Femoral nerve block: a novel psoas compartment lateral pre‐iliac approach in dogs

ObjectiveTo describe a new approach to block the femoral nerve and to evaluate the distribution of a dye injected into the psoas compartment using a new femoral nerve block approach; to assess its clinical application, when combined with a sciatic nerve block, for surgical anaesthesia/analgesia of the pelvic limb in dogs.Study designProspective anatomical, research and clinical study.AnimalsTwo dog cadavers; two dogs that had to be euthanized for reasons unrelated to this study, and 15 dogs undergoing pelvic limb orthopaedic surgery.MethodsPhase 1: anatomical dissections were performed to determine a simple method to approach the femoral nerve within the psoas compartment. Phase 2: 0.1 mL kg^?1 of a lidocaine-new methylene blue solution was injected bilaterally after successful electrolocation of the femoral nerve in two anaesthetized dogs. Colorant spread was evaluated through femoral nerve dissections after euthanasia. Phase 3: in 15 dogs undergoing pelvic limb orthopaedic surgery under light general anaesthesia with isoflurane, intra-operative analgesic effect (cardiovascular responses) and early post-operative pain score, of the novel femoral nerve block combined with a sciatic nerve block as the sole analgesic protocol, were evaluated.ResultsPhase 1: a needle inserted from the lateral aspect of the lumbar muscles, cranially to the iliac crest and with a 30–45° caudo-medial direction, reaches the femoral nerve in the caudal portion of the psoas compartment. Phase 2: Four femoral nerves were stained >2 cm. Phase 3: this novel lateral pre-iliac approach, combined with the sciatic nerve block, blunted the intra-operative cardiovascular response to surgical stimulation in 13 out of 15 anaesthetized dogs. In addition, rescue analgesia was not required in the early post-operative 2-hour period.Conclusion and clinical relevanceThe lateral pre-iliac femoral nerve block technique may provide adequate intra- and early post-operative pain relief in dogs undergoing pelvic limb surgery.     

Nerve Stimulator–Guided Sciatic-Femoral Block in Pet Rabbits (Oryctolagus cuniculus) Undergoing Hind Limb Surgery: A Case Series

This article describes the clinical applicability of a nerve stimulator–guided technique, previously described in dogs, to block the sciatic and the femoral nerves in 4 pet rabbits (Oryctolagus cuniculus) undergoing hind limb surgeries. Preanesthetic intramuscular doses of medetomidine (0.08 mg/kg), ketamine (15 mg/kg), and buprenorphine (0.03 mg/kg) were administered to the rabbit patients. The rabbits were intubated and general anesthesia was maintained using isoflurane in oxygen. The sciatic-femoral nerve block was performed with 2% lidocaine at a volume of 0.05 mL/kg/nerve. Sciatic-femoral block was feasible in rabbits, and the motoric responses following electrical stimulation of both nerves were consistent with those reported in dogs after successful nerve location. Iatrogenic complications, namely nerve damage and local anesthetic toxicity, did not occur. Based on these results, the authors conclude that the sciatic-femoral nerve block described in dogs can be safely performed in rabbits. Clinical trials are required to assess the analgesic efficacy of the combined sciatic-femoral nerve block in rabbits as a part of multimodal pain management.     

Ultrasound‐guided proximal paravertebral anaesthesia in cattle

ObjectiveTo develop and evaluate a method for ultrasound-guidance in performing the proximal paravertebral block for flank anaesthesia in cattle through a cadaveric study, followed by clinical application.Study designprospective experimental cadaveric study and clinical series.AnimalsPreviously frozen lumbar sections of cows without known spinal abnormalities were used. The clinical case group comprised of ten animals for which a right flank laparotomy was indicated.MethodsTwenty cow cadavers were used to perform ultrasound-guided bilateral injections of 1.0 mL dye (1.0 mL 1% Toluidine Blue in 1% Borax) at the intervertebral foramen at the level of T13, L1 and L2 spinal nerves. Distance and depth of injection, staining of the dorsal and ventral nerve branches, and deviation from the target were evaluated. The investigator’s confidence as to visualisation and expected success at staining the nerve was assessed. Ten clinical cases received the ultrasound-guided proximal paravertebral anaesthesia. Analgesic success was evaluated using a 4-grade scoring system at 10 minutes after the injection and during surgery, respectively. Categorical variables were described using frequencies and proportions.ResultsBoth dorsal and ventral branches of the spinal nerves T13, L1 or L2 were at least partially stained in 41% of injections, while in 77% of injections one of the branches was stained. Five out of ten clinical cases had a satisfactory anaesthesia. There was no significant association between confidence at injection and either staining or analgesic success.ConclusionResults from the cadaveric and clinical study suggest no significant improvement using ultrasound guidance to perform proximal paravertebral block in cows compared to our previous clinical experience and to references in the literature using the blind method.Clinical relevanceFurther research should be conducted to improve the ultrasound-guided technique described in this study.     

