bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of i.v. metoclopramide, atropine and their combination on gastric insufflation in children anaesthetized with sevoflurane and nitrous oxide
Authors: Suga Akihiko , Tanaka Makoto , Toyooka Hidenori 
Published: March 2003

Methods: To determine effects of i.v. metoclopramide, atropine and their combination on the airway pressures at which gastric insufflation occurs in children, 45 healthy infants and children (ASA I) received an inhalational induction of anaesthesia with sevoflurane, N2O and O2. A blinded observer used a stethoscope to auscultate over the upper abdomen for any air entry. First, proximal airway pressure was slowly increased by closing the pop‐off valve of the anaesthesia machine until gas was heard entering the stomach (pop‐off point, control measurement). If the peak inspiratory pressure reached 40 cm H2O, the patient was to be excluded from the study. Then, all subjects randomly received i.v. atropine 0.01 mg·kg–1, metoclopramide 0.2 mg·kg–1, or atropine 0.01 mg·kg–1 plus metoclopramide 0.2 mg·kg–1 (n=15 each), and determination of the pop‐off point was repeated 5 min later. The stomach was evacuated before each measurement. Results: Atropine significantly decreased the pop‐off point [from 21 ± 3 to 19 ± 2 cm H2O (mean ± SD), P < 0.05], while metoclopramide significantly increased the pop‐off point (from 20 ± 3 to 26 ± 6 cm H2O, P < 0.05). The combination of metoclopramide and atropine did not alter the pop‐off point (from 20 ± 2 to 19 ± 5 cm H2O). Conclusions: Since metoclopramide exerts only mild effect on the pop‐off point, cricoid pressure still remains the standard anaesthetic practice to prevent gastric insufflation in children. Prophylactic i.v. metoclopramide may be restricted to, and its clinical usefulness should be determined in, symptomatic patients with gastro‐oesophageal reflux.
Monitoring of pacemaker induced changes in cardiac output with inspired to endtidal oxygen difference in paediatric cardiac surgery patients
Authors: Bengtsson Jan , Edberg Karl Erik , Nilsson Boris , Bengtson Jan Peter 
Published: March 2003

Methods: Fourteen children aged 4–15 months were studied after corrective cardiac surgery. Heart rate was increased by 20% with an external pacemaker. Cardiac output (CO) was measured with thermodilution. Oxygen saturation was measured in systemic artery (SaO2), central vein (ScvcO2) and pulmonary artery (SvO2). Inspiratory to endtidal oxygen difference (FI‐ETO2) was measured using a paramagnetic technique. SvO2 was measured continuously using a spectrophotometric technique. Results: CO increased in three patients and decreased in 11 patients during pacing. Regression between ΔCO and Δ(1/Sa‐vO2), Δ(FI‐ETO2/Sa‐vO2), Δ(FI‐ETO2/Sa‐cvcO2) showed r=0.70, r=0.76 and r=0.75, respectively. ΔCO exceeded 10% in 17 of 26 interventions. Changes in FI‐ETO2 of equal direction as changes in CO occurred in 12 of these 17 interventions. Conclusions: Estimations of CO changes, based on SvO2, can be enhanced if changes in FI‐ETO2 are also measured. ScvcO2 instead of SvO2 gives equivalent results. Sudden changes in FI‐ETO2 after pacemaker initiation or termination can predict the direction of CO changes.
Accuracy and limitations of continuous oesophageal aortic blood flow measurement during general anaesthesia for children: comparison with transcutaneous echography‐Doppler
Authors: Wodey Eric , Gai Valerie , Carre François , Ecoffey Claude 
Published: March 2003

