IVRA Complications in Cattle: Safety of Lignocaine-Ketamine Anesthesia
Table of Contents
Category: Academic resources > zoology thesis
Introduction
While Intravenous Regional Anesthesia (IVRA) is a highly effective and practical technique for limb surgery in cattle, the safety of any anesthetic protocol is paramount. Veterinarians must be acutely aware of potential side effects and complications to ensure patient well-being. This is particularly true when combining drugs like lignocaine and ketamine, where the benefits of enhanced anesthesia must be weighed against any potential risks.
This article, drawing directly from a master’s-level clinical study, provides a crucial examination of the IVRA complications in cattle. It details the specific side effects observed during the research and discusses their clinical significance, offering invaluable safety insights for veterinary practitioners and students.
An Original Excerpt on IVRA Complications in Cattle
(The following is an excerpt adapted from a thesis for clarity and online readability. The full citation is provided below.)
Monitoring for IVRA Complications in Cattle
In any anesthetic procedure, vigilant monitoring for signs of toxicity and adverse reactions is critical. During this study, any sign and symptom of local anesthesia toxicity—like regurgitation, pain, skin rashes, bradycardia, tachycardia, hypotension, and convulsion—was vigilantly looked for. The research specifically aimed to identify any postoperative complications after the release of the tourniquet to understand the safety profile of different IVRA protocols.
Observed Complications After Tourniquet Release
Upon release of the tourniquet after the administration of lignocaine HCl alone and its combination with ketamine, no severe signs of cardiovascular or CNS toxicity were noted. This is a significant finding, suggesting a high safety margin for the tested protocols. However, some minor and transient IVRA complications in cattle were observed, particularly in the group receiving a higher dose combination.
Table 10: Complications after removal of tourniquet in different group of animals
| Parameters | Group I (Lignocaine) | Group II (Lignocaine + Ketamine) | Group III (Lignocaine) | Group IV (Lignocaine + Ketamine) |
|---|---|---|---|---|
| Regurgitation | – | – | – | – |
| Tachycardia | – | + | – | – |
| Bradycardia | – | – | – | – |
| Prostration | – | + | – | – |
| Stumbling | – | + | – | – |
(Note: ‘+’ indicates the complication was observed; ‘-’ indicates it was not.)
The animals in which upper IVRA was induced by a combination of lignocaine and ketamine (group II) were in prostration for 5-6 minutes. A slight increase in heart rate (tachycardia) was observed in group II animals, though this change was within the normal range. Just after recovery and when animals were returned from lateral recumbency to standing, slight stumbling was noted in group II animals. Importantly, animals of groups I, III, and IV did not show any sign of toxicity.
Discussion of Specific IVRA Complications in Cattle
The main and most known complication of intravenous regional anesthesia is systemic toxicity due to local anesthetics that occurs following the accidental tourniquet release immediately after injection. This study aimed to evaluate the lower IVRA technique and the effect of adding ketamine to lignocaine on reducing the dose and side effects of lidocaine.
Heart Rate (Tachycardia) as a Side Effect
A significant (P < 0.05) increase in heart rate was noted after IVRA in the study. Ketamine has well-known hemodynamic effects (hypertension and tachycardia) but it failed to show any of these effects during the study in all the groups when given as an adjuvant in IVRA. This could be due to the fact that the tourniquet was not deflated before 60-69 min.
However, after removal of the tourniquet, a significant increase in heart rate (tachycardia) was observed in group II. This may be attributed to the high dose rate of ketamine (3.0 mg/kg) which was used in the study. Ketamine is expected to cause tachycardia in high doses. However, small doses of ketamine (≤ 0.1 mg/kg) did not show any significant hemodynamic changes or clinical side effects.
Ketamine failed to show significant tachycardia and hypertension when given as an adjuvant in IVRA due to the fact that the tourniquet was not deflated before 60-68 min. The observed changes in heart rate in group II animals were within the normal range.
Analyzing Postoperative Complications After Tourniquet Release
Release of the tourniquet after the administration of lignocaine HCl alone and its combination with ketamine resulted in no signs of cardiovascular or CNS toxicity.
The animals in which upper IVRA was induced by a combination of lignocaine and ketamine (group II) were in prostration for 5-6 minutes, with a slight increase in heart rate (tachycardia) and slight stumbling upon standing. These minor IVRA complications in cattle were transient. Animals of groups I, III and IV did not show any sign of toxicity.
Approximately 70% of lignocaine remains within the tissues of the previously isolated limb following tourniquet release, the remainder entering the general circulation in the subsequent 45 minutes.
Release of tissue-bound lidocaine is increased if the limb is exercised, emphasizing the importance of keeping the previously anesthetized limb quiescent immediately after tourniquet deflation.
The addition of ketamine to lower doses of lidocaine in animals receiving IVRA significantly reduced postoperative pain, and reduced the likelihood of systemic toxicity with lidocaine without causing significant adverse effects.
The appetite of the animals was normal. The combination of ketamine and lidocaine for IVRA improved the quality of anesthesia without inducing significant clinical side effects and reduces the dose of lidocaine and ketamine, hence it reduces their potential toxicity. This is a critical factor in managing IVRA complications in cattle.
Conclusion
When evaluating IVRA complications in cattle, this research provides reassuring evidence for the overall safety of the technique, especially when utilizing a lower IVRA approach. While the higher-dose combination of lignocaine and ketamine (Group II) did result in transient side effects like tachycardia, prostration, and stumbling, these were minor and resolved quickly. Critically, no severe cardiovascular or CNS toxicity was observed in any group.
The study concludes that combining ketamine with a reduced dose of lignocaine in a lower IVRA protocol (Group IV) offers the best of both worlds: superior anesthesia and analgesia with a minimized risk of complications, thereby enhancing the safety and efficacy of anesthesia for hoof surgery in cattle.
Source Citation:
- Researcher: Dr. Vipin Kumar Yadav
- Thesis Title: Comparative Studies on Upper versus Lower Intravenous Regional Anesthesia (IVRA) Using Lignocaine and Its Combination with Ketamine in Bovines
- Guide: Dr. A. K. Gangwar
- University: Narendra Dev University of Agriculture and Technology, Kumarganj, Faizabad (U.P.)-India
- Completion Date: 2018
- Excerpted From: Pages 60, 63, 64, 71-72, 75-76
Disclaimer:
Disclaimer: Some sentences have been lightly edited for SEO and readability. For the complete and original research, please refer to the full thesis PDF above.
What has been your experience with the side effects of regional anesthesia in large animals? Share your insights or ask a question in the comments below. Help your colleagues stay informed by sharing this important safety analysis.
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