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Manuel Martin-Flores Daniel M. Sakai Chia T. Tseng Robin D. Gleed Luis Campoy 《Veterinary anaesthesia and analgesia》2019,46(2):182-187
Objective
To assess the ability to visually detect fade during train-of-four (TOF) or double burst stimulation (DBS) in anesthetized dogs recovering from nondepolarizing neuromuscular block.Study design
Online anonymous survey.Population
Data from 112 participants.Methods
A web-based survey containing 12 videos of the response to ulnar nerve stimulation with TOF and 12 with DBS obtained at different levels of recovery from rocuronium-induced block was distributed to participants of the American College of Veterinary Anesthesia and Analgesia and the Academy of Veterinary Technicians in Anesthesia and Analgesia e-mail lists. Participants were asked to provide their highest training degree in anesthesiology, watch each video no more than twice, and determine whether fade was present. The probability to correctly recognize fade was calculated using binomial general linear models. General linear models and Tukey’s tests were used to assess the effects of level of neuromuscular block, pattern of stimulation, and observers’ training on the probability to detect fade.Results
The survey was completed by 53 diplomates, 29 licensed veterinary technicians, 24 residents and six doctors of veterinary medicine (DVMs). The probability to detect fade decreased as partial neuromuscular block became more shallow (p < 0.0001). A TOF or DBS ratio of 0.7 had a 50% chance of being detected. DBS was superior to TOF for detecting fade when the ratio was 0.3–0.69. TOF was superior to DBS when the ratio was 0.7–0.9 (p < 0.0001). There were no differences among groups of observers when assessing fade with TOF or DBS.Conclusions and clinical relevance
Detection of fade from observations of the response to TOF in dogs is unreliable. Advance training in anesthesiology or the use of DBS confers little to no advantage for this subjective test. 相似文献10.
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Despite the economic importance of nematodes for sheep enterprises, it is often difficult to convince producers to adopt best practice in worm control. In this paper we discuss key issues in effecting change by communicating worm control messages. The adoption of new strategies is affected by many factors including the relative advantage, complexity, compatibility and the ability to trial the proposed change. The visibility of the problem to be solved and proposed positive outcome are also important. Extension campaigns from the last 30 years, including "WormKill" and "CRACK", are used as examples, and future opportunities and tools, including the internet, for promoting best practice in sheep worm management are discussed. 相似文献
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