Send the link below via email or IMCopy
Present to your audienceStart remote presentation
- Invited audience members will follow you as you navigate and present
- People invited to a presentation do not need a Prezi account
- This link expires 10 minutes after you close the presentation
- A maximum of 30 users can follow your presentation
- Learn more about this feature in our knowledge base article
Transcript of Anaesthesia
Anaesthesia can be done in more ways than one...
What is it?
Why do it?
Loss of feeling or sensation
43 different types of anaesthesia...
Which ones are important to veterinary practice?
What is it?
What is it used for?
What are the processes of anaesthesia?
Role of the nurse in an anaesthetic
How to achieve best practice anaesthesia
- always a good idea
Is it any procedure an animal wakes up from?
Quiet Clear-headed Recovery
How to achieve a successful Anaesthetic?
Thorough pre-operative examination
Tailored premedication and
Good anaesthetic monitoring
Adjunctive therapies and support
Quiet & warm recovery area
- but keep looking at the patient!
17 out of every 1000 dogs and 24 out of every 1000 cats
die under anaesthetic....
What is involved in Anaesthesia?
When does the pre-anaesthetic period begin?
What happens on admission?
What are the ("routine") pre-anaesthetic instructions?
What happens after the anaesthetic agent is turned off?
Well before any drugs are administered.
Arguably as soon as there is a decision to have an anaesthetic...
..... could be the week before with the old diabetic dog needing a dental, or the HBC needing an emergency splenectomy.....
Fasting? How long? Why?
What if the patient
doesn't bark or meow?
Talk to the owner:
- Has the animal been fasted if necessary?
- Has the animal been un-necessarily fasted?
- Has the animal been well?
- Does the owner understand what is going to happen?
- Who is responsible?
- What is involved a pre-op exam?
Anything else before drug administration?
Regional nerve block
State of unconsciousness together with a loss of sensation over the entire body
How do you achieve general anaesthesia?
What is a premedicant?
What is an induction agent?
- a sedative (ACP, medetomidine, xylazine)
- an analgesic (methadone, morphine, buprenorphine, butorphanol)
pre-emptive pain relief
lower induction agent requirement
Extubation - Swallowing
Environment - warm, quiet
Thorough Pre-Anaesthetic Evaluation
Previous Anaesthetic History
Tailored premedicant and Anaesthetic Dosing
A drug that is given prior to an anesthetic
What is Alfaxan?
An injectable intravenous anaesthetic agent - suitable for both induction and maintenance
Registered for dogs and cats
A steroid compound like progesterone
Acts centrally in the brain and spinal cord to produce anaesthesia
How do we decide what to use?
Induction (with premedication)
- dogs draw up 2mg/kg or 0.2ml/kg
- cats draw up 5mg/kg or 0.5ml/kg
- Give 1/4 every 15 seconds
Dogs 6-7 mg/kg/hr
How does ALFAXAN compare to other anaesthetics?
Alfaxan vs Propofol
Superior safety margin - up to 20mg/kg
Less cardiac depression
Less apnoea and respiratory depression
Non-painful IV administration
Longer storage - 7 days in the fridge
Alfaxan vs Ketamine
Better muscle relaxation
Safer in kidney and liver patients
Can be used in epileptic patients
Better cardiovascular stability - does not
Clear headed recovery
Ketamine is an S8
Alfaxan vs Thiopentone
Better Cardiovascular and respiratory function
No risk of extra-vascular damage
Can be used in sighthounds
Safety margin up to 20mg/kg in dogs and 25mg/kg in cats
Minimal Cardiovascular side effects, at normal doses
No direct effect on the heart muscle
At normal doses no significant effect on cardiac output, blood pressure, SpO2
Close anaesthetic monitoring
How is Alfaxan used?
What makes Alfaxan different?
Metabolised by the liver, but very severe liver failure required before rate of metabolism is decreased
Mostly hepatic metabolism, so Alfaxan clearence wont be delayed
Yes - about the same induction dose rates as for adults.
Anaesthetic of choice for the RSPCA
Think about the effects of premeds
Yes - steroid anaesthetic and metabolic pathways of foetuses are developed.
No significant difference in puppy survival in a multiclinic trial.
no accumulation in the body and rapid metabolism
What is the best premed to use?
All premeds are safe to use with Alfaxan, however benzodiazepenes like Diazepam have been found to not provide enough sedation when used alone
WHAT DOES IT MEAN TO monitor anaesthesia?
jaw tone - puppies & kittens?
Respiratory rate & depth
Heart Rate & Rhythm
Mucous membrane colour
Capillary refil time
Blood gas analysis?
The induction agent is only one component of the anaesthetic process
Other factors such as the effects of premeds, concurrent disease, age and breed all affect anaesthesia as a whole, and may also impact on induction doses
Dr. Scott Cumming BVSc (Hons) MCom
Jurox Companion Animal Product Manager
Preparation is the key!
Minimal Undesirable Effects
Early is better
Look for trends
- rate and rhythm
What does the patient tell you & what does it mean?
(And what is your role?)
The person monitoring can be the difference
Other types of anaesthesia?
What do you do with all of these numbers?
2. Pre-emptive pain relief
- almost always needed in the post op period
- pain is 'plastic'!
- top up
- opioids vs NSAIDs vs other
- "It had a premed, we can't give any more"