1
|
Shores A, Mendoza ML. Complications in Intracranial Surgery of Companion Animals. Vet Clin North Am Small Anim Pract 2024:S0195-5616(24)00060-3. [PMID: 39244444 DOI: 10.1016/j.cvsm.2024.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2024]
Abstract
The most common complications of intracranial surgery in companion animals chiefly consist of brain swelling, hemorrhage, seizures, and worsening of neurologic status, aspiration pneumonia, and anesthetic death. Further dividing these into intraoperative and postoperative complications, postoperative are more common. Preventative measures can include careful surgical planning, cerebro-protective anesthetic regimes, seizure prophylaxis, and postoperative sedation/pain management that allows for an early return to function and ambulation and an adequate and accelerated nutrition.
Collapse
Affiliation(s)
- Andy Shores
- Department of Clinical Science, College of Veterinary Medicine, Mississippi State Univeristy, 240 Wise Center Drive, Mississippi State, MS 39762, USA.
| | - Michelle L Mendoza
- Department of Clinical Science, College of Veterinary Medicine, Mississippi State Univeristy, 240 Wise Center Drive, Mississippi State, MS 39762, USA
| |
Collapse
|
2
|
Morton BA, Selmic LE, Vitale S, Packer R, Santistevan L, Boudrieau B, Hinson W, Kent M, Hague DW. Indications, complications, and mortality rate following craniotomy or craniectomy in dogs and cats: 165 cases (1995-2016). J Am Vet Med Assoc 2022; 260:1048-1056. [PMID: 35417413 DOI: 10.2460/javma.21.04.0189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the most common indications for cranial surgery and identify risk factors associated with the occurrence of complications and death in the perioperative period following cranial surgery. ANIMALS 150 dogs and 15 cats. PROCEDURES For this multi-institutional retrospective case series, medical records of dogs and cats that underwent cranial surgery at any of the 4 participating institutions between 1995 and 2016 were reviewed. Variables were evaluated included species, sex, age, neurolocalization, history of preoperative seizures, surgical approach, histological results, perioperative complications, and outcome. Logistic regression analysis was performed to assess for risk factors for complications. RESULTS The most common neurolocalization was the forebrain (110/165 [66.7%]), with 94 (57.0%) animals having had seizures preoperatively. The rostrotentorial (116/165 [70.3%]) and caudotentorial (32/165 [19.4%]) surgical approaches were most commonly reported. The most common indication was the treatment of meningioma (75/142 [52.8%]). Complications arose in 58 of the 165 (35.2%) cases within 24 hours and in 86 (52.1%) cases 1 to 10 days postoperatively. Perioperative complications included hypotension (38/165 [23.0%]) and anemia (27/165 [16.4%]). During the postoperative period, the most common complications were neurologic deficits, seizures, postoperative anemia, and aspiration pneumonia. The mortality rate with death or euthanasia perioperatively or ≤ 10 days postoperatively was 14.5% (24/165). Long-term complications occurred in 65 of the 165 (39.4%) animals, with seizures and neurologic deficits being the most common. CLINICAL RELEVANCE Cranial surgery was performed most commonly for the removal of neoplastic lesions in dogs and cats, and most complications were not life-threatening.
