Search Results (20)

The development of standardised, reproducible preclinical models is essential for advancing pleural mesothelioma (PM) research. Here, we present a simple and reliable minimally invasive transthoracic intrapleural injection technique that could improve the efficiency of orthotopic PM model generation. By incorporating a simple needle sleeve to control the injection depth, this method eliminates the need for surgery or general anaesthesia, reducing technical complexity and animal stress while ensuring precise delivery into the pleural cavity. We demonstrate the effectiveness of this approach by achieving a 100% tumour engraftment rate following the injection of AE17 tumour cells. Additionally, this technique has been successfully used for asbestos fibre injection in mesothelioma models, highlighting its versatility. By providing a more accessible, standardised alternative to existing methods, this protocol improves the reliability of PM models and facilitates broader adoption by researchers, including those with limited experience in invasive procedures. Full article

The administration of lidocaine as part of multimodal analgesia in dogs undergoing ovariohysterectomies demonstrates variable analgesic efficacy. The aim of this prospective, double–blinded clinical study was to evaluate the effectiveness of lidocaine 2% irrigation on the ovarian suspensory ligament, followed by localised massage, in achieving sufficient intraoperative analgesia. Thirty-eight female dogs were randomly divided to two groups and received either a splash block of 0.5 ml lidocaine 2% on each ovarian suspensory ligament (GL) or an equal volume of saline (GNS). All dogs were premedicated with dexmedetomidine (5 μg·kg⁻¹) and buprenorphine (20 μg·kg⁻¹) intramuscularly and meloxicam (0.2 mg·kg⁻¹) subcutaneously. Anaesthesia was induced with propofol and maintained with isoflurane. The surgical procedure was initiated after an adequate depth of anaesthesia was achieved. Heart rate (HR), respiratory rate (f_R) and mean arterial pressure (MAP) were continuously monitored. Fentanyl (2 μg·kg⁻¹) was administered as rescue analgesia in case of a 30% increase in HR, f_R, or MAP, compared to their values before manipulation of the ovaries. Data were analysed using a mixed model for repeated measures ANOVA and Pearson’s Chi-Square test. The need for rescue analgesia differed significantly between the two groups (p < 0.0005). In GNS, 89.47% (17/19) of the dogs required rescue analgesia, compared to 10.53% (2/19) of the dogs in GL. The relative risk of rescue for the GNS compared to the GL was approximately 8.5. In conclusion, intraoperative analgesia during ovariohysterectomies in dogs can be enhanced using a lidocaine 2% splash block combined with massage of the ovarian suspensory ligament. Full article

Cryotherapy is widely used in veterinary medicine to manage pain and swelling, yet optimal methods for specific tissue depths remain unclear. Cryotherapy modalities, including cold packs (CPs), cold compression (CC), and hyperbaric gaseous cryotherapy (HGC), were applied to nine beagle dogs under general anaesthesia. A custom 3D-printed guide facilitated consistent and accurate measurements of tissue temperatures at depths of 1 and 3 cm. After a 20 min application, all modalities significantly reduced the muscular tissue temperatures at both measured depths. HGC exhibited the most effective rapid temperature reduction, whereas CC displayed the most extended sustained cooling effect. In comparison, CPs showed a lower temperature reduction. The effectiveness of cryotherapy varies with tissue depth, and selecting the appropriate method can improve therapeutic outcome. Full article

Cervical cancer continues to be a public health concern, as it remains the second most common cancer despite screening programs. It is the third most common cause of cancer-related death for women, and the majority of cases happen in developing nations. The standard treatment for locally advanced cervical cancer involves the use of external beam radiation therapy, along with concurrent chemotherapy, followed by an image-guided adaptive brachytherapy (IGABT) boost. The five-year relative survival rate for European women diagnosed with cervical cancer was 62% between 2000 and 2007. Updated cervical cancer treatment guidelines based on IGABT have been developed by the Gynecological working group, which is composed of the Group Européen de Curiethérapie–European Society for Therapeutic Radiology and Oncology. The therapeutic strategy makes use of three-dimensional imaging, which can be tailored to the target volume and at-risk organs through the use of computed tomography or magnetic resonance imaging. Under anaesthesia, the brachytherapy implantation is carried out. Ultrasonography is utilised to assess the depth of the uterine cavity and to facilitate the dilation of the uterine canal during the application insertion. In this study, we examine data from the international literature regarding the application of ultrasound in cervical cancer brachytherapy. Full article

