Saturday 31 August 2019

Lupine Publishers | Forced Traction: An Error

Lupine Publishers | Journal of Veterinary Science

Introduction

Immediate cause of dystocia requires certain preparations and precautions so that if dystocia occur, prompt handling may prevent injury or death of either or both the dam and fetus. The maternal causes of dystocia are largely those factors that produce a narrowing or stenos are of the birth passage or prevent the normal entrance of the fetus into the birth canal. Robert [1] stated that hereditary or congenital hypoplasia of the birth canal or vulva; compression or stenos is of the cervix, vagina, or vulva by indurations caused by scars and connective tissue usually from injuries at previous parturitions; failure of the cervix to dilate can leads to maternal dystocia.

Case History and Observations

A five year old, full term pregnant, Kankrej cow of her second parity was presented to the Jalaram Gauseva Kendra, Bhabhar, district Banaskantha. The history revealed that the cow was in labour since last day. The true water bag was ruptured before 3hrs and progress of two hind limbs was noticed at vulvar orifice. The owner has made efforts to deliver the fetus by application of traction at both hind limbs. The cow was in lateral recumbency with eversion of vagina and the fetus was presented at external so in posterior longitudinal presentation, lumbo-sacral position with the hind limbs protruding out of the cervix (Figure 1).
Figure 1: Prolapse of the vagina at the time of parturition in Kankrej cow.
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Treatment

The cow was brought on the dorsal recumbancy and epidural anaesthesia was induced with 6ml of 2% lignocain hydrochloride. Inj. Dexamethasone 5ml was injected before the intervention. The dorsal aspect of the external so of the cervix was incised to widen the passage and calving rope was applied at the pastern joint of both hind limbs. The cervix was hold at the external so and gentle forced traction was applied on the calving rope. The dead male fetus was delivered (Figure 2). The placenta was removed manually, the incision was sutured using chromic catgut #1 and the prolapsed mass was relocated as per standard procedure. Four boluses of Oxytetracycline hydrochoride were placed in uterus. The cow was treated with Inj. DNS- 4 lit. I/v, Inj. RL-2 lit. I/v, Inj. Analgine-15ml I/m, Inj.Oxytetracycline Hydrochloride 40ml I/v and Injection Chlorpheneramine maleate 10ml I/m. The cow could not survive and succumbed to death after 3 hrs of the treatment.
Figure 2: Dead delivered male fetus.
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Discussion

Robert [1] stated that when the balance between fetus size and pelvic or genital tract diameter gets upset, the dystocia results. When traction is applied the operator should constantly watch, examine and direct the progress of fetus by instructing his assistance when to apply traction, when it should cease, and in what direction it should be applied. If the progress of the fetus through the birth canal ceases, traction should be discontinued and the fetus and the birth canal should be carefully examined to determine the cause of the obstruction. The cause should be overcome or corrected before exerting further traction. If the patient is straining, traction should be applied principally during expulsive efforts. These both aids the withdrawn of the fetus and to some extent prevents the fetus dragging parts of the uterus and vagina along with it. To avoid the lacerations and ruptures of the soft structures of the birth canal time should be allowed for dilatation of the birth canal as the fetus advances. In the present case prolapse of the vagina might have occurred due to applying extreme expulsive efforts while the cervix was incompletely dilated and the fetus might have died due to asphyxia. The death of the cow might have occurred due to hypovolaemia resulted into shock.


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Friday 30 August 2019

Lupine Publishers | Amaranth - A Functional Food

Lupine Publishers | Journal of Veterinary Science

Abstract

Amaranthus, collectively known as amaranth or pigweed, is a cosmopolitan genus of herbs. Approximately 60 species are presently recognized, with inflorescences and foliage ranging from purple and red to gold. Because of recent concerns about global food security and malnutrition scientists all over the world are engaged in exploring the plant biodiversity to broaden the crop list. Due to described agricultural advantages, unique nutritional properties and versatile usage, grain amaranth (Amaranthus spp.) has gained increased attention. Amaranth seeds have a high content of storage proteins (14-19%) whose amino acid composition is rich in lysine and methionine, two limiting amino acids in cereals and legumes, respectively. Amaranth (Amaranthuscaudatus), quinoa (Chenopodium quinoa) and ka~niwa (Chenopodiumpallidicaule) are originally from the Andes of South America where they have remained a staple since Pre-Hispanic times. Due to its good protein quality which is comparable to casein, high fibre content and bioactive compounds, and these gluten-free grains are formidable food alternatives for celiac patients and/or those suffering from gluten-sensitivity.


