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Vézina-Audette R, Kantyka M, Gianotti G, Silverstein DC. Comparison of Mean Arterial Blood Pressure and Heart Rate Changes in Response to Three Different Randomized Isotonic Crystalloid Boluses in Hypotensive Anesthetized Dogs. Animals (Basel) 2022; 12:ani12141781. [PMID: 35883328 PMCID: PMC9312031 DOI: 10.3390/ani12141781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 06/23/2022] [Accepted: 07/08/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this prospective, randomized, nonblinded, controlled clinical trial was to compare mean arterial blood pressure (MAP) and heart rate (HR) during an intravenous bolus of three different balanced isotonic crystalloid solutions in euvolemic, anesthetized dogs with hypotension. Thirty healthy dogs (American Society of Anesthesiologists Physical Status I–II) weighing at least 15 kg that presented for elective orthopedic or dental surgical procedures at the Ryan Veterinary Hospital for Small Animals of the University of Pennsylvania were included in this study. Anesthetized hypotensive patients (defined as a MAP ≤ 65 mmHg), were administered an infusion of Lactated Ringer’s solution (LRS), Plasma-Lyte (PLYTE) or Canadian Plasma-Lyte (PLYTECA), selected at random. The infusion was administered over 15 min via a volumetric fluid pump. Differences in oscillometric MAP and HR between time points and across treatments were evaluated by mANOVA. Intravenous isotonic crystalloid infusions over 15 min did not significantly change MAP or HR in hypotensive dogs under general anesthesia. Neither LRS, PLYTE nor PLYTECA exacerbated hypotension or caused tachycardia.
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Affiliation(s)
- Raphaël Vézina-Audette
- Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, 3900 Delancey Street, University of Pennsylvania, Philadelphia, PA 19104, USA; (G.G.); (D.C.S.)
- Correspondence:
| | - Marta Kantyka
- Section of Anaesthesiology and Pain Therapy, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, 3012 Bern, Switzerland;
| | - Giacomo Gianotti
- Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, 3900 Delancey Street, University of Pennsylvania, Philadelphia, PA 19104, USA; (G.G.); (D.C.S.)
| | - Deborah C. Silverstein
- Department of Clinical Studies, Matthew J. Ryan Veterinary Hospital, 3900 Delancey Street, University of Pennsylvania, Philadelphia, PA 19104, USA; (G.G.); (D.C.S.)
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Clark TP. The history and pharmacology of buprenorphine: New advances in cats. J Vet Pharmacol Ther 2022; 45 Suppl 1:S1-S30. [DOI: 10.1111/jvp.13073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 04/19/2022] [Accepted: 05/14/2022] [Indexed: 11/30/2022]
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Development of an ultrasound-guided transgluteal injection of the pudendal nerve in cats: a cadaveric study. Vet Anaesth Analg 2021; 49:189-196. [PMID: 35000841 DOI: 10.1016/j.vaa.2021.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To develop an ultrasound-guided interfascial plane technique for injection of the pudendal nerve near its sacral origin in cats. STUDY DESIGN Prospective, randomized, anatomical study. ANIMALS A group of 12 feline cadavers. METHODS Gross and ultrasound anatomy of the ischiorectal fossa, the pudendal nerve relationship with parasacral structures, and the interfascial plane were described. Computed tomography was employed to describe a cranial transgluteal approach to the pudendal nerve. Bilateral ultrasound-guided injections were performed in eight cadavers using low [(LV) 0.1 mL kg-1] or high volume [(HV) 0.2 mL kg-1] of ropivacaine-dye solution. Dissections were performed to determine successful staining of the pudendal nerve (>1 cm) and inadvertent staining of the sciatic nerve, and any rectal, urethral, or intravascular puncture. Pudendal nerve staining in groups LV and HV were compared using Fisher's exact and Wilcoxon rank-sum test as appropriate (p = 0.05). RESULTS The pudendal nerve and its rectal perineal and sensory branches coursed through the ischiorectal fossa, dorsomedial to the ischiatic spine. The pudendal nerve was not identified ultrasonographically, but the target plane was identified between the sacral transverse process, the ischiatic spine, the pelvic fascia and the rectum, and it was filled with dye solution. Both branches of the pudendal nerve were completely stained 75% and 87.5% in groups LV and HV, respectively (p = 1.00). The dorsal aspect of the sciatic nerve was partially stained in 37% of injections in group HV. Rectal or urethral puncture and intravascular injection were not observed. CONCLUSIONS AND CLINICAL RELEVANCE In cats, ultrasound-guided cranial transgluteal injection successfully stained the pudendal nerve in at least 75% of attempts, regardless of injectate volume. Group HV had a greater probability of sciatic nerve staining.
