scholarly journals Effects of intramuscular alfaxalone-midazolam combination in pigs

2019 ◽  
Vol 88 (2) ◽  
pp. 187-192 ◽  
Author(s):  
Cecilia Vullo ◽  
Marina Meligrana ◽  
Adolfo Maria Tambella ◽  
Angela Palumbo Piccionello ◽  
Fabrizio Dini ◽  
...  
Keyword(s):  
Repeated Measure ◽  
Intramuscular Administration ◽  
Arterial Oxygen ◽  
Neck Muscle ◽  
Pain On Injection ◽  
Arterial Blood ◽  
Measure Analysis ◽  
American Society ◽  
Lateral Recumbency

The aim of this experimental study was to evaluate the sedative and cardiorespiratory effects of alfaxalone and midazolam after intramuscular administration in pigs. Fourteen pigs, weighing 18 to 22 kg, aged between 55 and 70 days, American Society of Anaesthesiologists classification 2, affected by congenital reducible umbilical hernia, were included in the study. Alfaxalone (5 mg/kg) and midazolam (0.5 mg/kg) mixed in the same syringe were administered into the neck muscle. Pain on injection, quality of sedation and time to achieve lateral recumbency were recorded. Heart rate (HR), respiratory frequency (fR), and rectal temperature (RT) were recorded at 0 (baseline: before drug administration), 10, 15, and 20 min after the injection. Oxygen saturation of haemoglobin (SpO2), arterial blood pH, arterial oxygen (PaO2) and carbon dioxide (PaCO2) tensions and bicarbonate concentration (HCO3-) were recorded at 10, 15, and 20 min after injection. Continuous data were analysed using a repeated-measure analysis of variance (ANOVA) and a P-value < 0.05 was considered significant. Ten animals out of fourteen showed no pain on injection, whereas the remaining four exhibited mild pain. The time from the end of injection to lateral recumbency was 266 ± 40 s. The quality of sedation ranged between good to very good. No significant changes in the variables monitored were observed between the time points. In conclusion, the intramuscular administration of alfaxalone and midazolam in pigs at the doses used induced reliable and fast sedation, without pain on injection and moderate respiratory effects.

Intrathecal Ropivacaine and Clonidine for Ambulatory Knee Arthroscopy

2001 ◽  
Vol 94 (4) ◽  
pp. 574-578 ◽  
Author(s):  
Marc De Kock ◽  
Philippe Gautier ◽  
Luc Fanard ◽  
Jean Luc Hody ◽  
Patricia Lavand’homme
Keyword(s):  
Small Dose ◽  
Knee Arthroscopy ◽  
Systemic Effects ◽  
Motor Blockade ◽  
Arterial Blood ◽  
Group 2 ◽  
American Society ◽  
Double Blinded ◽  
Intrathecal Clonidine

Background The aim of this study was to evaluate the association of a small dose of intrathecal ropivacaine with small doses of intrathecal clonidine for ambulatory surgery. Methods One hundred twenty patients, classified as American Society of Anesthesiologists physical status I and scheduled for knee arthroscopy, were studied. Patients were randomly assigned to receive 4 ml of one of the following double-blinded isobaric intrathecal solutions: 8 mg of ropivacaine (group 1; n =30); 8 mg ropivacaine plus 15 microg clonidine (group 2; n =30); 8 mg ropivacaine plus 45 microg clonidine (group 3; n =30); and 8 mg ropivacaine plus 75 microg clonidine (group 4; n =30). The level and duration of sensory anesthesia were recorded, along with the intensity and duration of motor block. Patient and surgeon were interviewed to evaluate the quality of anesthesia. Results Intrathecal ropivacaine (8 mg alone) produced short sensory anesthesia and motor blockade (132 +/- 38 min and 110 +/- 35 min; mean +/- SD). However, the quality of anesthesia was significantly lower than in any other group (P &lt; 0.05). Ropivacaine (8 mg) plus 75 microg clonidine produced significantly longer sensory and motor anesthesia (195 +/- 40 min and 164 +/- 38 min; P &lt; 0.05). However, this was associated with systemic effects, such as sedation and reduction of arterial blood pressure. Ropivacaine (8 mg) plus 15 microg clonidine did not prolong sensory or motor blockade, afforded high quality anesthesia, and was not associated with detectable systemic effects. Conclusion Small-dose intrathecal clonidine (15 microg) plus 8 mg intrathecal ropivacaine produces adequate and short-lasting anesthesia for knee arthroscopy.

