An Assessment of Surgical Experience among Obstetric and Gynaecology SpR Trainees.

Changes in gynaecological practice have resulted in a significant reduction in surgical exposure for trainees. We have attempted to assess surgical experience among obstetric and gynaecology SpR's in Ireland using an anonymous on-line questionnaire. Trainees were asked to assess their own ability to perform a variety of general gynaecological procedures. There was a 97% response rate (29/33 trainees). There were 11 trainees who were in the final or penultimate year of the scheme. This group were analysed separately to assess competency rates in those approaching the end of the scheme. They were subdivided in to those who have completed one year in a general hospital doing pure gynaecology and those who have not. Approximately half of this group (6/11) had completed a pure gynaecology year. All of these trainees deemed themselves competent to perform all general gynaecological procedures listed, with the exception of trans-urethral tape procedures, for which 3/6 reported the requirement of direct supervision. Only 2/6 deemed themselves competent to perform a total laparoscopic hysterectomy. Year 4/5 trainees who had not completed a pure gynaecology year displayed significantly lower competency rates for most of the procedures. With the current changes in gynaecological practice, these results highlight the importance of dedicated gynaecological surgical training.

Correction: Evidence-Based Guideline on Laparoscopy in Pregnancy: Commissioned by the British Society for Gynaecological Endoscopy (BSGE) Endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG).

[This corrects the article on p. 5 in vol. 11, PMID: 31695854.].

Evidence-Based Guideline on Laparoscopy in Pregnancy: Commissioned by the British Society for Gynaecological Endoscopy (BSGE) Endorsed by the Royal College of Obstetricians & Gynaecologists (RCOG).

Laparoscopy is widely utilised to diagnose and treat acute and chronic, gynaecological and general surgical conditions. It has only been in recent years that laparoscopy has become an acceptable surgical alternative to open surgery in pregnancy. To date there is little clinical guidance pertaining to laparoscopic surgery in pregnancy. This is why the BSGE commissioned this guideline. MEDLINE, EMBASE, CINAHL and the Cochrane library were searched up to February 2017 and evidence was collated and graded following the NICE-approved process. The conditions included in this guideline are laparoscopic management of acute appendicitis, acute gall bladder disease and symptomatic benign adnexal tumours in pregnancy. The intended audience for this guideline is obstetricians and gynaecologists in secondary and tertiary care, general surgeons and anaesthetists. However, only laparoscopists who have adequate laparoscopic skills and who perform complex laparoscopic surgery regularly should undertake laparoscopy in pregnant women, since much of the evidence stems from specialised centres.

Study of ovarian cancer management.

Ovarian cancer is the most lethal gynecological malignancy. Many patients present at an advanced stage as the symptoms of early stage disease can be vague. AIM We evaluated the demographics, treatment regimens and survival rates of ovarian cancer patients attending Beaumont Hospital Dublin over a nine year period. A retrospective chart review of ovarian cancer patients attending Beaumont Hospital between 11/10/94 and 30/6/3 was performed. Patients were selected from pathology records. Patients with borderline histology and those who died of unrelated causes were excluded. 31% of individuals presented with distension as their only clinical sign. 20% presented with a mass as their only clinical sign. The most common cell type was papillary serous adenocarcinoma in two thirds of cases. 54% presented with advanced disease [stage IIl-IV]. Treatment involved surgical clearance or debulking +/- chemotherapy. 5 year survival for Stage I was 95% versus 19% for Stage IlI. This highlights the importance of early diagnosis.

Prevalence factors associated with equine herpesvirus type 1 infection in equids with upper respiratory tract infection and/or acute onset of neurological signs from 2008 to 2014.

The objective of the present case-control study was to determine prevalence factors associated with the detection of equine herpesvirus type 1 (EHV-1) by quantitative PCR (qPCR) in horses presented to veterinarians with clinical signs related to an upper respiratory tract infection and/or acute onset of neurological disease from March 2008 to December 2014. Nasal secretions and whole blood from 4228 equids with acute onset of fever, respiratory signs and/or neurological deficits were tested by qPCR for EHV-1. Categorical analyses were performed to determine the association between observations and EHV-1. A total of 117/4228 (2.7 per cent) equids tested qPCR-positive for EHV-1, with most of the isolates belonging to the non-neuropathogenic genotype (N752). EHV-1 PCR-positive equids were over-represented in racing horses. Depression, anorexia, nasal discharge and coughing were significantly less frequently reported in the EHV-1 qPCR-positive equids compared with the EHV-1 qPCR-negative cases. Neurological deficits were more frequently reported in the EHV-1 qPCR-positive cases. This study provides contemporary information on the frequency of EHV-1 detection by qPCR in blood and nasal secretions from horses with fever, respiratory signs and neurological deficits.

