Efficacy and cardiorespiratory effects of lumbosacral intrathecal 2% procaine and 2% xylazine with or without sedation in calves undergoing umbilical surgery.

Aims: To compare the effects of intrathecal anaesthesia using procaine and xylazine, with and without sedation with I/V xylazine and butorphanol, on sedation and cardiorespiratory measures in calves undergoing umbilical surgery. Methods: Male dairy calves, aged <3 months, were recruited that had enlargement of the umbilical stalk which was abnormal when palpated. They were assigned to receive either intrathecal injection between the sixth lumbar and first sacral vertebrae of 4 mg/kg of 2% procaine and 0.2 mg/kg 2% xylazine, with I/V injection of 0.02 mg/kg xylazine and 0.1 mg/kg of butorphanol (IT + SED group; n = 6), or the same intrathecal injection and I/V injection of 0.9% saline (IT group; n = 7). Surgery to correct abnormalities was carried out with calves positioned in dorsal recumbency. Rescue analgesia with injections of 2% procaine around the surgical wound was administered when movements triggered by surgery were observed. Post-operative analgesia was provided using I/V 0.5 mg/kg meloxicam. Duration of surgery was recorded, as well as degree of sedation, heart rate, systolic (SAP), diastolic (DAP) and mean (MAP) arterial blood pressure during surgery. Results: All anaesthetic and surgical procedures were successfully performed. Mean total duration of surgery was similar for the IT + SED and the IT groups (30.33 (SD 10.09) and 31.00 (SD 10.21) minutes, respectively) (p = 0.92). All calves were at least mildly sedated from 5 minutes after injections to the end of the surgery. One calf in the IT + SED group and three calves in the IT group required rescue analgesia when the umbilicus was manipulated. Between 0 and 10-15 minutes after injection, decreases in mean heart rate, SAP, MAP and DAP were observed in both groups. Mean SAP was lower in the IT + SED than the IT group. Hypotension (MAP<60 mm Hg) was present in four calves from the IT + SED group and in one from the IT group. Conclusions and clinical relevance: Intrathecal administration of 2% procaine and 2% xylazine allowed the successful completion of umbilical surgery, but 30% of calves needed rescue analgesia during surgery. Clinically, the addition of I/V sedation seemed to provide better analgesia than intrathecal block alone but resulted in greater hypotension.

[Ceftazidime in severe infections in burnt patients]. / La ceftazidime dans les infections sévères chez le brûlé.

Infections being common and severe in burnt patients, their control is of paramount importance. In 49 burnt patients treated with ceftazidime 60 treatments (43 curative and 17 preventive) were prescribed. Ceftazidime was used as first-line therapy, usually combined with an aminoglycoside (amikacin as a rule). The overall success rate was 81 per cent, and only 5 cases (8.6 per cent) could be regarded as true failures. These results, comparable to those found in the literature, are discussed in detail. No significant change occurred in the bacterial population of our hospital unit during the period of the study (more than 3 years). Our experience confirms that ceftazidime should play a predominant role in the treatment of severe infections affecting burnt patients.

Burns and the toxic effects of a derivative of hydrazine.

Comments are presented on a case history of extensive burns associated with 1,1-dimethylhydrazine (UDMH) toxicity in a 31-year-old man. Neurological symptoms dominated early developments. Specific treatment with pyridoxine, while begun late, effected a quite rapid resolution and the subsequent progression of treatment was straightforward. In reviewing previous reported findings, the authors have clarified the distinctive characteristics of UDMH toxicity, the methods for its detection and modes of treatment. They draw conclusions, based on problems encountered, linked to the exceptional character of acute UDMH toxicity especially in its association with extensive burns.