Small Animal Anesthesia Techniques E-Book

Amanda M. Shelby

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 389

Veröffentlichungsjahr: 2014

Beschreibung

Small Animal Anesthesia Techniques provides a quick reference to protocols for anesthetizing canine, feline, and exotic animal patients in veterinary practice. This portable companion provides complete information on anesthetic procedures, from the basics of pharmacology, physiology, and equipment to handling challenging procedures and the compromised patient. A companion website features videos, images, and worksheets for calculations. The book offers an overview of the anesthetic process, with tips on how to anticipate and avoid complications, with example protocols for specific patients. Veterinarians and veterinary technicians will find this how-to guide to providing anesthesia to be an ideal resource for fast access to drug dosages, anesthesia protocols, and special considerations for specific procedures.

Leseprobe

Table of Contents

Title page

Copyright page

Contributors

Preface

Acknowledgments

About the companion website

Chapter 1: Anesthetic process

Step 1: Preanesthetic assessment

Step 2: Premedication

Step 3: Induction

Step 4: Maintenance phase

Step 5: Recovery/postoperative phase

Chapter 2: Anesthesia equipment and monitoring

I. Anesthesia machine

II. Setting up the anesthesia machine

III. Monitoring patient depth

IV. Mechanical ventilation (MV) or intermittent positive pressure ventilation (IPPV)

V. Monitoring equipment

Chapter 3: Anesthetic drugs and fluids

Introduction

I. Acepromazine

II. Albuterol: Intermediate-acting beta2-adrenergic agonist

III. Alfaxalone

IV. Amantadine

V. Atenolol: Beta1-adrendergic antagonist

VI. Atipamezole

VII. Atracurium

VIII. Atropine

IX. Bupivacaine

X. Buprenorphine

XI. Butorphanol

XII. Calcium gluconate: Calcium supplement

XIII. Carprofen

XIV. Cisatracurium

XV. Dantrolene: Muscle relaxant

XVI. Deracoxib

XVII. Desflurane

XVIII. Desmopressin (DDAVP): Related to antidiuretic hormone (vasopressin)

XIX. Dexamethasone SP (dexamethasone sodium phosphate): Glucocorticoid

XX. Dexmedetomidine

XXI. Dextrans

XXII. Dextrose: Fluid supplement

XXIII. Diazepam

XXIV. Diphenhydramine: Antihistamine

XXV. Dobutamine

XXVI. Dopamine

XXVII. Doxapram: Respiratory stimulant

XXVIII. Edrophonium

XXIX. Ephedrine

XXX. Epinephrine

XXXI. Eutetic mixture of local anesthetic (EMLA) cream (AstraZeneca, London)

XXXII. Esmolol: Beta receptor antagonist

XXXIII. Etomidate

XXXIV. Famotidine: H2 receptor antagonist

XXXV. Fentanyl

XXXVI. Flumazenil

XXXVII. Furosemide: Diuretic

XXXVIII. Gabapentin

XXXIX. Glycopyrrolate

XL. Hydromorphone

XLI. Hydroxyethyl starch “hetastarch”

XLII. Isoflurane

XLIII. Isoproterenol: Beta agonist

XLIV. Ketamine

XLV. Ketoprofen

XLVI. Lactated ringers solution (LRS)

XLVII. Lidocaine

XLVIII. Mannitol: Osmotic diuretic

XLIX. Maropitant

L. Meloxicam

LI. Meperedine

LII. Mepivacaine

LIII. Methadone

LIV. Midazolam

LV. Morphine

LVI. Naloxone

LVII. Neostigmine

LVIII. Nitroprusside

LIX. Norepinephrine

LX. Normosol

LXI. Oxymorphone

LXII. Pancuronium

LXIII. Pentobarbital

LXIV. Phenylephrine

LXV. Plasma-lyte 148

LXVI. Potassium chloride (KCl): Electrolyte supplement

LXVII. Procainamide: Class IA antiarrhythmic

LXVIII. Propofol

LXIX. Propranolol: Nonselective beta blocker

LXX. Remifentanil

LXXI. Sevoflurane

LXXII. Sodium bicarbonate: Alkalizing agent

LXXIII. Sodium chloride

LXXIV. Sodium chloride 7.5%

LXXV. Terbutaline: Intermediate-acting beta2-adrenergic agonist

LXXVI. Tiletamine and zolazepam “Telazol”

LXXVII. Tramadol

LXXVIII. Vasopressin

LXXIX. Xylazine

LXXX. Yohimbine

Chapter 4: Anesthetic protocols for specific procedures

I. Soft tissue surgeries

II. Orthopedic/neurology procedures

III. Ocular procedures

IV. Scoping procedures

V. Miscellaneous procedures

