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Objective: To evaluate the accuracy with which veterinary anaesthetists and nurses of different experience draw up small volumes of liquid., Study Design: Prospective blinded randomized study., Methods: A group of seven European College of Veterinary Anaesthesia and Analgesia (ECVAA) diplomates, six ECVAA residents and six anaesthesia nurses participated in the study. For each participant, five target volumes between 0.01 and 1.0 mL were randomly allocated. They were drawn up 20 times in random order using a 1 mL syringe attached to a 23 gauge needle. A total of 1900 measurements were analysed. An investigator filled the syringe and needle dead space with water for injection before each experiment. The change in mass of the syringe once filled to the target volume was used to calculate the actual volume of liquid drawn up., Results: Large errors were made with measurements < 0.04 mL, so they were excluded from the statistical analysis. There was a significant effect of the target volume (p < 0.001) and of the order (p < 0.01). For each mL increase in the target volume, the absolute error decreased by 4% and from the first to the hundredth withdrawal each participant's absolute error decreased by 1%. The target volume was underestimated in 52.3% of measurements, 42% were overestimated and 5.7% were on target. None of the between-subject predictor variables approached significance., Conclusions and Clinical Relevance: Accuracy of veterinary anaesthetists and nurses in drawing up medications decreases as the target volume becomes smaller. Small veterinary patients receive small volumes of anaesthetic drugs with higher risks of overdosing compared with larger dogs. Years of experience and staff grade are not associated with greater accuracy. Large percentage errors may be seen with target volumes less than 0.04 mL. Dilutions are recommended for volumes > 0.19 mL in 1 mL syringe., (Crown Copyright © 2023. Published by Elsevier Ltd. All rights reserved.)

Objective: To investigate the analgesic effect of epidural morphine after surgical extrahepatic portosystemic shunt (EHPSS) attenuation., Study Design: Randomized clinical trial., Animals: A total of 20 dogs with a congenital EHPSS., Methods: Dogs were randomly allocated to be given either a single epidural dose of 0.2 mg kg -1 preservative-free morphine (group M) or not (group C) before surgery. All dogs were administered 0.3 mg kg -1 methadone intravenously (IV) as preanaesthetic medication. Pain scores were determined every 2 hours for the first 24 hours postoperatively using the short-form Glasgow Composite Measure Pain Scale (GCMPS-SF). Dogs with a GCMPS-SF pain score >4/20 or >5/24 received 0.1 mg kg -1 methadone IV as rescue analgesia and were reassessed 30 minutes later. If more than three doses of methadone were administered in a 2 hour period, alternative pain relief was provided and a treatment failure recorded. The GCMPS-SF pain scores and number of rescue analgesia injections were analysed over 24 hours. The last observation carried forward method was applied in case of treatment failure. Food consumption and time to first urination were recorded. Data were analysed using a Mann-Whitney U test and presented as median (minimum-maximum range), with significance set at p < 0.05., Results: Group M showed lower GCMPS-SF pain scores [15 (11-41) versus 31 (11-86); p = 0.023] and lower postoperative methadone requirements [0 (0-0.2) versus 0.25 (0-0.5) mg kg -1 ; p = 0.029] than group C. There were three treatment failures in group C only. Food consumption and time to first urination did not differ between groups., Conclusions and Clinical Relevance: Epidural morphine reduced the requirement for postoperative analgesia in this study population., (Copyright © 2019 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objectives: The aim of this study was to report the incidence of anaesthetic complications associated with feline bronchoscopy., Methods: This was a retrospective analysis of anaesthetic records and electronic case logs of feline bronchoscopies at two university hospitals (centres B and L) between January 2013 and December 2015. A two-tailed Fisher's exact test was used for comparison of variables and outcomes between centres., Results: Seventy-nine cases were included. Desaturation (SpO 2 <90%) was the most frequently encountered complication, reported in 24 cats (30.3%); centre B reported significantly less desaturation than centre L (22.4% vs 52.4%; P = 0.014). The use of an endotracheal tube or laryngeal mask airway resulted in a lower incidence of desaturation (22.9% vs 22.2%) than the use of a tracheal catheter through which oxygen was insufflated (48.0%). The latter method was associated with an increased incidence of desaturation ( P = 0.034). Patients to which terbutaline was administered had a lower incidence of desaturation (27.5%) than those that did not receive it (35.7%), although this was not statistically significant ( P = 0.46). Airway management method and the use of terbutaline differed significantly between centres, as did the profile of complications. Pneumothorax was encountered in two cats (2.5%) and cardiac arrest resulting in the death in one of these cats (1.3%)., Conclusions and Relevance: Desaturation is a frequently encountered complication during and after bronchoscopy. Airway management method and the use and timing of terbutaline warrant prospective evaluation for their role in decreasing the incidence of desaturation. Bronchoscopy is a high-risk procedure with frequent requirement for post-procedure oxygen supplementation. Pneumothorax and cardiac arrest are potential complications.

