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Pain is probably under-treated in animals, particularly in rabbits, due to a lack of familiarity with the species and limited information about analgesic dose, efficacy and safety. Tapentadol (TAP) is a novel opioid drug, with a proven efficacy and safety profile in humans, which could be useful as an analgesic in rabbits. In a clinical study, TAP was administered (5 mg/kg, IV) to seven male New Zealand White rabbits 5 min before anaesthetic induction with sevoflurane to perform orchiectomy. Monitoring of vital signs, including heart rate, electrocardiogram, respiratory rate, invasive blood pressure, oxygen saturation, righting reflex, palpebral reflex, jaw tone and tongue retraction, was performed throughout surgery. Pain was assessed for 8 h following surgery, using previously validated parameters, physiological assessments and behavioural assessments. Blood was also collected at regular intervals to assess the pharmacokinetic profile of the drug. TAP was rapidly distributed and eliminated in rabbits. Apnoea did not occurred in any subject. Following surgery, there were very few observable signs of pain in four rabbits and all resumed normal activities within a few hours. In conclusion, this is the first study about the clinical effects and potential utility of TAP as an adjunct drug for anaesthesia and analgesia in the rabbit. However, further studies are still needed before its use in the veterinary clinical practice. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of burnout among veterinary anaesthesia specialists and explore correlations with sociodemographic variables., Study Design: Cross-sectional, online, anonymous, voluntary survey., Population: A total of 530 worldwide veterinary anaesthesia specialists affiliated to American (ACVAA) and/or European (ECVAA) Veterinary Anaesthesia and Analgesia Colleges., Methods: An electronic questionnaire, incorporating the Maslach Burnout Inventory-Human Services Survey for Medical Personnel [MBI-HSS (MP)] and a sociodemographic questionnaire, was used. The MBI-HSS (MP) assessed the three burnout dimensions: emotional exhaustion (EE), depersonalization (DP) and personal accomplishment (PA) using 22 questions, each with a 7-point Likert-type scale answer option, to compute a total score for each dimension. Thresholds for high levels of EE ≥ 27, DP ≥ 10 and for low level of PA ≤ 33. Responders were categorized as high risk for burnout with EE ≥ 27 and DP ≥ 10, and as having burnout syndrome with EE ≥ 27, DP ≥ 10 and PA ≤ 33. Data were investigated with descriptive statistical and regression analysis; p-value < 0.05., Results: Participation rate was 54% (286/530 Diplomates); 65% were identified as women; mean age was 44 years; 59% were married/civil partnership; 52% were ACVAA affiliated; 50% were working in North America; and 51% in academia. The prevalence of high risk for burnout was 42.6% (122/286), and for burnout syndrome was 24.5% (70/286). Number of hours worked per week positively correlated with EE (p < 0.0001) and DP (p = 0.02). Out-of-hours duty positively correlated with EE (p = 0.01) and DP (p = 0.04) and negatively correlated with PA (p = 0.04). Higher burnout prevalence was identified among younger Diplomates, those working ≥ 40 hours per week, in academia/research, and in North America., Conclusions and Clinical Relevance: Concerted effort is required to address the unacceptably high risk of developing burnout and burnout syndrome observed among ACVAA/ECVAA Diplomates., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

The aim of this study was to evaluate the effect of the transverse quadratus lumborum block (QLB LQL-T ) on time to the first postoperative rescue analgesia in dogs submitted to laparoscopic ovariectomy. A total of twenty-three female dogs were included. Dogs were randomly assigned to receive a bilateral QLB LQL-T , performed either with 0.3 mL kg -1 ropivacaine 0.5% [group QLB 0.5% ( n = 8)] or with ropivacaine 0.33% [group QLB 0.33% ( n = 8)] or a fentanyl-based protocol [group No-QLB ( n = 7)]. Dogs were premedicated intravenously (IV) with fentanyl 5 mcg kg -1 , general anesthesia was induced IV with propofol and maintained with sevoflurane. Invasive mean arterial pressure (MAP) values were recorded five minutes before and five minutes after performing the QLB LQL-T . The short-form of the Glasgow composite measure pain scale was used every hour after extubation, and methadone 0.2 mg kg -1 was administered IV when pain score was ≥5/24. Kolmogorov-Smirnov test, ANOVA test combined with Tukey post hoc test, Student's T-test and Chi-square test were used to analyze data; p < 0.05. Time from QLB LQL-T to the first rescue analgesia was significantly longer in QLB 0.5% than in group QLB 0.33% and No-QLB. MAP pre- and post-block decreased significantly only in group QLB 0.33% .

