Anesthesia and pain management in dogs and cats : a color handbook / Jeff C. Ko.

Format:

Book

Author/Creator:

Ko, Jeff C.

Language:

English

Subjects (All):

Veterinary anesthesia--Handbooks, manuals, etc.

Veterinary anesthesia.

Pain in animals--Treatment--Handbooks, manuals, etc.

Pain in animals.

Pain in animals--Treatment.

Genre:

Handbooks and manuals.

Physical Description:

336 pages : color illustrations ; 24 cm

Other Title:

Small animal anesthesia and pain management.

Color handbook : small animal anesthesia and pain management.

Color handbook : anesthesia and pain management in dogs and cats.

Place of Publication:

London : Manson, 2013.

Summary:

This is a concise and quick reference guide, clinically oriented, based on experience underpinned by published research data. The book covers anesthetic equipment, monitoring, premedication, intravenous induction agents, injectable anesthetic combinations, inhalant anesthesia, anesthesia for specific diseases, fluid therapy, anesthetic emergencies and complications, acute and chronic pain management. Drug dosages and anesthetic protocols are provided in tabular form. The book contains a wealth of superb illustrations. Small Animal Anesthesia and Pain Management will be of value to all those who need practical information easily to hand: small animal practitioners, veterinary technicians/nurses, and veterinary students. Book jacket.

Contents:

Chapter 1 Equipment required for inhalant anesthesia / Jeff C Ko Ko, Jeff C 13

Introduction 14

Components of the anesthetic machine 15

Flowmeters 15

Regulators 16

Vaporizers 16

Gas supply 20

Scavengers 25

Breathing circuits and components 27

Rebreathing circuit (circle breathing system) 28

Non-rebreathing circuits 34

Selecting a breathing circuit 39

Ambu bags 40

Ventilators 40

Oxygen flow rates 41

The oxygen consumption requirements of the anesthetized animal 41

The amount of oxygen needed to carry inhalant anesthetic from the vaporizer to the patient 41

Amount of oxygen flow required to remove the CO₂ exhaled by the anesthetized animal from a non-rebreathing circuit 41

Changes to the speed of inhalant anesthetic uptake during the transition from intravenous induction to inhalant maintenance 42

Changes to the speed of chamber or face mask induction 42

Changes of anesthetic depth during anesthesia maintenance 42

Conservation of the patient's body temperature and airway moisture 43

Reducing the cost of a given inhalant anesthetic agent 44

Global issues, including pollution control and energy conservation 44

Endotracheal tubes 45

Types of endotracheal tubes 45

Endotracheal tube construction 45

Endotracheal tube selection 46

Laryngoscopes 48

Induction chambers and face masks 49

Induction chambers 49

Face masks 50

Checking the accuracy of the flowmeter 51

Checking the anesthetic machine and breathing circuit for leaks 52

Positive pressure leaks 52

Negative pressure leaks 54

Checking the scavenging system for leaks and malfunctions 56

Monitoring of waste gas and pollution 56

Further reading 57

Chapter 2 Preanesthetic medication: drugs and dosages / Jeff C Ko Ko, Jeff C 59

Introduction 60

Reasons for preanesthetic medication 60

Preanesthetic medication protocols 62

Phenothiazines: acepromazine 64

Quick points for consideration 64

Preanesthetic medication doses 64

Advantages of using acepromazine 64

Disadvantages of using acepromazine 64

Benzodiazepines: diazepam and midazolam 66

Quick points for consideration 66

Preanesthetic medication doses 66

Differences between diazepam and midazolam 66

Advantages of using benzodiazepines 66

Disadvantages of using benzodiazepines 66

Alpha-2 adrenoceptor agonists: xylazine, romifidine, medetomidine, and dexmedetomidine 68

