Veterinary anaesthesia and analgesia最新文献

英文中文

Objective assessment of chronic pain in donkeys using the Donkey Chronic Pain Scale 使用驴慢性疼痛量表客观评估驴的慢性疼痛。

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-31 DOI: 10.1016/j.vaa.2024.05.011

Objective

To clinically evaluate previously developed pain scales [Donkey Chronic Pain Composite Pain Scale (DCP-CPS), Donkey Chronic Pain Facial Assessment of Pain (DCP-FAP) and combined Donkey Chronic Pain Scale (DCPS)], including behavioural and facial expression–based variables, for the assessment of chronic pain in donkeys.

Study design

Prospective, blinded clinical study.

Animal

A group of 77 donkeys (34 patients and 43 healthy control animals).

Methods

Animals were assessed by two observers that were blinded to the condition of the animals.

Results

Both DCP-CPS and DCP-FAP, and resulting combined DCPS scores, showed good interobserver reliability [intraclass correlation coefficient (ICC) = 0.91, 95% confidence interval (CI) = 0.86–0.95, p < 0.001; ICC = 0.71, CI = 0.50–0.83, p < 0.001 and ICC = 0.84, CI = 0.72–0.91, p < 0.001, respectively]. All scores (DCP-CPS, DCP-FAP and the resulting combined DCPS) were significantly higher for patients than for controls at all time points (p < 0.001 for all three scales). Sensitivity and specificity for identification of pain (cut-off value >3) was 73.0% and 65.1% for DCP-CPS, and 60.9% and 83.3% for DCP-FAP, respectively. For the combined DCPS, sensitivity was 87.0% and specificity 90.9% (cut-off value >6).

Conclusions and clinical relevance

Based on behavioural and facial expression–based variables, DCPS proved a promising and reproducible tool to assess different types of chronic pain in donkeys. The combination of behavioural and facial expression–based variables showed the best discriminatory characteristics in the current study. Further studies are needed for refinement of these tools.

目的临床评估之前开发的用于评估驴慢性疼痛的疼痛量表[驴慢性疼痛综合疼痛量表（DCP-CPS）、驴慢性疼痛面部疼痛评估（DCP-FAP）和驴慢性疼痛综合量表（DCPS）]，包括基于行为和面部表情的变量：研究设计：前瞻性、盲法临床研究：动物：77 头驴（34 头患者和 43 头健康对照组动物）：动物：77 头驴（34 头患者和 43 头健康对照组动物）：DCP-CPS和DCP-FAP以及由此得出的DCPS综合评分均显示出良好的观察者间可靠性[类内相关系数（ICC）= 0.91，95%置信区间（CI）= 0.86-0.95，p < 0.001；ICC = 0.71，CI = 0.50-0.83，p < 0.001和ICC = 0.84，CI = 0.72-0.91，p < 0.001]。在所有时间点，患者的所有评分（DCP-CPS、DCP-FAP 和由此得出的 DCPS 综合评分）均显著高于对照组（所有三个量表的 p 均 <0.001）。DCP-CPS 对疼痛（临界值大于 3）的敏感性和特异性分别为 73.0% 和 65.1%，DCP-FAP 为 60.9% 和 83.3%。综合 DCPS 的灵敏度为 87.0%，特异性为 90.9%（临界值大于 6）：基于行为和面部表情变量，DCPS 被证明是评估驴不同类型慢性疼痛的一种有前途且可重复的工具。在目前的研究中，行为变量和面部表情变量的组合显示出最佳的鉴别特性。还需要进一步的研究来完善这些工具。

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引用次数: 0

Preliminary experience with quadratus lumborum catheters for intermittent analgesia in three dogs with acute abdominal pain 在三只急性腹痛的狗身上使用腰椎四头肌导管进行间歇性镇痛的初步经验。

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-30 DOI: 10.1016/j.vaa.2024.05.010

引用次数: 0

Comparison of inhaled salbutamol and salmeterol for the treatment of arterial hypoxaemia in anaesthetized horses: a randomized clinical trial 吸入沙丁胺醇和沙美特罗治疗麻醉马动脉低氧血症的比较：随机临床试验。

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-29 DOI: 10.1016/j.vaa.2024.05.009

Objective

To compare the efficacy of inhaled salbutamol with salmeterol for the treatment of arterial hypoxaemia in anaesthetized horses.

Study design

Prospective, randomized, clinical study.

Animals

A total of 108 client-owned horses (American Society of Anesthesiologists status I–V) anaesthetized for elective and emergency procedures.