Background: Because it is noninvasive and easy to use, oesophageal Doppler ultrasonography appears to be a worthwhile alternative for continuous assessment of cardiac output measurement during anaesthesia. A new oesophageal Doppler‐echography device (Dynemo 3000™, Sometec, Paris, France) can simultaneously determine aortic diameter and aortic blood flow at the same anatomical level (DEeso). The purpose of this study was to assess the accuracy and the potential limitations of this device during general anaesthesia among 20 children, using transcutaneous Doppler‐echocardiography for comparison (DEtra). Methods: The reproducibility of paired measurements of mean aortic blood flow velocity (MAFV), aortic diameter (ØAo) and aortic blood flow (ABF) was analysed with both methods. Second, haemodynamic values were measured simultaneously in a blinded manner by both methods before and after surgery. Results: The percent change (%Δ) in MAFV and ABF was calculated with both methods for each child. The age and weight of children included in this study was 8.3 ± 2.5 years and 27 ± 8 kg, respectively. Intraoperator reproducibility of MAFVtra, ABFtra, MAFVeso and ABFeso, was 5.0 ± 4.1%, 7.0 ± 5.6%, 20.1 ± 17.5% and 22.0 ± 16.6%, respectively. ABFtra was significantly linked to ABFeso (R=0.55, P < 0.01). Bias ± SD of ABF measurements between both methods was 2.2 ± 1.1 l · min−1. %ΔABFtra was significantly linked to %ΔABFeso (R=0.62, P < 0.01). The bias ± SD inherent to %ΔABF measurements with both methods was −0.02 ± 18%. Conclusions: These results suggest that this new oesophageal Doppler method is unsuitable to measure accurately absolute CO values and relative CO changes in children during anaesthesia.
Comparison of fast versus slow rewarming following acute moderate hypothermia in rats
Authors: Eshel Gideon , Reisler Gad , Berkovitch Matitiahu , Shapira Shlomo , Grauer Ettie , Barr Joseph 
Published: March 2003

Background: The aim of this study was to compare the biochemical and physiological responses of fast vs. slow rewarming from moderate hypothermia in anaesthetized rats.Methods: Anaesthetized rats were surface cooled to 28 °C, for 20 min, then rewarmed either quickly over 30 min or slowly over 120 min with monitoring of vital signs, systemic vascular resistance (SVR), cardiac output, biochemical changes and activity for 31 days.Results: At hypothermia, cardiac output decreased to 77 ± 38 ml·min–1 and lactate increased to 4.62 ± 4.73 mmol·l–1. Fast rewarming caused an abrupt increase in cardiac output (270 ± 24 ml·min–1) and a sharp drop in SVR (325.6 ± 23.3 dyne·s–1·cm–5), compared with a smoother course with cardiac output (142 ± 18 ml·min–1, P < 0.01) and SVR (662.8 ± 41.0 dyne·s–1·cm–5, P < 0.01), measured during slow rewarming. Lactate failed to return to normal values (upon returning to normothermia) (2.5 ± 0.75 mmol·l–1) only in the fast rewarming group. In both groups, activity in the open field was not different from control rats.Conclusions: In rats, moderate hypothermia for 20 min does not appear to cause lasting biochemical or behavioural consequences, whether rewarming lasted over 30 or 120 min. However, there was a greater early change in cardiac output and heart rate, due to systemic vasodilatation in the fast rewarming animals. These acute changes may have consequences in patients with compromized cardiovascular reserves.
Comparison of pre‐ and postoperative administration of ketoprofen for analgesia after tonsillectomy in children
Authors: KOKKI HANNU , SALONEN AARRE 
Published: March 2003

Background: Tonsillectomy is commonly performed in children, but unfortunately it is associated with intense postoperative pain. The use and optimal timing of nonsteroidal anti‐inflammatory drugs (e.g. ketoprofen) during tonsillectomy is controversial. Methods: We evaluated the safety and efficacy of ketoprofen in 109 children, aged 3–16 years, during and after tonsillectomy in 1998–2000. Standardized anaesthesia was used. Forty‐seven children received ketoprofen 0.5 mg·kg–1 at induction (preketoprofen group) and 42 children after surgery (postketoprofen group), followed by continuous ketoprofen infusion of 3 mg·kg–1 over 24 h in both groups; 20 children received normal saline (placebo group). Oxycodone was used for rescue analgesia. Results: Pre‐ and postketoprofen groups did not differ in experienced pain or in opioid consumption in the first 24 h after surgery; demonstrating that ketoprofen did not have a pre‐emptive effect. Patients in the placebo group received 30 more oxycodone doses than did patients in the ketoprofen groups, but the difference was not significant (P=0.074). Two patients (5) in the postketoprofen group had postoperative bleeding at 4 h and 26 h, respectively. Both patients required electrocautery to stop bleeding. Neither the incidence nor the severity of adverse events differed between study groups. Conclusions: This study demonstrates that ketoprofen did not have a preemptive effect and, at the dose used, did not perform statistically significantly better than placebo.
Pulmonary Doppler flow velocity pattern during caudal epidural anaesthesia in children
Authors: OZASA HIROSHI , HASHIMOTO KEISHI , SAITO YOJI 
Published: March 2003

