Veterinary Anaesthesia

 
 
Saunders Ltd. (Verlag)
  • 11. Auflage
  • |
  • erschienen am 28. Juni 2013
  • |
  • 625 Seiten
 
E-Book | ePUB mit Adobe DRM | Systemvoraussetzungen
E-Book | PDF mit Adobe DRM | Systemvoraussetzungen
978-0-7020-5423-5 (ISBN)
 

This is a fully revised new edition of this essential text covering anaesthesia and analgesia in all large and small animal species. The new edition has greatly expanded sections on anaesthesia of exotic species such as small mammals, llamas, camels and many more, and also has a new section on anaesthesia of wild animals, both large and small, and birds.

The book is divided into 3 sections; the first, Principles and Procedures covers pharmacology and pharmacokinetics, monitoring, sedation and premedication and much more. The second section comprises chapters on anaesthesia in all the main species and the third section covers anaesthesia in special cases, complications and crises !

Almost 200 prints and line illustrations enhance the comprehensive text, and make the new edition of Veterinary Anaesthesia 10/e an essential purchase for all vets !

  • all large and small animal species covered in one book: includes new advances in anaesthesia in horses, birds, lab animals and wild animals

  • glossary of USA and UK drug names: up-dated coverage of all new anaesthetic agents in Europe and the USA

  • first section covers principles of drug action, pharmacokinetics and pharmacodynamics

    • the only book to discuss anaesthesia of individual species in detail: lot of info on anaesthesia of goats, sheep and other herbivores such as camels and llamas

      • also covers analgesia in all species

      • chapter on special cases such as anaesthesia in obstetrics

      • chapter on anaesthetic accidents and crises !
      • the new edition will be made more student-friendly by adding special boxes in the text which will be relevant for this group.

      • Full revision and update of content
      • Englisch
      • London
      • |
      • Großbritannien
      Illustrations, unspecified
      • Höhe: 246 mm
      • |
      • Breite: 189 mm
      • |
      • Dicke: 0 mm
      • 32,15 MB
      978-0-7020-5423-5 (9780702054235)
      0702054232 (0702054232)
      weitere Ausgaben werden ermittelt
      • Front cover
      • Veterinary Anaesthesia
      • Copyright page
      • Table of Contents
      • Contributors
      • Preface
      • In memoriam
      • 1 Principles and procedures
      • 1 An introduction to anaesthesia and general considerations
      • Introduction
      • Veterinary anaesthesia
      • General anaesthesia
      • Mechanisms of action of general anaesthetic agents
      • Depth of anaesthesia
      • Electroencephalography (EEG)
      • Power spectrum analysis
      • Cerebral function monitors
      • Evoked responses
      • The 'classic' signs of anaesthesia
      • Computer control in anaesthesia
      • Minimum Alveolar Concentration (MAC) and Minimum Infusion Rate (MIR)
      • Minimum alveolar concentration
      • Minimum infusion rate
      • Anaesthetic risk
      • General considerations in the selection of the anaesthetic method
      • Individual animals
      • Evaluation of the patient before anaesthesia
      • Biochemical tests prior to anaesthesia
      • Significance of conditions found by preanaesthetic examination
      • Cardiovascular and respiratory disease
      • Drug metabolism and disease states
      • Factors affecting transport of drugs in the body
      • Renal disease
      • Preparation of the patient
      • Food and water
      • Fluid and electrolytes
      • Haemoglobin level
      • Influence of pre-existing drug therapy
      • Pharmacogenetics
      • References
      • 2 Patient monitoring and clinical measurement
      • Introduction
      • General considerations relating to monitoring
      • Clinical assessment of the patient
      • Monitoring the central nervous system
      • Eye position and reflexes
      • Anaesthetic gas analysers
      • EEG and Bispectral index
      • Monitoring the circulation
      • Pulse rate and rhythm
      • Heart rate monitors
      • Oesophageal stethoscope
      • Electrocardiography
      • Tissue perfusion
      • Arterial blood pressure
      • Doppler ultrasound for indirect measurement of blood pressure
      • Oscillometry for indirect measurement of blood pressure
      • High-definition oscillometry
      • Direct measurement of blood pressure
      • Central venous pressure
      • Left atrial pressure (pulmonary arterial occlusion pressure)
      • Cardiac output
      • Fick method
      • Indicator dilution method
      • Pulse contour method
      • Flow method
      • Impedance cardiography
      • Blood loss
      • Monitoring the respiratory system
      • Rate monitors and apnoea alarms
