Veterinary anaesthesia and analgesia
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Review
Review of hypoxaemia in anaesthetized horses: predisposing factors, consequences and management.
To discuss how hypoxaemia might be harmful and why horses are particularly predisposed to developing it, to review the strategies that are used to manage hypoxaemia in anaesthetized horses, and to describe how successful these strategies are and the adverse effects associated with them. ⋯ Although there is no evidence that hypoxaemia is associated with increased morbidity and mortality in anaesthetized horses, most anaesthetists would agree that it is important to recognise and prevent or treat it. Favourable anatomical and physiological adaptations of a horse for exercise adversely affect gas exchange once the animal is recumbent. Hypoxaemia is recognised more frequently in horses than in other domestic species during general anaesthesia, although its incidence in healthy horses remains unreported. Management of hypoxaemia in anaesthetized horses is challenging and often unsuccessful. Positive pressure ventilation strategies to address alveolar atelectasis in humans have been modified for implementation in recumbent anaesthetized horses, but are often accompanied by unpredictable and unacceptable cardiopulmonary adverse effects, and some strategies are difficult or impossible to achieve in adult horses. Furthermore, anticipated beneficial effects of these techniques are inconsistent. Increasing the inspired fraction of oxygen during anaesthesia is often unsuccessful since much of the impairment in gas exchange is a direct result of shunt. Alternative approaches to the problem involve manipulation of pulmonary blood away from atelectatic regions of the lung to better ventilated areas. However, further work is essential, with particular focus on survival associated with general anaesthesia in horses, before any technique can be accepted into widespread clinical use.
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Clinical Trial
The effect of anesthetic drug choice on accuracy of high-definition oscillometry in laterally recumbent horses.
To determine the accuracy of high-definition oscillometry (HDO) for arterial pressure measurement during injectable or inhalation anesthesia in horses. ⋯ More variability in HDO occurred during TD. The cuff width:tail girth ratio is important for accuracy of HDO.
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Comparative Study
Comparison of arterial blood pressure measurements obtained invasively or oscillometrically using a Datex S/5 Compact monitor in anaesthetised adult horses.
To assess agreement between noninvasive blood pressure (NIBP) oscillometrically-derived values from a multiparameter monitor (Datex Ohmeda S/5 Compact) with those obtained by invasive blood pressure (IBP) measurement in anaesthetised horses undergoing elective surgery. ⋯ Oscillometric blood pressure measurement using the Datex Ohmeda S/5 Compact multiparameter monitor conforms to ACVIM standards when the NIBP cuff is placed on the tail. However, because of the wide variability in measurements, we cannot recommend this technique to guide therapy in anaesthetised adult horses.
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To evaluate replicate effects and test-retest reliability of mechanical and thermal quantitative sensory testing (QST) in normal dogs and dogs with osteoarthritis (OA)-associated pain. ⋯ If QST is to be used clinically to evaluate a sensitized state, the variability over time needs to be accounted for in the study design.
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To assess the reliability of using video recordings to evaluate anesthesia recovery in dogs. ⋯ The use of a video to evaluate recovery in dogs should be used with caution. Individual raters' agreement for specific scores was poor, but evaluating recovery overall had perfect agreement.