Veterinary anaesthesia and analgesia最新文献

{"title":"Accidental coadministration of medetomidine, vatinoxan and ketamine in a cat","authors":"Maria Koura,&nbsp;Eleni Koliou,&nbsp;Stavroula Kourmpeti,&nbsp;Georgios Kazakos","doi":"10.1016/j.vaa.2025.03.011","DOIUrl":"10.1016/j.vaa.2025.03.011","url":null,"abstract":"<div><div>An 8-month-old, Domestic Shorthair male cat was presented for elective orchiectomy. Preanaesthetic clinical examination was unremarkable. The anaesthetic plan included intramuscular medetomidine (30 μg kg^-1) and tramadol (2 mg kg^-1) for premedication followed by intramuscular ketamine (8 mg kg^-1) for induction of general anaesthesia. The premedication mixture, presumed to be medetomidine and tramadol, was given as a single injection. Approximately 15 minutes after premedication, the cat was profoundly sedated, with a heart rate of 140 beats minute^-1. A catheter was placed in a cephalic vein. Ketamine was injected intramuscularly approximately 30 minutes after premedication in line with educational objectives. Within 2 minutes of injecting ketamine, the cat was exhibiting signs of excitement (mydriasis, head tilting, ataxia) and was no longer recumbent or cooperative, and its heart rate had increased to 280 beats minute^-1. Examination of the drug vials used revealed that a combined formulation of medetomidine and vatinoxan had been inadvertently given, instead of medetomidine alone, as intended. Midazolam (0.2 mg kg^-1) was given intravenously to counteract agitation. Surgery was postponed and the cat fully recovered (normal response to external stimuli, normal gait) approximately 1 hour after midazolam had been given. The predisposing factors contributing to this medication error were probably multifactorial: trainee involvement in anaesthesia care, similar appearance of drug vials and inadequate supervision during drug preparation. The medication error could explain the adverse events of tachycardia and excitement. Tachycardia may have been secondary to the effects of vatinoxan (offsetting bradycardia caused by the alpha-2 adrenergic receptor agonist) and ketamine (increasing heart rate), and the excitement resulting from the decreased plasma concentration of medetomidine (inadequate to counteract ketamine effects) when it is combined with vatinoxan. Given the inherent limitations of a single case observation, the ability to conclusively determine causes of the observed adverse events are limited.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 4","pages":"Pages 503-506"},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062295","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":"Ultrasound-guided ischiorectal fossa block targeting the pudendal nerve in dogs: a cadaveric study","authors":"Jalise N. Zumstein,&nbsp;Erin K. Keenihan,&nbsp;Jessica D. Briley","doi":"10.1016/j.vaa.2025.03.012","DOIUrl":"10.1016/j.vaa.2025.03.012","url":null,"abstract":"<div><h3>Objective</h3><div>To describe an ultrasound-guided (USG) regional anesthesia technique for perineural injection of the pudendal nerve (PdN) in dogs.</div></div><div><h3>Study design</h3><div>Prospective, randomized, anatomic study.</div></div><div><h3>Animals</h3><div>A total of seven thawed and 15 fresh canine cadavers.</div></div><div><h3>Methods</h3><div>Anatomical dissection, sonography and computed tomography (CT) techniques were used. In this study, 17 cadavers (11 males and six females), with body mass of 25.2 ± 6.3 kg (mean ± standard deviation) were used: four for anatomical study and approach development and 13 administered bilateral USG transgluteal injections. Using a dorsomedial-to-ventrolateral needle trajectory, the ischiorectal fossa was targeted medial to the ischiatic spine. Each hemipelvis was randomized to be administered high (HV, 0.2 mL kg^–1) or low (LV, 0.1 mL kg^–1) volume injections of ropivacaine–dye solution. Following injection, cadavers were dissected. Successful PdN staining (&gt;1 cm nerve length stained) and inadvertent staining of the sciatic nerve, or rectal, urethral or intravascular puncture was recorded. Volumes were compared using a mixed effects ordinal logistic regression model (<em>p</em> &lt; 0.05 considered significant).</div></div><div><h3>Results</h3><div>We excluded five cadavers owing to poor tissue preservation. The neurovascular bundle containing PdN and landmarks for ischiorectal fossa were defined using CT. Sonographically, landmarks were identified and dye solution injected into the fossa. Complete staining of the PdN was achieved in 69.2% (HV) and 58.3% (LV) of injections. There was no significant difference in nerve staining between groups (<em>p</em> = 0.864). There was no significant difference in sciatic nerve staining between HV (7.7%) and LV (8.3%) (<em>p</em> = 0.71). Rectal, urethral or intravascular puncture was not observed.