Anesthesia and Analgesia for Veterinary Technicians

1. Introduction to Anesthesia
   

   History of anesthesia

   The Veterinary Technician’s Role in the Practice of Anesthesia

2. Patient Preparation

Communication-A Key to Success

The Minimum Patient Database

Patient History

Physical Examination and Physical Assessment

Preanesthetic Diagnostic Workup

Determination of the Physical Status Classification

Selection of the Anesthetic Protocol

Preinduction Patient Care

Withholding Food before Anesthesia

Patient Stabilization

Intravenous Catheterization

Reasons for Intravenous Catheterization

Choosing and Placing an Intravenous Catheter

Fluid administration

Composition of Body Fluids

Fluid Homeostasis

Fluid Needs

Classification of IV Fluids

IV Fluid Selection and Administration Rates

Adverse Effects of Fluid Administration

Calculating Fluid Administration Rates

Other Preanesthetic Care

3. Anesthetic Agents and Adjuncts

Introduction to Anesthetic Agents and Adjuncts

Agonists, Partial Agonists, Mixed Agonist-Antagonists, and Antagonists

Analgesic Effects of Anesthetics and Adjuncts

Using drugs in combination

Regulatory Considerations for Controlled Substances

Preanesthetic Medications

Reasons for the use of preanesthetic medications

Anticholinergics

Tranquilizers and Sedatives

Opioids

Neuroleptanalgesia

Opioid Antagonists

Injectable Anesthetics

Barbiturates

Propofol

Dissociative anesthetics

Etomidate

Guaifenesin.

Inhalation Anesthetics

Classes of Inhalation Agents

CNS and Respiratory Stimulants

Doxapram

4. Anesthetic Equipment

Endotracheal Tubes and Associated Equipment

Endotracheal tube parts

Laryngoscopes

Masks

Anesthetic Chambers

Anesthetic Machines

Components of the Anesthetic Machine

Rebreathing Systems

Non-rebreathing Systems

Operation of the Anesthetic Machine

Care and Maintenance of Anesthetic Equipment

5. Anesthetic Monitoring

Introduction to Monitoring

Stages and Planes of Anesthesia

Overview of Anesthetic Stages and Planes

Finding the Optimum Depth

Determining whether or not the Patient is Safe

Indicators of Circulation

Heart rate

Heart rhythm

Capillary refill time

Blood Pressure

Pulse strength

Indicators of Oxygenation

Mucous membrane color

Physiology of Oxygen transport

Pulse Oximeter

Blood Gas Analysis

Indicators of Ventilation

Respiratory rate

Tidal volume

Respiratory Character

Apnea monitor

Capnograph (End-tidal CO2 monitor)

Blood gas analysis

Indicators of Body Temperature

Assessment of Anesthetic Depth

Reflexes and Other Indicators of Anesthetic Depth

Judging Anesthetic Depth

Recording Information during Anesthesia

6. Special Techniques

Local anesthesia

Local anesthetic agents

Characteristics of local anesthetics

Mechanism of Action

Route of Administration of Local Anesthetics

Toxicity of Local Anesthetics

Assisted and controlled ventilation

Ventilation in the Awake Animal

Ventilation in the Anesthetized Animal

Types of Controlled Ventilation

Risks of Controlled Ventilation

Neuromuscular blocking agents

7. Analgesia

Physiology of pain

Consequences of untreated pain

Signs of pain in animals

Pain assessment tools

Assessing response to therapy

Perioperative pain management

Pharmacologic analgesic therapy

Opioid Agents

Nonsteroidal Antiinflammatory Drugs

Other Analgesic Agents

Multimodal Therapy

Home Analgesia

Nursing care

Non-pharmacologic therapies

8. Canine and Feline Anesthesia

Patient Preparation

Selecting a Protocol

Summary of a General Anesthetic Procedure

Anesthetic induction with an IM agent or combination

Anesthetic induction with an IV injection of an ultra-short acting agent to effect

