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  • Author or Editor: Jesús Usón-Gargallo x
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Abstract

OBJECTIVE To compare the usefulness of fresh-frozen canine cadavers (FFCCs) and a validated canine simulator model for training veterinary students in basic gastrointestinal endoscopic procedures.

DESIGN Randomized trial.

SAMPLE 48 veterinary students in their final year of training.

PROCEDURES Students were randomly assigned to receive basic gastrointestinal endoscopic training on a canine simulator or FFCC. All students were trained as assigned in esophagogastroduodenoscopy, endoscopic gastric biopsy, and gastric foreign body removal for 2 h/d for 5 days. They then performed each procedure on a live dog, and procedure completion time and performance ability were compared between groups. Two experienced endoscopists used a validated Likert-type procedural rating scale to rate the students' performance. Students completed a survey to rate their training model.

RESULTS No significant differences were identified between groups in quality of performance of the 3 endoscopic procedures on a live dog. Students required significantly less time to complete the procedures on a live dog when trained on an FFCC versus canine simulator. Although both training models were considered equally useful by students, training on the simulator was significantly more stimulating.

CONCLUSIONS AND CLINICAL RELEVANCE Students showed the same skill level in performing basic endoscopic procedures on live dogs regardless of the training model used, although students who trained on the FFCC completed these procedures faster than students trained on the canine simulator. Use of the simulator appeared to be a viable alternative to use of FFCCs for veterinary endoscopic training, providing students with a good level of proficiency before performing endoscopic procedures on live dogs.

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate the use of ultrasonography to detect morphologic changes in the pylorus during pyloroplasty performed laparoscopically or via conventional abdominal surgery in dogs.

Animals—10 healthy mixed-breed dogs.

Procedure—Laparoscopic ultrasonography of the pylorus was performed in 5 dogs during laparoscopic pyloroplasty (LP), and ultrasonography of the pylorus was performed in 5 dogs during pyloroplasty via conventional abdominal surgery (CAP group). Appearance and dimensions of the pyloric sphincter were evaluated by use of a 7.5-MHz flexible laparoscopic linear-transducer probe.

Results—Mean ± SD duration of the ultrasonographic procedure was 11 ± 3.04 minutes (range, 6 to 18 minutes). In the CAP group, cross-sectional views of the pylorus revealed significant differences between the overall transverse external diameter, overall craniocaudal external diameter, and transverse diameter of the pyloric lumen. After surgery, the pyloric area was significantly increased. Longitudinal views of the pylorus revealed that width of the pyloric ring was significantly less after surgery. Transverse views of the pylorus for the LP group revealed a significant increase in the transverse diameter and craniocaudal diameter of the pyloric lumen after LP. The pyloric area was also significantly increased after surgery. Longitudinal views of the pylorus revealed that width of the pyloric ring was significantly less after surgery. Transverse diameter of the pyloric lumen was significantly increased after LP.

Conclusions and Clinical Relevance—Analysis of results of this study suggests that ultrasonography is useful for detecting relevant morphologic changes in the pyloric sphincter after pyloroplasty. (Am J Vet Res 2003;64:1099–1104)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To determine the effects of prolonged anesthesia with desflurane in dogs undergoing laparotomy or abdominal laparoscopy.

Design—Randomized prospective study.

Animals—20 adult mixed-breed dogs.

Procedure—Dogs were randomly assigned to 1 of 2 groups with 10 dogs/group. Anesthesia was induced with propofol and maintained with desflurane and fentanyl, and pyloroplasty was performed. In 10 dogs, a ventral midline laparotomy was performed; in the other 10, abdominal laparoscopy was performed. Dogs were monitored for cardiovascular and respiratory responses (ECG, oxygen saturation [SpO2], arterial blood pressure, rectal temperature, end-tidal partial pressure of carbon dioxide [PETCO2], and expired desflurane concentration). Recovery times were recorded.

Results—Mean ± SD duration of anesthesia was 201 ± 25 minutes for dogs undergoing laparotomy and 287 ± 15 minutes for dogs undergoing laparoscopy. Anesthesia was accompanied by hypotension that was less severe in dogs undergoing laparoscopy. Heart rate did not vary significantly during anesthesia. The SpO2 was > 97% in all dogs at all times, and PETCO2 remained within reference limits. Recovery times for dogs that underwent laparotomy were not significantly different from those for dogs that underwent laparoscopy. Mean ± SD time to standing was 13.6 ± 2.4 minutes for dogs that underwent laparotomy and 12.5 ± 2.9 minutes for dogs that underwent laparoscopy.

Conclusions and Clinical Relevance—Results suggest that induction of anesthesia with propofol and maintenance with desflurane and fentanyl is safe in dogs undergoing abdominal surgery. (J Am Vet Med Assoc 2001;219:941–945)

Full access
in Journal of the American Veterinary Medical Association

Abstract

Objective—To evaluate relationships among various techniques for monitoring anesthetic depth in sevoflurane-anesthetized dogs undergoing orthopedic surgery.

Animals—10 dogs.

Procedure—Dogs were medicated with acepromazine (0.05 mg/kg, IM), buprenorphine (0.01 mg/kg, IM), and atropine (0.04 mg/kg, IM). Anesthesia was induced and maintained with sevoflurane. Cardiovascular and respiratory responses were monitored. Anesthetic depth was monitored by use of the bispectral index (BIS), and a proprietary index was used to monitor activity of the autonomic nervous system.