Fibrosarcoma over the tarsal groove of a 14-month-old Quarter horse.

A 14-month-old male Quarter horse was presented for evaluation of a grade 3 out of 5 (grade 0 = sound; grade 5 = non-weight bearing) right rear lameness. A firm, 8 x 16 cm mass was palpable at the caudal medial aspect of the distal tibia and proximal tarsal region of the right hind limb. A percutaneous needle aspirate contained mesenchymal cells that were moderate to large in size with single, oblong nuclei. Differential diagnoses included fibrous hyperplasia, fibroma, or well-differentiated fibrosarcoma. Excisional biopsy for both definitive diagnosis and treatment was offered and selected by the owner. A fibrosarcoma was confirmed by histological examination of the mass. One and a half years after resection signs of lameness or evidence of regrowth of the mass were not evident.

Pulmonary blood flow distribution in standing horses is not dominated by gravity.

Recent studies using microspheres in dogs, pigs and goats have demonstrated considerable heterogeneity of pulmonary perfusion within isogravitational planes. These studies demonstrate a minimal role of gravity in determining pulmonary blood flow distribution. To test whether a gravitational gradient would be more apparent in an animal with large vertical lung height, we measured perfusion heterogeneity in horses (vertical lung height = approximately 55 cm). Four unanesthetized Thoroughbred geldings (422-500 kg) were studied awake in the standing position with fluorescent microspheres injected into a central vein. Between 1,621 and 2,503 pieces (1.3 cm3 in volume) were obtained from the lungs of each horse with spatial coordinates, and blood flow was determined for each piece. The coefficient of variation of blood flow throughout the lungs ranged between 22 and 57% among the horses. Considerable heterogeneity was seen in each isogravitational plane. The relationship between blood flow and vertical height up the lung was characterized by the slope and correlation coefficient of a least squares regression analysis. The slopes within each horse ranged from -0.052 to +0.021 relative flow units/cm height up the lung, and the correlation coefficients varied from 0.12 to 0.75. A positive slope, indicating that flow increased with vertical distance up the lung (opposite to gravity), was observed in three of the four horses. In addition, blood flow was uniformly low in three of the four horses in the most cranial portions of the lungs. We conclude that in lungs of resting unanesthetized horses, animals with a large lung height, there is no consistent vertical gradient to pulmonary blood flow and there is a considerable degree of perfusion heterogeneity, indicating that gravity alone does not play the major role in determining blood flow distribution.

Effect of furosemide on pulmonary blood flow distribution in resting and exercising horses.

We determined the spatial distribution of pulmonary blood flow (PBF) with 15-micron fluorescent-labeled microspheres during rest and exercise in five Thoroughbred horses before and 4 h after furosemide administration (0.5 mg/kg iv). The primary finding of this study was that PBF redistribution occurred from rest to exercise, both with and without furosemide. However, there was less blood flow to the dorsal portion of the lung during exercise postfurosemide compared with prefurosemide. Furosemide did alter the resting perfusion distribution by increasing the flow to the ventral regions of the lung; however, that increase in flow was abated with exercise. Other findings included 1) unchanged gas exchange and cardiac output during rest and exercise after vs. before furosemide, 2) a decrease in pulmonary arterial pressure after furosemide, 3) an increase in the slope of the relationship of PBF vs. vertical height up the lung during exercise, both with and without furosemide, and 4) a decrease in blood flow to the dorsal region of the lung at rest after furosemide. Pulmonary perfusion variability within the lung may be a function of the anatomy of the pulmonary vessels that results in a predominantly fixed spatial pattern of flow distribution.

Palliation of intractable cancer pain by MRI-guided cingulotomy.

CASE REPORT: Three cases of intractable pain arising from widespread metastatic cancer with poor response to opioids were treated with MRI-guided cingulotomy. RESULTS AND CONCLUSIONS: In most cases, MRI-guided cingulotomy was associated with significant pain relief and reduced opioid use. To provide insight into the role of MRI-guided cingulotomy in oncologic pain refractory to more conservative measures, the relative risks and benefits of cingulotomy are discussed, along with the course of one patient who experienced postoperative cognitive impairment. This report also describes the relevant neurosurgical and pharmacotherapeutic issues associated with management of pain in patients with widespread metastatic disease.

