Objective: To compare the effects of constant rate infusions (CRI) of fentanyl or dexmedetomidine, combined with lidocaine and ketamine, on cardiovascular response during surgery, sevoflurane requirement and postoperative pain in dogs undergoing mastectomy.
Study Design: Prospective, randomized, blinded, clinical trial.
Animals: A total of 29 female dogs with mammary tumors.
Methods: Premedication consisted of intramuscular acepromazine and morphine. General anesthesia was induced with intravenous propofol and maintained with sevoflurane. Dogs were randomized to be administered intravenous DLK [dexmedetomidine 1 μg kg loading dose (LD) and 1 μg kg hour; lidocaine 2 mg kg LD and 3 mg kg hour; ketamine 1 mg kg LD and 0.6 mg kg hour; n = 14] or FLK (fentanyl 5 μg kg LD and 9 μg kg hour; same doses of lidocaine and ketamine; n = 15) during anesthesia. Cardiorespiratory variables and end-tidal sevoflurane (Fe'Sevo) were recorded during surgery. The number of dogs administered ephedrine to treat arterial hypotension [mean arterial pressure (MAP) < 60 mmHg] was recorded. Meloxicam was administered to both groups. Postoperative pain and rescue analgesia requirement were assessed for 24 hours using the short form of the Glasgow Composite Measure Pain Scale. Data were compared using a mixed effects model or a Mann-Whitney test.
Results: More dogs required ephedrine in FLK than in DLK (67% versus 7%). Heart rate was not significantly different between groups, whereas lower values of MAP (p ≤ 0.01) and Fe'Sevo (p = 0.018) were observed in FLK than in DLK. Rescue analgesia was administered to 2/15 dogs in FLK and 0/14 dogs in DLK.
Conclusions And Clinical Relevance: Based on the cardiovascular response during surgery, intraoperative infusions of FLK and DLK provided adequate antinociception. Infusion of DLK provided greater stability of blood pressure. Both protocols resulted in minimal need for additional analgesia within 24 hours postoperatively.
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http://dx.doi.org/10.1016/j.vaa.2024.04.006 | DOI Listing |
JTCVS Open
December 2024
Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, School of Medicine, Baltimore, Md.
Objective: Optimal perioperative pain management is an essential component of perioperative care for the cardiac surgical patient. This turnkey order set is part of a series created by the Enhanced Recovery After Surgery Cardiac Society, first presented at the Annual Meeting of The American Association for Thoracic Surgery in 2023. Several guidelines and expert consensus documents have been published to provide guidance on pain management and opioid reduction in cardiac surgery.
View Article and Find Full Text PDFAesthetic Plast Surg
January 2025
, 433 N Camden Dr #770, Beverly Hills, CA, 90210, USA.
Background: Venous thromboembolism (VTE) is the most feared complications of abdominoplasty, and multiple studies in the plastic surgery literature have sought to prevent these complications. General inhalational anesthesia can increase the risk of VTE via a variety of mechanisms. This study evaluates whether performing abdominoplasties under total intravenous anesthesia (TIVA) instead of general inhalational anesthesia can reduce the risk of VTE.
View Article and Find Full Text PDFCan J Vet Res
January 2025
Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
The objective of this prospective study was to investigate whether repeated consecutive general anesthesia in horses undergoing 2 different anesthetic protocols could lead to improved recovery scores. Six healthy female Standardbred horses (453 ± 57 kg; 6.5 ± 4.
View Article and Find Full Text PDFOpen Vet J
November 2024
Department of Molecular Biotechnology, Central Laboratory Unit, University Nacional Hermilio Valdizán, Huánuco, Perú.
Background: The limited and detailed literature on total intravenous anesthesia (TIVA), as well as the clinical indications for unilateral ovariectomy in llamas, are not well-defined. Therefore, it is necessary to understand the anesthetic events and the surgical intervention in this species.
Aim: The objective of this study was to evaluate the intraoperative physiological and clinical parameters in llamas undergoing unilateral ovariectomy, under three protocols of TIVA.
Objective: To evaluate the clinical benefit and adverse events following outpatient intravenous (IV) ketamine-lidocaine (KL) infusions for palliation of cancer pain in dogs and cats.
Methods: Medical records from 15 years (2008 to 2023) were searched and data reviewed retrospectively. Animals were prescribed ketamine (0.
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