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Launois T, Hontoir F, Dugdale A, Dedieu M, Vandeweerd JM. Effect of Volumes of Solutions on Intraocular Pressure During Intravitreal Injection of Low Dose Gentamicin in Horses With Recurrent Uveitis: A Randomized Controlled Study. J Equine Vet Sci 2023; 122:104228. [PMID: 36657629 DOI: 10.1016/j.jevs.2023.104228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 01/09/2023] [Accepted: 01/12/2023] [Indexed: 01/18/2023]
Abstract
Horses with recurrent uveitis can be treated by intravitreal injection of low dose gentamicin under sedation and after local anesthetic techniques including the retrobulbar nerve block. Since it is reported that retinal degeneration can be secondary to an acute increase of intraocular pressure (IOP), the current randomized controlled study was carried out in order to investigate the changes in IOP following retrobulbar anesthesia, with two different volumes of local anesthetic (lidocaine) solution (10 and 5 mL), and intravitreal injection of 6 mg gentamicin in two different volumes of solution (0.3 and 0.15 mL). Multivariate regression showed that IOP was significantly lower in the pathologic eye at baseline (estimated effect size -6.1 mmHg; P = .0001) and after sedation (estimated effect size -9.4 mmHg; P < .0001). The IOP was significantly higher after a 10 mL block (P .0002) but this effect was very small (+0.5 mmHg). There was no significant difference in IOP after the injection of 0.15 or 0.3 mL solution of gentamicin. There was no significant combined effect of the volume of local anesthetic used for the block and the volume of the gentamicin solution. Since the expected anesthetic effects (desensitization and akinesia) were met in all cases, the smaller volume of 5 mL of lidocaine solution would be preferable for retrobulbar block for intravitreal injections, while intravitreal injections volumes of 0.15 and 0.30 mL can be used indifferently.
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Affiliation(s)
| | - Fanny Hontoir
- Department of Veterinary Medicine, Faculty of Sciences, Integrated Veterinary Research Unit (IVRU) - Namur Research Institute for Life Sciences (NARILIS), University of Namur, Namur, Belgium
| | - Alexandra Dugdale
- Paragon Veterinary Referrals, Paragon Business Village, Wakefield, UK
| | | | - Jean-Michel Vandeweerd
- Department of Veterinary Medicine, Faculty of Sciences, Integrated Veterinary Research Unit (IVRU) - Namur Research Institute for Life Sciences (NARILIS), University of Namur, Namur, Belgium.
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Possible Brainstem Anaesthesia in a Cat after Ultrasound-Guided Retrobulbar Block. Animals (Basel) 2023; 13:ani13050781. [PMID: 36899638 PMCID: PMC10000029 DOI: 10.3390/ani13050781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
A 13-year-old neutered, blue-eyed female Siamese cat with a bodyweight of 4.8 kg was admitted for enucleation of the right eye. An ultrasound guided retrobulbar block with 1 mL of ropivacaine was performed under general anaesthesia. When the tip of the needle was visualised inside the intraconal space, negative aspiration of the syringe before injection and no obvious resistance during injection were confirmed. Instantly, after ropivacaine was administered, the cat became apnoeic, and its heart rate and the blood pressure increased significantly for a short period of time. During surgery, the cat needed cardiovascular support to maintain blood pressure and was under continuous mechanical ventilation. Spontaneous breathing returned 20 min after the end of anaesthesia. Brainstem anaesthesia was suspected, and after recovery, the contralateral eye was examined. A reduced menace response, horizontal nystagmus, mydriasis, and absence of the pupillary light reflex were present. The following day, mydriasis was still present, but the cat was visual and was discharged. The inadvertent intra-arterial injection of ropivacaine was suspected to be the cause of the spread into the brainstem. To the current authors' knowledge, possible brainstem anaesthesia has only been reported in a cat 5 min after a retrobulbar block but never instantly.
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Thieme K, Mesquita L, Lieberth S, Dancker C, Doherr MG, Eule JC. Safety and accuracy of blind vs. ultrasound‐guided dorsal retrobulbar nerve blocks in horses—A cadaveric study. Vet Ophthalmol 2022; 26:135-144. [PMID: 36536509 DOI: 10.1111/vop.13053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/06/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE There is limited knowledge regarding the safety and accuracy of ultrasound-guided retrobulbar nerve blocks in horses. The aim of this study was to compare these parameters between blind and ultrasound-guided injection techniques for the dorsal retrobulbar nerve block in horses. METHODS Equine cadaver heads were used to inject the retrobulbar space with contrast medium (CM). Injections were performed either blindly based on anatomic landmarks (blind group, n = 44) or under ultrasonographic guidance (US-group, n = 44), equally divided between an experienced and unexperienced operator. Needle position and distribution of CM were assessed with computed tomography imaging and evaluated by a board-certified veterinary diagnostic imager blinded to the technique. Safety and accuracy of both techniques were compared. RESULTS Ocular penetration was observed in two cases (n = 2/44) in the blind group but not in the US group (n = 0/44). No intrathecal, intraneural, or intravascular injections were seen in either group. Safety was significantly improved in the US group (p = .026). There was no statistically significant difference between the groups regarding the accuracy of the injection. Excellent accuracy was achieved more often with the ultrasound-guided technique (n = 11/22) than with the blind technique (n = 7/22) when performed by the unexperienced operator, but this difference was not statistically significant. CONCLUSION To prevent globe-threatening complications and improve the safety of the injection, we recommend using the ultrasound-guided injection technique for the dorsal retrobulbar nerve block.
