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Perez BR, Hawkins A, Fiske‐Jackson A, Jimenez CP. Opioid‐free anaesthesia protocol for standing spinal surgery in a horse. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Affiliation(s)
- Bartolome Rico Perez
- Anaesthesia Department Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - Alexander Hawkins
- Anaesthesia Department Clinical Science and Services The Royal Veterinary College Hatfield UK
| | - Andrew Fiske‐Jackson
- Anaesthesia Department Clinical Science and Services The Royal Veterinary College Hatfield UK
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Beazley S, Focken A, Fernandez-Parra R, Thomas K, Adler A, Duke-Novakovski T. Evaluation of lung ventilation distribution using electrical impedance tomography in standing sedated horses with capnoperitoneum. Vet Anaesth Analg 2022; 49:382-389. [DOI: 10.1016/j.vaa.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/29/2022]
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Gardner AK, Schroeder EL. Pathophysiology of intraabdominal hypertension and abdominal compartment syndrome and relevance to veterinary critical care. J Vet Emerg Crit Care (San Antonio) 2022; 32:48-56. [PMID: 35044059 DOI: 10.1111/vec.13125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 01/16/2018] [Accepted: 01/20/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Increased intraabdominal pressure, termed intraabdominal hypertension (IAH), is reported as an independent cause of morbidity and mortality in the human ICU but, until recently, has been rarely described in veterinary species outside of experimental models. Failure to identify severe IAH leads to organ dysfunction, termed abdominal compartment syndrome, and rapidly becomes fatal without therapeutic intervention. Although the veterinary community has been slow to address the concept of IAH and associated comorbidities, recent companion and large animal case series and experimental studies suggest IAH may also be common in veterinary species and correlates well with risk factors and grading systems already described in the human literature. PATHOPHYSIOLOGY Increasing abdominal pressures exert deleterious local effects through visceral ischemia and reperfusion injury as well as systemic effects on the cardiovascular, pulmonary, renal, and central nervous systems. Even mild grades of IAH increase systemic vascular resistance, impede venous return, increase pulmonary wedge pressure, and decrease pulmonary function. More severe grades cause azotemia, oliguria, decreased coronary blood flow, hypoxia, increased intracranial pressure, and death. IMPORTANCE Many of the common diseases in veterinary patients are associated with IAH, including gastric dilatation-volvulus, colon volvulus, closed pyometra, hemoperitoneum, ascites, uroperitoneum, and hydrops. Monitoring of the veterinary patient is difficult, but several experimental studies validate both the presence of IAH and the ability to monitor abdominal pressures in large and small animal species. Moreover, prompt recognition of IAH and subsequent treatment is feasible in the veterinary ICU. KEY POINTS Increasing abdominal pressures exert deleterious local effects through visceral ischemia and reperfusion injury as well as systemic effects on the cardiovascular, pulmonary, renal, and central nervous systems. Increases in central venous pressure, systemic vascular resistance, pulmonary wedge pressure, and a decreased cardiac output by way of both decreased preload and increased afterload have been documented as a result of intraabdominal hypertension (IAH). Direct diagnosis of IAH is achieved by blind or ultrasound-guided abdominal needle puncture attached to a water manometer or direct pressure monitoring transducer. Transvesicular measurement of intraabdominal pressure (IAP) is relatively noninvasive, and many patients that would benefit from rapid diagnosis of IAH and abdominal compartment syndrome already have indwelling bladder catheters. Recommendations for interventions are based on the assigned grade of IAH (mild, moderate, severe). KEY POINTS If IAH is strongly suspected or diagnosed, abdominal wall compliance may be improved through judicious use of neuromuscular blockers and sedation. Decompression, either minimally invasive or surgical, is absolutely recommended for IAPs consistently above 20 mm Hg, especially in the presence of signs attributed to secondary organ dysfunction.