Quick points for consideration 68

Preanesthetic medication doses 68

Differences between the various alpha-2 adrenocepter agonists 68

Advantages of using alpha-2 adrenoceptor agonists 70

Disadvantages of using alpha-2 adrenoceptor agonists 70

Dissociatives: ketamine and tiletamine 72

Quick points for consideration 72

Preanesthetic medication doses 72

Differences between the dissociatives 72

Advantages of using dissociatives 74

Disadvantages of using dissociatives 74

Anticholinergics: atropine and glycopyrrolate 75

Quick points for consideration 75

Preanesthetic medication doses 75

Differences between atropine and glycopyrrolate 75

Advantages of using anticholinergic agents 75

Opioids 77

Quick points for consideration 77

Preanesthetic medication doses and properties 77

Differences between the various opioids 79

Advantages of using opioids 79

Disadvantages of using opioids 79

Neuroleptic-analgesic combinations 80

Overview 80

ASA I and II dogs 80

Sick (ASA III, IV, V, III-E, IV-E, V-E), pediatric, or geriatric dogs 81

ASA I and II cats 81

ASA III and IV dogs and cats 83

Case example 84

Further reading 85

Chapter 3 Intravenous injection techniques and intravenous anesthetic agents / Jeff C Ko Ko, Jeff C 87