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Affiliation(s)
- Katharina Thieme
- Small Animal Clinic Freie Universität Berlin Berlin Germany
- Equine Clinic, Surgery and Radiology Freie Universität Berlin Berlin Germany
| | - Luis Mesquita
- Radiology Department Willows Veterinary Centre and Referral Service Solihull UK
| | - Simona Lieberth
- Equine Clinic, Surgery and Radiology Freie Universität Berlin Berlin Germany
| | | | - Marcus Georg Doherr
- Institute for Veterinary Epidemiology and Biostatistics Freie Universität Berlin Berlin Germany
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Gomez‐Martinez MI, Kumaratunga V, Khenissi L. Use of bupivacaine‐infused absorbable gelatin haemostatic sponge following eye enucleation in a corn snake. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Vim Kumaratunga
- Small Animal Referral Hospital Langford Vets, University of Bristol Bristol UK
- Queen Mother Hospital for Small Animals. Royal Veterinary College University of London London UK
| | - Latifa Khenissi
- Small Animal Referral Hospital Langford Vets, University of Bristol Bristol UK
- Rainbow Equine Hospital, Old Malton Malton UK
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Hagag U, El Nahas A. Ultrasound-guided retrobulbar nerve block in donkey cadavers. Vet Anaesth Analg 2022; 49:197-202. [DOI: 10.1016/j.vaa.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 01/09/2022] [Accepted: 01/09/2022] [Indexed: 10/19/2022]
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Hefner EM, Lin HC, Cole RC, Moore PA, McMullen RJ. Comparison of image quality of corneal and retinal optical coherence tomography using sedation and general anesthesia protocols with or without retrobulbar anesthesia in horses. Am J Vet Res 2021; 83:72-79. [PMID: 34727049 DOI: 10.2460/ajvr.21.02.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare image quality and acquisition time of corneal and retinal spectral domain optical coherence tomography (SD-OCT) under 3 different sedation-anesthesia conditions in horses. ANIMALS 6 middle-aged geldings free of ocular disease. PROCEDURES 1 randomly selected eye of each horse was evaluated via SD-OCT under the following 3 conditions: standing sedation without retrobulbar anesthetic block (RB), standing sedation with RB, and general anesthesia with RB. Five regions of interest were evaluated in the cornea (axial and 12, 3, 6, and 9 o'clock positions) and fundus (optic nerve head). Three diagnostic scans of predetermined quality were obtained per anatomical region. Image acquisition times and total scans per site were recorded. Corneal and retinal SD-OCT image quality was graded on a subjective scale from 0 (nondiagnostic) to 4 (excellent). RESULTS Mean values for the standing sedation without RB, standing sedation with RB, and general anesthesia conditions were 24, 23, and 17, respectively, for total cornea scan attempts; 23, 19, and 19 for total retina-scan attempts; 14.6, 13.2, and 9.2 minutes for total cornea scan time; 19.1, 9.2, and 13.0 for total retina scan time; 2.0, 2.3, and 2.5 for cornea grade; and 2.7, 2.9, and 2.5 for retina grade. CONCLUSIONS AND CLINICAL RELEVANCE The RB facilitated globe akinesia and improved the percentage of scans in frame and region of interest accuracy for retinal imaging via OCT in horses. Retrobulbar blocks improved clinical image acquisition while minimizing motion artifact.