Background: Haemodynamic effects of caudal anaesthesia in children have not been fully investigated. In the present study, we evaluated pulmonary haemodynamics during caudal anaesthesia in otherwise healthy children using Doppler‐echocardiography. Methods: Fifteen children undergoing elective lower abdominal surgery were randomly divided into two groups: nine children received 1.5% lidocaine and six physiological saline in the caudal epidural space. General anaesthesia was slowly induced and maintained using nitrous oxide and sevoflurane in oxygen. An epidural catheter was inserted into the caudal epidural space. Haemodynamic data including those with echocardiography were measured before and after epidural administration of lidocaine or saline. Results: Mean blood pressure, enddiastolic diameter of the left ventricle, ejection fraction of the left ventricle and mean velocity circumferential fibre shortening did not change in either group following caudal epidural block. Indices of pulmonary Doppler flow velocity, including peak velocity of pulmonary flow and acceleration‐to‐ejection time ratio, demonstrated a significant decrease after caudal lidocaine, but not after saline. Conclusions: Our data suggest that pulmonary Doppler flow velocity changes during caudal epidural anaesthesia, probably due to an increase in the pulmonary arterial resistance.
A survey of parental satisfaction during parent present induction of anaesthesia for children undergoing cardiovascular surgery
Authors: Odegard Kirsten C. , Modest Sally A. , Laussen Peter C. 
Published: March 2003

Methods: To assess parental reaction and possible complications of parent present induction (PPI) for children undergoing cardiovascular surgery, the parents of 183 patients were provided with a questionnaire to complete after they had participated in PPI. Questions included: prior experience with PPI, which member of the staff initiated the plan for PPI, parental role in the process, how prepared parents felt, and overall satisfaction.Results: PPI was successfully performed in the 183 patients surveyed. No parent was asked to leave the operating room because of respiratory or haemodynamic complications; 77.6% of the parents had no prior experience with PPI; however, 91.8% were aware of their role in the operating room, 94.5% were aware how their child would be anaesthetized and 96.7% felt prepared for their role and believed that this was a positive experience for themselves and their child.Conclusions: This prospective survey demonstrated a high level of parental acceptance and satisfaction for PPI in children undergoing cardiovascular surgery, with a low incidence of untoward events, despite the underlying congenital heart disease. Further work is necessary to objectively characterize anxiety levels associated with induction of anaesthesia in this group of patients and parents.
Thoracic epidural catheters placed by the caudal route in infants: the importance of radiographic confirmation
Authors: VALAIRUCHA SONGYOS , SEEFELDER CHRISTIAN , HOUCK CONSTANCE S. 
Published: March 2003

Background: Cephalad advancement of epidural catheters to the thoracic region via the caudal route has been shown to be feasible in neonates and small infants. This has allowed many young infants to receive thoracic level epidural analgesia with dilute local anaesthetic solutions using the simpler caudal approach. Since radiographic confirmation of the catheter tip is routine at this institution, we wished to determine how often radiographic studies led to adjustment or replacement of the epidural catheter. Methods: After institutional review board approval, we retrospectively reviewed the medical records of neonates and infants less than 6 months of age who had thoracic or lumbar epidural analgesia via the caudal route between August 1995 and January 2000. Demographic data were recorded, including age, weight and type of surgery. The epidural catheter type, tip location by radiograph and any manipulation of the catheter after the radiograph were also noted. Results: During the study period, a total of 115 infants were identified as having received caudal placement of a thoracic catheter. Radiographic studies were available for 86 of these infants. The position of 28 (32%) of the epidural catheters was considered to be inadequate after review of the confirmatory radiograph. Ten of these catheters were determined to be in the high thoracic or cervical region and were pulled back to the desired level. Seventeen of these catheters were coiled in the lumbosacral area and 15 of these were replaced at an adequate level. One catheter was found to be outside the epidural space in the presacral area. No correlation could be found between age, weight, type of catheter or type of surgery and the need for catheter manipulation. Conclusions: Even in young infants, radiographic determination of the catheter tip appears warranted when thoracic catheters are placed via the caudal route.
The comparison of caudal ketamine, alfentanil and ketamine plus alfentanil administration for postoperative analgesia in children
Authors: Özbek Hayri , Bilen Ahmet , Özcengiz Dilek , Günes Yasemin , Özalevli Mehmet , Akman Hasan 
Published: March 2003

