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To develop and assess the efficacy of an ultrasound (US)-guided pericapsular hip desensitization (PHD) technique in dogs.Prospective, randomized, anatomical study and a case series.A total of 30 healthy dogs, eight canine cadavers and seven dogs with hip osteoarthritis.After studying the US anatomy of the medial aspect of the coxofemoral joint and determining an acoustic window to perform an US-guided PHD in healthy dogs, the US-guided PHD was performed bilaterally in canine cadavers. A low [(LV) 0.1 mL kgThe US-guided PHD could be performed by inserting the needle between the iliopsoas muscle and the periosteum of the ilium. The articular branches of the femoral and obturator nerves were stained in all cadavers using both volumes. The main femoral nerve was never stained, but the main obturator nerve was stained in 37.5% and 100% of injections using LV and HV, respectively (p = 0.026). Treated animals showed decreased dynamic pain response after the injection. Compared with baseline, CBPI scores were reduced by ≥ 50% for ≥ 12 weeks in all but one dog.The US-guided PHD with both 0.1 and 0.2 mL kg

To assess the feasibility of an ultrasound (US)-guided quadratus lumborum (QL)-psoas muscle (Pm) interfascial plane injection using a dorsoventral (DV) approach, and to compare needle visualization and distribution pattern between DV and ventrodorsal (VD) approaches.Experimental anatomical study.A total of 14 cat cadavers.Bilateral in-plane US-guided injections in the QL-Pm plane were performed at the level of the second lumbar (L2) transverse process. A spinal needle was inserted using either a VD or DV approach. A total volume of 0.4 mL kgThe QL-Pm plane was visualized, and dye was present in the target plane using both approaches. Needle visualization in the VD approach was enhanced compared with the DV approach (p = 0.0005). Mean distribution along the sympathetic trunk was 4.8 and 4.1 segments in the VD and DV approaches, respectively, showing non-statistical differences. The ventral branches of L1, L2 and L3 were successfully stained in 11/14 and 6/14 using the VD and DV approaches, respectively. Substantial agreement (κ = 0.61) of sympathetic trunk staining was observed between CT scan and anatomical dissection. Dye was observed cranial to the diaphragm in 7/8 cases on CT with both approaches. Epidural and abdominal cavity dye distribution was not observed.The DV approach to the QL-Pm plane could be an alternative to the VD approach. Both approaches seem capable of reaching the spinal nerves, the sympathetic trunk and both splanchnic and coeliac nerves in feline cadavers.

Objective To develop an ultrasound-guided dorsal approach to the brachial plexus and to investigate the nerve distribution and staining of a dyed injectate in common kestrel (Falco tinnunculus) cadavers. Study design Prospective, cadaver study. Animals A group of three common kestrel cadavers (six wings). Methods All cadavers were fresh-frozen at –20 °C and thawed for 10 hours at room temperature before the study. The cadavers were placed in sternal recumbency and their wings were abducted. A 8–13 MHz linear-array transducer was placed over the scapulohumeral joint, at the centre of a triangle formed by the scapula and the humerus. The brachial plexus was identified between the scapulohumeralis muscle and the pectoralis major muscle, as hypoechoic structures lying just cranially to the axillary vessels. After ultrasound-guided brachial plexus identification, a 22 gauge, 50 mm insulated needle was advanced in-plane using ultrasound visualization. A volume of 0.5 mL kg–1 of a 3:1 (2% lidocaine:methylene blue) solution was injected. Following cadaver dissection, the pattern of the spread was assessed, and the extent of nerve staining was measured with a calliper and deemed adequate if more than 0.6 cm of the nerve staining was achieved. Results The brachial plexus was clearly identified in all wings with the dorsal approach. After dye injection, all the branches of the brachial plexus defined as nerves 1–5 (N1, N2, N3, N4 and N5) were completely stained in five (83%) and partially stained in one (17%) of the six wings. Conclusions and clinical relevance The ultrasound-guided dorsal approach allows a clear visualization of the brachial plexus structure. The injection of 0.5 mL kg–1of a lidocaine/dye solution produced complete nerve staining in most cases. Further in vivo studies are mandatory to confirm the clinical efficacy of this locoregional anaesthesia technique in common kestrels (Falco tinnunculus).