Cryptorchidism in North American cattle: breed predisposition and clinical findings.

The authors analyzed data collected over 26 years from 143 cryptorchid bulls admitted to 23 North American veterinary schools. Breed was found to be a risk factor. The medical records of 41 cryptorchid cattle were also obtained, and the physical examination findings, method of diagnosis, and surgical management were recorded. Polled Hereford and Shorthorn cattle were at significantly greater risk for cryptorchidism; however, polled cattle were not at an increased risk for cryptorchidism. Cryptorchidism was most commonly diagnosed by external palpation of the superficial inguinal rings and by palpation per rectum. Unilateral cryptorchidism appears to be more common than bilateral cryptorchidism. The incidence of cryptorchidism was 69% for the left testis and 31% for the right testis. Sixty-six percent of the retained testes were located in the inguinal canal. Cryptorchidectomy was performed through an inguinal, paramedian or flank approach in 26 bulls. Cryptorchidism appears to be rare in bovine bulls admitted to North American veterinary schools, with 1.7 cases per 1,000 bull admissions. We suggest that cryptorchidism be considered an inherited trait in the Shorthorn and Polled Hereford breeds.

Quantification of exercise-induced pulmonary haemorrhage with bronchoalveolar lavage.

Exercise-induced pulmonary haemorrhage (EIPH) causes serious economic losses in the horse racing industry. Endoscopic examination indicates that 40-90% of horses exhibit EIPH following sprint exercise, but the limitations of the endoscope prevent diagnosis in many horses. Bronchoalveolar lavage (BAL) was utilised to detect red blood cells (RBCs) in the terminal airways in 6 horses. Two lavages were performed at weekly intervals prior to exercise, one within 90 min after exercise, and 5 at weekly intervals after exercise. The horses were exercised strenuously at 12.5-14.6 m/s on a treadmill (3 degree incline). Heart rates ranged from 192-207 beats/min, and mean pulmonary arterial pressures (mPAP) ranged from 80-102 mmHg. Neither epistaxis nor endoscopic evidence of EIPH was seen in any of the 6 horses following exercise. However, the number of RBCs in the lavage fluid increased significantly over control values immediately after exercise in all horses but returned to control values by one week after exercise. Haemosiderophages in the BAL fluid did not increase until one week after exercise and remained elevated for 3 weeks after exercise. Twenty per cent of the total population of alveolar macrophages contained haemosiderin. A positive relationship occurred between the number of RBCs in the lavage fluid and mPAP; the amount of haemorrhage increased as the mPAP exceeded 80 to 90 mmHg. The results with BAL used as the diagnostic tool, suggest that all strenuously exercised horses may exhibit EIPH; the amount of haemorrhage appears to be associated with the magnitude of the high pulmonary arterial pressure.

The effect of intra-articular methylprednisolone acetate and exercise on equine carpal subchondral and cancellous bone microhardness.

Dorsal carpal osteochondral injury is a major cause of lameness in horses undergoing high intensity training. Intra-articular corticosteroid treatment is used commonly to manage exercise-associated articular pain, but its use remains highly controversial in the equine athlete. This project, therefore, aimed to compare the mechanical properties of intra-articular MPA and diluent-treated middle carpal subchondral and cancellous bone in horses undergoing a short-term treadmill exercise programme. It was hypothesised that subchondral and cancellous bone mechanical properties are influenced by intra-articular administration of methylprednisolone acetate (MPA). Eight 2-year-old female horses had MPA or diluent administered into contralateral middle carpal joints at 14 day intervals, for a total of 4 treatments per horse. Horses underwent a standard treadmill exercise protocol until euthanasia (Day 70). Standard sites were located on the dorsal aspect of third, radial and intermediate carpal bones. Osteochondral samples from each test site were divided into subchondral bone and cancellous bone portions. These were dried, resin-embedded and gold-coated. Microhardness measurements were obtained at each test site. No significant effect of intra-articular treatment was detected. At each site, cancellous bone trabecular struts had an 18-19% higher microhardness value than the overlying subchondral bone. These findings indicate that intra-articular administration of MPA at this dose has no effect on subchondral or cancellous bone adaptation to short-term exercise and, therefore, on the propensity of carpal bones to injury. Further investigation into the calcified cartilage layer, effect of different corticosteroid preparations and diffusion of medication are required.

