Comparison of 2 blind approaches to the paravertebral brachial plexus regional block in canine cadavers

The paravertebral brachial plexus block (PVB) provides thoracic limb analgesia. The objective was to describe a blind craniocaudal (CC) approach to the PVB and compare its accuracy, time, and difficulty of performance with a blind dorsoventral (DV) approach. The operator was initially trained by experienced clinicians to perform both approaches on 5 cadavers. Next, a CC or DV approach to the PVB was performed on both thoracic limbs of 20 cadavers (20 for each approach). Methylene blue dye was equally divided into 4 aliquots to stain the ventral branches of the sixth to eighth cervical and first thoracic spinal nerves. Successfully stained (stain ≥ 1 cm) spinal nerves were counted. The time to perform each approach was recorded and ease of performance was scored using a numerical scale (1 “easy” to 4 “difficult”). The phrenic nerve was checked for stain. A Wilcoxon signed-rank test was used to compare approaches. The data are presented as median (interquartile range; minimum to maximum range). The number of stained nerves with the CC approach 3 (1; 2 to 4), was higher than the DV approach 2 (2; 0 to 4) (P = 0.002). The time (in seconds) to perform the CC approach 125 (79; 70 to 194), was not different from the DV approach 142 (54; 101 to 232) (P = 0.084). The CC approach 2 (2; 1 to 4) was easier to perform than the DV approach 3 (1; 2 to 4) (P = 0.024). No phrenic nerve staining was observed with either approach. The CC approach is an alternative to the DV approach for performing the PVB in dogs.     

Influence of lidocaine and diazepam on peri-induction intraocular pressures in dogs anesthetized with propofol–atracurium

The purpose of this study was to evaluate the effects on the intraocular pressure (IOP) of lidocaine or diazepam administered intravenously (IV) before induction of anesthesia with propofol-atracurium and orotracheal intubation in normal dogs, as well as the effects on the IOP of lidocaine applied topically to the larynx after induction with propofol-atracurium. We randomly assigned 32 random-source dogs, obtained from municipal pounds, to receive the following: lidocaine, 2 mg/kg IV, with saline, 0.1 mL/kg topically applied to the larynx (LIDOsal); saline, 0.1 mL/kg IV, with lidocaine, 2 mg/kg topically applied to the larynx (SALlido); diazepam (Valium), 0.25 mg/kg IV, with saline, 0.1 mL/kg topically applied to the larynx (VALsal); or saline, 0.1 mL/kg IV, with saline, 0.1 mL/kg topically applied to the larynx (SALsal). We measured arterial pressure directly, by means of an indwelling catheter placed in a peripheral artery. Anesthesia was induced with propofol, 8 mg/kg IV, until loss of jaw tone, followed by atracurium, 0.3 mg/kg IV. We measured the IOP in triplicate in each eye before premedication, before induction, before intubation, and after intubation. After induction, the IOP was significantly increased except in the VALsal group, in which the IOP was significantly lower than in the negative-control group before intubation. After intubation, the IOP was significantly elevated in all the groups compared with the values before induction. Cardiovascular parameters were essentially similar in all the groups, except for a significant increase in blood pressure after intubation in the SALlido group. Thus, propofol-atracurium anesthesia causes an increase in IOP that is blunted by diazepam. However, diazepam does not blunt the increase in IOP observed with intubation.     

Radiographic evaluation of positional atelectasis in sedated dogs breathing room air versus 100% oxygen

This study documents the degree of positional atelectasis in sedated dogs receiving 100% oxygen (O₂) versus room air. Initial lateral recumbency was determined by an orthopedic study and initial treatment (O₂ or room air) was randomized. Each dog was maintained in lateral recumbency for 15 min, at which time ventrodorsal (VD) and opposite lateral thoracic radiographs were obtained. Each dog was then maintained in the opposite lateral recumbency and received the other treatment for 15 min, followed by a VD and opposite lateral radiograph. Radiographs were scored for severity of pulmonary pattern and mediastinal shift by 3 radiologists. Dogs breathing O₂ had significantly higher scores than dogs breathing room air. If radiographically detectable dependent atelectasis is present, repeat thoracic images following manual positive ventilation and/or position change to the opposite lateral recumbency should be made to rule out the effect of O₂ positional atelectasis and avoid misdiagnosis.     

