Veterinary Anesthesia and Analgesia

by McKelvey & Hollingshead

• ISBN13: 9780323019880
• ISBN10: 0323019889
• Edition: 3rd
• Format: Paperback
• Copyright: 2003-04-28
• Publisher: Mosby

Summary

This practical resource is a concise guide designed to prepare veterinary technicians to administer anesthesia in animals. It discusses essential topics such as preanesthetic preparation of the patient, induction procedures, monitoring animals' vital signs during the anesthetic period, and postoperative care. The operation of anesthetic machines and breathing circuits are described in detail, as well as: the actions and side effects of anesthetic agents; the physiology of respiration, heart rate, and blood pressure; emergency response; and specialized techniques such as local anesthesia, postoperative analgesia, and the use of muscle-paralyzing agents and ventilators. In addition to canine and feline anesthesia, this edition has added information on anesthesia of rodents, rabbits, and other animals used in research, plus a new section on anesthesia of cattle, horses, small ruminants and pigs. This is the only book on veterinary anesthesia written explicitly for technicians, providing detailed, essential information that technicians must know. Concepts are presented in a clear, readable, well-organized format with key points, learning objectives, and review questions. Health and Safety issues surrounding anesthesia are discussed and safety procedures are outlined, as required by OSHA. Emphasis is placed on appropriate response to emergencies, and provisions of the effective pain control. Effective learning features such as objectives, key points, and review questions, help reinforce key information. All drugs and procedures included throughout the book are fully are up-to-date. Clear, useful illustrations and tables highlight important facts and concepts. A solid balance of theory and application takes the reader from learning to real-world practice. Step-by-step Procedures boxes clarify the technician's role in anesthesia delivery. Notes throughout the text highlight important precautions and/or emergency interventions. A section on client education focuses on compliance with NPO instructions and age-related complications of anesthesia. New information is provided on the use of NSAID (nonsteroidal antiinflammatory drugs aspirin, ibuprofen) and opioid analgesics for pain control now accepted as an indispensable aspect of anesthesia. Expanded discussions of sophisticated monitoring instruments and equipment address capnography, pulse oximetry, blood pressure measurement, and electrocardiology. An expanded section on anesthestic agents includes newer drugs such as medetomidine (Domitor) seroflurane, and analgesics such as carprofen (Rimadyl) and meloxicam (Metacam). The new title, previously published as Small Animal Anesthesia and Analgesia, reflects this edition's expanded scope and inclusion of other species. A new chapter on large animal anesthesia focuses predominantly on horses and cows. A new chapter on exotics covers various exotic pets, with an emphasis on pocket pets and birds. New line drawings and photographs of new equipment and techniques for delivery bring the book up to date with advances in the field.

Author Biography

Diane McKelvey, BSc, DVM: Kamloops Veterinary Clinic Kamloops, British Columbia, Canada K. Wayne Hollingshead, MSc, DVM: Assistant Professor, Small Animal Medicine and Surgery Animal Health Technology The University College of the Cariboo Kamloops, British Columbia, Canada