Normal laparoscopic anatomy of the bovine abdomen.

Three laparoscopic procedures were performed on each of 6 adult Jersey cows in the first trimester of gestation to describe normal laparoscopic anatomy of the bovine abdomen. Also, a technique for laparoscopy of the cranioventral portion of the abdomen was described. Right paralumbar fossa, left paralumbar fossa, and cranioventral midline laparoscopy were performed 72 hours apart of each cow. Physical examination findings, CBC, serum biochemical analysis, and peritoneal fluid analysis before and 72 hours after the first surgery were used to assess the effects of the procedures on the cows. Exploratory celiotomy was performed 2 weeks after the last laparoscopy. The cows were then reexamined 6 weeks after the last procedure. The t-test for paired data was used for statistical analysis; the level of significance was P < 0.05. Laparoscopy was performed without complication in all cows. Adverse effects of laparoscopy, individually or serially, were not observed. Significant differences were not found between CBC, serum biochemical, and peritoneal fluid variables taken before and 72 hours after surgery.

Evaluation of a porous bovine collagen membrane bandage for management of wounds in horses.

OBJECTIVE: To evaluate the effect of a porous bovine-derived collagen membrane (PBCM) on the rates of wound healing, cellular events, presence of granulation tissue, and appearance at termination of the study in surgically created full-thickness cutaneous wounds of the distal portion of the extremities of horses. DESIGN: Treated wounds (n = 12) received a PBCM dressing and control wounds were covered with a nonadherent dressing. Forelimbs and hind limbs were cross paired; the right forelimb and left hind limb always received the same dressing application, as did the left forelimb and right hind limb. Limbs pairs were then randomly assigned to 1 of the 2 dressings. ANIMALS: Six healthy male horses (3 sexually intact, 3 geldings) ranging from 2 to 10 (mean, 6.5) years and weighing between 278 and 568 (mean, 408.5) kg were studied. PROCEDURE: Full-thickness skin wounds (6.25 cm2) were created on the dorsal metatarsi and metacarpi of the experimental animals. A preformed PBCM dressing was evaluated in half the wounds (n = 12). Control wounds (n = 12) were dressed with a nonadherent gauze dressing. At each bandage change, wounds were subjectively assessed and were photographed, and measurements of horizontal and vertical wound dimensions were documented. Wound biopsy specimens obtained on days 2, 5, 7, 10, 21, and 31 were evaluated for presence of collagen, fibrin, inflammation, epithelium, and cellular elements of healing. Planar morphometry was used to determine total wound area and granulation area from the wound photographs. Percentage of contraction and epithelialization were calculated from these values. Linear regression analysis of the square root of the total wound area and the granulation area was performed. Wound area measurements were analyzed, using ANOVA for repeated measures. Regressions were compared, using covariance analysis and ANOVA. Significance was considered at P < 0.05. RESULTS: Fibrin score, neutrophil score, and degree of inflammation were significantly greater in the PBCM-treated wounds. No significant differences in the total wound, epithelialized, or contraction areas were detected between the PBCM-treated and control (nonadherent-treated) wounds. Rates of wound healing were not statistically different between the 2 treatment groups, though they were significantly slower in the hind limbs, compared with the forelimbs. Scabs were formed more frequently in the PBCM-treated wounds. CONCLUSIONS: Application of a porous collagen bandage was not detrimental to full-thickness cutaneous wound healing in horses.

Effects of subject velocity on ground reaction force measurements and stance times in clinically normal horses at the walk and trot.

