OBJECTIVE-To evaluate a laparoscopic technique for implantation of a urinary catheter in the right paramedian area in male sheep and to determine feasibility, benefits, and risks for this technique. DESIGN-Evaluation study. ANIMALS-6 Healthy male sheep (mean +/- SD body weight, 42.16 +/- 11.95 kg [92.75 +/- 26.29 lb]). PROCEDURES-Each sheep was anesthetized and positioned in dorsal recumbency. A 10-mm laparoscope was inserted in the right paramedian area between the xiphoid and preputial orifice. After creation of capnoperitoneum, grasping forceps were inserted in the left paramedian area at the level of the teats and used to immobilize the urinary bladder. A pigtail balloon catheter was implanted transcutaneously in the right paramedian area between the preputial orifice and teats and directed into the urinary bladder by use of laparoscopic guidance. The catheter was removed 10 days after implantation. Fourteen days after initial surgery, a second laparoscopy was performed to evaluate pathologic changes. RESULTS-Inadvertent insertion of the first trocar into the rumen of 1 sheep was the only intraoperative complication encountered. Laparoscopic-assisted implantation of the urinary catheter was successfully performed in all sheep. No postoperative complications were detected. CONCLUSIONS AND CLINICAL RELEVANCE-Laparoscopic-assisted implantation of a urinary catheter in the right paramedian area was successfully performed and may be a feasible method for use in sheep. This method can be considered as an alternative to tube cystotomy performed by laparotomy.
The treatment of acute respiratory failure in infants by means of extracorporeal membrane oxygenation (ECMO) is thought to be associated with a treatment-related inflammatory reaction, which may deteriorate the underlying disease process. The aim of this study was to compare the venoarterial (VA) and venovenous (VV) modality of ECMO with regard to their pulmonary and serological cytokine release during rescue from acute hypoxia. The inflammatory response was measured in piglets undergoing hypoxic ventilation with a gas mixture of 92% N 2 and 8% O 2 , which were then rescued through VA-(n = 5) or VV-ECMO (n = 5). The effect of cannulation and anesthesia on the inflammatory response was deducted from regularly ventilated control animals (n = 5). The concentrations of the proinflammatory interleukins (IL)-1 and IL-8 increased in the bronchoalveolar lavage fluid of all groups over a study period of 5 h but were significantly higher (P < 0.05) during VA-ECMO treatment, whereas the anti-inflammatory IL-10 concentrations were significantly higher in the bronchoalveolar lavage fluid of VV-treated animals (P < 0.001). No statistical difference between groups was found in the serum concentrations of cytokines. We conclude that in this animal model rescue from hypoxia by means of the VA modality of ECMO leads to a more pronounced inflammatory reaction of the lung than when applying the VV modality.
With appropriate care it was possible to obtain a reproducible curvature in immature sheep. The methods described are suitable for use in studies of growth modulation and other spinal devices.
Aim: To describe a technique of laparoscopic-assisted cystotomy in male sheep. Experimental animals: five healthy male sheep aged approximately nine months (mean weight: 39.6 ± 1.51 kg). Laparoscopy was performed on sheep placed under general anaesthesia in dorsal recumbency. A 10-mm laparoscope was inserted through the right paramedian region between the xiphoid and preputial orifice. After creation of a capnoperitoneum, grasping forceps were inserted through the left paramedian region close to the last pair of teats. The urinary bladder was elevated using grasping forceps and exteriorized through an abdominal incision. The bladder was opened extracorporeally, lavaged, closed, and then repositioned. A pigtail balloon catheter was subsequently inserted percutaneously under laparoscopic control and removed ten days later. A repeat laparoscopy was performed at 14 days after the first procedure to assess gross pathological changes. Laparoscopic-assisted cystotomy was successfully performed on all sheep. In one sheep, both the ventral and dorsal bladder walls were inadvertently perforated when placing the urinary catheter. The postoperative course was favourable: all sheep had a good appetite and showed no pathological findings during physical examination. During the repeat laparoscopy, it was observed that one sheep had developed a focal adhesion of the parietal peritoneum to the bladder catheter portal site. Laparoscopic-assisted cystotomy with catheter implantation is shown to be feasible in male sheep. This technique may be useful for removal of uroliths in patients suffering from obstructive urolithiasis opening the urinary bladder and for performing urinary diversion.
The purpose of the study was to assess the haemodynamic (blood pressure and heart rate) changes and stress responses (serum cortisol and serum amyloid A [SAA] concentrations) to surgery in piglets during total intravenous anaesthesia (TIVA) with propofol and fentanyl. After preanaesthetic medication with intramuscular midazolam (0.5 mg/kg body mass), ketamine (10 mg/kg) and butorphanol (0.5 mg/kg) anaesthesia was induced in five piglets, with intravenous propofol (1 mg/kg) followed by tracheal intubation and mechanical lung ventilation. Soft tissue surgery was performed in the jugular and inguinal regions during TIVA with propofol (8 mg/kg/h) and fentanyl (35 mg/kg/h). Anaesthesia was maintained for 300 min after surgery as the piglets were the control group of a project involving extracorporeal membrane oxygenation. Mean plasma cortisol concentration decreased significantly (P , 0.05) from 59 + 39.9 nmol/L (mean + 1 SD) before surgery to 7.5 + 2.5 nmol/L 300 min after end of surgical procedure. The mean SAA concentrations increased over the same period from 1.6 + 2.3 mg/mL to 4.2 + 5.6 mg/mL without statistical significance. The baseline ( presurgery) mean arterial pressure (MAP) was 72 + 9 mmHg compared with 72 + 11 mmHg 300 min after end of surgery. Neither heart rate nor lactate concentrations changed significantly over the same time points: heart rate was 104 + 11 and 103 + 15 beats/min whereas mean lactate concentrations were reduced from 1.14 + 0.45 mmol/L to 0.90 + 0.22 mmol/L. Haemodynamic stability, a decrease in serum cortisol and a non-statistically significant rise in mean SAA concentrations suggest that the anaesthetic described suppresses the stress response of piglets to surgery without adverse cardiovascular effects. Therefore, it may prove useful in cardiovascular research.
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