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Affiliation(s)
- Alison K Gardner
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
| | - Eric L Schroeder
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, Ohio, USA
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Munsterman AS, Gillen AM, Coleridge MOD, Hanson RR. Evaluation of the effects of medial saphenous venous pressures as an indirect method of measurement of intra-abdominal pressures in the horse. J Vet Emerg Crit Care (San Antonio) 2020; 30:660-669. [PMID: 33030803 DOI: 10.1111/vec.13000] [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: 03/20/2018] [Revised: 12/17/2018] [Accepted: 02/18/2019] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To evaluate the effect of changes in intra-abdominal pressure (IAP) on medial saphenous venous pressure (MSVP) and hemodynamics in normal horses. DESIGN Experimental, in-vivo study. SETTING University Teaching Hospital. ANIMALS Convenience sample of 7 mixed breed horses; 5 geldings, and 2 mares. INTERVENTIONS Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minutes to evaluate the effect of sustained intra-abdominal hypertension. The MSVP and vital parameters were recorded, along with direct arterial blood pressure from the transverse facial artery. MEASUREMENTS AND MAIN RESULTS As IAP increased, MSVP increased in a stepwise manner, in concert with changes in IAP. The consistency in measurement between MSVP and IAP was high (intraclass correlation coefficient = 0.92; P < 0.001) and repeated measures correlation was excellent (r = 0.98; P < 0.001). Heart rate was unchanged over the course of the experiment (P = 0.09), however, respiratory rate increased with increasing IAP (P < 0.001). Arterial blood pressure also increased with insufflation (P < 0.001), with a significant difference at an IAP of 15 mm Hg (P = 0.04). CONCLUSIONS This report provides preliminary data demonstrating a strong correlation between equine MSVP and changes in IAP, similar to that observed in other species. Further investigations are needed to evaluate this relationship, and to confirm these results in clinical patients.
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Affiliation(s)
- Amelia S Munsterman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI
| | - Alexandra M Gillen
- The Philip Leverhulme Equine Hospital, University of Liverpool, Chester High Road, Neston, Cheshire, United Kingdom
| | | | - R Reid Hanson
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
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Munsterman AS, Gillen AM, Coleridge MOD, Hanson RR. Evaluation of the effects of intraabdominal hypertension on equine central venous pressure. J Vet Emerg Crit Care (San Antonio) 2020; 30:653-659. [PMID: 32929882 DOI: 10.1111/vec.13001] [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: 03/20/2018] [Revised: 12/17/2018] [Accepted: 02/18/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the effect of changes in intraabdominal pressure (IAP) on central venous pressure (CVP) in normal horses. DESIGN Experimental, in vivo study. SETTING University Teaching Hospital. ANIMALS Convenience sample of 7 mixed breed horses-5 geldings and 2 mares. INTERVENTIONS Pneumoperitoneum was induced in horses under standing sedation with carbon dioxide gas using a laparoscopic insufflator for a total of 60 minutes to simulate clinical elevation in IAP. Pressure was increased stepwise to 20 mm Hg over 30 minutes, and maintained at that pressure for 30 minutes to evaluate the effect of sustained intraabdominal hypertension. CVP was obtained from the cranial vena cava, concurrent with pressure obtained from the peritoneal cavity. MEASUREMENTS AND MAIN RESULTS CVP increased as IAP increased up to 12 mm Hg, and declined as IAP increased further. The changes in CVP over time were significantly different (P < 0.03). Repeated measures correlation was positive, and highest, for mean CVP as IAP increased from 0 to 12 mm Hg (r = .70; 95% CI, .43-.85; P < 0.0001). Correlation of mean CVP with insufflation pressure became negative as IAP increased further from 15 to 20 mm Hg (r = -.47; 95% CI, -.66 to -.21; P = 0.0006). CONCLUSIONS This report provides preliminary data demonstrating a biphasic trend in equine CVP caused by changes in IAP, similar to that observed in other species. Further investigations are needed to evaluate this trend and to confirm these results in clinical patients.