Este artículo se encuentra disponible en la siguiente URL: https://www.sciencedirect.com/science/article/abs/pii/S1467298721000611?via%3Dihub En este artículo de investigación también participan: Lisa Tarragona y Diego A. Portela. Este es el pre-print del siguiente artículo: Verdier, N., Martinez-Taboada, F., Otero, P. E., Redondo García, J. I., Zaccagnini, A. S., Costoya, A. A., Tarragona, L. & Portela, D. A. (2021). Evaluation of electrical nerve stimulation to confirm sacrococcygeal epidural needle placement in dogs. Veterinary Anaesthesia and Analgesia, vol. 48, i. 4 (jul.), pp. 612?616, que se ha publicado de forma definitiva en https://doi.org/10.1016/j.vaa.2020.12.008. This is the pre-peer reviewed version of the following article: Verdier, N., Martinez-Taboada, F., Otero, P. E., Redondo García, J. I., Zaccagnini, A. S., Costoya, A. A., Tarragona, L. & Portela, D. A. (2021). Evaluation of electrical nerve stimulation to confirm sacrococcygeal epidural needle placement in dogs. Veterinary Anaesthesia and Analgesia, vol. 48, i. 4 (jul.), pp. 612?616, which has been published in final form at https://doi.org/10.1016/j.vaa.2020.12.008. Objectives: To evaluate the use of 0.7 mA as a fixed electrical current to indicate epidural needle placement and to confirm that 0.7 mA is greater than the upper limit of the minimal electrical threshold (MET) for sacrococcygeal epidural needle placement in dogs. Study design: Prospective clinical study. Animals: A group of 20 client-owned dogs. Methods: During general anaesthesia and with standard monitoring, the presence of the 3patellar reflex was confirmed in all dogs. An insulated needle was inserted through the sacrococcygeal intervertebral junction and absence of tail movement was confirmed when a fixed electrical current of 0.7 mA was applied. Then, the needle was further advanced towards the epidural space until the expected motor response was obtained – the 'nerve stimulation test' (NST). The NST was considered positive when a motor response of the muscles of the tail was elicited but not the perineal muscles, whereas it was considered negative when no movement of the tail was evoked. The electrical current was turned to 0 mA and then increased by 0.01 mA increments until tail movement was evoked, this was recorded as the MET. In the positive NST cases, 0.05 mL cm-1 occipitococcygeal length of 2% lidocaine or 0.25-0.5% bupivacaine was administered. Epidural blockade was confirmed by the loss of patellar reflex. Descriptive statistics were used to present data. Results: Sacrococcygeal epidural needle placement, corroborated by loss of the patellar reflex, was correctly predicted in 89.5% (95% confidence interval: 68.6%-97.1%) of the cases. The MET was 0.22 mA (0.11-0.36). Conclusions and clinical relevance: A current of 0.7 mA is approximately twice the upper limit of the MET for epidural placement. Therefore, this study demonstrates, with a success rate of 89.5%, the adequacy of using 0.7 mA as the fixed electrical current to detect sacrococcygeal epidural needle placement in dogs. Preprint

