Anesthetic management of thoracotomy

Successful anesthesia for thoracic surgery requires an understanding of the clinical disease and the physiologic changes accompanying the disease, as well as anesthetic agents available for use. The authors discuss selection of appropriate anesthetic drugs, perioperative management considerations, pharmacologic support, intraoperative monitoring and postoperative pain management.     

Cesarean section. Anesthetic management and surgical technique

Cesarean section can be an elective procedure but more often it is an emergency procedure that is made necessary because of dystocia. A successful outcome for both the maternal and fetal patients is primarily dependent on a thorough understanding of the physiologic alterations during normal and abnormal pregnancy and parturition. A complete history and physical examination are necessary for assessment of the dam and planning of fluid therapy and anesthetic technique. Timely coordination of presurgical preparation, anesthesia, and the surgical procedure is crucial. Because little documentation exists to prove that any one anesthetic protocol is best, this article will stress the basic principles of obstetrical anesthesia and patient management.     

Adenovirus pathogenicity in immature ostriches.

Two group I avian adenoviruses implicated as the possible cause of "fading chick syndrome" in ostriches less than 8 wk of age were isolated in primary chicken embryo liver cells. These viruses were identified by virus neutralization and further characterized by a pathogenicity trial in immature ostriches. The results showed that these isolates were noninfectious in ostrich chicks.     

Anesthetic management in feline renal transplantation

Objective To document perioperative and anesthetic management of 30 feline renal transplant recipients (1996–1998). Study design Retrospective clinical study. Animals Thirty adult cats in end‐stage renal failure that underwent heterotopic renal transplantation. Materials and methods The medical records were reviewed from 30 feline heterotopic renal transplant recipients. Cases were included only if they had been treated for hypertension using a beta‐adrenergic antagonist, a calcium channel blocker or hemodialysis. Data regarding signalment, preoperative management, surgical technique, type and doses of anesthetics administered, perioperative hemodynamics and intra‐ and postoperative complications, postoperative analgesia, morbidity and early mortality were recorded. Data were expressed as mean ± SD. Results Preanesthetic medication included a combination of an anticholinergic and an opioid (oxymorphone). Anesthesia induction was performed mostly with isoflurane and oxygen delivered by mask. Anesthesia maintenance was primarily achieved with isoflurane in 100% oxygen. Nitrous oxide was often used as part of the anesthetic technique. The mean duration of anesthesia was 4.6 hours ± 27 minutes. The mean renal allograft ischemic time was 60 minutes. During the anesthetic period, the majority of the recipient cats received either fresh whole blood (FWB) (N = 25, 83%), cross‐matched packed red blood cells (PRBC) (N = 3, 10%) or fresh frozen plasma (FFP) (N = 2, 7%) combined with a balanced electrolyte solution. Blood products administered averaged 63 ± 34 mL and crystalloid 94 ± 62 mL. The most common treated intraoperative complications were hypotension (N = 14, 47%), hypothermia (N = 13, 43%), metabolic acidosis (N = 11, 37%), hypocalcemia (N = 5, 17%), hypoglycemia (N = 4, 13%), hypertension (N = 2, 7%), bradycardia (N = 1, 3%), and ventricular premature contractions (N = 1, 3%). All cats received opioid analgesics postoperatively. Complications observed in the first 24 hours postoperatively were hypertension (N = 20, 67%), hematuria (N = 14, 47%), electrolyte disturbances (N = 9, 30%), temperature imbalances (N = 5, 17%), decreased PCV requiring blood transfusion (N = 5, 17%), decreased perfusion of a foot associated with external iliac anastomosis technique (N = 5, 17%), seizures associated with hypertension (N = 3, 10%), uroabdomen (N = 2, 7%), acute graft rejection (N = 1, 3%) and, corneal ulceration (N = 1, 3%). Survival rates in the perioperative period were 100, 96.7, and 93.4% intraoperatively, at 24 hours, and 7 days following surgery. Conclusion Successful anesthesia can be performed in critically ill renal transplant recipients. However, for optimal graft function and patient survival, normothermia, normovolemia, normotension, and normal acid–base and electrolyte balance should be carefully maintained. Successful anesthetic management requires understanding of the pathophysiology of end‐stage renal disease and the maintenance of homeostasis during the different stages of the perioperative period.     

Anesthetic management of the head trauma patient

Objective: To describe the optimal anesthetic management of patients with brain injury, with emphasis on the support of oxygen delivery to the brain, and the effects of anesthetic agents on cerebral perfusion. Data sources: Clinical and experimental studies from both the human and veterinary neuroanesthesia literature. Summary: The management of patients following primary traumatic brain injury (TBI) significantly impacts outcome. Outcome can be improved by strategies that improve oxygen delivery to the brain and prevent cerebral ischemia. Anesthetic agents have widely variable effects on the blood supply to the brain and, therefore, choice of anesthetic agent can influence neurological outcome. Although in the past, anesthetic agents have been selected for their neuroprotective properties, it is increasingly being recognized that the support of cerebral perfusion during anesthesia contributes more significantly to a positive outcome for these patients. Support of cardiorespiratory function is, therefore, highly important when anesthetizing patients with TBI. Conclusion: Choice of anesthetic agent is determined by the extent of brain injury and intracranial pressure (ICP) elevation. Factors that should be considered when anesthetizing head trauma patients include the effects of anesthetic agents on the cardiac and respiratory systems, their effects on cerebral blood flow (CBF), ICP, and possible neuroprotective benefits offered by certain agents.     