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Affiliation(s)
- Amelia S Munsterman
- Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, Michigan
| | - Alexandra M Gillen
- The Philip Leverhulme Equine Hospital, University of Liverpool, Chester High Road, Neston, Cheshire, UK
| | | | - R Reid Hanson
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL
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Hollis AR, Pascal M, Van Dijk J, Jolliffe C, Kaartinen J. Behavioural and cardiovascular effects of medetomidine constant rate infusion compared with detomidine for standing sedation in horses. Vet Anaesth Analg 2019; 47:76-81. [PMID: 31619335 DOI: 10.1016/j.vaa.2019.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 06/20/2019] [Accepted: 06/25/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To compare the efficacy of a medetomidine constant rate infusion (CRI) with a detomidine CRI for standing sedation in horses undergoing high dose rate brachytherapy. STUDY DESIGN Randomized, controlled, crossover, blinded clinical trial. ANIMALS A total of 50 horses with owner consent, excluding stallions. METHODS Each horse was sedated with intravenous acepromazine (0.02 mg kg-1), followed by an α2-adrenoceptor agonist 30 minutes later and then by butorphanol (0.1 mg kg-1) 5 minutes later. A CRI of the same α2-adrenoceptor agonist was started 10 minutes after butorphanol administration and maintained for the treatment duration. Treatments were given 1 week apart. Each horse was sedated with detomidine (bolus dose, 10 μg kg-1; CRI, 6 μg kg-1 hour-1) or medetomidine (bolus dose, 5 μg kg-1; CRI, 3.5 μg kg-1 hour-1). If sedation was inadequate, a quarter of the initial bolus of the α2-adrenoceptor agonist was administered. Heart rate (HR) was measured via electrocardiography, and sedation and behaviour evaluated using a previously published scale. Between treatments, behaviour scores were compared using a Wilcoxon signed-rank test, frequencies of arrhythmias with chi-square tests, and HR with two-tailed paired t tests. A p value <0.05 indicated statistical significance. RESULTS Total treatment time for medetomidine was longer than that for detomidine (p = 0.04), and ear movements during medetomidine sedation were more numerous than those during detomidine sedation (p = 0.03), suggesting there may be a subtle difference in the depth of sedation. No significant differences in HR were found between treatments (p ≥ 0.09). Several horses had arrhythmias, with no difference in their frequency between the two infusions. CONCLUSIONS AND CLINICAL RELEVANCE Medetomidine at this dose rate may produce less sedation than detomidine. Further studies are required to evaluate any clinical advantages to either drug, or whether a different CRI may be more appropriate.
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Affiliation(s)
| | | | - Jan Van Dijk
- Animal Health Trust, Lanwades Park, Kentford, UK
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Gozalo-Marcilla M, Luna SP, Gasthuys F, Pollaris E, Vlaminck L, Martens A, Haspeslagh M, Schauvliege S. Clinical applicability of detomidine and methadone constant rate infusions for surgery in standing horses. Vet Anaesth Analg 2019; 46:325-334. [PMID: 30935776 DOI: 10.1016/j.vaa.2019.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 12/12/2018] [Accepted: 01/19/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To determine the required rate of a detomidine infusion (loading dose 5 μg kg-1; initial rate 12.5 μg kg-1 hour-1) added to a constant infusion of methadone (0.2 mg kg-1; 0.05 mg kg-1 hour-1) for sedation in standing horses and ponies undergoing elective surgeries with appropriate local anaesthetic techniques. STUDY DESIGN Prospective, clinical study. ANIMALS Adult, healthy, client-owned, non-food-producing horses or ponies sedated for elective standing surgeries longer than 45 minutes. METHODS At baseline (in the stables before administration of sedative agents), at 10 minutes after sedation and every 5 minutes thereafter, ataxia, sedation and surgical condition were evaluated; each scored 0-3. These scores were used to adjust the detomidine administration rate using the Ghent Sedation Algorithm. A 10 cm visual analogue scale (VAS) was used by the main surgeon at the end of the procedure to evaluate the surgical conditions. Heart rate, systolic arterial pressure and respiratory frequency were also recorded at each time point. For statistical analysis, anova for normal, Kruskal-Wallis H-test for non-normal variables, and Mann-Whitney U test for VAS were used. RESULTS From the 42 horses/ponies included in this study, 28 underwent dental procedures and 14 other types of procedures. Overall, dental procedures required higher mean detomidine rates compared with other types of surgeries (16.9 ± 4.5 versus 9.0 ± 1.9 μg kg-1 hour-1) (p < 0.001). Dental procedures were assigned similar VAS scores, median (range), of 7.8 (5.8-10) with other procedures, 8.7 (2.8-10). Cardiovascular changes were not clinically significant. No signs or behavioural changes of abdominal pain were observed postoperatively. CONCLUSIONS AND CLINICAL RELEVANCE Satisfactory surgical conditions were achieved using a combination of detomidine and methadone infusions with locoregional anaesthesia, with no adverse effects. Dental procedures required higher detomidine dose rates compared with other surgeries.
