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Use of aVR and Jastrzębski algorithms in the classification of wide complex tachycardia in dogs – a preliminary study
2018
Michałek, Marcin | Frydrychowski, Piotr | Adamowicz, Jakub | Sławuta, Agnieszka | Pasławska, Urszula | Noszczyk-Nowak, Agnieszka
Ventricular rhythm disturbances are a common pathology in human and veterinary medicine. In humans, the algorithmic approach is used to differentiate wide QRS complex tachycardia. The most commonly used are the aVR and Brugada algorithms as well as the ventricular tachycardia (VT) score developed by Jastrzębski and coworkers. In veterinary medicine, no such algorithms are available and the only parameter used to describe VT abnormalities is the duration of the QRS complexes. The aim of this analysis was determining whether human medicine algorithms for VT are applicable in veterinary medicine to differentiate wide QRS complex tachycardia in dogs. A retrospective analysis was performed on 11 dogs of both sexes and various breeds and age diagnosed with VT. The diagnosis was based on ambulatory ECG, further established based on the reaction to lidocaine or adenosine or an invasive electrophysiological study. Of the 11 tracings passed through the aVR algorithm, 10 met the VT criteria. The most common criterion was the Vi/Vt ratio (8 out of 11 tracings). Based on the VT score, seven out of eight dogs had a high probability of VT. Retrospective analysis of ECGs by aVR and VT score indicates that the applied algorithms may be useful in differentiating wide QRS complex tachycardia as a quick, easy, and non-invasive alternative to cardiac electrophysiology.
Show more [+] Less [-]Plasma concentrations of lidocaine following laryngeal administration or laryngeal and intratesticular administration in cats
2018
Soltaninejad, Hamzeh | Vesal, Nasser
OBJECTIVE To determine plasma concentrations of lidocaine after laryngeal administration or laryngeal and intratesticular administration in cats. ANIMALS 14 healthy adult sexually intact male cats (7 cats/treatment). PROCEDURES Cats were randomly allocated to receive 0.1 mL of 2% or 10% lidocaine hydrochloride solution (treatments L2 and L10, respectively) sprayed on the larynx for laryngeal desensitization, followed by endotracheal intubation and isoflurane anesthesia. After a 7-day washout period, cats were again randomly allocated to receive treatment L2 or L10, and castration was performed under isoflurane anesthesia following intratesticular administration of 2% lidocaine solution (0.1 mL/kg). In both experiments, a blood sample for measurement of plasma lidocaine concentration was obtained before (0 minutes) and 3, 5, 10, 15, 20, 30, 45, 60, and 75 minutes after laryngeal administration of lidocaine solution. Anesthesia was discontinued at 60 minutes. Plasma lidocaine concentrations were measured with high-performance liquid chromatography. RESULTS After treatments L2 and L10, median maximum plasma lidocaine concentrations were 34.1 ng/mL (range, 0 to 279.4 ng/mL) and 93.6 ng/mL (range, 79.3 to 182.2 ng/mL), respectively. Time to maximum plasma concentration was 10 minutes (range, 0 to 20 minutes) for each treatment. When cats received intratesticular lidocaine administration following L2 or L10 treatment, median maximum plasma concentration was 181.0 ng/mL (range, 103.7 to 600.2 ng/mL) and 301.2 ng/mL (range, 265.8 to 1,770.0 ng/mL), respectively. CONCLUSIONS AND CLINICAL RELEVANCE On the basis of these data, combined laryngeal and intratesticular administration of lidocaine solution at a total dose of approximately 5 mg/kg appears to be safe for use in healthy adult cats.
Show more [+] Less [-]Effect of the addition of epinephrine to a lidocaine solution on the efficacy and duration of palmar digital nerve blocks in horses with naturally occurring forefoot lameness
2018
Alvarez, Ana Velloso | Schumacher, John | DeGraves, Fred J.
OBJECTIVE To determine whether addition of epinephrine to a lidocaine solution would prolong and potentiate the efficacy of a palmar digital nerve block (PDNB) in horses. ANIMALS 6 adult horses with naturally occurring forefoot lameness. PROCEDURES Initially, a PDNB with a 2% lidocaine solution was performed on the affected foot of each horse. Three days later, the PDNB was repeated with a 1% lidocaine solution or a 1% lidocaine solution containing epinephrine (dilution, 1:200,000). After another 3-day washout period, the PDNB was repeated with the treatment opposite that administered for the second PDNB. Gait was analyzed with a computerized lameness analysis system and heart rate and extent of skin sensation between the heel bulbs of the blocked foot were evaluated at predetermined times for 2 hours after each PDNB. RESULTS Efficacy and duration of the PDNB did not differ significantly between the 2% and 1% lidocaine treatments. The addition of epinephrine to the 1% lidocaine solution improved the efficacy and prolonged the duration of the PDNB. It also resulted in a positive correlation between skin desensitization and amelioration of lameness. Median heart rate remained unchanged throughout the observation period for all 3 treatments. No adverse effects associated with the PDNBs were observed. CONCLUSIONS AND CLINICAL RELEVANCE Addition of epinephrine (dilution, 1:200,000) to a 1% lidocaine solution improved the efficacy and prolonged the duration of a PDNB in horses with naturally occurring lameness and might be clinically useful for lameness evaluations and standing surgery of the forefoot of horses.
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