Objective To describe the sonoanatomy of the abdominal wall in live cats and to compare the distribution pattern of two versus three ultrasound-guided transversus abdominis plane (TAP) injections using clinically applicable volumes of lidocaine–dye solution in cat cadavers. Study design Prospective anatomical study. Animals A total of eight client-owned healthy cats and eight cat cadavers. Methods Ultrasound anatomy of the abdominal wall, landmarks and sites for needle access were determined in live cats. Ultrasound-guided TAP injections were performed in eight thawed cat cadavers. Volumes of 0.25 or 0.16 mL kg−1 per point of a lidocaine–dye solution were injected using either two [subcostal and preiliac (SP)] or three [subcostal, retrocostal and preiliac (SRP)] injection points, respectively. Each cadaver was then dissected to determine the injectate distribution and the number of thoracolumbar nerves stained with each approach. The target nerves were defined as the ventromedial branches of the thoracic nerves 10 (T10), T11, T12, T13 and lumbar nerves 1 (L1) and L2. Results Sonoanatomy was consistent with anatomy upon dissection and the TAP was identified in all cadavers. A total of 16 subcostal, 16 preiliac and nine retrocostal TAP injections were performed. The overall staining success rate of the target nerves was 66.7% and 92.6% for the SP and SPR approaches, respectively (p = 0.02). The ventromedial branches of T10, T11, T12, T13, L1 and L2 were stained in 57.1%, 100.0%, 85.7%, 28.6%, 42.9% and 85.7%, and in 66.7%, 100.0%, 100.0%, 100.0%, 88.9% and 100.0% of the cases with the SP and SRP approaches, respectively. Conclusions and clinical relevance The SRP approach allowed a broader distribution around the target nerves, whereas a staining gap was observed at T13 and L1 with the SP approach. Further studies are necessary to investigate the analgesic effect of these approaches in a clinical setting.

Objective To develop an ultrasound-guided approach to intercostal nerve injection and to compare the success rate of intercostal nerve injections using blind or ultrasound-guided technique in canine cadavers. Study design Prospective, randomized, descriptive, experimental anatomic study. Animals A total of 14 mid-sized adult canine cadavers. Methods Ultrasound landmarks were identified by dissection of four cadavers and used to develop an ultrasound-guided technique. The remaining 10 cadavers were randomly assigned to blind (five cadavers) or ultrasound-guided (five cadavers) injections of the third to the ninth intercostal nerves bilaterally with 0.03 mL kg–1 of colorant per injection. The target for intercostal injections was the caudal border of the respective rib, between the internal intercostal membrane and the parietal pleura. Additionally, displacement of the parietal pleura without visible intramuscular distribution was considered the end point for ultrasound-guided injections. For each cadaver, a practitioner in training performed the blocks on one hemithorax, while an experienced practitioner performed the blocks on the opposite hemithorax. Injections were considered successful if ≥1 cm of the target nerve was stained with colorant upon dissection. Success rates and length of nerve staining were analyzed with Fisher’s exact and t tests, respectively. Data were considered statistically different with p Results Success rates of blind and ultrasound-guided technique were 57.1% and 91.4%, respectively (p Conclusions and clinical relevance Ultrasound guidance improves the accuracy of intercostal nerve injections when compared with blind technique, independently of the level of expertise in regional anesthesia.

Objective To compare the dye distribution following either two lateral abdominal or one lateral abdominal and one subcostal ultrasound-guided transversus abdominis plane (TAP) injections of a clinically relevant volume of dye solution in dogs. Study design Randomized cadaveric study. Animals A total of eight canine cadavers. Methods On one side of each cadaver, two TAP injections were performed on the lateral aspect of the abdomen (approach LL), caudal to the last rib and cranial to the iliac crest. On the contralateral hemiabdomen, one subcostal (caudal to the costal arch) and one lateral abdominal injection (between last rib and iliac crest), were performed (approach SL). Side allocation was randomly determined. A spinal needle was introduced in-plane to the transducer for each injection of methylene blue (0.25 mL kg−1). All cadavers were dissected to assess dye distribution and number of stained target nerves. Results All injections were performed in the TAP. The proportion of target nerve staining was 53.5% versus 80.4% with approaches LL and SL, respectively (p = 0.005). Approach LL stained the first lumbar (L1) spinal nerve in 100% of injections and ninth thoracic (T9), T10, T11, T12, T13 and L2 were stained in 0%, 0%, 37.5%, 62.5%, 87.5% and 87.5% of injections, respectively. Approach SL stained T11, L1 and L2 in 100% of injections and T9, T10, T12 and T13 were stained in 37.5%, 87.5%, 75% and 62.5% of injections, respectively. Approach SL resulted in greater staining of nerves cranial to T12 compared with approach LL. The two approaches were equivalent in staining nerves caudal to T12. Conclusions and clinical relevance Approach SL provided a broader distribution of the injected solution than approach LL, which may result in a larger blocked area in live animals undergoing celiotomy.

