Veterinary anaesthesia and analgesia
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Randomized Controlled Trial
Ventilation distribution assessed with electrical impedance tomography and the influence of tidal volume, recruitment and positive end-expiratory pressure in isoflurane-anesthetized dogs.
To examine the intrapulmonary gas distribution of low and high tidal volumes (VT) and to investigate whether this is altered by an alveolar recruitment maneuver (ARM) and 5 cmH2O positive end-expiratory pressure (PEEP) during anesthesia. ⋯ Both low and high VT were poorly distributed to dorsal dependent regions, where ventilation was improved following the current ARM and PEEP only during high VT. Studies on the role of high VT on pulmonary complications are required.
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To investigate the efficacy of a new intravenous (IV) nanoemulsified isoflurane formulation for maintenance of general anesthesia in dogs. ⋯ Administration of 15% isoflurane-loaded lipid nanoemulsion IV was effective in maintaining general anesthesia in dogs but did not reduce the amount of isoflurane necessary to maintain general anesthesia. Significant hypotension and nonrespiratory acidosis occurred with the injectable form.
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In UK law, allowing an animal protected under the Animal Welfare Act 2006 (AWA 2006) (as devolved) to suffer 'unnecessarily' may render the person responsible for it to prosecution. The act does not define suffering, although 'case law' suggests that suffering encompasses more than pain. Clinicians responsible for animals under their care in the intensive care unit (ICU) are likely to also be responsible in law for the welfare of those animals, and may be called upon to justify why any suffering was necessary, or more likely, why they did not act to end any suffering when it became 'unnecessary'. As animals are considered to be 'property' in law, the legal requirement to prevent 'unnecessary suffering' may conflict with the owner's property rights. Additionally, professional conflict may arise between the clinicians whose opinion of where the border between 'heroic treatment' and 'futile treatment' lays. Different types of suffering that might be relevant to clinical and ethical decision making for patients in the ICU are discussed, with suggestions for how these might be categorised, measured and recorded, so that objective data is available on which discussions about the animal's actual and projected welfare can be held with the animal's owner, and other clinicians involved in the case. ⋯ The development of 'welfare scoring systems' for the ICU may assist clarifying the point at which heroic treatment is becoming futile, and therefore suffering becoming unnecessary, and place veterinary anaesthetists in an even stronger position to act as 'advocate for the animal' in their care.
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Randomized Controlled Trial
Thermal antinociception following oral administration of tapentadol in conscious cats.
To evaluate the onset, magnitude and duration of thermal antinociception after oral administration of two doses of tapentadol in cats. ⋯ Oral administration of tapentadol increased ST and TT in cats. The durations of thermal antinociception were similar between HighTAP and BUP, both of which were twice as long as that in LowTAP. Studies of different formulations may be necessary before tapentadol can be accepted into feline practice.
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To examine changes in the distribution of ventilation and regional lung compliances in anaesthetized horses during the alveolar recruitment manoeuvre (ARM). ⋯ The proportion of tidal volume distributed to dependent and left lung regions increased during ARM, presumably as a result of opening atelectasis. Monitoring compliance of the dependent lung with EIT may substitute PaO2 measurements during ARM to identify an optimal PEEP.