Results—A significant decrease in BIS was seen after induction but concurrent changes were not observed for the other techniques. The proprietary index increased significantly after intubation, but no changes were seen for the other techniques. No significant changes were detected during incision or when higher nociceptive stimuli were applied. We did not identify a correlation between BIS and the proprietary index, the proprietary index and hemodynamic variables, or the BIS and hemodynamic variables during induction and maintenance. A significant increase in the proprietary index and BIS was detected at the time of resumption of reflexes. During anesthetic recovery, a correlation was found between the proprietary index and BIS but not between hemodynamic variables and the other techniques.

Conclusions and Clinical Relevance—A significant increase in the proprietary index, but not the BIS or hemodynamic variables, was detected during intubation. Anesthetic induction with sevoflurane did not prevent the sympathetic stimulus attributable to tracheal intubation. Monitoring of hemodynamic variables does not provide sufficient information to allow clinicians to evaluate stress during anesthetic recovery. (Am J Vet Res 2004;65:1128–1135)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate bispectral index (BIS), spectral edge frequency 95% (SEF), and median frequency (MED) in relation to a visual analogue scale (VAS) as indicators of anesthetic depth for various concentrations of sevoflurane and isoflurane in pigs.

Animals—32 pigs.

Procedure—Pigs were randomly allocated to 8 groups (4 pigs/group). An electroencephalogram (EEG) was recorded in each conscious pig. Pigs were then anesthetized by use of sevoflurane (n = 16) or isoflurane (16). Agents were administered in oxygen at minimum alveolar concentrations (MACs) of 1, 1.25, 1.5, and 1.75 MAC in a randomized order. End-tidal sevoflurane and isoflurane concentrations were maintained for 30 minutes, after which an EEG was recorded for 5 minutes; BIS, SEF, and MED were then calculated. Anesthetic depth was evaluated by use of the VAS. Cardiovascular and EEG responses to nociceptive stimuli were evaluated for each anesthetic agent.

Results—BIS decreased significantly for the various concentrations of each anesthetic. At equivalent MACs, BIS values were significantly higher during sevoflurane-induced anesthesia than during isoflurane- induced anesthesia. Values of MED and SEF decreased significantly from basal values to 1 MAC of sevoflurane and isoflurane. For both agents, there was good correlation between VAS scores and BIS values and between VAS scores and SEF values.

Conclusions and Clinical Relevance—BIS was useful for predicting changes in anesthetic depth at clinical dosages of inhalant anesthetics. Values of BIS, SEF, and MED were significantly higher during anesthesia induced by administration of sevoflurane than during anesthesia induced by administration of isoflurance at equivalent MACs. (Am J Vet Res 2003;64:866–873)

Full access
in American Journal of Veterinary Research

Abstract

OBJECTIVE To evaluate muscle activity and hand motion in veterinarians performing a standard set of laparoscopic training tasks.

SAMPLE 12 veterinarians with experience performing laparoscopic procedures.

PROCEDURES Participants were asked to perform peg transfer, coordination, precision cutting, and suturing tasks in a laparoscopic box trainer. Activity of the right biceps brachii, triceps brachii, forearm flexor, forearm extensor, and trapezius muscles was analyzed by means of surface electromyography. Right hand movements and wrist angle data were registered through the use of a data glove, and risk levels for the wrist joint were determined by use of a modified rapid upper limb assessment (RULA) method. One-way repeated-measures ANOVA with a Bonferroni post hoc test was performed to compare values between tasks.

RESULTS Activity in the biceps muscle did not differ significantly among the 4 tasks. Activity in the triceps, forearm flexor, and forearm extensor muscles was significantly higher during precision cutting than during the coordination task. Activity in the trapezius muscle was highest during the suturing task and did not differ significantly among the other 3 tasks. The RULA score was unacceptable (score, 3) for the coordination, peg transfer, and precision cutting tasks but was acceptable (score, 2) for the suturing task.

CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that the ergonomics of laparoscopic training depended on the tasks performed and the design of the instruments used. Precision cutting and suturing tasks were associated with the highest muscle activity. Acceptable wrist position, as determined with the RULA method, was found with the suturing task, which was performed with an axial-handled instrument. (Am J Vet Res 2016;77:186–193)

Full access
in American Journal of Veterinary Research

Abstract

Objective—To evaluate bispectral index (BIS) values in pigs during anesthesia maintained with sevoflurane- fentanyl or propofol-fentanyl as a predictor of changes in hemodynamic parameters and duration of recovery from anesthesia.

Animals—12 pigs.

Procedure—Pigs were randomly allocated to undergo 1 of 2 anesthetic regimens. Anesthesia was induced with propofol (2 mg/kg, IV); 6 pigs were administered sevoflurane via inhalation (1 minimum alveolar concentration [MAC] at a fresh gas flow rate of 3 L/min; group I), and 6 were administered propofol (11 mg/kg/h, IV; group II). All pigs received fentanyl (2.5 mg/kg, IV, q 30 min). After abdominal surgery, pigs were allowed to recover from anesthesia. Cardiovascular variables and BIS values were recorded at intervals throughout the procedure; duration of recovery from anesthesia was noted.

Results—No correlation was established between arterial blood pressure and BIS and between heart rate and BIS. Mean BIS at discontinuation of administration of the anesthetic agent was greater in group-II pigs (65.2 ± 10.6 minutes) than in group-I pigs (55.8 ± 2.9 minutes). However, recovery from anesthesia was significantly longer in group II (59.80 ± 2.52 minutes) than in group I (9.80 ± 2.35 minutes).

Conclusions and Clinical Relevance—In swine anesthetized with sevoflurane or propofol and undergoing abdominal surgery, the BIS value derived from an electroencephalogram at the end of anesthesia was not useful for predicting the speed of recovery from anesthesia. Moreover, BIS was not useful as a predictor of clinically important changes in arterial blood pressure and heart rate in those anesthetized pigs. (Am J Vet Res 2004;65:409–416)

Full access
in American Journal of Veterinary Research