Effect of lidocaine, fentanyl, or dexmedetomidine on minimum infusion rate and cardiorespiratory variables in dogs undergoing ketofol total intravenous anesthesia.

Background: It has been proposed that dose reduction via co-administration of other agents might ameliorate respiratory depression associated with ketofol. Aims: The present study was designed to evaluate the effects of adding lidocaine, fentanyl, or dexmedetomidine on the required dose and cardiorespiratory variables in dogs undergoing total intravenous anesthesia (TIVA) with ketofol. Methods: In phase I, twelve dogs (six per each treatment) were induced and maintained with two out of four anesthetic regimens of (1) ketofol (4 mg/kg and 0.3 mg/kg/min, respectively; KET), (2) ketofol and lidocaine (1.5 mg/kg and 0.25 mg/kg/min, respectively; KLD), (3) ketofol and fentanyl (5 µg/kg and 0.1 µg/kg/min, respectively; KFN), and (4) ketofol and dexmedetomidine (2 µg/kg and 2 mg/kg/h, respectively; KDX) with at least one-week interval. The minimum infusion rate (MIR) of ketofol was determined. In phase II, the other twelve dogs were given the same anesthetic regimens for 60 min with the determined infusion rate of ketofol, and cardiorespiratory variables were recorded. Results: Mean MIR of ketofol for KET, KLD, KFN, and KDX were 0.35, 0.23, 0.15, and 0.08 mg/kg/min, respectively. In phase II, the times of recovery events were shorter in KFN and KDX than KET and KLD. The heart rate was significantly higher than baseline in KET and KLD, which was also significantly lower than KFN and KDX at several time points. In all treatments, respiratory depression was detected. Conclusion: Despite the decrease in the dose of ketofol, none of the added drugs attenuated respiratory depression caused by this agent.

Comparison of the application of lidocaine, lidocaine-dexamethasone and lidocaine-epinephrine for caudal epidural anesthesia in cows.

The aim of the present study was to determine whether the addition of dexamethasone or epinephrine to lidocaine altered the characteristics of anesthesia and cardiorespiratory variables following caudal epidural application in cows. Twenty adult dairy cows were randomly assigned to receive one of the treatments of lidocaine (LID, 0.2 mg/kg), dexamethasone (DEX, 8 mg), lidocaine-dexamethasone (LIDEX; 0.2 mg/kg and 8 mg, respectively) and lidocaine-epinephrine (LIDEP; 0.2 mg/kg and 5 µg/ml, respectively) by epidural injection with the final volume of 0.018 ml/kg and 10 ml of solution as the upper limit. The time to the onset and duration of anesthesia as well as heart rate (HR), respiratory rate (f R) and rectal temperature (RT) were recorded. No local anesthetic effects were observed in DEX. The onset of anesthesia did not show significant differences among LID, LIDEX and LIDEP. The duration of anesthesia was significantly longer in LIDEX (152.4 ± 25.8 min) as compared to LID (116.0 ± 11.5 min). Although the duration of anesthesia in LIDEP (137.7 ± 10.0 min) was longer in comparison to LID, the difference was not statistically significant. There was no significant difference regarding the onset and duration of anesthesia between LIDEX and LIDEP. HR, f R and RT did not show significant changes over time. Mild transient ataxia was observed in groups that received lidocaine-containing solutions. In conclusion, addition of dexamethasone to lidocaine, without altering the time to onset, produced more prolonged anesthesia than that of lidocaine alone following caudal epidural application in cows.

Histopathologic and Radiographic evaluation of the electroacupuncture effects on ulna fracture healing in dogs.

