A 12‐year‐old, neutered, male, domestic shorthair cat presented for investigation of acute‐onset respiratory distress and cough. Computed tomography scan showed bilateral pleural effusion and dorsal elevation of the trachea compatible with a mass effect. A median sternotomy was performed. Anaesthetic protocol consisted of premedication with intravenous methadone (0.2 mg/kg), induction with alfaxalone to effect and maintenance with isoflurane in oxygen. Transversus thoracic muscle plane block was performed injecting 0.4 mL/kg of 0.25% bupivacaine per side. Fentanyl (2 μg/kg) was administered as rescue analgesia once during surgery. The Glasgow Composite Pain Scale was assessed postoperatively. Methadone was given as rescue analgesia postoperatively when Glasgow pain score was greater than 5/20. The first administration of methadone was required at 8 hours after the transversus thoracic muscle plane block was performed. This case showed that the ultrasound‐guided transversus thoracic muscle plane block is a feasible technique in feline patients as part of a multimodal analgesia plan in a cat undergoing sternotomy.
A 2‐year 8‐month‐old female dobermann presented for a recheck after previous crown reduction and vital pulp therapy. On cardiac auscultation, rapid and irregularly irregular heart rhythm and irregular and asynchronous pulses were detected. On electrocardiogram and transthoracic echocardiogram, findings were suggestive of constrictive pericarditis complicated with bi‐atrial enlargement and atrial fibrillation. Subtotal pericardiectomy was performed. The patient was premedicated with methadone (0.2 mg/kg intravenously), and anaesthesia was induced with midazolam (0.2 mg/kg intravenously) and propofol (60 mg), and maintained with isoflurane in oxygen. Constant‐rate infusions of fentanyl (0.1–0.2 µg/kg/min) and lidocaine (50 µg/kg/min) were administered. Dobutamine (1–5 µg/kg/min) helped to maintain mean arterial blood pressure above 65 mmHg. Fluid resuscitation and noradrenaline infusion (0.1 µg/kg/min) started after constriction was released to optimise preload. Haemodynamic support and ventricular rate control continued during the immediate postoperative period. Recovery from general anaesthesia was uneventful.
A four-month-old male Springer Spaniel presented for investigation of ascites of three weeks’ duration. On transthoracic echocardiogram, cor triatriatum dexter was diagnosed with associated right-sided congestive heart failure. Medical therapy consisting of furosemide, spironolactone and benazepril was initiated. On the day of surgery, the dog was premedicated with methadone 0.2 mg/kg intravenously, and general anaesthesia was induced with midazolam 0.2 mg/kg intravenously and propofol 25 mg. Anaesthesia was maintained with isoflurane in oxygen. Concurrently, constant rate infusions of fentanyl 0.2–0.3 µg/kg/minute and lidocaine 50 µg/kg/minute were administered. Ventricular premature complexes and ventricular tachycardia developed during the placement of the catheter and during the first balloon dilation. Antiarrhythmic therapy with lidocaine 2 mg/kg was required. At the end of the procedure, acepromazine 5 µg/kg intravenous and buprenorphine 20 µg/kg intravenous were administered. Recovery from general anaesthesia was uneventful.
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