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Biomedical subjects

P J Pascoe

Publications and source records attributed to P J Pascoe.

At least 19 recordsLinked to original sources
PubMed2001

Periparturient and neonatal anesthesia.

Small animal patients may need to be anesthetized in the periparturient period for emergency, nonobstetric reasons, elective ovariohysterectomy, or cesarean section. In each case, the physiologic changes in the dam must be accounted for in designing an anesthetic protocol, but the requirements of the fetuses will be different. Subsequent to birth, the neonatal animal may need to be anesthetized, and the unique physiology and pharmacology at this age is described.

Anesthesia, General↗
PubMed2001

Neonatal critical care.

The first few minutes after a neonate's birth may determine the quality of its entire life. Immediate care includes prevention of hypothermia, clearing of nasal and oral passages, stimulation of ventilation and oxygenation, and, in a few cases, advanced life support. Any additional stress during the first weeks of life can also result in neonatal morbidity and mortality. Care of the diseased newborn must focus not only on treatment of the underlying disease but on aggressive supportive care. A safe, warm, clean, proper environment and adequate nutrition are essential.

Animals↗
PubMed2000

Opioid analgesics.

Opioids are useful and potent drugs for the management of pain in small animal patients. They have a wide therapeutic index and can be given by a number of different routes. Some of these techniques (e.g., epidural and intraarticular) allow for the production of profound analgesia in a localized area of the body while limiting the dose and the side effects, and others provide a noninvasive method for the delivery of continuous analgesia (e.g., transdermal administration).

Analgesics, Opioid↗
PubMed2000

Perioperative pain management.

The management of perioperative pain starts with the use of approaches to minimize anxiety and distress before the procedure. The administration of analgesics or local anesthetics before the start of surgery reduces the nociceptive input occurring during the procedure and reduces the need for postoperative analgesics. As the animal recovers from anesthesia, it is important to administer analgesics to minimize the patient's experience of pain and to continue this therapy through at least the first 12 to 24 hours. Techniques that provide a continuous level of analgesia are more effective than those that allow the pain to return.

Animals↗
PubMed2000

Effects of xylazine hydrochloride during isoflurane-induced anesthesia in horses.

OBJECTIVE: To quantitate dose- and time-related anesthetic-sparing effects of xylazine hydrochloride (XYL) during isoflurane-induced anesthesia in horses and to characterize selected physiologic responses of anesthetized horses to administration of XYL. ANIMALS: 6 healthy adult horses. PROCEDURE: Horses were anesthetized 2 times to determine the minimum alveolar concentration (MAC) of isoflurane in O2 and to characterize the anesthetic-sparing effect (MAC reduction) after IV administration of XYL (0.5 and 1 mg/kg of body weight, random order). Selected measures of cardiopulmonary function, blood glucose concentrations, and urinary output also were measured during the anesthetic studies. RESULTS: Isoflurane MAC (mean +/- SEM) was reduced by 24.8 +/- 0.5 and 34.2 +/- 1.9% at 42 +/- 7 and 67 +/- 10 minutes, respectively, after administration of XYL at 0.5 and 1 mg/kg. Amount of MAC reduction by XYL was dose- and time-dependent. Overall, cardiovascular and respiratory values varied little among treatments. Administration of XYL increased blood glucose concentration; the magnitude of change was dose- and time-dependent. Urine volume increased but not significantly. CONCLUSIONS AND CLINICAL RELEVANCE: Administration of XYL reduced the anesthetic requirement for isoflurane in horses. The magnitude of the decrease is dose- and time-dependent. Administration of XYL increases blood glucose concentration in anesthetized horses in a dose-related manner.

Anesthetics, Inhalation↗
PubMed1999

Haemodynamic effects of ATP in dogs during hypoxia-induced pulmonary hypertension.