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Pratt CL, Balakrishnan A, McGowan E, Drobatz KJ, Reineke EL. A prospective randomized, double-blinded clinical study evaluating the efficacy and safety of bupivacaine versus morphine-bupivacaine in caudal epidurals in cats with urethral obstruction. J Vet Emerg Crit Care (San Antonio) 2020; 30:170-178. [PMID: 32100466 DOI: 10.1111/vec.12944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 08/21/2018] [Accepted: 10/31/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate the efficacy and safety of the caudal epidural technique in cats with urethral obstruction (UO). DESIGN Prospective, double-blinded, randomized, sham-controlled study. ANIMALS Eighty-eight male cats with UO. INTERVENTIONS Thirty cats randomized to bupivacaine epidural (BUP), 28 cats to bupivacaine-morphine epidural (BUP/MOR), and 30 cats to sham epidural (SHAM). MEASUREMENTS AND MAIN RESULTS Time to perform the epidural and efficacy of the epidural was assessed by evaluation of tail and perineal responses. The amount of propofol for urinary catheterization and time to administration of rescue analgesia (buprenorphine) was recorded. Cats were monitored for epidural complications. The median time to perform the epidural was 2 min (range, 0.2-13 min and range, 0.5-13 min), with an epidural success rate of 70%. The median amount of propofol administered for urinary catheterization was significantly less in the BUP (2.1 mg/kg; range, 0-7.5 mg/kg) and MOR/BUP cats (1.85 mg/kg; range, 0-8.6 mg/kg) as compared to SHAM cats (4 mg/kg; range, 0-12.7 mg/kg) (P = 0.006, P = 0.0008, respectively). The median time to administration of rescue analgesia was also significantly longer in the BUP (10 h; range, 2-32 h) and MOR/BUP cats (10 h; range, 4-45 h) as compared to SHAM cats (4 h; range, 2-36 h) (P = 0.0026, P = 0.0004, respectively). There were no recognized complications related to the epidural. CONCLUSION Caudal epidural appears to be safe, may reduce the amount of IV anesthesia needed to facilitate urinary catheterization, and can be used to provide long-term analgesia in the hospital.
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Affiliation(s)
- Chap L Pratt
- Department of Clinical Sciences and Advanced Medicine-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Anusha Balakrishnan
- Department of Clinical Sciences and Advanced Medicine-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Erin McGowan
- Department of Clinical Sciences and Advanced Medicine-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kenneth J Drobatz
- Department of Clinical Sciences and Advanced Medicine-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Erica L Reineke
- Department of Clinical Sciences and Advanced Medicine-Philadelphia, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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Sarotti D, Cattai A, Franci P. Combined spinal and general anaesthesia in 58 cats undergoing various surgical procedures: description of technique and retrospective perioperative evaluation. J Feline Med Surg 2019; 21:1127-1133. [PMID: 30565967 PMCID: PMC10814265 DOI: 10.1177/1098612x18819496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES The aim of this retrospective study was to describe the spinal anaesthesia (SA) technique and evaluate the incidence of perioperative complications in cats. METHODS The anaesthetic records of cats of American Society of Anaesthesiologists physical status I, II and III, which received general and SA for different surgeries between 2012 and 2016, were examined. SA was administered through a 25 G Quincke needle, using an isobaric solution of bupivacaine and morphine at the level of either the L7-S1 interspaces (sternal recumbency) or the L5-6/L6-7 interspaces (lateral recumbency). Procedural failure rate (PFR), drugs and dose used, heart rate (HR), arterial blood pressure, incidence of bradycardia (HR <100 bpm) and hypotension (mean arterial pressure [MAP] <60 mmHg for at least 5 mins), intraoperative rescue