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

Authors:
  • BBBrigitte A. Brisson
    Brigitte A. Brisson
  • MSMelissa D. Sinclair
    Melissa D. Sinclair
  • WSWilliam C. Sears
    William C. Sears
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Abstract
Objective—To evaluate the use of laparoscopic-assistedjejunostomy 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. Animals—15 healthy mixed-breed dogs. Procedures—Dogs were randomly assigned to receive open surgical J-tube placement under general anesthesia (n = 5dogs; 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 O2 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 O2 delivery in group 3 dogs, compared with group 1 and 2 dogs. Minimal differences in hemodynamic parameters were foundbetween groups undergoing laparoscopic-assistedandopen 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 and Clinical Relevance—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.

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