Ultrasound-guided (US-guided) loco-regional anesthesia can provide significant analgesia and anesthetic-sparing effects when used in rabbits. The aims of this study were to investigate the thoraco-lumbar anatomy of the rabbits, particularly the quadratus lumborum (QL) muscle, to design an appropriate US-guided quadratus lumborum block (QLB) specific for rabbits, and to define the most adequate volume of injectate required to consistently cover the ventral branches of T11 to L3 without affecting the pelvic limb innervation (L4, L5 and L6). Sixteen adult rabbit cadavers were included in the study. After randomization, four different volumes of injectate (0.1 mL/kg, 0.2 mL/kg, 0.3 mL/kg and 0.4 mL/kg) were tested, with these volumes additionally randomized to two sites of injection (right or left QL fascia). An ultrasound-guided QLB was performed with a solution of lidocaine, iodinated contrast and tissue dye (in a proportion of 3:1:1 volume, respectively), with subsequent computed tomography (CT) and anatomical dissection, to evaluate the spread of the injectate. In all but one case, the US-guided QLB performed with a dorsolateral approach using 0.3 mL/kg was adequate, while a dose of 0.4 mL/kg consistently reached the targeted nerves but also extended to L4 and caudally. This may suggest that an injectate volume of 0.3 mL/kg may be the most appropriate to produce adequate spread while not affecting pelvic limb innervation.

Objective: To explore the satisfaction and well-being experienced by anaesthesia residents during their training, and to investigate factors that may have influenced their experiences., Study Design: Cross-sectional online anonymous voluntary survey., Sample Population: A total of 150 (of approximately 600 canvassed) former veterinary anaesthesia residents., Methods: Participants were invited to complete an internet-based survey regarding the satisfaction and well-being experienced during their residency. Multiple choice, categorical, dichotomous, Likert-type rating scales and slider questions were used to investigate five domains (demographic, working conditions, educational environment, training satisfaction, well-being). Sampling adequacy, questionnaire reliability and participant responses were investigated by Kaiser-Meyer-Olkin (KMO) indices, Cronbach's α and standard statistical techniques, respectively (p < 0.05)., Results: The questionnaire demonstrated good sampling adequacy (median KMO index 0.74; range 0.51-0.89) and high item 'reliability' (α = 0.82-0.94). Of the 150 responders, (25% participation rate) 62% were satisfied, 14% were neutral and 24% were dissatisfied with their residency training; 60.6% would do the residency again, 39.3% would not or were unsure. Sex and age did not correlate with training satisfaction (p > 0.05). Salary/stipend was considered inadequate by 70% of responders; 66% received no on-call supplement. Greater supervisory input, a good working environment and extra income when on-call were positively correlated with training satisfaction (p < 0.01). The majority (94.6%) of trainees suffered from at least one medical condition during their residency, with fatigue, sleep disturbance or anxiety reported by > 62%., Conclusions: Although a quarter of responders were dissatisfied with their residency, several modifiable factors were identified, particularly with respect to supervisors' input, working environment and pay, which could inform improvements for future residency programmes. Most trainees experienced negative health impacts; however, this parallels the general situation in both the medical and veterinary professions, which requires greater attention from the supervisors, trainees and colleges., (Copyright © 2021 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Ultrasound-guided (US-guided) loco-regional anesthesia techniques allow direct visualization and blockade of sensory nerves. The saphenous nerve (SN), a terminal branch of the femoral nerve (FN), is strictly a sensory nerve for which electrical locator devices are ineffective for localization as no effector muscle contractions can be evoked. US-guided SN block in species other than rabbits produces hind-limb analgesia without affecting FN motor function. The aims of this study were to develop a US-guided SN block technique in rabbits and to compare the spread obtained using two different dye volumes. Twelve hind-limbs from six cadavers (1.62 ± 0.1 kg) were included; after randomization, the SN block was performed on the right or left hind-limb, injecting 0.05 mL kg -1 or 0.1 mL kg -1 of tissue dye in lidocaine (1:50 v : v ). Subsequent dissections allowed nerve staining measurements. All SNs were identified, and 17.8 ± 4.6% and 31.0 ± 8.9% of the SN length were stained using low-volume and high-volume of the dye, respectively. Regardless of the volume used, the SN was consistently stained while the motor branch of the FN was not. This US-guided technique may provide hind-limb analgesia without affecting FN motor function in rabbits undergoing mid-distal hind-limb surgeries.

