Designing more engaging computer-tailored physical activity behaviour change interventions for breast cancer survivors: lessons from the iMove More for Life study.

BACKGROUND: Participating in regular physical activity is a recommended cancer recovery strategy for breast cancer survivors. However, tailored support services are not widely available and most survivors are insufficiently active to obtain health benefits. Delivering tailored programs via the Internet offers one promising approach. However, recent evaluations of such programs suggest that major improvements are needed to ensure programs meet the needs of users and are delivered in an engaging way. Understanding participants' experiences with current programs can help to inform the next generation of systems. PURPOSE: The purposes of this study are to explore breast cancer survivor's perspectives of and experiences using a novel computer-tailored intervention and to describe recommendations for future iterations. METHODS: Qualitative data from a sub-sample of iMove More for Life study participants were analysed thematically to identify key themes. Participants long-term goals for participating in the program were explored by analysing open-ended data extracted from action plans completed during the intervention (n = 370). Participants negative and positive perceptions of the website and recommendations for improvement were explored using data extracted from open-ended survey items collected at the immediate intervention follow-up (n = 156). RESULTS: The majority of participants reported multi-faceted goals, consisting of two or more outcomes they hoped to achieve within a year. While clear themes were identified (e.g. 'being satisfied with body weight'), there was considerable variability in the scope of the goal (e.g. desired weight loss ranged from 2 to 30 kg). Participants' perceptions of the website were mixed, but clear indications were provided of how intervention content and structure could be improved. CONCLUSIONS: This study provides insight into how to better accommodate breast cancer survivors in the future and ultimately design more engaging computer-tailored interventions.

Preterm delivery risk in women initiating antiretroviral therapy to prevent HIV mother-to-child transmission.

OBJECTIVES: The aim of the study was to describe the relationship between preterm delivery (PTD; < 37 weeks of gestation) and antiretroviral therapy in a single-centre cohort of pregnant women with HIV infection. METHODS: A retrospective analysis of data for 331 women who received care in a dedicated HIV antenatal clinic between 1996 and 2010 was carried out. Data on first CD4 cell count and viral load (HIV-1 RNA copies/mL) recorded in pregnancy, class and timing of antiretroviral therapy, gestational age at delivery, and risk factors for and causes of PTD were available from a clinical database. RESULTS: Overall, 13.0% of deliveries were preterm, of which 53% were severe preterm (< 34 weeks of gestation). The lowest rate of PTD was observed in women treated with zidovudine monotherapy (6.2%). Higher rates of PTD were observed in women starting combination antiretroviral therapy (cART) in pregnancy compared with women conceiving while on cART [odds ratio (OR) 2.52; 95% confidence interval (CI) 1.22-5.20; P = 0.011]. Of the women who were eligible for zidovudine monotherapy on the basis of CD4 counts and HIV viral load but who were treated with short-term cART to prevent HIV mother-to-child transmission, 28.6% delivered preterm. Women on short-term cART remained at the highest risk of PTD compared with zidovudine monotherapy in multivariate analysis (OR 5.00; 95% CI 1.49-16.79; P = 0.015). CONCLUSIONS: The causes of PTD are multiple and poorly understood. The timing of initiation and type of antiretroviral therapy administered during pregnancy appear to contribute to PTD risk. Understanding this association should improve the safety of antiretroviral therapy in pregnancy without increasing the risk of transmission.

A systematic review of physical activity-based behaviour change interventions reaching men with prostate cancer.

PURPOSE: Men who are survivors of prostate cancer report a variety of psychological and physical factors contributing to a lower quality of life, and physical activity can assist to mitigate these issues. This review aims to provide a summary of physical activity behaviour change trials targeting prostate cancer survivors, assess the feasibility of these interventions and, if possible, identify intervention and study characteristics associated with significant intervention effects. METHOD: Four databases (PubMed, CINAHL, PsycINFO and EMBASE) were systematically searched for randomised controlled trials containing at least one behavioural outcome relating to physical activity published up until July 2016. Forward and backwards, hand, key author citation searching and known research were also considered. RESULTS: From a total of 13, 828 titles, the search resulted in 12 studies (6 prostate cancer only and 6 mixed cancer interventions), eight of which found positive results most often related immediately to post-intervention aerobic activity. Factors relating to efficacy were not conclusive due to the heterogeneity of studies and lack of cancer-specific data in mixed cancer trials. Future research focusing on intervention reach, maintenance of intervention effects and resistance training outcomes is needed. CONCLUSION: There is preliminary evidence to suggest that a variety of physical activity behaviour change interventions targeting men with a history of prostate cancer can be efficacious, at least in the short term. Experimental studies are required to identify key intervention features. IMPLICATIONS FOR CANCER SURVIVORS: Physical activity interventions can assist prostate cancer survivors in relation to short-term lifestyle change, though more evidence is required to improve the clarity of factors related to efficacy.