scholarly journals Effects of ketamine/xylazine premedication on emulsified isoflurane general anaesthesia in swine undergoing embryo transplantation

2014 ◽  
Vol 59 (No. 7) ◽  
pp. 325-330
Author(s):  
S. Jiang ◽  
K. Hu ◽  
HG Fan ◽  
BS Yin ◽  
X. Li ◽  
...  
Keyword(s):  
Muscle Relaxation ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Physiological Changes ◽  
Anaesthetic Induction ◽  
Continuous Administration ◽  
Intravenous Anaesthesia ◽  
Arterial Blood ◽  
Lateral Recumbency ◽  
Experimental Embryo

Cardiorespiratory effects were assessed during ketamine/xylazine premedication followed by emulsified isoflurane anaesthesia in swine undergoing experimental embryo transplantation. Ketamine (10 mg/kg) and xylazine (3.5 mg/kg) were premedicated intravenously, followed by continuous administration of intravenous emulsified isoflurane (2.8 ml/kg/h). Cardiorespiratory parameters, including heart rate, respiratory rate, mean arterial blood pressure, arterial oxygen saturation, and rectal temperature, were recorded in sows undergoing surgical embryo transplantation. Ketamine/xylazine premedication resulted in anaesthetic induction and lateral recumbency within 1 minute without any adverse effects. The physiological changes observed after drug administration remained within biologically acceptable limits. In conclusion, the combination of ketamine/xylazine provided anaesthetic induction, muscle relaxation, and analgesia sufficient for emulsified isoflurane intravenous anaesthesia. There were no adverse events in the experimental animals. This finding supports the use of emulsified isoflurane following ketamine/xylazine premedication in pigs.

Combined spinal and general anaesthesia in 58 cats undergoing various surgical procedures: description of technique and retrospective perioperative evaluation

2018 ◽  
Vol 21 (12) ◽  
pp. 1127-1133
Author(s):  
Diego Sarotti ◽  
Andrea Cattai ◽  
Paolo Franci
Keyword(s):  
Perioperative Complications ◽  
Intrathecal Injection ◽  
Inclusion Criteria ◽  
Physical Status ◽  
Median Dose ◽  
Rescue Analgesia ◽  
Arterial Blood ◽  
American Society ◽  
Lateral Recumbency ◽  
Observation Period

Objectives The aim of this retrospective study was to describe the spinal anaesthesia (SA) technique and evaluate the incidence of perioperative complications in cats. Methods The anaesthetic records of cats of American Society of Anaesthesiologists physical status I, II and III, which received general and SA for different surgeries between 2012 and 2016, were examined. SA was administered through a 25 G Quincke needle, using an isobaric solution of bupivacaine and morphine at the level of either the L7–S1 interspaces (sternal recumbency) or the L5–6/L6–7 interspaces (lateral recumbency). Procedural failure rate (PFR), drugs and dose used, heart rate (HR), arterial blood pressure, incidence of bradycardia (HR <100 bpm) and hypotension (mean arterial pressure [MAP] <60 mmHg for at least 5 mins), intraoperative rescue analgesia (iRA) and any other detrimental events and their treatment until discharge were recorded. Abdominal surgery cases were excluded from the intraoperative evaluation. Results A total of 58 anaesthetic records met the inclusion criteria and were analysed. PFR related to the space of injection (L7–S1 vs L5–6/L6–7) was 3/11 (27%) and 1/47 (2%), respectively ( P = 0.017). The total median dose of intrathecal bupivacaine and morphine was 0.8 (range 0.5–1.6 mg/kg) and 0.10 (0.05–0.18 mg/kg), respectively. Nine of 46 (20%) cats received iRA, and no iRA cases were reported with a dose of bupivacaine higher than 0.8 mg/kg. Median HR and MAP before intrathecal injection (T0) and 10 mins after (T1) were, respectively, 118 bpm (range 74–190 bpm) and 106 bpm (67–160 bpm) ( P = 0.005), and 65 mmHg (range 50–94 mmHg) and 52 mmHg (range 35–85 mmHg) ( P = 0.003). Bradycardia was reported in 18/46 (39%) cats and hypotension in 23/46 (50%) cats. No complications were recorded during the observation period. Conclusions and relevance SA was characterised by a low PFR when performed at the L5–6/L6–7 interspaces and low postoperative complications. Hypotension and bradycardia were the most common side effects.

