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1.
Vet J ; 253: 105391, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31685136

ABSTRACT

Brachycephalic obstructive airway syndrome (BOAS) is a common disorder presenting enlarged soft palate, stenotic nares and abnormal turbinate growth. Surgical correction of BOAS abnormalities with caudal palatoplasty is an elective therapy. This prospective study aimed to compare the effect of an air plasma device and diode laser in dogs undergoing palatoplasty. Outcome measures were as follows: (1) intra-operative and immediate post-operative complications; (2) evaluation of thermal injury in histological tissue sections of the excised soft palate. Twenty dogs with enlarged soft palates underwent palatoplasty, using an air plasma device (n=10) and diode laser (n=10). Soft palate specimens underwent masked histopathological analysis to assess post-operative thermal injury. In this pilot study, no differences were observed in surgical times; all dogs were discharged 24h after surgery and had stable respiration. In the air plasma group, post-operative bleeding occurred in two cases and revision surgery was performed. No difference in thermal injury was observed using the two devices (P>0.05). The air-plasma device was a viable surgical option for palatoplasty in dogs with BOAS.


Subject(s)
Airway Obstruction/veterinary , Burns/veterinary , Craniosynostoses/veterinary , Dog Diseases/surgery , Lasers, Semiconductor/adverse effects , Palate, Soft/abnormalities , Airway Obstruction/surgery , Animals , Craniosynostoses/surgery , Dogs , Female , Male , Palate, Soft/pathology , Pilot Projects , Postoperative Complications/veterinary , Prospective Studies , Treatment Outcome
3.
J Small Anim Pract ; 57(1): 40-3, 2016 Jan.
Article in English | MEDLINE | ID: mdl-26780855

ABSTRACT

Three cats showing chronic, intermittent respiratory distress associated with increased noise on inspiration were examined. Head, neck and thoracic radiographs were unremarkable and laboratory findings were within normal ranges. In all three cats direct laryngoscopy revealed bilateral redundant arytenoid mucosa, which collapsed into the supraglottic and glottis airways during inspiration. Temporary tracheostomy and endoscopic diode laser excision of the excessive mucosa resolved symptoms in all three cats. Redundant arytenoid mucosa is a rare condition that may cause signs similar to laryngeal paralysis or laryngeal mass in cats. According to our results, diode laser surgery in association with temporary tracheostomy appears an appropriate mode of therapy.


Subject(s)
Airway Obstruction/veterinary , Arytenoid Cartilage/abnormalities , Cat Diseases/diagnosis , Airway Obstruction/complications , Airway Obstruction/diagnosis , Animals , Cat Diseases/pathology , Cats , Diagnosis, Differential , Female , Laryngoscopy/veterinary , Male , Respiratory Sounds/etiology , Respiratory Sounds/veterinary
4.
J Small Anim Pract ; 56(11): 675-8, 2015 Nov.
Article in English | MEDLINE | ID: mdl-25828931

ABSTRACT

Laryngeal tumours are rare in dogs. Surgery is the treatment of choice, but it is usually palliative in malignant conditions, due to advanced stage of the tumour at the time of diagnosis. In veterinary medicine, little information is available about the use of diode laser in laryngeal oncological surgery. In the case reported here, a dog with an epiglottic chondrosarcoma was successfully treated with diode laser epiglottectomy. The surgical technique and follow up are described.


