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At least 253 records · Page 14Linked to original sources
PubMed1997

Surgery of the adnexa.

Review of the functional anatomy of ocular adnexal tissues is followed by presentation of surgical procedures aimed at correcting conditions of the eyelids, conjunctiva, and third eyelids of small animals. Procedures used effectively by the primary author are described in detail including instances where combination procedures may be indicated. Some newer, recently described techniques are also briefly discussed. Illustrations of applied anatomy and multiple surgical techniques are provided by illustrator and coauthor Dr. Gheorghe Constantinescu. References are given to encourage readers to further explore alternative techniques focusing on the surgical correction of adnexal diseases of dogs and cats.

Animals↗
PubMed1997

Surgery for glaucoma.

Most cases of glaucoma in small animals ultimately require surgical treatment for long-term control of intraocular pressure. Surgical procedures that have the potential to preserve vision in acute cases are categorized into those that reduce aqueous production (cyclodestructive techniques). Salvage procedures for irreversibly blind eyes include enucleation, implantation of an intraocular prosthesis, and pharmacologic ciliary body ablation. The indications, surgical technique, and complications of these procedures are discussed in this article.

Animals↗
PubMed1997

Phacoemulsification. Technology and fundamentals.

The number one rule of phacoemulsification and aspiration cataract surgery is to know your machine. This chapter is designed to help the surgeon who is currently using phacoemulsification, or those who wish to understand more about technique, learn the basics and technology of the various types of phacoemulsification machines. Fluidics, pump design, handpiece mechanics, phacoemulsification needles, and fundamentals of phacoemulsification of cataracts will be reviewed.

Animals↗
PubMed1997

Surgery for lens instability.

Lens luxation is a common and potentially blinding disease of dogs. If left untreated, degenerative changes in the pathways for aqueous humor result in glaucoma; however, if the lens is removed by ICLE before significant secondary changes occur, vision can be preserved. In addition, it is now possible to restore excellent vision by replacing the luxated lens with a synthetic IOL.

Animals↗
PubMed1997

Surgery of the orbit.

Orbital surgery is performed infrequently but when necessary, requires detailed understanding of orbital anatomy and the probable biologic behavior and extent of the pathologic process affecting the orbit. Thorough preoperative characterization of an orbital disease allows the surgeon to develop a surgical strategy. Inaccurate or hasty preoperative localization, determination of extension, and diagnosis may result in selection of an inappropriate surgical approach or discretionary surgery when medical treatment is indicated. In most instances, diagnostic images (MR, CT, echography) should always be made and fine-needle aspiration be done before orbital surgery is performed. The choice of surgical approach or combination of approaches is determined primarily by the type, location, size, and extent of disease present. Extensive surgical exposure of the orbit is limited to centimeters or fractions of a centimeter because of the compact anatomy and tight confines of the orbital region. Careful tissue manipulation, surgical dissection, and postoperative assessment are necessary to preserve the globe and functional vision when orbital disease endangers function.

Animals↗
PubMed1999

Fluid therapy and newer blood products.

A fluid therapy plan for a patient is developed prior to surgery and is designed to meet each patient's needs. The volume and type of fluid are dependent on the patient's physical status; the acid-base, fluid, and electrolyte status; the surgical procedure; and the expected losses occurring during the procedure. No one fluid regimen is ideal for all patients. All fluid regimens must be continually re-evaluated. A brief minor surgical procedure in a healthy surgical candidate requires little or no fluid administration. In cases of more extensive surgical procedures involving invasion of the abdomen or chest as well as in cases with trauma and major blood loss, much more volume and a specific balanced replacement fluid are required. Depending on the severity of the surgical case, administration rates of 5 to 15 mL/kg/h or greater of crystalloid may be required to maintain perfusion. These rates are merely guidelines, and resuscitation should continue until the desired end point is reached. Balanced replacement fluids may be used to replace blood loss at a ratio of 3:1 and are added to maintenance and replacement requirements. Blood loss of 20% to 25% of the calculated blood volume or hematocrit values less than 20% are indications for colloids or blood replacement at a ratio of 1:1. The optimal fluid therapy regimen for a patient may involve a combination of crystalloids as well as natural and synthetic colloids, using each type of fluid to obtain and maintain perfusion and oxygenation to the tissues.

Animals↗
PubMed1999

Newer diagnostic and surgical techniques and their impact on anesthesia.

There are several newer diagnostic and surgical techniques available to veterinarians today. Careful anesthetic management is essential when using these modalities both to avoid accidents and to enable their use. For example, total intravenous anesthetic techniques can be used if the airway is occupied by an endoscope or laser surgery is being performed in the airway. The anesthesiologist must also be aware of the physiological changes that may occur during procedures such as laparoscopy and act to minimize their impact on patients.