Pulmonary hypertension may result from an increase in vascular resistance caused by persistent hypoxia. We have investigated the effects of adenosine triphosphate (ATP), administered into the pulmonary artery, on haemodynamic changes occurring in anaesthetized adult dogs subjected to acute hypoxic pulmonary vasoconstriction. Hypoxia alone (ventilation with 10% O2/90% N2) caused significant increases in mean pulmonary arterial blood pressure (PAP), central venous pressure (CVP), and cardiac index (CI) by 71, 102 and 38%, respectively. ATP (0.03-3.0 micromol/kg/min approximately 0.02-1.65 mg/kg/min), when infused under hypoxic conditions, significantly reduced both mean PAP and systemic arterial blood pressure (ABP) in a dose-dependent manner. The maximum decrease in mean PAP amounted to 20%; mean ABP, on the other hand, was decreased by up to 52% (P<0.01). Heart rate, CI, CVP and pulmonary occlusion pressure were not dose-dependently affected by ATP. Our data indicate that while pulmonary arterial administration of ATP in mature dogs during hypoxic pulmonary hypertension causes dilation in the pulmonary vascular bed, it is even more effective in dilating the systemic vasculature. This result suggests a need for further evaluation and warrants cautious use of ATP in the treatment of hypoxic pulmonary hypertension in adult dogs.

Adenosine Triphosphate↗
PubMed1999

Effects of intravenously administered glycopyrrolate in anesthetized horses.

The purpose of this study was to determine the heart rate (HR) and blood pressure (BP) effect of glycopyrrolate in anesthetized horses with low HR (< or = 30 beats/min). The horses were randomly treated with glycopyrrolate (2.5 micrograms/kg body weight (BW)) or saline, intravenously (i.v.) (n = 17). If HR failed to increase (by > 5 beats/min within 10 min), glycopyrrolate (same dose) was administered. Heart rate increased by > 5 beats/min in 3 out of 9 horses following the initial glycopyrrolate treatment. Overall changes in HR and mean BP were not significantly different, while systolic and diastolic BP increased significantly (P < 0.025 using a Bonferroni corrected paired t-test). On the 2nd treatment, 3 out of 7 horses given 2.5 micrograms/kg BW glycopyrrolate, and 4 out of 5 horses given 5.0 micrograms/kg BW (total dose) showed an increase in heart rate of > 5 beats/min, which was significant. A significant increase in BP was produced following treatment with 2.5 micrograms/kg BW, but not following 5.0 micrograms/kg BW. A final increase in HR, of > 5 beats/min, was associated with a significant rise in BP (P < 0.05 using an unpaired t-test). In conclusion, an increase in HR can occur with 2.5 to 5.0 micrograms of glycopyrrolate/kg BW, i.v., and results in improvement in BP in anesthetized horses.

Adjuvants, Anesthesia↗
PubMed1998

Perioperative management and mortality rates of dogs undergoing cesarean section in the United States and Canada.

OBJECTIVE: To describe dogs undergoing cesarean section in the United States and Canada, to determine perioperative management, and to calculate survival proportions. DESIGN: Multicenter prospective case series. ANIMALS: 3,908 puppies from 808 dams. RESULTS: Survival rates immediately, 2 hours, and 7 days after delivery were 92, 87, and 80%, respectively, for puppies delivered by cesarean section (n = 3,410) and 86, 83, and 75%, respectively, for puppies born naturally (498). For 614 of 807 (76%) litters, all puppies delivered by cesarean section were born alive. Maternal mortality rate was 1% (n = 9). Of 776 surgeries, 453 (58%) were done on an emergency basis. The most common breeds of dogs that underwent emergency surgery were Bulldog, Labrador Retriever, Boxer, Corgis, and Chihuahua. The most common breeds of dogs that underwent elective surgery were Bulldog, Labrador Retriever, Mastiff, Golden Retriever, and Yorkshire Terrier. The most common methods of inducing and maintaining anesthesia were administration of isoflurane for induction and maintenance (n = 266; 34%) and administration of propofol for induction followed by administration of isoflurane for maintenance (237; 30%). CLINICAL IMPLICATIONS: Mortality rates of dams and puppies undergoing cesarean section in the United States and Canada are low. Knowledge of mortality rates should be useful to veterinarians when advising clients on the likelihood of puppy and dam survival associated with cesarean section.

Anesthesia↗
PubMed1998

Comparison of two techniques for total intravenous anesthesia in horses.