</div></div><div><h3>Conclusions and clinical relevance</h3><div>This is the first description of an USG ischiorectal fossa block using a transgluteal approach targeting the PdN in dogs. The described USG technique could provide anesthesia of the urethra and perineal region. Further studies are necessary to investigate this approach in live animals.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 4","pages":"Pages 438-445"},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062301","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":"Data-driven safety limits for assessing perianesthetic mortality risk in dogs and cats undergoing elective procedures","authors":"Carina Salt ,&nbsp;Jo Ann Morrison ,&nbsp;Nate Spofford ,&nbsp;Abigail O’Rourke","doi":"10.1016/j.vaa.2025.03.008","DOIUrl":"10.1016/j.vaa.2025.03.008","url":null,"abstract":"<div><h3>Objective</h3><div>To create data-driven clinical pathology thresholds for routine blood tests to assess perianesthetic mortality risk in dogs and cats undergoing elective procedures.</div></div><div><h3>Study design</h3><div>Retrospective analysis.</div></div><div><h3>Animals</h3><div>Data from dogs and cats visiting Banfield hospitals between January 2019 and March 2023.</div></div><div><h3>Methods</h3><div>Using routinely collected veterinary data from dogs and cats undergoing elective procedures at primary care veterinary practices, data-driven clinical pathology thresholds were calculated to identify perianesthetic mortality risk. This process involved simulation from a generalized additive model that estimated perianesthetic mortality risk, based on signalment data, procedure type, physical status classification and blood analyte values, with data collected between January 2019 and March 2023. The simulated data was used to test 400 potential thresholds. Optimal thresholds were chosen to maximize sensitivity (proportion of deaths correctly predicted) subject to limits on false positive rate (number of non-deaths incorrectly identified). These optimal limits were evaluated on observed data.</div></div><div><h3>Results</h3><div>Two levels of data-driven clinical pathology thresholds were determined, ‘stop’ and ‘critical stop’, with the latter more stringent. For the ‘stop’ limits, the overall median sensitivity on observed data was 7.16% (interquartile range 4.29%–9.88%) and 11.80% (11.00%–14.60%) for dogs and cats, respectively, and the overall median false positive rate was 2.65% (2.40%–3.31%) and 8.25% (6.86%–9.66%) for dogs and cats, respectively. Albumin, hematocrit, neutrophils and white blood cells were identified as having strong evidence for their utility in creating thresholds for dogs. Neutrophils showed strong evidence for thresholds for cats. These new data-driven thresholds offer more consistent and quantifiable false positive rates and increased sensitivities compared with existing limits. However, weaker evidence resulted in fewer useful thresholds for cats owing to lower data availability.</div></div><div><h3>Conclusions and clinical relevance</h3><div>It is possible to use routinely collected data to create data-driven clinical pathology thresholds for blood tests to identify animals at increased risk of perianesthetic mortality.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 5","pages":"Pages 557-570"},"PeriodicalIF":1.9,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144034414","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":"Cardiovascular, antinociceptive and electroencephalographic effects of epidural and unintentional spinal anaesthesia in pigs: an observational prospective trial","authors":"Chiara Parodi ,&nbsp;Marie Rabinovici ,&nbsp;Luisana G. Garcia Casalta ,&nbsp;Mariafrancesca Petrucci ,&nbsp;Manuel Egle ,&nbsp;Sarah L. Longnus ,&nbsp;Daniela Casoni","doi":"10.1016/j.vaa.2025.03.010","DOIUrl":"10.1016/j.vaa.2025.03.010","url":null,"abstract":"<div><h3>Objective</h3><div>To report rate of unintentional spinal puncture and compare intraoperative effects of a combination of morphine and ropivacaine at a volume of 0.2 mL kg^–1 in the lumbosacral epidural or subarachnoid space.</div></div><div><h3>Study design</h3><div>Prospective, observational, experimental study.</div></div><div><h3>Animals</h3><div>A total of 36 Edelschwein pigs (34 males and two females) 4 ± 0.5 months old, 55.6 ± 6.5 kg bodyweight (mean ± standard deviation).</div></div><div><h3>Methods</h3><div>With pigs anaesthetized in sternal recumbency, an 18 gauge Tuohy needle was inserted at the lumbosacral intervertebral space intending to reach the epidural space. If the dural sac was accidentally punctured, the same volumes of ropivacaine 0.75% (1.45 mg kg^–1) and morphine (0.1 mg kg^–1) were administered spinally. Invasive blood pressure (IBP) and heart rate (HR) (<em>n</em> = 36) and electroencephalogram variables (<em>n</em> = 17) were recorded before and at regular intervals after injection. Differences in IBP over time and between groups were investigated with two-way repeated measures (RM) ANOVA. Remaining values were compared with RM ANOVA on ranks (over time) and U test (between groups, only for HR). <em>p</em> &lt; 0.05. Need for rescue analgesia was reported in the 11 animals that underwent sternotomy before circulatory death.