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Biomedical subjects

C M Trim

Publications and source records attributed to C M Trim.

At least 19 recordsLinked to original sources

Complications associated with anaesthesia for ocular surgery: a retrospective study 1989-1996.

This retrospective study was initiated to identify complications of anaesthesia occurring during ocular surgery. Records of 74 horses anaesthetised for eye enucleation, 65 horses anaesthetised for surgery of the eye and adnexa, and 51 horses anaesthetised for splint bone excision were reviewed. Fifty-three percent of the horses anaesthetised for eye enucleation moved during surgery which was significantly more frequent than in the other groups (P = 0.001). The incidence of moving was significantly reduced by use of an anaesthetic gas analyser for monitoring (P = 0.001). Transient hypertension was measured in 6 horses during removal of the eye. One horse experienced a momentary decrease in heart rate from 36 to 26 beats/min at the start of surgery involving a mass on the third eyelid. The incidence of unsatisfactory recovery from anaesthesia involving multiple attempts to stand was significantly greater after ocular surgery than after splint bone excision (P = 0.036). Our conclusions were 1) the oculocardiac reflex was not active in these horses undergoing ocular surgery, 2) increased attention must be paid to provision of analgesia and adequate depth of anaesthesia, which may be facilitated by use of an anaesthetic gas analyser and 3) horses were at greater risk for unsatisfactory recoveries from anaesthesia after ocular surgery.

Anesthesia↗

Anesthesia in a Baird's tapir (Tapirus bairdii).

A Baird's tapir (Tapirus bairdii) was satisfactorily immobilized on two occasions with i.m. detomidine (0.065-0.13 mg/kg) and butorphanol (0.13-0.2 mg/kg). On the second occasion, anesthesia was induced by i.v. administration of ketamine (2.2 mg/kg). Twenty minutes later, endotracheal intubation was performed after an additional i.v. injection of ketamine (1.5 mg/kg). Anesthesia was maintained with isoflurane, which provided excellent conditions for radiology and surgery. Anesthesia was associated with hypoxemia when the tapir was allowed to breathe air and with hypoventilation. Mean arterial pressure remained satisfactory. No antagonist drugs were administered, and recovery from anesthesia was rapid and smooth.

Analgesics↗

Severe nasal hemorrhage in an anesthetized horse.

An 8-year-old Thoroughbred gelding with colic was anesthetized for surgical correction of right dorsal displacement of the ascending colon. Removal of the nasogastric tube at the end of surgery resulted in hemorrhage from the nares and loss of 24 L of blood. Treatment included administration of acetated Ringer's solution, hypertonic saline solution, and dobutamine. A blood transfusion was started after hemorrhage was controlled, and arterial pressure was restored to the prehemorrhage value, but was stopped after infusion of 2.7 L of blood because of a suspected adverse reaction. This case indicates that infusion of balanced electrolyte solution, hypertonic saline solution, and dobutamine may maintain adequate arterial pressure after severe blood loss, and also supports the suggestion that administration of hypertonic saline solution potentiates blood loss in the absence of hemostasis.

Anesthesia↗

Postanesthetic hemorrhagic myelopathy or myelomalacia.

Hemorrhagic myelopathy or myelomalacia is an uncommon cause of failure to stand after general anesthesia. Affected horses are usually young and have been anesthetized for relatively short times in dorsal recumbency. Clinical signs involve the hind limbs and include loss of deep pain perception. Etiology of this condition is not known. Differentiation from other forms of neuropathy and myopathy is important to the prognosis.

Anesthesia↗

Effects of an infusion of dopamine on the cardiopulmonary effects of Escherichia coli endotoxin in anaesthetised horses.

Horses with colic may be endotoxaemic and subsequently develop hypotension during anaesthesia for surgical operation. The aim of this study was to evaluate the efficacy of dopamine as a means to improve cardiovascular function in anaesthetised endotoxaemic horses. Nine horses (five in group 1 and four in group 2) were anaesthetised with thiopentone and guaifenesin and anaesthesia was maintained with halothane. After approximately one hour, facial artery pressure, heart rate, pulmonary artery pressure, cardiac output, temperature, pHa, PaCO2, PaO2, base excess, packed cell volume, plasma protein concentration and white cell count were measured (time 0). Escherichia coli endotoxin was infused intravenously over 15 minutes in both groups. Group 2 horses were given an intravenous infusion of dopamine (5 micrograms kg-1 min-1) starting five minutes after the start of the endotoxin infusion and continuing for 60 minutes. Measurements were made at 15 minute intervals for 120 minutes. In group 1, one horse died during the endotoxin infusion and in two other horses mean facial artery pressures decreased to 50 mm Hg. Total pulmonary vascular resistance and packed cell volume were significantly increased. Cardiac output, cardiac index and change in mean arterial pressure were significantly greater in group 2 horses than in group 1 horses. Conversely, diastolic pulmonary artery pressure, total vascular resistance and total pulmonary resistance were significantly less in group 2 than in group 1. PaO2, base excess and white blood cell count were significantly decreased in both groups. It was concluded that dopamine improved cardiovascular function in the presence of endotoxaemia and attenuated the rate of haemoconcentration, but had no effect on the development of decreased PaO2 or metabolic acidosis.

