Veterinary anaesthesia and analgesia最新文献

{"title":"Evaluating the ratio of arterial partial pressure of oxygen to inspired oxygen fraction and dynamic compliance following anesthetic induction for predicting postanesthetic hypoxemia in dogs.","authors":"Minha Kim, Taehoon Sung, Changhoon Nam, Inhyung Lee, Won-Gyun Son","doi":"10.1016/j.vaa.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.07.003","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate correlation between postanesthetic induction ratio of arterial partial pressure of oxygen to inspired oxygen fraction (PaO₂:FIO₂) and dynamic compliance (C_dyn) with postanesthetic hypoxemia [PaO₂ < 80 mmHg (10.7 kPa)] in mechanically ventilated dogs, and to compare PaO₂:FIO₂ and C_dyn for predicting postanesthetic hypoxemia.</p><p><strong>Study design: </strong>Retrospective, single-cohort, observational study.</p><p><strong>Animals: </strong>A total of 168 dogs anesthetized with isoflurane under pressure-controlled ventilation.</p><p><strong>Methods: </strong>Postinduction arterial blood gas (ABG) analysis was performed 5-40 minutes postintubation and following postextubation (room-air). C_dyn values were matched to the nearest postinduction ABG measurement (within 15 minutes). PaO₂:FIO₂ and C_dyn values were categorized using thresholds of 300 mmHg (40.0 kPa) and 400 mmHg (53.3 kPa), and 1.0 and 1.5 mL cmH₂O^-1 kg^-1. Linear-by-linear association was used to evaluate PaO₂:FIO₂ and C_dyn with the prevalence of postanesthetic hypoxemia. Diagnostic accuracy of these variables was assessed using receiver operating characteristic (ROC) curve analysis. Optimal cut-off values for distinguishing hypoxemia were determined using the empirical quantile bootstrap method (fixed sensitivity of 95%).</p><p><strong>Results: </strong>Postanesthetic hypoxemia was observed in 22/168 dogs. Lower postinduction PaO₂:FIO₂ (p = 0.033) and C_dyn (p = 0.002) values were associated with a significantly higher prevalence of postanesthetic hypoxemia. The area under the ROC curve (AUC) of PaO₂:FIO₂ {0.696 [95% confidence interval (CI): 0.599-0.807]} and C_dyn [0.716 (95% CI 0.602-0.824)] exhibited good (AUC 0.6-0.7) to satisfactory (AUC 0.7-0.8) diagnostic accuracy, with no significant difference between variables (p = 0.432). Optimal cut-off values were 332.80 mmHg (44.4 kPa) (95% CI 274.41-374.52 mmHg, 36.6-49.9 kPa) for PaO₂:FIO₂ and 1.01 (95% CI 0.86-1.13) mL cmH₂O^-1 kg^-1 for C_dyn.</p><p><strong>Conclusions and clinical relevance: </strong>Postanesthetic hypoxemia was more frequently observed in dogs with low postinduction PaO₂:FIO₂ and C_dyn. These variables had good to satisfactory diagnostic accuracy.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between ejection fraction and shortening fraction in dogs, and diagnostic accuracy of shortening fraction in identifying normal and abnormal ventricular contraction.","authors":"Manuel Martin-Flores, Mark Rishniw","doi":"10.1016/j.vaa.2025.06.012","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.06.012","url":null,"abstract":"<p><strong>Objective: </strong>To examine the relationship between shortening fraction and ejection fraction, and to calculate the diagnostic performance of shortening fraction in identifying normal, subnormal and supranormal ejection fractions in dogs.</p><p><strong>Study design: </strong>Reanalysis of prospective data.</p><p><strong>Animal population: </strong>A group of 224 dogs; 86 healthy, 96 with mitral valve disease, and 42 with other cardiac pathologies.</p><p><strong>Methods: </strong>Echocardiographic cineloops of right parasternal short- and long-axis (RPSA and RPLA) and left apical four-chamber (LA4C) views were analyzed by five experienced echocardiographers. Ejection fraction was measured using the Simpson's method of discs from RPLA and LA4C, and shortening fraction from RPSA with M-mode. Sensitivity, specificity, and positive and negative predictive values of shortening fraction for identifying a low, normal, or high ejection fraction for each volumetric method, and the diagnostic performance of the LA4C volumetric method against the RPLA volumetric method, were calculated.