2. Universidad Cardenal Herrera-CEU

Background: Patient safety is essential in small animal anaesthesia. Thisstudy aimed to assess anaesthesia-related deaths in cats worldwide, identifyrisk and protective factors and provide insights for clinical practice.Methods: A prospective multicentre cohort study of 14,962 cats from198 veterinary centres across different countries was conducted. Data onanaesthesia-related deaths, from premedication up to 48 hours postex-tubation, were collected. Logistic regression was used to analyse patientdemographics, American Society of Anesthesiologists (ASA) classification,procedure type and anaesthetic drugs.Results: The anaesthesia-related mortality was 0.63%, with 74.5% of deathsoccurring postoperatively. Cats with cachexia, a higher ASA status or whounderwent abdominal, orthopaedic/neurosurgical or thoracic proceduresexhibited elevated mortality. Mechanical ventilation use was associated withincreased mortality. Mortality odds were reduced by the use of alpha2 -agonistsedatives, pure opioids in premedication and locoregional techniques.Limitations: Limitations include non-randomised sampling, potentialbiases, unquantified response rates, subjective death cause classification andlimited variable analysis.Conclusions: Anaesthetic mortality in cats is significant, predominantlypostoperative. Risk factors include cachexia, higher ASA status, specificprocedures and mechanical ventilation. Protective factors include alpha2 -agonist sedatives, pure opioids and locoregional techniques. These findingscan help improve anaesthesia safety and outcomes. However, further researchis required to improve protocols, enhance data quality and minimise risks.

Background: We designed a device to close accidental dural puncture via the offending puncturing epidural needle directly after diagnosis of the puncture and before removing the needle. The aim of this study was to quantify this device's ability to seal cerebrospinal fluid leakage. Methods: Forty-six anesthetized adult sheep were studied in a single-blind randomized controlled fashion in two equal groups.An intentional dural puncture was performed with an 18-gage Tuohy needle on all the sheep between L6 and S1 levels. Contrast medium was injected through the needle. Twenty-three animals receive treatment with the sealing device. Two minutes after device placement, or dural puncture in the control group, a CT scan was performed on the animals to estimate contrast material leakage. A region of interest (ROI) was defined as the region that enclosed the subarachnoid space, epidural space, and neuroforaminal canal (the vertebral body above and half of its equivalent height in sacrum below the puncture site). In this region, the total contrast volume and the volumes in the epidural space (EPIDURAL) were measured. The primary outcome measure was the EPIDURAL/ROI ratio to ascertain the proportion of intrathecally injected fluid that passed into the epidural space in both groups. The secondary outcomes were the total amount of contrast in the ROI and the EPIDURAL. Results: The device was deployed successfully in all but two instances, where it suffered from manufacturing defects.Leakage was less in the study group (1.0 vs 1.4 mL, p=0.008). The median EPIDURAL/ROI ratio was likewise less in the study group (29 vs 46; p=0.013; 95% CI (-27 to -3.5)). Conclusion: This novel dural puncture-sealing device, also envisaged to be used in other comparable iatrogenic leakage scenarios to be identified in the future, was able to reduce the volume of cerebrospinal fluid that leaked into the epidural space after dural puncture. The device is possibly a valuable way of preventing fluid leakage immediately after the recognition of membrane puncture.

Background:Ensuring patient safety during small animal anaesthesia is cru-cial. This study aimed to assess anaesthetic-related deaths in dogs globally,identify risks and protective factors and inform clinical practice.Methods:This prospective cohort multicentric study involved 55,022 dogsfrom 405 veterinary centres across various countries. Data on anaesthesia-related deaths from premedication to 48 hours post-extubation werecollected. Logistic regression was used to analyse patient demographics,American Society of Anesthesiologists (ASA) classification, procedure typeand anaesthetic drugs used.Results:Anaesthetic-related mortality was 0.69%. Most deaths occurred post-operatively (81%). Age, obesity and a higher ASA classification score wereassociated with increased mortality. Urgent procedures, non-urgent butunscheduled anaesthesias and short procedures also had higher mortality.Some sedatives, systemic analgesics, hypnotics and the use of locoregionalanaesthesia were linked to a decrease in mortality.Limitations:The limitations of the study include the non-randomised sam-ple, potential selection bias, lack of response rate quantification, variable dataquality control, subjectivity in classifying causes of death and limited analysisof variables.Conclusion:Careful patient evaluation, drug selection and monitoring canbe associated with reduced mortality. These findings can be used to developguidelines and strategies to improve patient safety and outcomes. Furtherresearch is needed to refine protocols, enhance data quality systems andexplore additional risk mitigation measures.

The QL block is a high-level locoregional anesthesia technique, which aims to provide analgesia to the abdomen. Several approaches of the QL block have been studied to find out which one allows a greater distribution of the injectate. The aim of this study is to compare the traditional interfascial QL block (IQL) with a new latero-ventral approach (LVQL). We hypothesize that this new approach could be safer and easier to perform, since the injectate is administered more superficially and further away from vital structures. Our second objective is to assess whether a higher volume of injectate (0.6 mL/kg) could reach the ventral branches of the last thoracic nerves, leading to a blockade of the cranial abdomen. Six thawed canine cadavers (12 hemiabdomens) were used for this purpose. Both approaches were performed in all cadavers. A combination of methylene blue/iopromide was administered to each hemiabdomen, randomly assigned to the LVQL or IQL. No differences were found regarding the ease of perform the LVQL with respect to IQL. The results show that both techniques reached the ventral branches from L1 to L3, although only the IQL consistently stained the sympathetic trunk (5/6 IQL vs. 1/6 LVQL). The use of a higher volume did not enhance a more cranial distribution of the injectate.