Objective: To compare sedative and analgesic properties of buprenorphine or morphine for standing procedures combined with a detomidine continuous rate infusion (CRI)., Study Design: Blinded, prospective, randomized clinical pilot study., Animals: Ten horses presented for dental or sinus procedures., Methods: Horses received 0.02 mg kg(-1) acepromazine intravenously (IV), followed 30 minutes later by detomidine 10 μg kg(-1) IV. Five minutes later, buprenorphine 0.01 mg kg(-1) (n = 6) or morphine 0.1 mg kg(-1) (n = 4) was administered IV. Detomidine was administered by CRI (0.2 μg kg(-1) minute(-1)) and adjusted to maintain appropriate sedation. Heart rate, respiratory frequency, gastrointestinal motility and rectal temperature were measured; pain, ataxia and sedation were scored. Sedation, pain scores and ataxia scores were analysed using a mixed linear model. Detomidine dose and procedure success scores were compared using Wilcoxon's rank sum test. Complications between groups were analysed using Fisher's exact test., Results: Two horses had incomplete data. Weights and ages were not different between groups (p = 0.15 and p = 0.42, respectively). The dose rate for detomidine was not different between groups (0.33 ± 0.02 μg kg(-1) minute(-1) in the buprenorphine group and 0.33 ± 0.05 μg kg(-1) minute(-1), in the morphine group p = 0.89). Intraoperative visual analogue scale scores were greater after buprenorphine than morphine (mean ± SD, buprenorphine 48 ± 4, morphine 40 ± 5, p = 0.0497). Procedure duration was not different between groups (buprenorphine 142 ± 33, morphine 140 ± 12 minutes). All horses treated with buprenorphine experienced complications compared with none in the morphine group (p = 0.0286)., Conclusions and Clinical Relevance: At the doses used, buprenorphine produced greater sedation but more post-operative complications than morphine. However, Type I or Type II errors cannot be excluded and larger studies are required to confirm these findings., (© 2015 Association of Veterinary Anaesthetists and the American College of Veterinary Anesthesia and Analgesia.)

Introduction: In clinical practice, evaluating dynamic compliance of the respiratory system (Cdyn) could provide valuable insights into respiratory mechanics. Reference values of Cdyn based on body weight have been reported, but various factors may affect them and the evidence is scanty. This study aimed to establish a reference interval for Cdyn and identify associated variables. Methods: Data were collected from 515 client-owned dogs requiring anesthesia, excluding those with lower airway disease. The dogs were anesthetized, the tracheas intubated, and lungs ventilated at clinicians' discretion across 11 centers in six countries, with no restrictions on anesthesia protocols or ventilation settings, except avoiding inspiratory pauses. Three Cdyn measurements from three consecutive breaths per dog were recorded using a standardized form, which also documented factors affecting Cdyn identified through literature and an online survey. Various spirometry technologies were used. The substantial variance in Cdyn measurements led to a comprehensive analysis using a multiple linear regression model. Multicollinearity (variables highly correlated with each other) was addressed by investigating, transforming, or excluding factors. Initial simple linear regression assessed each variable's individual effect on Cdyn, followed by a multiple linear regression model constructed via stepwise forward selection and backward elimination. Results: The best-fitting model identified a linear relationship between Cdyn and body mass when the following conditions were met: high BCS (Body Condition Score), orotracheal tubes <7% smaller than predicted, the use of a D-lite flow sensor, and the absence of a high FIO2 (>80%) exposure for more than 10 minutes before Cdyn measurement. In cases where these conditions were not met, additional factors needed to be incorporated into the model. Low (1/9, 2/9, 3/9) and medium (4/9, 5/9) BCS, an orotracheal tube of the predicted size or larger and longer inspiratory times were associated with increased Cdyn. The use of alternative spirometry sensors, including Ped-lite, or prolonged exposure to high FIO2 levels resulted in decreased Cdyn. Conclusion and clinical relevance: Establishing a reference interval for Cdyn proved challenging. A single reference interval may be misleading or unhelpful in clinical practice. Nevertheless, this study offers valuable insights into the factors affecting Cdyn in healthy anesthetized dogs, which should be considered in clinical assessments. [ABSTRACT FROM AUTHOR]