scholarly journals Comparison of Mean Platelet Counts in Preterm Infants with and without Retinopathy of Prematurity

2021 ◽  
Vol 18 (7) ◽  
pp. 3783
Author(s):  
Zi Di Lim ◽  
Edwin Pheng ◽  
Evelyn Tai Li Min ◽  
Hans Van Rostenberghe ◽  
Ismail Shatriah
Keyword(s):  
Risk Factors ◽  
Retinopathy Of Prematurity ◽  
Primary Source ◽  
Analysis Of Covariance ◽  
Repeated Measure ◽  
Platelet Counts ◽  
Related Risk ◽  
Measure Analysis ◽  
Repeated Measure Analysis ◽  
Over Time

Platelets are a primary source of pro- and anti-angiogenic cytokines. However, the evidence of their role in retinopathy of prematurity (ROP) is controversial. This retrospective study aimed to compare mean weekly platelet counts between infants with and without ROP over the first 6 weeks of life. A total of 93 infants matched by gestational age and birth weight were recruited (31 with ROP, 62 without ROP). Weekly mean platelet counts and other related risk factors were documented. The repeated measure analysis of variance (ANOVA) and the repeated measure analysis of covariance (ANCOVA) were used to compare mean platelet counts over time between the two groups, with and without adjusting for confounders. We found significant differences in the weekly mean platelet counts of infants with and without ROP over the first 6 weeks of life (p = 0.002). These differences disappeared after adjusting for covariates (p = 0.489). Lower mean platelet counts in ROP infants are not directly related to ROP, but rather to the presence of other risk factors for ROP, such as culture-proven sepsis, blood transfusion and bronchopulmonary dysplasia.

scholarly journals Accuracy of two pulse-oximetry measurements for INTELLiVENT-ASV in mechanically ventilated patients: a prospective observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shinshu Katayama ◽  
Jun Shima ◽  
Ken Tonai ◽  
Kansuke Koyama ◽  
Shin Nunomiya
Keyword(s):  
Oxygen Saturation ◽  
Pulse Oximetry ◽  
Prospective Observational Study ◽  
Arterial Oxygen Saturation ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Arterial Blood ◽  
Ventilated Patients

AbstractRecently, maintaining a certain oxygen saturation measured by pulse oximetry (SpO2) range in mechanically ventilated patients was recommended; attaching the INTELLiVENT-ASV to ventilators might be beneficial. We evaluated the SpO2 measurement accuracy of a Nihon Kohden and a Masimo monitor compared to actual arterial oxygen saturation (SaO2). SpO2 was simultaneously measured by a Nihon Kohden and Masimo monitor in patients consecutively admitted to a general intensive care unit and mechanically ventilated. Bland–Altman plots were used to compare measured SpO2 with actual SaO2. One hundred mechanically ventilated patients and 1497 arterial blood gas results were reviewed. Mean SaO2 values, Nihon Kohden SpO2 measurements, and Masimo SpO2 measurements were 95.7%, 96.4%, and 96.9%, respectively. The Nihon Kohden SpO2 measurements were less biased than Masimo measurements; their precision was not significantly different. Nihon Kohden and Masimo SpO2 measurements were not significantly different in the “SaO2 < 94%” group (P = 0.083). In the “94% ≤ SaO2 < 98%” and “SaO2 ≥ 98%” groups, there were significant differences between the Nihon Kohden and Masimo SpO2 measurements (P < 0.0001; P = 0.006; respectively). Therefore, when using automatically controlling oxygenation with INTELLiVENT-ASV in mechanically ventilated patients, the Nihon Kohden SpO2 sensor is preferable.Trial registration UMIN000027671. Registered 7 June 2017.

scholarly journals Can Alveolar-Arterial Difference and Lung Ultrasound Help the Clinical Decision Making in Patients with COVID-19?