A prospective, randomized clinical trial was designed to compare four epidural treatments in dogs undergoing total unilateral mastectomy. The epidural volume of injectate was based on the individual occipito-coccygeal length (OCL) aiming to reach the first thoracic vertebra (T1). The first ten dogs were allocated in a control group (C) and did not receive epidural treatment. Subsequently, forty dogs were randomly allocated in four groups of ten: epidural ropivacaine 0.5% (R0.5%); morphine 0.1 mg kg−1 plus ropivacaine 0.5% (MR0.5%); morphine 0.1 mg kg−1 plus ropivacaine 0.35% (MR0.35%); morphine 0.1 mg kg−1 plus ropivacaine 0.25% (MR0.25%). Intraoperatively, isoflurane requirement (1.3% vs. <1.1% FE’Iso) and fentanyl requirement (9.8 vs. <1.1 µg kg−1 h−1) were significantly higher in C group compared to all epidural groups. Postoperatively, methadone requirement was higher (1.8 mg kg−1 vs. <0.8 mg kg−1) for C group compared to all epidural treatment groups. The ability to walk and to urinate returned 4 h earlier in MR0.35% and MR0.25%. The mean epidural volume of ropivacaine, using a dose regimen based on OCL, to reach T1 was about 0.15 mL cm−1. The addition of morphine further reduced the methadone requirement, without affecting urinary and motor functions.

Objective: To assess the accuracy and trending capability of continuous measurement of haemoglobin concentration [Hb], haemoglobin oxygen saturation (SaO 2 ) and oxygen content (CaO 2 ) measured by the Masimo Radical-7 pulse co-oximeter in horses undergoing inhalational anaesthesia., Study Design: Prospective observational clinical study., Animals: A group of 23 anaesthetized adult horses., Methods: In 23 healthy adult horses undergoing elective surgical procedures, paired measurements of pulse co-oximetry-based haemoglobin concentration (SpHb), SaO 2 (SpO 2 ), and CaO 2 (SpOC) and simultaneous arterial blood samples were collected at multiple time points throughout anaesthesia. The arterial samples were analysed by a laboratory co-oximeter for total haemoglobin (tHb), SaO 2 and manually calculated CaO 2 . Bland-Altman plots, linear regression analysis, error grid analysis, four-quadrant plot and Critchley polar plot were used to assess the accuracy and trending capability of the pulse co-oximeter. Data are presented as mean differences and 95% limits of agreement (LoA)., Results: In 101 data pairs analysed, the pulse co-oximeter slightly underestimated tHb (bias 0.06 g dL -1 ; LoA -1.0 to 1.2 g dL -1 ), SaO 2 (bias 1.4%; LoA -2.0% to 4.8%), and CaO 2 (bias 0.3 mL dL -1 ; LoA -2.1 to 2.7 mL dL -1 ). Zone A of the error grid encompassed 99% of data pairs for SpHb. Perfusion index (PI) ≥ 1% was recorded in 58/101 and PI < 1% in 43/101. The concordance rate for consecutive changes in SpHb and tHb with PI ≥ 1% and < 1% was 80% and 91% with four-quadrant plot, and 45.8% and 66.6% with Critchley polar plot., Conclusions: Pulse co-oximetry has acceptable accuracy for the values measured, even with low PI, whereas its trending ability requires further investigation in those horses with a higher [Hb] variation during anaesthesia., (Copyright © 2021 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To compare values of haemoglobin concentration (SpHb), arterial haemoglobin saturation (SpO 2 ) and calculated arterial oxygen content (SpOC), measured noninvasively with a pulse co-oximeter before and after in vivo adjustment (via calibration of the device using a measured haemoglobin concentration) with those measured invasively using a spectrophotometric-based blood gas analyser in anaesthetized dogs., Study Design: Prospective observational clinical study., Animals: A group of 39 adult dogs., Methods: In all dogs after standard instrumentation, the dorsal metatarsal artery was catheterised for blood sampling, and a pulse co-oximeter probe was applied to the tongue for noninvasive measurements. Paired data for SpHb, SpO 2 and SpOC from the pulse co-oximeter and haemoglobin