Methods

Horses were premedicated with acepromazine [intramuscularly 0.1 mg kg^–1 or intravenously (IV) 0.05 mg kg^–1] and xylazine (0.6 mg kg^–1 IV). Midazolam (0.06 mg kg^–1 IV) and ketamine (2.2 mg kg^–1 IV) were combined to induce anaesthesia, and isoflurane in oxygen/air mixture (inspired oxygen fraction 0.7) was used for maintenance of anaesthesia. Mechanical ventilation was initiated without delay using the following ventilator settings: tidal volume 10 mL kg^–1, respiratory rate 8 breaths minute^–1, inspiratory-to-expiratory time ratio 1:2, no positive end-expiratory pressure. If arterial blood gas analysis revealed PaO₂ < 100 mmHg (13.3 kPa), the administration of either inhaled salbutamol (2 μg kg^–1) or salmeterol (0.5 μg kg^–1) was randomly assigned Blood gas analysis was repeated 15 and 30 minutes after treatment. The intervention was considered successful when PaO₂ after treatment ≥ 1.2 × PaO₂ before treatment (i.e. ≥20% increase). PaO₂ at 15 and 30 minutes was compared between groups using Mann–Whitney U test; p < 0.05 was considered significant.

Results

Of the 108 horses, 60 were administered salbutamol, 65% and 60% responded successfully at 15 and 30 minutes, increasing their initial PaO₂ by 38% and 44%, respectively. The other 48 horses were administered salmeterol, 35% responded successfully at 15 and 30 minutes, increasing their initial PaO₂ by 3% and 4%, respectively. PaO₂ was significantly higher after salbutamol than after salmeterol at 15 and 30 minutes.

Conclusions and clinical relevance

Using the described protocol, inhaled salbutamol was more effective than salmeterol in improving PaO₂ in anaesthetized horses with value < 100 mmHg (13.3 kPa).

研究目的比较吸入沙丁胺醇和沙美特罗治疗麻醉马动脉低氧血症的疗效：研究设计：前瞻性、随机临床研究：方法：用醋丙咪嗪（肌肉注射 0.1 毫克/千克-1 或静脉注射 0.05 毫克/千克-1）和甲苯咪嗪（0.6 毫克/千克-1 静脉注射）对马匹进行预处理。咪达唑仑（0.06 毫克/千克-1 静脉注射）和氯胺酮（2.2 毫克/千克-1 静脉注射）用于诱导麻醉，异氟醚在氧气/空气混合物（吸入氧分压 0.7）中用于维持麻醉。立即启动机械通气，呼吸机设置如下：潮气量 10 毫升/千克-1，呼吸频率 8 次/分-1，吸气与呼气时间比 1:2，无呼气末正压。如果动脉血气分析显示 PaO2 < 100 mmHg（13.3 kPa），则随机分配吸入沙丁胺醇（2 μg kg-1）或沙美特罗（0.5 μg kg-1）。当治疗后的 PaO2 ≥ 1.2 × 治疗前的 PaO2 时（即增加≥20%），则认为干预成功。采用 Mann-Whitney U 检验比较各组在 15 和 30 分钟时的 PaO2，P < 0.05 为差异有显著性：结果：108 匹马中，60 匹服用了沙丁胺醇，65% 和 60% 在 15 和 30 分钟后反应成功，初始 PaO2 分别提高了 38% 和 44%。另外 48 匹马接受了沙美特罗治疗，35% 的马在 15 分钟和 30 分钟后反应成功，初始 PaO2 分别提高了 3% 和 4%。15分钟和30分钟后，沙丁胺醇的PaO2明显高于沙美特罗：结论和临床意义：采用所述方案，吸入沙丁胺醇比沙美特罗能更有效地改善PaO2值小于100 mmHg（13.3 kPa）的麻醉马的PaO2。

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引用次数: 0

Veterinary students’ attitudes toward anesthesiology as a specialty 兽医专业学生对麻醉学这一专业的态度。

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-29 DOI: 10.1016/j.vaa.2024.05.008

Objective

To identify the perceptions of veterinary students interested in specialization regarding veterinary anesthesiology.

Study design

Cross-sectional, multi-institutional, voluntary, anonymous, nonrandomized survey.

Population

Veterinary students (303 of 557 total respondents) from 10 veterinary schools.