Subject(s)
Chondrosarcoma/veterinary , Dog Diseases/surgery , Epiglottis/surgery , Laryngeal Neoplasms/veterinary , Lasers, Semiconductor/therapeutic use , Animals , Chondrosarcoma/surgery , Dogs , Female , Laryngeal Neoplasms/surgery
5.
J Vet Intern Med ; 27(4): 840-6, 2013.
Article in English | MEDLINE | ID: mdl-23647392

ABSTRACT

BACKGROUND: Little information is available about the association between bronchomalacia and historical or clinicopathologic data. Also, studies applying an endoscopic classification scheme that differentiates between static and dynamic bronchial collapse and based on a scoring system are lacking. OBJECTIVES: To describe the clinical presentation of bronchomalacia in dogs, to classify endoscopic findings, and to evaluate associations among historical, clinicopathologic data, and endoscopic findings. ANIMALS: Fifty-nine client-owned dogs with an endoscopic diagnosis of bronchomalacia. METHODS: In this retrospective study, medical records were analyzed and video documentation was reviewed to assign a score to endoscopic findings. Univariate analysis was performed on categorical variables organized in contingency tables, and a stepwise logistic regression model was used for multivariate analysis. RESULTS: Of the 59 dogs included in the study, 2 were affected by static bronchial collapse (SBC), 35 by dynamic bronchial collapse (DBC), and 22 by both SBC and DBC. The association between SBC and DBC was more frequently seen in the dogs with higher body weight, pulmonary hypertension, a bronchial type of radiographic pattern, and nodularity at endoscopic examination. Thirty-one dogs were presented with tracheomalacia and bronchomalacia; an association emerged between these concurrent disorders in dogs living indoors. Multivariate analysis of the endoscopic scores showed a correlation between DBC severity and cough duration. CONCLUSION AND CLINICAL IMPORTANCE: Results of this study provide evidence for 2 different types of bronchial collapse. Endoscopic scoring scheme has proved to be promising in the bronchomalacia classification, although further evaluation of its applicability in larger canine populations is needed.


Subject(s)
Bronchomalacia/veterinary , Bronchoscopy/veterinary , Dog Diseases/pathology , Animals , Bronchomalacia/classification , Bronchomalacia/diagnosis , Bronchomalacia/pathology , Dog Diseases/classification , Dogs , Female , Male
6.
Climacteric ; 16(1): 96-103, 2013 Feb.
Article in English | MEDLINE | ID: mdl-22530684

ABSTRACT

AIM: To investigate the association between socioeconomic, demographic, behavioral, and reproductive factors and the metabolic syndrome (MS) in climacteric women. METHOD: This cross-sectional study was carried out in a sample of 527 women aged 40-65 years seen at an outpatient menopause and gynecologic surgery clinic in Southern Brazil. MS was defined according to NCEP-ATP III diagnostic criteria. Poisson regression was used to calculate crude and adjusted prevalence ratios and their respective 95% confidence intervals (CI). RESULTS: The prevalence of MS was 54.8% (95% CI 50.6-59.1%), varying with menopausal status (45.7% before menopause, 56.3% in perimenopause, and 57.5% in postmenopausal women). Among the components of MS, hypertension and abdominal obesity were the most prevalent (84.8% and 66.8%, respectively). The prevalence of MS rose with advancing age and increasing parity. Women with low education (years of schooling) showed a higher prevalence of MS compared to those with a high education level (64% vs. 36.8%). Women with early menarche (≤11 years of age) showed an increase of 32% in MS prevalence (95% CI 1.08-1.62) compared to those with a late menarche (≥14 years of age). CONCLUSION: These findings are relevant to public health, particularly as they show the significance of exposure to long-term, hard-to-reverse effects, such as early menarche and low educational achievement, in the development of metabolic syndrome.


Subject(s)
Menarche , Menopause , Metabolic Syndrome/epidemiology , Adolescent , Adult , Age Factors , Aged , Brazil/epidemiology , Child , Confidentiality , Cross-Sectional Studies , Educational Status , Female , Humans , Middle Aged , Poisson Distribution , Prevalence , Risk Factors
7.
Zentralbl Chir ; 136(2): 178-80, 2011 Apr.
Article in German | MEDLINE | ID: mdl-20509109

ABSTRACT

Lymphangiomas are rare benign tumors. In most cases, resection is necessary to obtain a precise histopathological analysis. There are capillary, caverous and cystic lymphangiomas. The therapy of choice is a complete excision. Recurrence has been reported after incomplete resection. We present the case of a 45-year-old man with a lymphangioma of the omentum minus and -review the literature.


