[Spontaneous respiration versus IPPV in pigeons]. / Spontane ademhaling versus IPPV bij de duif.

Veterinary textbook on anaesthesia in birds that volatile anaesthetics can accumulate in the air sac system during spontaneous respiration of birds anaesthetized with inhalational anaesthetics. In order to quantify the extent of accumulation, air samples were collected from the endotracheal tube and from the left abdominal air sac of ten pigeons anaesthetized with O2, NO2, and isoflurane. In this way, O2, CO2, and isoflurane concentrations were measured continuously at two places, during both spontaneous respiration and positive pressure ventilation. During spontaneous respiration, CO2-concentrations were higher in the air sac than in the endotracheal tube in 60% of the animals. The average difference for the whole group was 0.8 volume per cent; individual differences were as high as 2.9 volume per cent. The concentration of isoflurane was on average 1.1 volume per cent lower in the abdominal air sac than in the endotracheal tube. During mechanical ventilation, the percentage of CO2 was lower in the abdominal air sac than in the endotracheal tube in all pigeons. At the same time, the differences between isoflurane concentrations in the endotracheal tube and air sac decreased. Thus the results of our study with isoflurane-anaesthetized pigeons do not support the suggestion that volatile anaesthetics accumulate in the air sacs of spontaneously breathing birds anaesthetized with inhalation anaesthetics. The results also show that, under these conditions, CO2 concentrations in the endotracheal tube can only be measured reliably during positive pressure ventilation.

[Intramuscularly administered non-opiate anesthesia in dogs. A report on the use of ketamine/xylazine, tiletamine/zolazepam, ketamine/midazolam and metomidine]. / Intramusculair toegediende non-opiaat anesthesie bij de hond. Een rapportage over het gebruik van ketamine/xylazine, tiletamine/zolazepam, ketamine/midazolam en medetomidine.

In the present paper, findings on the use of ketamine/xylazine, ketamine/midazolam, tiletamine/zolazepam, and medetomidine following intramuscular injection in dogs are reported. The combined use of ketamine/xylazine induced anaesthesia, the duration of which was thirty minutes. Untoward side-effects were not observed. Administration of tiletamine/zolazepam failed to induce a surgical level of anaesthesia. Recovery was prolonged. In this group, five out of the ten dogs showed signs of post-anaesthetic muscle spasms. Neither the combination ketamine/midazolam nor medetomidine induced a surgical level of anaesthesia. Post-anesthetic muscle spasms were a frequently observed side-effect when the combination ketamine/midazolam was administered. The use of medetomidine resulted in a qualitatively satisfactory and prolonged sedation.

Bilateral mammary artery surgery or percutaneous transluminal coronary angioplasty for multivessel coronary artery disease? An analysis of effects and costs.

Seventy-two patients with stable or unstable angina treated since 1983 by multivessel-PTCA(MVP) were retrospectively compared with 44 similar patients that were suitable for MVP, but who had undergone bilateral mammary artery (BIMA) surgery (and additional vein grafts in 60.5% of the patients) since 1986. Both groups were comparable (P = not significant [NS]) for gender, age, most risk factors, objective ischaemia and left ventricular function; however, in the BIMA group there were more previous infarctions (P = 0.02), hypertension (P = 0.03), three-vessel disease (P = 0.0001), and less severe angina (P = 0.007). In the BIMA group, a mean of 3.1 (range 2-5) vessels were treated and in the MVP group 2.0 (range 2-3) vessels (P = 0.0001). Both groups were almost completely revascularized (NS). In 39.5% of the BIMA group, no veins were used and in 20.9% the BIMAs were used as sequential grafts. In-hospital mortality was comparable: 2.3% for BIMA and 1.4% for MVP, so were periprocedural infarctions (13.6% vs 8.3%), rethoracotomies (9.1% vs 0%), emergency procedures (0% vs 5.7%), low cardiac output (2.3% vs 5.6%) and other complications (18.2% vs 9.2%). The mean stay (days) on the ICU/CCU for BIMA was 2.3 and for MVP 1.6 (P = 0.005) and the mean hospital stay for BIMA 12.3 and for MVP 6.6 (P = 0.0001). The maximum and mean follow-up (months) of 43 BIMA and 71 MVP hospital survivors was 35 vs 72 and 9.5 vs 22.3 (P = 0.0001) with a late mortality of 0% and 4.2% (NS). MVP patients, including 12 with re-procedures, had more recurrent angina (17.7% vs 4.7%, P less than 0.05) and more often used anti-anginal medications (62.0% vs 18.6%, P less than 0.0001). Late complications (excluding re-procedures) were comparable for MVP and BIMA (20% vs 9.3%, 4.4% vs 0%, 9.2% vs 14%). MVP patients had more re-hospitalizations (34 vs 5, P less than 0.0001), re-catheterizations (33% vs 2.3%, P less than 0.0001) and cardiac re-procedures (16 vs 0, P = 0.0006) than BIMA patients. Recurrent-angina-free survival at 1 year was 96% after BIMA and 64% after MVP (P less than 0.01). Event-free survival at 1 year was 86% after BIMA and 58% after MVP (P less than 0.05).(ABSTRACT TRUNCATED AT 400 WORDS)