Acid-Base Equilibrium↗

Prolongation of anesthesia with xylazine, ketamine, and guaifenesin in horses: 64 cases (1986-1989).

On 74 occasions, 54 horses and 6 foals were anesthetized with xylazine and ketamine or xylazine, guaifenesin, and ketamine, with or without butorphanol. On 64 occasions, anesthesia was prolonged for up to 70 minutes (34 +/- 15 min) by administration of 1 to 9 supplemental IV injections of xylazine and ketamine at approximately a third the initial dosage. All horses except 5 were positioned in lateral recumbency, and oxygen was insufflated. In adult horses, the time from induction of anesthesia to the first supplemental xylazine and ketamine injection was 13 +/- 4 minutes and the time between supplemental injections was 12.1 +/- 3.7 minutes. These results were consistent with predicted plasma ketamine concentration calculated from previously published pharmacokinetic data for ketamine in horses. Respiratory and heart rates and coccygeal artery pressure remained consistent for the duration of anesthesia. The average interval between the last injection of ketamine and assumption of sternal position was approximately 30 minutes, and was the same regardless of the number of supplemental injections. The time to standing was significantly longer (P less than 0.05) in horses given 2 supplemental injections, compared with those not given any or only given 1, but was not longer in horses given 3 supplemental injections. Recovery was considered unsatisfactory in 5 horses, but did not appear to be related to prolongation of anesthesia.

Anesthesia↗

Epidural analgesia with 0.75% bupivacaine for laparotomy in goats.

Epidural nerve block with 0.75% bupivacaine (1 ml/4 kg of body weight) was performed in 17 goats tranquilized by IM administration of acetylpromazine (0.07 mg/kg). For comparison, epidural nerve block with 2% lidocaine containing 1:100,000 epinephrine (1 ml/5 kg) was performed in 7 goats. Transient signs of CNS stimulation were observed during injection of bupivacaine in 5 goats and of lidocaine in 2 goats. Analgesia of the flank was inadequate for laparotomy in 4 goats given bupivacaine (including 1 goat given a two-thirds dose) and in 2 goats given lidocaine. Analgesia for these goats was provided by local infiltration of the operative site with lidocaine. With bupivacaine, the onset of analgesia was up to 40 minutes, and the duration of analgesia was several hours; most goats were unable to stand for at least 11 hours. In comparison, epidural nerve block with lidocaine had a more rapid onset and much shorter duration. For both anesthetic drugs, despite adequate analgesia for laparotomy, response to manipulation of abdominal viscera was observed in 12 goats. Arterial blood pressure and blood gas tensions were measured in 8 goats given bupivacaine; 3 goats had mean arterial blood pressure less than 70 mm of Hg. Seven goats had normal PaCO2 but 2 goats had low PaO2; 1 goat sedated with xylazine had increased PaCO2 and hypoxemia.

Analgesia, Epidural↗

A retrospective survey of anaesthesia in horses with colic.

The purpose of this survey was to identify complications occurring in horses with colic during anaesthesia and recovery from anaesthesia; and to determine any relationships between these complications and drugs used for induction or maintenance of anaesthesia. Two hundred and thirty nine horses were anaesthetised on a total of 250 occasions for colic surgery between January 1985 and May 1987. Of these, 189 recovered from 200 anaesthetic episodes. Most horses received xylazine and guaifenesin with either thiobarbiturate (68 per cent) or ketamine (24 per cent) and anaesthesia was maintained with either halothane (51 per cent), isoflurane (43 per cent), or first halothane then isoflurane (6 per cent). Sixty nine per cent also received an opioid. Hypotension or tachycardia were recorded in 15 and 13 per cent of anaesthesias, respectively. Arterial PO2 was less than 13.3 kPa in 17 per cent of 175 anaesthesias. None of these complications was associated with a specific anaesthetic agent. Hypertension was recorded in 11.5 per cent of anaesthesias and occurred more frequently during isoflurane anaesthesia (P < 0.05). The mean duration of anaesthesia was 126 mins (range, 50-270 mins), and was not different for horses receiving thiobarbiturate or ketamine, halothane or isoflurane. The time taken to stand after anaesthesia recorded on 149 occasions and was 63 +/- 24 mins (range, 15-135 mins). This was not different for the different anaesthetic agents. Horses that were excited or had difficulty standing up during recovery had a significantly longer duration of anaesthesia (165 +/- 51 mins) (P < 0.05) but no specific anaesthetic agent was involved. Of the 189 horses, 148 (75 per cent) survived and were discharged from the hospital. Horses that did not survive had a significantly increased prevalence of anaesthetic complications, and longer durations of anaesthesia.