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Yang VY, Eaton JS, Harmelink K, Hetzel SJ, Sanchez A, Lund JR, Smith LJ. Retrobulbar lidocaine injection via the supraorbital fossa is safe in adult horses but produces regionally variable periocular anaesthesia. Equine Vet J 2021; 54:807-819. [PMID: 34396584 DOI: 10.1111/evj.13496] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/14/2021] [Accepted: 07/29/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Injection techniques for retrobulbar anaesthesia are published in horses, but neither safety nor anaesthetic efficacy and duration have been evaluated objectively in vivo. OBJECTIVE To characterise the safety and efficacy of one published technique for retrobulbar anaesthesia. STUDY DESIGN Randomised, controlled descriptive experiment. METHODS Unilateral retrobulbar injection with 10 mL lidocaine (2%) was performed in eight sedated adult mares. Contralateral eyes served as untreated controls. Neurophthalmic parameters, intraocular pressure (IOP), and corneal and periocular sensation were measured awake, post-sedation and at periodic time points for 24 hours following injection. Adverse effects were documented. RESULTS Injection of 10 mL lidocaine significantly increased IOP for up to 2 hours (P < .05) maximally at 30 min (mean [95% CI]: 6.0 [2.7, 9.2] mm Hg, P < .001). Six of the eight treated eyes developed mild to moderate reversible chemosis for 2 to 24 hours. One eye developed severe chemosis and superficial corneal ulceration at 24 and 48 hours following injection respectively. Corneal sensitivity significantly decreased for 6 hours (P < .05), maximally at 10 min (-44.4 [-34.6, -54.1] mm, P < .001). Periocular sensitivity (measured as increase in applied force) significantly decreased dorsally and medially for up to 2 hours (maximal at 2 hours (367.1 [238.5, 495.7] g, P < .001, and at 30 min: 345.8 [202.6, 488.9] g, P < .001) respectively). Ventral and lateral sensitivity were not effectively decreased beyond 30 min. Optic nerve function was not consistently reduced following injection. MAIN LIMITATIONS Investigators were not masked to the treated eye. CONCLUSIONS Retrobulbar injection using 10 mL lidocaine is safe in normal eyes of adult horses, but carries risk in structurally compromised or glaucomatous eyes due to transient IOP increase. Reversible chemosis commonly develops 2-4h following injection, and may be severe in some horses with risk for corneal ulceration. Corneal anaesthesia is rapid and prolonged, but all periocular regions are not consistently anaesthetised. Retrobulbar injection should be combined with other local anaesthetic injections for eyelid surgeries or enucleations.
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Affiliation(s)
- Vanessa Y Yang
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Joshua Seth Eaton
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Katherine Harmelink
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, Institute for Clinical and Translational Research (ICTR), University of Wisconsin-Madison, Madison, WI, USA
| | - Adriana Sanchez
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Jane R Lund
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | - Lesley J Smith
- Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
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Mansour C, Mocci R, Santangelo B, Sredensek J, Chaaya R, Allaouchiche B, Bonnet-Garin JM, Boselli E, Junot S. Performance of the Parasympathetic Tone Activity (PTA) index to predict changes in mean arterial pressure in anaesthetized horses with different health conditions. Res Vet Sci 2021; 139:43-50. [PMID: 34246942 DOI: 10.1016/j.rvsc.2021.07.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 06/30/2021] [Accepted: 07/01/2021] [Indexed: 11/17/2022]
Abstract
The parasympathetic tone activity (PTA) index is based on heart rate variability and has been developed recently in animals to assess their relative parasympathetic tone. This study aimed to evaluate PTA index in anaesthetized horses with different health conditions and the performance of PTA variations (∆PTA) to predict changes in mean arterial pressure (MAP). Thirty-nine client-horses were anaesthetized for elective or colic surgery and divided into "Elective" and "Colic" groups. During anaesthesia, dobutamine was administered as treatment of hypotension (MAP <60 mmHg). In both groups, no significant variation of PTA and MAP were detected immediately before and after cutaneous incision. The PTA index increased 5 min before each hypotension, whereas it decreased 1 min after dobutamine administration. Horses of the Colic group had lower PTA values than those of the Elective group, whereas MAP did not differ between groups. To predict a 10% decrease in MAP, ΔPTA performance was associated with: AUC ROC [95% CI] =0.80 [0.73 to 0.85] (p < 0.0001), with a sensitivity of 62.5% and a specificity of 94.6% for a threshold value of 25%. The PTA index in anaesthetized horses appears to be influenced by the health condition. The shift toward lower PTA values in colic horses may reflect a sympathetic predominance. An increase in PTA of >25% in 1 min showed an acceptable performance to predict MAP decrease of >10% within 5 min. Even though these results require further evaluation, this index may thus help to predict potential autonomic dysfunctions in sick animals.
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Affiliation(s)
| | - Rita Mocci
- Univ Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Anesthésiologie, F-69280 Marcy l'Etoile, France.
| | - Bruna Santangelo
- Univ Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Anesthésiologie, F-69280 Marcy l'Etoile, France.
| | - Jerneja Sredensek
- Univ Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Anesthésiologie, F-69280 Marcy l'Etoile, France.
| | - Rana Chaaya
- Faculté d'Agronomie et de Médecine Vétérinaire, Pharmacologie, Département de Médecine Vétérinaire, Université Libanaise, Beirut, Lebanon.
| | - Bernard Allaouchiche
- Univ Lyon, APCSe, VetAgro Sup, F-69280 Marcy l'Etoile, France; Univ Lyon, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Réanimation Médicale, APCSe, Pierre-Bénite, France.
| | | | - Emmanuel Boselli
- Univ Lyon, APCSe, VetAgro Sup, F-69280 Marcy l'Etoile, France; Département d'Anesthésiologie, Centre Hospitalier Pierre Oudot, Bourgoin-Jallieu, France.
| | - Stéphane Junot
- Univ Lyon, APCSe, VetAgro Sup, F-69280 Marcy l'Etoile, France; Univ Lyon, VetAgro Sup, Campus Vétérinaire de Lyon, Anesthésiologie, F-69280 Marcy l'Etoile, France.
