Monoamine oxidase inhibitors (MAOIs) are widely accepted as effective antidepressants. Unfortunately their use has been limited by their capacity to potentiate dietary tyramine (the so called "cheese effect") and their interaction with other drugs. The latter poses a particular problem for patients undergoing anaesthesia. Traditional advice has been to stop MAOI therapy 2 weeks prior to anaesthesia. With the advent of reversible, specific inhibitors of MAO-A (RIMAs) there is less potential for dietary and drug interaction. While experience with these newer drugs is limited so far, this review suggests that combination of modern anaesthetic techniques and newer, specific reversible MAOIs should allow safe anaesthesia with maintenance of antidepressant therapy.
Squamous cell carcinoma (SCC) is a common dermatological neoplasia found in large animal species. Treatment options, such as surgery and cryotherapy may be difficult or not feasible. Alternative therapies, such as immunomodulating drugs, can potentially be used for companion large animals. The hypothesis of the following retrospective study is: following multiple intravenous and intralesional injections of a mycobacterial cell wall stimulant (MCW) regression of SCC in equine, bovine and caprine patients will be observed. In this observational-retrospective case series, patients included are 2 bovine, 2 caprine and 3 equine patients. The medical records at two different teaching veterinary hospitals were searched for cases with a positive histopathological diagnosis of squamous cell carcinoma that were subsequently treated with MCW, as either the sole therapy, or in conjunction with other therapies. Seven cases were included in this retrospective study. The median duration of therapy was 56.5 days, with 3 of the 7 patients being euthanized. Significant complications were seen in 3/7 patients. Repeated injections of a MCW may lead to reduction in lesion size of SCC in some cases, but long-term resolution is unlikely and the risk of significant complications is high; due to limited sample size and the variety in species, it is difficult to conclude if MCW is an effective therapy for SCC.
SummaryA 2% solution of propojol has been compared with the I% fiwmulation for sedation in patients whose lungs were being mechanicolly ventilated in an intensive care unit ,fbIlowing coronary artery bypass surgery. There were no significant di3erences in the amount qfprop?fol used in the two groups, the rate of propofid infusion or the number of changes made to the infusion rate to maintain the desired level of sedation. Recovery times and times to tracheal extubation were similar. The mean heart rates of those receiving 2% propofd were significantly higher throughout the period of the study for no apparent reason. Propofbl 2% n.as ,found to be sufi. easy to administer and a practical alternative to Ihe I% solution .for sedating cardiuc surgicul patients.
SummaryWe have studied the effects of the epidural administration of diamorphine 0. I mg/kg at the L , interspace on somatosensory evoked potentials in the cervical epidural space before corrective surgery for idiopathic adolescent scoliosis. A further eight patients in whom anaesthesia was maintained with a propofol infusion acted as a control group. Epidural diamorphine had no effect on the latency or amplitude of the evokedpotentials. We conclude that epidural diamorphine is a suitable technique to use in scoliosis surgery because of its lack of eflect on neurophysiological variables, although the potential respiratory problems need investigation.
Limited knowledge exists regarding the use of lidocaine as a prokinetic in ruminants and camelids to treat gastrointestinal ileus. In this retrospective study, ruminant and camelid cases diagnosed with ileus and treated with a lidocaine constant rate of infusion were assessed for adverse reactions and medical outcomes. A review of medical records was performed to identify cases in which lidocaine was administered as a prokinetic. Ten cases were identified consisting of 8 cattle, 1 goat, and 1 alpaca. Nine animals improved with a lidocaine treatment. No adverse effects were reported during lidocaine administration. Nine animals were discharged, and 1 was euthanized.
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