Muscle relaxants in canine anaesthesia 2: Clinical application

There are a variety of factors which are likely to influence the action of muscle relaxants in canine anaesthesia. These include age, body temperature and muscle diseases. Of the anaesthetic agents it is only the inhalational anaesthetic agents which significantly increase the duration of action of muscle relaxants. Antibiotic therapy particularly with the aminoglycoside antibiotics is likely to increase their duration of action. The indications for the use of muscle relaxants and the main contraindications such as the absence of anaesthetic equipment and the inability to ensure unconsciousness are discussed. The choice of anaesthetic technique together with a discussion on the premedication induction and maintenance of anaesthesia are important factors when using relaxants as is the technique of artificial ventilation. The various advantages and disadvantages of neuromuscular block monitoring are discussed as is the reversal of neuromuscular block.     

The use of muscle relaxants in veterinary anaesthesia

Extract

A balanced anaesthetic technique should be capable of providing sleep, analgesia, and muscular relaxation. By using a specific drug to provide muscle relaxation, the amount of general anaesthetic needed may be reduced. Relaxation of skeletal muscles during anaesthesia often makes access to the surgical site easier and in this way minimizes surgical trauma. Because the voluntary muscles are relaxed, operative procedures may be more easily accomplished.     

Muscle disorders and rehabilitation in canine athletes.

Muscle disorders associated with physical exertion in human athletes include delayed-onset muscle soreness, muscle strain, muscle tears, rhabdomyolysis, and acute and chronic compartment syndromes. Given that the structure of muscle is similar among different species, it is reasonable to expect that dogs experience the same phenomena. This article focuses on several of the muscle disorders of bird dogs, namely, coccygeal muscle injury and infraspinatus muscle contracture, and on those of dogs involved in tracking-obedience-protection training, namely, fibrotic myopathy, with an additional discussion of muscle strain. For injury prevention, one important area that can be adapted to canine athletes is the incorporation of warm-up and cool-down into the training program.     

Antimuscarinic premedication in canine anaesthesia: a comparison of atropine, hyoscine and glycopyrrolate

Anticholinergic drugs are commonly given as preanaesthetic medication to reduce secretions and bradycardia. In this trial, clinical cases were given atropine, hyoscine or glycopyrrolate on a logarithmic dose scale. Another group was not given any anticholinergic agent. Anaesthesia was induced with thiopentone and maintained with halothane in oxygen and nitrous oxide. All the anticholinergic drugs decreased salivation although there was also a small fall in salivation in the control group. Pulse rates rose on induction and fell over the course of anaesthesia in the control group but the mean pulse rates did not fall below the normal range. Atropine and hyoscine produced a tachycardia followed by a fall in pulse rate similar to the control group during anaesthesia. Glycopyrrolate maintained the pulse at the same level throughout. In view of the disadvantages of tachycardia, glycopyrrolate is probably the anticholinergic agent of choice when such a drug is indicated.     

Dexmedetomidine continuous rate infusion during isoflurane anaesthesia in canine surgical patients

OBJECTIVE: To determine the effects of three rates of dexmedetomidine (DMED) constant rate infusion (CRI) on overall tissue perfusion, isoflurane (ISO) requirements, haemodynamics and quality of recovery in canine surgical patients. STUDY DESIGN: Prospective, randomized, blinded clinical study. ANIMALS: Client-owned dogs presented for soft tissue or orthopaedic surgery. METHODS: Following intravenous (IV) pre-medication with DMED (5 microg kg(-1)) and buprenorphine (10 microg kg(-1)) and propofol induction, anaesthesia was maintained with ISO in oxygen/air supplemented with a DMED CRI (1, 2 or 3 microg kg(-1) hour(-1); groups 1, 2 and 3, respectively). Ventilation was controlled in all animals using intermittent positive pressure ventilation (IPPV). Monitoring included end-tidal (ET) gases, ECG, arterial blood pressure, body temperature and sequential arterial blood gas and lactate measurements. Quality of recovery was scored after intramuscular (IM) administration of atipamezole (ATI) (12.5 microg kg(-1)). Immediate post-operative analgesia was provided with carprofen and/or buprenorphine. An analysis of variance was conducted for repeated measurements obtained during 80 minutes after first incision. Categorical data were evaluated with Chi-square analyses. RESULTS: Arterial blood pressure remained stable and within clinically acceptable limits. Mean heart rate in group 2 was significantly lower than in group 1. The incidence of 2nd degree AV block type II was significantly higher in group 3. Mean arterial lactate concentrations remained below 2 mmol/L in all groups during the study, with a significant increase occurring during recovery compared with surgery for group 3. Mean e'ISO% was similar and <1% in all groups. Complete recovery from anaesthesia was achieved after ATI administration and was of good quality in all but three animals. CONCLUSIONS AND CLINICAL RELEVANCE: Dexmedetomidine CRI is a reliable and valuable adjunct to ISO anaesthesia in maintaining surgical anaesthesia in ASA I-II dogs. Data reported indicate adequate overall tissue perfusion and a low ISO requirement while enabling a smooth and rapid recovery following ATI. The DMED CRI of 1 microg kg(-1) hour(-1) following a loading dose of 5 microg kg(-1) produced the most favourable results.     