Can you elaborate on that? Addressing participants' need for cognition in computer-tailored health behavior interventions.

Computer-tailored interventions, which deliver health messages adjusted based on characteristics of the message recipient, can effectively improve a range of health behaviours. Typically, the content of the message is tailored to user demographics, health behaviours and social cognitive factors (e.g., intentions, attitudes, self-efficacy, perceived social support) to increase message relevance, and thus the extent to which the message is read, considered and translated into attitude and behaviour change. Some researchers have suggested that the efficacy of computer-tailored interventions may be further enhanced by adapting messages to suit recipients' need for cognition (NFC) - a personality trait describing how individuals tend to process information. However, the likely impact of doing so, especially when tailored in conjunction with other variables, requires further consideration. It is possible that intervention effects may be reduced in some circumstances due to interactions with other variables (e.g., perceived relevance) that also influence information processing. From a practical point of view, it is also necessary to consider how to optimally operationalise and measure NFC if it is to be a useful tailoring variable. This paper aims to facilitate further research in this area by critically examining these issues based on relevant theories and existing evidence.

How do different delivery schedules of tailored web-based physical activity advice for breast cancer survivors influence intervention use and efficacy?

PURPOSE: The purpose of the study is to investigate the impact of differing delivery schedules of computer-tailored physical activity modules on engagement and physical activity behaviour change in a web-based intervention targeting breast cancer survivors. METHODS: Insufficiently active breast cancer survivors (n = 492) were randomly assigned to receive one of the following intervention schedules over 12 weeks: a three-module intervention delivered monthly, a three-module intervention delivered weekly or a single module intervention. Engagement with the website (number of logins, time on site, modules viewed, action plans completed) was measured using tracking software. Other outcomes (website acceptability, physical activity behaviour) were assessed using online surveys. Physical activity outcomes were analysed using regression models for both study completers and when applying intention-to-treat (using multiple imputation). RESULTS: Completers allocated to the monthly module group rated the intervention higher (b = 2.2 95 % CI = 0.02-4.53) on acceptability and had higher levels of resistance-training (IRR = 1.88, 95 % CI = 1.16-3.04) than those in the single module group. When accounting for missing data, these differences were no longer significant. The completion of at least two action plans was higher among those allocated to the monthly module group compared to those in the weekly module group (53 vs 40 %, p = 0.02); though the completion of at least two modules was higher in the weekly module group compared to the monthly module group (60 vs 46 %; p = 0.01). There were no other significant between group differences observed. CONCLUSION: This study provides preliminary evidence that web-based computer-tailored interventions can be used to increase physical activity among breast cancer survivors. Further, there were some outcome differences based on how the tailored modules were delivered, with the most favourable outcomes observed in the monthly delivery group. IMPLICATIONS FOR CANCER SURVIVORS: This study will be useful for informing the design of future web-based interventions targeting breast cancer survivors.

Clinical efficacy and safety of dexmedetomidine and buprenorphine, butorphanol or diazepam for canine hip radiography.

OBJECTIVES: To investigate the usefulness of dexmedetomidine for restraint and sedation during hip radiographic examination of hip-extended or stress-radiography views when combined with either buprenorphine, butorphanol or diazepam. METHODS: One hundred and twenty-seven client-owned clinically healthy golden retrievers or rottweilers were enrolled in a clinical trial that compared hip-extended and PennHIP methods for diagnosing hip dysplasia and were randomly allocated to receive dexmedetomidine or medetomidine in combination with buprenorphine, butorphanol or diazepam. Subjective assessments were made for response to pain, response to noise, palpebral reflex, muscle tone and overall quality of sedation; non-invasive physiological variables were also recorded. RESULTS: Overall quality of sedation was graded as good or excellent for dogs administered with a combination of butorphanol or diazepam. However, more dogs that received a combination involving buprenorphine had overall a relatively poorer quality of sedation and required additional administration of buprenorphine before the radiographic procedure could commence. Once sedated, clinically sufficient muscle relaxation accompanied by a very low proportion of dogs responding to pain or noise stimuli were observed in all treatment groups. Heart and respiratory rate, and procedure and recovery times were similar for all treatment groups, and no adverse events were observed during the study. CLINICAL SIGNIFICANCE: Dexmedetomidine sedative protocols, particularly in combination with butorphanol and diazepam, can be used effectively and safely in dogs for radiographic procedures.

