Objective: To evaluate and compare the time to extubation in two commonly used methods of analgesia in dogs undergoing elective pelvic limb orthopedic procedures.
Study Design: Prospective, randomized, double-blinded clinical study.
Animals: Twenty-five adult, client-owned, healthy dogs aged 4.4 ± 1.6 years and weighing 38.5 ±3.5 kg.
Methods: All dogs were premedicated with dexmedetomidine (5-10 μg kg(-1)) intramuscularly (IM) and anesthesia was induced with propofol (2-6 mg kg(-1)) intravenously (IV). Atipamazole (0.05-0.1 mg kg(-1)) was administered IM after instrumentation. Anesthesia was maintained with isoflurane in oxygen. Dogs were randomly assigned to one of two groups. In one group, morphine (0.1 mg kg(-1)) and lidocaine (2% lidocaine added to a total volume of 0.2 mL kg(-1)) were administered epidurally and a saline placebo constant rate infusion (CRI) was administered IV (group EPI). In the other group (group MLK), morphine (4 μg kg(-1) minute(-1)), lidocaine (50 μg kg(-1) minute(-1)) and ketamine (10 μg kg(-1) minute(-1)) were administered as an IV CRI and a saline placebo was administered by epidural injection. Temperature at the discontinuation of isoflurane, temperature at extubation, time to extubation, duration of inhalation anesthesia and duration of surgery were recorded.
Results: No significant differences between the groups were found in time to extubation, temperature at the end of surgery, temperature at extubation and total surgical time. Total anesthesia time was significantly longer in group EPI.
Conclusions And Clinical Relevance: Administration of MLK at the doses reported in this study did not prolong the time to extubation in comparison with a morphine-lidocaine epidural nerve block. The results indicate that concern over prolonging the time to extubation is not a reason to avoid the administration of MLK.
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http://dx.doi.org/10.1111/vaa.12273 | DOI Listing |
J Clin Med
January 2025
Department of Cardiovascular Surgery, School of Medicine, Kocaeli University, 41001 Kocaeli, Turkey.
: The Charlson Comorbidity Index (CCI) is designed for evaluating comorbidities and mortality risks, with the age-adjusted CCI (ACCI) combining age and comorbidity assessments. Despite its long-standing use, research on CCI's application in cardiac surgery patients is limited. This study assessed the effectiveness of CCI and ACCI in predicting in-hospital mortality and post-surgery outcomes for patients undergoing isolated coronary artery bypass grafting (CABG).
View Article and Find Full Text PDFMedicina (Kaunas)
January 2025
Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Konyang University Myunggok Medical Research Institute, Konyang University College of Medicine, Daejeon 35365, Republic of Korea.
: Neuromuscular blocking agents are essential to ensure optimal surgical conditions during general anesthesia. Sugammadex, a selective binding agent, is widely used to reverse neuromuscular blockade. While weight-based dosing (2 mg/kg for moderate blockade) is recommended, many clinicians administer a fixed dose of 200 mg in clinical practice, potentially leading to overdosing.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
January 2025
Department of Anesthesiology, The Yangzhou Clinical Medical College of Xuzhou Medical University, Yangzhou, Jiangsu Province, China. Electronic address:
Objective(s): To investigate whether cerebral oximetry index (COx)-guided blood pressure management during cardiopulmonary bypass (CPB) could reduce postoperative delirium (POD) in patients undergoing acute type A aortic dissection (ATAAD) repair.
Design: A prospective, randomized controlled trial.
Setting: Patients undergoing ATAAD repair with CPB.
PLoS One
January 2025
Department of Computer Science, University College London, London, United Kingdom.
Complex biological systems undergo sudden transitions in their state, which are often preceded by a critical slowing down of dynamics. This results in longer recovery times as systems approach transitions, quantified as an increase in measures such as the autocorrelation and variance. In this study, we analysed paediatric patients in intensive care for whom mechanical ventilation was discontinued through removal of the endotracheal tube (extubation).
View Article and Find Full Text PDFAm J Emerg Med
January 2025
Departments of Emergency Medicine and Critical Care Medicine, Stanford Health Care, 900 Welch Road, Palo Alto, CA 94304, USA.
Background: Critically ill ED patients on life support may undergo transition to comfort care as decided by the surrogate decision maker. When several hours are needed for loved ones to arrive and say farewell before initiating comfort care ("delayed comfort care"), these patients require prolonged ED stays or costly intensive care unit (ICU) admissions.
Methods: A novel ED observation unit (EDOU)-based delayed comfort care pathway for ED patients on invasive mechanical ventilation and/or vasopressors was created in 2013 at Stanford Hospital.
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