Administration, Inhalation↗

Renal effects of dopamine infusion in conscious horses.

An ultrasonic flow probe was implanted around a branch of the left renal artery in five horses. The effects of dopamine were studied in the unsedated horses 10 days after surgery. Three experiments, separated by at least two days, were performed in random order on each horse. In two experiments, dopamine was infused intravenously for 60 mins at either 2.5 and 5.0 micrograms/kg bodyweight (bwt)/min. Saline was infused for 60 mins before and after each infusion, and for 180 mins in the third experiment as a control. Renal blood flow increased during administration of dopamine at both dose rates (P = 0.0001). Urine volume increased (P = 0.055), and osmolality decreased (P < 0.05), with infusion of dopamine at 5.0 micrograms/kg bwt/min. Arterial blood pressure and heart rate were not significantly affected. Fractional excretions of sodium and potassium were not significantly changed with dopamine infusion. The higher dopamine dose rate was accompanied by dysrhythmias in some horses.

Animals↗

Cardiovascular effects recorded in horses during anaesthesia after treatment with trichlorfon.

Five horses were anaesthetised twice with thiopentone sodium, guaifenesin and halothane. The second anaesthesia was 16 days after the first and two days following oral administration of trichlorfon. Heart rate, carotid arterial, pulmonary arterial and right atrial pressures, cardiac output and blood temperature were measured every 15 minutes for 120 minutes. Heart rate, carotid arterial pressure and cardiac output were similar on both occasions. Pulmonary arterial and right atrial pressures were highest during anaesthesia after treatment with trichlorfon when compared with values obtained before treatment. Pulmonary vascular resistance was significantly decreased at four measurement times during anaesthesia after treatment with trichlorfon. All cardiovascular measurements were within ranges accepted as normal for halothane anaesthesia in horses. In a second experiment, four ponies were anaesthetised with xylazine and ketamine on two occasions one week apart. Two ponies received trichlorfon two days before the second anaesthesia. Heart rate, arterial pressure and respiratory rate recorded during anaesthesia were not different in ponies after organophosphate treatment. The time to standing after the second anaesthesia was significantly increased in all ponies.

Anesthesia, General↗

Effects of xylazine on renal function and plasma glucose in ponies.

The intravenous administration of xylazine (1.1 mg/kg bodyweight) in six ponies resulted in a significant increase in urine output over two hours, with maximum flow occurring between 30 and 60 minutes after injection. Urine specific gravity, osmolality and glucose concentration decreased. Renal clearance of endogenous creatinine was unchanged. Significant increases in the excretion of potassium and chloride occurred. Plasma glucose concentration was increased 30 minutes after the administration of xylazine by a mean value of 37 per cent. Serum osmolality and sodium, potassium and chloride concentrations remained unchanged.

Animals↗

Hypertension in bulls and steers anesthetized with guaifenesin-thiobarbiturate-halothane combination.

Eight bulls and steers (research animals) and 18 bulls (surgical patients) were anesthetized with guaifenesin and thiopental or thiamylal and for 90 minutes with halothane. Arterial blood pressure and heart rate were recorded in all animals. Cardiac output, plasma glucose and lactate concentrations, PCV, plasma proteins and plasma thromboxane B2 values were determined before (control) and every 15 minutes during anesthesia in the research animals. Plasma catecholamine concentrations were measured in 3 of the research animals and 3 of the surgical patients. Arterial pressure, heart rate, and plasma thromboxane B2 and catecholamine concentrations were also measured immediately after the trachea was intubated. All animals, except one, were hypertensive during anesthesia. Heart rate during anesthesia was significantly increased, compared with control measurements, and cardiac output was decreased. Plasma glucose and lactate values significantly increased when the animals were restrained on their sides. Plasma glucose concentrations remained increased during anesthesia, but lactate decreased. Packed cell volume and plasma proteins were unchanged by the induction of anesthesia. Plasma norepinephrine concentration was unchanged during anesthesia, and epinephrine concentration was decreased. Endotracheal intubation caused a transient significant increase in arterial pressure, heart rate, and thromboxane B2 and a nonsignificant increase in norepinephrine.