</p><p><strong>Results: </strong>Sensitivity and specificity to detect low ejection fraction were 92% and 93% (RPLA) and 71% and 91% (LA4C). The positive and negative predictive values for low ejection fraction were 55% and 99% (RPLA) and 46% and 97% (LA4C).</p><p><strong>Conclusions and clinical relevance: </strong>Shortening fraction was a robust indicator of ejection fraction in dogs, with high sensitivity and specificity for the detection of decreased left ventricular systolic function. Given its simplicity and despite its limitations, shortening fraction might be a valuable tool during perianesthetic examinations of dogs.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rocuronium and sugammadex in neonatal and juvenile foals.","authors":"Manuel Martin-Flores, Joaquin Araos, Robin D Gleed","doi":"10.1016/j.vaa.2025.06.010","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.06.010","url":null,"abstract":"","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of a long-duration intravenous infusion of detomidine, with and without vatinoxan, on equine energy metabolism and urine composition.","authors":"Noora Jantunen, Marja Raekallio, Bartlomiej Obrochta, Heidi Tapio, Luis Gracia Calvo, Rebecca Rivera Pöyhönen, Kati Hagman, Ninja Karikoski","doi":"10.1016/j.vaa.2025.06.011","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.06.011","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effects of a 4 hour detomidine constant rate infusion (CRI) with and without a vatinoxan CRI on energy metabolism and urine composition.</p><p><strong>Study design: </strong>Randomized, blinded, crossover study.</p><p><strong>Animals: </strong>Eight Finnhorses, 587 (550-620) kg [median (range)] and 13 (4-16) years old.</p><p><strong>Methods: </strong>Horses were administered an intravenous (IV) detomidine loading dose (0.01 mg kg^-1) followed by 240 minutes CRI (0.015 mg kg^-1 hour^-1) (DET) and the same detomidine protocol combined with an IV vatinoxan loading dose (0.15 mg kg^-1) and CRI (0.05 mg kg hour^-1) (DET+VAT). Blood samples for glucose, insulin, non-esterified fatty acid (sNEFA), and β-hydroxybutyrate (sBHB) concentrations were collected during and for 240 minutes after CRI. Urine samples for glucose and sodium concentrations were collected at the end of CRI. Data were analysed using repeated measures ANCOVA and Wilcoxon signed-rank test.</p><p><strong>Results: </strong>Blood glucose concentrations were significantly higher during CRI with DET compared with DET+VAT (all p < 0.001). Median insulin concentration was significantly lower during CRI with DET compared with DET+VAT (p = 0.012-0.018) and peaked at the end of follow-up period. With DET+VAT CRI, sBHB and sNEFA were significantly higher compared with DET (p < 0.001-0.002, p < 0.001-0.007). Urination was more frequent during DET CRI than with DET+VAT (p = 0.020). Glucosuria was more profound with DET [6.3 (2.4-11.1) mmol L^-1] than with DET+VAT [0.1 (0.0-3.1) mmol L^-1] (p = 0.012). More sodium was excreted into urine with DET [49.0 (22-66) mmol L^-1] than with DET+VAT [27.0 (8-43) mmol L^-1] (p = 0.012).</p><p><strong>Conclusions and clinical relevance: </strong>Vatinoxan alleviated detomidine-induced hypoinsulinaemia and hyperglycaemia and diminished urination frequency, glucosuria, and natriuresis during and after a 4 hour CRI. Vatinoxan may be beneficial during standing sedation with alpha2-adrenoceptor agonists.