To analyze the role of PEEP on dynamic relative regional strain (DRRS) in a model of ARDS, respective maps were generated by electrical impedance tomography (EIT).Eight ARDS pigs submitted to PEEP steps of 0, 5, 10, and 15 cm HAt constant ventilation, respiratory compliance increased progressively with PEEP (lowest value at zero PEEP 10 ± 3 mL/cm HEIT-derived DRRS maps showed high strain in ventral lung zones at low levels of PEEP. The findings suggest overdistention of the baby lung.

To investigate the injectate spread and nerve staining of ultrasound-guided erector spinae plane (ESP) injections at the thoracolumbar spine in canine cadavers.Prospective, randomized, descriptive, anatomic study.A total of 15 canine cadavers.The location of the medial and lateral branches of the dorsal branches of the spinal nerves (DBSN) from the tenth thoracic (T10) to the third lumbar vertebra (L3) were identified by dissection of three cadavers. ESP injections of dye (0.5 mL kgGross anatomic dissections showed that the medial and lateral branches of the DBSN change their path in relation to the epaxial muscles caudal to T11. Approaches ESPThese results suggest that the mammillary process should be used as anatomic landmark to perform ultrasound-guided ESP blocks in the thoracolumbar spine caudal to T11 when targeting the medial branches of the DBSN. Injections should be performed one spinal segment caudal to the level intended to desensitize.

Amorphous silicon thin film solar cells exhibit a degrading effect during the first hours of illumination. This phenomenon is worsen by thick intrinsic layers, thus light trapping strategies are employed to increase optical absorption. We use a method developed to measure the performance of these techniques. The procedure allows us to approximate both, the effective path of light inside the cell and the collection length of carriers, out of the internal quantum efficiency. Simulated and experimental data were compared finding good agreement.

A cat was anaesthetised with midazolam and alfaxalone for a pelvic limb amputation due to a metatarsal fracture complicated with soft tissue necrosis. The femoral nerve and lumbosacral trunk were blocked with ropivacaine 0.75 per cent using a combined ultrasound/nervestimulation-guided approach. Anaesthesia was maintained with end-tidal concentrations of isoflurane between 1 per cent and 1.1 per cent. Vital parameters were stable during anaesthesia although moderate hypothermia (33.6°C–35.5°C) was encountered. The lateral cutaneous branch of the femoral nerve was desensitised with lidocaine 2 per cent at the end of the surgical procedures. The cat recovered well from anaesthesia and received meloxicam 0.05 mg/kg daily for postoperative pain treatment. Repeated evaluations using a composite pain scale showed values compatible with low probability of pain during the following 48 hours. Only one dose of methadone (0.2 mg/kg) was given. The combined femoral nerve and lumbosacral trunk block provided optimal intraoperative antinociception and postoperative pain relief.

Objectives To describe the ultrasonographic anatomy of the caudal lumbar spine in cats and to detect ultrasound (US) signs associated with epidural or intrathecal injection. Study design Prospective, clinical study. Animals Twenty‐six client‐owned cats. Methods Transverse (position 1) and parasagittal (position 2) two‐dimensional US scanning was performed over the caudal lumbar spine in all cats. Midline distances between the identified structures were measured. Cats assigned to epidural injection (group E, n = 16) were administered a bupivacaine–morphine combination confirmed by electrical stimulation. Cats assigned to intrathecal injection (group I, n = 10) were administered a morphine–iohexol combination injected at the lumbosacral level and confirmed by lateral radiography. The total volume injected (0.3 mL kg −1 ) was divided into two equal aliquots that were injected without needle repositioning, with the US probe in positions 1 and 2, respectively. The presence or absence of a burst of color [color flow Doppler test (CFDT)], dural sac collapse and epidural space enlargement were registered during and after both injections. Results US scanning allowed measurement of the distances between the highly visible structures inside the spinal canal. CFDT was positive for all animals in group E. In group I, intrathecal injection was confirmed in only two animals, for which the CFDT was negative; seven cats inadvertently and simultaneously were administered an epidural injection and showed a positive CFDT during the second aliquot injection, and the remaining animal was administered epidural anesthesia and was excluded from the CFDT data analysis. Dural sac collapse and epidural space enlargement were present in all animals in which an epidural injection was confirmed. Conclusions and clinical relevance US examination allowed an anatomical description of the caudal lumbar spine and real‐time confirmation of epidural injection by observation of a positive CFDT, dural sac collapse and epidural space enlargement.