analgesia (iRA) and any other detrimental events and their treatment until discharge were recorded. Abdominal surgery cases were excluded from the intraoperative evaluation. RESULTS A total of 58 anaesthetic records met the inclusion criteria and were analysed. PFR related to the space of injection (L7-S1 vs L5-6/L6-7) was 3/11 (27%) and 1/47 (2%), respectively (P = 0.017). The total median dose of intrathecal bupivacaine and morphine was 0.8 (range 0.5-1.6 mg/kg) and 0.10 (0.05-0.18 mg/kg), respectively. Nine of 46 (20%) cats received iRA, and no iRA cases were reported with a dose of bupivacaine higher than 0.8 mg/kg. Median HR and MAP before intrathecal injection (T0) and 10 mins after (T1) were, respectively, 118 bpm (range 74-190 bpm) and 106 bpm (67-160 bpm) (P = 0.005), and 65 mmHg (range 50-94 mmHg) and 52 mmHg (range 35-85 mmHg) (P = 0.003). Bradycardia was reported in 18/46 (39%) cats and hypotension in 23/46 (50%) cats. No complications were recorded during the observation period. CONCLUSIONS AND RELEVANCE SA was characterised by a low PFR when performed at the L5-6/L6-7 interspaces and low postoperative complications. Hypotension and bradycardia were the most common side effects.
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Affiliation(s)
| | - Andrea Cattai
- Department of Animal Medicine Productions and Health, University of Padua, Legnaro, Italy
| | - Paolo Franci
- Department of Animal Medicine Productions and Health, University of Padua, Legnaro, Italy
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Dancker C, MacFarlane P, Love EJ. Pruritus and myoclonus following five consecutive doses of morphine administered through an epidural catheter in a dog. VETERINARY RECORD CASE REPORTS 2019. [DOI: 10.1136/vetreccr-2019-000831] [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)
| | | | - Emma J Love
- Bristol Veterinary SchoolUniversity of BristolLangfordUK
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Ferreira JP. Epidural anaesthesia–analgesia in the dog and cat: considerations, technique and complications. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/coan.2018.23.11.628] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jacques P Ferreira
- European and RCVS specialist in Veterinary Anaesthesia and Analgesia, Willows Veterinary Centre and Referral Service, Highlands Road, Shirley, Solihull, West Midlands B90 4NH
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Myoclonus and hypersensitivity of the tail following intrathecal administration of morphine and bupivacaine in a cat. Vet Anaesth Analg 2018; 45:238-239. [PMID: 29428303 DOI: 10.1016/j.vaa.2017.09.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 08/25/2017] [Accepted: 09/06/2017] [Indexed: 11/21/2022]
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Steagall PVM, Simon BT, Teixeira Neto FJ, Luna SPL. An Update on Drugs Used for Lumbosacral Epidural Anesthesia and Analgesia in Dogs. Front Vet Sci 2017; 4:68. [PMID: 28553642 PMCID: PMC5427076 DOI: 10.3389/fvets.2017.00068] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 04/20/2017] [Indexed: 12/20/2022] Open
Abstract
This review aims to report an update on drugs administered into the epidural space for anesthesia and analgesia in dogs, describing their potential advantages and disadvantages in the clinical setting. Databases searched include Pubmed, Google scholar, and CAB abstracts. Benefits of administering local anesthetics, opioids, and alpha2 agonists into the epidural space include the use of lower doses of general anesthetics (anesthetic “sparing” effect), perioperative analgesia, and reduced side effects associated with systemic administration of drugs. However, the potential for cardiorespiratory compromise, neurotoxicity, and other adverse effects should be considered when using the epidural route of administration. When these variables are considered, the epidural technique is useful as a complementary method of anesthesia for preventive and postoperative analgesia and/or as part of a balanced anesthesia technique.