Total Intravenous Anesthesia (TIVA) by IV boluses of an ultra-short acting agent

Total Intravenous Anesthesia (TIVA) by constant rate infusion (CRI)

Induction and maintenance with an inhalant agent

IV induction and maintenance with an inhalant agent

Equipment Preparation

Premedication or Sedation

Anesthetic Induction

IV Induction

Inhalation Agents

Mask Induction

Chamber Induction

IM Induction

Oral administration

Endotracheal Intubation

Equipment for Endotracheal Intubation

Selecting an Endotracheal Tube

Preparing the Tube

Intubation Procedure

Checking for Proper Placement

Securing the Tube

Cuff inflation

Laryngospasm

Complications of Intubation

Maintenance of Anesthesia

Maintenance with an Inhalant Agent

Maintenance with repeat boluses of propofol or other ultrashort-acting agent

Maintenance with a CRI

Maintenance with injectable and inhalant agents

Maintenance with an IM injection

Patient Positioning, Comfort and Safety

Anesthetic Recovery

Anesthetist's Role in the Recovery Period

Signs of Recovery

Monitoring

Oxygen Therapy

Extubation

The Postanesthetic Period

9. Equine Anesthesia

Patient Preparation

Selecting a Protocol

Summary of a General Anesthetic Procedure

Equipment Preparation

Premedication or Sedation

Standing chemical restraint

Anesthetic Induction

IV Induction

Inhalation Induction via Nasotracheal Tube

Endotracheal Intubation

Equipment for Endotracheal Intubation

Selecting an Endotracheal Tube

Preparing the Tube

Intubation Procedure

Complications of Intubation

Maintenance of Anesthesia

Maintenance with an Inhalant Agent

Maintenance with intravenous agents, or TIVA

Maintenance with injectable and inhalant agents

Patient Positioning, Comfort and Safety

Anesthetic Recovery

Preparation for recovery

Monitoring during recovery

Signs of recovery

Extubation

Standing after regaining consciousness

The Postanesthetic Period

10. Food Animal Anesthesia

Ruminants

Patient preparation

Selecting a Protocol

Summary of a General Anesthetic Procedure

Equipment Preparation

Premedication or Sedation

Anesthetic Induction

Endotracheal Intubation

Maintenance of Anesthesia

Patient Positioning, Comfort and Safety

Anesthetic Recovery

The Post-anesthetic Period

Swine

Physical examination

Sedation

Anesthetic Induction

Maintenance of Anesthesia

Recovery

11. Anesthesia of Rodents and Rabbits

Patient evaluation

Handling and restraint

Physical examination

Diagnostic tests

Preanesthetic patient care

Withholding food

Correction of preexisting problems

Preanesthetic agents

Anticholinergics

Phenothiazines

Benzodiazepines

Alpha2 adrenergic agonists

Opioids

General anesthesia

Induction techniques and agents

Intubation and maintenance of anesthesia

Postoperative care

Anesthetic emergencies

Respiratory depression

Circulatory failure

Postoperative Analgesia

Pain assessment

Analgesic agents

Chronic pain

Administration of analgesics

12. Anesthetic Problems and Emergencies

Reasons That Anesthetic Problems and Emergencies Arise

Human Errors That May Lead to Anesthetic Problems and Emergencies

Equipment Issues That May Lead to Anesthetic Problems and Emergencies

Adverse Effects of Anesthetic Agents

Patient Factors that may lead to Anesthetic Problems and Emergencies

Response to Anesthetic Problems and Emergencies

Role of the Veterinary Technician in Emergency Care

General Approach to Emergencies

Emergency Situations That May Arise During Anesthesia

Problems That May Arise in the Recovery Period

13. Workplace Safety

Hazards of Waste Anesthetic Gas

Short-Term Effects

Long-Term Effects

Assessment of Risk

Reducing Exposure to Waste Anesthetic Gas

Anesthetic techniques and procedures

Monitoring Waste Gas Levels

Safe Handling of Compressed Gases

Fire Safety Precautions

Use and Storage of Compressed Gas Cylinders

Accidental Exposure to Injectable Agents

  Glossary