Methods

Quantitative data were obtained via 5-point Likert scale questions about anesthesia-related topics. Open-ended questions were used to obtain qualitative data. A multivariate logistic regression model assessed the likelihood of choosing a career as an anesthesiologist. Spearman’s rank correlation coefficient was used to assess the relationship between ‘anesthesia is interesting’ and other variables.

Results

Of the respondents, 14 (6%) indicated veterinary anesthesia as their chosen specialty. There was a significant positive relationship between ‘anesthesia is interesting’ and the following variables: age, enjoyment in anesthesia class, belief in the importance of anesthesia for their career, belief in the importance of analgesia for their career, belief that anesthesia and analgesia have a large impact on patient care, interest in pharmacology, interest in physiology, interest in learning technical skills, belief that anesthesiologists are respected by their colleagues and belief that anesthesiologists are an important part of the health care team. More weeks on the anesthesia clinical rotation was positively and significantly associated with increased rotation enjoyment. Enjoyment in the anesthesia class [p = 0.001, Exp(β) = 2.1, 95% confidence interval (CI): 1.3–3.4] and belief that anesthesia is interesting [p = 0.013, Exp(β) = 2.6, 95% CI: 1.2–5.4] were predictors that respondents would be more likely to consider a career as a veterinary anesthesiologist.

Conclusions

Those veterinary students with an interest in pharmacology and who enjoyed their anesthesia course were more likely to consider a career as a veterinary anesthesiologist. If students indicated no interest in specializing in veterinary anesthesia, they appreciated the value the specialty brings to animal care and believed that veterinary anesthesiologists are respected by their peers.

研究目的研究设计：横断面、多机构、自愿、匿名、非随机调查：横断面、多机构、自愿、匿名、非随机调查：调查对象：来自 10 所兽医学校的兽医专业学生（557 名受访者中的 303 名）：方法：通过有关麻醉相关主题的 5 点李克特量表问题获得定量数据。采用开放式问题获取定性数据。多变量逻辑回归模型评估了选择麻醉师职业的可能性。斯皮尔曼等级相关系数用于评估 "麻醉很有趣 "与其他变量之间的关系：在受访者中，14 人（6%）表示兽医麻醉是他们选择的专业。麻醉很有趣 "与以下变量之间存在明显的正相关关系：年龄、对麻醉课的喜爱程度、相信麻醉对其职业生涯的重要性、相信镇痛对其职业生涯的重要性、相信麻醉和镇痛对病人护理有很大影响、对药理学的兴趣、对生理学的兴趣、对学习技术技能的兴趣、相信麻醉师受到同事的尊重以及相信麻醉师是医疗团队的重要组成部分。麻醉临床轮转周数的增加与轮转乐趣的增加呈显著正相关。喜欢上麻醉课[p = 0.001, Exp(β) = 2.1, 95% 置信区间 (CI): 1.3-3.4]和认为麻醉很有趣[p = 0.013, Exp(β) = 2.6, 95% CI: 1.2-5.4]是受访者更有可能考虑成为兽医麻醉师的预测因素：结论：对药理学感兴趣并喜欢麻醉课程的兽医专业学生更有可能考虑成为一名兽医麻醉师。如果学生表示对兽医麻醉专业没有兴趣，他们也赞赏该专业为动物护理带来的价值，并认为兽医麻醉师受到同行的尊重。

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引用次数: 0

Ultrasound- and fluoroscopy-guided retrograde epidural catheter placement in a dog as a rescue analgesia after multiple perineal surgeries 超声波和荧光透视引导下逆行硬膜外导管置入狗体内，作为多次会阴手术后的抢救性镇痛。

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-27 DOI: 10.1016/j.vaa.2024.05.007

引用次数: 0

Tidal volume selection in volume-controlled ventilation guided by driving pressure versus actual body weight in healthy anesthetized and mechanically ventilated dogs: A randomized crossover trial 在健康麻醉犬和机械通气犬中，以驱动压力和实际体重为导向的容量控制通气潮气量选择：随机交叉试验

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-24 DOI: 10.1016/j.vaa.2024.05.006

Objective

To compare static compliance of the respiratory system (C_stRS) and the ratio of partial pressure of end-tidal to arterial carbon dioxide (Pe′CO₂/PaCO₂), in healthy dogs using two approaches for tidal volume (V_T) selection during volume-controlled ventilation: body mass based and driving pressure (ΔPaw) guided.

Study design

Randomized, nonblinded, crossover, clinical trial.

Animals

A total of 19 client-owned dogs anesthetized for castration and ovariohysterectomy.