Table of Contents

The Preanesthetic Period	1	(50)
Patient Evaluation	2	(13)
Patient History	2	(3)
Physical Examination	5	(6)
Diagnostic Tests	11	(3)
Classification of Patient Status	14	(1)
Selection of the Anesthetic Protocol	15	(2)
Factors that Influence Selection	15	(2)
Preanesthetic Patient Care	17	(7)
Withholding Food Before Anesthesia	17	(1)
Correction of Preexisting Problems	18	(1)
Intravenous Catheterization	18	(6)
Other Preanesthetic Care	24	(1)
Preanesthetic Agents	24	(27)
Reasons for Use	25	(2)
Anticholinergics (Parasympatholytics)	27	(4)
Tranquilizers and Sedatives	31	(1)
Phenothiazines	32	(2)
Benzodiazepines	34	(2)
Alpha-2 Agents	36	(3)
Opioids	39	(12)
General Anesthesia	51	(68)
Definition of General Anesthesia	51	(1)
Components of General Anesthesia	52	(2)
Preanesthesia	52	(1)
Induction	53	(1)
Maintenance	53	(1)
Recovery	53	(1)
Safety of General Anesthesia	54	(1)
Classical Stages and Planes of Anesthesia	55	(4)
Stage I	56	(1)
Stage II	56	(1)
Stage III	56	(2)
Stage IV	58	(1)
Overview of Anesthetic Stages and Planes	58	(1)
Induction Techniques and Agents	59	(6)
Injectable Agents	59	(3)
Inhalation Agents	62	(3)
Monitoring during the Induction Period	65	(1)
Endotracheal Intubation	65	(10)
Advantages	66	(1)
Problems	66	(9)
Maintenance of Anesthesia	75	(30)
Monitoring Vital Signs	76	(6)
Use of Instruments to Monitor Vital Signs	82	(8)
Determination of SaO2	90	(7)
Reflexes and Other Indicators of Anesthetic Depth	97	(6)
Judging Anesthetic Depth	103	(2)
Recording Information During Anesthesia	105	(1)
Patient Positioning and Comfort During Anesthesia	105	(5)
Recovery from General Anesthesia	110	(9)
Stages of Recovery	110	(1)
Anesthetist's Role in the Recovery Period	110	(9)
Anesthetic Agents and Techniques	119	(46)
Comparison of Inhalation and Injectable Anesthesia	119	(2)
Injectable Anesthetics	121	(21)
Barbiturates	121	(10)
Cyclohexamines	131	(7)
Neuroleptanalgesia	138	(1)
Propofol	138	(3)
Etomidate	141	(1)
Guaifenesin	141	(1)
Inhalation Anesthetics	142	(15)
Characteristics of an Ideal Agent	142	(1)
Classes of Inhalation Agents	143	(2)
Mechanism of Action	145	(1)
Effect of Inhalation Agents on Vital Systems	145	(1)
Distribution and Elimination	146	(1)
Physical Properties	147	(3)
Halothane	150	(1)
Isoflurane	151	(2)
Sevoflurane	153	(1)
Methoxyflurane	154	(1)
Other Halogenated Agents	155	(1)
Nitrous Oxide	156	(1)
Agents Used in the Postanesthetic Period	157	(8)
Doxapram	158	(7)
Anesthetic Equipment	165	(52)
Endotracheal Tubes	166	(4)
Anesthetic Machines and Breathing Circuits	170	(2)
Components of the Anesthesia Delivery System	172	(15)
Compressed Gas Supply	173	(7)
Anesthetic Machine	180	(1)
Breathing Circuit	181	(6)
Vaporizers	187	(7)
Precision Vaporizers	188	(2)
Nonprecision Vaporizers	190	(1)
VOC versus VIC	190	(2)
Factors that Influence Vaporizer Function	192	(2)
Operation of the Anesthetic Machine	194	(13)
Rebreathing Systems	195	(1)
Nonrebreathing Systems	195	(4)
Choice of Rebreathing versus Nonrebreathing Systems	199	(1)
Carrier Gas Flow Rates	200	(5)
Safety Concerns with a Total Rebreathing System	205	(2)
Care and Use of Anesthetic Equipment	207	(10)
Daily Setup	207	(1)
Ongoing Maintenance	207	(10)
Workplace Safety	217	(21)
Hazards of Waste Anesthetic Gas	217	(14)
Short-Term Effects	218	(1)
Long-Term Effects	218	(2)
Assessment of Risk	220	(2)