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Greco A, Costanza D, Senatore A, Bruzzese D, Micieli F, Chiavaccini L, Di Giancamillo M, Della Valle G, Vesce G, Brunetti A, Meomartino L. A computed tomography-based method for the assessment of canine retrobulbar cone volume for ophthalmic anaesthesia. Vet Anaesth Analg 2021; 48:759-766. [PMID: 34391668 DOI: 10.1016/j.vaa.2021.03.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 01/01/2021] [Accepted: 03/12/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To develop a comprehensive formula for calculating the volume of local anaesthetic solution used for retrobulbar anaesthesia in dogs with different skull morphologies. STUDY DESIGN Retrospective cohort imaging study. ANIMALS Skull computed tomography (CT) images of 188 dogs of different breeds collected between January 2009 and December 2017. METHODS Anatomical integrity of the orbit and adjacent structures, presenting complaint, clinical signs and CT findings were verified to exclude ocular abnormalities. The volume of the retrobulbar cone of 376 eyes was calculated using CT scans of the dogs' skulls. Additional data recorded included morphology of the skull, body weight, sex and size of the dogs, all of which were matched for possible association to the retrobulbar cone volume through univariable and multivariable linear regression models. Results of linear regression models were expressed as estimated beta coefficients with the corresponding 95% confidence intervals (95% CIs). RESULTS Using univariate analysis, the retrobulbar cone volume was positively associated with weight and male sex. In addition, brachycephalic and dolichocephalic dogs showed a larger retrobulbar cone volume than mesocephalic dogs, while sex was no longer significantly associated with the retrobulbar cone volume. In multivariate analysis, when considering all variables in the model, weight emerged as the strongest predictor (beta coefficient: 0.062 mL kg-1, 95% CI: 0.056-0.067 mL kg-1, p < 0.001). CONCLUSIONS and clinical relevance In the veterinary literature, there is no agreement on the precise volume of local anaesthetic solution that should be used to achieve intraconal retrobulbar anaesthesia in dogs. Here we suggest a formula to calculate the retrobulbar cone volume and, accordingly, the injection volume of local anaesthetic solution for effective retrobulbar anaesthesia.
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Affiliation(s)
- Adelaide Greco
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy; Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy.
| | - Dario Costanza
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy
| | - Andrea Senatore
- Centro Intedipartimentale di Ricerca sui Biomateriali, Università degli Studi di Napoli 'Federico II', Naples, Italy
| | - Dario Bruzzese
- Dipartimento di Sanità Pubblica, Università di Napoli 'Federico II', Naples, Italy
| | - Fabiana Micieli
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Ludovica Chiavaccini
- Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA
| | - Mauro Di Giancamillo
- Dipartimento di Medicina Veterinaria, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Della Valle
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Giancarlo Vesce
- Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
| | - Arturo Brunetti
- Dipartimento di Scienze Biomediche Avanzate, Università di Napoli 'Federico II', Naples, Italy
| | - Leonardo Meomartino
- Centro Interdipartimentale di Radiologia Veterinaria, Università di Napoli 'Federico II', Naples, Italy; Dipartimento di Medicina Veterinaria e Produzioni animali, Università di Napoli 'Federico II', Naples, Italy
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Rabbogliatti V, De Zani D, Zani DD, Di Cesare F, Brioschi FA, Gioeni D, Crivellari B, Ravasio G. Comparison of four peribulbar anaesthetic techniques: a preliminary study in equine cadavers. Vet Anaesth Analg 2020; 48:442-450. [PMID: 33640273 DOI: 10.1016/j.vaa.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 07/07/2020] [Accepted: 10/01/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To compare the peribulbar injectate distribution and probability of regional anaesthesia of four peribulbar anaesthetic techniques in equine cadavers. STUDY DESIGN Prospective experimental cadaver study. ANIMALS A total of 12 isolated equine cadaver heads and 24 eyes. METHODS The 24 orbits underwent one of four injection techniques (six orbits each) with a mixture (1:4) of contrast medium and saline (CM): 20 mL ventrolateral peribulbar injection (V-20), 20 mL dorsolateral peribulbar injection (D-20), combined ventrolateral and dorsolateral peribulbar injections 10 mL each (VD-20) or 20 mL each (VD-40). To evaluate and score CM distribution at the base of, within the extraocular muscle cone (EOMC), and around the optic nerve (before and after pressure application to the periorbital area), computed tomography was performed. To assess the probability of achieving locoregional anaesthesia, two criteria were applied and both scored as 'likely', 'possible' or 'unlikely'. To compare CM distribution scores between injection techniques, Kruskal-Wallis analysis of variance was used. Mann-Whitney U test was used for post hoc comparisons between groups when needed. A p value < 0.05 was considered significant. RESULTS The CM distribution within the EOMC and around the optic nerve circumference was detected as 'possible' only after pressure application in seven out of 24 orbits (V-20, 3; D-20, 1; VD-40, 3). It was never considered 'likely' either before or after pressure application. The CM distribution at the EOMC base was considered 'likely' to provide regional anaesthesia in 50% (V-20), 0% (D-20), 33% (VD-20), 100% (VD-40) and in 66% (V-20), 16% (D-20), 50% (VD-20), 100% (VD-40) before and after applying pressure, respectively. CONCLUSIONS AND CLINICAL RELEVANCE Complete regional anaesthesia seems more likely using the VD-40 technique, although the authors advise caution due to the risk of potential complications. Future studies are necessary to evaluate the efficacy of the technique in vivo.