OBJECTIVE: To characterize responses associated with two 1-hour total intravenous anesthesia techniques in horses. ANIMALS: 6 mature, healthy mares. PROCEDURE: Each horse was anesthetized 3 times. Treatment order was determined by a series of Latin squares. After baseline measurements and instrumentation, horses were given xylazine (XYL) i.v.; anesthesia was induced 5 minutes later with 10% guaifenesin given i.v., then either ketamine (KET) or propofol (PRO) was given i.v. After anesthesia induction, each horse received an infusion of XYL and either KET or a low or high dose of PRO. Cardiopulmonary variables were measured at 20, 40, and 60 minutes after the start of the infusion; arterial blood samples were collected prior to each set of measurements, and blood gas tensions and plasma drug concentration were determined. A noxious stimulus was applied after each of the 3 sets of measurements. RESULTS: Differences in measured cardiopulmonary variables were significant among all treatments at different times. Most notable differences were between KET and high PRO. Times to regaining sternal and standing posture were shortest for KET, and differed significantly from values for low and high PRO. Purposeful responses were not observed for high PRO in horses after noxious stimulation. In contrast, 4 horses given KET responded at all time points and 1 horse given low PRO responded. CONCLUSION: None of the infusion techniques were flawless, but results support continued efforts at technique refinement and selected clinical use.

Anesthesia, Intravenous↗
PubMed1997

Cardiovascular effects of equipotent isoflurane and alfentanil/isoflurane minimum alveolar concentration multiple in cats.

OBJECTIVE: To determine whether administration of opioids to anesthetized cats induced less cardiovascular depression than that induced by an equivalent amount of anesthetic alone, and to measure endocrine responses to a noxious stimulus. ANIMALS: 6 healthy female cats. PROCEDURE: Anesthesia was induced with isoflurane and was maintained for 60 minutes at 1.3 isoflurane MAC. Blood gas tensions, pH, and plasma alfentanil and hormone concentrations, blood pressures, and cardiac output were measured. A noxious stimulus was applied for 5 minutes, while blood acquisition and measurements were repeated. Alfentanil was administered i.v. to achieve estimated plasma concentration of 500 ng/ml, and end-tidal isoflurane concentration was reduced by 35%. After another 60 minutes, blood was obtained and measurements were taken, then a second 5-minute noxious stimulus was applied while blood acquisition and measurements were retaken. RESULTS: Alfentanil administration and reduction of isoflurane concentration significantly increased body temperature, heart rate, mean arterial pressure, mean pulmonary arterial pressure, stroke index, cardiac index, hemoglobin, oxygen delivery index, PvO2 and PvCO2, dopamine, epinephrine (EPI), norepinephrine (NOREPI), and cortisol values, and significantly decreased arterial and venous pH. Application of a noxious stimulus significantly increased heart rate, stroke index, cardiac index, PaO2, oxygen delivery index, arterial and venous pH, and NOREPI values, and decreased bicarbonate, PaCO2, PvCO2, and EPI values. Alfentanil administration blunted cardiac index, PaCO2, oxygen delivery index, arterial pH, PaO2, and EPI, and NOREPI responses to a noxious stimulus. CONCLUSIONS: Compared with isoflurane alone, alfentanil administration and reduction of isoflurane MAC improved cardiovascular variables, and blunted respiratory, hormonal, and most hemodynamic responses to a noxious stimulus in cats. CLINICAL RELEVANCE: Use of the balanced opioid anesthesia regimen induced some beneficial effects in healthy cats; effects were similar to, although greater in nature, than effects induced by a noxious stimulus.

Acid-Base Equilibrium↗
PubMed1997

Effect of alfentanil on the minimum alveolar concentration of isoflurane in cats.