Acepromazine‐dexmedetomidine‐ketamine for injectable anaesthesia in captive European brown hares (Lepus europaeus)

ObjectiveTo evaluate a combination of acepromazine, dexmedetomidine and ketamine (ADK) on induction and recovery from anaesthesia, and on physiological parameters in hares undergoing non‐invasive procedures.Study designProspective clinical study.AnimalsSixteen European hares (Lepus europaeus), seven males and nine females, aged (mean ± SD) 3.25 ± 0.9 months and weight 2.1 ± 0.6 kg.MethodsAcepromazine 1% (A), dexmedetomidine 0.05% (D) and ketamine 5% (K) were mixed and given intramuscularly (IM) at 0.25 mL kg^?1, representing 10 mg kg^?1 K, 0.25 mg kg^?1 A, 12.5 μg kg^?1 D. If the righting reflex was present after four minutes, a second injection of 0.15 mL kg^?1 (6 mg kg^?1 K, 0.15 mg kg^?1 A, 7.5 μg kg^?1 D) was administered IM. Surgical anaesthesia was judged as present when righting, palpebral, ear‐pinch and pedal withdrawal reflexes were absent. Anaesthetized hares were tagged, and underwent blood sampling and ocular ultrasound examination. Physiological parameters were recorded every ten minutes, and were compared by Kruskal‐Wallis tests.ResultsA single dose induced loss of righting reflex in 11/16 (69%) hares within four minutes; the second dose was effective in the remaining hares. Ten minutes after the loss of the righting reflex, a surgical plane of anaesthesia was present in all hares. Sleep time to regaining righting reflex was 34 ± 11 (range 21–62) minutes and recovery was calm. Although there were some statistical differences over time, cardiovascular parameters remained within an acceptable range but there was respiratory depression and hares were hypoxemic.Conclusions and clinical relevanceThe ADK mixture produced a smooth and rapid induction of anaesthesia, a low incidence of untoward side effects and full recovery after four hours. Supplementary oxygen might be advisable if a deeper plane of anaesthesia was required. Chemical restraint was adequate to perform non‐invasive procedures.     

RESEARCH PAPER: Ultrasound‐guided nerve blocks of the pelvic limb in dogs

ObjectivesTo evaluate the efficacy of ultrasound‐guidance in nerve blockade of the sciatic and saphenous nerves in dogs and to determine if this technique could allow lower anaesthetic doses to be used with predictable onset and duration of effect.Study designProspective randomized (for dose and leg) blinded experimental crossover trial with 10 day washout period.AnimalsSix healthy female Hound dogs aged 12.3 ± 0.5 (mean ± SD) months and weighing 18.7 ± 0.8 (mean ± SD) kg.MethodsAn ultrasound‐guided, perineural injection was used with saline at 0.2 mL kg^?1 (Sal) or bupivacaine 0.5% at 0.05 (low dose; LD), 0.1 (medium dose; MD), or 0.2 (high dose; HD) mL kg^?1, divided 2/3 at the sciatic nerve and 1/3 at the saphenous nerve. Blocks were performed using dexmedetomidine sedation with atipamezole reversal immediately after completion of the injections. Motor/proprioceptive and sensory functions were scored using a 0–8 and a 0–2 scale, respectively. Clinically relevant blocks were defined as a motor score ≥2 and sensory score ≥1. Nonparametric methods were used for statistical analysis.ResultsNo adverse effects were noted. There was a significant difference between the treatments with bupivacaine and the saline control, but not between the three bupivacaine treatments. Success rates of clinically relevant sciatic and saphenous blocks were both 67% (CI 95% 0.22–0.96). Onset and duration of the blocks were variable; 20–160 and 20–540 minutes, respectively.Conclusion and clinical relevanceNone of the bupivacaine doses was significantly superior, though there was a tendency for a better block with the high bupivacaine dose. Either the technique or the doses used need further modification before this method will be useful in clinical practice.     

Ultrasound‐guided ‘two‐in‐one’ femoral and obturator nerve block in the dog: an anatomical study