OBJECTIVE: The objective of the study reported here was to evaluate the effects of changing velocity on stance time and ground reaction force (GRF) measurements in horses at the walk and trot. DESIGN: Force plate gait analysis was used to evaluate clinically normal horses at variable velocities. Ground reaction force measurements and stance times were recorded and compared. ANIMALS: 12 adult horses. PROCEDURE: Data were obtained from 192 valid trials at the walk and 162 valid trials at the trot. Vertical, braking, and propulsive peak forces and impulses were measured. Pearson's correlation coefficients were determined for velocity and stance time and all measured forces and impulses in the forelimbs and hind limbs. Trials were divided into distinct velocity ranges. Trials obtained at velocities within the established ranges were analyzed to evaluate changes in vertical, braking, and propulsive peak forces and impulses at differing speeds within the walk and trot gaits. RESULTS: At the walk and trot, a significant negative correlation was found between velocity and forelimb and hind limb stance times. Velocity and stance time were significantly correlated with many of the GRF and impulse measurements. Velocity was significantly correlated with vertical and braking forces in the hind limbs at the walk, with vertical force in the forelimbs at the trot, and with braking force in the forelimbs and hind limbs at the trot. Velocity and stance time correlated significantly with forelimb and hind limb vertical impulses. Forelimb and hind limb stance times decreased significantly as velocity increased. Hind limb braking force increased and forelimb and hind limb vertical impulses decreased significantly as walk velocity increased. Forelimb braking force increased significantly between velocity ranges at the trot. CONCLUSIONS: Results of this study confirm that a significant negative linear correlation exists between subject velocity and stance times in clinically normal horses at the walk and trot. Significant correlations were also identified between velocity and many GRF measurements, indicating that subject velocity does influence the generation of GRF measurements in horses. Variation in subject velocity should be minimized when performing force-plate analysis in horses.

Endoscopic evaluation of the nasopharynx, pharynx, and larynx of Jersey cows.

Endoscopy of the nasopharynx, pharynx, and larynx was performed in each of 25 adult Jersey cows, age and body weight of which ranged from 2 to 6 years and 300 to 365 kg, respectively. The endoscopic appearance of normal anatomic structures of the proximal portion of the airway were described. Observations specific to female dairy cattle were: the nasal septum, which tapered caudodorsally in the distal third of the nasal passage; the ability to observe both ethmoturbinates from the same viewing side; presence of a pharyngeal septum; the nasopharyngeal opening of the auditory tubes dorsolateral to the pharyngeal septum; and the appearance of the larynx--a triangular epiglottis with round borders and prominent corniculate process of the arytenoid cartilages. Tracheoscopy was performed in 13 cows. Of 11 cows for which the soft palate could be observed immediately after withdrawing the endoscope, 7 had dorsal displacement of the soft palate.

Acute effects of perineural administration of sodium hyaluronate on palmar digital neurectomy sites in horses.

Biaxial palmar digital neurectomy of all limbs was performed on 6 mixed-breed castrated adult male horses, using a standard guillotine method. Using a Teflon catheter, 20 mg (2 ml) of sodium hyaluronate (group 1), 2 ml of phosphate-buffered saline solution (group 2), or catheter placement with no infusion (group 3) was applied to 4 (group 1) or 2 (groups 2 and 3) of 8 incisions/horse. Treatments were administered after closure of the neurectomy incision, and the catheter was removed. Horses were evaluated daily for 1 week, then weekly over a 9-week period for evidence of lameness, swelling, and ultrasonographic changes. On week 9, horses were euthanatized and neurectomy sites were removed en bloc for histologic evaluation of axonal regrowth, inflammation, and fibrosis. Neither lameness nor sign of painful neuroma was observed clinically in any of the horses. Neurectomy eliminated cutaneous heel sensation in all limbs for the duration of the study. Swelling was evident at all neurectomy sites. There were no significant differences between treatment sites for measurement of pastern circumference or ultrasonographic evaluation of incisional swelling. Foci of ultrasonographic hyperechogenicity increased over time, but there was no significant difference in hyperechogenicity between treatment groups. Histologic evidence of neuroma formation was observed at all sites. Morphometric assessment of neuroma cross-sectional areas revealed no significant difference between the groups, as did subjective histologic assessment of neuroma density and fibrous tissue content.(ABSTRACT TRUNCATED AT 250 WORDS)

Inhibition of equine complement activity by polysulfated glycosaminoglycans.

The ability of polysulfated glycosaminoglycans (PSGAG) to inhibit the complement cascade was evaluated. The role of complement in inflammation and infection has been well documented. Inhibition of the complement cascade by PSGAG could explain why intra-articularly administered PSGAG diminish diarthrodial joint inflammation and potentiate septic arthritis in horses. Hemolytic complement testing was performed to evaluate the effect of PSGAG on the equine classical and alternate pathways of complement, using rabbit erythrocytes as the target cells. Concentration of PSGAG between 0.2 mg/ml and 0.6 mg/ml significantly (P less than 0.05) inhibited equine complement in dose-related fashion. Further increase in complement inhibition was not observed at PSGAG concentration greater than 0.6 mg/ml. Difference was not apparent in the extent of inhibition of complement from each of the 4 horses tested. Polysulfated glycosaminoglycans appeared to inhibit the classical and alternate complement pathways equally, indicating possible effect on complement components common to both pathways. Heat inactivation of complement function completely inhibited (P less than 0.01) the hemolytic activity of the serum from all horses.