      • Tidal and minute volume monitors
      • Blood gas analysis
      • Hypercarbia, hypocarbia
      • Oxygenation
      • Oxygen content
      • Oxygen affinity
      • Mixed venous, central venous, and venous PO2
      • Pulse oximetry
      • Capnography
      • Transcutaneous CO2 analysis
      • Acid-base analysis
      • Blood gas and acid-base values
      • Interpretation of acid base abnormalities
      • Monitoring body temperature
      • Hypothermia
      • Hyperthermia
      • Malignant hyperthermia
      • Monitoring urine volume
      • Monitoring blood glucose
      • Monitoring neuromuscular blockade
      • References
      • 3 An introduction to pharmacokinetics
      • Introduction
      • Physical principles
      • Tension (partial pressure), units and atmospheric pressure
      • Solubility coefficients of gases
      • Concentration of a gas in solution
      • Pharmacokinetics of inhaled anaesthetics
      • Uptake of inhaled anaesthetics
      • Blood solubility and alveolar tension
      • The tension of anaesthetic agents in brain tissue
      • Recovery from anaesthesia
      • Speed of uptake and elimination related to safety of inhalation agents
      • Volatility
      • Potency
      • Uptake and elimination of inhalation anaesthetics in clinical practice
      • Other factors affecting inhalation anaesthetic administration
      • The vaporizer
      • The breathing system
      • The lungs
      • Cardiac output
      • Pharmacokinetics of intravenous anaesthetics
      • Total apparent volume of distribution
      • Total elimination clearance (ClE) and elimination half-life (t1/2ß)
      • Compartmental models
      • The one compartment model
      • The two compartment model
      • The multicompartment model
      • Practical methods of drug delivery during intravenous anaesthesia
      • Target controlled infusions (TCI)
      • References
      • 4 Principles of sedation, anticholinergic agents, and principles of premedication
      • Terminology
      • Phenothiazine derivatives
      • Acepromazine
      • Propionylpromazine
      • Fluphenazine
      • Other phenothiazine agents
      • Butyrophenones
      • Azaperone
      • Droperidol
      • Fluanisone
      • Benzodiazepines
      • Diazepam
      • Midazolam
      • Climazolam
      • Zolazepam
      • Benzodiazepine antagonists
      • Flumazenil
      • Sarmazenil
      • a2-Adrenoceptor agonists
      • Clinically relevant actions of a2-adrenoceptor agonist drugs
      • Pharmacokinetics: routes of administration
      • Sedation: hypnosis
      • Analgesia
      • Cardiovascular effects
      • Respiratory and pulmonary actions
      • Other actions
      • Xylazine
      • Detomidine
      • Medetomidine
      • Dexmedetomidine
      • Romifidine
      • Clonidine
      • a2-Adrenoceptor antagonists
      • Atipamezole
      • Yohimbine
      • Tolazoline
      • Idazoxan
      • Peripheral a2-antagonist MK-467
      • Other agents used for sedation
      • Sedative-opioid combinations
      • Immobilon®
      • Anticholinergic agents
      • Atropine
      • Hyoscine
      • Glycopyrrolate
      • Fenpipramide
      • Premedication
      • References
      • 5 Analgesia
      • Physiology of pain
      • Pain assessment
      • Pain scales
      • Non-steroidal anti-inflammatory drugs (NSAIDs)
      • Pharmacology
      • COX-1 and COX-2
      • Side effects
      • Drugs available
      • Carprofen
      • Meloxicam
      • Ketoprofen
      • Phenylbutazone
      • Suxibuzone
      • Flunixin
      • Firocoxib
      • Robenacoxib
      • Mavacoxib
      • Dual Inhibitors: tepoxalin
      • Opioids
      • Pharmacology
      • Side effects
      • Drugs available
      • Morphine
      • Methadone
      • Pethidine (meperidine)
      • Papaveretum
      • Buprenorphine
      • Butorphanol
      • Fentanyl
      • Remifentanil
      • Alfentanil
      • Etorphine
      • Sufentanil and carfentanil
      • Opioid antagonists
      • Local anaesthetics
      • Anatomy and physiology
      • Pharmacology
      • Side effects
      • Drugs available
      • Procaine
      • Amethocaine
      • Lidocaine
      • Prilocaine
      • Mepivacaine
      • Bupivacaine
      • Levo-bupivacaine
      • Ropivacaine
      • Routes of administration
      • Topical local analgesia
      • Regional local analgesia
      • Intravenous regional analgesia (IVRA)
      • Intra-articular analgesia
      • Epidural and intrathecal analgesia
      • Anatomy of the epidural space
      • Drugs used for epidural injection
      • Continuous epidural block
      • Contraindications to epidural injections
      • Side effects
      • Systemic administration of lidocaine
      • Ketamine
      • Tramadol
      • Gabapentin
      • Other analgesic agents
