Anesthesia

Anesthetizing a patient with cardiac disease requires a plan for the use of supportive measures to maintain adequate tissue perfusion. As in the case of left sided cardiac dysfunction patients, volume administration frequently is not an option to support blood pressure. In these cases, should a positive inotropic or pressor agent be indicated, the volume of the adjunctive agent required should be deducted from the volume of crystalloid administered to maintain a balanced hourly rate.

What is pain? Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. All potential and actual tissue damage in animals should be considered to cause pain. Pain can be experienced with or without accompanying signs of stress (e.g., tachycardia, hypertension). The first step in treating pain is to recognize the signs and symptoms.

The palmar digital nerves are blocked by injecting up to 2 ml of anesthetic over the nerves, along the edge of the DDFT. Much discussion has taken place regarding the proximal to distal level that the injection should occur. The PDN can be blocked anywhere from the proximal margin of the collateral cartilage to the mid pastern region.

As with any trauma patient presented to triage, a thorough pre-operative assessment must be performed and patient assessment begins with the first step inside the door. The traumatized patient will have altered physiological responses that will in turn alter the pharmacokinetics of the agents commonly used to provide anesthesia.

An introduction to the principles of clinical blood gas analysis and interpretation--including two case examples.

An 8-year-old 44-lb (20-kg) spayed female Siberian husky is a poorly regulated diabetic presenting for surgical excision of a grade I fibrosarcoma on the right thoracic wall.

A 5-year-old 37.6-lb (17.1-kg) neutered male border collie has a three-day history of vomiting.

To make a hands-free anesthesia face mask, we place a soft dog muzzle over the front of the mask and then attach the anesthetic hose to the front.

The capnograph is a noninvasive monitoring device that can provide information on ventilation (pulmonary function), blood flow, and equipment function. Knowledge of respiratory and cardiovascular physiology is essential to the understanding of capnography.

The presence of disease has been shown to be positively associated with increased anesthesia-related mortality. Indeed, the possibility of rapid decompensation when sedative or anesthetic drugs are administered in the presence of respiratory disease makes anesthesia in these patients particularly challenging.

Cardiopulmonary arrest and resuscitation are not practice-builders! The success rate of cardiopulmonary cerebral resuscitation (CPCR) for animals or humans is disappointingly low.

I'll review the pathophysiological changes associated with the common congenital and acquired cardiac defects in small animal medicine and discuss the characteristics of anesthetic drugs that may make them desirable of undesirable for each problem.

The liver is integral to the production of clotting factors and albumin, and the metabolism of proteins, carbohydrates, fats. In addition, a variety of other endogenous and exogenous substances are metabolized in the liver. Indeed, the liver plays a role in the elimination of most anesthetic drugs.

Anesthetic and pain related mortality would appear to be an easily quantifiable statistic that could be used to measure the outcome of the profession's current anesthetic practices. However, to rely solely on death rate as the measure of the quality of anesthetic care provided is inadequate. The anesthetist's goal should be to minimize the risks to the patient's health while reducing pain and stress.

One of the most important assessments a veterinarian can make is whether or not oxygen delivery is adequate. Unfortunately, it is not possible to easily or directly assess oxygen delivery in our patients.

Anesthetic mishaps can lead to patient morbidity and mortality. Most problems anesthesia-related problems can be prevented by advanced planning, training, patient monitoring, and the development of standard operating protocols.

The purpose of this presentation is to review several articles published in veterinary journals over the last three years and to present them in a way that is relevant to the practicing veterinarian.

Cesarean section may be indicated for animals with prolonged gestation periods, refractory uterine inertia (primary or secondary), or those with obstructive dystocias. In addition, elective cesarean section may be done in those breeds with consistent fetal oversize (i.e., English bulldogs).

The field of invertebrate medicine is in its infancy. Traditionally veterinary interest in invertebrates has centered on the control of species that are involved in vertebrate disease processes. The husbandry and medical care of captive invertebrates has typically fallen to scientists and hobbyists, with very little veterinary involvement. Now, as many institutions and private individuals maintain large invertebrate collections, a genuine interest exists in advancing the quality of medical care available for these taxa.

What should electronic anesthetic monitoring systems check for?

All veterinary team members play a role in providing patients safe anethetic experiences.

Anesthesia is a vital inclusion in any clinic's medical practice, but it does come with risks. By avoiding these common mistakes, your patients will receive a safer anesthetic experience.

A Q&A with Dr. James Gaynor.

Don't assume dental procedures are of little anesthetic risk.

The results of a University of Wisconsin randomized controlled trial assessing the efficacy of retrobulbar analgesia on the control of postoperative pain in dogs undergoing enucleation was recently published.

The use of a modified spirometric monitoring system for anesthetized equine patients was recently evaluated.

When assisting with anesthesia and surgery, our technician sets her cell phone, which is in her pocket, to vibrate every five minutes.

Another possible cause of abnormal capnograph readings.

We already know that the way we each perceive pain will be different depending on our past experiences. The way we respond to that pain also varies from person to person. These two points make recognizing and treating pain difficult, especially in regards to our veterinary patients.

The biggest concern with all exotic animals under anesthesia is hypothermia. Other main concerns include airway access, intravenous access, pain management, and hemorrhage.