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Affiliation(s)
- Vanessa Rabbogliatti
- Department of Veterinary Medicine, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Milan, Italy
| | - Donatella De Zani
- Department of Veterinary Medicine, Centro Clinico Veterinario e Zootecnico Sperimentale, Università degli Studi di Milano, Milan, Italy
| | - Davide D Zani
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - Federica Di Cesare
- Department of Health, Animal Science and Food Safety, Università degli Studi di Milano, Milan, Italy
| | - Federica A Brioschi
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | - Daniela Gioeni
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
| | | | - Giuliano Ravasio
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy.
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Association Between Disease Severity, Heart Rate Variability (HRV) and Serum Cortisol Concentrations in Horses with Acute Abdominal Pain. Animals (Basel) 2020; 10:ani10091563. [PMID: 32887514 PMCID: PMC7552187 DOI: 10.3390/ani10091563] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/27/2020] [Accepted: 09/01/2020] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Acute abdominal pain is a major cause for emergency treatment in horses and associated with a high stress level leading to an increased serum cortisol concentration. Stress can also be assessed by analyzing the heart rate variability (HRV). We investigated whether the stress level was different between horses with different causes of abdominal pain and, therefore, demanding a different treatment strategy. Heart rate, its variability in the time domain analyses, and cortisol level indicated a decrease in the stress level the day after admission and the day of discharge from the hospital in comparison to admission for both conservatively and surgically treated patients. However, such changes, over time, were not seen in horses that were euthanized during the hospitalization. Furthermore, the difference in the parameters measured between horses that were eventually euthanized and those that survived was best visible the day after admission. Therefore, we concluded that HRV can give further important information on the stress level in horses with colic and might be helpful in assessing possible outcome. However, further studies are required to assess the validity of HRV analyses in horses with colic. Abstract Heart rate variability (HRV) is a noninvasive technique to detect changes in the autonomous nervous system. It has rarely been investigated in horses with colic. Therefore, the objective was to assess the evolution of HRV parameters and cortisol concentrations in horses with colic. The 43 horses included in this study were categorized into three groups according to the treatment (1, surgical; 2, conservative; 3, euthanized). The HRV and laboratory variables were measured at admission (T1), the day after admission (T2), and at discharge (T3) and compared between groups and over time with an ANOVA with Bonferroni correction. Relationships between the HRV parameters themselves and the laboratory variables was assessed by Pearson correlation coefficients. Evolution of the heart rate (HR) over time, mean normal to normal R intervals (meanNN) and cortisol concentrations indicate a decreased sympathetic stimulation over time in group 1 and 2, in contrast to group 3. For group 3, the meanNN and HR differed significantly to group 2 at T1 and to group 1 and 2 at T2. Treatment induced a change in the HRV and cortisol response in horses managed conservatively or surgically but not in horses that required euthanasia. However, further studies are required to assess the validity of HRV analyses in horses with colic.
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Ali HM, Elbadawy AM. Comparative Study of Retrobulbar Block versus Ketamine Infusion during Eye Enucleation/Evisceration (Randomized Controlled Trial). Anesth Essays Res 2020; 14:92-99. [PMID: 32843800 PMCID: PMC7428106 DOI: 10.4103/aer.aer_146_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/02/2020] [Accepted: 01/07/2020] [Indexed: 11/04/2022] Open
Abstract
Background The aim of this study is to compare the safety and efficacy of retrobulbar block versus intraoperative ketamine infusion in eye enucleation or evisceration under general anesthesia. Materials and Methods Forty-five patients belonging to American Society of Anesthesiologists Physical Status I and II undergoing eye enucleation or evisceration were randomly allocated to three equal groups (15 patients each). General anesthesia was used as the standardized technique in all patients. Group R received a single retrobulbar injection, Group K received intravenous ketamine infusion, and Group C received normal saline with the same rate of ketamine infusion. Intraoperative heart rate and mean arterial pressure, recovery time, postoperative pain score, time to first rescue analgesic, number of patients who required rescue analgesia, and any adverse events were reported. Results Postoperative pain Visual Analog Scale was significantly lower in R and K groups in comparison to the C group and was significantly higher in K than R group at 3, 6, 12, and 24 h. In addition, the time to first rescue analgesic was significantly longer in R group (429 ± 54 min) than that in K group (272 ± 34 min), but compared to both groups, it was longer in C group (52 ± 7 min). In K group, the recovery time was longer with higher sedation score in comparison to the other two groups. Conclusions Single retrobulbar injection and low-dose ketamine infusion are safe and effective when used as adjuvants to general anesthesia, but retrobulbar block provides better control of postoperative pain with prolonged time to first rescue analgesic and reduced analgesic consumption.