Anesthesia↗
PubMed1999

Management of geriatric patients. A common occurrence.

The anesthetic and perioperative care of geriatric animals requires increased vigilance and support. The margin of acceptable physiological variation is probably more narrow than in younger patients. Underlying disease, which is often subclinical, influences metabolism and recovery from anesthetics and also predisposes the patients to adverse outcome. Limited respiratory and cardiovascular reserve diminishes the ability of many older patients to meet the challenges of anesthesia and surgery or other stressful medical procedures. The psychological, as well as physiological, stress of hospitalization is increased in many geriatric patients.

Aging↗
PubMed1999

Analgesics and pain.

There has been a substantial increase in the use of analgesics for pain management in the last 10 years. Traditionally, veterinarians have not been trained in the identification of or monitoring of patients that are in pain, even though an evaluation of pain is inherent in assessing improvement in many medical and surgical diseases. Until recently, the physiology and pharmacology of opioids, NSAIDs, local anesthetics, and alpha 2 agonists were taught, but the therapeutic role of these drugs was generally believed to be related to restraint, anesthesia, or control of inflammation rather than to pain management.

Analgesics, Opioid↗
PubMed1999

Newer analgesics. Nonsteroid anti-inflammatory drugs, opioids, and combinations.

Analgesia is an intrinsic part of anesthesia, and the use of opioids for premedication, supplementation of anesthesia, and postoperative analgesia is not new. Development of new potent and less toxic NSAIDs has now resulted in this type of analgesic, also playing a major role in perioperative analgesia. Weak cyclo-oxygenase inhibitors, and NSAIDs with high COX2 activity, are proving successful in the provision of analgesia in dogs and cats. Some newer opioids developed for man have potential for use in dogs and cats, and buprenorphine, a partial agonist, deserves further evaluation. Some novel analgesics have potential for use in animals, but the specific analgesic role of old friends ketamine and the alpha 2 adrenoceptor agonists is worthy of closer scrutiny.

Analgesics, Opioid↗
PubMed2002

Neuromuscular blocking agents.

In summary, with proper vigilance, neuromuscular blocking agents can be used safely in anesthetized equine patients to optimize conditions for certain surgical procedures. By appropriate use of neuromuscular monitoring techniques and reversal agents, residual blockade and muscle weakness should be avoided, allowing the horse to recover to standing without difficulty. Research is ongoing to develop the ideal muscle relaxant, one that has a rapid onset, predictable duration and recovery times, and negligible hemodynamic effects. As newer agents become available, they should be evaluated for their suitability for use in equine patients.

Anesthesia↗
PubMed2000

History and instrumentation of laparoscopic surgery.

Equine surgery continues to benefit from advances in endoscopic surgical techniques. Much of what we have learned in equine endoscopy comes from techniques used in humans. Descriptions of the normal anatomy of the standing horse and advances in instrumentation have improved our ability to perform laparoscopic surgery in standing and dorsally recumbent horses. This article describes the history of laparoscopy and available instrumentation.

Animals↗
PubMed2000

History, instrumentation, and techniques of flexible endoscopic laser surgery in horses.

There are clearly a number of applications for which flexible endoscopic laser surgery has become the state of the art in equine surgery, and the Nd:YAG laser seems to be the most versatile instrument for this type of surgery. Nevertheless, it is critical to understand the advantages and disadvantages of each laser technique. For example, the Nd:YAG laser used in a noncontact fashion seems to be superior when ablation of tissue is required such as treatment of upper airway masses. Conversely, contact Nd:YAG laser techniques have proven themselves to be superior when more precise cutting is advantageous such as treatment of epiglottic entrapment. Ultimately, it seems that a range of lasers is necessary to ensure selection of the most appropriate technique, adding significantly to the expense of equipment but improving the outcome for a range of equine diseases.

Animals↗
PubMed1996

Instrument sterilization, skin preparation, and wound management.

Recent advances in instrument sterilization include the introduction of gas plasma sterilization and the increased use of glutaraldehyde. Gas plasma sterilization has the advantages of no toxic residue effects, reduced turnover time, and applicability for sterilization of heat- and moisture-sensitive instruments. Chlorhexidine gluconate (4%) appears to be a superior preoperative surgical scrub for both the surgeon and the patient because of its increased antimicrobial efficacy, residual activity, and minimal tissue reactions. There are many new wound dressings and topical medications for treatment of wounds, but the efficacy of most of these preparations has been evaluated only in humans, dogs, and cats. The ideal topical wound preparation and dressing for equine wounds, particularly wounds affecting the distal limb, have not yet been found.

Animals↗