      • References
      • 6 General pharmacology of the injectable agents used in anaesthesia
      • Introduction
      • Formulation of injectable anaesthetic agents
      • Water based
      • Lipid emulsion
      • Cyclodextrins
      • Propylene glycol
      • Micelle formulations
      • Solvents no longer used
      • Sites of action of injectable anaesthetic agents
      • IV agents acting primarily at the GABAA receptors
      • The barbiturates
      • Thiopental
      • Methohexital
      • Pentobarbital sodium
      • Other barbiturates
      • Thiamylal sodium
      • Phenols
      • Propofol
      • Fospropofol
      • Steroid anaesthesia
      • Alfaxalone
      • Imidazole derivatives
      • Etomidate
      • Metomidate
      • New etomidate derivatives
      • Eugenols
      • Drugs acting primarily at the NMDA receptor
      • Dissociative agents
      • Ketamine
      • Tiletamine and Tiletamine-Zolazepam combination
      • Miscellaneous agents
      • Chloral hydrate
      • Chloralose
      • References
      • 7 General pharmacology of the inhalation anaesthetics
      • Introduction
      • Minimum alveolar concentration (MAC)
      • Analgesia
      • Uptake and elimination
      • Flammability and chemical stability
      • Biotransformation and organ toxicity
      • Actions on vital body functions
      • Interaction with other drugs
      • Occupational exposure to inhalation anaesthetic agents
      • Individual inhalation anaesthetics
      • Nitrous oxide (N2O)
      • Xenon
      • Diethyl ether
      • Halothane
      • Methoxyflurane
      • Enflurane
      • Isoflurane
      • Desflurane
      • Sevoflurane
      • Comparison of volatile agents for veterinary clinical practice
      • References
      • 8 Relaxation of the skeletal muscles
      • Introduction
      • Relaxation using agents which act centrally
      • Utilizing drugs which have a peripheral action
      • Using specific neuromuscular blocking agents
      • Theory of neuromuscular transmission
      • Release of acetylcholine
      • Effector mechanisms (nicotinic acetylcholine receptors (nAChRs))
      • Other influences on the neuromuscular receptor
      • Neuromuscular block
      • Non-depolarizing NMBs (competitive)
      • Depolarizing NMB (non-competitive)
      • Pattern of neuromuscular block
      • Sensitivity of muscles to neuromuscular block
      • 1. Perfusion
      • 2. Acetylcholine receptor numbers, distribution and type
      • 3. Fibre and end-plate size in the muscle
      • Monitoring of neuromuscular block
      • Peripheral nerve stimulation
      • Site of stimulation
      • Strength and pattern of stimulation
      • The single twitch
      • Train-of-four
      • Double burst stimulation (DBS)
      • Tetanic stimulation and post-tetanic count
      • Assessment of muscle contraction
      • Subjectively
      • Acceleromyography
      • Mechanomyography
      • Electromyography
      • Factors affecting monitoring
      • Hypothermia
      • Recognition of paralysis when a nerve stimulator is not used
      • Neuromuscular blocking agents
      • Requirements of a neuromuscular blocking agent
      • Agents which produce depolarizing block
      • Suxamethonium (succinylcholine)
      • Dose rates and duration
      • Agents which produce non-depolarizing (competitive) block
      • Steroidal Agents
      • Pancuronium
      • Vecuronium
      • Rocuronium
      • Benzylisoquinolinium agents
      • Atracurium
      • Cisatracurium
      • Mivacurium
      • Non-depolarizing NMBAs no longer in common use
      • Factors affecting the action of neuromuscular blocking drugs
      • Pharmacokinetics of the NMBAs
      • Body temperature
      • Administration of other drugs
      • Extracellular pH
      • Neuromuscular disease
      • Blood pressure and flow
      • Electrolyte imbalance
      • Evoked recovery from neuromuscular block
      • Practical aspects of reversal of NMB
      • Reversal agents
      • Neostigmine
      • Edrophonium
      • Sugammadex (Org 25969): a new concept in NMB reversal
      • Sugammadex in veterinary medicine
      • Use of neuromuscular blocking drugs in veterinary anaesthesia
      • Indications
      • Essential requirements for use of NMBAs
      • Ability to ventilate
      • Ensuring unconsciousness and analgesia
      • Recovery from NMB
      • Technique of use
      • Use of non-depolarizing NMBAs for surgery
      • Postoperative complications of neuromuscular blocking agents
      • Prolonged apnoea
      • Continued NMB
      • Deep anaesthesia
      • Hypothermia
      • Overventilation
      • Residual NMB
      • Centrally acting muscle relaxants
      • Guaifenesin
      • Benzodiazepines
      • References
      • 9 Pulmonary gas exchange:
      • Introduction
