Comparison of intraoperative pain responses following intratesticular or mesorchial injection of lidocaine in standing horses undergoing laparoscopic cryptorchidectomy.

OBJECTIVE: To compare pain responses in stallions undergoing standing laparoscopic cryptorchidectomy following intratesticular or mesorchial infiltration of lidocaine. DESIGN: Clinical trial. ANIMALS: 20 stallions with 1 or 2 undescended testes. PROCEDURES: Standing horses were administered a nonsteroidal anti-inflammatory drug and a caudal epidural injection of detomidine hydrochloride and underwent laparoscopic cryptorchidectomy. The undescended testis (1/horse) was grasped to determine the preoperative pain response (present vs absent) and assess severity of pain (by use of a visual analog scale [VAS]). The undescended testis or its mesorchium was injected with 2% lidocaine (10 mL); saline (0.9% NaCl) solution (10 mL) was injected in the untreated structure. Presence and severity of pain was determined by 2 individuals as the testis was grasped following infiltration and at the times of ligature placement and transection of the spermatic cord. Serum cortisol concentration was analyzed preoperatively, after ligation, and after transection. Presence or absence of signs of pain, severity of pain, and serum cortisol concentrations were compared within and between treatment groups. RESULTS: Detection of signs of pain and VAS pain scores did not differ between observers at any time point. Perceived pain responses associated with ligature placement differed significantly from preoperative responses. Pain responses and serum cortisol concentrations after intratesticular and mesorchial infiltration of lidocaine did not differ. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that intratesticular or mesorchial infiltration of lidocaine combined with administration of a nonsteroidal anti-inflammatory drug and caudal epidural injection of detomidine provides adequate analgesia in standing stallions undergoing laparoscopic cryptorchidectomy.

Intraoperative spinal ultrasonography in two dogs with spinal disease.

Ultrasonography was performed during spinal surgery on two dogs that were suspected of having intramedullary lesions by myelography and magnetic resonance imaging. Ultrasonographically, the pathologic conditions of the spinal canal or cord were adequately imaged during surgery in both dogs. On the basis of ultrasonographic findings, a biopsy was obtained in Patient 1 and removal of the lesion was accomplished in Patient 2. Histopathologic diagnosis was myelomalacia in Patient 1 and spinal nephroblastoma in Patient 2. Intraoperative ultrasonography was demonstrated to be suitable for detecting intradural conditions, and, thus, is valuable for increasing the accuracy of biopsies or completeness of resections of intramedullary lesions.

Behavioral and clinical pathology changes in koi carp (Cyprinus carpio) subjected to anesthesia and surgery with and without intra-operative analgesics.

Fish surgery is becoming increasingly common in laboratory and clinical settings. Behavioral and physiologic consequences of surgical procedures may affect experimental results, so these effects should be defined and, if possible, ameliorated. We document behavioral and clinical pathology changes in koi carp (Cyprinus carpio) undergoing surgery with tricaine methanesulphonate (MS-222) anesthesia, with and without intraoperative administration of the opiate butorphanol (0.4 mg/kg intramuscularly) or the nonsteroidal antiinflammatory analgesic ketoprofen (2 mg/kg intramuscularly). For all fish combined, surgery resulted in reduced activity, lower position in the water column, and decreased feeding intensity at multiple time points after surgery. The butorphanol-treated group was the only one not to experience significant (P < 0.05) alterations from presurgical behaviors. Clinical pathology changes at 48 h after anesthesia and surgery included decreased hematocrit, total solids, phosphorus, total protein, albumin, globulin, potassium, and chloride and increased plasma glucose, aspartate aminotransferase, creatine kinase, and bicarbonate. The only clinical pathology difference between treatment groups was a lower increase in creatine kinase in the ketoprofen-treated group. No adverse effects of butorphanol or ketoprofen at these doses were identified. These results suggest a mild behavioral sparing effect of butorphanol and reduced muscle damage from the antiinflammatory activity of ketoprofen.

