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A look through the latest literature

The latest academic publications providing further insight into this month's In Focus topic: anaesthesia and analgesia

Impact of pre-surgical echocardiography on the anaesthetic management of cats

Louise Clark and others, Royal Veterinary College, Hawkshead

Non-specific, incidental clinical findings that could be attributed to heart disease, such as heart murmurs, abnormal heart sounds and cardiac arrhythmias, are commonly encountered in cats. Interpreting such findings can be challenging when planning sedation or general anaesthesia. The authors examined the impact of preanaesthetic echocardiography on the anaesthetic management plans in cats showing such findings. They carried out scans on 40 cats and then compared the anaesthetic plans of different anaesthetists who had or had not been shown the results. They found that access to the echocardiography findings did significantly affect the anaesthetic choices, for example in decisions on alpha-2 agonist use in cats with evidence of atrial enlargement.

Veterinary Anaesthesia and Analgesia, 47, 614-620

Evaluation of a novel analgesia combination in dogs undergoing ovariohysterectomy

Butch KuKanich and others, Kansas State University, Manhattan

Methadone is an opioid that produces effective but rather short-lived analgesia in dogs. It has been formulated in combination with fluconazole to extend the duration of pain control, and naltrexone as a deterrent to human opioid misuse. The authors assess the quality of analgesia achieved using this three-agent combination in bitches undergoing ovariohysterectomy. Their findings demonstrate that this novel formulation, delivered orally every 12 hours, is as effective as subcutaneous doses of methadone given over four hours.

American Journal of Veterinary Research, 81, 699-707

Pharmacokinetics of carprofen and firocoxib in racing greyhounds

Tim Morris and others, University of Nottingham

Veterinary treatment of animals used in sport is necessary on welfare grounds but clinicians must ensure there are no residues detectable that infringe the rules of racing. The authors investigated the pharmacokinetics of two licensed analgesic drugs to inform guidelines on their use in treating greyhounds. Their findings suggest appropriate levels for carprofen and firocoxib in urine and plasma that may be considered irrelevant. The findings also suggest recommended limits of detection for cases in which animals consume analgesic drug residues in meat.

Australian Veterinary Journal, 98, 578-585

Effect of epaxial muscle infiltration with bupivacaine on opioid use after spinal surgery

William McFadzean and others, University of Bristol

Post-operative pain management in patients that have undergone intervertebral disc herniation surgery will usually involve systemic dosing with opioid and non-steroidal anti-inflammatory drugs. An alternative method used in humans is based on injections of local anaesthetic agents into the epaxial muscles. The authors describe a similar technique in dogs involving the peri-incisional infiltration of bupivacaine before surgery and at wound closure. They found that pre-surgical administration reduced the need for opioids and resulted in a longer period before the dogs needed methadone.

The Veterinary Journal, 270, 105622

Mepivacaine versus lidocaine for local anaesthesia when castrating stallions

Alycia Crandall and others, University of Pennsylvania

Local anaesthetic agents are an attractive option for castration procedures in stallions because of their low cost and predictable effects. The authors compare the efficacy of two local agents when delivered into the testes of horses undergoing Henderson drill castration. Their findings suggest that intratesticular mepivacaine produced better cremaster muscle relaxation than intratesticular lidocaine when administered five minutes before beginning the procedure.

Equine Veterinary Journal, 52, 805-810

Prevention of hypotension during general anaesthesia in cattle

Laura Gomez Fernandez and others, University College Dublin

Treatment of hypotension in cattle is more challenging than in some other species due to the limited number of drugs available for use in food-producing animals. The authors describe two cases in which a continuous infusion of adrenaline was used to restore and maintain normal blood pressure in animals which developed hypotension during surgical procedures. Clinically significant improvements in blood pressure were only seen with infusion rates exceeding 0.05µg/kg/min.

Irish Veterinary Journal, 73, 13

Comparison of three inhalant agents used for general anaesthesia in snakes

Lauren Kane and others, University of Illinois, Urbana

Inhalant anaesthetics are preferred to injectable agents for both induction and maintenance of anaesthesia in veterinary procedures involving snakes. Yet there are few published studies evaluating the effectiveness of inhalant agents in these patients. The authors compared the response of prairie rattlesnakes (Crotalus viridis) to anaesthesia using three different agents. They found that exposure to isoflurane and sevoflurane produced consistent and predictable loss of the righting reflex and induction of anaesthesia deep enough to allow intubation. Desflurane was less effective in this species.

Journal of the American Veterinary Medical Association, 257, 945-949

Choice of pre-emptive analgesia in tibial plateau levelling osteotomy

William Pownall and others, University of Berne, Switzerland

Tibial plateau levelling osteotomy is a widely used surgical technique in the management of dogs with cruciate ligament damage. However, because of the invasiveness of the technique, patients are at high risk of developing chronic post-operative pain. The authors examined the effects of different forms of pre-emptive analgesia, involving a spinal/epidural or a sciatic-femoral nerve block. After examining the records from 101 cases, they found that the type of pre-emptive locoregional analgesia used did not appear to affect the likelihood of long-term chronic post-surgical pain.

Veterinary Surgery, 50, 71-80