Methods

After a stable 10 minute baseline, each dog was mechanically ventilated with a V_T selection strategy, randomized to a constant V_T of 15 mL kg^–1 of actual body mass (V_TBW) or ΔPaw-guided V_T (V_TΔP) of 7–8 cmH₂O. Both strategies used an inspiratory time of 1 second, 20% end-inspiratory pause, 4 cmH₂O positive end-expiratory pressure and fraction of inspired oxygen of 0.4. Respiratory frequency was adjusted to maintain Pe′CO₂ between 35 and 40 mmHg. Respiratory mechanics, arterial blood gases and Pe′CO₂/PaCO₂ were assessed. Continuous variables are presented as mean ± SD or median (interquartile range; quartiles 1–3), depending on distribution, and compared with Wilcoxon signed-rank tests.

Results

The V_T was significantly higher in dogs ventilated with V_TΔP than with V_TBW strategy (17.20 ± 4.04 versus 15.03 ± 0.60 mL kg^–1, p = 0.036). C_stRS was significantly higher with V_TΔP than with V_TBW strategy [2.47 (1.86–2.86) versus 2.25 (1.79–2.58) mL cmH₂O⁻¹ kg^–1, p = 0.011]. There were no differences in Pe′CO₂/PaCO₂ between V_TΔP and V_TBW strategies (0.94 ± 0.06 versus 0.92 ± 0.06, p = 0.094). No discernible difference in ΔPaw was noted between the strategies.

Conclusions and clinical relevance

While no apparent difference was observed in the Pe′CO₂/PaCO₂ between the V_T selection strategies employed, C_stRS significantly increased during the V_TΔP approach. A future trial should explore if V_TΔP improves perioperative gas exchange and prevents lung damage.

目的比较健康犬在容量控制通气过程中使用两种潮气量 (VT) 选择方法（基于体重和驱动压力 (ΔPaw) 引导）时呼吸系统的静态顺应性 (CstRS) 和潮气末与动脉二氧化碳分压的比值 (Pe′CO2/PaCO2)。研究设计随机、非盲、交叉、临床试验。方法在稳定的 10 分钟基线后，对每只狗采用潮气量选择策略进行机械通气，随机选择 15 mL kg-1 实际体重 (VTBW) 的恒定潮气量或 7-8 cmH2O 的ΔPaw 引导潮气量 (VTΔP)。两种策略均使用 1 秒钟的吸气时间、20% 的吸气末暂停、4 cmH2O 的呼气末正压和 0.4 的吸氧分数。调整呼吸频率以将 Pe′CO2 维持在 35 至 40 mmHg 之间。对呼吸力学、动脉血气和 Pe′CO2/PaCO2 进行了评估。根据分布情况，连续变量以平均值 ± SD 或中位数（四分位数间距；1-3 分位数）表示，并采用 Wilcoxon 符号秩检验进行比较。结果采用 VTΔP 通气的狗的 VT 显著高于 VTBW 策略（17.20 ± 4.04 对 15.03 ± 0.60 mL kg-1，p = 0.036）。VTΔP 的 CstRS 明显高于 VTBW 策略 [2.47 (1.86-2.86) 对 2.25 (1.79-2.58) mL cmH2O-1 kg-1，p = 0.011]。VTΔP 和 VTBW 策略之间的 Pe′CO2/PaCO2 没有差异（0.94 ± 0.06 对 0.92 ± 0.06，p = 0.094）。结论和临床意义虽然所采用的 VT 选择策略之间的 Pe′CO2/PaCO2 没有明显差异，但 VTΔP 方法期间 CstRS 显著增加。未来的试验应探讨 VTΔP 是否能改善围手术期气体交换并预防肺损伤。