Behavioral problems of farmed ostriches in Canada.

Ostriches farmed in Canada often have particular behavioral problems that are brought about by periods of extreme confinement during winter months. Although they still perform normal species specific behaviors such as twirling, kanteling, and kicking, abnormal behaviors become prominent when excessively confined. They include for all age groups of ostriches, feather-picking, behavioral stargazing, dietary indiscretion, pica, anorexia and adipsia, and aggression. These abnormal behaviors initiated by inadequate husbandry techniques, eventually become medical problems because of their severity.     

Anesthetic management of a horse with traumatic pneumothorax

A traumatic pneumothorax and severe hemorrhage were present in a mare with a large thoracic wall defect, lung perforation, and multiple rib fractures. General anesthesia was induced to allow surgical exploration. We describe the anesthetic technique, and discuss the management of the ventilatory, hemodynamic, and metabolic disturbances encountered.     

鸵鸟的育雏技术

据调查,鸵鸟育雏成活率普遍较低,低者仅为20%,高者为75%,严重影响鸵鸟饲养效益。笔者在多年的农技推广过程中,总结了几点提高鸵鸟育雏成活率的经验,兹介绍如下,供大家参考。一、选择优良种蛋入孵。对过大、过小、沙壳、刚皮、软壳蛋不能入孵。实践证明,孵化率高的雏鸵易培育。要提高孵化率,就要养好种鸵鸟,尽量缩短种蛋存放时间,一般存放时间不超过7天,种蛋入孵前按消毒制度严格消毒。二、选养体质健壮的雏鸵。健壮的雏鸵应是精神活泼、绒毛洁净、体大、头大、脚粗,腹部大小适中,出壳时间正常,根据体重大小适时分群饲养,以每群25～30只为宜,…     

Reference serum biochemical values for emus and ostriches.

Reference serum biochemical values were determined in blood samples from 15 male, 18 female, and 4 unsexed emus (Dromaius novaehollandiae) 1 to 48 months old. Serum biochemical values also were obtained for 19 male, 26 female, and 4 unsexed ostriches (Struthio camelus) 1 to 60 months old. Parametric (mean +/- 2 SD) and non-parametric (fifth to 95th percentile) reference ranges and linear trends as influenced by age were determined for enzyme activities and concentrations of glucose, inorganic phosphate, BUN, uric acid, creatinine, triglyceride, cholesterol, total protein, and albumin. Species differences for all analytes, except cholesterol and inorganic phosphate concentrations, were detected. Creatine kinase values in ostriches were higher than those in emus. There were no linear relationships between age and analyte values in emus, and sex did not significantly (P < 0.05) affect the values in emus. Analyte values in ostriches tended to increase with age, but cholesterol, creatine kinase, inorganic phosphate, and alkaline phosphatase concentrations decreased with age. Glucose, triglyceride, gamma-glutamyltransferase, and cholinesterase concentrations in ostriches were not linearly associated with age. Age had a greater effect on the analyte values of female ostriches than it did on male ostriches. Concentrations generally increased with age in female ostriches, except for cholesterol, cholinesterase, inorganic phosphate, and alkaline phosphatase concentrations, which decreased with age.     

Proventriculotomy to relieve foreign body impaction in ostriches.

A study was conducted to identify the clinical signs associated with impaction of the proventriculus in ostriches, to identify diagnostic aids, and to develop a surgical procedure for management of the disorder. Clinical signs indicating the need for surgical intervention included chronic inappetance, a change in fecal consistency or production, dehydration, weight loss, and failure to respond to laxatives. Diagnosis of impacted proventriculus was by abdominal radiography and external palpation. Impactions were caused by sand and rocks (5 ostriches), hay and sand (1 ostrich), and leaves (1 ostrich). After surgery, 5 of the ostriches were clinically normal within (mean) 1 week. One ostrich failed to regain a normal appetite until 2 weeks after surgery, and one juvenile ostrich died after surgery. Of the 6 ostriches that survived, 1 died 1 week after discharge from the hospital. The remaining birds survived without redevelopment of impaction.     

Anesthetic management of ruminants and swine with selected pathophysiologic alterations

Surgical diseases induce pathophysiologic alterations in ruminants and swine that are often of critical importance in the perioperative period. Circulation and ventilation may be severely compromised. Alterations in acid-base balance, fluids, and electrolytes should be anticipated, identified, and corrected. Also discussed is the selection of appropriate anesthetic techniques and supportive therapy based upon the patient's physiologic status and surgical requirements.