ObjectiveTo evaluate the dye extent and distribution at the lumbar plexus (LP) of three volumes of local anaesthetic-methylene-blue solution administered close to the femoral nerve (FN) by the use of a ventral ultrasound (US)-guided suprainguinal approach (SIA).Study designProspective experimental trial.AnimalsTwenty mongrel canine cadavers weighing 17.7 ± 3.8 kg (mean ± SD).MethodsThe left and right LP of two cadavers were dissected to identify the FN, obturator nerve (ON) and lateral femoral cutaneous nerve (LFCN). The extent and distribution of dye at the LP of each of three volumes of injectate of 0.2, 0.4 and 0.6 mL kg^?1 administered close to the FN by a ventral US-guided SIA then were studied in a further 18 dog cadavers (n = 6 per group). Staining of ≥2 cm along the target nerves was indicative of sufficient spread to produce a nerve block.ResultsThe ventral US-guided SIA allowed the observation of the FN within the iliopsoas muscle (IPM) in a total of 17 cadavers. The assessment of the dye extent and distribution revealed a similar pattern regardless of the injected volume. From the injection site, the spreading of injectate occurred in cranial, lateral and caudal directions. The FN and ON were effectively stained in all the cases. The LFCN was not effectively stained in any case.Conclusions and clinical relevanceA volume of 0.2 mL kg^?1 administered close to the FN by a ventral US-guided SIA produced a sufficient distribution of the injectate within the IPM to produce effective staining of the FN and ON. This US-guided technique may be an appropriate alternative to previously reported techniques based on electrolocation to block the FN and ON in the dog.     

Opioid requirements after locoregional anaesthesia in dogs undergoing tibial plateau levelling osteotomy: a pilot study

ObjectiveTo determine the intraoperative and early postoperative opioid requirement after ultrasound-guided sciatic and/or femoral nerve block or epidural anaesthesia in dogs undergoing tibial plateau levelling osteotomy (TPLO).Study designProspective, masked, pilot, randomized, clinical trial.AnimalsA total of 40 client-owned dogs undergoing TPLO.MethodsEach dog was randomly assigned to group SF (combined sciatic and femoral nerve block), group S (sciatic nerve block), group F (femoral nerve block) or group E (epidural anaesthesia). A total of 0.3 mL kg^–1 of ropivacaine 0.5% was administered to each nerve or in the epidural space. Intraoperatively, fentanyl (2 μg kg^–1) was administered intravenously when heart rate, mean arterial pressure or respiratory rate increased by >30% compared with baseline values. Postoperatively, a visual analogue scale (VAS) and a modified German version of the French pain scale (4AVet) were used to assess pain every 30 minutes for 150 minutes and again once the morning after surgery. Methadone (0.1 mg kg^–1) was administered intravenously if the VAS was ≥ 4 cm [maximal value 10 cm; median (interquartile range)] or the composite pain score was ≥5 [maximal value 15; median (interquartile range)]. Significance was defined as p ≤ 0.05.ResultsGroups SF and E required less total intraoperative and early postoperative opioid doses compared with groups S and F (p = 0.031). No dogs in group SF had a block failure or required postoperative methadone. A reduced methadone requirement was found in group SF compared with all the other groups up to 150 minutes after recovery (p = 0.041).Conclusions and clinical relevanceCombined sciatic and femoral nerve block and epidural anaesthesia lead to less cumulative consumption of perioperative opioids than single nerve blockade. Sciatic or femoral nerve block alone might be insufficient to control nociception and early postoperative pain in dogs undergoing TPLO.     

Palpation‐ and ultrasound‐guided brachial plexus blockade in Hispaniolan Amazon parrots (Amazona ventralis)

ObjectiveTo compare palpation-guided with ultrasound-guided brachial plexus blockade in Hispaniolan Amazon parrots.Study designProspective randomized experimental trial.AnimalsEighteen adult Hispaniolan Amazon parrots (Amazona ventralis) weighing 252–295 g.MethodsAfter induction of anesthesia with isoflurane, parrots received an injection of lidocaine (2 mg kg^?1) in a total volume of 0.3 mL at the axillary region. The birds were randomly assigned to equal groups using either palpation or ultrasound as a guide for the brachial plexus block. Nerve evoked muscle potentials (NEMP) were used to monitor effectiveness of brachial plexus block. The palpation-guided group received the local anesthetic at the space between the pectoral muscle, triceps, and supracoracoideus aticimus muscle, at the insertion of the tendons of the caudal coracobrachial muscle, and the caudal scapulohumeral muscle. For the ultrasound-guided group, the brachial plexus and the adjacent vessels were located with B-mode ultrasonography using a 7–15 MHz linear probe. After location, an 8-5 MHz convex transducer was used to guide injections. General anesthesia was discontinued 20 minutes after lidocaine injection and the birds recovered in a padded cage.ResultsBoth techniques decreased the amplitude of NEMP. Statistically significant differences in NEMP amplitudes, were observed within the ultrasound-guided group at 5, 10, 15, and 20 minutes after injection and within the palpation-guided group at 10, 15, and 20 minutes after injection. There was no statistically significant difference between the two groups. No effect on motor function, muscle relaxation or wing droop was observed after brachial plexus block.Conclusions and clinical relevanceThe onset of the brachial plexus block tended to be faster when ultrasonography was used. Brachial plexus injection can be performed in Hispaniolan Amazon parrots and nerve evoked muscle potentials were useful to monitor the effects on nerve conduction in this avian species. Neither technique produced an effective block at the doses of lidocaine used and further study is necessary to develop a useful block for surgical analgesia.     

