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Induction of general anaesthesia by rapid injection of propofol and dexmedetomidine or propofol and buthorphanol: cardiopulmonary and echocardiographic parameters in unpremedicated dogs
No full text2011 The Authors. Veterinary Anaesthesia and Analgesia
20 2011 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesiologists, 38, 1–35 Induction of general anaesthesia by rapid
injection of propofol and dexmedetomidine
or propofol and butorphanol:
cardiopulmonary and echocardiographic
parameters in unpremedicated dogs
G Ravasio, L Borghi, D Fonda, P Brambilla, V Bronzo,
J Cincotti & C Locatelli
Universita` degli Studi di Milano, Facolta` di Medicina
Veterinaria di Milano, via Celoria 10, 20133 (MI) Italy
The aim was to compare quality of induction,
echocardiographic and cardiopulmonary effects of
two different general anaesthesia induction protocols.
Twelve dogs (ASA I-II) were assigned randomly
into two groups. Both groups received a rapid bolus
of propofol (2.2 mg kg)1 IV) immediately followed
by a rapid bolus of dexmedetomidine 3 lg kg)1 IV
(group A) or butorphanol 0MAP, SAP (NIBP) were recorded and 2, 5, 10, 15,
20 minutes after drug administration. Induction
quality, intubation time, additional propofol dose to
achieve intubation, sedation score (Fernandez et al.
2005) and adverse effects were recorded. Echocardiogram
was performed at baseline and immediately
after tracheal intubation. Data were analyzed using
repeated measures ANOVA and Wilcoxon test
(p < 0.05).
Induction quality, intubation time (A: 75 ± 25,
B: 145 ± 66.8 seconds) were statistically different
between groups, HR was statistically lower in group
A compared to baseline (62 ± 23; 101 ± 23), fR
was not statistically different between groups but
lower than baseline in group A, NIBP was statistically
higher in group A and lower in group B
compared to baseline. Body temperature, SpO2,
PE¢CO2 were not statistically different. No apnoea
(>30 seconds) or emesis were recorded. Five group
B dogs required additional propofol (1.1 ± 0.7
mg kg)1 IV) to achieve tracheal intubation. Left
ventricular end-diastolic diameter was statistically
lower in group B and statistically higher in group A
compared to baseline. Cardiac output decrease was
18.5% in group A and 24.4% in group B.
Quality of induction was better in group A.
Echocardiographic parameters varied compared to
baseline in both groups but remained within normal
ranges for adult dogs (Cornell et al. 2004).
References: Fernandez JG, Parodi E, Garcia P et al.
(2005) Clinical action of subarachnoid sevoflurane
in vivo: a study in dogs. Brit J Anaesth 95(4), 530–
534.
Cornell CC, Kittleson MD, Della Torre P et al.
(2004) Allometric scaling of M-Mode cardiac measurements
in normal adult dogs. J Vet Intern med
18(3), 311–321..4 mg kg)1 IV (group B)
administered by a blinded operator. Baseline HR
Three dexmedetomidine constant rate infusion (CRI) in feline ovariectomized patients: sedative and analgesic effects
No full textThree dexmedetomidine constant rate infusion (CRI) regimens in feline ovariectomized patients: sedative and analgesic effects.
