RESUMEN
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.
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Conductas Relacionadas con la Salud , Terapia Asistida por Computador/métodos , Cognición/fisiología , Atención a la Salud/métodos , Utilización de Instalaciones y Servicios , Educación en Salud/métodos , Promoción de la Salud/métodos , Humanos , Procesos Mentales/fisiología , Evaluación de Necesidades , Telemedicina/estadística & datos numéricosRESUMEN
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.
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Terapia Conductista/métodos , Ejercicio Físico/fisiología , Neoplasias de la Próstata/terapia , Anciano , Anciano de 80 o más Años , Supervivientes de Cáncer/psicología , Terapia por Ejercicio , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Actividad Motora , Neoplasias de la Próstata/psicología , Calidad de Vida , Entrenamiento de Fuerza/métodosRESUMEN
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.
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Neoplasias de la Mama/terapia , Supervivientes de Cáncer/psicología , Computadores/estadística & datos numéricos , Internet/estadística & datos numéricos , Actividad Motora/fisiología , Adulto , Anciano , Neoplasias de la Mama/mortalidad , Femenino , Humanos , Persona de Mediana Edad , Adulto JovenRESUMEN
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.
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Neoplasias de la Mama/rehabilitación , Ejercicio Físico/fisiología , Internet/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , Neoplasias de la Mama/mortalidad , Femenino , Humanos , Encuestas y Cuestionarios , SobrevivientesRESUMEN
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.
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Fármacos Anti-VIH/efectos adversos , Infecciones por VIH/tratamiento farmacológico , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Complicaciones Infecciosas del Embarazo/tratamiento farmacológico , Nacimiento Prematuro/inducido químicamente , Zidovudina/efectos adversos , Terapia Antirretroviral Altamente Activa/efectos adversos , Recuento de Linfocito CD4 , Femenino , Infecciones por VIH/transmisión , Humanos , Embarazo , Nacimiento Prematuro/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Carga ViralRESUMEN
PURPOSE: The majority of post treatment breast cancer survivors do not engage in physical activity (PA) at the recommended level. The promotion of PA among this group has the potential to dramatically improve quality of life and health outcomes. To maximise effectiveness, programs should be theory-based and address key determinants of PA behaviour. Social Cognitive Theory (SCT) has shown particular promise for developing and guiding PA interventions, but future research regarding how each SCT construct relates to PA among this group is needed. This study aims to explore how core SCT constructs impact on PA participation among post treatment breast cancer survivors, and gain greater insights into how to shape PA program strategies that will be appealing and effective for this group. METHODS: Post treatment breast cancer survivors were recruited from the Breast Cancer Network Australia's review and survey group. Semi-structured telephone interviews examined PA patterns and SCT constructs and data were analysed thematically. RESULTS: Eight post treatment breast cancer survivors participated in the study. Changes in activity level since diagnosis were common; in most cases this reflected a decline in PA. Key social cognitive and environmental influences on PA were described under the following themes: knowledge, outcome expectations, self-efficacy and personal, behavioural and environment facilitators and inhibitors. CONCLUSION: The results of this study demonstrate the utility of SCT for guiding PA programs. Insight into how social cognitive factors may influence PA behaviour in this group is offered and direction for how oncology-based health professionals can promote PA among breast cancer survivors is provided.