OBJECTIVE: To evaluate effect of incremental doses of alfentanil on isoflurane minimum alveolar concentration (MAC) in cats to determine whether alfentanil reduces isoflurane MAC and, if so, maximal isoflurane MAC reduction. ANIMALS: 6 healthy spayed female cats. PROCEDURE: Cats were anesthetized with isoflurane and instrumented to allow collection of arterial blood for measurement of gas tensions, pH, and plasma alfentanil concentration and to measure arterial blood pressure. Isoflurane MAC was determined in triplicate, and alfentanil was administered i.v., using a computer-driven syringe pump to achieve estimated plasma alfentanil concentrations of 50, 100, 250, 500, 750, and 1,000 ng/ml; isoflurane MAC was determined at each alfentanil concentration. Cats were allowed to recover, and the process was graded as poor, good, or excellent. RESULTS: Alfentanil had a significant dose effect on isoflurane MAC reduction. Significant regression was found for normalized isoflurane MAC versus estimated plasma alfentanil concentration. A quadratic term was necessary to fit the model and, using this curve, MAC reduction (35.0 +/- 6.6%) was estimated to be maximal at a plasma alfentanil concentration of 500 ng/ml. Significant differences were evident in rectal temperature, bicarbonate concentration, base deficit, arterial carbon dioxide and oxygen tensions, and arterial pH between isoflurane alone and some plasma alfentanil concentration and the corresponding reduction in isoflurane concentration. CONCLUSIONS: Infusion of alfentanil resulted in maximal MAC reduction midway between that reported for horses and dogs. At such plasma alfentanil concentration, adverse effects were minimal, but included increase in rectal temperature, metabolic acidosis, and decrease in PaO2. Provided cats were not handled during the recovery period, recovery was smooth and quiet. CLINICAL RELEVANCE: Infusion of alfentanil decreases the need for potent inhalant anesthetics in cats and could potentially be a clinically useful anesthetic regimen in sick cats.

Acid-Base Equilibrium↗
PubMed1996

Case-control study of the association between intraoperative administration of nafcillin and acute postoperative development of azotemia.

OBJECTIVE: To describe 7 cases of acute postoperative azotemia in dogs and to examine by use of a case-control study the possible association between this complication and administration of nafcillin. DESIGN: Retrospective and case-control study. ANIMALS: 7 case dogs and 28 matched control dogs. PROCEDURE: Cases of acute renal failure or acute renal insufficiency were identified by retrospective study of records of dogs treated between July 1, 1992, and Feb 28, 1995, and from information received from a practitioner. A random sample of records of dogs undergoing invasive procedures between Dec 1, 1992, and Nov 30, 1993, was examined to determine the prevalence of nafcillin use. Each case dog was matched with 4 control dogs, and data were subjected to logistic regression analysis, employing exact conditional inference on the parameter estimates. RESULTS: Case dogs were between 1 and 9 years old and weighed between 21 and 60 kg. Preoperatively, none of the dogs had a history of renal disease, and BUN concentrations, hematocrit, and plasma protein concentrations were within reference ranges. Postoperatively, each dog became azotemic and had clinical signs consistent with uremia. Hyponatremia was recorded in 6 case dogs. One dog did not respond to treatment and was euthanatized. Two dogs had persistent isosthenuria, and 4 dogs recovered. Nafcillin was used in approximately 502 of 2,184 (23%) dogs that underwent invasive procedures between Dec 1, 1992, and Nov 30, 1993. The use of nafcillin ceased on Nov 30, 1993, and no further cases were recorded in the following 15 months. In the case-control study, the only factor that was significantly associated with the occurrence of acute postoperative azotemia was administration of nafcillin. CLINICAL IMPLICATIONS: Intraoperative use of nafcillin maybe associated with development of acute postoperative azotemia in dogs.

Acute Disease↗
PubMed1996

Evaluation of propofol for general anesthesia in premedicated horses.

