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Lumbo-sacral epidural anaesthesia as a complement to dissociative anaesthesia during scrotal herniorrhaphy of livestock pigs in the field.

Ekstrand C, Sterning M, Bohman L, Edner A - Acta Vet. Scand. (2015)

Bottom Line: There were no significant differences between groups in respiratory rate, heart rate, blood pressure, SpO2 or blood gases.It improved analgesia and anaesthesia during herniorrhaphy of sufficient duration to enable surgical skills training.The risks and consequences of hypoxaemia and hypoventilation should be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, PO box 7054, SE 750 07, Uppsala, Sweden. carl.ekstrand@slu.se.

ABSTRACT

Background: In Sweden, scrotal or inguinal herniorrhaphy of livestock pigs in the field has traditionally been an important part of the surgical skills training of veterinary students. Few substances meet the legal requirements for field anaesthesia of production animals in the European Union but a protocol based on azaperone-detomidine-butorphanol-ketamine does. Unfortunately the anaesthesia is characterised by unpredictable duration and depth and of abrupt awakenings which is not acceptable from an animal welfare perspective and impedes surgical training. Lumbo-sacral epidural analgesia is proven to provide sufficient analgesia to allow abdominal surgery, but there are few reports on the field use of this loco-regional technique. The study aim was to evaluate whether lumbo-sacral anaesthesia can be safely and successfully used in the field by a veterinary student and whether the combination of dissociative and lumbo-sacral epidural anaesthesia improves analgesia and anaesthesia to guarantee animal welfare during herniorrhaphy in livestock pigs, enabling surgical skills training.

Results: Pigs in the control-group (placebo) responded significantly stronger to surgery, with five out of 11 requiring additional doses of detomidine and ketamine. There were no significant differences between groups in respiratory rate, heart rate, blood pressure, SpO2 or blood gases. SpO2 levels <94 % were recorded in several pigs in both groups. No post-injection complications were reported at follow-up.

Conclusions: The results from this study showed that lumbo-sacral epidural anaesthesia with lidocaine could successfully be administered during dissociative anaesthesia of livestock pigs by a veterinary student and without reported post-injection complications. It improved analgesia and anaesthesia during herniorrhaphy of sufficient duration to enable surgical skills training. The risks and consequences of hypoxaemia and hypoventilation should be considered.

No MeSH data available.


Related in: MedlinePlus

Differences between Group C and Group L in variables indicating anaesthetic depth and analgesia. Accumulated frequencies of the variables: Response to surgery, pedal withdrawal reflex, nasal septum pinch, iteration of drugs (detomidine-ketamine), muscular relaxation of forelimbs and spontaneous movement; during herniorrhaphy in pigs receiving an epidural injection of lidocaine (Group L: black rhombus) or an equivalent volume of physiological saline (Group C: grey squares) during azaperone-detomidine-butorphanol-ketamine anaesthesia. The X-axis shows the time in minutes relative to start of surgery at time 0. The time for epidural injection is indicated with an arrow below the X-axis. Significance levels between groups: * = P < 0.05, ** = P < 0.01, *** = P < 0.001
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Fig1: Differences between Group C and Group L in variables indicating anaesthetic depth and analgesia. Accumulated frequencies of the variables: Response to surgery, pedal withdrawal reflex, nasal septum pinch, iteration of drugs (detomidine-ketamine), muscular relaxation of forelimbs and spontaneous movement; during herniorrhaphy in pigs receiving an epidural injection of lidocaine (Group L: black rhombus) or an equivalent volume of physiological saline (Group C: grey squares) during azaperone-detomidine-butorphanol-ketamine anaesthesia. The X-axis shows the time in minutes relative to start of surgery at time 0. The time for epidural injection is indicated with an arrow below the X-axis. Significance levels between groups: * = P < 0.05, ** = P < 0.01, *** = P < 0.001

Mentions: There were significant differences between the groups in regard to the accumulated frequency of the variables PWR, NSP, muscular relaxation of forelimbs, spontaneous movements and reaction to surgery with more responders in group C (Fig. 1). No pig in group L reacted to surgery during herniorrhaphy, whereas three group C pigs reacted to surgery on more than one occasion. One group C pig and one group L pig reacted at castration of the second testicle (not shown in Fig. 1). The pig in group L only showed a minor, transient change in breathing pattern.Fig. 1


Lumbo-sacral epidural anaesthesia as a complement to dissociative anaesthesia during scrotal herniorrhaphy of livestock pigs in the field.