      • Spontaneous respiration
      • IPPV when the chest wall is intact
      • 1. Short application of positive pressure
      • 2. Rapid gas flow rate
      • 3. Low expiratory resistance
      • 4. Subatmospheric pressure during the expiratory phase
      • IPPV after opening of the pleural cavity
      • Collapse of the lung
      • Paradoxical respiration
      • Mediastinal movement
      • Effects on the circulation
      • Possible harmful effects of IPPV
      • PEEP, CPAP and recruitment manoeuvres
      • Recruitment manoeuvres
      • Management of IPPV
      • Manual ventilation
      • Lung ventilators
      • Essential characteristics
      • Ventilator settings
      • Weaning from IPPV
      • Other modes of lung ventilation
      • High frequency lung ventilation
      • Lung ventilation in intensive care
      • Ventilation in veterinary anaesthesia: the future
      • References
      • 10 Apparatus for administration of anaesthetics
      • Administration of intravenous agents
      • Syringes, needles, and catheters
      • Intraosseous needles
      • Vascular access ports
      • Infusion apparatus
      • Administration of inhalation agents
      • Anaesthesia workstation
      • Gases and cylinders
      • Oxygen
      • Liquid oxygen
      • Oxygen generators
      • Nitrous oxide
      • Air
      • Carbon dioxide
      • Helium-Oxygen
      • Pressure gauges
      • Regulators
      • Flowmeters
      • Vaporizers
      • Oxygen flush valve
      • Common gas outlet
      • Injection vaporization
      • Magnetic resonance imaging (MRI) compatible machines
      • Delivery (breathing) systems
      • Rebreathing circuits
      • Circle circuit
      • To-and-Fro
      • Non-rebreathing circuits
      • T-piece
      • Bain circuit
      • Magill and Lack circuits
      • Hazards of coaxial circuits
      • Humphrey ADE circuit
      • Patient devices
      • Facemasks
      • Anaesthetic induction chambers
      • Endotracheal intubation
      • Laryngeal mask airways
      • Laryngoscopes
      • Filters and humidity and moisture exchangers
      • Scavenging waste anaesthetic gases
      • Clinical use of the anaesthesia workstation
      • Troubleshooting the delivery circuits
      • Cleaning and sterilizing of anaesthetic equipment
      • References
      • 2 Anaesthesia of the species
      • 11 Anaesthesia of the horse
      • Introduction
      • Sedation of the standing horse
      • Phenothiazines
      • Acepromazine
      • a2-adrenoceptor agonists
      • Xylazine
      • Detomidine
      • Romifidine
      • Other a2-agonists
      • Practical use of a2-adrenoceptor agonists
      • Infusions of a2-agonists
      • a2-Agonists as analgesics
      • Sedative and sedative-opioid combinations
      • Infusions of sedative-opioid combinations
      • Benzodiazepines
      • Diazepam, midazolam, climazolam and zolazepam
      • Analgesia
      • Non-Steroidal Anti-inflammatory Analgesics (NSAIDS)
      • Opioid analgesics
      • Additional routes of administration of opioid agents
      • Other drugs used for analgesia
      • Gabapentin
      • Lidocaine
      • Local analgesia
      • Epidural and intrathecal analgesia
      • Caudal epidural injection and catheterization
      • Catheterization
      • Subarachnoid injection and catheterization
      • Drugs used by epidural and intrathecal routes
      • Specific Nerve Blocks
      • Infraorbital nerve block
      • Mandibular nerve block
      • Mental nerve block
      • Supraorbital nerve block
      • Auriculopalpebral nerve block
      • Palmar/plantar nerve block
      • Technique for palmar/plantar (abaxial sesamoid) injection
      • Technique of palmar/plantar metacarpal/metatarsal injection
      • Technique of blocking palmar terminal digital nerves
      • Indications for palmar/plantar block
      • The complete desensitization of the forelimb below the carpus
      • Median nerve
      • Ulnar nerve
      • Musculocutaneous nerve
      • The complete desensitization of the distal hind limb
      • Tibial nerve
      • Peroneal (fibular) nerve
      • Saphenous nerve
      • Local analgesia for castration
      • Paravertebral analgesia
      • General anaesthesia
      • Problems relating to size and temperament
      • Disturbances in cardiopulmonary function
      • Cardiovascular effects
      • Tissue blood flow versus arterial blood pressure
      • Pulmonary changes
      • Diffusion impairment
      • Atelectasis
      • Venous admixture
      • Effect of cardiac output
      • Lung volume
      • Preventive methods and/or treatments
      • Inspired oxygen concentrations
      • Ventilatory strategies
      • Pharmacological treatments
      • Muscle and nerve damage
      • Postanaesthetic myopathy (rhabdomyolysis)
      • Neuropathy
