Anesthetic management of ostriches.

We evaluated and characterized several anesthetic induction protocols used to facilitate intubation and anesthetic maintenance with isoflurane in 7 adult ostriches and 1 juvenile ostrich. Induction protocols included IV administration of zolazepam/tiletamine, IV administration of diazepam/ketamine with and without xylazine, IV administration of xylazine/ketamine, IM administration of carfentanil or xylazine/carfentanil, and mask induction with isoflurane. General anesthesia was maintained with isoflurane in 100% oxygen for various procedures, including proventriculotomy (6 birds), tibial (1 bird) or mandibular (1 bird) fracture repair, and drainage of an iatrogenic hematoma (1 bird). Heart rate and respiratory rate varied greatly among birds. The arterial blood pressure values recorded from 6 of the birds during maintenance of general anesthesia were higher than values recorded for most mammalian species, but were comparable to values reported for awake chickens and turkeys.     

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.     

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.     

Use of sevoflurane for anesthetic management of horses during thoracotomy

OBJECTIVE: To evaluate sevoflurane as an inhalation anesthetic for thoracotomy in horses. ANIMALS: 18 horses between 2 and 15 years old. PROCEDURE: 4 horses were used to develop surgical techniques and were euthanatized at the end of the procedure. The remaining 14 horses were selected, because they had an episode of bleeding from their lungs during strenuous exercise. General anesthesia was induced with xylazine (1.0 mg/kg of body weight, IV) followed by ketamine (2.0 mg/kg, IV). Anesthesia was maintained with sevoflurane in oxygen delivered via a circle anesthetic breathing circuit. Ventilation was controlled to maintain PaCO2 at approximately 45 mm Hg. Neuromuscular blocking drugs (succinylcholine or atracurium) were administered to eliminate spontaneous breathing efforts and to facilitate surgery. Cardiovascular performance was monitored and supported as indicated. RESULTS: 2 of the 14 horses not euthanatized died as a result of ventricular fibrillation. Mean (+/- SD) duration of anesthesia was 304.9 +/- 64.1 minutes for horses that survived and 216.7 +/- 85.5 minutes for horses that were euthanatized or died. Our subjective opinion was that sevoflurane afforded good control of anesthetic depth during induction, maintenance, and recovery. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of sevoflurane together with neuromuscular blocking drugs provides stable and easily controllable anesthetic management of horses for elective thoracotomy and cardiac manipulation.     

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.     

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.     

Anesthetic management of an off-pump open-heart surgery in a dog

ObservationsA 9 year-old, 40 kg, female spayed Bouvier des Flandres was anesthetized for surgical removal of an intra-cardiac mass. Pre-anesthetic work-up included thoracic radiographs, which revealed moderate pleural effusion, and cardiac ultrasound, which identified a mass attached to the wall of the right ventricular outflow tract (RVOT). The mass caused dynamic obstruction of the RVOT during systole. The dog was pre-medicated with intravenous (IV) hydromorphone (0.05 mg kg^?1). Following pre-oxygenation, anesthesia was induced with ketamine (3.75 mg kg^?1, IV) and diazepam (0.18 mg kg^?1, IV). Anesthesia was maintained with isoflurane in oxygen, an intravenous constant rate infusion (CRI) of fentanyl (10–30 μg kg^?1 hour^?1) and a CRI of lidocaine (50–200 μg kg^?1 minute^?1). A right lateral thoracotomy was performed. The heart was stopped transiently with a cold cardioplegic solution for 7.83 minutes to allow the removal of the mass through an open-heart procedure. No cardiopulmonary bypass was used. The heart was successfully restarted after cardiopulmonary resuscitation with internal cardiac massage and internal defibrillation. The dog recovered uneventfully from anesthesia without any apparent neurological sequelae. Post-operative analgesia consisted of intercostal nerve blocks with bupivacaine, CRIs of fentanyl (2–5 μg kg^?1 hour^?1) and lidocaine (40 μg kg^?1 minute^?1) and with oral meloxicam (0.1 mg kg^?1). Five days following surgery, the dog was discharged from the hospital. Histopathology and immunohistochemistry of the mass identified an ectopic thyroid carcinoma.ConclusionsThis case showed the feasibility of whole body hypothermia and using a cold cardioplegic solution to induce cardiac arrest for a short open-heart procedure.     

Anesthetic management with sevoflurane and oxygen for orthopedic surgeries in racehorses

Eighty-five thoroughbred racehorses with various types of fracture were subjected to arthroscopic surgery (44 horses) or internal fixation (41 horses) under sevoflurane anesthesia. The mean end-tidal sevoflurane concentration during anesthesia ranged from 2.5 to 2.8%. PaCO2 was maintained between 50 and 65 mmHg by controlled ventilation. The mean arterial blood pressure was maintained above 65 mmHg by infusion of dobutamine and fluids, however, heart rate significantly increased with time. Recovery from anesthesia was calm and smooth in almost all cases. No apparent complication was observed during and after anesthesia in all cases. Therefore, sevoflurane anesthesia is considered to be safe and useful for orthopedic surgery in racehorses.     

Anesthetic management of an incisional dehiscence in recovery following exploratory laparotomy in a horse.

A 5-year old Arabian mare fell during recovery from general anesthesia after an exploratory laparotomy. This fall resulted in dehiscence of the abdominal closure, and a substantial amount of intestines were exteriorized. Chemical and manual restraints were rapidly used to prevent trauma to the exposed intestines. A second general anesthesia was initiated to clean the intestines and close the incision. Multiple anesthetic problems were encountered, including arterial hypotension and hypoxemia. The horse recovered from the second general anesthesia and surgery, and all complications gradually resolved. The horse was discharged and has not had further problems to date.     

Anesthetic management of an orangutan (Pongo abelii/pygmaeus) undergoing laparoscopic tubal ligation.

An adult hybrid orangutan (Pongo abelii/pygmaeus) was presented to a veterinary teaching hospital for laparoscopic tubal ligation. The orangutan was immobilized with the use of injectable anesthetic agents, then orotracheally intubated. Anesthesia was maintained with the use of isoflurane in oxygen, and positive-pressure ventilation was used to ensure adequate gas exchange. Parameters monitored included arterial blood pressure, ECG, capnometry, and arterial blood gases. Anesthesia was uneventful, and recovery was smooth.