Ekstrand C, Sterning M, Bohman L, Edner A - Acta Vet. Scand. (2015)

Differences between Group C and Group L in variables indicating anaesthetic depth and analgesia. Accumulated frequencies of the variables: Response to surgery, pedal withdrawal reflex, nasal septum pinch, iteration of drugs (detomidine-ketamine), muscular relaxation of forelimbs and spontaneous movement; during herniorrhaphy in pigs receiving an epidural injection of lidocaine (Group L: black rhombus) or an equivalent volume of physiological saline (Group C: grey squares) during azaperone-detomidine-butorphanol-ketamine anaesthesia. The X-axis shows the time in minutes relative to start of surgery at time 0. The time for epidural injection is indicated with an arrow below the X-axis. Significance levels between groups: * = P < 0.05, ** = P < 0.01, *** = P < 0.001
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4491221&req=5

Fig1: Differences between Group C and Group L in variables indicating anaesthetic depth and analgesia. Accumulated frequencies of the variables: Response to surgery, pedal withdrawal reflex, nasal septum pinch, iteration of drugs (detomidine-ketamine), muscular relaxation of forelimbs and spontaneous movement; during herniorrhaphy in pigs receiving an epidural injection of lidocaine (Group L: black rhombus) or an equivalent volume of physiological saline (Group C: grey squares) during azaperone-detomidine-butorphanol-ketamine anaesthesia. The X-axis shows the time in minutes relative to start of surgery at time 0. The time for epidural injection is indicated with an arrow below the X-axis. Significance levels between groups: * = P < 0.05, ** = P < 0.01, *** = P < 0.001
Mentions: There were significant differences between the groups in regard to the accumulated frequency of the variables PWR, NSP, muscular relaxation of forelimbs, spontaneous movements and reaction to surgery with more responders in group C (Fig. 1). No pig in group L reacted to surgery during herniorrhaphy, whereas three group C pigs reacted to surgery on more than one occasion. One group C pig and one group L pig reacted at castration of the second testicle (not shown in Fig. 1). The pig in group L only showed a minor, transient change in breathing pattern.Fig. 1

Bottom Line: There were no significant differences between groups in respiratory rate, heart rate, blood pressure, SpO2 or blood gases.It improved analgesia and anaesthesia during herniorrhaphy of sufficient duration to enable surgical skills training.The risks and consequences of hypoxaemia and hypoventilation should be considered.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, PO box 7054, SE 750 07, Uppsala, Sweden. carl.ekstrand@slu.se.

ABSTRACT

Background: In Sweden, scrotal or inguinal herniorrhaphy of livestock pigs in the field has traditionally been an important part of the surgical skills training of veterinary students. Few substances meet the legal requirements for field anaesthesia of production animals in the European Union but a protocol based on azaperone-detomidine-butorphanol-ketamine does. Unfortunately the anaesthesia is characterised by unpredictable duration and depth and of abrupt awakenings which is not acceptable from an animal welfare perspective and impedes surgical training. Lumbo-sacral epidural analgesia is proven to provide sufficient analgesia to allow abdominal surgery, but there are few reports on the field use of this loco-regional technique. The study aim was to evaluate whether lumbo-sacral anaesthesia can be safely and successfully used in the field by a veterinary student and whether the combination of dissociative and lumbo-sacral epidural anaesthesia improves analgesia and anaesthesia to guarantee animal welfare during herniorrhaphy in livestock pigs, enabling surgical skills training.

Results: Pigs in the control-group (placebo) responded significantly stronger to surgery, with five out of 11 requiring additional doses of detomidine and ketamine. There were no significant differences between groups in respiratory rate, heart rate, blood pressure, SpO2 or blood gases. SpO2 levels <94 % were recorded in several pigs in both groups. No post-injection complications were reported at follow-up.

Conclusions: The results from this study showed that lumbo-sacral epidural anaesthesia with lidocaine could successfully be administered during dissociative anaesthesia of livestock pigs by a veterinary student and without reported post-injection complications. It improved analgesia and anaesthesia during herniorrhaphy of sufficient duration to enable surgical skills training. The risks and consequences of hypoxaemia and hypoventilation should be considered.

No MeSH data available.


Related in: MedlinePlus