Arterial to end-tidal CO2 tension and alveolar dead space in halothane- or isoflurane-anesthetized ponies.

The correlation between end-tidal partial pressure of CO2 (PETCO2) and arterial (PaCO2) was determined for spontaneously breathing ponies under halothane or isoflurane anesthesia. The PETCO2 was useful as a trend indicator of PaCO2 during the first 60 minutes of halothane or isoflurane anesthesia when PaCO2 values were less than 60 to 70 mm of Hg. Halothane anesthesia lasting greater than 90 minutes was associated with PaCO2 values in excess of 60 to 70 mm of Hg, a large arterial- to end-tidal PCO2 difference (PaCO2-PETCO2) and a significant increase in alveolar dead space. These effects were not seen during the same period of isoflurane anesthesia. Arterial blood gas analysis is therefore recommended during halothane anesthesia when the PETCO2 is greater than 60 to 70 mm of Hg. A decrease in alveolar capillary perfusion relative to alveolar ventilation is the most likely cause for the increase in alveolar dead space during halothane anesthesia. Based on these findings, isoflurane may be superior to halothane for prolonged anesthesia of spontaneously breathing horses.

Cardiovascular and pharmacokinetic effects of isoxsuprine in the horse.

Isoxsuprine (0.6 mg/kg) administered IV to 6 standing horses produced substantial, transient decreases in systemic blood pressure, systemic vascular resistance, and stroke volume. It also produced substantial, transient increases in heart rate, cardiac output, and purposeful movement. Plasma concentrations of isoxsuprine peaked soon after the drug was administered IV and then decreased over a 12-hour period in a biexponential manner, with distribution and elimination half-lives of 14 minutes and 2.67 hours, respectively. Total body clearance and steady-state volume of distribution were calculated to be 53.8 ml/min/kg and 10.5 L/kg, respectively. When a recommended therapeutic dosage regimen (0.6 mg/kg 2 times a day, per os) was used in 4 of these horses, changes were not detected. Isoxsuprine was not detected in plasma after the drug was given orally. We conclude that 0.6 mg of isoxsuprine/kg given orally every 12 hours is not likely to produce cardiovascular changes in the resting horse and that this is probably because plasma concentrations are not high enough to do so.

Cardiac performance in cats after administration of xylazine or xylazine and glycopyrrolate: echocardiographic evaluations.

Cardiac performance was evaluated in 9 healthy cats sedated with xylazine. Each cat was evaluated echocardiographically before and after the administration of xylazine or xylazine and glycopyrrolate. Each cat was echocardiographically evaluated during manual restraint only (control value), after IM administration of 0.55 mg of xylazine/kg of body weight, after IM administration of 2.2 mg of xylazine/kg, and after IM administration of 0.011 mg of glycopyrrolate/kg followed 10 minutes later by IM administration of 2.2 mg of xylazine/kg. Echocardiographic indices of cardiac performance (fractional shortening, left ventricular wall amplitude, aortic amplitude, mitral valve E point septal separation) indicated a significant decrease (P less than 0.05) in the left ventricular function and heart rate after the small (0.55 mg/kg) and large (2.2 mg/kg) dosages of xylazine. With the administration of glycopyrrolate, the bradycardia was minimized, but cardiac performance was not improved. After administration of glycopyrrolate, cardiac performance decreased, but the decrease was not significant when compared with the ventricular performance of the cats after administration of the large dosage of xylazine. Compared with control values, the reduction in left ventricular function values associated with administration of xylazine or xylazine and glycopyrrolate was independent of the heart rate. Therefore, the alpha-2 adrenergic agonist xylazine has a marked depressive effect on cardiac performance in the cat, and premedication with glycopyrrolate may not completely alleviate the undesirable bradycardia, but may actually be detrimental to the cardiovascular system.

Quantitative electroencephalographic evaluation to determine the quality of analgesia during anesthesia of horses for arthroscopic surgery.