OBJECTIVE: To evaluate selected hemodynamic, respiratory, and behavioral responses to propofol in horses premedicated with xylazine or detomidine. DESIGN: Xylazine (0.5 and 1.0 mg/kg of body weight) was administered IV on different days to each of 6 horses prior to IV administration of propofol (2 mg/kg). In a second group of 6 horses, detomidine (15 and 30 micrograms/kg) was similarly studied. ANIMALS: 2 groups of 6 mature healthy horses. PROCEDURE: Rectal temperature, heart and respiratory rates, arterial blood gas tensions, and direct arterial blood pressures were recorded before and at fixed intervals after drug administration. Induction and recovery events were quantitatively and qualitatively assessed. Cardiopulmonary and behavioral data to follow were statistically analyzed (P < or = 0.05). RESULTS: Heart rate decreased in dose-dependent manner from a mean (+/- SD) of 39.5 +/- 5.1 beats/min after xylazine and detomidine. Second-degree atrioventricular dissociation was commonly seen at the higher drug doses. After propofol administration, heart rate either transiently increased or was less depressed early in recumbency, compared with predrug values. Direct arterial blood pressures varied inconsistently from predrug values. Mean arterial carbon dioxide tension tended to increase after drug administration (significance variable) from predrug values of 42 to 46 mm of Hg in both drug groups. After xylazine or detomidine administration, arterial oxygen tension decreased significantly from predrug values of 97 to 103 mm of Hg. The magnitude and duration of decrease was dose-dependent and greatest during recumbency. Behavioral responses to anesthetic induction were variable, but horses were uniformly calm and coordinated during recovery. Recumbency time increased in response to the higher dose of either premedicant drug. Mean (+/- SD) times to standing were 25.02 +/- 4.42 and 35.57 +/- 6.83 minutes for the low and high doses of xylazine, respectively and 41.04 +/- 11.21 and 52.64 +/- 14.67 minutes for the low and high doses of detomidine, respectively. CONCLUSION: Neither xylazine nor detomidine prevented excitation associated with propofol injection in horses. CLINICAL RELEVANCE: Xylazine or detomidine-propofol combinations likely will not replace common anesthetic induction techniques for horses. However, recovery characteristics associated with propofol encourage further study in horses.

Anesthesia, General↗
PubMed1994

Arterial hypertension associated with topical ocular use of phenylephrine in dogs.

In 3 dogs scheduled for surgical removal of cataracts, systemic and topical treatment with antibiotics and topical ocular treatment with prednisolone, atropine, flurbiprofen, and phenylephrine were used to achieve maximal mydriasis, with minimal risk of pupillary constriction in response to surgery. Each dog developed arterial hypertension, with systolic, diastolic, and mean arterial pressures ranging from 170 to 205, 90 to 112, and 123 to 148 mm of Hg, respectively. Hypertension was treated with acepromazine maleate (0.001 to 0.005 mg/kg of body weight) i.v., decreasing arterial pressures to reference values. Phenylephrine dosages for topical use ranged from 50 to 367 times greater than the i.v. dose required to increase arterial pressure by 50% in anesthetized dogs. Although adverse sequelae to these episodes of hypertension were not noticed, this report documents the uptake of phenylephrine from topical ocular application and suggests the need for dose-response measurements for this adjunct to mydriatic treatment in dogs.

Acepromazine↗
PubMed1994

Effect of xylazine and ketamine on the pharmacokinetics of alfentanil during halothane anaesthesia.

We measured plasma concentrations of alfentanil in two horses after three different randomly ordered treatments. Each horse received halothane in oxygen by mask followed by a bolus dose of alfentanil 60 micrograms kg-1 i.v., halothane in oxygen by mask followed by an i.v. alfentanil infusion for 120 min and xylazine and ketamine followed by halothane and a bolus dose of alfentanil 60 micrograms kg-1 i.v. Halothane was maintained at 1.05-1.07% end-tidal concentration with a PaCO2 of 6-7.3 kPa. The plasma concentration-time curves were similar after bolus and infusion doses of alfentanil with halothane and could be fitted to a two-compartment open model. A plateau was noted in the plasma concentration-time curve in the presence of xylazine-ketamine which could not be modelled adequately, but suggested a three-compartment open model with an additional input component.

Alfentanil↗
PubMed1994

Public hospital pathology--at what cost?

Public hospital laboratories have in the past fended off financial scrutiny and accountability on the grounds of their complexity and lack of compelling need. However, the cost of providing diagnostic laboratory services has now come under intense scrutiny because of budget reductions and options for private sector competition. Costing of pathology services is not difficult, but their organisation and outputs do have unique features that need to be understood and defined to ensure that the costing model used provides robust data that accurately reflects how resources are consumed. The cost data generated for diagnostic services can then be compared to the various benchmarks widely used for activity-based funding, such as the Commonwealth Medical Benefits Schedule and the pathology component of the AN-DRG Service Weights System, while the requirement and funding for other activities can be rationally determined.

Australia↗