Introduction


Amaranthus is recognized as a promising plant genus that may provide high-quality protein, unsaturated oil, and various other valuable constituents. Amaranths are valued as leaf vegetables and cereals.It is noted not only for its environmental hardiness but also for the excellent nutritional quality of its seeds (Bejosano, [1]). Due to its unique nutritional properties and versatile usage, grain amaranth (Amaranthus spp.) has gained increased attention. Amaranthus, collectively known as amaranth or pigweed, is a cosmopolitan genus of herbs. Approximately 60 species are presently recognized, with inflorescences and foliage ranging from purple and red to gold. Most species are considered as opportunistic weeds and only three of them, Amaranthuscaudatus, Amaranthuscruentus and Amaranthushypochondriacus, are commonly consumed by humans as a seed or used as a functional ingredient in foods (Gamel). Amaranth is a pseudocereal because of its flavor and cooking similarities to grains. The word “Amaranth” comes from the Greek amarantos, the ‘one that does notwither’ or the never-fading flower. It contains high content of fibre and bioactive compounds Repo-Carrasco [2], these gluten-free grains are formidable food alternatives for celiac patients and/or those suffering from gluten-sensitivity. It also provides a good source of dietary fiber and dietary minerals such as iron, magnesium, phosphorus, copper, and especially manganese. Amaranth was recognized as gluten-free and is therefore suitable for diets of celiac disease patients (Fasano and Catassi [3]; Thompson [4]. The seeds are eaten as a cereal grain. They are ground into flour, popped like popcorn, cooked into porridge, and made into a confectionery called alegría. The leaves can be cooked like spinach, and the seeds can be germinated into nutritious sprouts. The leaves are variable in size, green or purple, with slender stalks. These are alternate, usually simple, with entire margins and distinct markings, depending on species. Amaranth species are also cultivated and consumed as a leaf vegetable in many parts of the world. In India the leaf is added in preparation of a popular dal called thotakurapappu. In China the leaves and stems are used as a stir-fry vegetable. In East Africa amaranth leaf is known as mchicha- “a vegetable for all”. The seeds are used as a source of lipids and a material for the production of flour, flakes, popped seeds, several sorts of bread (Januszewska-Jóźwiak and Synowiecki, [5]) and confectionery Sindhuja [6].