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Affiliation(s)
- Hassan Mohamed Ali
- Department of Anesthesia, Faculty of Medicine, Cairo University, Cairo, Egypt
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McKinney RA. The retrobulbar block: A review of techniques used and reported complications. EQUINE VET EDUC 2020. [DOI: 10.1111/eve.13351] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Vézina-Audette R, Steagall PVM, Gianotti G. Prevalence of and covariates associated with the oculocardiac reflex occurring in dogs during enucleation. J Am Vet Med Assoc 2020; 255:454-458. [PMID: 31355722 DOI: 10.2460/javma.255.4.454] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the prevalence of and covariates associated with the oculocardiac reflex (OCR) occurring in dogs during enucleations. SAMPLE 145 dogs that underwent enucleation at 2 veterinary teaching hospitals between January 2010 and June 2015. PROCEDURES Information was collected from the medical records of included dogs regarding age and body weight at hospital admission, breed (for classification of brachycephalic status), and whether they had received anticholinergic drugs or a retrobulbar nerve block (RNB) prior to enucleation. An OCR was considered to have occurred if there was a sudden decrease of ≥ 30% in heart rate from the baseline value (mean heart rate prior to the sudden decrease) during surgery in the absence of intraoperative administration of opioids or α2-adrenoceptor agonists. Associations were explored between the collected data and the prevalence of OCR by means of binomial logistic regression. RESULTS 4.8% (7/145) of dogs had an OCR noted during enucleation. Dogs that received a preoperative RNB (n = 82) had significantly lower odds of an OCR being observed than dogs that received no preoperative RNB (OR, 0.12). No association with OCR was identified for age or brachycephalic conformation or for preoperative administration of anticholinergic drugs. CONCLUSIONS AND CLINICAL RELEVANCE These findings suggested that preoperative administration of an RNB, but not preoperative administration of anticholinergic drugs, was associated with a lower prevalence of OCR in dogs during enucleations.
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Shilo-Benjamini Y, Slav SA, Kahane N, Kushnir Y, Sarfaty H, Ofri R. Analgesic effects of intraorbital insertion of an absorbable gelatin hemostatic sponge soaked with 1% ropivacaine solution following enucleation in dogs. J Am Vet Med Assoc 2020; 255:1255-1262. [PMID: 31730436 DOI: 10.2460/javma.255.11.1255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate analgesic effects and complications associated with intraorbital insertion of an absorbable gelatin hemostatic sponge (AGHS) soaked with 1% ropivacaine solution following enucleation in dogs. ANIMALS 20 client-owned dogs undergoing enucleation. PROCEDURES Dogs were randomly assigned to receive an AGHS soaked with 1% ropivacaine solution (n = 10) or saline (0.9% NaCl) solution (control group; 10) inserted intraorbitally prior to skin closure following enucleation. Carprofen (2 mg/kg [0.9 mg/lb]) was administered SC once after orotracheal extubation and then PO twice a day for 5 days. During the postoperative recovery period, apparent pain level was scored at various points with a modified short-form Glasgow Composite Pain Scale (score range, 0 to 19), and methadone was administered for rescue analgesia if any score was ≥ 5. After dogs returned home, owners recorded their behavior and apparent pain level for the first 3 days following enucleation. RESULTS At extubation, the median (range) pain score was significantly higher in the control group (8 [2 to 14]) versus the ropivacaine group (3 [1 to 7]). A greater proportion of dogs in the control group received methadone (7/10 vs 1/10) and had crying or attention-seeking behavior on the first day following enucleation (7/10 vs 1/10). No complications were observed in either group. CONCLUSIONS AND CLINICAL RELEVANCE Addition of intraorbital insertion of a ropivacaine-soaked AGHS to the analgesic protocol for dogs undergoing enucleation provided better analgesia than was achieved without this treatment as measured immediately and the first day after surgery, with no noted adverse effects.
