No abstract

No abstract

BackgroundPost‐anaesthetic sedation is administered to horses to improve recovery quality from inhalant anaesthesia and reduce the risk of catastrophic injury. A single dose of dexmedetomidine for this purpose has not been evaluated clinically.ObjectivesTo determine whether dexmedetomidine improves recovery quality from sevoflurane anaesthesia compared to a previously studied dose of romifidine.Study designProspective, randomised, masked clinical trial.MethodsNinety‐nine, adult, client‐owned horses anaesthetised for elective procedures completed the trial. Anaesthetic protocol was standardised. Horses were randomly assigned to receive either dexmedetomidine 1 mcg/kg bwt (D) or romifidine 20 mcg/kg bwt (R) intravenously at their first spontaneous breath in recovery. Recoveries were reviewed and independently assigned subjective visual analogue scale (VAS) scores (0‐100 mm, worst to best) for overall quality and standing ataxia scores (1‐4, none to severe) by two anaesthesiologists blinded to treatment group. Objective anaesthesia and recovery data were also recorded. Comparisons were made using the Chi‐square, Wilcoxon rank sum, linear models or Welch‐Satterthwaite two‐sample t‐test (P ≤ .05). Predictors of VAS score were analysed independent of treatment group.ResultsThere were no significant differences between groups except end‐tidal sevoflurane (FE´Sevo) concentration and post‐induction extra ketamine dosing. Including FE´Sevo and additional ketamine in the analysis as covariates, VAS scores and time to standing were not significantly different between groups. Increased age, not receiving a nerve block, increased duration of hypotension, and having a nervous temperament were significant predictors of VAS score.Main limitationsNo universal recovery scale exists for inter‐study comparisons.ConclusionsAfter sevoflurane anaesthesia, sedation with dexmedetomidine or romifidine provides clinically similar recovery time and quality.

No abstract

Headstand, the king of all yoga poses, requires practitioners to support the full body with the forearms and crown of the head. A goal of novice and expert practitioners alike, sirsasana performance technique significantly modifies head and neck loads. This study examined the weight-bearing responsibility of the head and neck (separate from the arms) at moments of peak force during entry, stability, and exit of three typical performance methods. The three methods were: symmetrical extended leg (SE), symmetrical flexed leg (SF), and asymmetrical flexed leg (AF). Three groups of 15 participants each (2 males, 13 females) were formed, each group performing one technique. All 45 subjects (18-60 years of age) reported an active yoga practice including sirsasana with no record of cervical injury. After a 10 min warm up, participants performed three headstands.Kinematic and kinetic Vicon data were analyzed to locate peak forces acting on the head, loading rate of those forces, center of pressure, and neck angle at C3 in the frontal plane.Force plate data revealed flexed leg techniques produced the greatest forces during entry and nominal forces on exit. The SE condition produced lower forces on entry as well as vi slower loading rates during stability. In the frontal plane, neck angle about C3 tended towards neutral, or natural cervical lordosis, in SE and flexion in SF and AF during entry.COP showed no significant differences between groups; however, lateral movement at the apex of the head was markedly larger than movement in the sagittal plane for all techniques. Previous research has shown flexed loading, rapid loading and larger loads can increase potential damage to the cervical spine especially in women and aging individuals. As that population is heavily represented in yoga studios, the data support the conclusion that modifying headstand technique may reduce some of the mechanical risks of headstand.vii Since its introduction into American culture just over a century ago, yoga has gained popularity as a modern method of obtaining states of meditation, wellness and physical fitness. Now a 6 billion dollar industry, this ancient mind-body practice has more than 15.8 million Americans regularly coming to their mats to reap the studied stress-relieving benefits of practice (YIAS, 2008). Practitioners pour into yoga studios to perform complex postures and conscious breathing exercises shown to collectively reduce stress, improve mood, bolster immunity, increase flexibility, improve sleep and aid in recovery processes (Curtis, 2011;Cohen, 2004;Bower, 2005;Gururaja, 2011;Hegde, 2011). However as the study of physiological aspects of yoga move forward in the scientific literature, the biomechanical aspects of what actually takes place on the mat are being ignored. Yoga practices often ask the body to move into uncommon positions.Inquiry into the structural impact of these potentially more risky positions is needed due to the repetitive nature of yoga practice, the lack of biomechanical research in this arena, and yoga...

