From: russ@wpg.com (Russell Lawrence)
Subject: anesthesia of LSU cats.  Was: Hypothetical case 
Organization: WP Group
Date: Thu, 28 Jan 1993 06:40:31 GMT

From article <1993Jan26.230142.23075@samba.oit.unc.edu>, by itsmine@med.unc.edu (Greg Popken):
> In article <C1FI3I.FG2@wpg.com> russ@wpg.com (Russell Lawrence) writes:
>>And, do you think they would report negative information, such as 
>>the allegations of sub-standard anesthesia in the "cat shooting" 
>>experiments?  
> 
> I can't believe you are still pushing this cat shooting thing.  Give it up
> Russell!  There is no evidence that substandard aneshesia was used.

Yes, there is.  I agree that much of the evidence isn't in the 
official record (yet), but the material that is available is more
than sufficient to justify the project's cancellation.

I've taken the time to keyboard some of the relevant passages 
from the report published by the General Accounting Office.  As 
you read through the material, kindly remember that we're 
discussing a project that was conducted by trained MD's with 
scientific experience who understood (or should have understood) 
the importance of notes.  

   "GAO found that anesthesia doses and the times they were
    administered were recorded for only 20 to 25% of the animals
    used in the research.  On the basis of a review of the anesthesia
    records GAO obtained from LSU researchers, the veterinary
    anesthesiologists doubted there was comparability in the depth
    of anesthesia among cats used in the experiment"  
    
   "Postoperative care for animals allowed to awaken from anesthesia
    is important in order to interpret physiological and behavioral
    changes that may be caused by experimental procedures, such as
    injury, or by anesthesia or pain.  Further, standardized post-
    operative care procedures are needed to ensure that research
    data for all animals used in the research are comparable.  However,
    the research team did not consider postoperative care factors
    important to the research.  The veterinary anesthesiologists
    GAO consulted identified several factors that suggest 
    deficiencies in postoperative care, such as the lack of detailed
    records to confirm that uniform care was provided to all 
    animals.  The veterinary anesthesiologists pointed out that 
    careful management of the postoperative period (that is,
    monitoring such factors as body temperature, fluid balance,
    and reflexes) is important to distinguish between the 
    recovery of treated and untreated animals to identify effective
    drug treatments.  GAO was not able to obtain sufficiently
    detailed records to answer the anesthesiologists questions
    about postoperative care.  [GAO/HRD-91-30, Army Biomedical 
    Brain-Wound Research, p 5]
    ...
   "The veterinary anesthesiologists indicated that it is 
    extremely important that the general anesthesia be administered
    in a careful and controlled manner so that the reactions of 
    study and control animals can be compared.  In this way, any
    changes that occur will be the result of the trauma rather
    than the anesthetic.  Many anesthesiologists have found,
    one veterinary anesthesiologist explained, that (1) brain 
    disease, tumors, and trauma modify brain function and blood
    flow, and (2) the effects of anesthetic agents are 
    unpredictable.  Therefore, he continued, in any cerebral
    trauma model it is important that the depth of anesthesia
    be precisely controlled so that any changes that occur ---
    which can be due to changes in cerebral autoregulation,
    blood flow, or metabolism --- are due to the damage and not
    to changes in carbon dioxide, anesthetic levels, or body
    temperature.

   "In the documentation they reviewed, the veterinary anesthesiologists
    saw no evidence that the dose of anesthesia was precisely
    regulated so that the depth of anesthesia was controlled.  Further,
    because the anesthetic was administered IP and maintained with
    bolus IV injections, the depth of anesthesia and the duration
    could vary during and between experiments.

   "For the most part, anesthesia records were not kept on individual
    animals used in the experiments.  LSU did not believe such
    records were important; it indicated that although specific
    anesthesia data generally were not recorded, protocols 
    applicable to the 33 experiments were followed (see app. III
    for protocols).  We found that when records were kept, however,
    doses actually given varied significantly and do not agree
    with the protocols.  [ibid, p 24]

Get the picture, Greg?   I'm sure you'll agree that an uncontrolled
variable as important as anesthesia is going to have a tremendous
impact on the reliability of the data.   [BTW, if you want to discuss
the ethical and scientific ramifications of the anesthesia, I'd
be happy to oblige, but I truly don't want to get into an interminable
round of quibbling.]

Let's turn to the issue that was raised in the Sixty Minutes broadcast,
namely the quality of postop analgesia.  The GAO report documents
some of the problems, as well as a glaring contradiction in the 
testimony of the researchers:

   "We discussed with veterinary anesthesiologists the issue of
    postoperative pain.  Two anesthesiologists noted that the wound
    itself would not cause pain since the brain has no nerve
    endings.  Yet three anesthesiologists believe that the animals
    would experience pain from (1) the incisions made to insert
    various catheters and monitors and to remove the anterior
    wall of the right frontal sinus and (2) any swelling that might
    result from the injury.  Four anesthesiologists stated that
    the animals used in the research would require postoperative
    analgesics.  One anesthesiologist commented that a topical
    anesthetic ointment is insufficient for pain relief since the
    ointment has poor tissue penetration and provides relief for
    only 6 to 7 minutes.

   "During our visit to LSU, we interviewed the veterinarian who
    has cared for the brain-wounded animals in the LSU animal care
    facility.  Individual records detailing the postoperative care
    and recovery for each animal were not maintained.  However,
    the veterinarian told us that he treated them for the pain
    with butorphanol tartrate, an analgesic drug.  In addition, he
    stated, the animals receive fluids by subcutaneous injections,
    but are not force-fed or supported through any other nutritional
    means.

   "We recounted the meeting with the LSU veterinarian in discussions
    with research team members.  They indicated that they were unaware
    that the animals received analgesics, saying that they had not
    ordered any and would object to their use.  However, the team did
    not believe that anything that might have been done in the animal
    care facility had affected the research results.  In a meeting with
    LSU officials 2 months later, we received a signed statement from
    the LSU veterinarian stating that he had given analgesic to only
    one animal. [ibid, pp 27-28]

As you know, a group of ambitious men who have little regard for 
the truth may stoop to weave any story that suits their 
convenience if it helps them to get what they want.  In the case 
at hand, however, it's clear that these folks were faced with 
scary options whichever way they chose to turn.  If they had 
maintained the claim that the animals had received analgesics, 
it's likely that scientific questions would have been raised 
about the integrity of their data.  On the other hand, the 
absence of analgesics raised the spectre of the local activists, 
backed by a substantial and growing segment of the New Orleans 
community.  [By the time the GAO investigation got underway, Carey 
had become the butt of nasty jokes in some affluent circles that 
normally wouldn't care less about most AR issues].  

If you understood the mindset that prevails in medico-political 
circles at LSU, you'd probably agree with me that it's no mystery 
that the notes re: anesthesia and analgesia were missing or 
non-existent [not to mention the fact that there were some gross 
descrepancies between the number of reported and unreported 
experiments].  In effect, the missing/nonexistent notes allowed 
the researchers to respond more freely to the government 
inquiries.  Such tactics would work well in combatting local 
malpractice suits, but they surely wouldn't satisfy a scientist 
like yourself who prefers truth to lies, regardless of the
political consequences.

-- 
Russell Lawrence, WP Group, New Orleans (504) 443-5000
russ@wpg.com   uunet!wpg!russ