      • Preparation for general anaesthesia
      • General considerations
      • Intravenous techniques
      • Catheterization of the jugular vein
      • Premedication and co-induction
      • Anticholinergics
      • Sedatives
      • Acepromazine
      • a2-Adrenoceptor agonists
      • Benzodiazepines
      • Analgesics
      • Induction of anaesthesia
      • Facilities for induction
      • Methods of control at anaesthetic induction
      • Free fall
      • Gate method
      • Tilting table
      • Intravenous regimens for anaesthetic induction
      • Dissociative agents
      • Ketamine-a2-agonist
      • Other ketamine combinations
      • Ketamine/benzodiazepines
      • Tiletamine/zolazepam
      • Hypnotic/anaesthetic agents
      • Thiopental
      • Thiopental/guaifenesin
      • Propofol
      • Alfaxalone
      • Other induction techniques
      • Etorphine (Immobilon)
      • Anaesthetic induction with inhalation agents
      • Maintenance of Anaesthesia
      • Endotracheal intubation
      • Positioning for surgery
      • Apparatus for administration of oxygen and for ventilation
      • Agents for the maintenance of anaesthesia
      • Intravenous agents: total IV anaesthesia (TIVA)
      • TIVA for short procedures (up to 30 minutes)
      • Agents used to extend the duration of anaesthesia
      • Ketamine
      • Barbiturates - thiopental and methohexital
      • TIVA for medium duration procedures (30-90 minutes)
      • a2-Agonist/guaifenesin/ketamine - the 'Triple Drip'
      • a2-Adrenoceptor agonist/ benzodiazepine/ketamine
      • Chloral hydrate/barbiturate
      • TIVA for long procedures (2 hours and more)
      • Propofol combinations
      • Anaesthetic maintenance with inhalation agents
      • Volatile agents
      • Halothane
      • Isoflurane
      • Sevoflurane
      • Desflurane
      • Nitrous oxide
      • General points in relation to maintenance of anaesthesia using volatile agents
      • Practical administration
      • Supplementary analgesia
      • Partial intravenous anaesthesia (PIVA)
      • Lidocaine
      • a2-Agonists
      • Opioids
      • Ketamine
      • Treatment of circulatory depression
      • Increase in circulating fluid volume
      • Positive inotropes
      • Dopamine
      • Dobutamine
      • Dopexamine
      • Phenylephrine and methoxamine
      • Norepinephrine
      • Calcium
      • Anticholinergic agents
      • Glycopyrrolate, atropine, hyoscine
      • Intermittent positive pressure ventilation (IPPV)
      • Use of muscle relaxants
      • Centrally acting muscle relaxants
      • Guaifenesin
      • Benzodiazepines
      • Neuromuscular blocking agents
      • Monitoring the block
      • Neuromuscular blocking drugs
      • Atracurium
      • Vecuronium
      • Rocuronium
      • Pancuronium bromide
      • Suxamethonium chloride
      • Termination of neuromuscular block
      • Anaesthetic recovery period
      • General points
      • Ensuring adequate oxygenation and a patent airway
      • Sedation
      • Assisted recovery
      • Rope-based
      • Swimming pool
      • Anaesthesia for horses with colic
      • Anaesthesia in the foal
      • Practical sedation and anaesthesia of foals
      • References
      • 12 Anaesthesia of cattle
      • Introduction
      • Restraint
      • Electroimmobilization
      • Sedation and analgesia
      • Agents used in bovine species
      • Xylazine
      • Detomidine
      • Medetomidine
      • Antagonists of a2-agonists
      • Acepromazine
      • Chloral hydrate
      • Sedative-opioid combinations
      • Non-steroidal anti-inflammatory drugs (NSAIDs)
      • Local analgesia
      • Techniques
      • Auriculopalpebral nerve block
      • Cornual nerve block
      • Petersen eye block
      • Peribulbar and retrobulbar block
      • Inverted L block
      • Paravertebral nerve block
      • Pudendal nerve block
      • Local analgesia for castration
      • Caudal epidural block
      • Lumbosacral epidural block
      • Lumbar epidural block
      • Digital nerve blocks
      • Intravenous regional analgesia
      • Intranasal local analgesia
      • General anaesthesia
      • Anaesthetic techniques
      • Intravenous injection
      • Endotracheal intubation
      • Injectable anaesthetic agents
      • Thiopental
      • Thiopental-guaifenesin
      • Pentobarbital
      • Ketamine
      • Ketamine-guaifenesin
      • Tiletamine-zolazepam
      • Propofol
      • Inhalation anaesthesia agents
      • Nitrous oxide
      • Adjunct agents
      • Neuromuscular blocking agents
      • Anaesthetic management
      • Positioning
      • Fluid therapy
      • Monitoring
      • Recovery from anaesthesia
      • References
      • 13 Anaesthesia of sheep, goats, and other herbivores
      • Sheep and Goats
      • Introduction
