Fenn J, Laber E, Williams K, Rousse C A, Early P J, Mariani C L, Muñana K R, De Decker S, Volk H A, Olby N J
Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.
Department of Statistics, North Carolina State University, Raleigh, NC.
J Vet Intern Med. 2017 May;31(3):814-824. doi: 10.1111/jvim.14677. Epub 2017 Mar 13.
Outcome of acute experimental spinal cord injury is strongly associated with tissue perfusion and oxygenation. Cardiopulmonary depression could affect outcome in dogs undergoing general anesthesia for surgical treatment of thoracolumbar intervertebral disk extrusion (IVDE).
HYPOTHESIS/OBJECTIVES: To evaluate the effects of general anesthesia on functional outcome in dogs undergoing surgery to treat thoracolumbar IVDE.
Eighty-four client-owned dogs with acute thoracolumbar IVDE treated by decompressive hemilaminectomy.
Exploratory, retrospective observational study. Medical records were reviewed for clinical presentation and anesthetic monitoring variables, including duration of anesthesia and surgery, hypotension, bradycardia, temperature, and respiratory parameters. Multivariable regression tree analysis was performed to explore associations between anesthetic variables and functional outcome scores after 6 weeks, as well as return to ambulatory status.
Episodes of bradycardia (69%) and hypotension (57%) were frequent. Across all outcome measures, regression tree analysis highlighted functional grade at presentation as the primary determining factor, and among pain perception negative dogs, there was a possible association between increased duration of surgery and poorer outcome. In dogs with intact pain perception, duration of bradycardia, mean body temperature, and mean end-tidal carbon dioxide were highlighted.
Exploratory statistical methods can facilitate hypothesis-generating studies to inform prospective investigations in veterinary medicine. Although the mechanism is uncertain, increased duration of surgery might be associated with poorer outcome in pain perception negative dogs with thoracolumbar IVDE.
急性实验性脊髓损伤的预后与组织灌注和氧合密切相关。心肺抑制可能会影响接受全身麻醉进行胸腰椎椎间盘突出症(IVDE)手术治疗的犬的预后。
假设/目的:评估全身麻醉对接受胸腰椎IVDE手术治疗的犬功能预后的影响。
84只由客户拥有的患有急性胸腰椎IVDE的犬,通过减压半椎板切除术进行治疗。
探索性回顾性观察研究。回顾病历以获取临床表现和麻醉监测变量,包括麻醉和手术持续时间、低血压、心动过缓、体温和呼吸参数。进行多变量回归树分析以探讨麻醉变量与6周后功能预后评分以及恢复行走状态之间的关联。
心动过缓(69%)和低血压(57%)发作频繁。在所有预后指标中,回归树分析突出显示就诊时的功能分级是主要决定因素,在疼痛感知阴性的犬中,手术持续时间增加与较差的预后之间可能存在关联。在疼痛感知正常的犬中,突出显示了心动过缓持续时间、平均体温和平均呼气末二氧化碳。
探索性统计方法可促进产生假设的研究,为兽医学的前瞻性研究提供信息。虽然机制尚不确定,但手术持续时间增加可能与胸腰椎IVDE且疼痛感知阴性的犬预后较差有关。