BIS was useful for predicting changes in anesthetic depth at clinical dosages of inhalant anesthetics. Values of BIS, SEF, and MED were significantly higher during anesthesia induced by administration of sevoflurane than during anesthesia induced by administration of isoflurance at equivalent MACs.
Increasing abdominal pressure up to laparoscopic pressure (14 mmHg) provokes morphological changes in the liver, vascular structures and diaphragm. These changes could be related to functional alterations that different organs experience after the induction of pneumoperitoneum.
Cardiovascular diseases are a major health concern and therefore an important topic in biomedical research. Large animal models allow researchers to assess the safety and efficacy of new cardiovascular procedures in systems that resemble human anatomy; additionally, they can be used to emulate scenarios for training purposes. Among the many biomedical models that are described in published literature, it is important that researchers understand and select those that are best suited to achieve the aims of their research, that facilitate the humane care and management of their research animals and that best promote the high ethical standards required of animal research. In this resource the authors describe some common swine models that can be easily incorporated into regular practices of research and training at biomedical institutions. These models use both native and altered vascular anatomy of swine to carry out research protocols, such as testing biological reactions to implanted materials, surgically creating aneurysms using autologous tissue and inducing myocardial infarction through closed-chest procedures. Such models can also be used for training, where native and altered vascular anatomy allow medical professionals to learn and practice challenging techniques in anatomy that closely simulates human systems.
Human laparoscopic simulators have been used in medical education for minimally invasive surgery (MIS) in the past years. Simulator-based laparoscopic training has attracted much interest because unique skills have to be learned not only by surgeons in training but also by surgeons in practice. MIS forces the surgeon to adapt to monocular vision and decreased tactile sensation and entails training and improving hand-eye and hand-hand coordination. Those skills require a learning curve that could be overcome gradually with use of simulators. The Canine Laparoscopic Simulator (CLS) for laparoscopic training was developed based on the working and optical space obtained from computed tomography (CT) scan images of three Beagle dogs. Thirty veterinarians (expert group, n=7; novice group, n=23) performed basic laparoscopic exercises in one training session on the CLS. During the performance of the exercises, an experienced laparoscopic veterinarian assessed all the tasks. Afterwards, participants were asked to complete an anonymous survey describing their experience. Most participants expressed positive opinions about the design and usability of the CLS. There were no significant differences between the two groups' opinions. The CLS showed good preliminary acceptance in the basic laparoscopy tasks by veterinarians. They perceived it to be a good training tool, and these results suggest that CLS is an engaging tool for education but still has some limitations inherent in training boxes. Further studies would be needed to establish the validity of training programs performed in the CLS.
SINERGIA laparoscopic virtual reality simulator is able to discriminate subjects according to their level of experience in laparoscopic surgery; therefore, it can be used within a training program as an assessment tool.
SummaryThe aim of this study was to determine and compare the degree of hypnosis achieved during propofol or sevoflurane anaesthesia in rabbits using bispectral index (BIS), and to evaluate its usefulness as a predictor of both haemodynamic changes during anaesthesia and recovery times. Twenty adult male New Zealand White rabbits, average weight 4.470.4 kg, were used for this study. Animals were randomly allocated to one of two groups with 10 rabbits/group. An electroencephalographic recording was obtained from each conscious rabbit prior to drug administration. All animals received buprenorphine as a preanaesthetic medication (0.05 mg/kg, intravenous [i.v.]). Anaesthesia was induced with propofol (8 mg/kg, i.v.) in all animals; 10 rabbits were maintained with sevoflurane via inhalation (1 minimum alveolar concentration -end-tidal sevoflurane concentration of 3.7% -at a fresh gas flow rate of 3 L/ min; group I), and 10 were maintained with i.v. propofol (0.6 mg/kg/min; group II). The rabbits were orotracheally intubated and spontaneous ventilation was maintained throughout the study (100% oxygen). After abdominal surgery through a ventral midline laparotomy, rabbits were allowed to recover from anaesthesia. Cardiovascular variables and BIS values were recorded at intervals throughout the procedure, as was the duration of recovery from anaesthesia.In both groups, mean BIS values were significantly decreased immediately after induction, compared with baseline values obtained during consciousness. Anaesthetic depth (evaluated by clinical observation) was similar in both groups; however, group II rabbits had significantly higher (Po0.001) BIS values from 30 s before incision until anaesthesia was discontinued. There was no significant difference in BIS recorded 1 and 5 min after incision as compared with values obtained 30 s before incision in either group.During sevoflurane or propofol administration, correlations were found between BIS values and mean arterial blood pressure (MABP), and between BIS values and heart rate (HR).Mean BIS values at discontinuation of administration of the anaesthetic agent were greater in group II (69.176.0) than in group I (49.372.2). However, recovery from anaesthesia was significantly longer in group II (38.477.2 min) than in group I (11.572.5 min).In conclusion, BIS can be used to differentiate between conscious and unconscious states during anaesthesia in rabbits. BIS values derived from an electroencephalogram at the end of anaesthesia were not useful for predicting the speed of anaesthetic recovery in sevoflurane or propofol-anaesthetized rabbits undergoing abdominal surgery. Despite the correlation found Correspondence: Marı´a Fernanda Martı´n Cancho, Minimally
The most important subtasks during suture learning process are needle puncture and first knot. The TMA could be a useful objective assessment tool to discriminate surgical experience and could be used in the future to measure and certify surgical proficiency.
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