A.M. Carotenuto, G. Ravasio, L. Borghi, S Boveri, M. Beccaglia, D. Fonda
Università degli Studi di Milano, Facoltà di Medicina Veterinaria di Milano, via Celoria 10, 20133 (MI) Italy
In cats, few studies have investigated the clinical effect of dexmedetomidine (DMED) CRI during perioperative period. Our aim was to evaluate the analgesic and sedative effects of three rates of DMED CRI in feline patients undergoing ovariectomy, postoperatively monitored for 24 hours. Eighteen female cats were enrolled. After premedication (5 μg kg-1 DMED IM; 0.2 mg kg-1 meloxicam SC), patients were induced with propofol and randomly allocated into three groups (D1-D2-D3) to receive 0.5 (n=6), 1.5 (n=6) and 2.5 (n=6) μg kg-1 h-1 DMED CRI respectively. Anaesthesia was maintained with isoflurane in oxygen and respiration was mechanically controlled using intermittent positive pressure ventilation to maintain normocapnia. Intraoperative hemodynamic parameters and end tidal isoflurane concentration were recorded every 5 minutes. Rescue anaesthesia was provided by means of 0.5 mg kg-1 of propofol in response to acute increases in HR or MAP (20% or more). Postoperatively, sedation, analgesia, muscular relaxation and quality of recovery were evaluated using three postoperative scales (Ansah et al. 2002; Shaffran et al. 2008; Belda et al. 2008). Buprenorphine (10 μg kg-1) was provided as rescue postoperative analgesic drug. Data were analyzed by ANOVA and Kruskal-Wallis test (P<0.05). Intraoperatively, significant differences among groups were not found and any cat did not required rescue propofol, showing stable hemodynamic state. Isoflurane sparing effect of 40% was obtained in D1 and around 48% in D2 and D3. Postoperative analgesia and muscular relaxation showed to be significantly increased in D3 patients than in D1 and D2, while sedative effects resulted to be decreased. Although none patient in three groups required rescue analgesia, D3 showed the most favourable results. DMED infusion, used as part of a balanced anaesthesia, seemed to be safe, useful and effective to obtain adequate intra and postoperative analgesia in feline patients undergoing ovariectomy.
References: Arora S (2008) Combining ketamine and propofol (“Ketofol”) for emergency department procedural sedation and analgesia: a review. WestJEM 9, 20-23.
Ilkiw JE, Pascoe PJ (2003) Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cat. AJVR 64, 913-91
Total intravenous anaesthesia with “ketofol” (ketamine/propofol combination) in cats undergoing ovariectomy: intra and post-operative evaluation
No full textTotal intravenous anaesthesia with “ketofol” in cats undergoing ovariectomy: intra and post-operative evaluation
G. Ravasio, D. Fonda, G. De Carli, Beccaglia M., L. Borghi, A.M. Carotenuto, M. Gallo, A. Zonca
Università degli Studi di Milano, Facoltà di Medicina Veterinaria di Milano, via Celoria 10, 20133 (MI) Italy
Ketamine (K) and propofol (P) combination CRI is intravenous (IV) association used in humans and veterinary medicine (Arora 2008, Ilkiw & Pascoe 2003). Intraoperative anaesthetic variables and postoperative analgesic and sedative effects were evaluated. Fifteen female cats undergoing ovariectomy received IV loading dose of K plus P (2 mg kg-1 each) (n=8) mixed in the same syringe (ketofol) or ketofol added of dexmedetomidine (0.003 mg kg-1 IV) (n=7), followed by IV infusion of the ketofol mixture (10 mg kg-1 h-1 each). Physiological parameters and venous emogasanalysis were monitored during surgery and the count in the Heinz bodies formation was investigated. Blood concentrations of ketamine, norketamine and propofol were quantified by HPLC analysis. Sedation degree, the quality of recovery and pain assessment were also evaluated in the postoperative period. The intraoperative HR was significantly higher and the time of extubation was significantly shorter in the group receiving ketofol without dexmedetomidine. Blood emogasanalyses were not substantial different among groups and the infusion of propofol did not significantly increase oxidative damage to the red blood cells. The pharmacokinetic profile was similar for propofol and ketamine. During recovery the animals in both groups appeared restful, without pain. The total intravenous anaesthesia (TIVA) with ketofol appeared to be safe in cats, with fast and smooth recovery and adequate analgesia during postoperative period. Decrease HR in dexmedetomidine group resulted in a more stable haemodynamic state, but prolonged recovery time. The infusion of ketofol could represent a useful protocol for TIVA in cats undergoing moderately painful surgery.
References: Arora S (2008) Combining ketamine and propofol (“Ketofol”) for emergency department procedural sedation and analgesia: a review. WestJEM 9, 20-23.