We compared the anesthetic combination of detomidine, ketamine, and halothane in control horses not undergoing apparently painful procedures with that in horses during arthroscopic surgery. The effectiveness of this regimen in suppressing neurologic response to surgery was, thus, evaluated. In this study, significant differences were not observed in electroencephalographic total amplitude, spectral edge, or beta-to-delta frequency ratio between surgically treated and nonsurgically treated (control) horses. On the basis of its attenuation of encephalographic responses, we conclude that detomidine (20 micrograms/kg of body weight, IV) and ketamine (2.2 mg/kg, IV) induction of anesthesia followed by maintenance with halothane is an effective regimen for control of pain in horses during arthroscopic surgery. The insignificant frequency changes observed without any other signs of inadequate anesthesia or pain may indicate a surgical stress response. We hypothesize that brain activity monitoring may give an earlier index to initiation of surgically induced stress than do hormonal responses, because endocrine alterations are not as rapidly perceived as is the electroencephalogram. Analysis of spectral edge frequency changes could be used to evaluate anesthetic regimens to find those that cause the least stress to the CNS during surgery in horses. Differences in species responses to an anesthetic agent or the regimen's effectiveness in prevention of pain during surgery may be identified by adoption of the study model. Evaluation of cardiopulmonary variables during anesthesia, with and without surgery, did not reveal any alterations that would be relevant to CNS responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiac dysrhythmias during anesthesia for cervical decompression in the dog.

In a retrospective study, the risk for cardiac dysrhythmias was evaluated in dogs undergoing ventral decompression and/or fenestration of the cervical spine (CERV) and compared with that for dogs undergoing dorsal laminectomy for decompression of the thoracic or lumbar spine (TL). The dogs in the CERV subset (48 dogs) tended to be heavier and older than the dogs in the TL subset (111 dogs). There was no apparent bias detected in treatment before anesthesia and surgery. The risk for dysrhythmias was 2.5 times greater in the CERV subset, compared with that in the TL subset (P less than 0.01). The risk for ventricular premature contraction was 3.5 times higher in the CERV group (P less than 0.05). Bradycardia was found in 6 dogs from the CERV subset and was not found in any dogs from the TL subset. A logistic model was derived from the data and may be used to evaluate the risk for dysrhythmias in similar patients undergoing similar surgery and anesthesia. This model uses age, preoperative heart rate, and site of surgery (CERV or TL) to estimate the risk.

Effects of gastric distention-volvulus on coronary blood flow and myocardial oxygen consumption in the dog.

Gastric distention-volvulus (GDV; at 50 mm of Hg gastric inflation pressure) was experimentally induced in 8 dogs anesthetized using pentobarbital. Hemodynamic indices including heart rate, mean arterial pressure, cardiac output, and coronary blood flow (4 dogs) were measured during a 20-minute period of GDV and for 10 minutes after decompression. Arterial and coronary venous oxygen tensions were also measured for calculation of myocardial oxygen extraction (7 dogs) and myocardial oxygen consumption (4 dogs). Dogs were monitored for 72 hours postoperatively for the occurrence of arrhythmias, then were euthanatized for gross and histologic examination of the heart. Experimental GDV resulted in significant (P less than 0.05) decreases in cardiac output (89%), mean arterial pressure (45%), and coronary blood flow (50%) compared with control values. Myocardial oxygen extraction increased (30%) and overall myocardial oxygen consumption decreased (50%), compared with control values. Evidence of subendocardial necrosis was seen in 6 dogs, 4 of which had developed ventricular arrhythmias 8 to 24 hours postoperatively.

Reduction of isoflurane anesthetic requirement by medetomidine and its restoration by atipamezole in dogs.

The isoflurane-sparing effect of the alpha 2-adrenergic agonist medetomidine (30 micrograms/kg of body weight, IV) was tested in 7 dogs, using a blinded, randomized-block study design. The baseline minimal alveolar concentration (MAC) of isoflurane was 1.18 vol% (95% confidence interval [0.97,1.39]). Medetomidine significantly (P < 0.003) reduced isoflurane MAC by 47.2%. Atipamezole (0.3 mg/kg, IV), an alpha 2-adrenergic antagonist, completely reversed the effect of medetomidine on isoflurane MAC. Atipamezole alone did not significantly alter isoflurane MAC. After medetomidine administration, marked bradycardia developed in all dogs and persisted for more than 2 hours. Mean arterial blood pressure increased acutely, but later decreased, and hypotension persisted for more than 2 hours. Atipamezole reversed the bradycardic and hypotensive effects of medetomidine. Results of this study indicate that medetomidine may be useful in clinical cases in which isoflurane MAC-reduction is desirable and that atipamezole might be used to reverse desirable and undesirable effects of medetomidine during isoflurane anesthesia.