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Shilo-Benjamini Y. A review of ophthalmic local and regional anesthesia in dogs and cats. Vet Anaesth Analg 2019; 46:14-27. [DOI: 10.1016/j.vaa.2018.10.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 10/19/2018] [Accepted: 10/20/2018] [Indexed: 12/17/2022]
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Rowland AL, Navas de Solis C, Lepiz MA, Cummings KJ, Watts AE. Bone Marrow Aspiration Does Not Induce a Measurable Pain Response Compared to Sham Procedure. Front Vet Sci 2018; 5:233. [PMID: 30327768 PMCID: PMC6174850 DOI: 10.3389/fvets.2018.00233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 09/10/2018] [Indexed: 11/23/2022] Open
Abstract
Bone marrow is commonly collected from horses for regenerative medicine applications. Little information is available regarding pain experienced by the horse during bone marrow aspiration. The objective of this study was to characterize horse reaction and pain response during bone marrow aspiration (BMA) compared to a sham (SHAM) procedure. We hypothesized there would be significantly greater horse reaction or pain response measured by salivary cortisol, heart rate variability, and depth and duration of sedation between BMA and SHAM. Twelve university owned horses underwent a BMA and sham procedure, 4 weeks apart in a randomized cross-over design, while sedated with 0.4 mg/kg xylazine hydrochloride. As measures of sedation depth, head height was recorded and sedation level was scored at specific procedural time points. Salivary cortisol was measured immediately before and 2 h after each procedure. Heart rate variability was assessed before, during, and after each procedure. There were no differences in head height, sedation score, or salivary cortisol between groups. No differences were noted between groups in heart rate variability before or during the procedure, but there was a significant decrease in low frequency/high frequency (LF/HF) ratio after the procedure in the BMA group. Over time, there was a significant reduction in LF/HF ratio during the procedure in both groups. Overall, BMA from the sternum did not result in a measurable pain response during, or in the 2 h following the procedure, in comparison to a sham procedure.
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Affiliation(s)
- Aileen L Rowland
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
| | - Cristobal Navas de Solis
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
| | - Mauricio A Lepiz
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
| | - Kevin J Cummings
- Department of Population Medicine and Diagnostic Sciences, Cornell University, Ithaca, NY, United States
| | - Ashlee E Watts
- Department of Large Animal Clinical Sciences, Texas A&M University, College Station, TX, United States
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Shilo-Benjamini Y, Pascoe PJ, Maggs DJ, Hollingsworth SR, Strom AR, Good KL, Thomasy SM, Kass PH, Wisner ER. Retrobulbar vs peribulbar regional anesthesia techniques using bupivacaine in dogs. Vet Ophthalmol 2018; 22:183-191. [DOI: 10.1111/vop.12579] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Yael Shilo-Benjamini
- Koret School of Veterinary Medicine; The Robert H. Smith Faculty of Agriculture, Food and Environment; The Hebrew University of Jerusalem; Rehovot Israel
| | - Peter J. Pascoe
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - David J. Maggs
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Steven R. Hollingsworth
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Ann R. Strom
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Kathryn L. Good
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Sara M. Thomasy
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
| | - Philip H. Kass
- Department of Population Health and Reproduction; School of Veterinary Medicine; University of California; Davis CA USA
| | - Erik R. Wisner
- Department of Surgical and Radiological Sciences; School of Veterinary Medicine; University of California; Davis CA USA
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Lenoir A, Trachsel DS, Younes M, Barrey E, Robert C. Agreement between Electrocardiogram and Heart Rate Meter Is Low for the Measurement of Heart Rate Variability during Exercise in Young Endurance Horses. Front Vet Sci 2017; 4:170. [PMID: 29090214 PMCID: PMC5650972 DOI: 10.3389/fvets.2017.00170] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 09/26/2017] [Indexed: 11/28/2022] Open
Abstract
Analysis of the heart rate variability (HRV) gains more and more importance in the assessment of training practice and welfare in equine industry. It relies on mathematical analyses of reliably and accurately measured variations in successive inter-beat intervals, measured as RR intervals. Nowadays, the RR intervals can be obtained through two different techniques: a heart rate meter (HRM) or an electrocardiogram (ECG). The agreement and reliability of these devices has not been fully assessed, especially for recordings during exercise. The purpose of this study was to assess the agreement of two commercially available devices using the two mentioned techniques (HRM vs ECG) for HRV analysis during a standardized exercise test. Simultaneous recordings obtained during light exercise and during canter with both devices were available for 36 horses. Data were compared using a Bland–Altman analysis and the Lin’s coefficient. The agreement between the assessed HRV measures from the data obtained from the ECG and HRM was acceptable only for the mean RR interval and the mean heart rate. For the other studied measures (SDNN, root mean square of successive differences, SD1, SD2, low frequency, high frequency), the agreement between the devices was too poor for them to be considered as interchangeable in these recording conditions. The agreement tended also to be worse when speed of the exercise increased. Therefore, it is necessary to be careful when interpreting and comparing results of HRV analysis during exercise, as the results will depend upon recording devices. Furthermore, corrections and data processing included in the software of the devices affect largely the output used in the subsequent HRV analysis; this must be considered in the choice of the device.