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of a transdermal eutectic lidocaine/prilocaine cream and subcutaneous lidocaine injection prior to jugular vein catheterization in horses: a randomized crossover study.","authors":"Biancia Amiet, Joanne Rainger, Steven Zedler, Allison Stewart, Solomon Woldeyohannes, Wendy Goodwin","doi":"10.1016/j.vaa.2025.06.009","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.06.009","url":null,"abstract":"<p><strong>Objective: </strong>To compare horses' aversive behavioural responses to the application of 5% prilocaine/lidocaine eutectic mixture of local anaesthetics (EMLA) cream versus subcutaneous infiltration of 2% lidocaine, followed by jugular vein catheterization.</p><p><strong>Study design: </strong>Blinded, randomized study.</p><p><strong>Animals: </strong>A group of 26 university-owned research horses.</p><p><strong>Methods: </strong>Each horse received both treatments at opposite jugular sites with ≥ 12 hours between procedures. One randomly assigned jugular site received 1 g cm^-2 of 5% EMLA cream 60 minutes before catheterization, while the contralateral site received 1.5 mL of 2% lidocaine subcutaneously 15 minutes prior. A 14 gauge catheter was introduced percutaneously and maintained for 20 minutes. A total of four blinded evaluators scored aversive behaviours during treatment application and catheterization using a simple descriptive scale (SDS). Treatment sites were assessed for erythema, blanching, or pain immediately after application and at 20 minutes and 24 hours post-catheter removal. Stratified multivariate Mann-Whitney U tests compared SDS values with significance at p < 0.05.</p><p><strong>Results: </strong>Horses showed significantly lower SDS scores during EMLA application versus lidocaine injection (0.3 ± 0.3 and 0.5 ± 0.4, respectively; p = 0.012). However, during catheterization, horses treated with lidocaine had lower SDS scores than those treated with EMLA (0.4 ± 0.4 and 0.8 ± 0.5, respectively; p = 0.006), although this difference was not significant when corrected for catheter placement side (p = 0.077). Neither treatment caused adverse effects at application sites.</p><p><strong>Conclusions and clinical relevance: </strong>The application of 5% EMLA cream was well tolerated in horses and may provide an alternative to subcutaneous infiltration of lidocaine prior to jugular vein catheterization in horses.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145034302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of early and late time-controlled adaptive ventilation on pulmonary gas exchange in anesthetized horses.","authors":"Caterina Vicenti, Marta Cercone, Gary Nieman, Nader M Habashi, Penny Andrews, Joshua Satalin, Pamela Velarde, Katharyn J Mitchell, Elizabeth Williams Louie, Victoria Albano, Haider Ali, Andrea King, Francesco Staffieri, Robin Gleed, Alex Bukoski, Klaus Hopster, David Hodgson, Andy Adler, Manuel Martin-Flores, Joaquin Araos","doi":"10.1016/j.vaa.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.06.007","url":null,"abstract":"<p><strong>Objective: </strong>To compare early versus late time-controlled adaptive ventilation (TCAV) for setting airway pressure release ventilation (APRV) on arterial oxygenation in dorsally recumbent anesthetized horses.</p><p><strong>Study design: </strong>A crossover, nonrandomized, experimental study.</p><p><strong>Animals: </strong>Six healthy adult horses.</p><p><strong>Methods: </strong>Each horse underwent two anesthetics: 1) volume-controlled ventilation (VCV) began for 30 minutes before switching to APRV using the TCAV method (late TCAV, TCAV_L); and 2) ventilation began immediately with TCAV (early TCAV, TCAV_E). The study lasted 180 minutes, with arterial blood gases and respiratory mechanics recorded at T0 and every 30 minutes. Electrical impedance tomography (EIT) was performed at T0, T30, T90 and T180 to calculate mid-cranial regional ventilation. A two-way repeated measures analysis of variance was used for comparisons. Lung ultrasound (LUS) images were obtained from three horses at baseline (before anesthesia) and at T30, T60, T120 and T180 during each crossover to calculate a mid-caudal LUS score. No statistical analysis was performed on ultrasound data.