Collapse
Affiliation(s)
- Bridget A Morton
- 1Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Laura E Selmic
- 2Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH
| | - Samantha Vitale
- 1Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| | - Rebecca Packer
- 3Department of Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Lawrence Santistevan
- 3Department of Clinical Sciences, College of Veterinary Medicine & Biomedical Sciences, Colorado State University, Fort Collins, CO
| | - Beth Boudrieau
- 4Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Whitney Hinson
- 4Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX
| | - Marc Kent
- 5Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
| | - Devon W Hague
- 1Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL
| |
Collapse
|
3
|
Schaldemose M, Lehnus K. Peripheral nerve block of the dorsal cranium in two dogs undergoing craniotomy. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
4
|
Pohlin F, Boustead KJ, Grace JF, Zeiler G. Isoflurane maintenance of neuroanaesthesia in two dogs with hydrocephalus and syringohydromyelia undergoing ventriculoperitoneal shunt surgery. VETERINARY RECORD CASE REPORTS 2020. [DOI: 10.1136/vetreccr-2020-001235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Friederike Pohlin
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
- Research Institute of Wildlife EcologyDepartment of Interdisciplinary Life SciencesUniversity of Veterinary Medicine ViennaViennaAustria
| | - Keagan John Boustead
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
| | - Justin Frederick Grace
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
| | - Gareth Zeiler
- Department of Companion Animal Clinical StudiesUniversity of PretoriaOnderstepoortSouth Africa
- Anaesthesia and Critical Care ServiceValley Farm Animal HospitalPretoriaSouth Africa
| |
Collapse
|
5
|
Marquez-Grados F, Vettorato E, Corletto F. Sevoflurane with opioid or dexmedetomidine infusions in dogs undergoing intracranial surgery: a retrospective observational study. J Vet Sci 2020; 21:e8. [PMID: 31940687 PMCID: PMC7000903 DOI: 10.4142/jvs.2020.21.e8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 10/23/2019] [Accepted: 10/23/2019] [Indexed: 12/15/2022] Open
Abstract
This study reports the clinical use of two sevoflurane-based anesthetic techniques in dogs undergoing craniectomy. Twenty-one animals undergoing elective rostrotentorial or transfrontal craniectomy for brain tumor excision, anesthetized with sevoflurane, were enrolled in this retrospective, observational study. Anesthetic records were allocated to two groups: Sevo-Op (sevoflurane and short acting opioid infusion): 8 dogs and Sevo-Dex (sevoflurane and dexmedetomidine infusion): 13 dogs. Average mean arterial pressure (MAP), heart rate, end-tidal carbon dioxide, end-tidal sevoflurane and intraoperative infusion rates during surgery were calculated. Presence of intra-operative and post-operative bradycardia, tachycardia, hypotension, hypertension, hypothermia, hyperthermia was recorded. Time to endotracheal extubation, intraoperative occurrence of atrioventricular block, postoperative presence of agitation, seizures, use of labetalol and dexmedetomidine infusion were also recorded. Data from the two groups were compared with Fisher's exact test and unpaired t tests with Welch's correction. Odds ratio (OR) and 95% confidence interval (CI) were calculated for categorical variables. Intra-operatively, MAP was lower in Sevo-Op [85 (± 6.54) vs. 97.69 (± 7.8) mmHg, p = 0.0009]. Time to extubation was longer in Sevo-Dex [37.69 (10–70) vs. 19.63 (10–25), p = 0.0033]. No differences were found for the other intra-operative and post-operative variables investigated. Post-operative hypertension and agitation were the most common complications (11 and 12 out of 21 animals, respectively). These results suggest that the infusion of dexmedetomidine provides similar intra-operative conditions and post-operative course to a short acting opioid infusion during sevoflurane anesthesia in dogs undergoing elective rostrotentorial or transfrontal intracranial surgery.
Collapse
|
6
|
Kohler RJ, Arnold SA, Eck DJ, Thomson CB, Hunt MA, Pluhar GE. Incidence of and risk factors for major complications or death in dogs undergoing cytoreductive surgery for treatment of suspected primary intracranial masses. J Am Vet Med Assoc 2019; 253:1594-1603. [PMID: 30668253 DOI: 10.2460/javma.253.12.1594] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine incidence of and risk factors for major complications occurring in dogs within 30 days after cytoreductive surgery performed by a single pair of surgeons for treatment of suspected primary intracranial masses. DESIGN Retrospective cohort study. ANIMALS 160 client-owned dogs that underwent cytoreductive surgery for treatment of suspected primary intracranial masses between January 2009 and December 2015 at a veterinary teaching hospital. PROCEDURES Medical records were retrospectively reviewed for complications occurring within 30 days after surgery. Data (eg, signalment, clinical signs, previous treatments, preoperative neurologic examination findings, neuroanatomical location, time from onset of clinical signs to surgery, surgical approach, and histopathologic diagnosis) were analyzed for associations with death and with development of major complications other than death. RESULTS 21 (13.1%) dogs died (11 during hospitalization and 10 after discharge) and 30 (18.8%) developed major complications other than death during the first 30 days after surgery. Dogs with abnormal preoperative neurologic examination findings were more likely to develop complications or die. Dogs undergoing a suboccipital approach were more likely to die. The most common postoperative complications other than death were seizures (n = 18 [11.3%]), worsening of neurologic status (6 [3.8%]), and aspiration pneumonia (6 [3.8%]). CONCLUSIONS AND CLINICAL RELEVANCE Results of the present study provided valuable information on predisposing factors, odds of major complications or death, and incidences of major complications or death in dogs during the first 30 days after undergoing cytoreductive surgery for treatment of suspected primary intracranial masses. Careful case selection may help improve outcomes and minimize complications.
