Little information is available about the management of adrenalectomies in veterinary anaesthesia. The aim of this study was to describe the anaesthetic techniques, the complication rate and outcome of these cases. Data were collected retrospectively from patients' records. Descriptive statistics were performed with Student's t-tests and Chi-square tests where appropriate. Forty-one cases were included. The mean age was 124.7 ± 29.4 months and the median body weight was 23.1 kg (5.3–69 kg). Carcinoma was the most common diagnosis (34.1%). Premedication was most commonly achieved with methadone alone (70.7%) IV. Propofol was the most common induction agent (39%). An infusion of opioids (80.4%) and an epidural injection of morphine (70.7%) were the most common analgesic techniques. Hypotension was the most common complication observed (51.2%). The mortality rate was 14.6%. The lowest recorded oesophageal temperature was statistically associated with the incidence of haemorrhage (P = 0.025). The invasion of the vena cava (P = 0.001) was significantly associated with haemorrhagic complications. The survival rate was better when patients received hydrocortisone intra-operatively (P = 0.026). This study highlights some possible association between the anaesthetic management and the outcome of the procedure.
A two-year-ten-month colt was referred for investigation and surgical treatment of cryptorchidism. Preanaesthetic clinical examination revealed no abnormalities and no relevant history was reported. The patient was anaesthetised with a total intravenous anaesthesia technique, both testicles were identified after induction, and a bilateral open castration was performed in the recovery box. Surgery, anaesthesia and recovery were uneventful. However, in the first hour postrecovery, clinical signs compatible with pulmonary oedema developed. Following arterial blood sampling and airway endoscopy, a low-grade pulmonary oedema was suspected and alleged to have occurred following transient laryngeal spasm. The patient was treated symptomatically and received supportive care. Two days after the surgery, the clinical signs were resolved, and the patient was discharged.
An 8-year and 2-month-old 37.2 kg crossbreed dog was presented with a persistent cough. Thoracic computed tomography was performed and identified a large lobar mass sitting within the left main stem bronchus. The mass was deemed operable, but considering the unique technical challenges associated with the surgery (need for specific ventilation strategies and risk of major haemorrhage) a guarded prognosis was given. A total left-sided pneumonectomy via a lateral thoracotomy was performed. One-lung ventilation was required in order to allow surgical access. During the surgery, the dog suddenly developed atrial fibrillation, which converted back to a normal sinus rhythm (SR) during the recovery period. The dog recovered uneventfully following the return to SR and was discharged 72 hours after the surgery. Histopathological results of the lung mass concluded to a primary pulmonary chondrosarcoma.
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