Acupuncture can affect bone healing by stimulation of sensory nerves and releasing of local and systemic neuropeptides. The purpose of this experimental study was to evaluate the effects of electroacupuncture on ulna fracture healing in dogs. In this study, 12 healthy dogs were randomly divided in to four equal groups, where group 1 was kept as control group and evaluated for 45 days, group 2: treatment group and evaluated for 45 days, group3: control group of 90 days and group 4: treatment group of 90 days. After induction of anesthesia, the ulna was cut with Gigli wire saw in each groups, 10 days after operation, the treatment (acupuncture) group was treated with 10 minutes electroacupuncture stimulations on the acupoints Kid1, Kid3, Kid6 and Kid7, for 10 days. Histopathologic samples of all dogs were harvested from bone osteotomized site in 45 and 90 days after surgery. Indices like, count of inflammatory cells, cartilaginous tissue, fibrotic tissue and deposition of collagen were evaluated on samples and classified with 0, 1, 2, and 3 degrees. Also, radiographic evaluation of the patients was applied using radiographic scoring system on days: 7, 15, 30, 45, 60 and 90 after surgery. This study revealed that, acupuncture had no effect on bone healing (p>0.05). Cause of non-significant difference changes between the control and treatment groups, and lack of complete healing in both groups may be due to lack of ulna bone fixation. Alternatively, selection of other acupoints in acupuncture could have a better healing role.

Effects of xylazine-ketamine anesthesia on plasma levels of cortisol and vital signs during laparotomy in dogs.

This study was designed to evaluate effects of xylazine-ketamine anesthesia on plasma levels of cortisol and vital signs during and after laparotomy in dogs. Eight clinically healthy, adult male dogs, weighing 20 kg were used. All dogs were initially sedated by acepromazine. Thirty minutes later, ketamine plus xylazine was used to induce anesthesia. Surgical incision of laparotomy was done. After a 5 min manipulation of the abdominal organs, the incision was sutured. Vital signs including heart rate, respiratory rate and rectal temperature (RT) were recorded at the times of -30: premedication, 0: induction and Surgical incision, 30: End of surgery, 60, 90 and 120 min. Blood was sampled at the above mentioned times and analyzed using a commercial ELISA kit for cortisol. A significant decreasing trend in RT was observed during the studied times. No significant changes were observed in heart rate and respiratory rate (p>0.05), except at the time of 60 respiratory rate significantly decreased when compared to the time of 90 (p=0.026) and 120 (p=0.041). A non-significant but increasing trend in plasma levels of cortisol was observed.

Systemic lupus erythematosus and amyloidosis.

Amyloidosis in association with Systemic Lupus Erythematosus (SLE) has rarely been reported. We report a patient with "SLE" and Amyloidosis presenting with recurrent bloody diarrhea and review the relevant literature.

Choroidopathy in a case of systemic lupus erythematosus.

Choroidopathy in association with systemic lupus erythematosus (SLE) has rarely been reported. We report a patient with SLE and choroidopathy manifested by bilateral multifocal, serous elevations of the neurosensory retina. Control of the systemic disease resulted in resolution of the serous detachment.

Proteinaceous lymphadenopathy in a patient with known rheumatoid arthritis--case report and review of the literature.

We describe a case of proteinaceous lymphadenopathy (also called lymph node hyalinosis) in a 30-yr-old woman with known rheumatoid arthritis (RA). Amyloidosis was excluded by negative staining with congo red viewed with and without polarized light. Proteinaceous lymphadenopathy should be included in the differential diagnosis of patients with lymphadenopathy and long-standing RA. The histopathologist should be familiar with the morphological appearances of this condition, which can be confused with amyloidosis. It appears that there is a good clinical response in RA-associated proteinaceous lymphadenopathy following successful treatment of arthritis.

Cerebellar atrophy in systemic lupus erythematosus.

Central nervous system involvement in systemic lupus erythematosus (SLE) is common; this is especially so in patients with positive antiphospholipid antibody. However, cerebellar involvement is very unusual. In our institution, we have seen 150 cases of SLE over the last 10 years; however, this is the only patient who has cerebellar involvement due to SLE. The patient had no other neurological deficit, and no other cause apart from her SLE to explain her cerebellar ataxia. Her antiphospholipid antibody was negative. The patient showed some improvement on high-dose steroids and azathioprin.

Systemic lupus erythematosus flare-up manifesting as a cilioretinal artery occlusion.

In this report we describe a patient with systemic lupus erythematosus who was clinically stable after treatment with the antimalarial drug chloroquine and pulse cyclophosphamide therapy. Three months after the discontinuation of chloroquine, the patient developed cilioretinal artery occlusion that was the only the manifestation of a clinical flare-up without evidence of clinical disease activity elsewhere. This case report confirms the clinical belief that the antimalarial agents can maintain the clinical quiescence of systemic lupus erythematosus and its discontinuation is associated with an increase in the risk of clinical flare-up.