</div></div><div><h3>Results</h3><div>Rate of accidental spinal puncture was 36%. After epidural or spinal injection, IBP significantly decreased over time but mean arterial pressure did not decrease below the treatment cut-off (65 mmHg). There was no significant difference between groups. HR did not vary significantly over time, nor did electroencephalogram variables. Overall antinociceptive efficacy was 81.8%.</div></div><div><h3>Conclusions and clinical relevance</h3><div>Lumbosacral epidural or spinal administration of ropivacaine and morphine (0.2 mL kg–1) caused mild cardiovascular alterations, prevented autonomic responses during sternotomy and did not worsen electroencephalographic cortical depression. In pigs, reducing the volume injected when the dural sac is accidentally punctured does not seem necessary.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 4","pages":"Pages 429-437"},"PeriodicalIF":1.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015841","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":"Temporary unilateral inability to close the mouth (‘dropped jaw’) after trigeminal nerve block in a cat undergoing ventral bulla osteotomy","authors":"Enzo Vettorato ,&nbsp;Taylor M. Masters ,&nbsp;Rachel W. Williams ,&nbsp;Ludovica Chiavaccini ,&nbsp;Diego A. Portela","doi":"10.1016/j.vaa.2025.03.009","DOIUrl":"10.1016/j.vaa.2025.03.009","url":null,"abstract":"","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 4","pages":"Pages 507-509"},"PeriodicalIF":1.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789052","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":"Effects of bupivacaine and morphine on the electroencephalogram and postoperative pain in castrated dogs","authors":"Robert K. Sawicki ,&nbsp;Kavitha Kongara ,&nbsp;Mike A. Gieseg ,&nbsp;Venkata S.R. Dukkipati ,&nbsp;Craig B. Johnson","doi":"10.1016/j.vaa.2025.03.007","DOIUrl":"10.1016/j.vaa.2025.03.007","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effects of locally administered bupivacaine and systemic morphine, separately or in combination, on the electroencephalogram (EEG) and postoperative pain in castrated dogs.</div></div><div><h3>Study design</h3><div>Randomized blinded clinical study.</div></div><div><h3>Animals</h3><div>A group of 21 healthy mixed-breed dogs.</div></div><div><h3>Methods</h3><div>Dogs were randomly assigned to one of three groups (<em>n</em> = 7 per group): morphine (0.5 mg kg^–1), bupivacaine (2 mg kg^–1) or a combination of both. Premedication consisted of acepromazine (0.05 mg kg^–1) (all groups) and morphine (morphine and combination groups only) administered subcutaneously. Anaesthesia was induced with intravenous propofol to effect and maintained with halothane in oxygen. Bupivacaine was infiltrated at the incision site 30 minutes prior to surgery in bupivacaine and combination groups. Systolic arterial blood pressure (SAP), heart rate (HR) and haemoglobin oxygen saturation (SpO₂) were recorded. All dogs underwent an open castration via a routine prescrotal approach. EEG was recorded throughout anaesthesia. Median frequency (F₅₀), 95% spectral edge frequency (F₉₅) and total power (P_tot) were derived from raw EEG traces. Postoperative pain was assessed at 1, 3, 6 and 9 hours using a short form of the Glasgow Composite Measure Pain Scale. EEG and pain scores were compared among groups using a generalized linear mixed model and Wilcoxon–Mann–Whitney odds macro, respectively. Data were presented as mean ± standard deviation (<em>p</em> &lt; 0.05).</div></div><div><h3>Results</h3><div>The morphine and bupivacaine groups had a significantly higher F₅₀ and F₉₅ and a lower P_tot than the combination group during castration. Postoperative pain scores did not significantly differ between bupivacaine and combination groups; both groups had significantly lower pain scores than the morphine group. SAP, HR and SpO₂ did not differ significantly among groups.</div></div><div><h3>Conclusions and clinical relevance</h3><div>Presurgical incisional infiltration of bupivacaine, alone or with a systemic opioid, reduces intraoperative nociception and postoperative pain in dogs undergoing castration.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 4","pages":"Pages 421-428"},"PeriodicalIF":1.