Plasma pharmacokinetics and pharmacodynamics of alfaxalone in neonatal foals after an intravenous bolus of alfaxalone following premedication with butorphanol tartrate

ObjectiveTo determine the pharmacokinetics and pharmacodynamics of the neurosteroid anaesthetic, alfaxalone, in neonatal foals after a single intravenous (IV) injection of alfaxalone following premedication with butorphanol tartrate.Study designProspective experimental study.AnimalsFive clinically healthy Australian Stock Horse foals of mean ± SD age of 12 ± 3 days and weighing 67.3 ± 12.4 kg.MethodsFoals were premedicated with butorphanol (0.05 mg kg^?1 IV) and anaesthesia was induced 10 minutes later by IV injection with alfaxalone 3 mg kg^?1. Cardiorespiratory variables (pulse rate, respiratory rate, direct arterial blood pressure, arterial blood gases) and clinical signs of anaesthetic depth were evaluated throughout anaesthesia. Venous blood samples were collected at strategic time points and alfaxalone plasma concentrations were assayed using liquid chromatography-mass spectrometry (LC/MS) and analysed by noncompartmental pharmacokinetic analysis.ResultsThe harmonic, mean ± SD plasma elimination half life (t½) for alfaxalone was 22.8 ± 5.2 minutes. The observed mean plasma clearance (Cl_p) and volume of distribution (Vd) were 19.9 ± 5.9 mL minute kg^?1 and 0.6 ± 0.2 L kg^?1, respectively. Overall, the quality of the anaesthetic inductions and recoveries was good and most monitored physiological variables were clinically acceptable in all foals, although some foals became hypoxaemic for a short period following recumbency. The mean durations of anaesthesia from induction to first movement and from induction to standing were 18.7 ± 7 and 37.2 ± 4.7 minutes, respectively.ConclusionsThe anaesthetic protocol used provided a predictable and consistent plane of anaesthesia in the five foals studied, with minimal cardiovascular depression. In foals, as in the adult horse, alfaxalone has a short elimination half life.Clinical relevanceAlfaxalone appears to be an adequate anaesthetic induction agent in foals and the pharmacokinetics suggest that, with continuous infusion, it might be suitable to provide more prolonged anaesthesia. Oxygen supplementation is recommended.     

Intramuscular administration of alfaxalone in red‐eared sliders (Trachemys scripta elegans) – effects of dose and body temperature

ObjectiveTo characterise the effects of alfaxalone by intramuscular (IM) injection in red-eared slider turtles and the influence of body temperature on anaesthetic duration and depth.Study designProspective, randomised part-blinded experimental trial.AnimalsTen healthy adult female red-eared sliders.MethodsEach turtle was anaesthetized four times with 10 and 20 mg kg^?1 alfaxalone at 20 and 35 °C respectively. Time to maximal effect and plateau and recovery periods were recorded. Skeletal muscle tone, presence of various reflexes, response to noxious stimuli, and heart rate were assessed.ResultsResults are given for protocols 10 mg kg^?1 20 °C; 20 mg kg^?1 20 °C; 10 mg kg^?1 35 °C and 20 mg kg^?1 35 °C, respectively: mean time (±SD) to maximal effect was 16 ± 8, 19 ± 6, 5 ± 2 and 7 ± 5 minutes; duration of the plateau phase was 13 ± 12, 28 ± 13, 8 ± 5 and 8 ± 5 minutes and recovery time was 76 ± 20, 126 ± 17, 28 ± 9 and 41 ± 20 minutes. Endotracheal intubation was successful in 80%, 100%, 0% and 30% of turtles, respectively. At 35 °C, all animals retained nociceptive sensation in the front limbs, hind limbs and vent, whereas at 20 °C a few turtles lost peripheral nociceptive sensation. Corneal and tap reflexes were retained in all trials. Mean heart rates were 30 ± 2 and 66 ± 4 beats minute^?1 at 20 and 35 °C, respectively.Conclusions and clinical relevanceAlfaxalone administered IM in red-eared sliders provided smooth, rapid induction and uneventful recovery. At 35 °C either dosage provided only short (5–10 minutes) and light sedation. At 20 °C, 10 mg kg^?1 provided sedation suitable for short non-invasive procedures. About 20 mg kg^?1 provided anaesthesia of approximately 20 minutes duration, appropriate for induction of inhalational anaesthesia or for brief surgical procedures with supplemental analgesia.     

