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- Haubro Andersen, Pia
(författare)
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Analgesic efficacy of intra-articular morphine in experimentally induced radiocarpal synovitis in horses
- 2010
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Ingår i: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 37, s. 171-185
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Tidskriftsartikel (refereegranskat)abstract
- Objective To compare the analgesic effect of intra-articular (IA) and intravenous (IV) morphine in horses with experimentally induced synovitis.Animals Eight adult horses.Study design Randomized, observer blinded, double dummy trial with sequential crossover design.Methods Radiocarpal synovitis was induced by IA injection of lipopolysaccharide on two occasions separated by a 3-week washout period. In one study period horses received treatment IA; morphine IA (0.05 mg kg(-1)) plus saline IV and in the other study period they received treatment IV; saline IA plus morphine IV ( 0.05 mg kg) 1). Lameness and pain were evaluated repeatedly by two observers throughout each of the two 168-hour study periods. Pain was evaluated by use of a visual analogue scale of pain intensity ( VAS) and a composite measure pain scale ( CMPS). Comparison of treatments was performed by analysis of variance with repeated measurements. Significance level was set to p <= 0.05. Inter-observer agreement and agreement between the VAS and CMPS was assessed by use of the Bland-Altman method.Results Intra-articular injection of LPS elicited a marked synovitis resulting in lameness and pain. IA morphine resulted in significantly less lameness than IV morphine (p = 0.03). CMPS (p = 0.09) and VAS (p = 0.10) pain scores did not differ significantly between treatments. Inter-observer agreement of the CMPS was classified as good, but only fair for the VAS. Agreement between the two pain scales was considered fair.Conclusions and clinical relevance An analgesic effect of IA morphine was demonstrated by significantly reduced lameness scores. The results support the common practice of including IA morphine in a multimodal analgesic protocol after arthroscopic surgery, although further studies in clinical cases are needed. The employed CMPS had good reproducibility, and was easy to use, but may have limited sensitivity at mild intensity pain.
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- Heinonen, Erkki, et al.
(författare)
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Pulsed delivery of nitric oxide counteracts hypoxaemia in the anaesthetized horse
- 2001
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Ingår i: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 28:1, s. 3-11
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Tidskriftsartikel (refereegranskat)abstract
- Objective To study the effect of the pulsed delivery of nitric oxide (NO) on pulmonary gas exchange in the anaesthetized horses.Design Prospective, controlled randomized.Animals Five healthy Standardbred trotters, three geldings and two mares.Methods The horses were anaesthetized with thiopentone and isoflurane and positioned in dorsal recumbency. Nitric oxide was added as a pulse to the inspired gas during the first half of each inspiration. In three horses the effect of NO on the ventilation–perfusion distribution was also investigated using the multiple inert gas elimination technique. Data were analysed with repeated measures ANOVA.Results During spontaneous breathing, arterial oxygen tension (PaO2) increased with NO inhalation, from 14 ± 2 to 29 ± 3 kPa (105 ± 15 to 218 ± 23 mm Hg) (p < 0.001). Arterial oxygen tension also increased, from 17 ± 3 to 31 ± 5 kPa (128 ± 23 to 233 ± 38 mm Hg) (p < 0.05) during intermittent positive pressure ventilation. The increase in PaO2 was mainly due to a reduced right to left vascular shunt, but ventilation and perfusion matching also improved. The beneficial effect of NO inhalation was lost within 5 minutes of its discontinuation.Conclusion Delivery of NO as a pulse during inspiration is an effective method for counteracting impaired gas exchange caused by anaesthesia in horses. Pulsation has to be continuous because of the transience of NO's therapeutic effect.Clinical relevance Horses with impaired pulmonary gas exchange during anaesthesia can be treated with pulsed NO inhalation.
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- Ingvast Larsson, Carina, et al.
(författare)
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Clinical pharmacology of methadone in dogs
- 2010
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Ingår i: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 37:1, s. 48-56
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate the pharmacokinetics and effects of methadone on behaviour and plasma concentrations of cortisol and vasopressin in healthy dogs. Study design Randomized, cross-over, experimental trial. Animals Nine adult dogs (beagle and beagle cross breeds), four males and five females. Methods Methadone hydrochloride, 0.4 mg kg-1, was administered intravenously (IV) and subcutaneously (SC) with a crossover design. Drug and hormone analyses in plasma were performed using Liquid Chromatography-Electrospray Ionization-Tandem Mass Spectrometry and radioimmunoassay respectively. Behavioural data were collected using a standardized protocol. Results After IV administration, the plasma concentration of methadone at 10 minutes was 82.1 +/- 9.2 ng mL-1 (mean +/- SD), the terminal half-life was 3.9 +/- 1.0 hours, the volume of distribution 9.2 +/- 3.3 L kg-1 and plasma clearance 27.9 +/- 7.6 mL minute-1 kg-1. After SC administration, time to maximal plasma concentration was 1.26 +/- 1.04 hours and maximal plasma concentration of methadone was 23.9 +/- 14.4 ng mL-1, the terminal half-life was 10.7 +/- 4.3 hours and bioavailability was 79 +/- 22%. Concentrations of both cortisol and vasopressin were increased for an hour following IV methadone. The observed behavioural effects of methadone were decreased licking and swallowing and an increase in whining after SC administration. The latter finding is notable as it can be misinterpreted as pain when methadone is used as an analgesic. Conclusion and clinical relevance When methadone was administered by the SC route, the half-life was longer, but the individual variation in plasma concentrations was greater compared with IV administration. Increased frequency of whining occurred after administration of methadone and may be a drug effect and not a sign of pain. Cortisol and vasopressin concentrations in plasma may not be suitable for evaluating analgesia after methadone treatment.