Objective To determine if a nerve stimulation test (NST) could act as a monitoring technique to confirm sacrococcygeal epidural needle placement in cats. Study design Prospective experimental trial in a clinical setting. Animals Twenty-four adult cats, scheduled for a therapeutic procedure where epidural anesthesia was indicated. Methods Under general anesthesia, an insulated needle was inserted through the S 3 -Cd 1 intervertebral space guided by the application of a fixed electrical current (0.7 mA) until a motor response was obtained. The NST was considered positive when the epidural nerve stimulation produced a motor response of the muscles of the tail, whereas it was considered negative when no motor response was evoked. In the NST positive cases, 0.3 mL kg −1 of 0.5% bupivacaine was administrated before needle withdrawal. Ten minutes after injection, epidural blockade was confirmed by the loss of perineal (anal), and pelvic limbs reflexes (patellar and withdrawal). Results The use of a fixed electrical stimulation current of 0.7 mA resulted in correct prediction of sacrococcygeal epidural injection, corroborated by post bupivacaine loss of perineal and pelvic limb reflexes, in 95.8% of the cases. Conclusion and clinical relevance This study demonstrates the feasibility of using, in a clinical setting, an electrical stimulation test as an objective and in real-time method to confirm sacrococcygeal epidural needle placement in cats.

To determine the minimal electrical threshold (MET) necessary to elicit appropriate muscle contraction when the tip of an insulated needle is positioned epidurally or intrathecally at the L5-6 intervertebral space (phase-I) and to determine whether the application of a fixed electrical current during its advancement could indicate needle entry into the intrathecal space (phase-II) in dogs.Prospective, blinded study.Thirteen (phase-I) and seventeen (phase-II) dogs, scheduled for a surgical procedure where L5-6 intrathecal administration was indicated.Under general anesthesia, an insulated needle was first inserted into the L5-6 epidural space and secondly into the intrathecal space and the MET necessary to obtain a muscular contraction of the pelvic limb or tail at each site was determined (phase-I). Under similar conditions, in dogs of phase-II an insulated needle was inserted through the L5-6 intervertebral space guided by the use of a fixed electrical current (0.8 mA) until muscular contraction of the pelvic limb or tail was obtained. Intrathecal needle placement was confirmed by either free flow of cerebrospinal fluid (CSF) or myelography.The current required to elicit a motor response was significantly lower (p 0.0001) when the tip of the needle was in the intrathecal space (0.48 ± 0.10 mA) than when it was located epidurally (2.56 ± 0.57). The use of a fixed electrical stimulation current of 0.8 mA resulted in correct prediction of intrathecal injection, corroborated by either free flow of CSF (n = 12) or iohexol distribution pattern (n = 5), in 100% of the cases.Nerve stimulation may be employed as a tool to distinguish epidural from intrathecal insulated needle position at the L5-6 intervertebral space in dogs. This study demonstrates the feasibility of using an electrical stimulation test to confirm intrathecal needle position in dogs.

