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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

Systolic, diastolic and mean arterial systemic blood pressures. Mean values ± SD for systemic, diastolic and mean arterial blood pressure (SAP, DAP, MAP) 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. Recordings are shown until completion of herniorrhaphy at 35 min after incision. Significant differences over time compared with time 0 are denoted + (P < 0.05), ++ (P < 0.001), or +++ (P < 0.0001)
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Fig2: Systolic, diastolic and mean arterial systemic blood pressures. Mean values ± SD for systemic, diastolic and mean arterial blood pressure (SAP, DAP, MAP) 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. Recordings are shown until completion of herniorrhaphy at 35 min after incision. Significant differences over time compared with time 0 are denoted + (P < 0.05), ++ (P < 0.001), or +++ (P < 0.0001)

Mentions: Heart rate, RR, SAP, MAP and DAP did not differ between the groups (Figs. 2 and 3). Mean arterial blood pressure was <60 mmHg during at least half of the procedure in two of the 11 pigs in group C and in four of the 11 pigs in group L.Fig. 2


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)

Systolic, diastolic and mean arterial systemic blood pressures. Mean values ± SD for systemic, diastolic and mean arterial blood pressure (SAP, DAP, MAP) 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. Recordings are shown until completion of herniorrhaphy at 35 min after incision. Significant differences over time compared with time 0 are denoted + (P < 0.05), ++ (P < 0.001), or +++ (P < 0.0001)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig2: Systolic, diastolic and mean arterial systemic blood pressures. Mean values ± SD for systemic, diastolic and mean arterial blood pressure (SAP, DAP, MAP) 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. Recordings are shown until completion of herniorrhaphy at 35 min after incision. Significant differences over time compared with time 0 are denoted + (P < 0.05), ++ (P < 0.001), or +++ (P < 0.0001)
Mentions: Heart rate, RR, SAP, MAP and DAP did not differ between the groups (Figs. 2 and 3). Mean arterial blood pressure was <60 mmHg during at least half of the procedure in two of the 11 pigs in group C and in four of the 11 pigs in group L.Fig. 2

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