Subject(s)
Abdomen/surgery , Cholecystectomy, Laparoscopic , Cholecystitis/surgery , Emergencies , Foreign Bodies/surgery , Jejunum/surgery , Laparoscopy/methods , Postoperative Complications/surgery , Postoperative Hemorrhage/surgery , Surgical Drapes , Aged , Foreign Bodies/diagnosis , Humans , Male , Postoperative Complications/diagnosis , Reoperation , Tissue Adhesions/diagnosis , Tissue Adhesions/surgery , Tomography, X-Ray Computed , Ultrasonography
8.
J Small Anim Pract ; 50(3): 143-6, 2009 Mar.
Article in English | MEDLINE | ID: mdl-19261085

ABSTRACT

A 15-year-old domestic shorthair feline immunodeficiency virus-positive cat was presented with a five day history of productive cough and acute respiratory distress. Physical examination revealed inspiratory dyspnoea and diffuse gingivostomatitis. Radiographs showed an intratracheal mass located at the level of the sixth and the seventh cervical vertebrae. Bronchoscopy revealed a unique intratracheal mass occluding about 85 per cent of the tracheal lumen. The tracheal mass was removed bronchoscopically. A diagnosis of pyogranulomatous inflammation referable to a mycobacterial infection was made based on cytological and histopathological findings. 16S rRNA polymerase chain reaction testing and sequence analysis identified a novel mycobacterial species, likely a slow grower, with 95 per cent identity with Mycobacterium xenopi. To our knowledge, this is the first description of a tracheal mycobacterial granuloma in a cat, and the first time, a mycobacterium with this sequence has been identified.


Subject(s)
Cat Diseases/microbiology , Feline Acquired Immunodeficiency Syndrome/complications , Granuloma/veterinary , Immunodeficiency Virus, Feline , Mycobacterium xenopi/isolation & purification , Tracheal Diseases/veterinary , Animals , Antineoplastic Agents/therapeutic use , Cat Diseases/diagnostic imaging , Cat Diseases/therapy , Cats , Enrofloxacin , Fluoroquinolones/therapeutic use , Granuloma/diagnostic imaging , Granuloma/microbiology , Granuloma/therapy , Italy , Male , Polymerase Chain Reaction/veterinary , Radiography , Tracheal Diseases/diagnostic imaging , Tracheal Diseases/microbiology , Tracheal Diseases/therapy , Treatment Outcome
9.
J Small Anim Pract ; 49(2): 95-9, 2008 Feb.
Article in English | MEDLINE | ID: mdl-17784931

ABSTRACT

A cat with a history of seizures and clinical suspicion of forebrain disorder underwent a brain magnetic resonance imaging. A space-occupying lesion was identified in the left temporal lobe. The mass was surgically removed, and cytological, histological and immunohistochemical examinations documented the presence of Toxoplasma gondii. A definitive diagnosis of an intracranial T gondii granuloma was made. The cat was treated with clindamycin and phenobarbital and the seizures did not recur. After 10 months, a second magnetic resonance imaging showed severe brain atrophy, but T gondii granuloma recurrence was not noted. Twenty-one months after surgery, the cat's condition deteriorated, and another magnetic resonance imaging showed a presumptive recurrence of T gondii granuloma. In cats, T gondii granuloma must be considered as a differential diagnosis even when only a single intracranial mass is present. Cytology and magnetic resonance imaging can be useful in making a definitive diagnosis and to follow the evolution of the lesion.