Chemical Composition and Nutrition Value

The small seeds are usually shiny black in colour, in contrast to those of grain types which are cream-coloured. There are up to 3 000 seeds per gram. The tiny, lens shaped seeds are usually pale in colour.A seed of grain amaranth is on average composed of 13.1 to 21.0% of crude protein; 5.6 to 10.9 % of crude fat; 48 to 69% of starch; 3.1 to 5.0% (14.2 %) of dietary fibre and 2.5 to 4.4 % of ash Grobelnik [7]. Enzyme inhibitors and allergens are known to be present in cereals. Protein isolated from wheat, rice, maize and barley may cause allergic reaction, a gliadin fraction isolated from wheat causes celiac disease. But these components are not available in pseudocereals and legumes such as soybean and amaranths Kuhn [8]. Furthermore, amaranths contain dietary fibre in high proportion, which improves lipid metabolism. Its nutritional value is mainly due to its protein fraction (Gorinstein [9] Oleszek [10]). Amaranth, a pseudocereal, is an unconventional and interesting source of proteins. Its seeds contain a large amount (14-17%, w/w) of high nutritional quality proteins (Bolontrade [11]), whose amino acid composition is rich in lysine and methionine, two limiting aminoacids in cereals and legumes, respectively [4,5]. Amaranth’s balanced amino acid composition is close to the optimum protein reference pattern in the human diet according to FAO/ WHO requirements. Protein is high in amino acid lysine but low in leucine. This is the opposite of most other grains. Thus mixing would form an almost perfect protein (Good ratio of unsaturated fat to saturated fat that is beneficial for hypertension and coronary heart disease).The nutritional quality of amaranth seed is high because of its high protein content and balanced essential amino acid composition (Oszvald [12]). Moreover, amaranth grain protein is rich in lysine, which is usually deficient in cereal grains. Proteins have high digestibility (approx. 90%) and are rich with lysine (4.9 to 6.1g/100 g protein) which usually appears in grains as a limiting amino acid. This high lysine concentration is complemented with elevated levels of sulphur amino acid content (2 to 5%), which is higher than that measured in the most important legumes (1.4% on average), such as peas, beans and soybeans (Gorinstein and Moshe, [13]). Leucine, isoleucine, valine, the limiting amino acids in amaranth, are not considered a serious problem since they are found in excess in most common grains, and therefore, amaranth is well suited for blending with cereals.The main protein fractions present in the amaranth grain are albumins, 11S-globulin, P-globulin, and glutelins .
Amaranth starch is of promising use. The features of starch like high solubility and digestibility are due to its uniquely small size which is about one-tenth the size of cornstarch and therefore offer new possibilities for food processing, pharmacology and cosmetics Resio [14]. The total mineral content has been reported to be generally higher than that observed in cereal grains, especially calcium and magnesium Alvarez-Jubete [15]. On the other hand, it is characterized by higher dietary fibre and lipid content than most cereals and also contains between 50 and 60g of starch per 100 g of grains Alvarez-Jubete [15]. Amaranth has recently become a focus of interest for its high nutritive values and great potential as a functional food given its cholesterol-lowering effect observed in animal models Mendonça [16]; Plate &Arêas [17]. According to Becker [18] seed of grain amaranth is a rich source of iron (72 to 174mg/kg), calcium (1,300 to 2,850mg/kg), sodium (160 to 480mg/kg), magnesium (2,300 to 3,360mg/kg) and zinc (36.2 to 40mg/kg) as well as vitamin riboflavin (0.19 to 0.23mg/100g of flour) ascorbic acid (4.5mg/100g), niacin (1.17 to 1.45mg/100g), and thiamine (0.07 to 0.1mg/100g). Amaranth oil is reported to have high levels of tocotrienols and squalene, which are natural organic compounds that are involved in the metabolism of cholesterol and that could play an important role in lowering LDL-cholesterol in blood. Amaranth lipid is unique with high squalene content ranging from 2.4 to 8.0% of the total oil contents (Rodas and Bressani, [19]. A comparative account of nutritive value of grain amaranths and other cereals is presented in Table 1. On the average pale-seeded amaranths contain 8% of dietary fibre and black coloured 16% with soluble fibre rate of 30 to 40% and 18 %, respectively (Schnetzler and Breene [20], Tosi [21] reported 14.2% of dietary fibre in the A. cruentus flour (8.1% soluble, 6.1% insoluble).
Table 1: Comparative account of nutritive value of grain amaranths and other cereals.
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Health Benefits

Amaranth leaves are a good source of energy in the body sicne the crude protein content in the leaves ranges is very high i.e.20 to 32%, on a dry weight basis. Amaranth leaves are a good source of elements like manganese, iron, copper, calcium, magnesium, potassium and phosphorus necessary to maintain adequate electrolyte balance in the body. People suffering from gluten intolerance or those suffering from celiac diseases can get daily recommended dose of protein from amaranth greens. Compared to other plant sources, such as wheat and rice amaranths are glutenfree and contain 30% more protein with complete set of amino acids. It can improve the digestive system and reduce constipation due to the high content of dietary fibre which is three times that of wheat. The protein in the leaves helps to reduce insulin levels in the blood and also releases a hormone that lessens hunger pranks and prevent over eating. One of the key health benefits of vegetable amaranth leaves is their cholesterol-lowering capacity. Due to the high fibre content, this leafy vegetable is effective in reducing LDL levels in the blood and promotes weight loss. Tocotrienols, a type of vitamin E available in vegetable amaranths, also contributes to its cholesterol lowering ability. Iron-rich (five times that of wheat) red amaranth leaves promote coagulation and increase haemoglobin content and red blood cell counts. It is also an excellent source of folic acid which is necessary to increase the blood haemoglobin level. Amaranth leaves are excellent dietary source of phytosterols that lowers blood pressure and prevents heart ailments including stroke. The presence of lysine (anessential amino acid) along with vitamin E, iron, magnesium, phosphorus, potassium and vitamin C helps to fight against free radicals responsible for ageing and formation of malignant cells which helps in fighting against cancer. The high calcium present in amaranth leaves (two times that of milk) is helpful to reduce risk of osteoporosis and other calcium deficiency- related disorders. Amaranth leaves are excellent source of β-carotene. Inclusion of amaranth leaves in the daily diet can help to prevent vitamin A deficiency. It was reported that the incidence of blindness in children due to malnutrition has been reduced with the consumption of 50-100 g of amaranth leaves per day Das [22].