Objective: To compare the incidence of corneal injury during general anesthesia (GA) and the immediate post‐operative period in eyes protected with topical ocular lubricant alone with eyes protected with topical lubricant followed by complete eyelid closure using tape. Animals Studied: One hundred client‐owned dogs (200 eyes) undergoing GA for MRI scan. Methods: Patients had ocular lubricant applied to both eyes upon induction of anesthesia. One eye was taped closed immediately after induction for the duration of anesthesia using Strappal® tape (BSN medical™; treatment group), and the other eye was not taped (control group). Eyes were randomly allocated to a treatment group. Ophthalmic examination was performed before and after anesthesia; the examiner was masked to eye treatment groups. Corneal injury was defined as corneal ulceration or corneal erosion. A McNemar's test was used to compare the incidence of corneal injury between groups. A paired‐samples t‐test was used to compare Schirmer‐1 tear test (STT‐1) readings between groups. Results: Sixteen eyes (8%) developed corneal erosion. No corneal ulceration occurred. There was no significant difference between incidence of corneal erosion between groups (p =.454). There was a significant decrease in STT‐1 readings following GA in both groups (p <.001), with no significant difference in STT‐1 between groups (p =.687). No adverse effects of taping the eye closed were observed. Conclusion: Taping the eyes closed during GA had no additional benefit to the lubrication protocol used in this study. [ABSTRACT FROM AUTHOR]

This report describes the perioperative anaesthesia and analgesia management of a 4‐month‐old lamb undergoing surgical decompression of a paraspinal abscess while adhering to the drug‐prescribing cascade. This is a legal requirement covered under UK prescribing regulations. Premedication with 2 μg/kg detomidine and 0.1 mg/kg butorphanol preceded induction, with 6 mg/kg ketamine administered to effect. General anaesthesia was maintained with isoflurane in 100% oxygen, 1 μg/kg/h detomidine and 10 μg/kg/min ketamine. Additional analgesia was provided with 10 mg/kg paracetamol, 0.5 mg/kg meloxicam and infiltration of 10 mg lidocaine. Postoperative analgesia was achieved with ketamine 5 μg/kg/min IV, butorphanol 0.1 mg/kg IV q6h, 0.5 mg/kg meloxicam IV q24h and 10 mg/kg paracetamol IV q8h. A withdrawal period of 28 days for meat/offal and 15 days for milk was recommended. Neurological improvement was observed, and the lamb was discharged at 7 days. [ABSTRACT FROM AUTHOR]

This study evaluated the breathing pattern and distribution of ventilation in horses prior to and following recovery from general anaesthesia using electrical impedance tomography (EIT). Six horses were anaesthetised for 6 hours in dorsal recumbency. Arterial blood gas and EIT measurements were performed 24 hours before (baseline) and 1, 2, 3, 4, 5 and 6 hours after horses stood following anaesthesia. At each time point 4 representative spontaneous breaths were analysed. The percentage of the total breath length during which impedance remained greater than 50% of the maximum inspiratory impedance change (breath holding), the fraction of total tidal ventilation within each of four stacked regions of interest (ROI) (distribution of ventilation) and the filling time and inflation period of seven ROI evenly distributed over the dorso-ventral height of the lungs were calculated. Mixed effects multi-linear regression and linear regression were used and significance was set at p<0.05. All horses demonstrated inspiratory breath holding until 5 hours after standing. No change from baseline was seen for the distribution of ventilation during inspiration. Filling time and inflation period were more rapid and shorter in ventral and slower and longer in most dorsal ROI compared to baseline, respectively. In a mixed effects multi-linear regression, breath holding was significantly correlated with PaCO2 in both the univariate and multivariate regression. Following recovery from anaesthesia, horses showed inspiratory breath holding during which gas redistributed from ventral into dorsal regions of the lungs. This suggests auto-recruitment of lung tissue which would have been dependent and likely atelectic during anaesthesia. [ABSTRACT FROM AUTHOR]

Objective To compare perioperative trends in plasma colloid osmotic pressure (COP) between horses undergoing orthopedic and colic surgery. Design Prospective clinical study September 2009-January 2011. Setting Veterinary university teaching hospital. Animals Thirty-three healthy, client-owned horses presenting for orthopedic surgery (non-GI) and 85 client-owned horses presenting for emergency exploratory celiotomy (GI, gastrointestinal). Interventions None. Measurements Data relating to the horse's parameters on presentation, surgical lesion, post-operative management and survival were extracted from computerized clinical records. Heparinized blood samples were taken on presentation (PreOp, pre-operative), on recovery from anesthesia (T0), at 12 (T12) and 24 (T24) hours post recovery. COP was measured within 4 hours of collection. Results There was no significant difference in PreOp or T0 COP between groups. Both groups had a significant decrease in COP during anesthesia. When compared to their respective pre-operative values, horses in the non-GI group had significantly increased COP at T12, whereas those in the GI group had significantly reduced COP. This trend was continued at T24. Horses in the GI group placed on intravenous crystalloid isotonic fluids post-operatively had a significantly lower COP at T12 and T24. Horses in the GI group that did not survive had significantly lower post-operative COP values at T24. Conclusions Horses undergoing exploratory celiotomy had significantly lower COP post-operatively than those horses undergoing orthopedic surgery. This difference was more marked in those horses receiving isotonic crystalloid intravenous fluid therapy post-operatively and in those that did not survive to discharge. In the non-GI group an increase in COP post-operatively was common. [ABSTRACT FROM AUTHOR]