title: Lumbo-sacral epidural anaesthesia as a complement to dissociative anaesthesia during scrotal herniorrhaphy of livestock pigs in the field.
abstract: BACKGROUND
  In Sweden, scrotal or inguinal herniorrhaphy of livestock pigs in the field has traditionally been an important part of the surgical skills training of veterinary students. Few substances meet the legal requirements for field anaesthesia of production animals in the European Union but a protocol based on azaperone-detomidine-butorphanol-ketamine does. Unfortunately the anaesthesia is characterised by unpredictable duration and depth and of abrupt awakenings which is not acceptable from an animal welfare perspective and impedes surgical training. Lumbo-sacral epidural analgesia is proven to provide sufficient analgesia to allow abdominal surgery, but there are few reports on the field use of this loco-regional technique. The study aim was to evaluate whether lumbo-sacral anaesthesia can be safely and successfully used in the field by a veterinary student and whether the combination of dissociative and lumbo-sacral epidural anaesthesia improves analgesia and anaesthesia to guarantee animal welfare during herniorrhaphy in livestock pigs, enabling surgical skills training.
  
  
  RESULTS
  Pigs in the control-group (placebo) responded significantly stronger to surgery, with five out of 11 requiring additional doses of detomidine and ketamine. There were no significant differences between groups in respiratory rate, heart rate, blood pressure, SpO2 or blood gases. SpO2 levels <94 % were recorded in several pigs in both groups. No post-injection complications were reported at follow-up.
  
  
  CONCLUSIONS
  The results from this study showed that lumbo-sacral epidural anaesthesia with lidocaine could successfully be administered during dissociative anaesthesia of livestock pigs by a veterinary student and without reported post-injection complications. It improved analgesia and anaesthesia during herniorrhaphy of sufficient duration to enable surgical skills training. The risks and consequences of hypoxaemia and hypoventilation should be considered.
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, PO box 7054, SE 750 07, Uppsala, Sweden. carl.ekstrand@slu.se.|Department of Biomedicine and Veterinary Public Health, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, PO box 7028, SE 750 07, Uppsala, Sweden. carl.ekstrand@slu.se.
authors.forename: Carl
authors.initials: C
authors.lastname: Ekstrand
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, PO box 7054, SE 750 07, Uppsala, Sweden. marie.sterning@slu.se.
authors.forename: Marie
authors.initials: M
authors.lastname: Sterning
authors.affiliation: Department of Sociology, Stockholm University, SE 106 91, Stockholm, Sweden. love.bohman@sociology.su.se.
authors.forename: Love
authors.initials: L
authors.lastname: Bohman
authors.affiliation: Department of Clinical Sciences, Faculty of Veterinary Medicine and Animal Science, Swedish University of Agricultural Sciences, PO box 7054, SE 750 07, Uppsala, Sweden. anna.edner@slu.se.
authors.forename: Anna
authors.initials: A
authors.lastname: Edner
mesh_terms: D000700:Analgesics / Q000008:administration & dosage; D000763:Anesthesia, Caudal / Q000662:veterinary*; D000778:Anesthetics, Dissociative / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000494:pharmacology*; D000827:Animal Welfare; D000818:Animals; D004520:Education, Veterinary / Q000379:methods; D059685:Herniorrhaphy / Q000662:veterinary*; D007093:Imidazoles / Q000008:administration & dosage; D007649:Ketamine / Q000008:administration & dosage; D008012:Lidocaine / Q000494:pharmacology*; D008297:Male; D012611:Scrotum / Q000601:surgery*; D013552:Swine / Q000601:surgery*
chemical_list: D000700:Analgesics; D000778:Anesthetics, Dissociative; D000779:Anesthetics, Local; D007093:Imidazoles; D007649:Ketamine; C041255:detomidine; D008012:Lidocaine