</p><p><strong>Results: </strong>TCAV_E showed significantly higher partial pressure of arterial oxygen to fraction of inspired oxygen (PaO₂/FiO₂) than TCAV_L, whereas TCAV did not significantly affect it compared with VCV in the TCAV_L group. TCAV_E resulted in significantly higher tidal volumes (V_T)than TCAV_L, whereas in the TCAV_L group, TCAV reduced V_T compared with VCV. No significant differences were found in respiratory system compliance or airway driving pressure. Both TCAV_E and TCAV_L significantly improved dorsal lung ventilation on EIT, but TCAV_L failed to reverse caudal atelectasis and consolidation seen on LUS, whereas TCAV_E appeared to prevent it.</p><p><strong>Conclusions and clinical relevance: </strong>TCAV_E improved oxygenation and regional ventilation, whereas TCAV_L failed to improve respiratory mechanics or oxygenation compared with VCV.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sedative and cardiovascular effects of premedication with acepromazine, methadone and dexmedetomidine in sevoflurane-anaesthetized dogs","authors":"Mihaela Klasić ,&nbsp;Alenka Seliškar ,&nbsp;Kristina Rakinić ,&nbsp;Manica Ipavec ,&nbsp;Jerneja Sredenšek ,&nbsp;Katerina Tomsič","doi":"10.1016/j.vaa.2025.06.008","DOIUrl":"10.1016/j.vaa.2025.06.008","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the sedative and cardiovascular effects of premedication with acepromazine, methadone and dexmedetomidine or acepromazine and methadone in sevoflurane-anaesthetized dogs.</div></div><div><h3>Study design</h3><div>A randomized, blinded, prospective clinical study.</div></div><div><h3>Animals</h3><div>A total of 38 client-owned healthy dogs scheduled for elective surgery.</div></div><div><h3>Methods</h3><div>Dogs were randomly assigned to intramuscular premedication with acepromazine (0.01 mg kg^-1), methadone (0.3 mg kg^-1) and dexmedetomidine (1.5 μg kg^-1) (Ace/D group) or with acepromazine (0.01 mg kg^-1) and methadone (0.3 mg kg^-1) (Ace group). The anaesthetist who performed the observations and anaesthesia was blinded to the group. Sedation was scored at 5, 10 and 15 minutes after premedication and postoperatively every hour until discharge, starting 30 minutes after extubation. Anaesthesia was induced with propofol and maintained with sevoflurane in oxygen and air. Body temperature, heart rate (HR), respiratory rate (<em>f</em>_R), direct arterial blood pressure, end-tidal sevoflurane, end-tidal carbon dioxide (P<span>e</span>´CO₂) and oxygen saturation were recorded at 5 minute intervals. The normality of data distribution was assessed with the Shapiro–Wilk test. The Mann–Whitney <em>U</em> test was used for comparison between groups, and effect size was calculated in cases of statistical significance (<em>p</em> &lt; 0.05).</div></div><div><h3>Results</h3><div>Dogs in the Ace/D group had significantly higher sedation scores 10 minutes after premedication (<em>p</em> = 0.02). The propofol induction doses were significantly lower in the Ace/D group (<em>p</em> = 0.001). During anaesthesia, dogs in the Ace/D group had significantly higher P<span>e</span>´CO₂ values (<em>p</em> = 0.03), but no significant differences in blood pressure, HR and <em>f</em>_R were observed between the groups. Significantly fewer dogs in the Ace/D group required rescue analgesia with fentanyl (<em>p</em> = 0.04) during surgery (three in Ace/D and nine in Ace group).</div></div><div><h3>Conclusions</h3><div>Low-dose dexmedetomidine improved preoperative sedation and intraoperative analgesia and reduced the induction dose of propofol in dogs premedicated with acepromazine and methadone.