A systematic review of sevoflurane and isoflurane minimum alveolar concentration in domestic cats

ObjectiveThe purpose of this systematic review is to summarize the results of studies which have determined the minimum alveolar concentration (MAC) of isoflurane and sevoflurane in domestic cats.Study DesignSystematic review.AnimalsCats.Methods usedA comprehensive search of research literature was performed without language restriction. The search utilized the Pubmed, Google Scholar, and CAB Abstracts electronic databases using a combination of free text terms ‘Minimum alveolar concentration’, ‘sevoflurane’, ‘isoflurane’, ‘anesthetic’, ‘cat’, ‘cats’ or ‘feline’. The search was conducted from November 2010 to June 2012.ResultsThe MAC for isoflurane ranged from 1.20 ± 0.13% to 2.22 ± 0.35% and the MAC for sevoflurane ranged from 2.5 ± 0.2% to 3.95 ± 0.33%. The average MAC for isoflurane was 1.71 ± 0.07% and for sevoflurane was 3.08 ± 0.4%.Conclusions &; Clinical RelevanceThe average MAC for isoflurane was 1.71 ± 0.07% and for sevoflurane was 3.08 ± 0.4%. Methodology differed among studies, and particular attention should be paid in the future to appropriate reporting of methods to allow sound conclusions to be made from the results.     

Development,implementation and impact of simple patient safety interventions in a university teaching hospital

ObjectiveTo determine the incidence of anesthesia patient safety incidents at a university teaching hospital, develop interventions to address the most common incidents, and determine the effectiveness of these interventions.Study designPre-post intervention observational.AnimalsFour thousand, one hundred forty dogs and cats anesthetized by the anesthesia service.MethodsThe study was divided into two 11.5 month periods. During each period, incidents were logged (e.g. closed adjustable pressure limiting (APL) valve, esophageal intubation, and medication error). At the end of the first period, four countermeasures were incorporated into the service’s protocols: 1) prior to any drug injection, the individual would read out aloud the drug name, patient name, and route of administration; 2) use of a uniquely colored occlusive wrap over arterial catheters; 3) a check box on the anesthesia record labeled “Technician Confirmed Intubation”; 4) a check box on the anesthesia record labeled “Technician Checked OR (operating room)”. The number of patient safety incidents during period 1 and period 2 were compared using Fisher’s Exact Test.ResultsDuring Period 1, there were 74 incidents documented in 2028 patients (3.6%) including 25 medication errors, 20 closed APL valves, and 16 of esophageal intubation. During Period 2, there were 30 incidents documented in 2112 patients (1.4%) including 14 medication errors, 5 closed APL valves, and 4 of esophageal intubation. The proportion of events during Period 2 was significantly smaller than during Period 1 (p < 0.0001).Conclusions and Clinical relevanceImplementation of four simple interventions was associated with a significant decrease in the number of incidents.     

The occurrence of tumors in large bears (Ursidae)--a literature review and six case descriptions

Histological findings on two Malayan sun bears and four sloth bears show that malignant neoplasms play an important role in tropic bears. Further, most of the tumors originated from the hepatic and biliary tract. Our results were compared with other investigations on zoo animals during the last 70 years revealing that malignant neoplasms are the most common ones in bears of the family Ursidae. Accordingly to our results, sloth and Malayan sun bears seem to have a disposition to develop malignant neoplasms of the hepatic and biliary tract, but within other species only polar bears seem to suffer predominantly from such neoplasia. The reason for this phenomenon could be an alimentary intake of carcinogens. Furthermore, Malayan sun bears show very often neoplasms of the thyroid gland as it is also observed in other carnivora.     

Transdermal fentanyl patches in small animals

Fentanyl citrate is a potent opioid that can be delivered by the transdermal route in cats and dogs. Publications regarding transdermal fentanyl patches were obtained and systematically reviewed. Seven studies in cats and seven studies in dogs met the criteria for inclusion in this review. Dogs achieved effective plasma concentrations approximately 24 hours after patch application. Cats achieved effective plasma concentrations 7 hours after patch application. In dogs, transdermal fentanyl produced analgesia for up to 72 hours, except for the immediate 0- to 6-hour postoperative period. In cats, transdermal fentanyl produced analgesia equivalent to intermittent butorphanol administration for up to 72 hours following patch application.     

The role of reforestation in carbon sequestration

New Forests - In the United States (U.S.), the maintenance of forest cover is a legal mandate for federally managed forest lands. More broadly, reforestation following harvesting, recent or...