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 761
Author(s):  
Gianmarco Secco ◽  
Francesco Salinaro ◽  
Carlo Bellazzi ◽  
Marco La Salvia ◽  
Marzia Delorenzo ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Lung Ultrasound ◽  
Signs And Symptoms ◽  
Clinical Decision ◽  
Arterial Oxygen ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Lung Dysfunction ◽  
Close Relationship

Background: COVID-19 is an emerging infectious disease, that is heavily challenging health systems worldwide. Admission Arterial Blood Gas (ABG) and Lung Ultrasound (LUS) can be of great help in clinical decision making, especially during the current pandemic and the consequent overcrowding of the Emergency Department (ED). The aim of the study was to demonstrate the capability of alveolar-to-arterial oxygen difference (AaDO2) in predicting the need for subsequent oxygen support and survival in patients with COVID-19 infection, especially in the presence of baseline normal PaO2/FiO2 ratio (P/F) values. Methods: A cohort of 223 swab-confirmed COVID-19 patients underwent clinical evaluation, blood tests, ABG and LUS in the ED. LUS score was derived from 12 ultrasound lung windows. AaDO2 was derived as AaDO2 = ((FiO2) (Atmospheric pressure − H2O pressure) − (PaCO2/R)) − PaO2. Endpoints were subsequent oxygen support need and survival. Results: A close relationship between AaDO2 and P/F and between AaDO2 and LUS score was observed (R2 = 0.88 and R2 = 0.67, respectively; p < 0.001 for both). In the subgroup of patients with P/F between 300 and 400, 94.7% (n = 107) had high AaDO2 values, and 51.4% (n = 55) received oxygen support, with 2 ICU admissions and 10 deaths. According to ROC analysis, AaDO2 > 39.4 had 83.6% sensitivity and 90.5% specificity (AUC 0.936; p < 0.001) in predicting subsequent oxygen support, whereas a LUS score > 6 showed 89.7% sensitivity and 75.0% specificity (AUC 0.896; p < 0.001). Kaplan–Meier curves showed different mortality in the AaDO2 subgroups (p = 0.0025). Conclusions: LUS and AaDO2 are easy and effective tools, which allow bedside risk stratification in patients with COVID-19, especially when P/F values, signs, and symptoms are not indicative of severe lung dysfunction.

scholarly journals BIOCHEMICAL STUDIES ON SHOCK

1944 ◽  
Vol 79 (1) ◽  
pp. 9-22 ◽  
Author(s):  
Frank L. Engel ◽  
Helen C. Harrison ◽  
C. N. H. Long
Keyword(s):  
Blood Pressure ◽  
Amino Acids ◽  
Oxygen Saturation ◽  
Hepatic Artery ◽  
Arterial Oxygen Saturation ◽  
Amino Nitrogen ◽  
Arterial Oxygen ◽  
High Positive Correlation ◽  
Peripheral Tissues ◽  
Arterial Blood

1. In a series of rats subjected to hemorrhage and shock a high negative correlation was found between the portal and peripheral venous oxygen saturations and the arterial blood pressure on the one hand, and the blood amino nitrogen levels on the other, and a high positive correlation between the portal and the peripheral oxygen saturations and between each of these and the blood pressure. 2. In five cats subjected to hemorrhage and shock the rise in plasma amino nitrogen and the fall in peripheral and portal venous oxygen saturations were confirmed. Further it was shown that the hepatic vein oxygen saturation falls early in shock while the arterial oxygen saturation showed no alteration except terminally, when it may fall also. 3. Ligation of the hepatic artery in rats did not affect the liver's ability to deaminate amino acids. Hemorrhage in a series of hepatic artery ligated rats did not produce any greater rise in the blood amino nitrogen than a similar hemorrhage in normal rats. The hepatic artery probably cannot compensate to any degree for the decrease in portal blood flow in shock. 4. An operation was devised whereby the viscera and portal circulation of the rat were eliminated and the liver maintained only on its arterial circulation. The ability of such a liver to metabolize amino acids was found to be less than either the normal or the hepatic artery ligated liver and to have very little reserve. 5. On complete occlusion of the circulation to the rat liver this organ was found to resist anoxia up to 45 minutes. With further anoxia irreversible damage to this organ's ability to handle amino acids occurred. 6. It is concluded that the blood amino nitrogen rise during shock results from an increased breakdown of protein in the peripheral tissues, the products of which accumulate either because they do not circulate through the liver at a sufficiently rapid rate or because with continued anoxia intrinsic damage may occur to the hepatic parenchyma so that it cannot dispose of amino acids.