Background: Our aim was to compare the effect of single dose caudal ketamine, alfentanil or a mixture of both drugs in the treatment of pain after hypospadias repair surgery in children. Methods: The group comprised 109 boys, ASA I–II, aged 1–9 years, who were undergoing hypospadias repair surgery as day cases. The children were randomly divided into three groups for postoperative analgesia: group 1, only alfentanil (20 μg·kg–1) was given caudally; group 2, ketamine (0.5 mg·kg–1) alone; and group 3, alfentanil (20 μg·kg−1)–ketamine (0.5 mg·kg–1) was given caudally. The analgesic effect of caudal block was evaluated using the Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) and sedation was assessed using a five‐point sedation score. The first analgesic requirement time and the number of supplementary analgesics required by each child in a 24‐h period were also recorded. Results: No statistical differences were found in demographic characteristics, haemodynamic and respiratory parameters, objective pain scores, postoperative sedation scores and duration of surgery among the groups. The median time to first analgesia was significantly shorter in group 1 than in groups 2 and 3 (P=0.009, P=0.001). Significantly more patients in group 1 required additional postoperative analgesia (paracetamol 15 mg·kg–1) compared with groups 2 and 3 (P < 0.001). Conclusions: Caudal administration of ketamine 0.5 mg·kg–1 with or without alfentanil in children produced satisfactory postoperative analgesia without respiratory depression or other side‐effects.
Uveitis and pupillary block glaucoma in an aphakic dog
Authors: Strubbe Todd 
Published: March 2003

AbstractUnilateral uveitis with pupillary occlusion and secondary glaucoma was treated with neodymium:YAG laser iridotomy and iridencleisis in an aphakic 2‐year‐old male Miniature Schnuauzer. The dog presented 4 months after bilateral phacoemulsification with a complaint of blepharospasm of the left eye. Examination revealed anterior uveitis with pupillary occlusion and iris bombé. A slit‐lamp mounted Q‐switched Nd:YAG laser was used to create a central iridotomy to deepen the anterior chamber and an iridencleisis was performed to recreate a pupil. The eye remained visual and normotensive over a 6‐month follow‐up period.
Clinical ocular toxoplasmosis in neonatal kittens
Authors: Powell Cynthia C. , Lappin Michael R. 
Published: March 2003

AbstractObjectiveTo describe ocular findings in kittens with congenital or early neonatal infection byToxoplasma gondiiand to determine if there are detectable differences in disease caused by three strains.Animals studiedSix adult female cats and the offspring from seven litters.MethodsFour kittens from uninfected specific pathogen‐free (SPF) queens and 21 kittens from SPF queens inoculated at various times late in gestation with Mozart, Maggie, or ME‐49 strain ofT. gondiiwere used. Ocular examinations were performed on queens prior to and after delivery, and on kittens weekly to bi‐weekly for up to 27 weeks. Whole blood for serology was collected from all kittens at 5½ to 8 weeks of age and again at 12 weeks of age or later.ResultsNo kittens from noninfected queens developed ocular lesions or antibody toT. gondii. Three of the 24 kittens from infected queens died or were euthanized early in the study. Chorioretinitis was detected in 15 of 21 living kittens from infected queens. Two developed concurrent anterior uveitis that resolved within 1 week. Posterior segment lesions varied ophthalmoscopically between strains. Of 21 kittens fromT. gondii‐infected queens, six developed positive antibody titers toT. gondiiduring the study. All seropositive kittens were born to queens infected with Mozart strain ofT. gondii.ConclusionResults of this study suggest that ocular toxoplasmosis can occur without other evidence of clinical illness in kittens infectedin uteroor in the neonatal period, and thatT. gondiistrains may have varying degrees of ocular pathogenicity in cats.
Enrofloxacin‐associated retinal degeneration in cats
Authors: Gelatt Kirk N. , Van Der Woerdt Alexandra , Ketring Kerry L. , Andrew Stacy E. , Brooks Dennis E. , Biros Daniel J. , Denis Heidi M. , Cutler Timothy J. 
Published: March 2003