Bioactive Components and Medicinal Properties

The health benefits of amaranths have always been recognised in homoeopathic and Ayurvedic medicines. Both the seeds and leaves of amaranth are used as herbal remedies and have nutraceutical value. Amaranth protein contains a low proportion of prolamins which makes it a safe ingredient for people with celiac disease and recent studies have shown that amaranth peptides displayed antihypertensive and anti-inflammatory activity. Peptides contained in amaranth seed proteins have shown various biological activities. Some studies using amaranth flour and protein isolates reported the occurrence of peptides with biological activities such as anti-hypertensive, anti-oxidant, anti thrombotic,anti-proliferative among others. Amaranth is ranked as one of the top five vegetables in antioxidant capacities Walter [23]). It contains ample amount of bioactive components, such as L-ascorbic acid, betacarotene, polyphenol, anthocyanins and lutein Walter[23]. It has been used as an antipyretic to reduce labour pain in Indian and Nepalese traditional medicine, as astringent, diuretic, haemorrhage and hepatoprotective agent (Kirtikar and Basu [24]. Amaranths have also been used to treat bladder distress, piles, toothache, blood disorders and dysentery (Madhav [25]. The health beneficial antioxidant activities are related to their bioactive components. The cholesterol- lowering effects in amaranth may be due to unsaturated fatty acids. Being a good source of magnesium which is effective to relax blood vessels and prevent constriction and rebound dilation, it helps to fight migraines. Cooking had no deleterious effect on total bioactive component except for the reduction of anthocyanins content. Home cooking increases the antioxidant activities and the contents of arytenoids, especially by steaming. Both simmering and blanching increased the betacarotene and lutein in the cooked amaranth (Han and Xu [26].

Food Uses of Amaranth

Vegetable amaranths are widely consumed as leafy vegetables in India and other Asian and Southeast Asian countries, also in African countries where as in North and South America grain amaranths are widely consumed. Amaranth leaves are a good source of high amount of protein, vitamins, minerals and dietary fibre. Chopped plants can also be used as forage for livestock. Amaranth seed oil has been reported to contain large amount (7-8% and 11%) of squalene which is often used in cosmetics and medicine, where olive oil contains only 1% of squalene. Amaranth oil is also a rich source of tocotrienols which is very effective to lower the LDL cholesterol (Becker [27] Plate and Areas [17]. In India A. hypochondriacus is known as the ‘king grain’ and is often popped to be used in confections. Amaranth grain may be processed in various ways, like grains can be popped, flaked, extruded and ground into flour. Popped amaranth can be enjoyed on its own or can be served with milk or soymilk and fruit for a healthy breakfast. Amaranth can be used as a substitute in porridge, stirred into soups; Amaranth grains can be cooked whole in a pot, rice cooker or pressure cooker to prepare breakfast porridge or savory ‘polenta’. The grain flour or flaked grains are combined with wheat or other flours to make cereals, cookies, bread and other baked goods. As per general recommendation, amaranth grain flour should contribute only 10-20% of the mixed flour blended with wheat flour. But it has been shown that amaranth grain flour blended up to 50-75% of the mixed flour, it will still retain functional properties as well as flavour.

Processing

Amaranth is cleaned with screens, by winnowing, with a fan or other blowing device. After harvesting, it is important to further dry the crop to ensure it won’t spoil during storage. It can be left on trays in the hot sun or placed near an indoor heat source. Amaranth has no hulls to remove unlike beans or true grains, Amaranth is relatively a small sized grain with average diameter of about 1mm. The embryo part accounts for about 25% of the kernel and situated in the peripheral region. The kernel consists of storage tissue or per sperm and the endosperm part is present as a two layered tissue Coimbra and Salema [28]. The seed coat of the amaranth grain is smooth and thin. Amaranth seed contains 26% of bran and germ components and 74% of flour. The nutrients are not uniformly distributed throughout the grain like other cereals. Nutrients are concentrated in bran and germ fractions of the grain. The amaranth grain can be toasted, popped, extruded or milled into flour and can therefore be consumed as such or included in other cereal products such as bread, cakes, muffins, pancakes, cookies, dumplings, crepes, noodles and crackers [29-84].