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 5","pages":"Pages 595-603"},"PeriodicalIF":1.9,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacokinetics and behavioural effects of a single oral dose of trazodone in rabbits.","authors":"Adalaïs Gibert, Ryota Watanabe, Marta Garbin, Tristan Juette, Francis Beaudry, Marion Desmarchelier, Inga-Catalina Cruz Benedetti","doi":"10.1016/j.vaa.2025.06.006","DOIUrl":"https://doi.org/10.1016/j.vaa.2025.06.006","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the pharmacokinetics and pharmacodynamics of a single oral dose of trazodone in laboratory rabbits.</p><p><strong>Study design: </strong>Randomised, blinded, Latin-square study.</p><p><strong>Animals: </strong>A group of eight healthy, juvenile, female New Zealand White rabbits.</p><p><strong>Methods: </strong>Auricular venous catheters were placed in six rabbits before oral trazodone (20 mg kg^-1) administration. Blood was sampled immediately before and at 15 and 30 minutes and 1, 2, 4, 8, 12, 18 and 24 hours after treatment. Trazodone plasma concentrations were determined using high-performance liquid chromatography-mass spectrometry. A group of eight rabbits were equipped with accelerometers (activity) and video recorded. They randomly received one of three treatments: oral trazodone (20 mg kg^-1; TRAZ), placebo (corn oil base; PLAC) or no treatment (CONTR) with a 3 day washout period between treatments. Exploring, grooming, resting, vigilance, hiding and ingesting behaviours were evaluated for 10 hours (0-2, 2-4, 4-6, 6-8 and 8-10 hours).</p><p><strong>Results: </strong>Mean maximum plasma concentration, 6592.6 ± 586.5 ng mL^-1, was 0.3 ± 0.11 hours after treatment. Mean half-life was 3.24 ± 0.36 hours and area under the curve from zero to infinity 25,412.5 ± 5420.9 ng mL^-1 hour^-1. Activity was higher in TRAZ and PLAC than CONTR at 0-2 hours, with TRAZ exploring more. Hiding was reduced in TRAZ versus CONTR (0-2 hours and 4-6 hours) and versus PLAC (0-6 hours). Resting increased in TRAZ versus PLAC (2-4 hours) and CONTR (4-6 hours); PLAC rested less at 2-4 hours than at 8-10 hours. Vigilance tended to be lower in TRAZ versus CONTR. Food intake decreased in TRAZ at 2-4 hours. Grooming varied over time.</p><p><strong>Conclusions and clinical relevance: </strong>Trazodone-treated animals showed reduced activity, less hiding and more resting than PLAC and decreased food intake 2-4 hours post-treatment.</p>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Confidential Enquiry into Perioperative Equine Fatalities: phase 4 (CEPEF4) – a worldwide observational, prospective, multicentre cohort study in 2025","authors":"Miguel Gozalo-Marcilla ,&nbsp;José I. Redondo ,&nbsp;Regula Bettschart-Wolfensberger ,&nbsp;Luis Domenech ,&nbsp;Javier Doménech ,&nbsp;G Mark Johnston ,&nbsp;Polly M. Taylor","doi":"10.1016/j.vaa.2025.06.005","DOIUrl":"10.1016/j.vaa.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>To report on the Confidential Enquiry into Perioperative Equine Fatalities 4 (CEPEF4).</div></div><div><h3>Study design</h3><div>Confidential, observational, prospective, multicentre, cohort study.</div></div><div><h3>Animals</h3><div>47,396 horses/ponies undergoing general anaesthesia (GA).</div></div><div><h3>Methods</h3><div>Characteristics of each GA (249 variables) were collected. Outcomes after seven days were ALIVE (or discharged), EUTHANASIA or DEAD. Logistic regression analysed patient demographics and the anaesthetic drugs (<em>p</em> &lt; 0.05).