2. Clinical Sedation and Pre Medication

Question 1

What is the difference between sedation and premedication?

Answer 1

Sedation:
Non painful procedure
Non invasive procedure e.f. radiograph, ultrasound
Generally want to do something to animal
Used as alternative to anaesthesia

Premed:
Administered PRIOR to anaesthesia
You will give MORE drugs before you do anything to the animal (usually drugs to anaesthetise the animal)

Question 2

Aims of pre medication

Answer 2

Relieve anxiety/ stress
Facilitate handling
Provide analgesia
Reduce muscle tone
Analgesia

All above is also why we sedate animals. Pre med also:

• To smooth induction of anaesthesia and make it faster
• To smooth the maintenance phase of anaesthesia (unconscious, analgesia, muscle relaxation)
• To smooth recovery from anaesthesia as background sedation makes recovery calmer and less frightening
• To reduce the dose of induction/ number of other agents used in anaesthesia: anaesthetic sparing effect
• When operating, less peaks and troughs of stimulation
• Pre emptive analgesia
• Reduce stress dog and vet
• Reduce muscle tone

Question 3

What does the anaesthetic sparing effect result in drug wise?

Answer 3

Means a reduction in the dose of induction and number of other agents needed
 reduced dose = lower end of dose range = less drug = less side effects
 we sue lots of drugs but at the lower end of dose range
 Anaesthetic (MAC) sparing effect

Question 4

Why do we sedate animals?

Answer 4

• To relieve anxiety / stress
• To facilitate handling
• To help perform minor procedures/ interventions to be carried out
• To provide analgesia (inability to feel pain)
  o As pre med while sedated as well as for any on going procedures when anaesthetised
  o Any procedure is painful really so any pre-emptive analgesia is great
• To reduce muscle tone
  o Relaxed patient is easier to operate on than rigid
  o To get job done e.g. can’t radiograph moving

Question 5

When picking drugs for pre med and sedation what do we want the drugs to do? (7)

Answer 5

 Relieve fear and anxiety pharmacologically (as well as nice blankets etc)
 Be Safe (high therapeutic index, safe dose range) to animals and you
 Reliable and predictable effect (how work and what we expect to see once administered)
 Quick onset, appropriate duration of action
 Easy to administer (route, volume, non-irritating)
 Minimal CV, resp and other side effects
 Provide analgesia
- price
- analgesia
- Provide amnesia

Question 6

What do we need to remember with all drugs for food producing animals?

Answer 6

1. Must have Maximum residue limit which is the max allowed conc of residue in a food producing product
2. appropriate withdrawal period

Question 7

Pre appointment anxious equine patient. What drug would you give

Answer 7

 acepromazine oral gel, detomodine oromucosal gel

Question 8

Pre appointment anxious dog/ cat patient. What drug would you give

Answer 8

 Gabapentin: 2 hours before appointment

 Trazadone: caution if history of seizures