Collapse
|
7
|
Tayari H, Bell A. Dexmedetomidine infusion as perioperative adjuvant in a dog undergoing craniotomy. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2018-000727] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Hamaseh Tayari
- School of Veterinary MedicineUniversity of GlasgowGlasgowUK
| | - Andrew Bell
- School of Veterinary MedicineUniversity of GlasgowGlasgowUK
| |
Collapse
|
8
|
Dehuisser V, Bosmans T, Kitshoff A, Duchateau L, de Rooster H, Polis I. Cardiovascular effects, induction and recovery characteristics and alfaxalone dose assessment in alfaxalone versus alfaxalone-fentanyl total intravenous anaesthesia in dogs. Vet Anaesth Analg 2017; 44:1276-1286. [DOI: 10.1016/j.vaa.2017.04.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 03/07/2017] [Accepted: 04/10/2017] [Indexed: 11/30/2022]
|
9
|
Vieitez V, Álvarez Gómez de Segura I, López Rámis V, Santella M, Ezquerra LJ. Total intravenous anaesthesia in a goat undergoing craniectomy. BMC Vet Res 2017; 13:287. [PMID: 28915921 PMCID: PMC5603036 DOI: 10.1186/s12917-017-1205-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 09/07/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Cerebral coenurosis is a disease of the central nervous system in sheep and goats, and is usually fatal unless surgical relief is provided. Information regarding neuroanaesthesia in veterinary medicine in goats is scant. CASE PRESENTATION We describe anaesthetic management of an intact female goat (2 years; 16 kg) presented for craniectomy. The goat was sedated with xylazine (0.05 mg kg-1, i.m.) and morphine (0.05 mg kg-1, i.m.). General anaesthesia was induced 20 min later with propofol and maintained with a constant rate infusion of propofol (0.2 mg kg-1 min-1). A cuffed endotracheal tube was placed and connected to a rebreathing (circle) system and mechanical ventilation with 100% oxygen was initiated. A bolus of lidocaine (1 mg kg-1), midazolam (0.25 mg kg-1) and fentanyl 2.5 μg kg-1 was delivered via the intravenous route followed immediately by a constant rate infusion of lidocaine (50 μg kg-1 min-1), midazolam (0.15 mg kg-1 h-1) and fentanyl (6 μg kg-1 h-1) administered via the intravenous route throughout surgery. Craniectomy was undertaken and the goat recovered uneventfully. CONCLUSION Total intravenous anaesthesia with propofol, lidocaine, fentanyl and midazolam could be an acceptable option for anaesthesia during intracranial surgery in goats.