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Cuidados Posteriores/métodos , Neoplasias de la Mama/rehabilitación , Ejercicio Físico/psicología , Conductas Relacionadas con la Salud , Sobrevivientes/psicología , Cuidados Posteriores/psicología , Anciano , Neoplasias de la Mama/psicología , Femenino , Promoción de la Salud/métodos , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Teoría Psicológica , Investigación CualitativaRESUMEN
Expression level of genes associated with oxygen [cytochrome oxidase 1 (COX1) and myoglobin (Mb)] and glucose utilization [glucose transporters (GLUTs) and hexokinases (HKs)] along with metabolic indices were determined in Atlantic cod (Gadus morhua) subjected to an hypoxic challenge of <45% oxygen saturation for 24 days. There were two closely related HKs considered to be homologues of mammalian HKIs. HKIa and HKIb share 86% sequence identity and are both ubiquitously expressed. Mb was also expressed in many tissues with highest levels occurring in heart. Over the first 15 days of hypoxia there were transient increases in plasma lactate in hypoxic relative to normoxic fish associated with a significant decrease in liver glycogen. Over days 1-6, there were in ten of eleven cases, increased average (with a number of conditions being statistically significant) expression levels of GLUTs (1, 2, 4) and HKs (1a and b) in gill, heart, liver, and white muscle in hypoxic relative to normoxic fish. There were significant increases in COX1 and Mb expression levels in gill by day 24 but no changes in these aerobic indicators in heart or liver. Overall the data suggest a transient increase in genes associated with glucose utilization during the early part of the hypoxic challenge followed by alterations in gene expression in gill.
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Proteínas de Peces/genética , Gadus morhua/genética , Gadus morhua/metabolismo , Expresión Génica , Glucosa/metabolismo , Oxígeno/metabolismo , Secuencia de Aminoácidos , Animales , Clonación Molecular , ADN Complementario/genética , Proteínas de Peces/química , Proteínas de Peces/metabolismo , Datos de Secuencia Molecular , Especificidad de Órganos , Fosforilación , Filogenia , Alineación de SecuenciaRESUMEN
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.
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Sedación Consciente/veterinaria , Perros/fisiología , Displasia Pélvica Canina/diagnóstico por imagen , Hipnóticos y Sedantes/administración & dosificación , Animales , Buprenorfina/administración & dosificación , Butorfanol/administración & dosificación , Dexmedetomidina/administración & dosificación , Diazepam/administración & dosificación , Quimioterapia Combinada , Femenino , Infusiones Intravenosas/veterinaria , Inyecciones Intramusculares/veterinaria , Masculino , Linaje , Radiografía/veterinaria , Resultado del TratamientoRESUMEN
The effects of propofol infusion were compared with propofol/isoflurane anaesthesia in six beagles premedicated with 10 microg/kg intramuscular (i.m.) dexmedetomidine. The suitability of a cold pressor test (CPT) as a stress stimulus in dogs was also studied. Each dog received isoflurane (end tidal 1.0%, induction with propofol) with and without CPT; propofol (200 microg/kg/min, induction with propofol) with and without CPT; premedication alone with and without CPT in a randomized block study in six separate sessions. Heart rate and arterial blood pressures and gases were monitored. Plasma catecholamine, beta-endorphin and cortisol concentrations were measured. Recovery profile was observed. Blood pressures stayed within normal reference range but the dogs were bradycardic (mean heart rate < 70 bpm). PaCO2 concentration during anaesthesia was higher in the propofol group (mean > 57 mmHg) when compared with isoflurane (mean < 52 mmHg). Recovery times were longer with propofol than when compared with the other treatments. The mean extubation times were 8 +/- 3.4 and 23 +/- 6.3 min after propofol/isoflurane and propofol anaesthesia, respectively. The endocrine stress response was similar in all treatments except for lower adrenaline level after propofol infusion at the end of the recovery period. Cold pressor test produced variable responses and was not a reliable stress stimulus in the present study. Propofol/isoflurane anaesthesia was considered more useful than propofol infusion because of milder degree of respiratory depression and faster recovery.