      • Local analgesia
      • Applications of local anaesthesia
      • Cornual nerve blocks for dehorning
      • Epidural and intrathecal nerve block
      • Epidural and intrathecal catheters
      • Management
      • Epidural and intrathecal opioids
      • Epidural and intrathecal xylazine and dexmedetomidine
      • Caudal epidural nerve block
      • Paravertebral nerve block
      • Inverted L block
      • Forelimb digital nerve blocks
      • Femoral and sciatic nerve blocks
      • Peroneal and tibial nerve blocks
      • Intravenous regional analgesia
      • Intra-articular local analgesia
      • Infiltration and topical analgesia
      • Sedation
      • Sedative agents employed in sheep and goats
      • Acepromazine
      • a2-Agonists
      • Benzodiazepines
      • Dissociative anaesthetics
      • Opioids and analgesia
      • General anaesthesia
      • Preparation
      • Anaesthetic techniques
      • Intravenous injection
      • Endotracheal intubation
      • Injectable anaesthetic agents
      • Alfaxalone
      • Etomidate
      • Ketamine
      • Ketamine and guaifenesin (glyceryl guaiacolate, GGE)
      • Pentobarbital
      • Propofol
      • Thiopental
      • Tiletamine-zolazepam
      • Inhalation anaesthesia
      • Potencies of isoflurane, sevoflurane, and desflurane
      • Nitrous oxide
      • Adjunct agents
      • Opioids
      • Lidocaine
      • Ketamine
      • Non-steroidal anti-inflammatory agents
      • Neuromuscular blockade
      • Anaesthetic management
      • Positioning
      • Fluid therapy
      • Monitoring
      • Treatment of hypotension
      • Recovery
      • Assessment of pain
      • Camelids
      • Introduction
      • Local analgesia
      • Applications for local anaesthesia
      • Caudal epidural analgesia
      • Local analgesia for castration
      • Caesarian section
      • General anaesthesia
      • Preparation for anaesthesia
      • Anaesthetic techniques
      • Venepuncture
      • Endotracheal intubation
      • Anaesthetic agents
      • Sedatives
      • Opioids
      • Guaifenesin
      • Ketamine
      • Propofol
      • Alfaxalone
      • Tiletamine-zolazepam
      • Inhalation agents
      • Anaesthetic management
      • Deer
      • Introduction
      • Anaesthetic agents
      • Xylazine
      • Xylazine and ketamine
      • Medetomidine combinations
      • Tiletamine-zolazepam
      • Camels
      • Introduction
      • Anaesthetic agents
      • Local analgesia
      • Elephants
      • Introduction
      • Anaesthetic agents
      • Inhalation anaesthesia
      • References
      • 14 Anaesthesia of the pig
      • Introduction
      • Porcine malignant hyperthermia
      • Clinical signs
      • Treatment of MH
      • Sedation
      • Agents employed for sedation in pigs
      • Acepromazine
      • a2-Agonists
      • Azaperone
      • Dissociative agents
      • Droperidol
      • Opioids
      • General anaesthesia
      • Preparation
      • Premedication
      • Analgesia
      • Intravenous technique
      • Endotracheal intubation
      • Injectable anaesthetic agents and combinations
      • Alfaxalone
      • Ketamine
      • Guaifenesin-ketamine-xylazine 'Triple Drip'
      • Pentobarbital sodium
      • Propofol
      • Tiletamine-zolazepam
      • Thiopental sodium
      • Inhalation anaesthesia
      • Isoflurane, sevoflurane
      • Desflurane
      • Nitrous oxide (N2O)
      • Monitoring
      • Postanaesthetic care
      • Neuromuscular blocking agents
      • Local analgesia
      • Epidural nerve block
      • Analgesia for castration
      • Caesarian section
      • References
      • Further Reading
      • 15 Anaesthesia of the dog
      • Introduction
      • Sedation and analgesia
      • General principles
      • Phenothiazines
      • Benzodiazepines
      • a2-Agonist sedatives
      • Xylazine
      • Medetomidine
      • Dexmedetomidine
      • Romifidine
      • Opioids
      • Tramadol
      • Maropitant
      • Sedative-opioid combinations
      • NSAIDs
      • Dipyrone (metamizole)
      • Antagonists
      • General anaesthesia
      • Preparation for anaesthesia
      • Concurrent drug therapy
      • Antibiotics
      • Antipsychotic drugs
      • Barbiturates
      • Cardiovascular drugs
      • Corticosteroids
      • Insulin
      • Breed characteristics
      • Brachycephalic breeds
      • Sighthounds
      • Age characteristics
      • Paediatric anaesthesia
      • Senior and geriatric dogs
      • Physical examination
      • Auscultation of the thorax
      • Overweight and obese dogs
      • Dogs weighing <_5 kg="kg" li="li">
      • Diagnostic tests
      • Evaluation of the significance of disease
      • Food and water restrictions
      • Gastro-oesophageal reflux
      • Premedication