Chapter 5: Anesthesia in patients with concurrent disease

I. Cardiovascular disease

II. Endocrine diseases

III. Hepatic function diseases

IV. Neurological disorders: Intracranial disease

V. Renal insufficiencies

VI. Respiratory/pulmonary disease

VII. Other conditions that influence anesthesia

Chapter 6: Anesthetic complications

I. Cardiovascular complications

II. Blood pressure

III. Respiratory complications

IV. Acid–base disturbances

IV. Electrolyte disturbances

V. Glycemic control

VI. Other complications

Chapter 7: Anesthesia and analgesia in the exotic patient

I. Common exotic mammals

II. Avians

III. Reptiles

Chapter 8: Local analgesic techniques (regional blocks)

I. Bier block or intravenous block

II. Brachial plexus block

III. Digit block or ring block (radial, ulnar, and/or medial nerves)

IV. Epidural

V. Femoral and sciatic nerve block

VI. Infiltrative or splash block

VII. Intercostal block

VIII. Intrapleural block

IX. Intra-articular block (joint block)

X. Oral nerve block

XI. Paravertebral block

XII. Retrobulbar blocks

Appendices

Appendix A: Instructions for using the CSU acute pain scale

Appendix B: Creating dilutions and reconstituting solutions

Appendix C: CPR

Appendix D: CRI calculations

Appendix E: Calculating fluid drip rates

Appendix F: Supplemental texts for exotic animals

Appendix G: Epidural calculations

Appendix H: Abdominal tap

Appendix I: Conversions

Index

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Library of Congress Cataloging-in-Publication Data

Shelby, Amanda, author.

Small animal anesthesia techniques / Amanda M. Shelby, Carolyn M. McKune.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-118-42804-7 (pbk.)

I. McKune, Carolyn, author. II. Title.

[DNLM: 1. Anesthesia–methods–Handbooks. 2. Anesthesia–veterinary–Handbooks. 3. Cats–Handbooks. 4. Dogs–Handbooks. 5. Pets–Handbooks. SF 914]

SF914

636.089'796–dc23

2013045086

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover images: ekg © Shevchuk Boris; cat © elenaleonova; dog sitting © druvo; dog laying down © aspenrock

Cover design by Matt Kuhns

Contributors

Nicole Fitzgerald, RVT, VTS-Anesthesia

Anesthesia Supervisor

Louisiana State University

Veterinary Teaching Hospital and Clinics

Carolyn M. McKune, DVM DACVAA

Mythos Veterinary LLC

Gainesville, Florida

Amanda M. Shelby, CVT, VTS-Anesthesia

Associate Clinical Specialist 3 (Anesthesia)

School of Veterinary Medicine

Louisiana State University

Baton Rouge, Louisiana

Preface

The purpose of this book is to provide an easily accessible guide to the veterinary professional, for development of a balanced anesthesia protocol with appropriate analgesia. The authors assume the reader is familiar with concepts of veterinary medicine; this book outlines the anesthetic process, gives example protocols for specific patients, and helps to anticipate anesthetic complications. The information, while supported by research where appropriate, is also reflective of the authors’ personal preferences and experiences. It is recommended the anesthetist become familiar with healthy patients for routine procedures before attempting anesthesia in the critical patient.

Amanda M. Shelby

Carolyn M. McKune

Acknowledgments

While many veterinary professionals have and continue to be influential, I would like to give special acknowledgment to the following individuals who helped inspire my interests in anesthesia and the development of this work: L. Pablo, for your patience and guidance; J. Bailey, for encouraging improvement; A. Shih, for inspiring awe and speediness; S. Robertson, for your humility and compassion; T. Torres, for believing in me before anyone else; M. Fitzgerald, for your contributions, writing, and patience; C. McKune, for encouragement, reassurance, and professional guidance; A. daCunha and P. Queiroz-Williams, for capturing the great shots; and Thumbwars, for bathing the kids. Thank you.