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036563","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":"Impact of induction of anaesthesia simulation training on veterinary students' perceived preparedness and confidence in anaesthesia","authors":"Luiz CP. Santos,&nbsp;Kerry Woodhouse","doi":"10.1016/j.vaa.2025.03.006","DOIUrl":"10.1016/j.vaa.2025.03.006","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the impact of a simulation-based workshop on veterinary students' perceived preparedness and confidence in performing anaesthesia-related tasks.</div></div><div><h3>Study design</h3><div>A pre- and post-survey study was conducted among 106 final-year veterinary students to evaluate their self-reported preparedness and confidence before and after a simulation-based workshop.</div></div><div><h3>Methods</h3><div>Students completed a survey before and after participating in a simulation-based workshop that involved two different scenarios, where they practised induction of anaesthesia. The survey included questions assessing students' perceived preparedness for induction of anaesthesia, confidence in assisting with anaesthetic procedures and perceived value of the simulation. Responses were assessed on a Likert scale from strongly agree (4) to strongly disagree (1) and are presented as mean ± standard deviation. Independent <em>t</em>-test was used to compare pre- and post-survey responses, with statistical significance set at <em>p</em> &lt; 0.05.</div></div><div><h3>Results</h3><div>Improvements were observed across multiple areas following the simulation. The mean score for ‘the ability of the workshop to enhance my understanding and preparation for anaesthesia rotation’ (Q1) increased from 3.48 ± 0.55 to 3.87 ± 0.34 (<em>p</em> &lt; 0.001). Students’ perceived preparedness for anaesthesia induction (Q2) improved from 2.56 ± 0.57 to 3.67 ± 0.49 (<em>p</em> &lt; 0.001). Students’ confidence in assisting with critical incidents (Q3) increased from 2.09 ± 0.59 to 3.36 ± 0.61 (<em>p</em> &lt; 0.001). Confidence in assisting with anaesthetic procedures (Q4) increased from 2.74 ± 0.52 to 3.57 ± 0.49 (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions and clinical relevance</h3><div>Simulation-based training improved veterinary students’ perceived preparedness and confidence for induction of anaesthesia. Although these findings highlight the value of simulation exercises in building students’ confidence and serving as a preparatory tool within the veterinary curriculum, further research is needed to assess their impact on hands-on skills and objective performance during live animal procedures.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 4","pages":"Pages 412-416"},"PeriodicalIF":1.4,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249779","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":"Management of refractory hypotension during adrenalectomy in a dog treated with phenoxybenzamine","authors":"Marcela L. Machado,&nbsp;Bruno H. Pypendop,&nbsp;Joao HN. Soares","doi":"10.1016/j.vaa.2025.03.005","DOIUrl":"10.1016/j.vaa.2025.03.005","url":null,"abstract":"<div><div><span><span>Pheochromocytoma<span><span> is a functional tumor of the adrenal medullary chromaffin cells<span> that releases excessive secreted catecholamines, often malignant and invasive of blood vessels. Preoperative treatment with an alpha-1 adrenergic receptor antagonist, such as </span></span>phenoxybenzamine, has been suggested to reverse chronic </span></span>vasoconstriction<span><span><span> A 12-year-old, 8 kg, female spayed Shih Tzu<span> dog was presented for left </span></span>adrenalectomy<span>. Clinical signs included polyuria and </span></span>polydipsia<span>, and lethargy. Abdominal ultrasound revealed chronic renal changes and an adrenal mass with phrenicoabdominal vein and vena cava invasion. Tests for hyperadrenocorticism<span> were negative. No urine metanephrine test was performed. Phenoxybenzamine (5 mg orally twice daily) was started 1 month before surgery. Anesthetic premedication consisted of methadone (0.3 mg kg</span></span></span></span>^-1) intravenously (IV) and atropine (0.02 mg kg^-1<span>) intramuscularly. General anesthesia was induced with alfaxalone (1.5 mg kg</span>^-1 IV) and midazolam (0.3 mg kg^-1<span><span> IV) and maintained with isoflurane in oxygen delivered via a circle breathing system. Systemic arterial blood pressure was measured invasively. During surgery, arterial hypotension was present for 195 minutes and treated with lactated Ringer’s solution and </span>hydroxyethyl starch boluses, dopamine (5–15 μg kg</span>^-1 min^-1<span> IV) and phenylephrine (0.1–0.5 μg kg</span>^-1 min^-1<span><span><span> IV) for 195 minutes and 100 minutes, respectively, aiming to maintain mean arterial blood pressure (MAP) ≥ 60 mmHg. Arterial blood gas analyses showed </span>hypoxemia intraoperatively and in recovery. Despite supplemental oxygen, hypoxemia did not improve. The owners decided to euthanize the dog. This report describes the use of an irreversible alpha-1 adrenergic receptor antagonist to treat severe preoperative hypertension (MAP 45 mmHg) associated with a malignant </span>adrenal gland tumor and the subsequent challenges in managing arterial blood pressure intraoperatively.