      • Anticholinergics
      • Sedative and analgesic premedication
      • Transdermal fentanyl
      • Intravenous technique
      • Intraosseous injection
      • Vascular port
      • Endotracheal intubation
      • Intubation via pharyngotomy
      • Intravenous agents
      • Thiopental
      • Methohexital
      • Pentobarbital
      • Ketamine
      • Tiletamine-zolazepam
      • Propofol
      • Propofol-thiopental
      • Propofol-ketamine ('ketofol')
      • Fospropofol
      • Etomidate
      • Alfaxalone
      • Sedative-opioid combinations
      • (Dex)medetomidine and an opioid
      • Fentanyl and diazepam or midazolam
      • Oxymorphone and diazepam or midazolam
      • Induction of anaesthesia
      • Total intravenous anaesthesia (TIVA)
      • Propofol-fentanyl
      • Inhalation anaesthesia
      • Inhalation agents
      • Isoflurane, sevoflurane, desflurane, halothane
      • Sevoflurane and CO2 absorbent
      • Nitrous oxide (N2O)
      • Systems of administration
      • Induction using a facemask
      • Intraoperative supplements
      • Opioids
      • Lidocaine
      • Ketamine
      • a2-Agonist sedatives
      • Propofol
      • Neuromuscular blocking agents
      • Agents used
      • Administration
      • Termination of neuromuscular block
      • Dose rates for NMBAs
      • Anaesthetic management
      • Positioning
      • Monitoring
      • Fluid therapy
      • Cardiovascular support
      • Artificial ventilation
      • Postoperative management
      • Oxygen supplementation
      • Analgesia
      • Specific patient and procedure problems
      • Cardiac disease
      • Mitral regurgitation
      • Cardiomyopathy
      • Ventricular dysrhythmias, myocardial ischaemia, myocardial contusions
      • Pacemakers
      • Patent ductus arteriosus (PDA)
      • Endoscopy
      • Bronchoscopy, transtracheal wash (TTW), bronchoalveolar lavage (BAL)
      • Gastroscopy and colonoscopy
      • Laparoscopy
      • Laryngoscopy
      • Rhinoscopy
      • Urinary bladder
      • Exploratory laparotomy
      • Gastric dilation-volvulus
      • Peritonitis
      • Biliary system
      • Hepatic disease
      • Neurological disease
      • Dorsal hemilaminectomy and ventral cervical decompression
      • Myelography, computed tomography
      • Craniotomy
      • Ocular surgery
      • Orthopaedic surgery
      • Renal disease
      • Trauma
      • Hit-by-car (HBC, RTA), high-rise syndrome (fell from a great height)
      • Big dog-little dog
      • Local analgesia
      • Auriculopalpebral nerve block
      • Brachial plexus block
      • Digital nerve blocks
      • Epidural and intrathecal block
      • Technique
      • Confirmation of needle placement in the epidural space
      • Epidural catheter
      • Drugs used in the epidural space
      • Potential complications
      • Infiltration
      • Soaker catheters
      • Soaker catheters
      • Intercostal nerve block
      • Interpleural block
      • Intra-articular analgesia
      • Intravenous regional analgesia (IVRA)
      • Mandibular and maxillary nerve blocks
      • Ocular nerve blocks
      • Peribulbar and retrobulbar
      • Intracameral lidocaine
      • Paravertebral nerve block (brachial plexus)
      • Pelvic limb blocks
      • Paralumbar plexus block
      • Femoral nerve block
      • Sciatic nerve block
      • Parasacral plexus block
      • Peroneal and tibial nerve blocks
      • RUMM blocks
      • Transdermal lidocaine patch
      • References
      • 16 Anaesthesia of the cat
      • Introduction
      • Patient evaluation
      • History
      • Physical examination
      • Diagnostic tests
      • Impact of disease
      • Vaccination
      • Handling
      • Sedation and analgesia
      • Agents
      • Acepromazine
      • a2-Agonist sedatives
      • Benzodiazepines
      • Opioids
      • Transdermal (TD) fentanyl
      • Side effects of opioid administration
      • Non-steroidal anti-inflammatory agents
      • Controversial issues
      • Evaluation of pain
      • Ovariohysterectomy, castration
      • Feral cats
      • Regional nerve blocks
      • Euthanasia
      • General anaesthesia
      • Preanaesthetic preparation
      • Premedication
      • Sedatives and analgesics
      • Anticholinergic agents
      • Intravenous injection
      • Endotracheal intubation
      • Injectable anaesthetic agents
      • Thiopental
      • Methohexital
      • Pentobarbital
      • Propofol
      • Alfaxalone
      • Etomidate
      • Ketamine
      • Tiletamine
      • Total intravenous anaesthesia (TIVA)
      • Inhalation anaesthesia
      • Administration of inhalation agents
      • Adjunct agents
      • Neuromuscular blockade
      • Monitoring and management
      • Ventilation
      • Cardiovascular system
      • Temperature
