Veterinary anaesthesia and analgesia
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Orbital and globe surgeries are commonly performed in companion animals and are considered to cause moderate to severe pain. Regional anesthesia techniques can provide complete sensory blockade, analgesia for painful procedures and improve surgical conditions. The purpose of this review is to summarize local and regional anesthesia techniques for ophthalmic surgery in dogs and cats with emphasis on veterinary publications in the past 12 years. ⋯ Reported techniques include regional techniques such as retrobulbar anesthesia, peribulbar anesthesia and sub-Tenon's anesthesia, and local techniques such as eyelid and conjunctival infiltration, intracameral anesthesia, splash block and insertion of intraorbital absorbable gelatin sponge infused with local anesthetic. Administration guidelines, indications and contraindications, and complications of each technique are discussed. Regional anesthesia techniques were reported to be effective during ophthalmic surgeries and are recommended for use as part of the anesthetic regimen and pain management in animals. However, the veterinary literature is still lacking controlled clinical trials and adverse events reports; therefore, there is very little evidence for choosing one technique over another.
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Randomized Controlled Trial
Impact of Trendelenburg (head down) and reverse Trendelenburg (head up) position on respiratory and cardiovascular function in anaesthetized horses.
To describe the cardiorespiratory effects of a change in table position in anaesthetized horses. ⋯ Gas exchange is better preserved in HU compared to HD, especially if applied from the start of the anaesthesia.
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To describe an ultrasound-guided thoracic paravertebral block and determine the distribution after injection of two volumes of methylene blue in dog cadavers. ⋯ Ultrasound-guided injection at the thoracic paravertebral space resulted in staining of the spinal nerve in all dogs. However, T5 paravertebral space was not accurately identified using anatomic landmarks. Dye distribution was not significantly different between the two groups; therefore, the use of the lower-volume and multiple-site injections would be potentially necessary in clinical cases to achieve ipsilateral blockade of the thoracic wall.
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Observational Study
Agreement among anesthesiologists regarding postoperative pain assessment in dogs.
To establish evidence for the validity and reliability of three commonly used pain scales in dogs when assessed by video by specialists in anesthesia. ⋯ The preferred use of the VAS and NRS over the use of the GPS should be cautiously considered for research applications when experts are observers. Revisions of the GPS to clarify descriptors and remove or modify items that may not be associated with pain in dogs should be considered.
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To evaluate the effects of an alveolar recruitment maneuver (ARM) followed by 5 cmH2O positive end-expiratory pressure (PEEP) in dogs undergoing laparoscopy. ⋯ In dogs undergoing laparoscopy, ARM followed by 5 cmH2O PEEP improves gas exchange and respiratory system mechanics.