Objective To determine the minimal electrical threshold (MET) necessary to elicit muscle contraction of the pelvic limb or tail when an insulated needle is positioned outside (MET out ) and inside (MET in ) the lumbosacral epidural space in cats. Study design Prospective, blinded study. Animals Twelve mixed-breed healthy adult cats, scheduled for a therapeutic procedure where lumbosacral epidural administration was indicated. Methods Under general anesthesia, an insulated needle was advanced through tissues of the lumbosacral interspace until its tip was thought to be just dorsal to the interarcuate ligament. An increasing electrical current (0.1 ms, 2 Hz) was applied through the stimulating needle in order to determine the MET necessary to obtain a muscle contraction of the pelvic limb or tail (MET out ), and then 0.05 mL kg −1 of iohexol was injected. The needle was further advanced until its tip was thought to be in the epidural space. The MET was determined again (MET in ) and 0.2 mL kg −1 of iohexol was injected. The cats were maintained in sternal position. Contrast medium spread was determined through lateral radiographic projections. Results The radiographic study confirmed the correct needle placement dorsal to the interarcuate ligament in all cats. When the needle was placed ventrally to the interarcuate ligament, iohexol was injected epidurally in ten and intrathecally in two cats. The MET out and MET in was 1.76 ± 0.34 mA and 0.34 ± 0.07 mA, respectively ( p Conclusion and clinical relevance Nerve stimulation can be employed as a tool to determine penetration of the interarcuate ligament but not the piercing of the dura mater at the lumbosacral space in cats.

In this paper hydrogenated amorphous silicon (a-Si:H) thin film solar cells have been investigated using advanced simulation tools and the obtained electrical values were compared with experimental results. The analysis considers the effects of series resistance and shunt leakage. The simulation tool is parameterized with standard theoretical models for the density of states in the mobility gap, generation/recombination statistics, and experimental optical data of a-Si:H thin films. Experimental measurements were used to implement a textured TCO. Calculation of the illuminated and dark current voltage characteristics for the initial and stabilized states of the ideal solar cell was done. The ideal device was adjusted to the experimental curves using a non-ohmic model for the shunt leakage (simulated as microscopic pip structures, arisen due to aluminum diffusion) and an ohmic series resistance, finding good correspondence. The simulation shows that these mechanisms reduce the cell’s efficiency in around an absolute 1%.

Objective—To determine the minimal electric threshold of neurostimulation dorsally and ventrally to the interarcuate ligament in the lumbosacral area necessary to cause muscle contraction of the hind limb or tail and determine whether a continuous electrical stimulation applied to an insulated needle during lumbosacral epidural needle placement could be used to distinguish the epidural from the intrathecal space in rabbits. Animals—24 New Zealand white rabbits. Procedures—Rabbits received iohexol (0.2 mL/kg) either dorsally (group 1) or ventrally to the interarcuate ligament in the lumbosacral area (groups 2 and 3). Correct placement of the needle was determined by use of the loss of resistance to injection technique (group 2) or a continuous electrical stimulation (group 3) and confirmed by examination of the iohexol distribution pattern on radiographs. Results—In all rabbits of group 1, iohexol was injected in the lumbosacral area, outside the epidural space. In groups 2 and 3, iohexol was injected intrathecally. No pure iohexol epidural migration of iohexol was observed. Mean ± SD minimal electric threshold to elicit a motor response was 1.2 ± 0.3 mA, 0.3 ± 0.1 mA, and 0.3 ± 0.1 mA in groups 1, 2, and 3, respectively. Conclusions and Clinical Relevance—Neurostimulation was a useful technique to determine correct intrathecal needle placement in rabbits but failed to detect the lumbosacral epidural space when the common technique, used in dogs and cats for the lumbosacral epidural approach, was used.

Objective To describe the landmarks and methodology to approach the thoracic paravertebral space in dogs; to evaluate if intercostal muscular response could be evoked by a nerve-stimulator; to radiographically assess the distribution pattern of a radio-opaque contrast medium after thoracic paravertebral injections. Study design Randomized, controlled, experimental trial. Animals Two mongrel dog cadavers (anatomical study) and 24 mongrel dogs (experimental study). Methods For the anatomic study 0.2 mL kg −1 of new methylene blue (NMB) was injected at the 5th thoracic paravertebral space; for the experimental study dogs were divided into three groups and received 1 (T 5 ), 2 (T 4 and T 6 ) or 4 (T 4 , T 5 , T 6 and T 7 ) paravertebral injections of iohexol. The paravertebral approach was performed with insulated needles using landmarks and a blind technique. When the needle tip reached the respective thoracic paravertebral space, the nerve-stimulator was switched-on and the presence/absence of intercostal muscular twitch was registered, thus a total volume of 0.2 mL kg −1 of iohexol, divided into equal parts for each injection point, was administered. Radiological studies were performed with two orthogonal projections at different times. Positive injection was confirmed when the paravertebral space was occupied by iohexol in both projections. Results NMB was distributed in the T 5 paraverterbal space. In the experimental study, when the needle tip reached the respective paravertebral space, intercostal twitching was obtained in 80% of the total injections with a stimulating current of 0.5 mA. The incidence of positive cases when the intercostal twitch was obtained with 0.5 mA was 83.3%. The main distribution pattern observed was cloud like without longitudinal diffusion. Conclusion and clinical relevance Intercostal muscular responses obtained with a stimulating current of 0.5 mA could be useful to locate thoracic spinal nerves in dogs and in our study the injected solution was confined to one thoracic paravertebral space.