A wide variety of substances have been used to anaesthetise invertebrates, but many are not anaesthetics and merely incapacitate animals rather than preventing pain. In essence, the role of an ideal general anaesthetic is to act as a muscle relaxant, an analgesic, an anaesthetic, and an amnesic. To achieve all these properties with a single substance is difficult, and various adjuvants usually need to be administered, resulting in a cocktail of drugs. In a clinical setting, the vast majority of patients are unaware of surgery being carried out and have no memory of it, so they can claim to have felt no pain, but this is much more difficult to demonstrate in invertebrates. Here, we show that 1% MgCl_2, a muscle relaxant_, is a useful adjuvant for the clinical anaesthetic isoflurane on Octopus vulgaris when applied alone in seawater for 10 min before the clinical anaesthetic. After this, full anaesthesia can be achieved in 5 min using 1% isoflurane insufflated into the saline still containing MgCl₂. Full recovery takes place rapidly in about 10 to 15 min. The depth of anaesthesia was monitored using changes in respiratory rate, chromatophore pattern, and withdrawal movements of the arms and siphon. This methodology reduces stress on the animal and minimises the quantity of anaesthetic used. Full article

Reflection facilitates medical education and professional practice by enhancing active and deep learning from experiences. The reflection period is a time for self-awareness and self-assessment of learning events and experiences to improve future experiences (e.g., skill acquisition). Advocates for reflection suggest that reflective practice has the power to enhance professionalism as it provides an opportunity for critical thinking. It can be of variable length and depth; however, the process should be explorative and factual. Critical reflection is a broader and in-depth consideration of historical, cultural and political contexts to challenge and change one’s or a group’s assumptions and actions. Although the process is beneficial to achieving the intended learning objectives, its impact on educational and clinical outcomes remains unclear in anaesthesia. The usefulness of reflection in the learning process or work practices varies depending on personal, professional and organisational factors. Several models and approaches are described to facilitate the reflection process. However, assessment of reflection within the curriculum boundaries and for workplace-based learning activities is complex and challenging due to the lack of validated tools for different types of reflection. PubMed and Google Scholar were searched for articles on reflection and its application in anaesthesia. The anaesthesia literature has minimal information on the theoretical and research aspects of reflective learning and teaching. This review aims to outline the purpose of reflection, discuss the utilisation of commonly used reflection models and underline the intricacy of reflection in anaesthesia learning, teaching and practice. This article highlights crucial factors which may foster or hinder reflection and its effectiveness in achieving meaningful intended outcomes. Full article

Two young (11-week-old) pigs underwent sole propofol anaesthesia as part of an experimental study. The depth of anaesthesia was evaluated both clinically and using the electroencephalography(EEG)-based monitor Sedline; in particular, the patient state index, suppression ratio, raw EEG traces, and its spectrogram were assessed. Physiological parameters and electrocardiographic activity were continuously monitored. In one pig (Case 1), during the administration of high doses of propofol, the Sedline-generated variables suddenly indicated an increased EEG activity while this was not confirmed by observation of either the raw EEG or its spectrogram. In the second pig (Case 2), a similar event was recorded during euthanasia with systemic pentobarbital. Both events happened while the EEG activity was isoelectric except for signal interferences and synchronous in rhythm and shape with the electrocardiographic activity. The suggestion of increased brain activity based on the interpretation of the Sedline variables was suspected wrong; most probably due to electrocardiographic interferences. In pigs, the patient state index and suppression ratio, as calculated by the Sedline monitor, could be influenced by the electrocardiographic activity contaminating the EEG trace, especially during otherwise isoelectric periods (strong EEG depression). Visual interpretation of the raw EEG and of the spectrogram remains necessary to identify such artefacts. Full article

The main objective of this prospective, randomized, blind, cross-over experimental study was to evaluate the effect of classical music on the depth of sedation and propofol requirements for the induction of anaesthesia in dogs. Twenty dogs were involved, and each was subjected to three different treatments with a 3-month gap: Chopin music, Mozart music, and no music, via loudspeakers. The dogs were premedicated with acepromazine and butorphanol by intramuscular injection, and anaesthesia was induced using propofol intravenously. To compare the depth of sedation and propofol requirements for the induction of anaesthesia among the different treatments, we utilized non-parametric tests (Kruskal–Wallis test) for the depth of sedation due to a slight deviation from the normal distribution and parametric (ANOVA) for propofol requirements. When exposed to music (Chopin or Mozart), dogs exhibited deeper sedation and required less propofol for their intubation compared to the no-music treatment (p < 0.05). Exposure to classical music had a positive impact on the level of sedation, and more profound central nervous system depression seemed to contribute to approximately 20% lower propofol dose requirements for tracheal intubation. Therefore, classical music during the preoperative period appeared to exert a beneficial effect, at least when applying the specific pre-anaesthetic medications used in the present study. Full article