Reducing Exposure to Waste Anesthetic Gas	222	(9)
Monitoring Waste Gas Levels	231	(1)
Safe Handling of Compressed Gases	231	(1)
Fire Safety Precautions	231	(1)
Use and Storage of Compressed Gas Cylinders	231	(1)
Accidental Exposure to Injectable Agents	232	(6)
Anesthetic Problems and Emergencies	238	(48)
Reasons Why Anesthetic Problems and Emergencies Arise	239	(19)
Human Error	239	(2)
Equipment Failure	241	(3)
Anesthetic Agents	244	(1)
Patient Factors	244	(14)
Response to Anesthetic Problems and Emergencies	258	(28)
Role of the Veterinary Technician in Emergency Care	258	(1)
Emergency Situations that May Arise during Anesthesia	259	(17)
Problems that May Arise in the Recovery Period	276	(10)
Special Techniques	286	(29)
Local Anesthesia	286	(14)
Agents	287	(1)
Characteristics	287	(1)
Mechanism of Action	288	(1)
Route of Administration of Local Anesthetics	289	(7)
Toxicity of Local Anesthetics	296	(4)
Controlled Ventilation	300	(7)
Ventilation in the Awake Animal	301	(1)
Ventilation in the Anesthetized Animal	301	(1)
Types of Controlled Ventilation	302	(5)
Risks of Controlled Ventilation	307	(1)
Neuromuscular Blocking Agents	307	(8)
Analgesia	315	(35)
Principles of Analgesia	315	(2)
What is Analgesia?	315	(1)
Why Treat Pain?	316	(1)
General Principles of Analgesia	317	(7)
Physiology of Pain	317	(1)
Monitoring Signs of Pain	318	(3)
Methods of Pain Control	321	(3)
Pharmacologic Analgesia	324	(2)
Preemptive Analgesia	324	(1)
Mechanisms of Pain Relief	325	(1)
Classes of Analgesic Drugs	326	(24)
Opioid Agents	326	(11)
Nonsteroidal Antiinflammatory Drugs	337	(6)
Other Analgesic Agents	343	(1)
Combination Therapy	344	(1)
Home Analgesia	345	(5)
Anesthesia of Rodents and Rabbits	350	(37)
Patient Evaluation	350	(11)
Handling and Restraint	351	(9)
Physical Examination of Small Mammals	360	(1)
Diagnostic Tests	361	(1)
Preanesthetic Patient Care	361	(1)
Withholding Food Before Anesthesia	361	(1)
Correction of Preexisting Problems	362	(1)
Preanesthetic Agents	362	(3)
Anticholinergics	363	(1)
Phenothiazines	363	(1)
Benzodiazepines	363	(1)
Alpha-2 Adrenoreceptor Agonists	363	(2)
Opioids	365	(1)
General Anesthesia	365	(13)
Induction Techniques and Agents	365	(5)
Summary of Recommended Techniques	370
Intubation and Maintenance of Anesthesia	368	(5)
Monitoring	373	(5)
Postoperative Care	378	(1)
Anesthetic Emergencies	378	(2)
Respiratory Depression	378	(1)
Circulatory Failure	379	(1)
Analgesia	380	(7)
Pain Assessment in Small Mammals	380	(1)
Analgesic Agents	381	(3)
Administration of Analgesics	384	(3)
Large Animal Anesthesia	387	(30)
General Considerations	387	(1)
Biologic Variations	387	(1)
Handling and Restraint	388	(1)
Horses	388	(14)
Sedation and Standing Chemical Restraint	388	(2)
Field Anesthesia	390	(2)
Inhalant Anesthesia	392	(2)
Monitoring and Supportive Care	394	(7)
Foals	401	(1)
Cattle	402	(5)
Sedation and Chemical Restraint	404	(1)
General Anesthesia	404	(1)
Monitoring and Supportive Care	405	(1)
Calves	406	(1)
Small Ruminants	407	(4)
Swine	408	(3)
Regional/Local Anesthetic Techniques in Large Animals	411	(1)
Summary	412	(5)
Appendix A Standard Values and Equivalents	417	(3)
Appendix B Catheter Comparison Scale	420	(1)
Appendix C Equipment for Intravenous (IV) Induction and Inhalation Anesthesia	421	(1)
Appendix D Equipment and Drugs for Use in an Emergency Crash Kit	422