arterial oxygen saturation (SaO 2 ) and arterial oxygen content (CaO 2 ) from the blood gas analyser were obtained before and after in vivo adjustment. Bland-Altman analysis for repeated measurements was used to evaluate the bias, precision and agreement between the pulse co-oximeter and the blood gas analyser. Data are presented as mean differences and 95% limits of agreement (LoA)., Results: A total of 39 data pairs were obtained before in vivo adjustment. The mean invasively measured haemoglobin-SpHb difference was -2.7 g dL -1 with LoA of -4.9 to -0.5 g dL -1 . After in vivo adjustment, 104 data pairs were obtained. The mean invasively measured haemoglobin-SpHb difference was -0.2 g dL -1 with LoA of -1.1 to 0.6 g dL -1 . The mean SaO 2 -SpO 2 difference was 0.86% with LoA of -0.8% to 2.5% and that between CaO 2 -SpOC was 0.66 mL dL -1 with LoA of -2.59 to 3.91 mL dL -1 ., Conclusions: Before in vivo adjustment, pulse co-oximeter derived values overestimated the spectrophotometric-based blood gas analyser haemoglobin and CaO 2 values. After in vivo adjustment, the accuracy, precision and LoA markedly improved. Therefore, in vivo adjustment is recommended when using this device to monitor SpHb in anaesthetised dogs., (Copyright © 2021 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To evaluate two transducer and needle handling methods, along the visual axis (AL) and across the visual axis (AC), in non-skilled and skilled clinicians., Study Design: Prospective randomized crossover study., Method: A total of 26 students with no ultrasound locoregional anaesthesia experience (non-skilled group) and six clinicians experienced and familiar with ultrasound locoregional anaesthesia (skilled group) were enrolled. The non-skilled group was asked to perform two tasks: the first on a phantom and the second on canine cadavers, whilst the skilled group performed only the second task. The tasks consisted of guiding the tip of the needle to a target point (simulated nerve on the jelly phantom and sciatic nerve on the cadavers) using two different methods of needle handling-AL or AC. All operators performed each task three times for each method. The time to drive the needle to the target for the two methods was analysed with a paired Student t test, and the number of times the needle was not visualized on the screen between the groups was compared using an unpaired Student t test. Data are presented as mean ± standard deviation. Value of p < 0.05 was considered significant., Results: The AL method, compared with the AC method, resulted in shorter performance time in both skilled (9 ± 5 versus 20 ± 8 seconds for the second task) and non-skilled groups (9 ± 8 versus 17 ± 15 seconds for the first task and 18 ± 11 versus 32 ± 26 seconds for the second task)., Conclusion and Clinical Relevance: In both groups, the AL method significantly reduced the time to complete the task. Results from this study indicate that the AL method should be the preferred method for learning/teaching ultrasound-guided regional anaesthesia., (Copyright © 2020 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To design and assess the perioperative analgesic efficacy of an ultrasound (US)-guided radial (R), ulnar (U), median (M) and musculocutaneous (Mc) nerve blocks, performed together in the axillary space by a single, in-plane approach., Study Design: Anatomical research and prospective clinical study., Animals: A group of three dog cadavers and 15 client-owned dogs undergoing orthopaedic thoracic limb surgery., Methods: Phase 1: Anatomical dissection and US study of the axillary space were performed to design the US-guided proximal RUMM block. The technique was considered successful if a total volume of 0.15 mL kg -1 new methylene blue solution completely stained the four nerves in two cadavers for ≥2 cm. Phase 2: In 15 client-owned dogs undergoing orthopaedic thoracic limb surgery, the RUMM block designed in phase 1 was performed to provide