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Anestésicos por Inhalación/farmacología , Anestésicos Intravenosos/farmacocinética , Perros/fisiología , Isoflurano/farmacología , Propofol/farmacología , Anestesia/veterinaria , Anestésicos por Inhalación/administración & dosificación , Anestésicos Intravenosos/administración & dosificación , Animales , Análisis de los Gases de la Sangre/veterinaria , Presión Sanguínea/efectos de los fármacos , Catecolaminas/sangre , Dexmedetomidina/administración & dosificación , Esquema de Medicación , Femenino , Frecuencia Cardíaca/efectos de los fármacos , Hidrocortisona/sangre , Hipnóticos y Sedantes/administración & dosificación , Infusiones Intravenosas/veterinaria , Inyecciones Intramusculares/veterinaria , Isoflurano/administración & dosificación , Masculino , Premedicación/veterinaria , Propofol/administración & dosificación , betaendorfina/sangreRESUMEN
Twenty-one otherwise healthy dogs that presented for surgical repair of a ruptured cranial cruciate ligament were blindly and randomly given either carprofen (2.2 mg/kg body weight, orally) or a placebo beginning 12 hours preoperatively and continuing every 12 hours for a total of three doses. The patients were assessed for postoperative pain using a subjective pain score and given oxymorphone (0.1 mg/kg body weight, intramuscularly) every four hours if the pain score was 2 or greater. Blood samples were also collected to determine serum cortisol levels. There was a significant increase in serum cortisol levels in the immediate postoperative period in both the placebo group and the carprofen group (p less than 0.05). There was no significant difference in the percentage of increase in serum cortisol levels between the two groups. No correlation was evident between the serum cortisol levels and the corresponding pain scores in either group. This subjective method of assessing postoperative pain was not accurate and should not be relied upon for determination of postoperative analgesic administration. Perioperative oral administration of carprofen did not appear to be effective in controlling postoperative pain in these patients.
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Lesiones del Ligamento Cruzado Anterior , Antiinflamatorios no Esteroideos/uso terapéutico , Carbazoles/uso terapéutico , Perros/fisiología , Dolor Postoperatorio/veterinaria , Administración Oral , Animales , Ligamento Cruzado Anterior/cirugía , Antiinflamatorios no Esteroideos/administración & dosificación , Carbazoles/administración & dosificación , Perros/lesiones , Perros/cirugía , Femenino , Hidrocortisona/sangre , Masculino , Dolor Postoperatorio/tratamiento farmacológico , Rotura/veterinaria , Resultado del TratamientoRESUMEN
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
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Anestesia General/veterinaria , Anestésicos Intravenosos , Propofol , Anestésicos Intravenosos/farmacocinética , Anestésicos Intravenosos/farmacología , Animales , Gatos , Perros , Propofol/farmacocinética , Propofol/farmacologíaRESUMEN
OBJECTIVE: To evaluate propofol for induction and maintenance of anesthesia, after detomidine premedication, in horses undergoing abdominal surgery for creation of an experimental intestinal adhesion model. STUDY DESIGN: Prospective study. ANIMALS: Twelve horses (424 +/- 81 kg) from 1 to 20 years of age (5 females, 7 males). METHODS: Horses were premedicated with detomidine (0.015 mg/kg i.v.) 20 to 25 minutes before induction, and a propofol bolus (2 mg/kg i.v.) was administered for induction. Propofol infusion (0.2 mg/kg/min i.v.) was used to maintain anesthesia. The infusion rate was adjusted to maintain an acceptable anesthetic plane as determined by muscle relaxation, occular signs, response to surgery, and cardiopulmonary responses. Oxygen (15 L/min) was insufflated through an endotracheal tube as necessary to maintain the SpO2 greater than 90%. Systolic (SAP), mean (MAP), and diastolic (DAP) arterial pressures, heart rate (HR), electrocardiogram (ECG), respiratory rate (RR), SpO2 (via pulse oximetry), and nasal temperature were recorded at 15 minute intervals, before premedication and after induction of anesthesia. Arterial blood gas samples were collected at the same times. Objective data are reported as mean (+/-SD); subjective data are reported as medians (range). RESULTS: Propofol (2.0 mg/kg i.v.) induced anesthesia (mean bolus time, 85 sec) within 24 sec (+/-22 sec) after the bolus was completed. Induction was good in 10 horses; 2 horses showed signs of excitement and these two inductions were not smooth. Propofol infusion (0.18 mg/kg/min +/- 0.04) was used to maintain anesthesia for 61 +/- 19 minutes with the horses in dorsal recumbency. Mean SAP, DAP, and MAP increased significantly over time from 131 to 148, 89 to 101, and 105 to 121 mm Hg, respectively. Mean HR varied over time from 43 to 45 beats/min, whereas mean RR increased significantly over anesthesia time from 4 to 6 breaths/min. Mean arterial pH decreased from a baseline of 7.41 +/- 0.07 to 7.30 +/- 0.05 at 15 minutes of anesthesia, then increased towards baseline values. Mean PaCO2 values increased during anesthesia, ranging from 47 to 61 mm Hg whereas PaO2 values decreased from baseline (97 +/- 20 mm Hg), ranging from 42 to 57 mm Hg. Muscle relaxation was good and no horses moved during surgery: Recovery was good in 9 horses and acceptable in 3; mean recovery time was 67 +/- 29 minutes with 2.4 +/- 2.4 attempts necessary for the horses to stand. CONCLUSIONS: Detomidine-propofol anesthesia in horses in dorsal recumbency was associated with little cardiovascular depression, but hypoxemia and respiratory depression occurred and some excitement was seen on induction. CLINICAL RELEVANCE: Detomidine-propofol anesthesia is not recommended for surgical procedures in horses if dorsal recumbency is necessary and supplemental oxygen is not available (eg, field anesthesia).
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Anestesia Intravenosa/veterinaria , Anestésicos Intravenosos , Caballos/cirugía , Hipnóticos y Sedantes/farmacología , Imidazoles/farmacología , Propofol , Abdomen/cirugía , Análisis de Varianza , Animales , Femenino , Hemodinámica/efectos de los fármacos , Masculino , Medicación Preanestésica/veterinaria , Estudios ProspectivosRESUMEN
Cardiovascular, pulmonary, and quantitative electroencephalographic parameters were assessed in 12 anesthetized dogs to determine the compatibility of the injectable anesthetic propofol with halothane and isoflurane. No cases of apnea were observed during induction of anesthesia. An adequate level of anesthesia was established in each protocol as judged by both the lack of response to mechanical noxious stimuli (i.e., tail clamping) and evidence of reduction in total amplitude of brain wave activity. The initial propofol-mediated decrease in arterial blood pressure continued during either halothane (52.4%) or isoflurane (38%) anesthesia without a simultaneous increase in heart rate. The results of this study suggest that propofol, in combination with inhalant agents, can be used effectively and safely for canine anesthesia in veterinary practice.
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Anestesia por Inhalación/veterinaria , Anestésicos por Inhalación/farmacología , Anestésicos Intravenosos/farmacología , Presión Sanguínea/efectos de los fármacos , Halotano/farmacología , Frecuencia Cardíaca/efectos de los fármacos , Isoflurano/farmacología , Propofol/farmacología , Análisis de Varianza , Anestesia por Inhalación/métodos , Animales , Dióxido de Carbono/sangre , Perros , Electroencefalografía/efectos de los fármacos , Electroencefalografía/veterinaria , Oxígeno/sangre , Dolor , Respiración/efectos de los fármacos , Volumen de Ventilación Pulmonar/efectos de los fármacosRESUMEN
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.