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Affiliation(s)
- Paulo V M Steagall
- Faculty of Veterinary Medicine, Department of Clinical Sciences, Université de Montréal, Saint-Hyacinthe, QC, Canada
| | - Bradley T Simon
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Francisco J Teixeira Neto
- Faculty of Veterinary Medicine and Animal Science, Department of Veterinary Surgery and Anaesthesiology, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
| | - Stelio P L Luna
- Faculty of Veterinary Medicine and Animal Science, Department of Veterinary Surgery and Anaesthesiology, Universidade Estadual Paulista (UNESP), Botucatu, Brazil
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Evangelista MC, Steagall P, Garofalo NA, Rodrigues JC, Teixeira-Neto F. Morphine-induced pruritus after epidural administration followed by treatment with naloxone in a cat. JFMS Open Rep 2016; 2:2055116916634105. [PMID: 28491414 PMCID: PMC5388069 DOI: 10.1177/2055116916634105] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2016] [Indexed: 11/16/2022] Open
Abstract
Case summary A young male domestic shorthair cat weighing 1.6 kg was admitted to a veterinary teaching hospital for elective orchiectomy. A lumbosacral epidural injection of preservative-free morphine (0.1 mg/kg) and lidocaine (0.25 ml/kg) was performed under general anesthesia. One hour after extubation, the cat became agitated. Severe licking and biting of the hindlimbs, tail and lumbar area were observed. Pruritus was suspected and likely to be caused by epidural morphine. Acepromazine (0.02 mg/kg IM) was administered but clinical signs did not cease. Naloxone (2 µg/kg IV) was administered and clinical signs resolved within 20 mins. Relevance and novel information Different therapeutic approaches are available for the treatment of morphine-induced pruritus. This case describes an additional treatment option using opioid antagonism with naloxone.
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Affiliation(s)
- Marina C Evangelista
- Department of Veterinary Anesthesia and Surgery, Faculty of Veterinary Medicine and Animal Sciences, Sao Paulo State University - UNESP, Botucatu, SP, Brazil
| | - Paulo Steagall
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, QC, Canada
| | - Natache A Garofalo
- Department of Veterinary Anesthesia and Surgery, Faculty of Veterinary Medicine and Animal Sciences, Sao Paulo State University - UNESP, Botucatu, SP, Brazil
| | - Jessica C Rodrigues
- Department of Veterinary Anesthesia and Surgery, Faculty of Veterinary Medicine and Animal Sciences, Sao Paulo State University - UNESP, Botucatu, SP, Brazil
| | - Francisco Teixeira-Neto
- Department of Veterinary Anesthesia and Surgery, Faculty of Veterinary Medicine and Animal Sciences, Sao Paulo State University - UNESP, Botucatu, SP, Brazil
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Bortolami E, Love EJ. Practical use of opioids in cats: a state-of-the-art, evidence-based review. J Feline Med Surg 2015; 17:283-311. [PMID: 25832586 PMCID: PMC11104155 DOI: 10.1177/1098612x15572970] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
RATIONALE Recent recognition of the need to improve pain management in cats has led to the investigation of the pharmacokinetics and efficacy of opioid analgesic drugs in this species. The results of these studies may be difficult to interpret because the effect of these drugs varies with dose, route of administration and the method used to assess them. As equipotency of different opioids is not known, it is hard to compare their effects. Animals do not verbalise the pain they feel and, in cats, it may be more difficult to recognise signs of pain in comparison with other species such as dogs. AIM This article reviews the use of opioid analgesics in cats. It must be remembered that not all drugs are licensed for use in cats, and that marketing authorisations vary between different countries.