Intravenous sufentanil‐midazolam versus sevoflurane anaesthesia in medetomidine pre‐medicated Himalayan rabbits undergoing ovariohysterectomy

ObjectiveTo compare physiological effects of sufentanil-midazolam with sevoflurane for surgical anaesthesia in medetomidine premedicated rabbits.Study designProspective, randomized controlled experimental study.AnimalsEighteen female Himalayan rabbits, weight 2.1 ± 0.1 kg.MethodsPremedication with 0.1 mg kg⁻¹ medetomidine and 5 mg kg⁻¹ carprofen subcutaneously, was followed by intravenous anaesthetic induction with sufentanil (2.3 μg mL⁻¹) and midazolam (0.45 mg mL⁻¹). After endotracheal intubation, anaesthesia was maintained with sufentanil-midazolam (n = 9) or sevoflurane (n = 9). Ovariohysterectomy was performed. Intermittent positive pressure ventilation was performed as required. Physiological variables were studied perioperatively. Group means of physiologic data were generated for different anaesthetic periods. Data were compared for changes from sedation, and between groups by anova. Post-operatively, 0.05 mg kg⁻¹ buprenorphine was administered once and 5 mg kg⁻¹ carprofen once daily for 2–3 days. Rabbits were examined and weighed daily until one week after surgery.ResultsSmooth induction of anaesthesia was achieved within 5 minutes. Sufentanil and midazolam doses were 0.5 μg kg⁻¹ and 0.1 mg kg⁻¹, during induction and 3.9 μg kg⁻¹ hour⁻¹ and 0.8 mg kg⁻¹ hour⁻¹ during surgery, respectively. End-tidal sevoflurane concentration was 2.1% during surgery. Assisted ventilation was required in nine rabbits receiving sufentanil-midazolam and four receiving sevoflurane. There were no differences between groups in physiologic data other than arterial carbon dioxide. In rabbits receiving sevoflurane, mean arterial pressure decreased pre-surgical intervention, heart rate increased 25% during and after surgery and body weight decreased 4% post-operatively. Post-operative problems sometimes resulted from catheterization of the ear artery.ConclusionSevoflurane and sufentanil-midazolam provided surgical anaesthesia of similar quality. Arterial blood pressure was sustained during sufentanil-midazolam anaesthesia and rabbits receiving sevoflurane lost body weight following ovariohysterectomy. Mechanical ventilation was required with both anaesthetic regimens.Clinical relevanceAnaesthesia with sufentanil-midazolam in medetomidine premedicated healthy rabbits is useful in the clinical and the research setting, as an alternative to sevoflurane.     

Tramadol improved the efficacy of ketamine–xylazine anaesthesia in young pigs

ObjectiveTo evaluate the influence of premedication with tramadol on xylazine–ketamine anaesthesia in young pigs.Study designProspective, randomized, blinded cross-over study.AnimalsTen young Niger hybrid pigs: mean weight 6.1 ± 0.6 kg.MethodsPigs were anaesthetized twice. Xylazine (2.5 mg kg^?1), ketamine (25 mg kg^?1) and atropine (0.04 mg kg^?1) were administered by intramuscular (IM) injection, 5 minutes after either tramadol (5 mg kg^?1)) (treatment XKT) or saline (treatment XKS). Time to loss of righting reflex (TLRR), duration of antinociception, duration of recumbency (DR) and recovery times (RCT) were recorded. Quality of induction of anaesthesia including ease of endotracheal intubation was assessed using a subjective ordinal rating score of 1 (worst) to 4 (best). Heart, pulse and respiratory rates, arterial oxygen saturations and rectal temperatures were determined over 60 minutes. Antinociception was assessed by the pigs’ response to artery forceps applied at the interdigital space. Data were compared with Student's t-test, Mann–Whitney's test or analysis of variance (anova) for repeated measures as appropriate and are presented as mean ± standard deviation.ResultsThe quality of anaesthetic induction was significantly better and duration of antinociception significantly longer (p < 0.05) in treatment XKT (3.1 ± 0.7 score; 43.7 ± 15.5 minutes) than in treatment XKS (2.8 ± 0.6 score; 32.0 ± 13.3 minutes). TLRR, DR and RCT did not differ significantly (p > 0.05) between treatment XKT (2.1 ± 0.8, 65.8 ± 17.0 and 13.2 ± 6.7 minutes) and treatment XKS (2.1 ± 1.3, 58.0 ± 14.8 and 10.3 ± 5.6 minutes). Physiological measurements did not differ between the treatments.Conclusion and clinical relevanceTramadol improved the quality of anaesthetic induction and increased the duration of antinociception in xylazine–ketamine anaesthetized young pigs without increasing duration of anaesthesia, nor causing additional depression of the physiological parameters measured.     