Haemostasis disorders are serious pathologies that could put dental and surgical procedures at risk as they are associated with postoperative bleeding, which in some circumstances could be prolonged and dangerous for the patient. In-depth knowledge of the problems associated with coagulation pathologies and the suitable specific procedures should be implemented in dental practice. A good awareness of the clinical protocols to be used in these circumstances may help reduce operator stress and increase patient compliance. Collaboration with the haematologist is always recommended to establish an adequate treatment plan, both regarding the administration of therapies that promote haemostasis and for assessing the operative risk. Hereby, we summarize the congenital and hereditary pathologies that lead to haemostasis disorders, which can be found in patients undergoing dental procedures. The purpose of this narrative review is to frame the diseases from a clinical, anamnestic, and etiopathological standpoint, as well as to evaluate an operative approach to the pathology under consideration, with particular attention to anaesthesia manoeuvres and post-surgical haemostasis, to avoid hematoma formation and uncontrolled bleeding which can lead procedure failure up and even death. Of note, it is likewise important to educate the patient about prevention, to keep the oral cavity healthy and avoid invasive procedures, limiting the number of operative sessions. Full article

Emergence delirium (ED) is a postoperative complication in pediatric anesthesia characterized by perception and psychomotor disorder and has a negative impact on morbidity in the form of maladaptive behavior, which can last weeks after anesthesia. Patients with developed ED present with psychomotor anxiety, agitation, and are at higher risk of unintentional extraction of an intravenous cannula, self-harm and nausea and vomiting. The described incidence of ED varies between 25–80%, with a higher prevalence among children younger than 6 years of age. We aimed to determine the incidence of ED in pediatric patients (>1 month) after general anesthesia in the post-anesthesia care unit (PACU), using Paediatric Anaesthesia Emergence Delirium (PAED) score, Watcha score and Richmond agitation and sedation scale (RASS). The incidence of ED was the highest in the PAED score with cutoff ≥10 points (89.0%, n = 1088). When using PAED score >12 points, ED incidence was 19.3% (n = 236). The lowest incidence was described by Watcha and RASS scores, 18.8% (n = 230) vs. 18.1% (n = 221), respectively. The threshold for PAED ≥10 points seems to give false-positive results, whereas the threshold >12 points is more accurate. RASS scale, although intended primarily for estimation of the depth of sedation, seems to have a good predictive value for ED. Full article

Background: The factors affecting cognitive function after treatment of subarachnoid haemorrhage (SAH) can be categorised into aneurysmal factors, procedural factors, and complications. The aim of this study was to investigate which of these factors has greater influence on the cognitive function. Methods: We retrospectively identified 14 patients with unruptured intracranial aneurysms (UIAs) and 34 patients with SAH with mild symptoms at disease onset (Hunt and Hess grade: >3). All patients underwent neuropsychological tests within 35 days of discharge from hospitalisation for treatment. The relationship between the clinical factors and each neuropsychological test score was evaluated using multiple linear regression analysis after controlling for age and years of education. Results: Patients with UIA showed greater cognitive impairment in visual memory and the frontal/executive domains. Hypertension was associated with cognitive impairment. Patients with SAH showed greater cognitive impairment in the visuospatial, verbal memory, and frontal/executive domains. The dome-to-neck ratio, aneurysms located in the posterior circulation, microsurgical clipping, procedure time, anaesthesia duration, and complications were associated with cognitive impairment. Conclusions: Underlying diseases, procedural factors, and complications contributed to cognitive impairment after treatment of intracranial aneurysms. Since the effect of each factor on each cognitive domain was slightly different, a more in-depth study of these effects is needed. Full article

This paper proposed a new depth of anaesthesia (DoA) index for the real-time assessment of DoA using electroencephalography (EEG). In the proposed new DoA index, a wavelet transform threshold was applied to denoise raw EEG signals, and five features were extracted to construct classification models. Then, the Gaussian process regression model was employed for real-time assessment of anaesthesia states. The proposed real-time DoA index was implemented using a sliding window technique and validated using clinical EEG data recorded with the most popular commercial DoA product Bispectral Index monitor (BIS). The results are evaluated using the correlation coefficients and Bland–Altman methods. The outcomes show that the highest and the average correlation coefficients are 0.840 and 0.814, respectively, in the testing dataset. Meanwhile, the scatter plot of Bland–Altman shows that the agreement between BIS and the proposed index is 94.91%. In contrast, the proposed index is free from the electromyography (EMG) effect and surpasses the BIS performance when the signal quality indicator (SQI) is lower than 15, as the proposed index can display high correlation and reliable assessment results compared with clinic observations. Full article