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- Nyman, Görel, et al.
(författare)
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Pulsed delivery of inhaled nitric oxide counteracts hypoxaemia during 2.5 hours of inhalation anaesthesia in dorsally recumbent horses
- 2012
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Ingår i: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 39:5, s. 480-487
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Tidskriftsartikel (refereegranskat)abstract
- Objective The study aimed to investigate the effect of varying pulse lengths of inhaled nitric oxide (iNO), and 2.5 hours of continuous pulse-delivered iNO on pulmonary gas exchange in anaesthetized horses.Study Design Experimental study. Animals Six Standardbred horses.Methods Horses received acepromazine, detomidine, guaifenesin, thiopentone and isoflurane in oxygen, were positioned in dorsal recumbency and were breathing spontaneously. iNO was on average pulsed during the first 20, 30, 43 or 73% of the inspiration in 15 minute steps. The pulse length that corresponded to the highest (peak) partial pressure of arterial oxygen (PaO2) in the individual horses was determined and delivered for a further 1.5 hours. Data measured or calculated included arterial and mixed venous partial pressures of O2 and CO2, heart rate, respiratory rate, expired minute ventilation, pulmonary and systemic arterial mean pressures, cardiac output and venous admixture. Data (mean +/- SD) was analysed using anova with p < 0.05 considered significant.Results Although the pulse length of iNO that corresponded to peak PaO2 varied between horses, administration of all pulse lengths of iNO increased PaO2 compared to baseline. The shortest pulse lengths that resulted in the peak PaO2 were 30 and 43% of the inspiration. Administration of iNO increased PaO2 (12.6 +/- 4.1 kPa [95 +/- 31 mmHg] at baseline to a range of 23.0 +/- 8.4 to 25.3 +/- 9.0 kPa [173 to 190 mmHg]) and PaCO2 (8.5 +/- 1.2 kPa [64 +/- 9 mmHg] to 9.8 +/- 1.5 kPa [73 +/- 11 mmHg]) and decreased venous admixture from 32 +/- 6% to 25 +/- 6%. The increase in PaO2 and decrease in venous admixture was sustained for the entire 2.5 hours of iNO delivery.Conclusions The improvement in arterial oxygenation during pulsed delivery of iNO was significant and sustained throughout 2.5 hours of anaesthesia.Clinical relevance Pulsed iNO potentially could be used clinically to counteract hypoxemia in anaesthetized horses.
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- Arnemo, Jon, et al.
(författare)
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Effective thiafentanil immobilization and physiological responses of free-ranging moose (Alces alces) in northern Sweden
- 2018
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Ingår i: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 45, s. 502-509
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Tidskriftsartikel (refereegranskat)abstract
- Objective To evaluate clinical and physiological responses in moose to thiafentanil administration for immobilization.Study design Cross-sectional clinical study.Animals Eleven (six males and five females) free-ranging adult moose (Alces alces).Methods Each moose was darted from a helicopter with 7.5 mg thiafentanil during March 2014 in northern Sweden. Physiological evaluation included vital signs and blood gases. Arterial blood was collected after induction and again after 10 minutes of intranasal oxygen administration and analyzed immediately with an i-STAT analyzer. A total of 10 mg naltrexone per milligram of thiafentanil was administered to all animals for reversal. Data were analyzed using descriptive statistics.Results All moose were sufficiently immobilized with a single dart injection. Induction occurred within 3 minutes in 10 of 11 moose. One individual became recumbent while crossing a river and naltrexone was immediately administered. Animals maintained sternal recumbency with their head raised and vital signs were stable. Nine of 10 moose were hypoxemic before oxygen administration, with seven becoming markedly hypoxemic [partial pressure of arterial oxygen (PaO2) between 40 and 59 mmHg (5.3-7.9 kPa)]. The PaO2 increased significantly between samples, but six moose remained hypoxemic despite therapy. Hypercapnia was seen in all moose, with eight having marked hypercapnia [partial pressure of arterial carbon dioxide (PaCO2) > 60 mmHg (> 8.0 kPa)]. All moose were acidemic, with nine showing marked acidemia (pH < 7.20). The pH increased significantly with time and lactate decreased. Recoveries were rapid and uneventful, and all moose were living 6 months after capture.Conclusions Thiafentanil provided rapid and sufficient immobilization of moose and its effects were rapidly reversed with naltrexone. As with other opioids, moose showed hypoxemia and varying degrees of respiratory and metabolic acidosis. Arterial oxygenation of moose improved following intranasal oxygen, but hypoxemia was not fully resolved despite therapy.
