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- Author or Editor: Tamara Grubb x
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Summary
Epidural analgesia was achieved at weekly intervals in 6 adults llamas by injection of 2% lidocaine, 10% xylazine, and a combination of 2% lidocaine/10% xylazine at the sacrococcygeal junction. Analgesia was determined by lack of response to pin prick or hemostat pressure in the perineal area. Ataxia could not be accurately evaluated because of the llamas’ tendency to assume sternal recumbency when restrained. Time to onset of analgesia was not different between lidocaine (3.16 ± 0.31 minutes) and lidocaine/xylazine (3.50 ± 0.56 minutes), but results for both groups were different than those for xylazine (20.67 ± 3.37 minutes). Duration of analgesia was different among all groups (lidocaine, 71.0 ± 6.15 minutes; xylazine, 186.83 ± 14.86 minutes; lidocaine/xylazine, 325.83 ± 29.39 minutes). Mild sedation developed in 4 llamas given xylazine alone. Lidocaine/xylazine caused mild sedation in 2 llamas and moderate sedation in 1 llama. Significant changes in pulse or respiratory rates were not observed among drugs, but changes were observed over time with all drugs. As has been reported in other species, lidocaine/xylazine provided rapid onset and prolonged duration of analgesia.
Abstract
OBJECTIVE To determine the impact of mechanical ventilation (MV) and perfusion conditions on the efficacy of pulse-delivered inhaled nitric oxide (PiNO) in anesthetized horses.
ANIMALS 27 healthy adult horses.
PROCEDURES Anesthetized horses were allocated into 4 groups: spontaneous breathing (SB) with low (< 70 mm Hg) mean arterial blood pressure (MAP; group SB-L; n = 7), SB with physiologically normal (≥ 70 mm Hg) MAP (group SB-N; 8), MV with low MAP (group MV-L; 6), and MV with physiologically normal MAP (group MV-N; 6). Dobutamine was used to maintain MAP > 70 mm Hg. Data were collected after a 60-minute equilibration period and at 15 and 30 minutes during PiNO administration. Variables included Pao 2, arterial oxygen saturation and content, oxygen delivery, and physiologic dead space-to-tidal volume ratio. Data were analyzed with Shapiro-Wilk, Mann-Whitney U, and Friedman ANOVA tests.
RESULTS Pao 2, arterial oxygen saturation, arterial oxygen content, and oxygen delivery increased significantly with PiNO in the SB-L, SB-N, and MV-N groups; were significantly lower in group MV-L than in group MV-N; and were lower in MV-N than in both SB groups during PiNO. Physiologic dead space-to-tidal volume ratio was highest in the MV-L group.
CONCLUSIONS AND CLINICAL RELEVANCE Pulmonary perfusion impacted PiNO efficacy during MV but not during SB. Use of PiNO failed to increase oxygenation in the MV-L group, likely because of profound ventilation-perfusion mismatching. During SB, PiNO improved oxygenation irrespective of the magnitude of blood flow, but hypoventilation and hypercarbia persisted. Use of PiNO was most effective in horses with adequate perfusion.
Abstract
Objective—To compare effects of isoflurane and sevoflurane on intracranial pressure and cardiovascular variables at 1.0, 1.5, and 2.0 times the minimum alveolar concentration (MAC) in mechanically ventilated normocapnic dogs.
Animals—6 healthy male Beagles.
Procedures—The individual MAC was determined for each agent with an electrical stimulus. After a minimum of 1 week, anesthetic induction by use of a mask with one of the inhalation anesthetics selected randomly was followed by mechanical ventilation and instrumentation for measurement of intracranial pressure and cardiovascular variables. Heart rate; systolic, mean, and diastolic arterial blood pressures; central venous pressure; mean pulmonary arterial pressure; pulmonary artery occlusion pressure; cardiac output; intracranial pressure (ICP); core body temperature; end-tidal inhalation anesthetic and carbon dioxide concentration; and arterial blood gas values were measured after attaining equilibrium at 1.0, 1.5, and 2.0 MAC of each inhalation anesthetic. Cardiac index, systemic vascular resistance, pulmonary vascular resistance, and cerebral perfusion pressure (CPP) were calculated.
Results—Mean ICP did not differ within and between anesthetics at any MAC. Compared with equipotent concentrations of isoflurane, the CPP and mean values for systolic, mean, and diastolic arterial blood pressures were increased at 2.0 MAC for sevoflurane, whereas mean values for mean and diastolic arterial blood pressures and systemic vascular resistance were increased at 1.5 MAC for sevoflurane.
Conclusions and Clinical Relevance—Although ICP was similar in healthy normocapnic dogs, CPP was better maintained during 2.0 MAC for sevoflurane, compared with isoflurane.
Abstract
Objective—To image the spatial distribution of pulmonary blood flow by means of scintigraphy, evaluate ventilation-perfusion (VA/Q) matching and pulmonary blood shunting (Qs/Qt) by means of the multiple inert gas elimination technique (MIGET), and measure arterial oxygenation and plasma endothelin-1 concentrations before, during, and after pulse-delivered inhaled nitric oxide (PiNO) administration to isoflurane-anesthetized horses in dorsal recumbency.
Animals—3 healthy adult Standardbreds.
Procedures—Nitric oxide was pulsed into the inspired gases in dorsally recumbent isoflurane-anesthetized horses. Assessment of VA/Q matching, Qs/Qt, and Pao 2 content was performed by use of the MIGET, and spatial distribution of pulmonary blood flow was measured by perfusion scintigraphy following IV injection of technetium Tc 99m–labeled macroaggregated human albumin before, during, and 30 minutes after cessation of PiNO administration.