Comparison of azaperone–detomidine–butorphanol–ketamine and azaperone–tiletamine–zolazepam for anaesthesia in piglets

ObjectiveTo investigate a combination of azaperone, detomidine, butorphanol and ketamine (DBK) in pigs and to compare it with the combination of azaperone, tiletamine and zolazepam (TZ).Study designProspective, randomized, blinded, cross–over study.AnimalsTwelve clinically healthy crossbred pigs aged about 2 months and weighing 16–25 kg.MethodsPigs were pre–medicated with azaperone (4 mg kg^?1). Ten minutes later anaesthesia was induced with intramuscular DBK (detomidine 0.08 mg kg^?1, butorphanol 0.2 mg kg^?1, ketamine 10 mg kg^?1) or TZ (tiletamine and zolazepam 5 mg kg^?1). The pigs were positioned in dorsal recumbency. Heart and respiratory rates, posture, anaesthesia score, PaO₂, PaCO₂, pH and bicarbonate concentration were measured. t–test was used to compare the areas under time–anaesthesia index curve (AUC_anindex) between treatments. Data concerning heart and respiratory rates, PaO₂, PaCO₂ and anaesthesia score were analysed with anova for repeated measurements. Wilcoxon signed rank test was used for the data concerning the duration of sedation and anaesthesia.ResultsThe sedation, analgesia and anaesthesia lasted longer after DBK than TZ. The AUC_anscore were 863 ± 423 and 452 ± 274 for DBK and TZ, respectively (p = 0.002). The duration of surgical anaesthesia lasted a median of 35 minutes (0–105 minutes) after DBK and a median of 15 minutes (0–35 minutes) after TZ (p = 0.05). Four pigs after DBK and six after TZ did not achieve the plane of surgical anaesthesia. The heart rate was lower after DBK than after TZ. Both treatments had similar effects on the other parameters measured.ConclusionsAt the doses used DBK was more effective than TZ for anaesthesia in pigs under field conditions.Clinical relevanceThe combinations can be used for sedation and minor field surgery in pigs. The doses and drugs chosen were insufficient to produce a reliable surgical plane of anaesthesia in these young pigs.     

Comparison of two formulations of alfaxalone for immersion anaesthesia in laboratory zebrafish (Danio rerio)

ObjectiveTo compare two commercial formulations of alfaxalone for immersion anaesthesia in laboratory zebrafish.Study designProspective, blinded, randomized study.AnimalsA total of 20 adult Danio rerio (Tuebingen strain).MethodsZebrafish were divided into two groups of 10 (five female, five male) and placed in individual immersion baths containing 10 mg L^–1 of unpreserved alfaxalone (group 1) or preserved alfaxalone (group 2). Anaesthetists blinded to treatment used a composite score scale (CSS) (range 0–12) to assess fish every 30 seconds until induction of anaesthesia. Anaesthetic induction occurred when equilibrium and response to stimulus were lost. Fish were then placed in a clean water bath and scored every 60 seconds. Recovery from anaesthesia was defined as a CSS of ≤ 1. Time variables recorded were anaesthetic induction time (AIT), anaesthetic recovery time (ART) and total procedure time (TPT). Fish were observed for evidence of roupgross external pathology during the procedure. Following anaesthesia, four fish from each group were randomly chosen and euthanized for gill histopathology analysis immediately after recovery criteria were met. Data are presented as mean ± standard deviation. An independent t test was used to compare the difference in average anaesthetic time variables between groups (α = 0.05).ResultsThere were no statistical differences between groups in reported variables. TPT, AIT and ART were 10.2 ± 1.2, 1.9 ± 0.9 and 8.3 ± 1.2 minutes for group 1 and 10.8 ± 2.9, 2.4 ± 1.2 and 8.4 ± 2.7 minutes for group 2. No gross external pathology was evident, and no fish died during the experimental period. Histopathology showed normal gill pathology and no difference between the groups.Conclusions and clinical relevanceImmersion anaesthesia using 10 mg L^–1 of either formulation of alfaxalone resulted in anaesthesia of similar quality and duration.     

The pharmacokinetics and pharmacodynamics of the injectable anaesthetic alfaxalone in the horse