Conclusion


Amaranths especially the grain amaranths are considered as the golden crop of future. Much of the research activities done on amaranths has focussed on its exceptional nutritive value. The health benefits of amaranths have been recognized in homoeopathic and Ayurvedic medicines. Both the seeds and leaves of amaranth are used as herbal remedies and have nutraceutical value.


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Thursday 29 August 2019

Lupine Publishers | The Use of Epidural Anaesthesia over General Anaesthesia in Ruminants

Lupine Publishers | Journal of Veterinary Science



Abstract


General anaesthesia is an essential component of modern medicine. It is a drug induced reversible condition that includes specific behavioral and physiological traits - unconsciousness, amnesia, analgesia, and akinesia- with concomitant stability of the autonomic, cardiovascular, respiratory, and thermoregulatory systems. General anesthesia in ruminants has inherent risks such as regurgitation of ruminal contents, excessive salivation and the possibility of pulmonary aspiration; therefore it is not always recommended and local or regional techniques may be used instead. Epidural anaesthesia is a central neuraxial block technique which is used regularly in veterinary practice for treatment of different obstetrical and surgical interferences in the perineal, sacral, lumbar, and caudal parts of the thoracic region of domestic animals. There have been several scientific researches on the use of epidural anesthesia in ruminants and other species for various surgical and laboratory procedures. In conclusion, the disadvantages of general anaesthesia outweigh the advantages especially in ruminant specie. Therefore, epidural anaesthesia is the most preferred.


Introduction


Anaesthesia is an indispensible prerequisite for most surgical interventions both in humans and in animals Muhammad [1] It is supposed to provide reversible unconsciousness, amnesia/ analgesia, muscle relaxation, and immobility with minimal adverse effects, rapid and smooth recovery of protective reflex and psychomotor function Bajwa [2] Hemming. General anaesthesia is the controlled and reversible loss of consciousness for many surgical procedures that warrant effective control of pain and movement.
General anaesthesia is an essential component of modern medicine. It is a drug induced, reversible condition that includes specific behavioral and physiological traits - unconsciousness, amnesia, analgesia, and akinesia- with concomitant stability of the autonomic, cardiovascular, respiratory, and thermoregulatory systems (Brown [3]. In the practice of medicine (especially surgery and dentistry), anaesthesia is a state of temporary induced loss of sensation or awareness. It may include analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), or unconsciousness A patient under the effects of anesthetic drugs is referred to as being anesthetized. Anesthesia enables the painless performance of medical procedures that would cause severe or intolerable pain to an unanesthetized patient. Three broad categories of anaesthesia exist: General anesthesia suppresses central nervous system activity and results in unconsciousness, total lack of sensation and loss of protective reflexes. Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness.
Regional anesthesia and local anesthesia, which block transmission of nerve impulses between a targeted part of the body and the central nervous system, causing loss of sensation in the targeted body part. A patient under regional or local anesthesia remains conscious, unless general anaesthesia or sedation is administered at the same time. Two broad classes exist:
a) Peripheral blockade inhibits sensory perception in an isolated part of the body, such as numbing a tooth for dental work or administering a nerve block to inhibit sensation in an entire limb.
b) Central, or neuraxial, blockade administers the anesthetic in the region of the central nervous system itself, suppressing incoming sensation from outside the area of the block. Examples include epidural anaesthesia and spinal anaesthesia.
To achieve the goals of anesthesia, drugs act on different but interconnected parts of the nervous system. Hypnosis, for instance, is generated through actions on the nuclei in the brain and is similar to the activation of sleep. The effect is to make the patient less aware and less reactive to noxious stimuli Miller and Ronald [4].
Loss of memory (amnesia) is created by action of drugs on multiple (but specific) regions of the brain. Memories are created as either declarative or non-declarative memories in several stages (short-term, long-term, and long-lasting) the strength of which is determined by the strength of connections between neurons termed synaptic plasticity. Each anesthetic produces amnesia through unique effects on memory formation at variable doses. Inhalational anesthetics will reliably produce amnesia through general suppression of the nuclei at doses below those required for loss of consciousness. Drugs like midazolam produce amnesia through different pathways by blocking the formation of long-term memories.
Tied closely to the concepts of amnesia and hypnosis is the concept of consciousness. Consciousness is the higher order process that synthesizes information. For instance, the “sun” conjures up feelings, memories and a sensation of warmth rather than a description of a round, orange warm ball seen in the sky for part of a 24 hour cycle. Likewise, a person can have dreams (a state of subjective consciousness) during anesthetic or have consciousness of the procedure despite having no indication of it under anesthetic. It is estimated that 22% of people dream during general anesthesia and 1 or 2 cases per 1000 have some consciousness termed “awareness during general anesthesia” Miller and Ronald [5].