Study Objective To compare duration of labor, mode of delivery, and local anesthetic consumed in women who received labor analgesia with epidural or combined spinal-epidural technique. Design Retrospective, observational study. Setting Delivery room of a university hospital. Patients 788 nulliparous women in labor at term with cervical dilation between three and 5 cm. Interventions In Group E (epidural alone), parturients received an epidural solution of 8 mL (levobupivacaine 0.125% with fentanyl 5 μg/mL). In Group CSE (combined spinal-epidural), parturients received a spinal injection of levobupivacaine two mg with fentanyl 15 μg (total volume two mL). Then an epidural catheter was placed in all patients and connected to a patient-controlled analgesia pump (basal infusion rate of 8 mL/hr of 0.1% levobupivacaine and fentanyl two μg/mL, patient-controlled bolus dose of three mL, and lockout time of 30 min). Measurements Labor duration, mode of delivery (spontaneous vaginal vs. instrumental delivery vs. cesarean section), and local anesthetic consumed, were recorded. Main Results Labor analgesia was performed with an epidural technique in 322 patients (40.9%), and a combined spinal-epidural technique in 466 patients (59.1%), of whom 39 Group E women (12.1%) and 46 Group CSE women (9.9%) required cesarean section ( P =ns). No differences in the mode of delivery were observed between the groups. Time from analgesia to delivery (Group E: 217 ± 111 min vs. Group CSE: 213 ± 115 min; P =ns), and epidural local anesthetic consumed (Group E: 35 ± 20 mL vs. Group CSE: 33 ± 20 mL; P =ns), were similar in both groups. Conclusions No significant differences were observed between epidural and combined spinal-epidural given for labor analgesia in nulliparous women in duration of labor, mode of delivery, or local anesthetic consumed.

The purpose of this study was to investigate the pharmacokinetics of ceftriaxone after single intravenous (i.v.), intramuscular (i.m.) and subcutaneous (s.c.) doses in healthy dogs. Six mongrel dogs received ceftriaxone (50 mg/kg) by each route in a three-way crossover design. Blood samples were collected in predetermined times after drug administration. Results are reported as mean +/- standard deviation (SD). Total body clearance (Cl(t)) and apparent volume of distribution (V(z)) for the i.v. route were 3.61 +/- 0.78 and 0.217 +/- 0.03 mL/kg, respectively. Terminal half-life harmonic mean (t(1/2 lambda)) was 0.88; 1.17 and 01.73 h for the i.v., i.m and s.c. routes, respectively. Mean peak serum concentration (C(max)) was 115.10 +/- 16.96 and 69.28 +/- 14.55 microg/mL for the i.m and s.c. routes, respectively. Time to reach C(max) (t(max)) was 0.54 +/- 0.24 and 1.29 +/- 00.64 h for the i.m and s.c. routes, respectively. Mean absorption time (MAT) was 1.02 +/- 0.64 and 2.23 +/- 00.73 h for the i.m and s.c. routes, respectively. Bioavailability was 102 +/- 27 and 106 +/- 14% for the i.m and s.c. routes, respectively. Statistically significant differences were determined in C(max), t(max), MAT and t(1/2 lambda) of s.c. administered ceftriaxone when compared with the i.v and i.m. routes. These findings suggest that once or twice s.c. or i.m. daily administered ceftriaxone should be adequate to treat most susceptible infections in dogs.