ObjectiveTo determine the pharmacokinetics and pharmacodynamics of the neurosteroidal anaesthetic, alfaxalone, in horses after a single intravenous (IV) injection of alfaxalone, following premedication with acepromazine, xylazine and guaiphenesin.Study designProspective experimental study.AnimalsTen (five male and five female), adult, healthy, Standardbred horses.MethodsHorses were premedicated with acepromazine (0.03 mg kg^?1 IV). Twenty minutes later they received xylazine (1 mg kg^?1 IV), then after 5 minutes, guaiphenesin (35 mg kg^?1 IV) followed immediately by IV induction of anaesthesia with alfaxalone (1 mg kg^?1). Cardiorespiratory variables (pulse rate, respiratory rate, pulse oximetry) and clinical signs of anaesthetic depth were evaluated throughout anaesthesia. Venous blood samples were collected at strategic time points and plasma concentrations of alfaxalone were assayed using liquid chromatography-mass spectrometry (LC/MS) and analysed by noncompartmental pharmacokinetic analysis. The quality of anaesthetic induction and recovery was scored on a scale of 1–5 (1 very poor, 5 excellent).ResultsThe median (range) induction and recovery scores were 4 (3–5) (good: horse slowly and moderately gently attained recumbency with minimal or no rigidity or paddling) and 4 (1–5) (good: horse stood on first attempt with some knuckling and ataxia) respectively. The monitored cardiopulmonary variables were within the range expected for clinical equine anaesthesia. The mean ± SD durations of anaesthesia from induction to sternal recumbency and from induction to standing were 42.7 ± 8.4 and 47 ± 9.6 minutes, respectively. The mean ± SD plasma elimination half life (t_1/2), plasma clearance (Clp) and volume of distribution (V_d) for alfaxalone were 33.4 minutes, 37.1 ± 11.1 mL minute^?1 kg^?1 and 1.6 ± 0.4 L kg^?1, respectively.Conclusions and clinical relevanceAlfaxalone, in a 2-hydroxypropyl-beta-cyclodextrin formulation, provides anaesthesia with a short duration of recumbency that is characterised by a smooth induction and satisfactory recovery in the horse. As in other species, alfaxalone is rapidly cleared from the plasma in the horse.     

Hyoscine‐N‐butylbromide premedication on cardiovascular variables of horses sedated with medetomidine

ObjectiveTo evaluate the effects of intravenous (IV) or intramuscular (IM) hyoscine premedication on physiologic variables following IV administration of medetomidine in horses.Study designRandomized, crossover experimental study.AnimalsEight healthy crossbred horses weighing 330 ± 39 kg and aged 7 ± 4 years.MethodsBaseline measurements of heart rate (HR), cardiac index (CI), respiratory rate, systemic vascular resistance (SVR), percentage of patients with second degree atrioventricular (2^oAV) block, mean arterial pressure (MAP), pH, and arterial partial pressures of carbon dioxide (PaCO₂) and oxygen (PaO₂) were obtained 5 minutes before administration of IV hyoscine (0.14 mg kg^?1; group HIV), IM hyoscine (0.3 mg kg^?1; group HIM), or an equal volume of physiologic saline IV (group C). Five minutes later, medetomidine (7.5 μg kg^?1) was administered IV and measurements were recorded at various time points for 130 minutes.ResultsMedetomidine induced bradycardia, 2^oAV blocks and increased SVR immediately after administration, without significant changes in CI or MAP in C. Hyoscine administration induced tachycardia and hypertension, and decreased the percentage of 2^oAV blocks induced by medetomidine. Peak HR and MAP were higher in HIV than HIM at 88 ± 18 beats minute^?1 and 241 ± 37 mmHg versus 65 ± 16 beats minute^?1 and 192 ± 38 mmHg, respectively. CI was increased significantly in HIV (p ≤ 0.05). Respiratory rate decreased significantly in all groups during the recording period. pH, PaCO₂ and PaO₂ were not significantly changed by administration of medetomidine with or without hyoscine.Conclusion and clinical relevanceHyoscine administered IV or IM before medetomidine in horses resulted in tachycardia and hypertension under the conditions of this study. The significance of these changes, and responses to other dose rates, requires further investigation.     

Assessment of brachial plexus blockade in chickens by an axillary approach

ObjectiveTo assess the brachial plexus block in chickens by an axillary approach and using a peripheral nerve stimulator.Study designProspective, randomized, double-blinded study.AnimalsSix, 84-week old, female chickens.MethodsMidazolam (1 mg kg⁻¹) and butorphanol (1 mg kg⁻¹) were administered into the pectoralis muscle. Fifteen minutes later, the birds were positioned in lateral recumbency and following palpation of the anatomic landmarks, a catheter was inserted using an axillary approach to the brachial plexus. Lidocaine or bupivacaine (1 mL kg⁻¹) was injected after plexus localization by the nerve stimulator. Sensory function was tested before and after blockade (carpus, radius/ulna, humerus and pectoralis muscle) in the blocked and unblocked wings. The latency to onset of motor and sensory block and the duration of sensory block were recorded. A Friedman nonparametric one-way repeated-measures anova was used to compare scores from baseline values over time and to compare the differences between wings at each time point.ResultsA total of 18 blocks were performed with a success rate of 66.6% (12/18). The latency for motor block was 2.8 ± 1.1 and 3.2 ± 0.4 minutes for lidocaine and bupivacaine, respectively. The latencies for and durations of the sensory block were 6.0 ± 2.5 and 64.0 ± 18.0 and 7.8 ± 5.8 and 91.6 ± 61.7 minutes for lidocaine and bupivacaine, respectively. There was no statistical difference between these times for lidocaine or bupivacaine. Sensory function was not abolished in nonblocked wings.Conclusions and clinical relevanceThe brachial plexus block was an easy technique to perform but had a high failure rate. It might be useful for providing anesthesia or postoperative analgesia of the wing in chickens and exotic avian species that have similar wing anatomy.     