Evaluation of selected cardiopulmonary and cerebral responses during medetomidine, propofol, and halothane anesthesia for laparoscopy in dogs.

OBJECTIVES: To compare the dose-sparing effect of medetomidine on the propofol induction dose and concentration of halothane for maintenance of anesthesia during laparoscopy and to provide guidelines for effective and safe use of these anesthetics in dogs to ensure desirable perioperative analgesia. ANIMALS: 14 purpose-bred dogs. PROCEDURE: Cardiopulmonary and electroencephalographic responses were determined during 2 anesthesia protocols in dogs scheduled for laparoscopy. Fifteen minutes before anesthesia induction, all dogs received atropine sulfate (0.02 mg/kg of body weight, i.m.). Seven dogs were then given propofol (6.6 mg/kg, i.v.); anesthesia was maintained with halothane in oxygen. The other dogs were given medetomidine hydrochloride (10 micrograms/kg, i.m.) 5 minutes after administration of atropine sulfate; anesthesia was then induced by administration of propofol (2.8 mg/kg, i.v.) and was maintained with halothane in oxygen. RESULTS: The halothane concentration required for laparoscopy was lower in dogs given medetomidine. Anesthetic requirements were significantly increased during abdominal manipulation in both groups. Total amplitude of the electroencephalograph in medetomidine-treated dogs was not significantly lower than that in dogs not given medetomidine. Pulmonary responses were stable throughout all procedures. The primary cardiovascular response was an increase in blood pressure associated with the medetomidine-atropine preanesthetic combination. Significant differences in total amplitude or frequency shifts (spectral edge) of brain wave activity were not associated with surgical stimulation. CONCLUSION: Lack of neurologic changes during laparoscopy supports the efficacy of either medetomidine-propofol-halothane or propofol-halothane combinations at higher concentrations to provide desirable analgesia and anesthesia in this group of dogs.

Surgical anesthesia in turkeys with thialbarbital sodium.

Thialbarbital sodium was found to be a reliable and economical general anesthetic for domesticated turkeys. Despite shortness of action of the initial dose, surgical anesthesia was maintained longer than 2 hours by intermittent infusion via a brachial vein cannula. The drug was reconstituted just before use (66 mg/ml) with sterile 1% saline solution. Rapid smooth induction was produced with an initial dosage of 30 mg/kg for hens and 26.5 mg/kg for toms, when administered within a 30- to 60-second interval. Supplemental infusion of the drug in increments of 0.25 to 1.5 ml was used to sustain the desired level of deep narcosis. The occurrence of respiratory failure was considerably less for thialbarbital than with pentobarbital sodium. Recovery was rapid and smooth.

Effects of medetomidine administration on intracranial pressure and cardiovascular variables of isoflurane-anesthetized dogs.

Intracranial pressure and cardiovascular variables after IV administration of medetomidine (0.03 mg/kg of body weight) were evaluated in 6 healthy, mixed-breed dogs anesthetized with 1.3% end-tidal isoflurane concentration and mechanically ventilated to normocapnia (PaCO2, 35 to 45 mm of Hg). Baseline values were determined for intracranial pressure, heart rate, arterial blood pressure, cardiac output, mean pulmonary artery pressure, pulmonary capillary wedge pressure, central venous pressure, end-tidal CO2 tension and isoflurance concentration, arterial pH and CO2 and O2 tensions, and core body temperature. Cerebral perfusion pressure, cardiac index, systemic and pulmonary vascular resistances, plasma HCO3- concentration, and base excess were calculated. Intracranial pressure was measured, using a calibrated, fiberoptic transducer placed within the brain parenchyma and secured to the calvarium by means of a subarachnoid bolt. Cardiac output was determined by thermodilution. End-tidal CO2 tension and isoflurane concentration were determined, using an infrared gas analyzer. Administration of medetomidine did not change intracranial pressure, but was associated with significant (P < 0.05) decreases in values for heart rate, cardiac index, end-tidal CO2, and HCO3- and with significant increases in systolic, mean, and diastolic pressure; pulmonary artery pressure; systemic vascular resistance; central venous pressure; and pulmonary capillary wedge pressure.

The case for high gas flows.