La pandemia Covid-19 supuso un fuerte impulso al teletrabajo y la formación virtual. El alumnado y el personal empleado tuvieron que desarrollar nuevas competencias para adaptarse al formato on-line. Ante esta situación, si bien han proliferado los estudios sobre los efectos de la pandemia tanto en el ámbito laboral como en el educativo, es poca la literatura acerca de su impacto en las prácticas curriculares. El presente estudio aborda el análisis, desde la perspectiva empresarial, de las competencias requeridas para la realización de teleprácticas eficaces. Se elaboró una encuesta exploratoria para conocer la opinión de las empresas que habían acogido estudiantes en prácticas on-line acerca de su intención de mantener esta modalidad en el futuro y de las competencias que más valoraban en su desempeño. A partir de esta, se ha realizado un análisis descriptivo de los resultados obtenidos, seguido de una prueba de proporciones Chi-Cuadrado. A continuación, se ha desarrollado un análisis factorial exploratorio y ejecutado un análisis de componentes principales (PCA). El objetivo era detectar relaciones de interdependencia entre las distintas competencias y, así, sintetizar la información mediante la creación de factores que las agrupan. Asimismo, se ha realizado un análisis cualitativo del contenido de la pregunta abierta sobre otras competencias requeridas. Los resultados del estudio introducen la singularidad competencial de las teleprácticas y permiten vislumbrar la necesidad de seguir investigando para crear un modelo eficaz que mejore la empleabilidad de los futuros egresados.

Pimobendan is an inotropic and vasodilator drug with no sympathomimetic effects. This study aimed to evaluate the haemodynamic effects of pimobendan during anaesthesia in healthy senior dogs. A prospective, randomised, triple-blinded, placebo-controlled clinical study was conducted. Thirty-three dogs (median [range]: 9 [7, 12] years) were anaesthetised for surgical procedures. The dogs were randomly allocated into two groups: eighteen dogs received intravenous pimobendan at a dose of 0.15 mg/kg (PIMOBENDAN), and fifteen dogs received intravenous saline solutions at a dose of 0.2 mL/kg (PLACEBO). Data were recorded before, 1 min, 10 min, and 20 min after injection. Velocity-time integral (VTI), peak-velocity (PV), and mean-acceleration (MA) were measured using an oesophageal Doppler monitor (ODM). Heart rate and mean arterial pressure were also registered. The data were analysed using a two-way ANOVA for trimmed means. Statistical differences were considered if p < 0.05. Twenty minutes after injection, the VTI (13.0 cm [10.4, 22.3]), PV (95.0 [83.0, 160]m/s), andMA (12.6 [9.40, 17.0]m/s2)were significantly higher in the PIMOBENDAN group compared to the PLACEBO group (VTI: 10.5 [6.50, 17.4] cm, PV: 80.0 [62.0, 103] m/s and MA: 10.2 [7.00, 16.0] ms2). No significant differences were observed in the rest of the variables. Using pimobendan during anaesthesia increases VTI, PV, and MA, as measured by an ODM.

The aim of the study was to describe the signalment, clinical presentation and presumptive or final diagnoses of dogs with cranial thoracic spinal cord lesions identified on advanced imaging. Retrospective evaluation of the databases of three veterinary specialty centres, between 2009 and 2021, was performed to identify dogs with a lesion a􀀀ecting the cranial thoracic vertebral column (T1- T6 vertebrae) as the primary cause for presenting signs of myelopathy and/or spinal pain. Eighty-four dogs were included in the study, with the majority (n = 76) presenting with a progressive history of over 4-weeks’ duration. On neurologic examination, most dogs were ambulatory (n = 64), and the most common neuroanatomic localisation was the T3-L3 spinal cord segments (n = 63). Twelve dogs (14%) showed a short-strided thoracic limb gait on clinical examination. The most common diagnosis was neoplasia (n = 33), followed by anomalies (n = 22, including vertebral body malformations in 14 dogs) and degenerative disorders (n = 16, with intervertebral disc protrusion diagnosed in 9 dogs). Themost common vertebrae a􀀀ected were T3 and T5.Most dogs with degenerative conditions showed asymmetric clinical signs, and the majority of dogs with neoplasia showed signs of spinal hyperaesthesia on examination. The findings of this study describe the clinical signs and presumptive or final diagnoses associated with lesions a􀀀ecting the cranial thoracic spinal cord. When combined with the signalment and clinical history, this information can assist in both the recognition of and problem-based approach to these cases

This study compared four methods to provide intraoperative analgesia during canine ovariohysterectomy in a veterinary teaching hospital. A retrospective study was designed to assess the nociceptive response, cardiorespiratory stability, quality of recovery and complications of four analgesic protocols: epidural analgesia (EPIDURAL group), Quadratus Lumborum block (QLB group), Transversus Abdominis Plane block (TAP group), and just systemic analgesia (GENERAL group). Undergraduate students carried out all the loco-regional techniques under the direct supervision of a qualified anaesthetist. A total of 120 cases met the inclusion criteria and were included in the study and were distributed as follows: 22, 27, 32 and 39 cases with EPIDURAL, GENERAL, QLB and TAP groups, respectively. Data were analysed with statistical software R using different statistical methods. Significant differences among groups were defined as p < 0.05. Based on our results, all the groups needed the same number of rescue analgesia during the intra-operative period. The use of loco-regional techniques anticipated a better quality of recovery compared with the general group. The EPIDURAL group showed a statistically lower expired fraction of sevoflurane. No differences were found regarding complications. In conclusion, these four analgesic methods are suitable and safe to be performed for canine ovariohysterectomy, although loco-regional techniques might have some advantages.