Asunto(s)
Anestésicos Combinados/farmacología , Encéfalo/efectos de los fármacos , Fenómenos Fisiológicos Cardiovasculares/efectos de los fármacos , Perros/fisiología , Halotano/farmacología , Imidazoles/farmacología , Propofol/farmacología , Sistema Respiratorio/efectos de los fármacos , Agonistas alfa-Adrenérgicos/administración & dosificación , Agonistas alfa-Adrenérgicos/farmacología , Analgésicos/administración & dosificación , Analgésicos/farmacología , Anestésicos Combinados/administración & dosificación , Anestésicos por Inhalación/administración & dosificación , Anestésicos por Inhalación/farmacología , Anestésicos Intravenosos/administración & dosificación , Anestésicos Intravenosos/farmacología , Animales , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Encéfalo/fisiología , Relación Dosis-Respuesta a Droga , Combinación de Medicamentos , Electroencefalografía/métodos , Electroencefalografía/veterinaria , Femenino , Halotano/administración & dosificación , Frecuencia Cardíaca/efectos de los fármacos , Frecuencia Cardíaca/fisiología , Imidazoles/administración & dosificación , Laparoscopía/métodos , Laparoscopía/veterinaria , Masculino , Medetomidina , Consumo de Oxígeno/efectos de los fármacos , Consumo de Oxígeno/fisiología , Guías de Práctica Clínica como Asunto , Propofol/administración & dosificación , Distribución Aleatoria , Fenómenos Fisiológicos RespiratoriosRESUMEN
Cardiovascular, pulmonary and anaesthetic-analgesic responses were evaluated in 18 male and female dogs to determine the effect of the injectable anaesthetic propofol used in conjuction with acepromazine and butorphanol. The dogs were randomly divided into three groups. Dogs in Group A were premeditated with 0.1 mg/kg of intramuscular acepromazine followed by an induction dose of 4.4 mg/kg of intravenous propofol; Group B received 0.2 mg/kg of intramuscular butorphanol and 4.4 mg/kg of intravenous propofol; dogs in Group AB were administered a premeditation combination of 0.1 mg/kg of intramuscular acepromazine and 0.2 mg/kg of intramuscular butorphanol, followed by induction with 3.3 mg/kg of intravenous propofol. The induction dose of propofol was given over a period of 30-60 seconds to determine responses and duration of anaesthesia. Observations recorded in the dogs included heart and respiratory rates, indirect arterial blood pressures (systolic, diastolic and mean), cardiac rhythm, end-tidal CO, tension, oxygen saturation, induction time, duration of anaesthesia, recovery time and adverse reactions. The depth of anaesthesia was assessed by the response to mechanical noxious stimuli (tail clamping), the degree of muscle relaxation and the strength of reflexes. Significant respiratory depression was seen after propofol induction in both groups receiving butorphanol with or without acepromazine. The incidence of apnea was 4/6 dogs in Group B, and 5/6 dogs in Group AB. The incidence of apnea was also correlated to the rate of propofol administration. Propofol-mediated decreases in arterial blood pressure were observed in all three groups. Moderate bradycardia (minimum value > 55 beats/min) was observed in both Groups B and AB. There were no cardiac dysrhythmias noted in any of the 18 dogs. The anaesthetic duration and recovery times were longer in dogs premeditated with acepromazine/butorphanol.
RESUMEN
The effects of noxious surgical stimulation on the electroencephalogram (EEG) in 15 horses anesthetized with isoflurane were evaluated during orthopedic (group 1) and soft tissue (group 2) procedures. The quantitative EEG variables theta/delta ratio (T/D), alpha/delta ratio (A/D), beta/delta ratio (B/D), median power frequency (MED), and 80% spectral edge frequency (SEF 80) recorded during Surgeries at 1.7% end-tidal concentration of isoflurane (ET(iso)) were compared with values from five nonstimulated control horses anesthetized at 1,7% ET(iso). The EEG variables T/D, A/D, MED, and SEF 80 from surgically stimulated horses were significantly higher compared with controls. These differences in measured EEG variables were accompanied by a significantly lower relative power in the delta frequency band and a concomitant significantly higher alpha activity. Because the A/D ratio, MED, and SEF 80 in surgically stimulated horses were significantly higher than in nonstimulated control horses these measured EEG variables may provide a valuable tool for identification of nociceptive transmission in isoflurane anesthetized horses.