Propofol and fentanyl infusions in dogs of various breeds undergoing surgery

ObjectiveTo report the cardiovascular variables, anaesthetic effects and recovery quality of an anaesthesia technique using variable rate infusion propofol combined with constant rate infusion fentanyl in dogs undergoing elective surgery.Study designProspective clinical trial.AnimalsA total of 27 dogs, aged 2.7 ± 2.65 years and weighing 24 ± 11 kg.MethodsFollowing intramuscular acepromazine (0.03 or 0.05 mg kg^?1) and subcutaneous carprofen (4 mg kg^?1) pre-medication, anaesthesia was induced with propofol (4.0 ± 0.5 mg kg^?1) intravenously (IV). All dogs were ventilated with 100% oxygen to maintain normocapnia. Propofol was infused at 0.4 mg kg^?1 minute^?1 for 20 minutes and then at 0.3 mg kg^?1minute^?1. If mean arterial blood pressure (MAP) decreased below 70 mmHg, propofol infusion was reduced by 0.1 mg kg^?1 minute^?1. Five minutes after induction of anaesthesia, fentanyl was administered (2 μg kg^?1) IV followed by the infusion at 0.5 μg kg^?1 minute^?1 and atropine (40 μg kg^?1) IV. Heart rate, MAP, respiratory rate, tidal volume, end-tidal carbon dioxide, presence of reflexes, movements and recovery times and quality were recorded.ResultsMean anaesthetic duration was 131 ± 38.5 minutes. Mean heart rate peaked 10 minutes after atropine injection and gradually declined, reaching pre-anaesthetic values at 55 minutes. MAP easily was maintained above 70 mmHg. Mean times to return of spontaneous ventilation, extubation, head lift and sternal recumbency were 21 ± 10.1, 33 ± 14.6, 43 ± 19.7 and 65 ± 23.4 minutes, respectively. Recovery was smooth and quiet. The time to sternal recumbency was significantly correlated with the duration of anaesthesia and total dose of propofol; time to extubation was correlated to total dose of propofol.Conclusion and clinical relevancePropofol and fentanyl infusions provided stable cardiovascular function and satisfactory conditions for surgery. Some modifications of infusion rates are required to improve the long-recovery times.     

Continuous infusion of propofol or intermittent bolus of tiletamine‐zolazepam in squirrel monkeys (Saimiri sciureus)

ObjectiveTo investigate an infusion of propofol for anesthesia in comparison to tiletamine-zolazepam anesthesia, evaluating physiological variables and recovery in squirrel monkeys.Study designProspective non-blinded randomized study.AnimalsEight healthy squirrel monkeys (Saimiri sciureus), aged 3 years and weighing 0.340–0.695 kg.MethodsPremedication was intramuscular midazolam (0.5 mg) and meperidine (4 mg). Anesthesia was induced with intravenous (IV) propofol (4 mg kg^?1 minute^?1) and maintained with propofol starting at 0.4 mg kg^?1 minute^?1 (PRO, n = 4) or IV tiletamine-zolazepam (5 mg kg^?1) and maintained with supplementary doses of TZ (TZ, n = 4). Cardiopulmonary variables were measured continuously. Arterial blood gases and lactate concentration were measured at the end of anesthesia. Quality and times of recovery were determined. Repeatedly measured data for significant differences were tested between groups with t-test and within groups by anova.ResultsMedian time for induction of anesthesia in PRO was 180 seconds. Mean maintenance infusion rate of propofol was 0.43 ± 0.05 mg kg^?1 minute^?1, varying during the 1 hour period. One monkey died after administration of TZ; others required 1, 4, or 8 supplemental doses. Cardiopulmonary variables were similar between groups, but hypotension was recorded. Recovery times to ventral recumbency in PRO (32 ± 17 minutes) and TZ (84 ± 11 minutes) and normal ambulation in PRO (58 ± 22 minutes) and TZ (358 ± 109minutes) were significantly different (p < 0.05). Recovery quality was superior in PRO, with less ataxia and fewer unsuccessful attempts to stand. Lactate concentration was not different between treatments.Conclusions and clinical relevanceCardiopulmonary variables were similar between protocols, aside from the higher incidence of hypotension in PRO, indicating that further studies with a larger number of animals are required. Compared to tiletamine-zolazepam, propofol anesthesia provided faster and superior anesthetic recovery in these animals.