Effects of sodium hyaluronate on tendon healing and adhesion formation in horses.

Sodium hyaluronate reduces adhesions after tendon repair in rodents and dogs, and has been used in limited clinical trials in people. To evaluate its effect on tendon healing and adhesion formation in horses and to compare these effects with those of a compound of similar visco-elastic properties, a study was performed in horses, using a model of collagenase injection in the flexor tendons within the digital sheath. Eight clinically normal horses were randomly allotted to 2 groups. Adhesion formation between the deep digital flexor tendon and the tendon sheath at the pastern region was induced in the forelimbs of all horses. Using tenoscopic control, a 20-gauge needle was inserted into the deep digital flexor tendon of horses under general anesthesia and 0.2 ml of collagenase (2.5 mg/ml) was injected. The procedure was repeated proximally at 2 other sites, spaced 1.5 cm apart. A biopsy forceps was introduced, and a 5-mm tendon defect was created at each injection site. Group-A horses had 120 mg of sodium hyaluronate (NaHA) gel injected into the tendon sheath of one limb. Group-B horses had methylcellulose gel injected at the same sites. The contralateral limbs of horses in both groups served as surgical, but noninjected, controls. Horses were euthanatized after 8 weeks of stall rest. Ultrasonographic evaluation revealed improved tendon healing after NaHa injection, but no difference in peritendinous adhesion formation. Tendon sheath fluid volume and hyaluronic acid (HA) content were greater in NaHA-treated limbs. Gross pathologic examination revealed considerably fewer and smaller adhesions when limbs were treated with NaHA. However, significant difference in pull-out strengths was not evident between NaHA-treated and control limbs. Histologically, the deep digital flexor tendon from the NaHA-treated limbs had reduced inflammatory cell infiltration, improved tendon structure, and less intratendinous hemorrhage. Treatment with methylcullulose had no significant effect on tendon healing, adhesion size, quantity, or strength or on the volume and composition of the tendon sheath fluid. Sodium hyaluronate, administered intrathecally, appears to have a pharmaceutically beneficial action in this collagenase-induced tendinitis and adhesion model in horses.

Effects of chemical restraint on the endoscopic appearance of laryngeal and pharyngeal anatomy and sensation in adult cattle.

Effects of 2 drugs commonly used for chemical restraint of cattle were evaluated for their effect on laryngeal and pharyngeal anatomy, function, and response to stimuli. Eighteen adult Jersey cows, free of respiratory tract disease, were studied. Cows were assigned at random to 1 of 3 treatment groups. Endoscopic evaluations were performed before and at a predetermined time interval after administration of each drug. Responses to stimuli were evaluated by stimulating 7 preselected sites (epiglottis, left and right arytenoid cartilages, left and right vocal folds, and left and right dorsolateral pharyngeal walls) with a closed, transendoscopic biopsy probe. Xylazine HCl (0.05 mg/kg of body weight, i.v.) was administered to group-1 cows (n = 6), and endoscopy was repeated 5 minutes after administration of the drug. Xylazine (0.07 mg/kg, i.v.) was administered to group-2 cows (n = 6), and endoscopy was repeated 5 minutes after administration of the drug. Acepromazine maleate (0.035 mg/kg, i.v.) was administered to group-3 cows (n = 6), and endoscopy was repeated 10 minutes after administration of the drug. Responses to stimuli were scored as brisk (0), moderate (1), slow (2), and absent (3). Scores for responses to stimuli were compared, using the Wilcoxon signed-rank test for data within groups, and a general linear models procedure, using the Kruskal-Wallis test between groups. Interobserver agreement rates were generated for each group. A value of P < 0.05 was considered significant. Xylazine profoundly changed laryngeal sensitivity and function at both dosages. The corniculate processes of the arytenoid cartilages were observed to be in a markedly adducted position after sedation.(ABSTRACT TRUNCATED AT 250 WORDS)