Subject(s)
Cat Diseases/diagnosis , Granuloma/veterinary , Toxoplasmosis, Animal/diagnosis , Toxoplasmosis, Cerebral/veterinary , Animals , Cat Diseases/drug therapy , Cat Diseases/parasitology , Cats , Clindamycin/therapeutic use , Fatal Outcome , Granuloma/diagnosis , Granuloma/drug therapy , Granuloma/parasitology , Magnetic Resonance Imaging/methods , Magnetic Resonance Imaging/veterinary , Male , Phenobarbital/therapeutic use , Recurrence , Seizures/drug therapy , Seizures/etiology , Seizures/parasitology , Seizures/veterinary , Toxoplasma/isolation & purification , Toxoplasmosis, Animal/drug therapy , Toxoplasmosis, Animal/parasitology , Toxoplasmosis, Cerebral/diagnosis , Toxoplasmosis, Cerebral/drug therapy , Toxoplasmosis, Cerebral/parasitology
10.
Schweiz Arch Tierheilkd ; 149(7): 314-8, 2007 Jul.
Article in English | MEDLINE | ID: mdl-17702491

ABSTRACT

This paper reports three clinical cases of needle tract implantation of neoplastic cells on the abdominal and thoracic wall after ultrasound (US) fine needle aspiration biopsy (FNAB). Primary tumors were two transitional cell carcinomas of the urinary bladder (2 dogs) and one pulmonary adenocarcinoma (1 cat). All three masses grew up along the needle tract. To our knowledge, the seeding of pulmonary adenocarcinoma cells after FNAB on the thoracic wall has never been reported in veterinary medicine.


Subject(s)
Adenocarcinoma/veterinary , Carcinoma, Transitional Cell/veterinary , Cat Diseases/pathology , Dog Diseases/pathology , Lung Neoplasms/veterinary , Neoplasm Seeding , Urinary Bladder Neoplasms/veterinary , Abdominal Wall/pathology , Adenocarcinoma/pathology , Animals , Biopsy, Fine-Needle/adverse effects , Biopsy, Fine-Needle/veterinary , Carcinoma, Transitional Cell/pathology , Cats , Diagnosis, Differential , Dogs , Fatal Outcome , Female , Lung Neoplasms/pathology , Male , Urinary Bladder Neoplasms/pathology
11.
Zentralbl Chir ; 132(2): 158-60, 2007 Apr.
Article in German | MEDLINE | ID: mdl-17516325

ABSTRACT

In the present case an 81-year-old patient was operated upon for a suspected atraumatic spleen rupture. During the operation a spleen abscess was found. Histological examination of the removed spleen revealed an Echinococcus multilocularis infection. There was no sign of further organ involvement: surprisingly the liver was not affected. Case history, clinical outcome and the prescribed treatment are described. A short overview of the Echinococchus multilocularis syndrome is presented.


Subject(s)
Echinococcosis/surgery , Echinococcus multilocularis , Splenic Diseases/surgery , Abscess/diagnosis , Abscess/pathology , Abscess/surgery , Aged, 80 and over , Animals , Echinococcosis/diagnosis , Echinococcosis/pathology , Female , Follow-Up Studies , Humans , Spleen/pathology , Splenectomy , Splenic Diseases/diagnosis , Splenic Diseases/pathology , Tomography, X-Ray Computed
12.
J Small Anim Pract ; 48(4): 233-6, 2007 Apr.
Article in English | MEDLINE | ID: mdl-17381770

ABSTRACT

A nine-month-old Labrador retriever was referred to the Clinica Veterinaria Privata San Marco because of frequent headshaking and downward turning of the right ear. Clinical examination revealed that there was no external acoustic meatus in the right ear. Computed tomography confirmed that the vertical part of the right auditory canal ended blindly, providing a diagnosis of external auditory canal atresia. Cytological examination and culture of fluid from the canal and the bulla revealed only aseptic cerumen; for this reason, it was assumed that the dog was probably affected by a congenital developmental deformity of the external auditory canal. Reconstructive surgery was performed using a "pull-through" technique. Four months after surgery the cosmetic and functional results were satisfactory.