{"title":"Tidal volume selection in volume-controlled ventilation guided by driving pressure versus actual body weight in healthy anesthetized and mechanically ventilated dogs: A randomized crossover trial","authors":"","doi":"10.1016/j.vaa.2024.05.006","DOIUrl":"10.1016/j.vaa.2024.05.006","url":null,"abstract":"<div><h3>Objective</h3><p>To compare static compliance of the respiratory system (C<sub>stRS</sub>) and the ratio of partial pressure of end-tidal to arterial carbon dioxide (P<span>e′</span>CO<sub>2</sub>/PaCO<sub>2</sub><span><span>), in healthy dogs using two approaches for </span>tidal volume (V</span><sub>T</sub>) selection during volume-controlled ventilation: body mass based and driving pressure (ΔPaw) guided.</p></div><div><h3>Study design</h3><p>Randomized, nonblinded, crossover, clinical trial.</p></div><div><h3>Animals</h3><p>A total of 19 client-owned dogs anesthetized for castration and ovariohysterectomy.</p></div><div><h3>Methods</h3><p>After a stable 10 minute baseline, each dog was mechanically ventilated with a V<sub>T</sub> selection strategy, randomized to a constant V<sub>T</sub> of 15 mL kg<sup>–1</sup> of actual body mass (V<sub>TBW</sub>) or ΔPaw-guided V<sub>T</sub> (V<sub>TΔP</sub>) of 7–8 cmH<sub>2</sub>O. Both strategies used an inspiratory time of 1 second, 20% end-inspiratory pause, 4 cmH<sub>2</sub>O positive end-expiratory pressure and fraction of inspired oxygen of 0.4. Respiratory frequency was adjusted to maintain P<span>e′</span>CO<sub>2</sub><span> between 35 and 40 mmHg. Respiratory mechanics, arterial blood gases and P</span><span>e′</span>CO<sub>2</sub>/PaCO<sub>2</sub> were assessed. Continuous variables are presented as mean ± SD or median (interquartile range; quartiles 1–3), depending on distribution, and compared with Wilcoxon signed-rank tests.</p></div><div><h3>Results</h3><p>The V<sub>T</sub> was significantly higher in dogs ventilated with V<sub>TΔP</sub> than with V<sub>TBW</sub> strategy (17.20 ± 4.04 <em>versus</em> 15.03 ± 0.60 mL kg<sup>–1</sup>, <em>p</em> = 0.036). C<sub>stRS</sub> was significantly higher with V<sub>TΔP</sub> than with V<sub>TBW</sub> strategy [2.47 (1.86–2.86) <em>versus</em> 2.25 (1.79–2.58) mL cmH<sub>2</sub>O<sup>−1</sup> kg<sup>–1</sup>, <em>p</em> = 0.011]. There were no differences in P<span>e′</span>CO<sub>2</sub>/PaCO<sub>2</sub> between V<sub>TΔP</sub> and V<sub>TBW</sub> strategies (0.94 ± 0.06 <em>versus</em> 0.92 ± 0.06, <em>p</em> = 0.094). No discernible difference in ΔPaw was noted between the strategies.</p></div><div><h3>Conclusions and clinical relevance</h3><p>While no apparent difference was observed in the P<span>e′</span>CO<sub>2</sub>/PaCO<sub>2</sub> between the V<sub>T</sub> selection strategies employed, C<sub>stRS</sub> significantly increased during the V<sub>TΔP</sub> approach. A future trial should explore if V<sub>TΔP</sub> improves perioperative gas exchange and prevents lung damage.</p></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141135131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Laryngocardiac reflex following placement of a transesophageal electrocardiogram probe in an isoflurane-anesthetized Vietnamese Pot-Bellied pig 在异氟醚麻醉的越南盆腹猪体内放置经食道心电图探头后的喉心肌反射

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-23 DOI: 10.1016/j.vaa.2024.05.005

引用次数: 0

2023 awards for outstanding contributions to veterinary anesthesiology 2023 年兽医麻醉学杰出贡献奖

IF 1.7 2区农林科学 Q1 Veterinary

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-22 DOI: 10.1016/j.vaa.2024.04.008

Peter Pascoe

引用次数: 0

Proptosis during endotracheal intubation in a brachycephalic dog 一只肱骨犬在气管插管过程中突眼。

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-21 DOI: 10.1016/j.vaa.2024.05.004

引用次数: 0

A retrospective case-control study evaluating systemic blood pressure and heart rate in dogs with brain herniation under general anesthesia 一项回顾性病例对照研究，评估全身麻醉下脑疝犬的全身血压和心率

IF 1.4 2区农林科学 Q2 VETERINARY SCIENCES

Veterinary anaesthesia and analgesia

Pub Date : 2024-05-19 DOI: 10.1016/j.vaa.2024.05.003

Objective

To examine whether increased systemic arterial blood pressure (ABP) and decreased heart rate (HR) under inhalant anesthesia were suggestive of the Cushing reflex (CR) in dogs with neurological diseases based on magnetic resonance imaging (MRI) findings.

Study design

Retrospective case-control study.

Animals

A sample of 137 client-owned dogs admitted to two veterinary teaching hospitals for diagnosis and patient care owing to suspected intracranial disease from 2005 to 2020. All dogs underwent general anesthesia for MRI of the brain.