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- Auckburally, Adam, et al.
(författare)
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Review of hypoxaemia in anaesthetized horses: predisposing factors, consequences and management
- 2017
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Ingår i: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 44, s. 397-408
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Forskningsöversikt (refereegranskat)abstract
- Objective To discuss how hypoxaemia might be harmful and why horses are particularly predisposed to developing it, to review the strategies that are used to manage hypoxaemia in anaesthetized horses, and to describe how successful these strategies are and the adverse effects associated with them.Databases used Google Scholar and PubMed, using the search terms horse, pony, exercise, anaesthesia, hypoxaemia, oxygen, mortality, morbidity and ventilation perfusion mismatch.Conclusions Although there is no evidence that hypoxaemia is associated with increased morbidity and mortality in anaesthetized horses, most anaesthetists would agree that it is important to recognise and prevent or treat it. Favourable anatomical and physiological adaptations of a horse for exercise adversely affect gas exchange once the animal is recumbent. Hypoxaemia is recognised more frequently in horses than in other domestic species during general anaesthesia, although its incidence in healthy horses remains unreported. Management of hypoxaemia in anaesthetized horses is challenging and often unsuccessful. Positive pressure ventilation strategies to address alveolar atelectasis in humans have been modified for implementation in recumbent anaesthetized horses, but are often accompanied by unpredictable and unacceptable cardiopulmonary adverse effects, and some strategies are difficult or impossible to achieve in adult horses. Furthermore, anticipated beneficial effects of these techniques are inconsistent. Increasing the inspired fraction of oxygen during anaesthesia is often unsuccessful since much of the impairment in gas exchange is a direct result of shunt. Alternative approaches to the problem involve manipulation of pulmonary blood away from atelectatic regions of the lung to better ventilated areas. However, further work is essential, with particular focus on survival associated with general anaesthesia in horses, before any technique can be accepted into widespread clinical use.
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| 10. |
- Grubb, Tamara, et al.
(författare)
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The effects of pulse-delivered inhaled nitric oxide on arterial oxygenation, ventilation-perfusion distribution and plasma endothelin-1 concentration in laterally recumbent isoflurane-anaesthetized horses
- 2013
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Ingår i: Veterinary Anaesthesia and Analgesia. - : Elsevier BV. - 1467-2987 .- 1467-2995. ; 40:6, s. E19-E30
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Anaesthetized horses commonly become hypoxaemic due to ventilation/perfusion ((V) over dot(A)/(Q) over dot) mismatch and increased pulmonary shunt fraction ((Q) over dots/(Q) over dott). Pulse-delivered inhaled nitric oxide may improve oxygenation but may increase plasma concentration of the potent vasoconstrictor, endothelin-1 (ET-1). Objectives: Study 1) compare arterial oxygen concentration (PaO2) and saturation (SaO(2)), calculated ((Q) over dots/(Q) over dott) and ET-1 concentration; and Study 2) assess ((V) over dot(A)/(Q) over dot) matching and measured ((Q) over dots/(Q) over dott) in isoflurane-anaesthetized horses in left lateral recumbency receiving pulse-delivered inhaled nitric oxide (PiNO group) or inhalant gas only (C group). Study design Prospective research trial. Animals Ten Healthy adult Standardbred horses. Two horses were anaesthestized in both groups in a random cross-over design with >4 weeks between studies. Methods Study 1) Cardiopulmonary data including PaO2, SaO(2), ((Q) over dots/(Q) over dott) and ET-1 concentration were measured or calculated prior to and at various points during PiNO administration in 6PiNO and 6C horses. Two-way repeated measures ANOVA with Bonferroni significant difference test was used for data analysis with p < 0.05 considered significant. Study 2) ((V) over dot(A)/(Q) over dot) matching and ((Q) over dots/(Q) over dott) were determined using the multiple inert gas elimination technique in 3 horses. Data were collected after 60 minutes of anaesthesia without PiNO (baseline) and 15 minutes after PiNO was pulsed during the first 30%, and then the first 60%, of inspiration. Data were descriptive only. Results Study 1) PaO2 and SaO2 were higher and calculated ((Q) over dots/(Q) over dott) was lower in the PiNO group than the C group at most time points. ET-1 was not different over time or between groups. Study 2) ((V) over dot(A)/(Q) over dot) matching and measured ((Q) over dots/(Q) over dott) were improved from baseline in all horses but PiNO60% provided no improvement when compared to PiNO30%. Conclusions and Clinical Relevance PiNO delivered in the initial portion of the inspiration effectively relieves hypoxaemia in anaesthetized horses by improving ((V) over dot(A)/(Q) over dot) matching and decreasing ((Q) over dots/(Q) over dott) without affecting ET-1.
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