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Affiliation(s)
- Miguel Gozalo-Marcilla
- The Royal (Dick) School of Veterinary Studies and the Roslin Institute, University of Edinburgh, Edinburgh, UK.
| | - Stelio Pl Luna
- School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - Frank Gasthuys
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Elke Pollaris
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Lieven Vlaminck
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Ann Martens
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | | | - Stijn Schauvliege
- Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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Gozalo-Marcilla M, de Oliveira AR, Fonseca MW, Possebon FS, Pelligand L, Taylor PM, Luna SPL. Sedative and antinociceptive effects of different detomidine constant rate infusions, with or without methadone in standing horses. Equine Vet J 2018; 51:530-536. [PMID: 30485499 DOI: 10.1111/evj.13054] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Accepted: 11/19/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Standing surgery avoids the risks of general anaesthesia in horses. OBJECTIVES To assess sedation, antinociception and gastrointestinal motility in standing horses after a detomidine loading dose and 2-h constant rate intravenous (i.v.) infusion, with or without methadone. STUDY DESIGN Blinded, randomised, crossover with seven healthy adult cross-bred horses, three geldings and four females (404 ± 22 kg). METHODS Five i.v. treatments were administered to all horses with 1-week washout period: saline (SAL), detomidine low (2.5 μg/kg bwt + 6.25 μg/kg bwt/h) (DL) and high doses (5 μg/kg bwt + 12.5 μg/kg bwt/h) (DH) alone or combined with methadone (0.2 mg/kg bwt + 0.05 mg/kg bwt/h), (DLM) and (DHM), respectively. Height of head above the ground (HHAG), electrical (ET), thermal (TT) and mechanical (MT) nociceptive thresholds and gastrointestinal motility were evaluated at predetermined times between 5 and 240 min. A mixed effect model and Kruskal-Wallis test were used to analyse normally and non-normally distributed data, respectively. RESULTS Sedation (<50% basal HHAG) was achieved for the duration of the infusion, and for an additional 15 min in DH and DHM groups. Nociceptive thresholds were higher than baseline, to the greatest degree and the longest duration, with DHM (ET and TT for 135 min and MT for 150 min). After DH, TT was significantly higher than baseline from 30 to 120 min and MT from 15 to 135 min. After DLM, ET was increased at 90 min, TT at 30 min and MT for 120 min. Gastrointestinal motility was reduced for up to 135 min after DL, 150 min after DLM and 210 min after DH and DHM. MAIN LIMITATIONS Nociceptive thresholds are not equivalent to surgical stimuli. CONCLUSION Methadone with the highest detomidine dose (DHM) may provide sufficient sedation and analgesia for standing surgical procedures and warrants further investigation.
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Affiliation(s)
- M Gozalo-Marcilla
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil.,The Royal (Dick) School of Veterinary Studies and the Roslin Institute, The University of Edinburgh, Midlothian, UK
| | - A R de Oliveira
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
| | - M W Fonseca
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
| | - F S Possebon
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
| | - L Pelligand
- Royal Veterinary College, North Mymms, Hatfield, Hertfordshire, UK
| | | | - S P L Luna
- São Paulo State University (UNESP), School of Veterinary Medicine and Animal Science, Botucatu, São Paulo, Brazil
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Davis JL. Nonsteroidal anti-inflammatory drug associated right dorsal colitis in the horse. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12454] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- J. L. Davis
- North Carolina State University College of Veterinary Medicine; Raleigh USA
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Valverde A. Balanced Anesthesia and Constant-Rate Infusions in Horses. Vet Clin North Am Equine Pract 2013; 29:89-122. [DOI: 10.1016/j.cveq.2012.11.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
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Nielsen LK, Whelan M. Compartment syndrome: pathophysiology, clinical presentations, treatment, and prevention in human and veterinary medicine. J Vet Emerg Crit Care (San Antonio) 2012; 22:291-302. [PMID: 22554185 DOI: 10.1111/j.1476-4431.2012.00750.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 06/11/2011] [Accepted: 03/25/2012] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To review the human and veterinary literature pertaining to all forms of compartment syndrome (CS). DATA SOURCES Data sources included scientific reviews and original research publications from the human and veterinary literature. HUMAN DATA SYNTHESIS While CS affecting the extremities has been recognized in people for decades, other forms of CS in the abdominal and thoracic cavities are recently gaining more attention. The role of CS in critically ill people is a rapidly growing area of interest. More research on prevention and treatment of CS is being conducted in people because some studies have found mortality rates as high as 80% for those suffering from these conditions. VETERINARY DATA SYNTHESIS While a significant amount of experimental studies of CS have been performed on small animals, there is a marked lack of primary veterinary studies. The majority of the veterinary literature includes case reports and series, and many of these studies were published over a decade ago. However, the increased recognition of CS in people has sparked an interest in veterinary critical care medicine and this has been demonstrated by the recent increased evaluation of compartment pressures in veterinary patients. CONCLUSIONS CS is a complex clinical condition where increased pressure within a compartment can cause significant adverse effects within the compartment as well as throughout the body. Systemic inflammatory responses and local ischemia-reperfusion elements can contribute to the detrimental effects seen in CS. This cascade of events results in increased mortality rates and contributes to the development of CS elsewhere. A better understanding of CS will help veterinarians improve patient care and outcome. Future studies on incidence, prevention, and treatment of CSs in the critical care patient are needed in veterinary medicine.
