DAP, CVP, PAOP, SVRI, LVSWI, O2 ER and PCV and significant decreases in CI and D˙O2. There were significant differences between treatments in HR, MAP, DAP, CVP, MPAP, PAOP, CI, SVRI, HCO3-, SBE, D˙O2, O2 ER and Q˙s/Q˙t.Cardiopulmonary changes associated with LD were within clinically accepted normal ranges whereas HD produced clinically significant changes. The LD may be useful as an anesthetic adjunct in healthy dogs.
- Anaesthetic and cardiorespiratory effects of a constant rate infusion of fentanyl in isoflurane- anaesthetized sheep. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Jul 31.
To determine the anaesthetic and cardiorespiratory effects of a constant rate infusion of fentanyl in sheep anaesthetized with isoflurane and undergoing orthopaedic surgery.Prospective, randomised, 'blinded' controlled study.Twenty healthy sheep (weight mean 41.1 ± SD 4.5 kg).Sheep were sedated with intravenous (IV) dexmedetomidine (4 μg kg(-1) ) and morphine (0.2 mg kg(-1) ). Anaesthesia was induced with propofol (1 mg kg(-1) minute(-1) to effect IV) and maintained with isoflurane in oxygen and a continuous rate infusion (CRI) of fentanyl 10 μg kg(-1) hour(-1) (group F) or saline (group P) for 100 minutes. The anaesthetic induction dose of propofol, isoflurane expiratory fraction (Fe'iso) required for maintenance and cardiorespiratory measurements were recorded and blood gases analyzed at predetermined intervals. The quality of recovery was assessed. Results were compared between groups using t-tests or Mann-Whitney as relevant.The propofol induction dose was 4.7 ± 2.4 mg kg(-1) . Fe'iso was significantly lower (by 22.6%) in group F sheep than group P (p = 0). Cardiac index (mean ± SD mL kg(-1) minute(-1) ) was significantly (p = 0.012) lower in group F (90 ± 15) than group P (102 ± 35). Other measured cardiorespiratory parameters did not differ statistically significantly between groups. Recovery times and recovery quality were statistically similar in both groups.Fentanyl reduced isoflurane requirements without clinically affecting the cardiorespiratory stability or post-operative recovery in anaesthetized sheep undergoing orthopaedic surgery.
- A study of measurement of noninvasive blood pressure with the oscillometric device, Sentinel, in isoflurane-anaesthetized horses. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Jul 31.
To assess accuracy of noninvasive blood pressure (NIBP) measured by oscillometric device Sentinel compared to invasive blood pressure (IBP) in anaesthetized horses undergoing surgery. To assess if differences between the NIBP measured by the Sentinel and IBP are associated with recumbency, cuff placement, weight of the horse or acepromazine premedication and to describe usefulness of the Sentinel.Prospective study examining replicates of simultaneous NIBP and IBP measurements.Twenty-nine horses.Invasive blood pressure was measured via a catheter in the facial artery, transverse facial artery or metatarsal artery. NIBP was measured using appropriate size cuffs placed on one of two metacarpal or metatarsal bones or the tail in random order. With both techniques systolic (SAP), mean (MAP), and diastolic (DAP) arterial blood pressures and heart rates (HR) were recorded. A mixed effects model compared the IBP to the NIBP values and assessed potential effects of catheter placement, localisation of the cuffs in combination with recumbency, weight of the horse or acepromazine premedication.Noninvasive blood pressure yielded higher measurements than IBP. Agreement varied with recumbency and cuff position. Estimated mean differences between the two methods decreased from SAP (lateral recumbency: range -5.3 to -56.0 mmHg; dorsal recumbency: range 0.8 to -20.7 mmHg), to MAP (lateral recumbency: range -1.8 to -19.0 mmHg; dorsal recumbency: range 13.9 to -16.4 mmHg) to DAP (lateral recumbency: range 0.5 to -6.6 mmHg; dorsal recumbency: range 21.0 to -15.5 mmHg). NIBP measurement was approximately two times more variable than IBP measurement. No significant difference between IBP and NIBP due to horse's weight or acepromazine premedication was found. In 227 of 1047 (21.7%) measurements the Sentinel did not deliver a result.According to the high variability of NIBP compared to IBP, NIBP measurements as measured by the Sentinel in the manner described here are not considered as an appropriate alternative to IBP to measure blood pressure in anaesthetized horses.
- An equine pain face. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Jul 31.
The objective of this study was to investigate the existence of an equine pain face and to describe this in detail.Semi-randomized, controlled, crossover trial.Six adult horses.Pain was induced with two noxious stimuli, a tourniquet on the antebrachium and topical application of capsaicin. All horses participated in two control trials and received both noxious stimuli twice, once with and once without an observer present. During all sessions their pain state was scored. The horses were filmed and the close-up video recordings of the faces were analysed for alterations in behaviour and facial expressions. Still images from the trials were evaluated for the presence of each of the specific pain face features identified from the video analysis.Both noxious challenges were effective in producing a pain response resulting in significantly increased pain scores. Alterations in facial expressions were observed in all horses during all noxious stimulations. The number of pain face features present on the still images from the noxious challenges were significantly higher than for the control trial (p = 0.0001). Facial expressions representative for control and pain trials were condensed into explanatory illustrations. During pain sessions with an observer present, the horses increased their contact-seeking behavior.An equine pain face comprising 'low' and/or 'asymmetrical' ears, an angled appearance of the eyes, a withdrawn and/or tense stare, mediolaterally dilated nostrils and tension of the lips, chin and certain facial muscles expressions can be recognized in horses during induced acute pain. This description of an equine pain face may be useful for improving tools for pain recognition in horses with mild to moderate pain.
- A preliminary trial of the sedation induced by intranasal administration of midazolam alone or in combination with dexmedetomidine and reversal by atipamezole for a short-term immobilization in pigeons. [JOURNAL ARTICLE]
- Vet Anaesth Analg 2014 Jul 24.
To assess the sedative and immobilization effect of intranasal administration (INS) of midazolam (MID) without or with INS dexmedetomidine (DXM), and some physiological changes induced by the drugs. The ability of INS atipamezole to reverse the DXM component was also assessed.Prospective 'blinded' experimental study.In total, 15 pigeons.Pigeons were sedated by INS MID alone at a dose of 5 mg kg(-1) (group MID, n = 6) or in combination with INS DXM at a dose 80 μg kg(-1) (group MID-DXM, n = 6). Measurements were made of heart rate (HR), respiratory rate (fR ) and cloacal temperature (CT). The degree of sedation was assessed at 15 minutes prior to, immediately after, and at intervals until 100 minutes after drug administrations. Following MID-DXM, INS atipamezole (250 μg kg(-1) ) was administered and the same indices measured 5 and 10 minutes later.MID had no effect on HR and fR , and although CT decreased, it remained within physiological range. MID-DXM caused significant falls in HR, fR and CT that persisted until the end of sedation. Atipamezole antagonized sedation and cardiorespiratory side effects of MID-DXM within 10 minutes of application. In addition, for MID compared to MID-DXM, the lowest sedation scores [10 (7-14) and 10.5 (5-14) versus 2 (1-4) and 2 (1-5)] were achieved in the 10th and 20th minute versus the 20th and 30th minute of the sedation, respectively.MID alone, given INS had minimal side effects on vital functions but caused inadequate immobilization of pigeons for restraint in dorsal recumbency. MID-DXM caused an effective degree of immobilization from 20 to 30 minutes after administration, at which time birds tolerated postural changes without resistance. Atipamezole antagonized both side effects and sedation, but complete recovery had not occurred within 10 minutes after its application.