Introduction 88

Intravenous injection techniques 88

Intravenous anesthetic agents 88

Induction or short-term restraint 88

Arm-Brain (cephalic vein to brain) circulation time 88

Apnea caused by intravenous anesthetic agents during induction 89

Characteristics of intravenous anesthetic agents used in dogs and cats 90

Thiopentone (thiopental) sodium 92

Overview 92

Induction 92

Short-term immobilization 92

Other factors to consider 93

Propofol 94

Overview 94

Induction 94

Short-term chemical restraint 95

Total intravenous anesthesia 95

Other factors to consider 96

Etomidate 97

Overview 97

Induction and maintenance 97

Other factors to consider 97

Alfaxalone 99

Overview 99

Induction and maintenance 99

Other factors to consider 100

Diazepam/ketamine 100

Overview 100

Induction and short-term immobilization 100

Tiletamine/zolazepam 101

Overview 101

Induction and immobilization 102

Other factors to consider 102

Further reading 103

Chapter 4 Inhalant anesthetic agents / Jeff C Ko Ko, Jeff C 105

Introduction 106

Uptake and distribution of inhalant anesthetic agents 108

Stages of anesthesia 108

Anesthetic partial pressure gradient: induction phase 108

Anesthetic partial pressure gradient: recovery phase 110

Types of volume barriers 110

Minimum alveolar concentration 112

Factors that decrease minimum alveolar concentration values 112

Factors that increase minimum alveolar concentration values 112

Factors that do not affect minimum alveolar concentration values 112

Blood gas solubility 113

Pungency and airway irritation 113

Isoflurane, sevoflurane, and desflurane 114

Isoflurane 114

Sevoflurane 114

Desflurane 114

Face mask and chamber induction with overpressurizing techniques 116

General principles 116

Technique for face mask induction 116

Technique for chamber induction 117

Advantages of using chamber followed by face mask induction 119

Inconsistencies during anesthesia maintenance 119

Premature awakening during a surgical procedure 119

Anesthetic plane becomes too deep 120

Recovery from inhalant anesthesia 121

Further reading 121

Chapter 5 Anesthesia monitoring and management / Jeff C Ko Ko, Jeff C 123

Introduction 124

Monitoring circulation 125

Subjective assessment of circulatory function 125

Objective assessment of circulatory function 125

Monitoring and managing blood pressure 128

Physiology of blood pressure monitoring 128

Non-invasive blood pressure monitoring 130

Invasive (or direct) arterial blood pressure monitoring 134

Drug and surgical effects on blood pressure 134

Interpretation of blood pressure values 135

Managing blood pressure 135

Monitoring oxygenation and management of hypoxemia 140

Subjective assessment of oxygenation 140

Objective assessment of oxygenation 140

Hemoximetry and pulse oximetry 140

Placement of the pulse oximeter probe 140

Factors that influence pulse oximetry 140

Normal values for SpO₂ 142

Normal values for PaO₂ 142

Relationship between SpO₂ (or SaO₂) and PaO₂ 142

Hypoxemia 142

Monitoring ventilation 146

Subjective assessment of ventilatory function 146

Objective assessment of ventilatory function 146

Managing end-tidal CO₂ 150

Overview 150

Interpretation of ETCO₂ concentrations 150

Managing abnormal ETCO₂ 150

Use of multigas (anesthetic gas) monitors 152

Monitoring and managing other vital parameters 154

Body temperature 154

Bood glucose levels 155

Blood lactate levels 156

Blood electrolytes, total protein, and packed cell volume 157

Depth of anesthesia 157

Proper pain management 159

Neuromuscular blockade monitoring 160

Further reading 162

Chapter 6 Fluid therapy / Ann B Weil Weil, Ann B 163

Introduction 164

Composition and fluid distribution within animals 164

Indications for fluid therapy under general anesthesia 164

Fluid classification 165

Crystalloids 165

Colloids 168

Blood products 168

Clinical case examples 171

Healthy patient undergoing general anesthesia for elective procedure 171

Patient with suspected portosystemic

shunt requiring general anesthesia 171

Patient with hemolytic anemia to be anesthetized for bone marrow aspiration 171

Patient with bleeding abdominal mass presented for surgery 171

Patient with ruptured bladder presenting for bladder repair 171

Two to three-month-old male puppy presented for laceration repair 171

Further reading 171

Chapter 7 Anesthetic emergencies and cardiopulmonary resuscitation / Ann B Weil Weil, Ann B, Jeff C Ko Ko, Jeff C 173

Introduction 174

Respiratory complications that result in anesthetic emergencies 174

Apnea 174

Hypoventilation 175

Loss of airway 175

Hypoxemia 175

Laryngospasm 176

Cardiovascular complications that result in anesthetic emergencies 177

Bradycardia 177

Hypotension 178

Hemorrhage 178

Cardiac arrhythmias 179

Other complications that result in anesthetic emergencies 181

Hypothermia 181

Hyperthermia 181

Cardiopulmonary resuscitation 182

Identification of arrest via checking of vital signs 182

Action to be taken 182

Defibrillation 185

Some considerations regarding cardiopulmonary resuscitation 186

Further reading 186

Chapter 8 Airway management and ventilation / Ann B Weil Weil, Ann B, Jeff C Ko Ko, Jeff C 187

Introduction 188

Managing the difficult airway 188

Difficulty in intubation 188

Laryngospasm 189

Airway occlusion and changing the endotracheal tube 190

Oral surgery 191

Perioperative oxygen administration 192

Extubation 192

Ventilation control 194

Indications for use 194

Types of ventilation 194

Ventilator settings 194

Assessing ventilatory efficiency 195

Types of ventilators 195

Bellows ventilations 195

Engler ADS 1000 196

Further reading 197

Chapter 9 Injectable sedative and anesthesia-analgesia combinations in dogs and cats / Jeff C Ko Ko, Jeff C 199

Introduction 200

Dexmedetomidine/medetomidine-based protocols 200

Dexmedetomidine/medetomidine-ketamine combinations 201

Dexmedetomidine/medetomidine-butorphanol combinations 203

Dexmedetomidine/medetomidine-butorphanol-midazolam/diazepam sedative combinations 204

Dog-specific dexmedetomidine combinations 206

Cat-specific combinations 210

Dexmedetomidine/medetomidine-butorphanol-ketamine-midazolam/diazepam combination 211

Alternative injectable anesthetic combinations and techniques for giant breed dogs 212

Chemical restraint combinations for animals with systemic illness or geriatric dogs and cats 213

Tiletamine/zolazepam-based protocols 215

Tiletamine/zolazepam-butorphanol-dexmedetomidine/medetomidine 215

Tiletamine/zolazepam-dexmedetomidine/medetomidine combination without opioids 218

Tiletamine/zolazepam-opioid combinations without dexmedetomidine/medetomidine 219

Case examples 220

Further reading 224

Chapter 10 Anesthetic considerations for specific diseases / Ann B Weil Weil, Ann B, Jeff C Ko Ko, Jeff C 225