AbstractObjectiveThe objective of this study was to evaluate the possible relationship between the administration of parenteral enrofloxacin and the onset of acute retinal degeneration in cats. The animals studied included 17 cats that received systemic enrofloxacin and developed retinal degeneration soon thereafter.ProceduresIn this retrospective clinical study, cats that received parenteral enrofloxacin and developed acute blindness were identified. Parameters recorded included breed, age, sex, enrofloxacin dosage (daily dose and number of days administered), medical condition for which the antibiotic had been prescribed, ophthalmic signs, examination results, and the visual outcome. Fundus photographs were obtained in seven cats, and electroretinography was performed in five cats. Histopathology was performed on two eyes from one cat (case 1) that received enrofloxacin 5 months previously and developed retinal degeneration.ResultsAll cats were the domestic shorthair breed; seven were females (one neutered) and ten were males (seven castrated). Ages ranged from 3 to 16 years old (mean ± SD; 8.8 ± 4.6 years). The medical disorders for which enrofloxacin was administered ranged from lymphoma and pancreatitis to otitis and dermatitis, and eight cats had urinary diseases. The daily and total dosage of enrofloxacin and number of days of administration were also highly variable. Presenting clinical signs were most often mydriasis and acute blindness. All cats had diffuse retinal degeneration as evidenced by increased tapetal reflectivity and retinal vascular attenuation. Absence of recordable electroretinographic responses suggested diffuse and extensive outer retinal disease. Vision returned in a few cats, but the retinal degeneration persisted or even progressed. Histopathology of two eyes revealed primarily outer retinal degeneration, with diffuse loss of the outer nuclear and photoreceptor layers, and hypertrophy and proliferation of the retinal pigment epithelium.ConclusionParenteral enrofloxacin is potentially retinotoxic in some cats, and may result in acute and diffuse retinal degeneration. Blindness often results, but some cats may regain vision. Practitioners should adhere closely to the manufacturer’s current enrofloxacin dosage recommendation (5 mg/kg q 24 h), and continue clinical observations for this drug toxicity in cats.
Phacoemulsification in a clouded leopard (Neofelis nebulosa)
Authors: Cooley Pennie L. 
Published: March 2003

AbstractPhacoemulsification and prophylactic retinopexy were performed on a 3‐month‐old hand‐raised clouded leopard with a unilateral mature cataract. The same procedures were repeated 3 months later when a cataract developed in the fellow eye. Examination procedures, anesthetic protocols, and surgical techniques were similar to those utilized in domestic cats. The patient retains highly functional aphakic vision at the present age of 2.5 years. An inherited basis for the cataracts is proposed. Although the cub was hand raised, the cataracts were unlike nutritional cataracts reported previously in domestic cats and dogs. To the author’s knowledge this is the first report of cataract formation and phacoemulsification in a clouded leopard.
Normal structure and age‐related changes of the equine retina
Authors: Ehrenhofer Marion C. A. , Deeg Cornelia A. , Reese Sven , Liebich Hans‐Georg , Stangassinger Manfred , Kaspers Bernd 
Published: March 2003

AbstractInvestigations of the pathophysiology of ocular diseases require a detailed knowledge of the microanatomy of the eye. The available information is still inadequate for the equine retina despite the importance of eye diseases in equine medicine. Here we provide a comprehensive analysis of the histologic features of the horse eye as a reference for future studies. Thirty normal eyes of 15 healthy horses were examined immediately after slaughter. The retina of the horse differs considerably in the degree and quantity of neurons and glial elements as well as in vascular patterns compared to the retina of other domestic animals. Morphometric analysis revealed that the thickness of the retina varies between 80 µm at the ora serrata and 250 µm medial to the optic disc. Approximately 90% of the equine retina is comparatively thin (< 130 µm). This is a physiologic response to the distance that oxygen can diffuse in avascular retina. Ganglion cells form a single layer in all parts of the retina. The majority of ganglion cells are very large Nissl‐positive cells. Small Nissl‐negative ganglion cells are less abundant. A high ganglion cell density is found only in the central area. Vascularization is virtually absent from the retina with the exception of a narrow strip around the disc of the optic nerve, as revealed by lectin histochemistry. Light microscopy of the eyes of older horses repeatedly revealed cystoid degenerations in the retina adjacent to the pars plana of the ciliary body, as well as a destruction of the regular layering of the peripheral region of the retina.
Bilateral proliferative keratitis in a Domestic Long‐haired cat
Authors: Colitz Carmen M. H. , Davidson Michael G. , Gilger Brian C. 
Published: March 2003

AbstractA 9‐year‐old, female spayed, Domestic Long‐haired cat was presented with bilateral, progressive, pink−white corneal opacities. The referring veterinarian had diagnosed feline herpesvirus‐1 (FHV‐1) keratitis though diagnostics for FHV‐1 had not been performed and treatment with antibiotics and antivirals did not improve the condition. Histopathology showed neutrophils, plasma cells and lymphocytes, but no eosinophils or mast cells. Routine diagnostics did not find an underlying cause, but Southern blot analysis for FHV‐1 was positive. The cat responded to topical corticosteroids and cyclosporine when used consistently.