Ilkiw JE, Pascoe PJ (2003) Cardiovascular effects of propofol alone and in combination with ketamine for total intravenous anesthesia in cat. AJVR 64, 913-91
Additivazione all'anestesia generale di blocchi locoregionali sugli arti in corso di chirurgia ortopedica canina : effetto analgesico della ropivacaina
No full textAim of this study was to evaluate the analgesic effect of ropivacaine(RPV) and bupivacaine (BPV) used for regional limb blockade, in anaesthetised dogs undergoing orthopaedic procedures localised distally to the scapula or hip. For the forelimb, brachialis plexus blockade was performed at a level of ventral branches of C6-C7-C8-T1. For the rearlimb, lumbosacral plexus blockade was performed at a level of ventral branches of lateral cutaneous femoral, femoral and obturator nerves (L4-L5), ischiatic (L5-L6-L7-S1-S2), pudendal and caudal cutaneous femoral nerves (S1-S2). A nerve locator guided technique was used in all the procedures. Analgesic effect of RPV (2 mg kg-1) was evaluated in 10 dogs (RPV group). All physiological parameters (HR, RR, NIBP, T°, SpO2, ETCO2, ECG), and evaluation of acute postsurgical pain (modified from Melbourne scale) (Gaynor & Muir, 2002), were compared with those obtained by BPV (2 mg kg-1) in the other 10 dogs (BPV group). The data was statistically analysed by ANOVA and t test (P< 0.05). Results. Monitored parameters during anaesthesia did not show statistically significant differences between groups. Recovery time values in RPV group (10 ± 6.24; 18.20 ± 9.78; 34.50 ± 21.02) compared with those in BPV group (9.30 ± 5.14; 23.20 ± 17.13; 82.11 ± 70.19) resulted not to be statistically different. Pain scores in RPV group (0.2 ± 0.63; 0 ± 0; 0.25 ± 0.71) compared with those in BPV group (0.3 ± 0.67;0.3 ± 0.67; 1±1.07) did not show statistical differences.
When using effect of regional limb blockade in dogs undergoing orthopaedic surgery ropivacaine seems to be as efficient as bupivacaine
Sistema di controllo del punto di lavoro di un modulatore elettro-ottico per impianti di CATV
No full textGiant congenital nevi of the scalp and forehead treated by skin expansion
No full textCongenital giant melanocytic nevi of the scalp and forehead are rare lesions present at birth. These lesions are associated with risk of malignant transformation, but they primarily represent a psychological problem to both patient and parents and merit early excision and reconstruction. In this study we report our own experience: seven patients, aged 8 months to 9 years, with congenital pigmented nevi involving forehead and scalp, and a 4-year old patient with congenital pigmented nevus of periorbital region and nose were treated successfully with excision and expanded skin flap reconstructions. The mean expansion procedures were 2 (range, 1 to 3), with an average of 8,8 injections for each expansion procedure (range, 6 to 11). In only one patient simultaneous expanders were placed in the scalp and forehead. Follow-up ranged from 4 months to 15 years. We had no rupture, extrusion or infection of the skin expanders. Complications included eyebrow ptosis and asymmetry in two patients underwent correction at a final procedure. In our opinion tissue expansion is an excellent technique for the treatment of giant nevi of the scalp and forehead because it offers the best aesthetic and functional outcomes
Pharmacokinetic and pharmacodynamic (PK/PD) evaluation of cefazolin in dog
No full textThe objectives of this study were to investigate the pharmacokinetics of danofloxacin and its metabolite N-desmethyldanofloxacin and to determine their concentrations in synovial fluid after administration by the intravenous, intramuscular or intragastric routes. Six adult mares received danofloxacin mesylate administered intravenously (i.v.) or intramuscularly (i.m.) at a dose of 5 mg/kg, or intragastrically (IG) at a dose of 7.5 mg/kg using a randomized Latin square design. Concentrations of danofloxacin and N-desmethyldanofloxacin were measured by UPLC-MS/MS. After i.v. administration, danofloxacin had an apparent volume of distribution (mean ± SD) of 3.57 ± 0.26 L/kg, a systemic clearance of 357.6 ± 61.0 mL/h/kg, and an elimination half-life of 8.00 ± 0.48 h. Maximum plasma concentration (Cmax) of N-desmethyldanofloxacin (0.151 ± 0.038 μg/mL) was achieved within 5 min of i.v. administration. Peak danofloxacin concentrations were significantly higher after i.m. (1.37 ± 0.13 μg/mL) than after IG administration (0.99 ± 0.1 μg/mL). Bioavailability was significantly higher after i.m. (100.0 ± 12.5%) than after IG (35.8 ± 8.5%) administration. Concentrations of danofloxacin in synovial fluid samples collected 1.5 h after administration were significantly higher after i.v. (1.02 ± 0.50 μg/mL) and i.m. (0.70 ± 0.35 μg/mL) than after IG (0.20 ± 0.12 μg/mL) administration. Monte Carlo simulations indicated that danofloxacin would be predicted to be effective against bacteria with a minimum inhibitory concentration (MIC) ≤0.25 μg/mL for i.v. and i.m. administration and 0.12 μg/mL for oral administration to maintain an area under the curve:MIC ratio ≥50
