Preliminary study of a teaching model for ultrasound-guided peripheral nerve blockade and effects on the learning curve in veterinary anesthesia residents.

OBJECTIVE: To evaluate the use of an experimental colloid model for teaching veterinary anesthesia residents ultrasound-guided technique for nerve blockade. STUDY DESIGN: Prospective, blinded and randomized. METHODS: Colloid models were constructed for practice in ultrasound-guided needle location. Nine veterinary anesthesia residents with no prior experience of ultrasound-guided technique for nerve blocks were randomly divided into three groups. Each group received theoretical orientation. Two groups were assigned to practical training using the experimental model: group 1 (G1) received 2 hours of training and group 2 (G2) received 1 hour of training prior to testing with specific tasks. Group 3 (G3) received no practical training. During testing, the time required for task completion (e.g., display of structures and positioning a needle) and the number of failures were recorded. RESULTS: The average times to completion of the tasks and the number of technical failures were: G1, 47 seconds and 1 failure; G2, 68 seconds and 2 failures; G3, 187 seconds and 7 failures. CONCLUSIONS AND CLINICAL RELEVANCE: In residents with no prior experience of ultrasound-guided needle placement, using an experimental colloid model and a longer training period was associated with increased accuracy and decreased time to task completion. Based on the results of this study, training with an experimental model can be recommended to improve the speed and accuracy of needle manipulation using ultrasound in clinicians with no prior experience of ultrasound-guided technique.

Comparison of preoperative tramadol and pethidine on postoperative pain in cats undergoing ovariohysterectomy.

BACKGROUND: A variety of analgesic agents are available, and which one can be used in dogs and cats is a highly controversial issue, existing however a fear in the use of opiates due to possible adverse effects that these drugs can cause. The aim of this study was to compare the analgesic effect provided by the administration of tramadol or pethidine on early postoperative pain of cats undergoing ovariohysterectomy in a double-blind prospective study. Fourty-two animals were randomly assigned into three groups. Pet received pethidine (6 mg/kg), Tra 2 received tramadol (2 mg/kg) and Tra 4 received tramadol (4 mg/kg); all intramuscularly and associated with acepromazine (0.1 mg/kg). The efficacy of each analgesic regimen was evaluated prior to surgery (baseline - TBL), during surgery and 1, 3 and 6 hours after extubation with subjective pain scale, physiologic parameters, serum concentrations of glucose, cortisol and IL-6. RESULTS: Changes in cardiovascular system were not clinically relevant. There were no significant differences in pain scores (P > 0.05) during the study, although the number of rescue analgesia was significantly higher (P < 0.05) at Pet group (5/14) than Tra 4 group (0/14), whereas in Tra 2, two animals (2/14) required additional analgesia. The serum cortisol values of Pet group were significantly higher at T1h T3h (P < 0.05) and T6h (P < 0.01) when compared to baseline (induction), also it was noticed a significant difference among the groups at T6h (Pet values were higher than Tra 2 and Tra 4; P < 0.05). CONCLUSIONS: Tramadol provided adequate analgesia and it was more effective than pethidine to at least six hours for the studied animals. At the higher dose (4 mg/kg) tramadol is probably more effective, since rescue analgesia was not necessary. No significant changes were observed physiological parameter that could contraindicate the use of these opioid in described doses, for the feline species.