Advantages and Disadvantages in Ruminants


Starter cultures

General anesthesia in ruminants has inherent risks such as regurgitation of ruminal contents, excessive salivation and the possibility of pulmonary aspiration; therefore it is not always recommended and local or regional techniques may be used instead (Hall and Clarke [5]) Sheep and goats are ideally suited to local analgesic techniques under manual restraint with or without sedation (Taylor [6]).
Local anesthesia is any technique to induce the absence of sensation in a specific part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with reduced pain and distress. In many situations, such as cesarean section, it is safer and therefore superior to general anesthesia. It is also used for relief of non-surgical pain and to enable diagnosis of the cause of some chronic pain conditions. Anesthetists sometimes combine both general and local anesthesia techniques.
However, there are other important reasons for using epidurals, including a reduction in the incidence of perioperative pulmonary and cardiac complications in certain settings Ballantyne [7] Beattie [8]. The evidence that epidurals offer better postoperative analgesia than systemic opioids is unequivocal, Block [9] and the risk of major complications from epidurals inserted in the perioperative period is low Cook [10].
Regional anaesthesia certainly provides high quality pain relief Popping [11]. However, it may carry a risk of neurological deficit. A systematic review of neurological complications after regional anaesthesia cited incidences of neuropathy of 1.48:100 for axillary block and of 2.84:100 for interscalene block, Brull [12] but permanent neurological injury is very rare. The balance of risks and benefits has to be considered in the context of the particular patient, operation, and regional block.