Subject(s)
Dogs/abnormalities , Dogs/surgery , Ear Canal/abnormalities , Ear Canal/surgery , Animals , Ear, Middle/abnormalities , Ear, Middle/surgery , Male , Treatment Outcome
13.
J Small Anim Pract ; 47(11): 682-5, 2006 Nov.
Article in English | MEDLINE | ID: mdl-17076794

ABSTRACT

Cytologically and histologically confirmed nasal melanosis was detected by rostrocaudal rhinoscopic evaluation of three dogs with unilateral nasal discharge caused by a chronic and severe odontopathic rhinitis. The extraction of affected teeth and prolonged antibiotic therapy led to a complete resolution of nasal disease. The nasal melanosis could be considered a partial metaplastic transformation of mucosal respiratory cells with accumulation of intracytoplasmic melanin.


Subject(s)
Dog Diseases/diagnosis , Melanosis/veterinary , Nose Diseases/veterinary , Animals , Anti-Bacterial Agents/therapeutic use , Diagnosis, Differential , Dog Diseases/diagnostic imaging , Dog Diseases/pathology , Dog Diseases/therapy , Dogs , Female , Male , Melanosis/diagnosis , Nasal Cavity/diagnostic imaging , Nasal Cavity/pathology , Nose Diseases/diagnosis , Paranasal Sinuses/diagnostic imaging , Paranasal Sinuses/pathology , Tomography, X-Ray Computed/veterinary , Tooth Extraction/veterinary
14.
Vet Res Commun ; 30(7): 723-33, 2006 Oct.
Article in English | MEDLINE | ID: mdl-17004037

ABSTRACT

The determination of enzymatic activity of cholinesterase is a useful diagnostic method to detect exposure to anticholinesterase compounds in human and in veterinary medicine. We validated a modification of the Ellman method in canine serum and applied it to the diagnosis of dogs poisoned with anticholinesterase substances. The method used butyrylthiocholine as substrate and potassium hexacyanoferrate as chromophore. The reference range calculated on 60 clinically healthy dogs was set between 3405 and 6561 U/L (chi-square test for normal distribution, p > 0.05). The overall mean intra-assay and inter-assay coefficients of variation were 0.53% and 3.83%, respectively. The assay was linear when using two sera with 12,538 U/L and 6604 U/L serum cholinesterase activity (r(2) = 0.997) and 0.999, respectively). The mean recovery values of pooled sera with a mean pseudocholinesterase (PChE) activity of 12,081 U/L and pooled sera with a mean PChE activity of 3415 U/L were 103.5% and 102.8%, respectively. Six dogs with a diagnosis of anticholinesterase compound intoxication showed a decrease in cholinesterase activity of at least 50% of normal activity with a mean +/- SD of 487 +/- 291 U/L ranging from 169 to 847 U/L. This technique conforms to the current standard for precision, linearity and accuracy and is a useful method for the complementary diagnosis of organophosphate or carbamate insecticide intoxication in dogs.


Subject(s)
Cholinesterases/metabolism , Spectrophotometry/veterinary , Animals , Biomarkers/metabolism , Case-Control Studies , Cholinesterase Inhibitors/poisoning , Cholinesterases/blood , Dog Diseases/diagnosis , Dogs , Insecticides/poisoning , Reference Values , Reproducibility of Results , Sensitivity and Specificity , Spectrophotometry/methods , Spectrophotometry/standards
15.
J Small Anim Pract ; 47(6): 316-9, 2006 Jun.
Article in English | MEDLINE | ID: mdl-16761983