Objective: We aimed to compare intraocular pressure (IOP) measurements using iCare^® PRO rebound tonometry (iCare) and Perkins applanation tonometry (Perkins) in childhood glaucoma subjects and healthy children and the influence of anaesthesia depth, age and corneal thickness. Material: Prospective clinical, case-control study of children who underwent an ophthalmologic examination under general anaesthesia according to our protocol. Children were 45.45 ± 29.76 months old (mean ± SD (standard deviation)). Of all children, 54.05% were female. IOP was taken three times (T1–T3), according to duration and the depth of anaesthesia. The order of measurement alternated, starting with iCare. Agreement between the device measurements was evaluated using Bland–Altman analysis. Results: 53 glaucoma subjects and 22 healthy controls. Glaucoma subjects: IOP measured with iCare was at T1: 27.2 (18.1–33.8), T2: 21.6 (14.8–30.6), T3: 20.4 mmHg (14.5–27.0) and Perkins 17.5 (12.0–23.0), 15.5 (10.5–20.5), 15.0 mmHg (10.5–21.0) (median ± IQR (interquartile range)). Healthy controls: IOP with iCare: T1: 13.3 (11.1–17.0), T2: 10.6 (8.1–12.4), T3: 9.6 mmHg (7.7–11.7) and Perkins 10.3 (8.0–12.0), 7.0 (5.5–10.5), 7.0 mmHg (5.5–8.5) (median ± IQR). The median IOP was statistically significantly higher with iCare than with Perkins (p < 0.001) in both groups. The mean difference (iCare and Perkins) was 6.0 ± 6.1 mmHg for T1–T3, 7.3 at T1, 6.0 at T2, 4.9 mmHg at T3. Conclusion: The IOP was the highest in glaucoma subjects and healthy children at T1 (under sedation), independently of the measurement method. iCare always leads to higher IOP compared to Perkins in glaucoma and healthy subjects, regardless of the duration of anesthesia. Full article

Castration is one of the most frequently performed surgical procedures in livestock. All methods of castration are associated with a significant degree of pain, affecting the patients’ welfare. Limited information on species-specific protocols in buffaloes is available. Considering the importance of this species and the scarcity of reports available, the objective of this study was to evaluate the effects of two different intramuscular doses of xylazine for premedication in water buffalo calves undergoing isoflurane maintenance anaesthesia for routine castration surgery. Twenty clinically healthy male water buffaloes undergoing bilateral orchiectomy were randomly assigned to two groups of 10 animals each: Group 1 was premedicated with xylazine 0.1 mg/kg bw i.m. and Group 2 was premedicated with xylazine 0.15 mg/kg bw i.m. Anaesthesia was induced by ketamine (2 mg/kg bw i.v.) and maintained with isoflurane-oxygen-air in both groups. The HR, RR, presence/absence of ataxia, sedation, depth of anaesthesia, muscle relaxation status, response to acoustic and tactile stimuli, eyelid reflex, extent of salivation and stimulus were evaluated every 5 min. Both protocols provided consistent sedation and were safe. Faster and more satisfactory sedation was recorded when xylazine was administered at 0.15 mg/kg bw i.m., leading us to recommend this dose for buffalo orchiectomy. Full article

Controversy continues to surround the use of opioids in equine anaesthesia, with variable effects reported. This blinded clinical study aimed to investigate the influence of a low-dose fentanyl continuous rate infusion (CRI) on isoflurane requirements, parasympathetic tone activity (PTA), and anaesthetic parameters in horses during general anaesthesia. All of the twenty-two horses included in the research underwent a standard anaesthetic protocol. Eleven horses in the fentanyl group (Group F) received a loading dose of fentanyl at 6 µg/kg, followed by a CRI of 0.1 µg/kg/min during anaesthesia. A further 11 horses in the control group (Group C) received equivalent volumes of normal saline. Anaesthetic parameters and PTA index were recorded during anaesthesia. The achieved mean fentanyl plasma concentration was 6.2 ± 0.83 ng/mL. No statistically significant differences between groups were found in isoflurane requirements, MAP values, and mean dobutamine requirements. However, horses in Group F required a significantly lower dose of additional ketamine to maintain a sufficient depth of anaesthesia. Significantly higher PTA values were found in the fentanyl group. Further research is warranted to determine the limitations of PTA monitoring, and the influence of various anaesthetics on its values. Full article