Cyclooxygenase selectivity of nonsteroidal anti-inflammatory drugs in canine blood

OBJECTIVE: To evaluate cyclooxygenase (COX) selectivity of several nonsteroidal anti-inflammatory drugs (NSAID) in canine blood in vitro. ANIMALS: 11 healthy adult male hound crosses. PROCEDURE: 9 NSAID were studied at 5 concentrations. Thromboxane B2 (TxB2) was assayed as a measure of COX-1 activity in clotted blood. Prostaglandin E2 (PGE2) was assayed as a measure of COX-2 activity in heparinized, lipopolysaccharide (LPS)-stimulated blood. All assays were competitive ELISA tests. Cyclooxygenase selectivity was expressed as a ratio of the concentration of an NSAID that inhibited 50% of the activity (IC50) of COX-1 to the IC50 of COX-2. A separate ratio of the concentration that inhibited 80% of COX activity (IC80) was also determined. A ratio of < 1.0 indicated selectivity for COX-1, whereas a ratio of > 1.0 indicated COX-2 selectivity. RESULTS: Ketoprofen, aspirin, and etodolac were COX-1 selective. Piroxicam, meloxicam, and carprofen had COX-2 selectivity. The IC50 and IC80 values were similar for most NSAID. CONCLUSIONS: This methodology provides repeatable data from individual dogs and is comparable to results of previous in vitro and ex vivo models. Findings are also consistent with those of canine studies performed in vivo, suggesting that this is a viable in vitro assessment of the COX selectivity of NSAID in dogs.     

Evaluation of haloperidol--ketamine mixture (1:1) anaesthesia in dogs

Four clinically healthy dogs of either sex, aged 3-5 years, weighing between 9 and 18 kg and maintained under uniform management conditions, were administered haloperidol (5 mg/ml) and ketamine (50 mg/ml) intravenously in 1:1 ratio until the pedal reflex was lost. The calculated doses of haloperidol and ketamine were 1.71 and 17.05 mg/kg body weight intravenously, respectively. Corneal and palpebral reflexes were maintained although pain reflexes were absent up to 20 min of the cocktail administration. The induction of anaesthesia was quick and smooth. There was moderate to good muscle relaxation and analgesia. Mean arterial and central venous pressures and tidal volume decreased significantly (P < 0.05) from baseline values. Significant tachycardia and hyperglycemia were observed.     

Immunomodulatory drugs and their application to the management of canine immune-mediated disease

This review summarises the current understanding of immune response and T cell subsets in the context of development of autoimmunity in the dog. Mode of action and rational usage in immune-mediated disease in the dog are discussed for the following drugs: glucocorticoids, azathioprine, cyclophosphamide, ciclosporin, tacrolimus, human intravenous immunoglobulin, vincristine, danazol, leflunomide, mycophenolate mofetil and liposome-encapsulated clodronate. Disease mechanisms are discussed and published evidence for drug efficacy is scrutinised for five important immune-mediated diseases: immune-mediated haemolytic anaemia, immune-mediated thrombocytopenia, myasthenia gravis, glomerulonephritis and inflammatory bowel disease. Future strategies for more refined manipulation of adverse immune responses are presented.     