Results—During PiNO administration, significant redistribution of blood flow from the dependent regions to the nondependent regions of the lungs was found and was reflected by improvements in VA/Q matching, decreases in Qs/Qt, and increases in Pao 2 content, all of which reverted to baseline values at 30 minutes after PiNO administration.
Conclusions and Clinical Relevance—Administration of PiNO in anesthetized dorsally recumbent horses resulted in redistribution of pulmonary blood flow from dependent atelectatic lung regions to nondependent aerated lung regions. Because hypoxemia is commonly the result of atelectasis in anesthetized dorsally recumbent horses, the addition of nitric oxide to inhaled gases could be used clinically to alleviate hypoxemia in horses during anesthesia.
Abstract
Objective—To determine the intraoperative and postoperative analgesic efficacy of intratesticular or epidural injection of analgesics for dogs undergoing castration.
Design—Randomized controlled trial.
Animals—51 healthy male dogs.
Procedures—Dogs were assigned to a control group that received analgesics systemically (hydromorphone [0.1 mg/kg {0.045 mg/lb}, IM] and carprofen [4.4 mg/kg {2.0 mg/lb}, SC]; n = 17), an epidural treatment group that received analgesics systemically and morphine (0.1 mg/kg) epidurally (17), or an intratesticular treatment group that received analgesics systemically and bupivacaine (0.5 mg/kg [0.23 mg/lb]/testis) intratesticularly (17). Dogs were anesthetized and castrated by veterinary students. Responses to surgical stimulation were monitored intraoperatively, and treatments were administered as required. Pain scores were assigned via a modified Glasgow composite pain scale after surgery. Serum cortisol concentrations were determined at various times. Rescue analgesia included fentanyl (intraoperatively) and hydromorphone (postoperatively).
Results—Compared with control dogs, dogs in the intratesticular bupivacaine and epidural morphine treatment groups received significantly fewer doses of fentanyl intraoperatively (11, 1, and 5 doses, respectively) and hydromorphone postoperatively (14, 7, and 3 doses, respectively) and had significantly lower postoperative pain scores (mean ± SEM score at first assessment time, 71 ± 0.5, 4.8 ± 0.2, and 4.5 ± 0.4, respectively). At 15 minutes after removal of the testes, serum cortisol concentrations were significantly higher than they were immediately prior to surgery for all groups and values for the intratesticular bupivacaine treatment group were significantly lower versus the other 2 groups.
Conclusions and Clinical Relevance—Intratesticular or epidural injection of analgesics improved perioperative analgesia for dogs undergoing castration.
Abstract
Objective—To determine the serum concentrations and sedative effects of fentanyl after transdermal administration at 3 dosages in llamas.
Animals—9 healthy adult female llamas (mean age, 8 ± 3 years; mean weight, 150 ± 18 kg).
Procedure—Llamas were allocated to 1 of 3 groups (3 llamas/group). Fentanyl patches (each providing transdermal delivery of 75 µg of fentanyl/h) were placed on shaved areas of the antebrachium of all llamas. In group 1, llamas were treated with 1 patch (anticipated fentanyl dosage, 75 µg/h). In group 2, llamas were treated with 2 patches (anticipated fentanyl dosage, 150 µg/h). In group 3, llamas were treated with 4 patches (anticipated fentanyl dosage, 300 µg/h). For each llama, the degree of sedation was assessed by use of a subjective scoring system and a blood sample was collected for determination of serum fentanyl concentration at 12, 24, 36, 48, 60, and 72 hours after patch placement.
Results—Following the placement of 4 patches, mean ± SD serum fentanyl concentration in group 3 llamas reached 0.3 ± 0.08 ng/mL within 12 hours. This concentration was sustained for 72 hours. In group 2, application of 2 patches provided inconsistent results; in group 1, application of 1 patch rarely provided measurable serum fentanyl concentrations. No llamas became sedated at any time.
Conclusions and Clinical Relevance—Results suggest that application of four 75 µg/h fentanyl patches provides consistent, sustained serum fentanyl concentrations without sedation in llamas. However, the serum concentration of fentanyl that provides analgesia in llamas is not known. (Am J Vet Res 2005;66:907–909)
Abstract
Objective—To determine the minimum alveolar concentration (MAC) of sevoflurane in spontaneously breathing llamas and alpacas.
Design—Prospective study.
Animals—6 healthy adult llamas and 6 healthy adult alpacas.
Procedure—Anesthesia was induced with sevoflurane delivered with oxygen through a mask. An endotracheal tube was inserted, and a port for continuous measurement of end-tidal and inspired sevoflurane concentrations was placed between the endotracheal tube and the breathing circuit. After equilibration at an end-tidal-to-inspired sevoflurane concentration ratio > 0.90 for 15 minutes, a 50-Hz, 80-mA electrical stimulus was applied to the antebrachium until a response was obtained (ie, gross purposeful movement) or for up to 1 minute. The vaporizer setting was increased or decreased to effect a 10 to 20% change in end-tidal sevoflurane concentration, and equilibration and stimulus were repeated. The MAC was defined as the mean of the lowest end-tidal sevoflurane concentration that prevented a positive response and the highest concentration that allowed a positive response.
Results—Mean ± SD MAC of sevoflurane was 2.29 ± 0.14% in llamas and 2.33 ± 0.09% in alpacas. Conclusions and Clinical Relevance—The MAC of sevoflurane in llamas and alpacas was similar to that reported for other species. (J Am Vet Med Assoc 2003;223:1167–1169)