Methods

Based on MRI study reports, dogs were divided into three study groups: group A, dogs with suspected brain herniation; group B, dogs with an abnormal MRI finding but without suspicion of herniation; and group C, dogs with structurally unremarkable brains (control). Initial evaluation by an anesthesiologist resulted in 58 cases selected for further review based on suspicion of having intracranial hypertension, as indicated by ABP and HR changes under anesthesia. Anesthetic records were randomized and independently reviewed by three board-certified anesthesiologists blinded to MRI diagnosis who allocated each dog into one of three groups: 1) likely to have CR; 2) unlikely to have CR; or 3) insufficient data for determination.

Results

Of the 58 cases evaluated, nine were considered likely to have CR and 48 were considered unlikely to have CR. In one case, the anesthesiologists were unable to determine whether CR occurred. Of the nine dogs with likely CR, three had an MRI diagnosis of intracranial herniation. The remaining six dogs suspected of CR belonged to the normal brain group.

Conclusions and clinical relevance

The ABP and HR changes associated with CR are not reliably associated with brain herniation in dogs undergoing general anesthesia.

研究设计回顾性病例对照研究动物抽样调查了2005年至2020年期间因疑似颅内疾病而在两家兽医教学医院接受诊断和患者护理的137只客户饲养的狗。方法根据核磁共振成像研究报告，狗被分为三个研究组：A组，疑似脑疝的狗；B组，核磁共振成像发现异常但未怀疑脑疝的狗；C组，大脑结构无异常的狗（对照组）。由麻醉师进行初步评估后，根据麻醉状态下 ABP 和 HR 的变化，怀疑有颅内高压的病例有 58 例需要进一步审查。麻醉记录由三位经委员会认证的麻醉师随机抽取并独立审查，他们对核磁共振成像诊断结果视而不见，并将每只狗分为三组：1）可能有 CR；2）不可能有 CR；或 3）数据不足，无法确定。结果在评估的 58 例病例中，9 例被认为可能有 CR，48 例被认为不可能有 CR。在一个病例中，麻醉师无法确定是否发生了 CR。在 9 只可能发生 CR 的狗中，有 3 只经磁共振成像诊断为颅内疝。结论和临床意义在接受全身麻醉的狗中，与 CR 相关的 ABP 和 HR 变化与脑疝没有可靠的关联。

{"title":"A retrospective case-control study evaluating systemic blood pressure and heart rate in dogs with brain herniation under general anesthesia","authors":"","doi":"10.1016/j.vaa.2024.05.003","DOIUrl":"10.1016/j.vaa.2024.05.003","url":null,"abstract":"<div><h3>Objective</h3><p><span>To examine whether increased systemic arterial blood pressure (ABP) and decreased heart rate (HR) under inhalant anesthesia were suggestive of the Cushing reflex (CR) in </span>dogs with neurological diseases based on magnetic resonance imaging (MRI) findings.</p></div><div><h3>Study design</h3><p>Retrospective case-control study.</p></div><div><h3>Animals</h3><p>A sample of 137 client-owned dogs admitted to two veterinary teaching hospitals for diagnosis and patient care owing to suspected intracranial disease from 2005 to 2020. All dogs underwent general anesthesia for MRI of the brain.</p></div><div><h3>Methods</h3><p>Based on MRI study reports, dogs were divided into three study groups: group A, dogs with suspected brain herniation; group B, dogs with an abnormal MRI finding but without suspicion of herniation; and group C, dogs with structurally unremarkable brains (control). Initial evaluation by an anesthesiologist resulted in 58 cases selected for further review based on suspicion of having intracranial hypertension, as indicated by ABP and HR changes under anesthesia. Anesthetic records were randomized and independently reviewed by three board-certified anesthesiologists blinded to MRI diagnosis who allocated each dog into one of three groups: 1) likely to have CR; 2) unlikely to have CR; or 3) insufficient data for determination.</p></div><div><h3>Results</h3><p>Of the 58 cases evaluated, nine were considered likely to have CR and 48 were considered unlikely to have CR. In one case, the anesthesiologists were unable to determine whether CR occurred. Of the nine dogs with likely CR, three had an MRI diagnosis of intracranial herniation. The remaining six dogs suspected of CR belonged to the normal brain group.</p></div><div><h3>Conclusions and clinical relevance</h3><p>The ABP and HR changes associated with CR are not reliably associated with brain herniation in dogs undergoing general anesthesia.</p></div>","PeriodicalId":23626,"journal":{"name":"Veterinary anaesthesia and analgesia","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141141569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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