ABSTRACT

OBJECTIVES: To compare the efficacy and diagnostic value of four different sample collection techniques for cytological identification of nasal aspergillosis-penicilliosis in dogs. METHODS: Fifteen dogs with a history of persistent nasal discharge and clinical and radiographic findings suggestive of aspergillosis were evaluated using four different cytological sampling techniques. These were a direct smear from the nasal discharge, blind swab collection under general anaesthesia, brushing from suspect lesions under direct endoscopic visualisation and a squash technique of mucosal biopsies from suspect lesions obtained under direct endoscopic visualisation. RESULTS: Direct smear collection and blind swab collection detected fungal hyphae in 13.3 and 20 per cent of examined cases, respectively; brush samples detected fungal hyphae in 93.3 per cent and fungal spores in the 45 per cent of examined cases and squash samples detected fungal hyphae in 100 per cent and fungal spores in 36 per cent of examined cases. CLINICAL SIGNIFICANCE: This study confirmed the high accuracy of cytology samples in the diagnosis of nasal aspergillosis-penicilliosis when collected under direct endoscopic visualisation and showed the poor value of samples that were collected by blind swabs or prepared from samples of nasal discharge.


Subject(s)
Aspergillosis/veterinary , Dog Diseases/diagnosis , Dog Diseases/microbiology , Endoscopy/veterinary , Nose Diseases/veterinary , Nose/microbiology , Animals , Aspergillosis/diagnosis , Aspergillus/isolation & purification , Cytological Techniques/veterinary , Dog Diseases/diagnostic imaging , Dog Diseases/pathology , Dogs , Endoscopy/methods , Female , Male , Nose Diseases/diagnosis , Predictive Value of Tests , Radiography , Specimen Handling
16.
J Vet Med A Physiol Pathol Clin Med ; 52(7): 339-46, 2005 Sep.
Article in English | MEDLINE | ID: mdl-16109100

ABSTRACT

In this paper, we report on our experience of cytology of fine needle biopsies performed on 92 dogs with testicular tumours during the period from 1998 to 2002. Cytological diagnosis was consistent with seminoma in 20 cases, sertolioma in 16 cases, Leydig cell tumours in 50 cases and mastocytoma in one case. Five cases could not be diagnosed by cytology. Cytological observations were confirmed after surgery by histopathological examination in 87 cases. Cytology provided a sensitivity of 95% for seminoma, 88% for sertolioma and 96% for Leydig cell tumours. The specificity was 100% for all three tumour types. In our experience cytology of fine needle aspirations of testicular tumours is a very reliable technique.


Subject(s)
Biopsy, Fine-Needle/veterinary , Dog Diseases/pathology , Testicular Neoplasms/veterinary , Animals , Biopsy, Fine-Needle/standards , Dog Diseases/epidemiology , Dogs , Italy/epidemiology , Leydig Cell Tumor/pathology , Leydig Cell Tumor/veterinary , Male , Mastocytoma/pathology , Mastocytoma/veterinary , Predictive Value of Tests , Seminoma/pathology , Seminoma/veterinary , Sensitivity and Specificity , Sertoli Cell Tumor/pathology , Sertoli Cell Tumor/veterinary , Testicular Neoplasms/pathology
17.
J Vet Med A Physiol Pathol Clin Med ; 51(7-8): 358-62, 2004.
Article in English | MEDLINE | ID: mdl-15533119

ABSTRACT

A 12-year-old intact female mixed breed dog was presented for chronic, intermittent vomiting and diarrhoea. On endoscopic examination a protruding mass arising from the mucosal surface of the pyloric region was detected. Cytological and histological examination revealed an accumulation of pleomorphic round/oval phagocytic cells suggesting histiocytic origin. This was confirmed by immunohistochemistry. No extra-gastric involvement was detected on clinical examination or at necropsy. This is the first report of primary gastric histiocytic sarcoma in a dog.