Pulse Oximetry: An Alternative Method for the Assessment of Oxygenation in Newborn Infants

PEDIATRICS ◽  
1987 ◽  
Vol 79 (4) ◽  
pp. 524-528
Author(s):  
Michael S. Jennis ◽  
Joyce L. Peabody
Keyword(s):  
Pulse Oximetry ◽  
Pulse Oximeter ◽  
Arterial Oxygen Saturation ◽  
Newborn Infants ◽  
Fetal Hemoglobin ◽  
Arterial Oxygen ◽  
Skin Injury ◽  
Reliable Technique ◽  
Arterial Blood

Continuous monitoring of oxygenation in sick newborns is vitally important. However, transcutaneous Po2 measurements have a number of limiations. Therefore, we report the use of the pulse oximeter for arterial oxygen saturation (Sao2) determination in 26 infants (birth weights 725 to 4,000 g, gestational ages 24 to 40 weeks, and postnatal ages one to 49 days). Fetal hemoglobin determinations were made on all infants and were repeated following transfusion. Sao2, readings from the pulse oximeter were compared with the Sao2 measured in vitro on simultaneously obtained arterial blood samples. The linear regression equation for 177 paired measurements was: y = 0.7x + 27.2; r = .9. However, the differences between measured Sao2 and the pulse oximeter Sao2 were significantly greater in samples with &gt; 50% fetal hemoglobin when compared with samples with &lt; 25% fetal hemoglobin (P &lt; .001). The pulse oximeter was easy to use, recorded trends in oxygenation instantaneously, and was not associated with skin injury. We conclude that pulse oximetry is a reliable technique for the continuous, noninvasive monitoring of oxygenation in newborn infants.

Do longitudinal orthodontic trials use appropriate statistical analyses? A meta-epidemiological study

2021 ◽  
Author(s):  
Samer Mheissen ◽  
Haris Khan ◽  
Mohammed Almuzian ◽  
Emad Eddin Alzoubi ◽  
Nikolaos Pandis
Keyword(s):  
Statistical Analysis ◽  
Epidemiological Study ◽  
Data Extraction ◽  
Statistical Significance ◽  
Repeated Measure ◽  
Exact Test ◽  
Optimal Analysis ◽  
Study Characteristics ◽  
Measure Analysis ◽  
Repeated Measure Analysis

Summary Background In orthodontic trials, longitudinal designs with multiple outcome measurements over time are common. The aim of this epidemiological study was to examine whether optimal statistical analysis approaches have been used in longitudinal orthodontic trials. Methods Pubmed was searched in August 2021 for longitudinal orthodontic trials with at least three time points of outcome assessment published in the 2017–20 period. Study selection and data extraction were done independently and in duplicate. The analysis approaches undertaken were tabulated and associations between study characteristics and the use of optimal analysis or not were assessed using Fisher’s exact test and logistic regression. Results One hundred forty-seven out of 563 unique records were deemed eligible for inclusion. Only 26.50% of these trials used an optimal statistical analysis for longitudinal data where the data structure is accounted for. None of the study characteristics except the statistical significance of the results were associated with the appropriateness of the statistical analysis. The odds of significant results in studies with suboptimal analyses were higher than that in studies with optimal longitudinal analyses (odds ratio: 3.48, 95% confidence interval: 1.62, 7.46, P = 0.001). For the studies with optimal analysis, the most frequent test was repeated-measure analysis of variance (RM-ANOVA). The reporting of the statistical analysis section was suboptimal in the majority of the trials. Conclusion Most longitudinal orthodontic trials are not analysed using optimal statistical approaches. Inferences and interpretation of their results are likely to be compromised.

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