</span></div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 5","pages":"Pages 682-686"},"PeriodicalIF":1.9,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796419","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":"Iatrogenic tension pneumothorax resulting from misconnection of the endotracheal tube to the auxiliary oxygen flowmeter of the anaesthetic machine","authors":"Desislava Bekkat-Berkani,&nbsp;Joanna Raszplewicz,&nbsp;Natalie Duffy","doi":"10.1016/j.vaa.2025.02.016","DOIUrl":"10.1016/j.vaa.2025.02.016","url":null,"abstract":"<div><div><span>A 1-year-old, male entire English Springer Spaniel dog<span>, presented for computed tomography investigation of bilateral pelvic limb </span></span>gait abnormality<span><span>. The dog developed tension pneumothorax<span><span> shortly after intubation<span> because of erroneous connection of the endotracheal tube to the auxiliary oxygen flowmeter instead of the breathing circuit. A prompt diagnosis, based on reduced compliance during manual ventilation, bradycardia and second-degree atrioventricular block, combined with barrel-shaped thoracic distension, led to an emergency needle </span></span>thoracocentesis, followed by bilateral </span></span>thoracostomy<span><span> tube placement. Computed tomography was then performed as scheduled with an added scan sequence for the thorax<span>. General anaesthesia was maintained using total intravenous techniques with </span></span>propofol<span> and ketamine infusions. Hospital morbidity and mortality rounds identified various active and system failures as contributing factors. The 22 mm connector attached to the auxiliary oxygen flowmeter tubing was recognized as the major contributing factor, as it could be connected to both the endotracheal tube and oxygen mask. Consequently, the decision was made to no longer use the auxiliary oxygen flowmeter for preoxygenation. This report discusses the circumstances leading to this adverse event and highlights the danger of anaesthesia-related errors.</span></span></span></div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 5","pages":"Pages 677-681"},"PeriodicalIF":1.9,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226871","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":"Return of spontaneous circulation after cardiopulmonary arrest in an adult horse recovering from anaesthesia","authors":"Marina Salles Munerato,&nbsp;Olivier Simon,&nbsp;Anthony Nicholson","doi":"10.1016/j.vaa.2025.02.015","DOIUrl":"10.1016/j.vaa.2025.02.015","url":null,"abstract":"<div><div>This report describes successful cardiopulmonary resuscitation of a healthy, 525 kg, 8 years 9 months-old Quarter horse gelding. After successful pelvic limb orthopaedic surgery to excise a metatarsal bone under general anaesthesia, with the horse in left lateral recumbency, the horse was hoisted into recovery. After the horse was positioned in recovery, a routine cardiac check by thoracic auscultation was performed. Cardiopulmonary arrest (CPA) was identified by absence of cardiac sounds and pulse, as evaluated by digital palpation of the facial artery, absence of the right palpebral reflex, mydriasis and pale coloration of the tongue. Chest compressions were started immediately, using the knee-drop technique, at 40–53 compressions minute⁻¹. Compressions were performed by four people (body masses ranging from 61 to 100 kg) with a different person taking a turn every 2 minutes. Intermittent positive pressure ventilation continued at 4–6 breaths minute⁻¹ using oxygen delivered via demand valve. Following two intravenous doses of epinephrine (0.002 mg kg⁻¹<span> per dose) and four compression cycles, end-tidal carbon dioxide varied between 10 and 21 mmHg (1.3–2.8 kPa), increasing during the fifth cycle to 31 mmHg (4.1 kPa), suggesting return of spontaneous circulation (ROSC). A sixth cycle was started and stopped after 28 seconds for thoracic auscultation, when heart sounds were audible and a pulse present on palpation of the facial artery, indicating ROSC. After standing, the horse showed signs of distress (shaking and sweating) and was non-weight bearing on its right thoracic limb. A grade 3/6 left-sided systolic heart murmur and tachycardia (56 beats minute</span>⁻¹) were present. Two days post-CPA, the heart murmur was undetectable, and the horse was weight bearing on all limbs. This case describes successful ROSC in an adult horse with low compression rates and highlights the importance of capnography to assess compression quality and ROSC.</div></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":"52 5","pages":"Pages 671-676"},"PeriodicalIF":1.9,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754764","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}