Anesthesia

Due to the fact that critical patients are more fragile than stabile patients, they require special nursing care. The same is true of these special patients under anesthesia.

Veterinary technicians are the veterinary hospital's mainstay when it comes to carefully and successfully anesthetizing critical patients. A large number of elderly canine and feline patients are affected by cardiac disease, and knowledge of how to safely monitor, anesthetize, and problem solve cardiac patients makes for a less stressful anesthesia for both the patient and technician.

Monitoring, for these purposes will consist of checking vitals on a regular basis. The vitals being monitored may be changed based upon the patient's status and the procedure performed. By watching for changes in trends we are able to catch and potentially stop a crisis from happening..

A new strategy to extend the duration of local anesthesia may markedly help patients with moderate to severe surgical injury. Implantation of a catheter into the surgical wound site prior to closure allows repeated or continuous infusion of local anesthetics into the affected area.

Cats can be difficult to safely anesthetize because of their small body size, fractious nature and altered metabolism of anesthetic drugs. Furthermore, cats are frequently undertreated for pain.

Constant rate infusions (CRI) of analgesic drugs are an excellent way to manage pain in both dogs and cats. A CRI of analgesic agents has several advantages over multiple repeated injections for pain relief.

No matter what anesthetic protocol is chosen, the addition of adequate analgesia is imperative for safe anesthesia and for enhanced patient outcome.

Our patient population has changed fairly dramatically in the last 10 years as our medical skills have progressed and we have become capable of supporting patients with advanced disease and advancing age. Now we must hone our anesthesia skills in order to support patients that largely don't fit into the 'young, healthy' category and it is no longer appropriate to think that safe anesthesia means recovering as many patients as we anesthetize.

Anesthesia should be thought of as 4 distinct and equally important periods: 1) preparation/premedication; 2) induction; 3) maintenance and 4) recovery. We tend to diminish the importance of the phases of preparation/premedication and recovery and yet these phases contribute as much to successful anesthesia as the phases of induction and maintenance.

Because the airway extends from the oral or nasal cavity to the alveoli, respiratory compromise has numerous manifestations. Complications can be encountered in both the upper and lower airways.

The most effective way to deal with anesthetic emergencies is to prevent them and appropriate 1) stabilization of the patient, 2) selection of type and dosage of anesthetic drugs, 3) preparation of anesthetic equipment, 4) pre-, post- and intra-operative support of the patient, and 4) physiologic monitoring, will make the anesthetic episode safer and will decrease the likelihood of anesthetic emergencies.

Regional or local anesthesia of the equine head greatly facilitates performing standing procedures that are anticipated to elicit pain in the patient. With effective local anesthesia, less systemic sedatives may be required for standing surgeries (e.g. dental extractions, laceration repairs, incisor avulsion repairs), patients under general anesthesia can be run at a lighter plane of anesthesia, and postoperative pain may be lessened if effective preemptive analgesia is in place.

This anesthetic agent can improve patient experience, boost client compliance.

When anesthetizing a pot-bellied pig, we use a mask made from a plastic gallon jug.

To make anesthesia masks hands-free, I create two small holes nearly opposite each other on the clear plastic mask.

Technicians: To truly keep anesthetized patients safe, you must use your hands.

The overall goal of anesthesia is survival and optimum recovery from surgery. In order to accomplish this goal, the surgery patient must be continually monitored for changes, especially deterioration in respiration, cardiac function and tissue perfusion regardless of the specific surgery.

Pain management in veterinary medicine was practically unheard of twenty years ago, and it has advanced dramatically over the past decade. Not only is the physiology of pain and its effects becoming better understood, pain management is considered a vital part of most treatment plans.

Monitoring anesthetized patients is imperative for all procedures. All anesthetic drugs act as cardiovascular and respiratory depressants on varying levels, and they can compromise a patient's homeostasis at unpredictable times in unpredictable ways. Crises are rapid in onset and devastating in nature.

Critical patients and patients undergoing prolonged and invasive procedures may need more intensive monitoring due to their increased risk for anesthetic complications. Some of these methods of monitoring may become more common in the near future considering veterinary anesthesia has advanced dramatically over the past decade.

All anesthetic drugs act as cardiovascular and respiratory depressants on varying levels, and they can compromise a patient's homeostasis at unpredictable times in unpredictable ways. A patient must maintain adequate blood pressure for the duration of any surgical procedure because prolonged anesthetic hypotension can have devastating effects such as renal failure or brain damage.

CRI stands for continuous rate infusion, and its use is becoming more prevalent in the veterinary field as a method to control intraoperative and postoperative pain. It was not long ago that the best options for surgical pain management were intramuscular or bolus injections of opioids, which remain acceptable options, but CRIs can be a better option for patients undergoing prolonged, invasive or painful procedures.

Anesthesia is concerning for every patient, this is especially so when the patient has pre-existing conditions. The value of a thorough physical examination and detailed history cannot be underestimated as part of a balanced anesthetic plan because the goal of the plan is to maximize its' effects while minimizing patient complications.

Patients vary and accidents occur. This truth emphasizes the need for patient monitoring. One only need visit the exhibit hall of a major veterinary meeting to appreciate the advancements made in veterinary patient monitoring.

Anesthetic 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.

Patients are typically sedated or anesthetized and placed in sternal or lateral recumbency. Next, the cranial edge of the wings of the ilia are palpated.

Pulse oximeters are relatively inexpensive and provide continuous information about pulse rate and hemoglobin saturation. Pulse oximetry has limitations that need to be understood by the anesthetist.

In the past blood gas analysis and interpretation was performed primarily at university and large referral hospitals. The main argument against not using blood gas analysis to guide case management in private practice was the cost of purchasing and maintaining a bench-top blood gas analyzer. With the availability of relatively inexpensive point of care units such as the i-STAT and IRMA, blood gas analysis and interpretation has become more common.

The electrocardiogram is a useful monitoring tool, but its proper use requires training. It provides a heart rate and a picture of the electrical activity of the heart muscle. The anesthetist should be trained to recognize many commonly encountered intraoperative arrhythmias (e.g., multifocal and unifocal ventricular premature complexes, atrioventricular blockade, ventricular tachycardia, etc.) and the veterinarian should be prepared to treat arrhythmias when they occur (if necessary).

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.