Post-anesthetic CPS and EQUUS-FAP scores in surgical and non-surgical equine patients: an observational study.

Background: Equine pain scoring may be affected by the residual effect of anesthetic drugs. Objectives: To compare pain scores in the hours immediately following anesthetic recovery to baseline pre-anesthetic scores in equine patients undergoing surgical and non-surgical procedures. Study design: Clinical observational study. Methods: Fifty adult horses undergoing anesthesia for surgical or non-surgical procedures were enrolled. Horses underwent pain scoring using the Composite Pain Score (CPS) and Equine Utrecht University Scale for Facial Assessment of Pain (EQUUS-FAP) prior to anesthesia (T0) and following anesthetic recovery to standing, every hour for 5 h (T1-T5). Data were analyzed using a generalized linear mixed effects model. A post-hoc Dunnett's test for multiple comparisons was performed for variables where an effect was detected. Results: Mean (95% confidence interval) CPS scores for T0-T5 were 1.6 (1.2-2.0), 6.8 (6.0-7.6), 5.1 (4.3-5.9), 4.3 (3.4-5.2), 3.7 (2.8-4.6), and 2.8 (2.0-3.6) and EQUUS-FAP scores were 0.6 (0.3-0.9), 3.0 (2.5-3.5), 1.9 (1.6-2.2), 1.1 (0.8-1.4), 0.6 (0.4-0.8), and 0.7 (0.4-1.0), respectively. For the CPS, scores greater than 5, and for the EQUUS-FAP scores greater than 3, are consistent with minor pain. There was no effect of type of procedure (surgical vs non-surgical) on CPS or EQUUS-FAP scores. There was an effect of time with CPS scores significantly greater than baseline at T1-T5 and EQUUS-FAP scores significantly greater than baseline at T1 and T2. Main limitations: Discomfort caused by hoisting was not quantified and it was difficult to ascertain if this affected the results. Conclusions: Post-anesthetic pain scores may be influenced by the residual effect of anesthetic agents for as long as 5 h and 2 h for the CPS and EQUUS-FAP, respectively.

Effects of intravenous acepromazine and butorphanol on propofol dosage for induction of anesthesia in healthy Beagle dogs.

OBJECTIVE: To determine the effects of intravenous (IV) premedication with acepromazine, butorphanol or their combination, on the propofol anesthetic induction dosage in dogs. STUDY DESIGN: Prospective, blinded, Latin square design. ANIMALS: A total of three male and three female, healthy Beagle dogs, aged 3.79 ± 0.02 years, weighing 10.6 ± 1.1 kg, mean ± standard deviation. METHODS: Each dog was assigned to one of six IV treatments weekly: 0.9% saline (treatment SAL), low-dose acepromazine (0.02 mg kg-1; treatment LDA), high-dose acepromazine (0.04 mg kg-1; treatment HDA), low-dose butorphanol (0.2 mg kg-1; treatment LDB), high-dose butorphanol (0.4 mg kg-1; treatment HDB); and a combination of acepromazine (0.02 mg kg-1) with butorphanol (0.2 mg kg-1; treatment ABC). Physiologic variables and sedation scores were collected at baseline and 10 minutes after premedication. Then propofol was administered at 1 mg kg-1 IV over 15 seconds, followed by boluses (0.5 mg kg-1 over 5 seconds) every 15 seconds until intubation. Propofol dose, physiologic variables, recovery time, recovery score and adverse effects were monitored and recorded. Data were analyzed using mixed-effects anova (p < 0.05). RESULTS: Propofol dosage was lower in all treatments than in treatment SAL (4.4 ± 0.5 mg kg-1); the largest decrease was recorded in treatment ABC (1.7 ± 0.3 mg kg-1). Post induction mean arterial pressures (MAPs) were lower than baseline values of treatments LDA, HDA and ABC. Apnea and hypotension (MAP < 60 mmHg) developed in some dogs in all treatments with the greatest incidence of hypotension in treatment ABC (4/6 dogs). CONCLUSIONS AND CLINICAL RELEVANCE: Although the largest decrease in propofol dosage required for intubation was after IV premedication with acepromazine and butorphanol, hypotension and apnea still occurred.

Repeatability and accuracy of fingertip pulse oximeters for measurement of hemoglobin oxygen saturation in arterial blood and pulse rate in anesthetized dogs breathing 100% oxygen.

OBJECTIVE: To evaluate the repeatability and accuracy of fingertip pulse oximeters (FPO) for measurement of hemoglobin oxygen saturation in arterial blood and pulse rate (PR) in anesthetized dogs breathing 100% O2. ANIMALS: 29 healthy client-owned anesthetized dogs undergoing various surgical procedures. PROCEDURES: In randomized order, each of 7 FPOs or a reference pulse oximeter (PO) was applied to the tongue of each intubated anesthetized dog breathing 100% O2. Duplicate measurements of oxygen saturation (Spo2) and PR were obtained within 60 seconds of applying an FPO or PO. A nonparametric version of Bland-Altman analysis was used. Coefficient of repeatability was the interval between the 5th and 95th percentiles of the differences between duplicate measurements. Bias was the median difference, and the limits of agreement were the 5th and 95th percentiles of the differences between each FPO and the PO. Acceptable values for the coefficient of repeatability of Spo2 were ≤ 6%. Agreements were accepted if the limits of agreement had an absolute difference of ≤ ± 3% in Spo2 and relative difference of ≤ ± 10% in PR. RESULTS: Coefficient of repeatability for Spo2 was acceptable for 5 FPOs, but the limits of agreement for Spo2 were unacceptable for all FPOs. The limits of agreement for PR were acceptable for 2 FPOs. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that some FPOs may be suitable for accurately monitoring PRs of healthy anesthetized dogs breathing 100% O2, but mild underestimation of Spo2 was common.