No abstract

OBJECTIVE To investigate the effects of orally administered trazodone on intraocular pressure (IOP), pupil diameter measured in the vertical plane (ie, vertical pupil diameter [VPD]), selected physical examination variables, and sedation level in healthy equids. ANIMALS 7 horses and 1 pony. PROCEDURES Food was withheld for 12 hours prior to drug administration. After baseline (time 0) sedation scoring, physical examination, and measurement of IOP and VPD, equids received 1 dose (approx 6 mg/kg) of trazodone orally. Examination and measurement procedures were repeated 0.5, 1, 2, 4, 8, 12, and 24 hours after drug administration. Blood samples were collected at each time point for analysis of plasma trazodone concentrations. Repeated-measures analysis was used to compare examination results between downstream time points and baseline. RESULTS 7 of 8 equids had mild sedation from 0.5 to 8 hours after treatment; compared with baseline values, mean IOP was significantly lower from 0.5 hours to 8 hours, mean VPD was significantly smaller at 0.5 hours, and mean rectal temperature was significantly lower from 1 to 8 hours after drug administration. Adverse effects (signs of excitement in 1 equid and sweating in 4) were self-limiting and considered minor. Mean maximum plasma concentration of trazodone was 1,493 ng/mL 0.75 hours after administration, and terminal half-life of the drug was 9.96 hours. CONCLUSIONS AND CLINICAL RELEVANCE The described oral dose of trazadone elicited sedation with a few self-limiting adverse effects in the study sample. Drug effects on IOP and VPD may alter ocular examination findings. Further investigation is warranted prior to use of trazodone for sedation in equids, particularly those with ophthalmic conditions.

BackgroundPheochromocytomas have been previously reported in horses, but successful antemortem diagnosis and surgical removal without recurrence of clinical signs have not been described.ObjectiveTo report the clinical presentation, diagnostic evaluation, surgical technique, anaesthetic management and post‐operative care of a mare diagnosed with pheochromocytoma.Study designClinical case report.MethodsAn 18‐year‐old Quarter Horse mare presented for recurrent episodes of colic, profuse sweating, muscle fasciculations and agitation over a 2‐month period. Clinical, clinicopathologic and ultrasonographic (transcutaneous, transrectal) abnormalities were consistent with a unilateral left‐sided adrenal mass. Surgical removal of the mass was performed via a trans‐costal approach with removal of the 18th rib and retraction of the left kidney to improve exposure. Associated vasculature was ligated, and the adrenal mass was removed and submitted for histopathology and immunohistochemistry.ResultsA trans‐costal surgical approach provided excellent visualisation of the adrenal mass and allowed for identification and ligation of associated vessels. Total surgical and anaesthesia time were 86 and 114 min, respectively. Several intraoperative (hypertension, tachycardia) and post‐operative (colic with tachycardia, tachypnea, large colon pelvic flexure impaction and nasogastric reflux) complications were encountered and managed successfully. Immunohistochemistry demonstrated positive labelling for synaptophysin and chromogranin A, confirming diagnosis of pheochromocytoma. The mare had recovered well at 6‐week recheck post‐operatively and returned to training at 6 months post‐operatively. No further clinical signs consistent with pheochromocytoma have been observed following removal.ConclusionsThe trans‐costal approach allowed for surgical removal of a pheochromocytoma in a mare. Surgical removal of adrenal masses in horses may be associated with complications yet was successfully performed without subsequent recurrence of clinical signs associated with tumour presence and return to athletic use in this mare.