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Affiliation(s)
- Augustin Lenoir
- Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Dagmar S Trachsel
- Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,CIRALE, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Mohamed Younes
- CIAMS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Eric Barrey
- GABI UMR1313, INRA, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
| | - Céline Robert
- Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France.,GABI UMR1313, INRA, AgroParisTech, Université Paris-Saclay, Jouy-en-Josas, France
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Abstract
There has been great progress in the understanding of basic neurobiologic mechanisms of pain, but this body of knowledge has not yet translated into new and improved analgesics. Progress has been made regarding pain assessment in horses, but more work is needed until sensitive and accurate pain assessment tools are available for use in clinical practice. This review summarizes and updates the knowledge concerning the cornerstones of pain medicine (understand, assess, prevent, and treat). It highlights the importance of understanding pain mechanisms and expressions to enable a rational approach to pain assessment, prevention, and management in the equine patient.
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Hermans H, Veraa S, Wolschrijn CF, van Loon JPAM. Local anaesthetic techniques for the equine head, towards guided techniques and new applications. EQUINE VET EDUC 2017. [DOI: 10.1111/eve.12757] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H. Hermans
- Department of Equine SciencesFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
| | - S. Veraa
- Division of Diagnostic ImagingFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
| | - C. F. Wolschrijn
- Department of Pathobiology Faculty of Veterinary Medicine Utrecht University Utrecht The Netherlands
| | - J. P. A. M. van Loon
- Department of Equine SciencesFaculty of Veterinary Medicine Utrecht UniversityUtrecht The Netherlands
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McConachie EL, Giguère S, Rapoport G, Barton MH. Heart rate variability in horses with acute gastrointestinal disease requiring exploratory laparotomy. J Vet Emerg Crit Care (San Antonio) 2015; 26:269-80. [PMID: 26260488 DOI: 10.1111/vec.12362] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 03/15/2015] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To describe heart rate variability (HRV) in horses with acute gastrointestinal disease that undergo exploratory laparotomy. We hypothesized that horses with ischemic gastrointestinal disease will have reduced HRV compared to horses with nonischemic lesions. We further hypothesized that a reduction in HRV will be associated with nonsurvival. DESIGN Prospective, clinical, observational study. SETTING University veterinary teaching hospital. ANIMALS Horses presented for acute colic (n = 57) or elective surgical procedures (n = 10) were enrolled. INTERVENTIONS Admission heart rate (HR) was recorded and within 2 hours of recovery from general anesthesia continuous telemetry was placed, monitored and recorded for 48-52 hours postoperatively. Stored electrocardiograms were manually inspected and R-to-R intervals were extracted and uploaded into HRV software for analysis. Time domain and frequency spectral analysis were investigated at Times 1 (2-10 h), 2 (16-24 h), 3 (30-38 h), and 4 (44-52 h) postoperatively. A two-way ANOVA for repeated measures was used for group comparisons. Logistic regression analysis was used to detect potential associations between admission HR, time and frequency domain variables, and nonsurvival. MEASUREMENTS AND MAIN RESULTS Horses diagnosed with an ischemic gastrointestinal lesion (n = 22) at the time of surgery had significantly higher postoperative heart rates and reduced time domain-derived measures of HRV than horses with nonischemic gastrointestinal lesions (n = 35) or control horses (n = 10). Horses that survived to discharge had significantly lower postoperative HRs, higher time domain, and lower low frequency spectral measures of HRV compared to nonsurvivors. The multivariable logistic regression model had a receiver operating characteristic area under the curve (AUC) of 0.95 and was significantly better at predicting nonsurvival than admission HR (P = 0.0124). CONCLUSIONS Reduced HRV was strongly associated with ischemic gastrointestinal disease and nonsurvival. HRV analysis is a noninvasive technique that may provide diagnostic and prognostic information pertinent to the management of postoperative horses with severe gastrointestinal disease.
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Affiliation(s)
- Erin L McConachie
- Departments of Large Animal Medicine, and Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Steeve Giguère
- Departments of Large Animal Medicine, and Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Gregg Rapoport
- Departments of Large Animal Medicine, and Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
| | - Michelle H Barton
- Departments of Large Animal Medicine, and Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602
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Stucke D, Große Ruse M, Lebelt D. Measuring heart rate variability in horses to investigate the autonomic nervous system activity – Pros and cons of different methods. Appl Anim Behav Sci 2015. [DOI: 10.1016/j.applanim.2015.02.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Shilo-Benjamini Y, Pascoe PJ, Maggs DJ, Pypendop BH, Johnson EG, Kass PH, Wisner ER. Comparison of peribulbar and retrobulbar regional anesthesia with bupivacaine in cats. Am J Vet Res 2014; 75:1029-39. [DOI: 10.2460/ajvr.75.12.1029] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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