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Munsterman AS, Hanson RR. Evaluation of gastric pressures as an indirect method for measurement of intraabdominal pressures in the horse. J Vet Emerg Crit Care (San Antonio) 2011; 21:29-35. [DOI: 10.1111/j.1476-4431.2010.00608.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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CANOLA PA, PEROTTA JH, LASKOSKI LM, ESCOBAR A, MELO E SILVA CA, CANOLA JC, JOHNSON PJ, VALADÃO CAA. Effect of passive pneumoperitoneum on oesophageal pressure, cardiovascular parameters and blood gas analysis in horses. Equine Vet J 2010; 43:446-50. [DOI: 10.1111/j.2042-3306.2010.00304.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Behavioural and cardiorespiratory effects of a constant rate infusion of medetomidine and morphine for sedation during standing laparoscopy in horses. Equine Vet J 2010; 41:153-9. [DOI: 10.2746/042516408x342984] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Brosnahan MM, Holbrook TC, Gilliam LL, Ritchey JW, Confer AW. Intra-abdominal hypertension in two adult horses. J Vet Emerg Crit Care (San Antonio) 2009; 19:174-80. [DOI: 10.1111/j.1476-4431.2009.00400.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hewitt SA, Brisson BA, Sinclair MD, Sears WC. Comparison of cardiopulmonary responses during sedation with epidural and local anesthesia for laparoscopic-assisted jejunostomy feeding tube placement with cardiopulmonary responses during general anesthesia for laparoscopic-assisted or open surgical jejunostomy feeding tube placement in healthy dogs. Am J Vet Res 2007; 68:358-69. [PMID: 17397290 DOI: 10.2460/ajvr.68.4.358] [Citation(s) in RCA: 8] [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 the use of laparoscopic-assisted jejunostomy feeding tube (J-tube) placement in healthy dogs under sedation with epidural and local anesthesia and compare cardiopulmonary responses during this epidural anesthetic protocol with cardiopulmonary responses during general anesthesia for laparoscopic-assisted or open surgical J-tube placement. ANIMALS 15 healthy mixed-breed dogs. PROCEDURES Dogs were randomly assigned to receive open surgical J-tube placement under general anesthesia (n = 5 dogs; group 1), laparoscopic-assisted J-tube placement under general anesthesia (5; group 2), or laparoscopic-assisted J-tube placement under sedation with epidural and local anesthesia (5; group 3). Cardiopulmonary responses were measured at baseline (time 0), every 5 minutes during the procedure (times 5 to 30 minutes), and after the procedure (after desufflation [groups 2 and 3] or at the start of abdominal closure [group 1]). Stroke volume, cardiac index, and O(2) delivery were calculated. RESULTS All group 3 dogs tolerated laparoscopic-assisted J-tube placement under sedation with epidural and local anesthesia. Comparison of cardiovascular parameters revealed a significantly higher cardiac index, mean arterial pressure, and O(2) delivery in group 3 dogs, compared with group 1 and 2 dogs. Minimal differences in hemodynamic parameters were found between groups undergoing laparoscopic-assisted and open surgical J-tube placement under general anesthesia (ie, groups 1 and 2); these differences were not considered to be clinically important in healthy research dogs. CONCLUSIONS AND CLINICAL RELEVANCE Sedation with epidural and local anesthesia provided satisfactory conditions for laparoscopic-assisted J-tube placement in healthy dogs; this anesthetic protocol caused less cardiopulmonary depression than general anesthesia and may represent a better choice for J-tube placement in critically ill patients.
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Affiliation(s)
- Saundra A Hewitt
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada
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