analgesia using a total volume of 0.15 mL kg -1 of ropivacaine 0.5%. The block was considered effective if the intraoperative fentanyl requirement was <1.2 mcg kg -1 hour -1 and until the postoperative pain score was [short-form Glasgow Composite Measure Pain Scale (SF-GCMPS)] ≤5/20., Results: Phase1: Detection of the four nerves was always feasible in a single US-window. The axillary artery and Mc nerve were used as landmarks. In-plane needling approach was feasible in both cadavers. All the nerves were completely stained for >2 cm. No intrathoracic dye spread was found. Phase 2: In 14/15 anaesthetized dogs, mean intraoperative fentanyl requirement was 0.25 ± 0.05 mcg kg -1 hour -1 . Postoperatively, all dogs had SF-GCMPS ≤5/20 up to 8 hours., Conclusions and Clinical Relevance: The US-guided proximal RUMM block performed at the axillary level with a single, in-plane needling approach using 0.15 mL kg -1 of ropivacaine 0.5% minimized fentanyl requirement during thoracic limb surgery, contributing to postoperative analgesia up to 8 hours after execution of the peripheral nerve block., (Copyright © 2019 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)

A 4-year-old Border collie was presented with one episode of collapse, altered mentation, and a suspected pharyngeal stick injury. Magnetic resonance imaging (MRI) and computed tomography showed a linear foreign body penetrating the right oropharynx, through the foramen ovale and the brain parenchyma. The foreign body was surgically removed and medical treatment initiated. Complete resolution of clinical signs was noted at recheck 8 weeks later. Repeat MRI showed chronic secondary changes in the brain parenchyma. To the authors' knowledge, this is the first report of the advanced imaging findings and successful treatment of a penetrating oropharyngeal intracranial foreign body in a dog., (© 2017 American College of Veterinary Radiology.)

Objective: To evaluate intraoperative and postoperative efficacy of ultrasound (US)-guided femoral (FN) and obturator (ON) nerves block, in the iliopsoas muscle compartment (IPM), using an in-plane technique., Study Design: Anatomical research and randomized, prospective, 'blinded' clinical study., Animals: Six dog cadavers and 20 client-owned dogs undergoing tibial plateau levelling osteotomy (TPLO) surgery., Methods: In phase 1, anatomical dissections and US imaging of the IPM were performed to design an US-guided nerve block involving the FN and ON simultaneously. The technique was considered successful if new methylene blue solution injection (0.1 mL kg -1 ) stained FN-ON for ≥2 cm. In phase 2, the US-guided nerve block designed in phase 1, combined with US-guided sciatic nerve (ScN) block, was performed in 20 dogs undergoing TPLO surgery. Patients were assigned randomly to one of two treatment groups: ropivacaine 0.3% (R3, n=10) and ropivacaine 0.5% (R5, n=10) at a volume of 0.1 mL kg -1 for each nerve block. Intraoperative success rate (fentanyl requirement < 2.1 mcg kg -1  hour -1 ) and postoperative pain score [Short Form-Glasgow Composite Measure Pain Scale (SF-GCMPS) ≥ 5/20] were evaluated., Results: In phase 1, the US image of FN-ON was detected between L6 and L7. In-plane needling technique produced a staining of >4 cm in six of six cases. No abdominal or epidural dye spread was found. In phase 2, median fentanyl infusion rates were 0.5 (0.0-0.9) μg kg -1  hour -1 for R3 and 0.6 (0.0-2.2) μg kg -1  hour -1 for R5. At 9 and 11 hours after the peripheral nerve blocks, an SF-GCMPS ≥ 5 was observed for R3 and R5, respectively., Conclusions and Clinical Relevance: The US-guided FN-ON block in the IPM, using an in-plane technique, combined with US-guided ScN block, provided sufficient analgesia to minimize the use of fentanyl during TPLO surgery. A longer postoperative analgesia was observed in group R5 compared with R3., (Copyright © 2017 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Ltd. All rights reserved.)