Collapse
Affiliation(s)
- Verónica Vieitez
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003 Cáceres, Spain
| | - Ignacio Álvarez Gómez de Segura
- Department of Animal Medicine and Surgery, Veterinary Faculty, University Complutense of Madrid, Avda. Puerta de Hierro, 28040 Madrid, Spain
| | - Víctor López Rámis
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003 Cáceres, Spain
| | - Massimo Santella
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003 Cáceres, Spain
| | - Luis Javier Ezquerra
- Veterinary Teaching Hospital, University of Extremadura, Avda, Universidad s/n, 10003 Cáceres, Spain
| |
Collapse
|
10
|
Scarabelli S, Bradbrook C. Anaesthesia of the patient with cardiovascular disease part 2: anaesthesia for specific disorders. ACTA ACUST UNITED AC 2016. [DOI: 10.12968/coan.2016.21.6.337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Stefania Scarabelli
- Resident in Anaesthesia and Analgesia, School of Veterinary Science, University of Liverpool, Chester High Road, Neston CH64 7TE
| | | |
Collapse
|
11
|
Cerasoli I, Nannarone S, Schauvliege S, Duchateau L, Bufalari A. The effects of intravenous lidocaine before propofol induction in premedicated dogs. J Small Anim Pract 2016; 57:435-40. [DOI: 10.1111/jsap.12502] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 03/08/2016] [Accepted: 03/28/2016] [Indexed: 11/27/2022]
Affiliation(s)
- I. Cerasoli
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke 9820 Belgium
| | - S. Nannarone
- Dipartimento di Medicina Veterinaria, Centro dello Studio del Cavallo Sportivo Veterinary Teaching HospitalUniversità degli Studi di Perugia Perugia 06126 Italy
| | - S. Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke 9820 Belgium
| | - L. Duchateau
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary MedicineGhent University Merelbeke 9820 Belgium
| | - A. Bufalari
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary MedicineGhent University Merelbeke 9820 Belgium
- Dipartimento di Medicina Veterinaria, Centro dello Studio del Cavallo Sportivo Veterinary Teaching HospitalUniversità degli Studi di Perugia Perugia 06126 Italy
| |
Collapse
|
12
|
Hicks JA, Kennedy MJ, Patterson EE. Perianesthetic complications in dogs undergoing magnetic resonance imaging of the brain for suspected intracranial disease. J Am Vet Med Assoc 2014; 243:1310-5. [PMID: 24134582 DOI: 10.2460/javma.243.9.1310] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the occurrence of perianesthetic complications in dogs undergoing MRI for suspected intracranial disease and identify risk factors associated with observed complications. DESIGN Retrospective case-control study. ANIMALS 238 client-owned dogs undergoing MRI of the brain. PROCEDURES Signalment, clinical signs, neurologic examination findings, presumptive diagnosis, anesthesia-related variables, whether CSF was collected and CSF analysis results, severe perianesthetic complications (need for a ventilator following anesthesia or perianesthetic death), and anesthetic recovery time were recorded. Selected factors were compared between dogs with and without intracranial lesions and dogs with and without perianesthetic complications (including severe complications and prolonged anesthetic recovery [> 20 minutes from the end of anesthesia to extubation]). RESULTS 3 of 149 (2%) dogs with and 0 of 89 dogs without intracranial lesions required ventilation following anesthesia; the difference was nonsignificant. Recovery time was significantly longer in dogs with (median, 15 minutes) than in dogs without (10 minutes) intracranial lesions. Abnormal mentation prior to anesthesia was the only clinical sign that differed significantly between dogs with (15/26 [58%]) and without (70/212 [33%]) perianesthetic complications. A significantly larger proportion of dogs with perianesthetic complications had intracranial masses (13/26 [50%]), compared with dogs without these complications (56/212 [26%]). CONCLUSIONS AND CLINICAL RELEVANCE Dogs with complications were more likely to have had intracranial lesions than were dogs without complications, but few dogs had severe complications. Abnormal mentation was more common in dogs with than in dogs without complications. Prospective studies to further evaluate perianesthetic risk factors and procedures for improving outcomes in these patients are warranted.
Collapse
Affiliation(s)
- Jill A Hicks
- Department of Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 50118
| | | | | |
Collapse
|
13
|
The effects on cardio-respiratory and acid–base variables of a constant rate infusion of alfaxalone–HPCD in sheep. Vet J 2013; 196:209-12. [DOI: 10.1016/j.tvjl.2012.09.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 09/12/2012] [Accepted: 09/17/2012] [Indexed: 11/18/2022]
|
14
|
Andreoni V, Lynne Hughes JM. Propofol and fentanyl infusions in dogs of various breeds undergoing surgery. Vet Anaesth Analg 2009; 36:523-31. [DOI: 10.1111/j.1467-2995.2009.00490.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|