</div></div><div><h3>Results</h3><div>Data were collected from 47,396 GAs in 93 centres in 28 countries. Death rates were 1.2% overall, 0.6% for cases classified as NON-COLIC and 4.2% for COLIC. For NON-COLICs (227 deaths from 39,798 NON-COLICs), the main three causes of death were fractures (35.7%), abdominal complications (18.1%) and central nervous system problems (13.2%). Logistic regression analyses revealed an increase in the odds of death for pregnant mares, geriatrics, thin horses, those with a higher American Society of Anesthesiologists grade, urgent procedures and those lasting &lt; 1 hour or &gt; 2 hours. Ketamine infusions and plasma lactate measurement during maintenance were associated with elevated risk. By contrast, monitoring invasive arterial pressure, end-tidal CO₂, blood gases and body temperature were each associated with reduced odds of death. Premedication with agonist-antagonist/partial-agonist opioids with non-steroidal anti-inflammatory drugs and administration of α₂-adrenoceptor agonists during recovery, alone or with acepromazine, were associated with reduced odds of death.</div></div><div><h3>Conclusions and clinical relevance</h3><div>CEPEF4 reports a reduction in the death rate compared with CEPEF2 in 2002: overall 1.2% <em>versus</em> 1.9%, colic death rate 4.2% <em>versus</em> 7.8% and non-colic death rate 0.6% <em>versus</em> 0.9%. Healthy horses still die, the majority because of fractures during recovery. We identified factors that may influence clinical decision-making and enhance patient safety. The CEPEF4 database will continue to provide clinically applicable information, with potential for further insights and improvements in equine anaesthesia.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 5","pages":"Pages 525-538"},"PeriodicalIF":1.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of fentanyl and alfentanil in combination with atropine for premedication of dogs undergoing radiotherapy","authors":"Giovanni Franchino,&nbsp;Adam Shuttleworth,&nbsp;Pietro Loddo,&nbsp;Chiara Adami","doi":"10.1016/j.vaa.2025.06.004","DOIUrl":"10.1016/j.vaa.2025.06.004","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of two opioid-based premedication protocols on propofol requirement, time to recovery and occurrence of post-anaesthetic vocalization, paddling, nystagmus and dysphoria in dogs anaesthetized for radiotherapy.</div></div><div><h3>Study design</h3><div>Blinded, randomized, crossover clinical study.</div></div><div><h3>Animals</h3><div>A total of 22 client-owned dogs, each serving as their own control.</div></div><div><h3>Methods</h3><div>Dogs were randomly assigned to one of two intravenous premedication protocols on their first radiotherapy session, and the other on their second session. Premedication consisted of atropine (10 μg kg⁻¹) mixed with equipotent doses of either alfentanil (10 μg kg⁻¹, group AA) or fentanyl (2.5 μg kg⁻¹, group FA), followed by propofol induction and maintenance with sevoflurane in oxygen. Cardiorespiratory variables and observation of dysphoria and nystagmus were recorded after premedication and during recovery. Time elapsed from discontinuation of sevoflurane to tracheal extubation, sternal position and walking were also recorded (minutes).</div></div><div><h3>Results</h3><div>The proportion of dogs showing dysphoria and nystagmus was not different between treatments at any time point. With both treatments, heart rate (mean ± standard deviation) decreased after premedication (82 ± 27 and 93 ± 27 beats minute⁻¹ in groups AA and FA, respectively) compared with baseline (117 ± 23 and 112 ± 26 beats minute⁻¹ in groups AA and FA, respectively; <em>p</em> &lt; 0.001). Propofol dose did not differ between treatments (3.8 ± 1.7 and 4.3 ± 1.3 mg kg⁻¹ in groups AA and FA, respectively). Time to extubation was shorter with treatment AA (5.3 ± 2.1 minutes) compared with treatment FA (6.2 ± 2.3 minutes; <em>p</em> = 0.049), while time to sternal recumbency and walking did not differ between treatments.</div></div><div><h3>Conclusions and clinical relevance</h3><div>Since the two protocols produced comparable clinical effects and were both found suitable for dogs undergoing repeated radiotherapy, fentanyl is recommended over alfentanil in countries where it is licensed.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 5","pages":"Pages 588-594"},"PeriodicalIF":1.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}