title: Comparison of cardiopulmonary responses during sedation with epidural and local anesthesia for laparoscopic-assisted jejunostomy feeding tube placement with cardiopulmonary responses during general anesthesia for laparoscopic-assisted or open surgical jejunostomy feeding tube placement in healthy dogs.
abstract: OBJECTIVE
  To evaluate the use of laparoscopic-assisted jejunostomy feeding tube (J-tube) placement in healthy dogs under sedation with epidural and local anesthesia and compare cardiopulmonary responses during this epidural anesthetic protocol with cardiopulmonary responses during general anesthesia for laparoscopic-assisted or open surgical J-tube placement.
  
  
  METHODS
  15 healthy mixed-breed dogs.
  
  
  METHODS
  Dogs were randomly assigned to receive open surgical J-tube placement under general anesthesia (n = 5 dogs; group 1), laparoscopic-assisted J-tube placement under general anesthesia (5; group 2), or laparoscopic-assisted J-tube placement under sedation with epidural and local anesthesia (5; group 3). Cardiopulmonary responses were measured at baseline (time 0), every 5 minutes during the procedure (times 5 to 30 minutes), and after the procedure (after desufflation [groups 2 and 3] or at the start of abdominal closure [group 1]). Stroke volume, cardiac index, and O(2) delivery were calculated.
  
  
  RESULTS
  All group 3 dogs tolerated laparoscopic-assisted J-tube placement under sedation with epidural and local anesthesia. Comparison of cardiovascular parameters revealed a significantly higher cardiac index, mean arterial pressure, and O(2) delivery in group 3 dogs, compared with group 1 and 2 dogs. Minimal differences in hemodynamic parameters were found between groups undergoing laparoscopic-assisted and open surgical J-tube placement under general anesthesia (ie, groups 1 and 2); these differences were not considered to be clinically important in healthy research dogs.
  
  
  CONCLUSIONS
  Sedation with epidural and local anesthesia provided satisfactory conditions for laparoscopic-assisted J-tube placement in healthy dogs; this anesthetic protocol caused less cardiopulmonary depression than general anesthesia and may represent a better choice for J-tube placement in critically ill patients.
authors.affiliation: Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, ON N1G 2W1, Canada.
authors.forename: Saundra A
authors.initials: SA
authors.lastname: Hewitt
authors.forename: Brigitte A
authors.initials: BA
authors.lastname: Brisson
authors.forename: Melissa D
authors.initials: MD
authors.lastname: Sinclair
authors.forename: William C
authors.initials: WC
authors.lastname: Sears
mesh_terms: D000704:Analysis of Variance; D000767:Anesthesia, Epidural / Q000662:veterinary*; D000768:Anesthesia, General / Q000662:veterinary*; D000772:Anesthesia, Local / Q000662:veterinary*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D003975:Diazepam / Q000494:pharmacology; D004285:Dogs; D004750:Enteral Nutrition; D006339:Heart Rate / Q000187:drug effects; D007649:Ketamine / Q000494:pharmacology; D010535:Laparoscopy / Q000662:veterinary*; D010100:Oxygen / Q000097:blood
chemical_list: D007649:Ketamine; D003975:Diazepam; D010100:Oxygen