Anesthesia, General↗

Use of dopamine hydrochloride during general anesthesia in the treatment of advanced atrioventricular heart block in four foals.

Heart block is a relatively common arrhythmia in the adult horse. It may be a normal physiologic phenomenon or it may have pathologic implication. Four foals in which advanced heart block developed during anesthesia were unresponsive to atropine sulfate and supportive treatment alone. Resolution of the heart blocks was achieved after the addition of dopamine hydrochloride to the therapeutic regimen.

Anesthesia, General↗

Effect of xylazine and ketamine on intraocular pressure in horses.

Intraocular pressure was measured with a MacKay-Marg tonometer in eight horses following auriculopalpebral nerve block and topical application of lignocaine. Measurements were recorded before and after xylazine, 1.1 mg/kg intravenously, every two minutes for 16 minutes after administration of ketamine, 2.2 mg/kg intravenously, and after recovery from anaesthesia. Before xylazine, intraocular pressure was 17.1 +/- 3.9 and 18.4 +/- 2.2 mm Hg in the left and right eyes, respectively. Intraocular pressure tended to decrease after administration of xylazine and ketamine, with a significant decrease in one eye six minutes after injection of ketamine.

Animals↗

Cardiopulmonary effects of dopamine hydrochloride in anaesthetised horses.

Dopamine hydrochloride was infused intravenously into six horses anaesthetised with halothane. Three dose rates; 0.5, 2.5 and 5.0 micrograms/kg/min, were evaluated in each horse. The cardiac output was significantly increased at 15 and 30 mins following administration of dopamine at 2.5 and 5.0 micrograms/kg/min. The heart rate, facial artery pressure and pulmonary artery pressure remained unchanged. Total peripheral resistance was significantly decreased at 30 mins with 2.5 micrograms/kg/min and at 15 and 30 mins with 5.0 micrograms/kg/min. No significant change was produced in packed cell volume, total protein, white blood cell count, platelets, glucose or lactate at any infusion rate. Supraventricular premature contractions occurred in one horse and episodes of tachycardia occurred in two horses during infusion of dopamine at 5.0 micrograms/kg/min. The results of the investigation demonstrated that dopamine administered at 2.5 and 5.0 micrograms/kg/min effectively increased the cardiac output of halothane anaesthetised horses and that dopamine at the high dosage may cause dysrhythmias.

Anesthesia, Inhalation↗

Cardiopulmonary effects of prostacyclin infusion in anesthetized horses.

Prostacyclin was infused IV into 6 horses anesthetized with halothane. Three dosage rates (10, 30, and 100 ng/kg of body weight/min) were evaluated in each horse. Facial and pulmonary artery pressures, heart rate, cardiac output, blood temperature, and arterial and mixed venous pH, PCO2, and PO2 were measured. Arterial blood was collected for determination of glucose, lactate, and PCV. Mixed venous blood was sampled for assay of 6-keto-prostaglandin F1 alpha and catecholamines. Infusion of prostacyclin at 10 ng/kg/min had no effect on the variables measured, whereas the 30 ng/kg/min dosage decreased diastolic and mean arterial pressure at 15 and 30 minutes and PaO2 at 15 minutes (P less than 0.05). Prostacyclin infusion at 100 ng/kg/min significantly decreased arterial pressure, total vascular resistance, and total pulmonary resistance. Heart rate increased slightly, and cardiac output increased by 44%. Arterial PO2 decreased from 311 mm of Hg to 137 and 135 mm of Hg at 15 and 30 minutes, respectively. Blood glucose was increased. Prostacyclin infusions of 30 and 100 ng/kg/min increased blood concentrations of 6-keto-prostaglandin F1 alpha by factors of 5 and 40, respectively. Significant changes in catecholamine concentrations did not occur.

Anesthesia, General↗

Cardiopulmonary effects of a xylazine and ketamine combination in pigs.

The carotid and pulmonary arteries were catheterised in six pigs anaesthetised with thiopentone sodium and halothane. A minimum of five days was allowed to elapse before the investigation. The carotid artery pressure, pulmonary artery pressure, cardiac output, arterial pH, PO2, PCO2, plasma glucose and lactate were measured before and after intravenous injection of xylazine (1 mg kg-1) and ketamine 10 mg kg-1). Complete analgesia was produced for 10 minutes in all pigs but by 25 minutes all animals responded to a painful stimulus. The cardiac output and arterial PO2 were significantly decreased for 30 minutes and 10 minutes, respectively. The total vascular resistance was significantly increased. No statistically significant changes occurred in the other variables measured.

Animals↗