Intraoperative ultrasonography of the portal vein during attenuation of intrahepatic portocaval shunts in dogs.

A method for intraoperative measurement of portal blood flow velocity with duplex Doppler ultrasonography in 7 dogs with congenital intrahepatic portosystemic shunts is described. The aims of the study were to determine whether intraoperative ultrasonography was an acceptable alternative to mesenteric portography in such dogs and to identify quantitative portal hemodynamic variables that might correlate with clinical outcome better than portal pressure does. Ultrasonographic measurements did not influence decision-making by the surgeon, who attenuated the shunt on the basis of appearance of the viscera and change in mean systemic arterial blood pressure. All dogs recovered without complications, and surgery was considered to be successful in all 7. Intraoperative B-mode ultrasonography provided real-time information about the anatomy of the shunt and the portal branches, suggesting that it may be a useful alternative to mesenteric portography. The time-averaged mean portal blood velocity ranged from 6.5 to 33.7 cm/s before shunt attenuation and from 5.0 to 9.5 cm/s after shunt attenuation. This narrow range of postligation velocities suggested that intraoperative ultrasonography might be an alternative to intraoperative portal pressure measurement.

The accuracy of intraoperative cytopathological diagnosis compared with conventional histopathological diagnosis.

To determine the accuracy of intraoperative cytopathological diagnosis compared with conventional histopathological diagnosis, the authors obtained 100 specimens from masses of various organ systems chosen randomly from 65 dogs, 30 cats, and five exotic animals. Of the 100 specimens, a specific diagnosis was obtained in 42%, the correct pathological process (i.e., mesenchymal neoplasia, epithelial neoplasia, round cell neoplasia, or inflammation) was identified in 41%, in 1% the diagnosis was deferred, and in 16% an incorrect diagnosis was obtained. The overall accuracy rate of intraoperative cytopathological examination was 83%, which increased to 90% by the exclusion of splenic masses. The accuracy rate of diagnosing neoplasia was 87%, with a sensitivity of 89% and a specificity of 100%. Intraoperative cytopathological examination is an accurate diagnostic method with good sensitivity and specificity for the identification of neoplasia.

The effects of active peripheral skin warming on perioperative hypothermia in dogs.

OBJECTIVE: This study evaluates the efficacy of three perioperative warming protocols to improve control of body temperature in anesthetized dogs. STUDY DESIGN: A randomized controlled clinical trial. ANIMALS OR SAMPLE POPULATION: Thirty-two client-owned dogs. METHODS: We prospectively studied dogs entering the University of Pennsylvania Veterinary Teaching Hospital for orthopedic or dental procedures and assigned them to one of three perianesthetic warming protocols. Group 1 (n = 10) had a single circulating warm water mattress applied over the trunk (single-trunk warming). Group 2 (n = 12) had two circulating warm water mattresses, one placed over and one under the trunk (double-trunk warming). Group 3 (n = 10) had warm circulating mattresses applied only around the feet and legs of all available limbs (peripheral warming). The warm water mattresses were prewarmed and maintained at 40 degrees C (104 degrees F) and applied immediately after induction of general anesthesia. All dogs had a layer of thick terry cloth toweling beneath and above the trunk. Body temperature measurements were recorded every 15 minutes for the first 2.5 hours of anesthesia. RESULTS: The lowest mean temperature for dogs in group 3 was 37.4 +/- 0.2 degrees C (99.5 degrees F), compared with 36.4 +/- 0.2 degrees C (97.4 degrees F) and 36.7 +/- 0.2 degrees C (98.0 degrees F) in groups 1 and 2, respectively. CONCLUSIONS: Dogs in the peripheral warming group maintained significantly higher core body temperatures than dogs in either trunk warming groups throughout the 2.5-hour study period. CLINICAL RELEVANCE: To maintain body heat in dogs during anesthesia, it is more effective to warm the feet and legs than to warm the trunk.