The pollicization of the index finger in the aplasia of the thumb
No full textWe have examined 11 patients with aplasia of the thumb and we have treated by pollicization of the index finger. We have conducted a follow up of 5 years. The total absence of the thumb may be an isolated anomaly, but it is often associated with some other congenital malformation. The absent thumb is as an autosomal dominant pathology or may be sporadic. It is frequently observed in the Holt-Oram syndrome, Fanconi's anemia, and ring D chromosome abnormalities. It is occasionally observed in the Rothmund syndrome, trisomy, thalidomide embryopathology and other congenital syndromes. An absent radius is almost always associated with an absent thumb, except in thrombocytopenia radial aplasia (Fanconi's syndrome), where the thumb is present even when the radius is absent. The treatment in most cases of the absent thumb is to perform a pollicization of the index finger. Our isolated congenital absence of the thumb patients have been treated with pollicization as described by Buck-Gramcko works well. It is a beautiful operation for the congenitally deformed, aplastic, or missing thumb. Pollicization of the index finger gives good functional and cosmetic results which are maintained. Conclusions: The total absence of the thumb in the congenitally pathology gives the hand of the patient insufficient in the functional movement and no cosmetic. So the pollicization with the second index fined gives a good reconstruction for the neo-thumb. In our five years follow-up, the 11 young patients that were treated with the pollicization, they are satisfy and use the neo-thumb like normal thumb. In congenitally absent thumbs clearly support the fact that the pollicized digit is used by most patients and is not ignored or bypassed
Preliminary clinical experience on hyaluronic acid to enhance the healing of canine spontaneous open wounds: an observational study on 12 cases
No full textMany in-vitro and in-vivo studies confirmed that hyaluronic acid (HA) is closely involved in fibroblast proliferation, enhanced formation of granulation tissue and even in keratinocyte proliferation and migration during wound healing process.1
The aim was to explore the application of available in commerce HA-containing wound dressing on naturally occurring canine skin open wounds healed by second intention. In addition to wound area the progress of healing was also monitored using two well-recognized wound assessment scales of human medicine that quantitatively described the status of salient physiologic wound characteristics.
Twelve canine spontaneous cutaneous open wounds healed completely by only second intention were prospectively enrolled. All wounds were treated using a range of wound dressing containing HA from admission to complete re-epithelialization of the wound assessed by clinician. Because wound healing is a dynamic process, the choice of which HA-containing dressing had to be used was modified during healing phases according to salient physiologic wound characteristics and to manufacturer's instruction.
At all clinical control and/or bandage change, for each wound, the wound area and the scale scoring assessments were performed and recorded in double blinded modality by two clinicians with same experience in wound healing assessment. An agreement between two clinicians' evaluations in the application of both scoring systems was also investigated.Based on wound etiology, 7 were traumatic, 2 were primary closure complication and 3 were excised wounds. At admission, the mean and median values of wound area were 72.8 and 32 cm2, respectively. After debridement an increased wound size was obtained while an improvement was determined by both scale score systems. The median number of return to clinic was 5 times, respectively. The mean and median time to complete wound healing were 42.3 and 34.5 days, respectively. The mean wound area at day 7 was 90.4%, at day 14 was 47.7%, at day 21 was 22.4% and at day 28 was 14.8% of the original size. All products were well tolerated. The agreement between the two operators was considered high using both wound healing assessment tools.
Even if no control group was available, considering the short median time of complete epithelialization HA- containing dressing could be consider a possible wound treatment to enhance healing of open wounds in dogs. The assessment of wound parameters in addition to wound area could be useful especially in the earlier healing period and also to direct clinical decision-making. Further studies are needed to confirm these results and to compare HA-containing dressing with other wound therapies
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