Asunto(s)
Anestésicos por Inhalación/farmacología , Encéfalo/fisiología , Estimulación Eléctrica , Electroencefalografía/veterinaria , Caballos/fisiología , Isoflurano/farmacología , Anestésicos por Inhalación/administración & dosificación , Animales , Artroscopía/métodos , Artroscopía/veterinaria , Encéfalo/efectos de los fármacos , Recolección de Datos , Relación Dosis-Respuesta a Droga , Femenino , Isoflurano/administración & dosificación , Masculino , Reproducibilidad de los Resultados , Cirugía VeterinariaRESUMEN
The biochemical holding strength and histological characteristics of a laparoscopic stapled gastropexy (LG) adhesion were compared with that of an incisional gastropexy (IG) adhesion. An LG was performed in 14 dogs and an IG was performed in six dogs. During the LG procedure, the abdomen was insufflated with carbon dioxide and three cannulae were placed in the caudal aspect of the right side of the abdomen. A 35 mm laparoscopic stapler was used to staple the gastric antrum to the adjacent right lateral abdominal wall. The IG procedure was performed through ventral midline celiotomy. A 35 mm IG was made by apposing the gastric antrum to the adjacent right lateral abdominal wall with two continuous rows of suture. Half of each group of dogs was euthanatized at 7 and 30 days after surgery. The mean tensile load to failure at 7 days was 44.86 +/- 18.54 N for the LG group and 85.33 +/- 23.59 N for the IG group (P < .05). At 30 days the values were 72.39 +/- 18.01 N for the LG group and 71.17 +/-12.11 N for the IG group (P = .41). The gastropexy adhesions in the 7-day postoperative group contained variable amounts of fibrin, hemorrhage, mononuclear cell inflammation, loose fibrovascular tissue, and mature collagenous connective tissue. Adhesions in the 7-day postoperative group were divided subjectively into three histological subgroups based on the relative amounts of mature connective tissue within the adhesion. The LG and IG adhesions were randomly distributed among these subgroups (P = 1.0). Adhesions in the 30-day postoperative group contained well-organized fibrous connective tissue. No difference in the amount of connective tissue could be detected histologically in the LG or IG adhesions. Complications with the LG procedure included stomach perforation (2 cases), splenic puncture (2 cases), and subcutaneous emphysema (4 cases).
Asunto(s)
Perros/cirugía , Laparoscopía/veterinaria , Estómago/cirugía , Animales , Fenómenos Biomecánicos , Enfermedades de los Perros/prevención & control , Enfermedades de los Perros/cirugía , Laparoscopía/efectos adversos , Laparoscopía/métodos , Vólvulo Gástrico/prevención & control , Vólvulo Gástrico/cirugía , Vólvulo Gástrico/veterinaria , Resultado del TratamientoRESUMEN
Cardiovascular and pulmonary effects of propofol, a relatively new nonbarbiturate intravenous anaesthetic, were assessed and compared in 22 male and female dogs. Dogs in group 1 did not receive any premedication prior to 6.6 mg/kg IV propofol, group 2 was premedicated with atropine (0.02 mg/kg IM) and the alpha 2-agonist medetomidine (10 micrograms/kg IM), and group 3 received the same premedication agents as group 2, but the medetomidine effects were reversed by the alpha 2-antagonist atipamezole (30 micrograms/kg IV) after 30 min of anaesthesia. Each dog in groups 2 and 3 received a propofol induction dose of 2.2 mg/kg IV. The anaesthetic duration was shortest with propofol alone and prolonged with medetomidine as a premedication which was reversible with atipamezole. In group 1, the most prominent effects were a temporary drop in diastolic arterial blood pressure (26% and 24%) at 2 and 5 min post-propofol, respectively and a drop in respiratory frequency (41%) 2 min after propofol induction. Similar respiratory depression was observed in groups 2 and 3 (20% and 48%, respectively) at the same time. Apnea was not observed. An increase in systemic arterial blood pressure was observed throughout the trial in groups 2 and 3 until dogs recovered or were reversed with atipamezole. Medetomidine significantly reduces propofol dosage requirements. Safe and effective injectable anaesthesia was produced by propofol in this group of dogs. The frequency of respiratory depression would suggest in clinical usage, the practitioner should be aware oxygen supplementation is the treatment of choice should apnea occur.