Introduction 226

Hepatic dysfunction 226

General considerations 226

Anesthetic management and pharmacologic considerations 227

Examples of anesthetic protocols for dogs with liver dysfunction 227

Anesthetic protocols for cats with liver dysfunction 228

Other considerations 228

Cardiac dysfunction 228

General considerations 228

Anesthetic management and pharmacologic considerations 230

Examples of anesthetic protocols for dogs with cardiac dysfunction 232

Anesthetic protocols for cats with cardiac dysfunction 232

Respiratory dysfunction 233

General considerations 233

Anesthetic management and pharmacologic considerations 233

Examples of anesthetic protocols for dogs and cars with respiratory dysfunction 234

Central nervous system dysfunction 235

General considerations 235

Anesthetic management and pharmacologic considerations 236

Examples of anesthetic protocols for dogs with central neervous system dysfunction 236

Other considerations 236

Endocrine dysfunction 237

Diabetes mellitus 237

General considerations 237

Anesthetic management and pharmacologic considerations 237

Hypothyroidism 237

Hyperthyroidism 237

Anesthetic management and pharmacologic considerations 238

Examples of anesthetic protocols for dogs and cats with endocrine disorders 238

Urinary and renal dysfunction 238

General considerations 238

Anesthetic management and pharmacologic considerations 239

Examples of anesthetic protocols for dogs and cats with urinary and renal dysfunction 240

Gastrointestinal dysfunction 241

General considerations 241

Anesthetic management and pharmacologic considerations 241

Examples of anesthetic protocols for dogs with gastric dilatation/volvulus 241

Cesarean section 242

General considerations 242

Anesthetic management and pharmacologic considerations 243

Examples of anesthetic protocols for cesarean section in dogs 244

Resuscitation of neonates 244

Trauma 246

General considerations 246

Anesthetic management and pharmacologic considerations 247

Examples of anesthetic protocols for traumatized orthopedic patients 248

Further reading 248

Chapter 11 Local anesthetic agents and anesthetic techniques / Jeff C Ko Ko, Jeff C, Tomo Inoue Inoue, Tomo 249

Introduction 250

Pharmacology of local anesthetic agents 250

Types of local anesthetic agent 250

Mechanism of action 251

Specific actions 251

Factors that determine the potency, onset, duration, and toxicity of a local anesthetic agent 251

Additives 251

Toxicity of local anesthetics and treatments 252

Dental blocks 252

Infraorbital block 252

Indications 252

Area and nerves blocked 252

Landmarks 252

Drugs and equipment 253

Approach 254

Mental foramen block 254

Indications 254

Area and nerves blocks 254

Landmarks 254

Drugs and equipment 255

Approach 255

Brachial plexus blocks 255

Indications 255

Area and nerves blocked 255

Landmarks 255

Drugs and equipment 256

Approach 256

Ring and point blocks for feline forelimb declawing or interdigital growth removal 258