High gas flows provide a higher margin of safety and fewer physiologic complications for extended anesthetic periods. The veterinarian should consider personnel, anesthetic, and monitoring equipment and the surgical procedure requiring anesthesia before making a final decision on which flow rates are appropriate.

Advantages and guidelines for using halothane.

Halothane is a frequently used agent. Its cost is inexpensive. Halothane is a safe and effective anesthetic agent if used properly. Proper usage includes adjusting the concentration administered to produce adequate anesthesia for the procedure without excess depression of cardiac, respiratory, and neurologic function. Proper monitoring of the patient indicates the adjustments needed in concentration or needed medications or procedures to increase safe usage. Potent tranquilizers, sedatives, and analgesics used as preanesthetics during halothane anesthesia or the early postanesthetic period may produce profound changes in anesthetic concentrations required or physiologic responses to the combined medications.

Propofol anesthesia.

Although questions may still remain regarding the use of this unique sedative-hypnotic drug with anesthetic properties in high-risk patients, our studies have provided cardiopulmonary and neurological evidence of the efficacy and safety of propofol when used as an anesthetic under normal and selected impaired conditions in the dog. 1. Propofol can be safely and effectively used for the induction and maintenance of anesthesia in normal healthy dogs. Propofol is also a reliable and safe anesthetic agent when used during induced cardiovascular and pulmonary-impaired conditions without surgery. The propofol requirements to induce the safe and prompt induction of anesthesia prior to inhalant anesthesia with and without surgery have been determined. 2. The favorable recovery profile associated with propofol offers advantages over traditional anesthetics in clinical situations in which rapid recovery is important. Also, propofol compatibility with a large variety of preanesthetics may increase its use as a safe and reliable i.v. anesthetic for the induction and maintenance of general anesthesia and sedation in small animal veterinary practice. Although propofol has proven to be a valuable adjuvant during short ambulatory procedures, its use for the maintenance of general anesthesia has been questioned for surgery lasting more than 1 hour because of increased cost and marginal differences in recovery times compared with those of standard inhalant or balanced anesthetic techniques. When propofol is used for the maintenance of anesthesia in combination with a sedative/analgesic, the quality of anesthesia is improved as well as the ease with which the practitioner can titrate propofol; therefore, practitioners are able to use i.v. anesthetic techniques more effectively in their clinical practices. 3. Propofol can induce significant depression of respiratory function, characterized by a reduction in the rate of respiration. Potent alpha 2 sedative/analgesics (e.g., xylazine, medetomidine) or opioids (e.g., oxymorphone, butorphanol) increase the probability of respiratory depression during anesthesia. Appropriate consideration of dose reduction and speed of administration of propofol reduces the degree of depression. Cardiovascular changes induced by propofol administration consist of a slight decrease in arterial blood pressures (systolic, mean, diastolic) without a compensatory increase in heart rate. Selective premedicants markedly modify this characteristic response. 4. When coupled with subjective responses to painful stimuli, EEG responses during propofol anesthesia provide clear evidence that satisfactory anesthesia has been achieved in experimental dogs. When propofol is used as the only anesthetic agent, a higher dose is required to induce an equipotent level of CNS depression compared with the situation when dogs are premedicated. 5. The propofol induction dose requirement should be appropriately decreased by 20% to 80% when propofol is administered in combination with sedative or analgesic agents as part of a balanced technique as well as in elderly and debilitated patients. As a general recommendation, the dose of propofol should always be carefully titrated against the needs and responses of the individual patient, as there is considerable variability in anesthetic requirements among patients. Because propofol does not have marked analgesic effects and its metabolism is rapid, the use of local anesthetics, nonsteroidal anti-inflammatory agents, and opioids to provide postoperative analgesia improves the quality of recovery after propofol anesthesia. 6. The cardiovascular depressant effects of propofol are well tolerated in healthy animals, but these effects may be more problematic in high-risk patients with intrinsic cardiac disease as well as in those with systemic disease. In hypovolemic patients and those with limited cardiac reserve, even small induction doses of propofol (0.75-1.5 mg/kg i.v.) can produce profound hypotens

Preanesthetic medications in ruminants and swine.

The use of preanesthetic agents alone or in various combinations in food animals is complex. In addition to considering the pharmacokinetics and dynamics of the medications, one must give additional consideration to the animals's temperament, its physical condition, and its environment. Also, the potential of residues from meat and milk products of animals treated with preanesthetic agents must be considered.