Subject(s)
Dog Diseases/pathology , Sarcoma/veterinary , Stomach Neoplasms/veterinary , Animals , Dog Diseases/diagnostic imaging , Dogs , Fatal Outcome , Female , Gastric Mucosa/pathology , Histiocytes , Immunohistochemistry/veterinary , Sarcoma/diagnostic imaging , Sarcoma/pathology , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/pathology , Tomography, X-Ray Computed
18.
J Small Anim Pract ; 45(4): 191-8, 2004 Apr.
Article in English | MEDLINE | ID: mdl-15116887

ABSTRACT

Percutaneous fine-needle biopsy was used to investigate thoracic and abdominal masses in the dog and cat. One hundred and thirty-two cases were included in the study; 20 cases were excluded from the comparative study due to poor cellularity or blood contamination (retrieval rate 86.8 per cent). One hundred samples (56 dogs and 44 cats) were classified by cytology as neoplastic. All the cytological diagnoses of neoplasia were confirmed by histological samples obtained either by non-surgical methods, at surgery or during postmortem examination. No false positive diagnoses of neoplasia were made. Thirty-two samples were cytologically classified as 'negative for neoplasia'. Subsequent histological examination revealed 18 true negative and 14 false negative results. The procedure had an overall 89.4 per cent (118 cases out of 132) agreement between the diagnosis of inflammatory disease versus neoplasia, with a sensitivity of 87.8 per cent, a specificity of 100 per cent, a predictive value of a positive test of 100 per cent and a predictive value of a negative test of 56.3 per cent.


Subject(s)
Abdominal Neoplasms/veterinary , Biopsy, Needle/veterinary , Cat Diseases/pathology , Dog Diseases/pathology , Thoracic Neoplasms/veterinary , Abdominal Neoplasms/pathology , Animals , Biopsy, Needle/methods , Cats , Dogs , Predictive Value of Tests , Records/veterinary , Retrospective Studies , Sensitivity and Specificity , Thoracic Neoplasms/pathology
19.
Cad Saude Publica ; 17(1): 141-6, 2001.
Article in Portuguese | MEDLINE | ID: mdl-11241936

ABSTRACT

The authors carried out a literature review of the subject "stillbirth", with special emphasis on its conceptual and epidemiological features, aimed at highlighting its importance as a perinatal health indicator.


Subject(s)
Fetal Death/epidemiology , Health Status Indicators , Perinatal Care , Death Certificates , Female , Humans , Infant, Newborn , Pregnancy , Risk Factors
20.
Ann Thorac Surg ; 66(2): 367-72, 1998 Aug.
Article in English | MEDLINE | ID: mdl-9725371

ABSTRACT

BACKGROUND: Thoracic epidural analgesia is considered the method of choice for postthoracotomy analgesia, but it is not suitable for every patient and is associated with some risks and side effects. We therefore evaluated the effects of an extrapleural intercostal analgesia as an alternative to thoracic epidural analgesia. METHODS: In a prospective, randomized study, pain control, recovery of ventilatory function, and pulmonary complications were analyzed in patients undergoing elective lobectomy or bilobectomy. Two groups of 15 patients each were compared: one received a continuous extrapleural intercostal nerve blockade (T3 through T6) with bupivacaine through an indwelling catheter, the other was administered a combination of local anesthetics (bupivacaine) and opioid analgesics (fentanyl) through a thoracic epidural catheter. RESULTS: Both techniques were safe and highly effective in terms of pain relief and recovery of postoperative pulmonary function. However, minor differences were observed that, together with practical benefits, would favor extrapleural intercostal analgesia. CONCLUSIONS: These results led us to suggest that extrapleural intercostal analgesia might be a valuable alternative to thoracic epidural analgesia for pain control after thoracotomy and should particularly be considered in patients who do not qualify for thoracic epidural analgesia.


Subject(s)
Analgesia, Epidural , Analgesia/methods , Pain, Postoperative/drug therapy , Thoracotomy , Bupivacaine/administration & dosage , Elective Surgical Procedures , Female , Fentanyl/administration & dosage , Humans , Male , Middle Aged , Nerve Block/methods , Pneumonectomy , Postoperative Complications , Prospective Studies , Respiration
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