犬特应性皮炎及其治疗药物的研究进展

犬特应性皮炎是一种具有遗传倾向的过敏性皮肤病。由于近年来我国养犬数量不断增加,犬特应性皮炎成为宠物临床上的常见疾病,严重危害了宠物犬的身体健康。该病病因复杂,大致可概括为遗传因素、环境因素、皮肤屏障功能失调、免疫功能失调和微生物菌群失调五个方面,且由于其临床症状与其他过敏反应、炎症反应相似,难以确诊,需要通过多种临床反应共同判定。随着小动物诊疗的不断发展,犬特应性皮炎治疗在以往基础疗法上又增加了使用抗炎止痒药物、JAK通路抑制药物、生物制品药物和PED-4 选择性抑制剂等治疗方式。本文综述了近年来犬特应性皮炎的病因、临床症状、诊断方法和治疗方法方面的研究进展,以期为犬特应性皮炎的治疗提供借鉴和参考。     

Effects of hyaluronidase on ropivacaine or bupivacaine regional anaesthesia of the canine pelvic limb

Objective

To determine the effect of hyaluronidase on time to onset and offset of anaesthesia in ropivacaine or bupivacaine femoral–ischiatic nerve blocks.

Muscle metabolic changes associated with long-term inhalation anaesthesia in the horse analysed by muscle biopsy and microdialysis techniques

During anaesthesia in the horse, muscle blood flow has been found to be reduced, possibly leading to hypoxia or ischaemia in the muscle. The aim of this study was to use the muscle biopsy and microdialysis techniques to determine whether long-term inhalation anaesthesia in laterally recumbent horses induces metabolic changes in gluteal muscle indicative of anaerobic metabolism. Muscle biopsies and plasma samples were taken from seven horses at the start and end of halothane anaesthesia. In six isoflurane-anaesthetised horses, given three pharmacological provocations (dobutamine, detomidine, acepromazine), repeated blood samples and microdialysis was performed during anaesthesia and muscle biopsies were taken before and at the end of anaesthesia. Adenosine triphosphate (ATP), adenosine diphosphate, adenosine monophosphate, inosine monophosphate (IMP) creatine phosphate and lactate concentrations did not differ between dependent and non-dependent muscles at either sampling time. Creatine phosphate decreased in both the halothane (-38%) and isoflurane (-28%) group. In the halothane group, ATP was decreased (-15%) at the end of anaesthesia, while IMP was increased (+32%). Lactate in muscle and plasma increased in both groups. Lactate in dialysate increased after induction and remained elevated above plasma concentrations. These results show that long-term inhalation anaesthesia in horses is associated with an anaerobic metabolic response within the muscle and that microdialysis can be used to detect metabolic changes within the muscle during equine anaesthesia.     

Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 1: lidocaine and ketamine

ObjectiveTo review the literature with regard to the use of different intravenous agents as supplements to inhalational anaesthesia in horses. These drugs include lidocaine, ketamine, opioids and α₂-agonists. The Part 1 of this review will focus in the use of lidocaine and ketamine.Databases usedPubmed &; Web of Science. Search terms: horse, inhalant anaesthesia, balanced anaesthesia, partial intravenous anaesthesia, lidocaine, ketamine.ConclusionsDifferent drugs and their combinations can be administered systemically in anaesthetized horses, with the aim of reducing the amount of the volatile agent whilst improving the recovery qualities and providing a multimodal analgesic approach. However, full studies as to whether these techniques improve cardiopulmonary status are not always available and potential disadvantages should also be considered.     

A review of drugs and techniques used for sedation and anaesthesia in captive rhinoceros species

Captive rhinoceros species are most frequently sedated and/or anaesthetised with the potent opioid, etorphine hydrochloride in combination with an alpha-2 adrenoreceptor agonist or the butyrophenone, azaperone. Carfentanil citrate based combinations have also been used to a lesser extent. In recent years butorphanol tartrate based combinations have been used with good success to induce neuroleptanalgesia. Sedation and anaesthesia are complicated by the large size of all rhinoceros species and their sensitivity to potent opioids. Potential complications include respiratory depression, hypoxaemia, hypertension, pulmonary shunting and ventilation/perfusion mismatch. The pharmacology of the principal drugs used for sedating/anaesthetising rhinoceros is reviewed. Techniques for sedating/anaesthetising the various species and potential complications associated with chemical restraint are discussed.