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Anesthesia 2 > Field- Horse anesthesia > Flashcards

Field- Horse anesthesia Flashcards

1
Q

Field anesthesia

A
  1. procedural considerations
  2. environmental considerations
    3.patient considerations (history, exam, stabilization, weight estimation)
    4.equipment (basics, oxygen)
    5.Personnel considerations
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2
Q

Procedural considerations

A

-what injury? surgery? duration of procedure (tops ups or triple drip)?
-standing sedation and local block OR general anesthesia?

**only simple procedures of short duration should be attempted away from safety of hospital

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3
Q

Environmental considerations

A

Optimal conditions: soft ground, flat or gentle gradient

Avoid: barbed wire fences, farm equipment, ponds, streams, ravines

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4
Q

Patient considerations

A

1.history and exam (cardiovascular and rsp, gut motility, pain)

  1. Stabilization (hemorrhage, fasting)

3.Weight estimation (drug doses require accurate weight)

  1. Owner consent
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5
Q

Weight estimation

A
  1. weigh tape= tape around heart girth

OR

  1. Calculation
    Wt= Girth^2 x length (cm)/ 11,877
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6
Q

Equipment

A

-minimum anesthesia equipment includes:

IV catheters, sufficient amount of drugs, soft ropes with appropriate halter, small towels covering/protecting eyes

Oxygen
-horses prone to hypoxemia during GA
-E tank with nasal insufflation (2200 psi, 625L of O2)

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7
Q

Personnel considerations

A

-safety of horse and everyone else
-only stand, sit, or kneel on dorsal aspect of horse laying in lateral

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8
Q

Sedation/pre med options for horses

A
  1. Acepromazine
  2. Alpha 2 agonists
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9
Q

Acepromazine

A

-used as premed in combo with other drugs OR alone for non-painful procedures
-30-40min onset
-can also be used to calm mare so you can work on their foal

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10
Q

Effects of acepromazine in horses

A

-sedation
-anti-arrhythmic effect
-vasodilation and hypotension because of alpha 1 antagonism
-penile prolapse (avoid use in breeding stallions

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11
Q

Alpha 2 agonists effects

A

-more reliable sedation
-provides analgesia and muscle relaxation
-some ataxia
-Cardiovascular effects if given IV
-Bradycardia initially- does not require atropine as will increase HR in a few mins; and atropine reduced GI motility

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12
Q

Doses of alpha 2 agonists in horses

A

Equipotent doses of 3 different alpha 2 agonists used in horses
-Standing sedation: use low dose
-Pre-anesthetic medication: usually use high dose

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13
Q

Alpha 2 agonists used in horses

A

-Xylazine (lasts 20mins)
-Detomidine (lasts 40mins)
-Romifidine (lasts 40mins)

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14
Q

Alpha 2 agonists used alone

A

-do not trust, horse can still kick

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15
Q

Opioids used with alpha 2s

A
  1. Butorphanol IV
  2. Morphine- need to use a longer lasting alpha 2 agonist

*Can be mixed or given separately

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16
Q

Alpha 2 agonists with opioids and acepromazine

A
  1. Commonly use, Detomidine/Butorphanol/Acepromazine
  2. Detomidine/Acepromazine is good for mares

**DO NOT MIX ROMIFIDINE AND ACEPROMAZINE- will precipitate

17
Q

Induction of anesthesia

A
  1. pre anesthetic prep
    -fast 6 hrs, water until 1 hr before; history, exam, hematology
  2. Assess facilities/environment
  3. Place an IV catheter
  4. Check halter and ropes
  5. Protect facial nerve if leaving halter on
  6. Select site- brief on safety and potential problems
18
Q

Field induction drugs

A
  1. Xylazine OR Detomidine - wait a few mins for peak
  2. Then mix diazepam and ketamine
    -diazepam optional but does smooth induction

3.Can add butorphanol or morphine depending on pain levels (but give after induction to avoid excitement)

  1. local block
19
Q

Ketamine induction

A

-Need nose to knees sedation and then check HR (should be 20bpm) then can induce

DO NOT USE IF sedation poor or HR is very low

20
Q

Horses in recumbency

A

-dont allow heat to smack ground
-check vital signs and anesthetic depth
-position of procedure
-protect eyes
-protect cranial nerves= remove halter

21
Q

Options for maintaining anesthesia

A
  1. Incremental top-up IV bolus
  2. Continuous intravenous infusions
22
Q

Top ups

A

Ketamine + Xylazine
-mix 1/3 to 1/2 pre med and induction doses which will provide 2-3 top ups
-give every 10-15mins depending on anesthesia depth

**Remember, ketamine is slightly cumulative. So after 3rd top up, increase dosing interval or decrease next doses

23
Q

Triple Drip

A

-used for longer duration anesthetic; max time= 90mins
-analgesia
-cardiopulmonary stability

-use Xylazine + Ketamine added to 5% Guaifenesin (muscle relax)
-give 2ml/kg/hr
-usually good for 60mins

24
Q

Check depth of anesthesia

A

-pulse quality
-mucous membrane colour
-CRT
-HR
-resp rate and depth
-eye reflexes (eye stays central; palpebral is brisk if used injectables)

LIGHT PLANE: spontaneous blinking, tearing, nystagmus

-dont use corneal reflexes

25
Q

Field monitoring

A

-portable equipment
-measure blood pressure with doppler and sphygmomanometer
-use pulse oximeter

26
Q

Life support

A

-usually just short procedures in field. If longer than consider oxygen and fluids

27
Q

Recovery

A

-usually dont use reversal
-control recovery
-avoid noise and keep eyes covered
-place urinary catheter and empty bladder if longer procedure
-consider sedation (xylazine) if recent top up with ketamine alone in previous 10 mins

28
Q

Analgesia options

A
  1. NSAIDs
  2. Opioids
  3. Local anesthetic blocks
29
Q

NSAIDs

A

-use pre-emptively to minimize surgical/inflammatory pain

30
Q

Opioids for recovery

A

-provide good analgesia and increase sedation

-butorphanol (IV; 60-90mins), morphine (IM or slow IV; 2-4hrs) , buprenorphine (IM; 12 hrs)

31
Q

Local anesthetic blocks

A

-can provide useful part of a balanced analgesia
-intra-testicular for castration

Anesthesia 2 (17 decks)

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