Epidural Anaesthesia

Epidural anaesthesia is a central neuraxial block technique which is used regularly in veterinary practice for treatment of different obstetrical and surgical interferences in the perineal, sacral, lumbar, and caudal parts of the thoracic region of domestic animals. Epidural anesthesia using local anesthetic drugs has been a common technique used in veterinary medicine to perform surgical procedures since the 1950s in North America and Europe. With the advent of safer injectable and inhalational anesthetic drugs and accessibility to anesthetic equipment, the use of epidural anesthesia became less frequent in the following years. In the late 1980s, however, with the recognition of opioids’ analgesic actions on the spinal cord, the use of epidural analgesia became an important tool that has re-emerged in intra- and postoperative epidural techniques to provide analgesia and anesthesia in veterinary medicine Valverde [13]. Epidural administration (from Ancient Greek ἐπί, “on, upon” + dura mater) is a medical route of administration in which a drug or contrast agent is injected into the epidural space of the spinal cord. Techniques such as epidural analgesia and epidural anaesthesia employ this route of administration. The injection can result in a loss of sensation, including the sensation of pain by blocking the transmission of signals through nerve fibers in or near the spinal cord. Injecting medication into the epidural space is primarily performed for analgesia. This may be performed using a number of different techniques and for a variety of reasons. Additionally, some of the side-effects of epidural analgesia may be beneficial in some circumstances (e.g., vasodilation may be beneficial if the subject has peripheral vascular disease). When a catheter is placed into the epidural space a continuous infusion can be maintained for several days, if needed. Epidural analgesia may be used:
a) For analgesia alone, where surgery is not contemplated. An epidural injection or infusion for pain relief (e.g. in childbirth) is less likely to cause loss of muscle power, but has to be augmented to be sufficient for surgery.
b) As an adjunct to general anaesthesia. The anaesthetist may use epidural analgesia in addition to general anaesthesia. This may reduce the patient’s requirement for opioid analgesics. This is suitable for a wide variety of surgery, for example gynaecological surgery (e.g. hysterectomy), orthopaedic surgery (e.g. hip replacement), general surgery (e.g. laparotomy) and vascular surgery (e.g. open aortic aneurysm repair).
c) As a sole technique for surgical anaesthesia. Some operations, most frequently Caesarean section, may be performed using an epidural anaesthetic as the sole technique. This can allow the patient to remain awake during the operation. The dose required for anaesthesia is much higher than that required for analgesia.
d) For post-operative analgesia, after an operation where the epidural technique is employed as the sole anaesthetic, or in conjunction with general anaesthesia. Analgesics are administered into the epidural space typically for a few days after surgery, provided a catheter has been inserted. Through the use of a patient-controlled epidural analgesia (PCEA) infusion pump, a person can supplement an epidural infusion with occasional doses of pain medication through an epidural catheter.
e) For the treatment of back pain. Injection of analgesics and steroids into the epidural space may improve some forms of back pain.
f) For the treatment of chronic pain or palliation of symptoms in terminal care, usually in the short- or mediumterm.
The epidural space is more difficult and risky to access as one ascends the spine (because the spinal cord gains more nerves as it ascends and fills the epidural space leaving less room for error), so epidural techniques are most suitable for analgesia anywhere in the lower body and as high as the chest. They are (usually) much less suitable for analgesia for the neck, or arms and are not possible for the head (since sensory innervation for the head arises directly from the brain via cranial nerves rather than from the spinal cord via the epidural space).
The epidural space is the space inside the bony spinal canal but just outside the dura mater (“dura”). In contact with the inner surface of the dura is another membrane called the arachnoid mater (“arachnoid”). The cerebrospinal fluid that surrounds the spinal cord is contained by the arachnoid mater. In adults, the spinal cord terminates around the level of the disc between L1 and L2 (in neonates it extends to L3 but can reach as low as L4), below which lies a bundle of nerves known as the cauda equina (“horse’s tail”). Hence, lumbar epidural injections carry a low risk of injuring the spinal cord. Insertion of an epidural needle involves threading a needle between the bones, through the ligaments and into the epidural potential space taking great care to avoid puncturing the layer immediately below containing CSF under pressure.
There have been several scientific researches on the use of epidural anesthesia in ruminants and other species for various surgical and laboratory procedures. Olaifa [14] reported the physiological and biochemical effects of epidural lidocaine with adrenaline in pregnant West African dwarf goats and this will serve as reference point for surgeons when operating on pregnant animals under epidural anaesthesia especially during caesarean section and rectal tear repairs. Olaifa [15] used epidural anaesthesia with plain lignocaine in naturally PPR infected WAD goats to produce effective anaesthesia which can be used for surgical procedures in such animals. Kisani and his colleagues [16] compared the effects of duration of epidural anaethesia in West African dwarf goats using ketamine Hcl, lidocaine Hcl and xylazine Hcl; lidocaine-distilled water and lidocaine-magnesium sulfate mixture Sadegh 17] Also, comparing the efficacy of medetomidine HCl and lignocaine HCl as epidural anesthetic in Buffalo Calves Akbar [18] Epidural morphine improves analgesia in goats undergoing hindlimb3 and abdominal2 surgery Pablo [19]; Hendrickson et al. [20]. Lumbosacral epidural lidocaine-epinephrine, lidocaine-xylazine and bupivacaine provide prolonged anaesthesia that may contribute to pain relief in the immediate postoperative period in animals undergoing surgical procedures involving the flank, perineum and hindlimb Rostami and Vesal [21]. The combination of bupivacaine (0.25mg kg-1) plus ketamine (1.25mg kg-1) has been used safely for epidural analgesia in sheep without any marked side effects Dadafarid and Najafpour [22]. Epidural administration of tramadol alone provided good anti-nociception in the perineal region, with a prolonged duration of effect with no ataxia, however, tramadol-lidocaine combination resulted in a rapid onset time and prolonged duration which may be useful in clinical practice for a single-dose epidural administration to enable surgical and obstetrical procedures of long duration to be completed Dehkordi. Epidural injection of lignocaine produced a longer duration of antinociception with lower frequency of pain associated behavioural changes in goat subjected to castration with the use of high tension band Ajadi [23]. Thoracolumbar epidural technique also promotes satisfactory analgesia in the animal’s flank, and a larger anaesthetized area. The combination of 0.5% bupivacaine and methadone was shown to be more effective in promoting analgesia, with a short-lasting ataxic period and no undesirable effects when compared to bupivacaine alone Silva [24,25].

Conclusion


In conclusion, from the scientific literatures and information gathered, the disadvantages of general anaesthesia outweigh the advantages especially in ruminant specie. Therefore, epidural anaesthesia is the most preferred.


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