Indications 258

Area and nerves blocked 258

Landmarks 258

Drugs and equipment 258

Approach 258

Nerve blocks for thoracic surgeries 259

Intercostal nerve blocks for thoracotomy 259

Indications 259

Area and nerves blocked 259

Landmarks 260

Drugs and equipment 260

Approach 260

Intrapleural infusion nerve blocks for thoracotomy 260

Indications 260

Area and nerves blocked 260

Lumbosacral epidural blocks 261

Indications 261

Area and nerves blocked 261

Landmarks 261

Drugs and equipment 262

Approach 262

Epidural catheter placement 266

Intravenous regional blocks (Bier blocks) 267

Indications 267

Area and nerves blocked 267

Landmarks 267

Drugs and equipment 267

Approach 267

Local anesthesia as an adjunct to general anesthesia for eye surgery 268

Indications 268

Nerves and areas blocked 268

Landmarks 268

Drugs 268

Lidocaine regional constant rate infusion 270

Indications 270

Nerves and areas blocked 270

Landmarks 270

Drugs and equipment 270

Approach 271

Intra-articular injection of a local anesthetic 273

Further reading 273

Chapter 12 Acute pain management / Jeff C Ko Ko, Jeff C 275

Introduction 276

Principles of pain management 276

Mechanisms of pain and mechanism-based pain management 277

Origins of somatic and visceral pain and pain management 277

Analgesic therapies for acute pain 280

Pre-emptive analgesia 280

Intraoperative analgesia 280

Postoperative analgesia 280

Drugs used in analgesic therapies for acute pain 280

Drugs and dosages for pre-emptive/preoperative pain management 282

Opioids 282

Alpha-2 adrenoceptor agonists 282

Non-steroidal anti-inflammatory drugs 282

Local anesthetic agents 282

Drugs and dosages for intraoperative pain management 284

Opioids 284

Alpha-2 adrenoceptor agonists 284

Other constant rate infusion alternatives 284

Local anesthetic blocks during surgery 286

Drugs and dosages for postoperative pain management 287

Opioids 287

Alpha-2 adrenoceptor agonists 287

Non-steroidal anti-inflammatory drugs 287

Take-home pain

medication 288

Buprenorphine 288

Tramadol 288

Fentanyl patch 290

Lidocaine patch 290

Similarities and differences between lidocaine patches and fentanyl patches 291

NSAIDS 292

Further reading 294

Chapter 13 Chronic pain management for osteoarthritis and neuropathic pain / Amy E Fauber Fauber, Amy E 295

Introduction 296

Classification of pain 297

Physiological pain 297

Pathologic pain 297

Nociception 297

Peripheral sensitization 297

Central sensitization 297

Hyperalgesia 297

Allodynia 297

Spinal wind-up 297

Medications used in the management of chronic pain 298

Non-steroidal anti-inflammatory drugs 301

Opioids 301

NMDA-receptor antagonists 301

Topical anesthetics 301

Anticonvulsants 301

Tricyclic antidepressants 301

Chondroprotectants 301

Other drugs that should be considered 301

Alternative therapies 302

Transcutaneous electrical nerve stimulator 302

Acupuncture 302

Physical therapy 302

Low-level laser therapy 302

Examples of pain management protocols 302

For mild to moderate osteoarthritic pain in dogs 302

For severe osteoarthritic pain in dogs 302

For mild to moderate neuropathic pain in dogs 302

For severe neuropathic pain in dogs 302

For mild to moderate osteoarthritis pain in cats 302

For severe osteoarthritis pain in cats 302

For neuropathic pain in cats 302

Further reading 303

Chapter 14 Cancer pain management / Michael D Lucroy Lucroy, Michael D 305

Introduction 306

Prevalence of cancer pain 306

Tumors associated with pain 306

Physiology of cancer pain 306

Assessing cancer pain 307

Drugs for cancer pain control 307

NSAIDS 307

Opioids 307

Adjuvants 308

Other treatments for cancer pain 308

Radiation therapy 308

Bisphosphonate drugs 308

Others 308

Case example 310

Further reading 310

Chapter 15 Anesthesia in shelter medicine and high volume/high quality spay and neuter programs / Jeff C Ko Ko, Jeff C, Rebecca A Krimins Krimins, Rebecca A 311

Introduction 312

Preimmobilization and anesthesia considerations 314

Anesthetic protocols 316

Tiletamine/zolazepam (Telazol/Zoletil), butorphanol (Torbugesic), dexmedetomidine (Dexdomitor) (TTDex) 316

Monitoring of anesthesia in shelters, high volume/high quality spay and neuter clinics, and trap-neuter-release environments 322

Further reading 322

Chapter 16 Euthanasia / Jeff C Ko Ko, Jeff C 323

Introduction 324

Principles of euthanasia 324

Euthanasia under general anesthesia 325

Two-stage approach to euthanasia: anesthesia-sedation prior to euthanasia 326

Drugs and solutions used for euthanasia 327

Barbiturate-based solutions 327

Potassium chloride 327

Intravenous access for chug administration 327

Avoiding agonal breathing and muscle spasms 328

Further reading 328.

Notes:

Includes bibliographical references.

ISBN:

9781840761795

1840761792

OCLC:

828743960