A.S.

The efforts of many people resulted in the creation of this book, starting with the influence of Dr. Mike Mison, who reintroduced me to an academic setting where I would eventually go on to meet Ms. Amanda Shelby, veterinary technician extraordinaire, who would involve me in this project. However, a few folks along the way deserve a special acknowledgment: all of the anesthesia technicians and anesthesiologists at UC Davis College of Veterinary Medicine (particularly Dr. L. Barter, Dr. R. Brosnan, and Dr. P. Wong), who directly shaped the anesthesiologist I am today; Ms. Amanda Shelby, a brilliant mind with a hardworking mother's ethics; and Dr. Sheilah Robertson, a selfless mentor who is truly beyond her time. In addition, all of the students I have had the pleasure of working with since 2003 have taught me more about what it means to be a compassionate veterinarian than all of the formal instruction I've ever had.

However, no professional endeavor will succeed without a strong personal foundation. My rock in that respect is my wonderful husband, Dr. Michael J. Dark, without whom this would not have been possible. If I have to dedicate this book to someone, it is to the joys of my life: my children, Michael D. Dark and Elspeth L. Dark. You are the future and this book is for you.

C.M.

About the companion website

This book is accompanied by a companion website:

www.wiley.com/go/shelbyanesthesia

The website includes:

VideosImagesWorksheets for calculations

Chapter 1

Anesthetic process

Step 1: Preanesthetic assessment

The patient's primary veterinarian performs a complete physical examination (PE) and history, which is made available to the anesthetist. The anesthetist then reviews the patient's history, performs his or her own preanesthetic PE, and reviews or requests additional diagnostic information (such as blood work [BW] or radiographs). The preceding information is obtained and reviewed within 24 hours of anesthesia, to ensure the most recent and therefore most pertinent assessment of the patient. When all the necessary information is collected, the anesthetist assigns the anesthesia candidate an American Society of Anesthesiologists' (ASA) score.

A. History

Important components of patient history include identification of the chief complaint(s), supporting diagnostic information, time of last meal, previous anesthetic complications, known allergies, vaccination records, and current medications. Each of these components plays a vital role in the anesthetist's ability to advocate for the patient. For example, identifying the chief complaint of the patient will ensure the appropriate analgesia is selected, correct area is prepared for surgery, appropriate fluids are chosen, necessary supportive measures (such as inotropes) are prepared in advance, and so on. The time of the last meal is a key determinant if fasting duration is appropriate (although this is not always possible in the emergent situation), to reduce the incidence of regurgitation and possible esophageal stricture. Previous anesthesia concerns and known allergies allow the anesthetist to appropriately tailor drugs to avoid combinations that would result in serious consequences (such as a patient that has allergies to eggs receiving propofol, which contains an egg lecithin). Vaccination records are important to control contagious disease and to protect from zoonotic diseases (such as rabies). Current medications also influence the anesthetic protocol; a good rule of thumb is to ask a client what passes through the pet's mouth other than food or water. Often, clients forget herbs or vitamins that are considered medications.

B. PE guidelines

The primary veterinarian performs a complete PE prior to electing anesthesia for a patient. However, the anesthetist systematically performs his or her own PE on every patient in his or her care. Developing a consistent approach to the PE increases the likelihood of recognizing abnormal findings. If possible, this exam is performed prior to any administration of drugs. A quiet, stress-limited environment for patient evaluation is ideal. The following is a rough guide for the anesthetic PE:

1. Overall observation

(a) Disposition:

Is the patient nervous, calm, anxious, or aggressive?

(b) Gait:

Is the patient lame or neurologic? Does the patient have a head tilt?

(c) Level of consciousness:

Is the patient bright or quiet? Is it alert and responsive or depressed and obtunded?

(d) Pain assessment:

Does the patient display any outward signs of discomfort or pain? A preemptive pain evaluation will assist in postoperative pain assessment and includes assessment of the patient's demeanor, attention and response to palpation of areas considered painful, desire or reluctance to move, and posture (1).