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Affiliation(s)
- Elisa Bortolami
- Department of Animal Medicine, Production and Health, University of Padua, Italy
| | - Emma J Love
- School of Veterinary Sciences, University of Bristol, Langford, UK
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Liu X, Zhang J, Zhao H, Mei H, Lian Q, Shangguan W. The effect of propofol on intrathecal morphine-induced pruritus and its mechanism. Anesth Analg 2014; 118:303-309. [PMID: 24445631 DOI: 10.1213/ane.0000000000000086] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Previous studies have shown that a low dose of propofol IV bolus had a beneficial effect on intrathecal morphine-induced pruritus in humans. However, its exact mechanism has not been fully understood. In this study, we hypothesized that propofol relieved intrathecal morphine-induced pruritus in rats by upregulating the expression of cannabinoid-1 (CB[1]) receptors in anterior cingulate cortex (ACC). METHODS Twenty-four Sprague-Dawley rats were divided into a control group and 20, 40, 80 μg/kg morphine groups to create an intrathecal morphine-induced scratching model. The effects of propofol on intrathecal 40 μg/kg morphine-induced scratching responses were then evaluated. Sixty rats were randomly assigned to control, normal saline, intralipid, and propofol groups, with pruritus behavior observation or killed 8 minutes after venous injection of normal saline, intralipid, or propofol, and brain tissues were then collected for assay. Immunohistochemistry was then performed to identify the expression of CB (1) receptor in ACC, and the concentration of CB(1) receptor in ACC was determined by Western blot analysis. RESULTS Compared with the control group, rats in the 20, 40, 80 μg/kg morphine groups had higher mean scratching response rates after intrathecal morphine injection (P =0.020, 0.005, and 0.002, respectively). There was a statistical difference between 20 and 40 μg/kg morphine groups at 10 to 15 and 15 to 20 timepoints after intrathecal morphine injection (P = 0.049 and 0.017, respectively). Propofol almost abolished the scratching response that was induced by 40 μg/kg intrathecal morphine injection (F[2, 15] = 46.87, P < 0.001; F[22, 165] = 2.37, P = 0.001). Compared with the intralipid and normal saline groups, the scratching behavior was significantly attenuated in the propofol group (P < 0.001). Compared with control, normal saline, and intralipid groups, the protein expression of CB(1) receptor in ACC (Western blot) in the propofol group increased (0.86 ± 0.21, 0.94 ± 0.18, 0.86 ± 0.13, and 1.34 ± 0.32, respectively, P < 0.001). There was no significant difference among control, normal saline, and intralipid groups. Compared with the control, normal saline, and intralipid groups, the average number of neurons of CB(1) receptor in the ACC area were higher in the propofol group (21.0 ± 1.4, 19.3 ± 1.8, 24.8 ± 7.7, and 37.2 ± 3.3, respectively, P < 0.001). CONCLUSIONS Morphine elicits dose-independent scratching responses after intrathecal injection in rats. Morphine 40 μg/kg intrathecal injection-induced scratching responses can be prevented by propofol. Increased protein expression of CB(1) receptors in ACC may contribute to the reversal of intrathecal morphine-induced scratching.
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Affiliation(s)
- Xiulan Liu
- From the Department of Anesthesiology, the 2nd Affiliated Hospital of WenZhou Medical College, Wenzhou, China
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Aarnes TK, Hubbell JAE, Hildreth BE. Use of sedation and ropivacaine-morphine epidural for femoral head and neck ostectomy in a dog. J Small Anim Pract 2014; 55:334-6. [PMID: 24602054 DOI: 10.1111/jsap.12202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2014] [Indexed: 11/28/2022]
Abstract
A five-year-old male German shepherd dog presented with traumatic craniodorsal luxation of the right coxofemoral joint with pre-existing moderate hip dysplasia. A femoral head and neck ostectomy was performed. The patient was sedated with acepromazine and morphine administered intramuscularly. A lumbosacral epidural was performed using a combination of morphine and ropivacaine. Intraoperatively, an infusion of medetomidine, morphine, lidocaine, and ketamine was administered intravenously, and oxygen was administered via facemask. Heart rate, respiratory rate and oscillometric arterial blood pressures were monitored. Postoperatively, carprofen was administered once subcutaneously. On the day of hospital discharge, carprofen and tramadol were administered orally every 12 hours. Twenty-one days later, the dog was doing well and the surgical staples were removed. Sedation with acepromazine and morphine, administration of an epidural containing morphine and ropivacaine, and intraoperative sedation with medetomidine, morphine, lidocaine and ketamine were suitable for femoral head and neck ostectomy.
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Affiliation(s)
- T K Aarnes
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH 43210, USA
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Gent T, Iff I, Bettschart–Wolfensberger R, Mosing M. Neuraxial morphine induced pruritus in two cats and treatment with sub anaesthetic doses of propofol. Vet Anaesth Analg 2013; 40:517-20. [DOI: 10.1111/vaa.12040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2012] [Accepted: 11/15/2012] [Indexed: 11/30/2022]
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Metzl N, Jackson AE. In this issue--October 2012. Aust Vet J 2012; 90:371-2. [PMID: 23004226 PMCID: PMC7159526 DOI: 10.1111/j.1751-0813.2012.00999.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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