      • Recovery from anaesthesia
      • Local analgesia
      • Brachial plexus nerve block
      • Dental nerve blocks
      • Digital nerve blocks
      • Epidural analgesia
      • Peroneal and tibial nerve block
      • Sciatic nerve block
      • Topical or transdermal
      • References
      • 17 Anaesthesia of zoological species (exotic pets, zoo, aquatic, and wild animals)
      • Introduction
      • Small mammals
      • Preanaesthetic sedation and analgesia
      • Regional anaesthesia and local blocks
      • Inhalation anaesthetic agents
      • Injectable anaesthetic agents
      • Ketamine
      • Neuroleptanalgesia
      • Other agents
      • Ventilation
      • Monitoring
      • Recovery and postoperative care
      • Lagomorphs - rabbits (Oryctolagus cuniculus) and hares (Lepus europaeus)
      • Rodents - rats (Rattus norvegicus), mice (Mus musculus), guinea pigs (Cavia porcellus), hamsters and gerbils (Mesocricetus auratus and Gerbillidae)
      • Mustelids - ferrets (Mustela putorius furo), mink (Mustela lutreaola), European otter (Lutra lutra), stoat or short-tailed weasel (Mustela ermine), polecat (Mustela putorius), badger (Meles meles)
      • Insectivores - European hedgehogs (Erinaceus europaeus), African pygmy hedgehogs (Atelerix albiventris)
      • Reptiles
      • Preanaesthetic stabilization, sedation and analgesia
      • Regional anaesthesia and local block
      • Injectable anaesthetic agents
      • Inhalation anaesthetic agents
      • Ventilation
      • Monitoring
      • Recovery and postoperative care
      • Birds
      • Preanaesthetic stabilization, sedation and analgesia
      • Regional anaesthesia and local block
      • Injectable anaesthetic agents
      • Inhalation anaesthetic agents
      • Ventilation
      • Monitoring
      • Recovery and postoperative care
      • Fish
      • Preanaesthetic stabilization, sedation and analgesia
      • Anaesthesia, monitoring and recovery
      • References
      • 18 Chemical immobilization of wild animals
      • Introduction and general concepts
      • Prior to capture and anaesthesia
      • Capture techniques and remote drug delivery
      • Human safety
      • Handling and treatment of accidental exposure to carfentanil or etorphine
      • Equipment
      • Remote delivery systems
      • Darts
      • Anaesthetic agents
      • Induction of anaesthesia
      • Stress and capture myopathy
      • Capture myopathy
      • Monitoring
      • Recovery
      • Anaesthetic agents for selected common wildlife species
      • References
      • 3 Special anaesthesia
      • 19 Anaesthesia for obstetrics
      • Introduction
      • The state of pregnancy
      • Circulatory changes
      • Respiratory system changes
      • Other systems
      • Pharmacology of drugs administered during pregnancy
      • Clinical significance of changes during pregnancy and parturition
      • Drug actions
      • Opioids
      • a2-Agonists
      • ketamine
      • Intravenous anaesthetics
      • neuromuscular blockers
      • Inhalation anaesthetics
      • Local analgesics
      • Anticholinergics
      • Anaesthesia for dystocia and caesarean section
      • Horses
      • Anaesthesia for caesarean section
      • Care of the newborn foal
      • Cattle
      • Care of the newborn calf
      • Postoperative behaviour
      • Sheep and goats
      • Camelids
      • Care of the newborn
      • Pigs
      • Dogs and cats
      • Anaesthetic management
      • Care of the newborns
      • Limitations of our knowledge
      • References
      • 20 Anaesthesia for intrathoracic procedures
      • General principles
      • Preanaesthetic evaluation and preparation
      • Ventilation and oxygenation
      • Lung recruitment manoeuvre
      • One-lung ventilation
      • Bronchial blocker
      • Double lumen tube
      • Pulmonary effects of OLV
      • Re-expansion pulmonary oedema
      • Choice of anaesthetic agents
      • Analgesia
      • Neuromuscular blockade
      • Monitoring
      • Closure of the thorax
      • Recovery from anaesthesia
      • Anaesthesia for specific procedures
      • Diaphragmatic rupture in dogs and cats
      • Choice of anaesthetic agents
      • Anaesthetic management
      • Recovery from anaesthesia
      • Patent ductus arteriosus (PDA)
      • Choice of anaesthetic agents
      • Anaesthetic management
      • Persistent right aortic arch (PRAA)
      • Thoracoscopy
      • References
      • 21 Complications
      • Introduction
      • Abnormal breathing
      • Abnormal or laboured breathing
      • Bronchodilation
      • Tachypnoea or panting
      • Irregular breathing patterns
      • Arrhythmias
      • Causes and management
      • Tachycardia
      • Cyanosis and hypoxaemia
      • Causes and management
      • a2-Antagonists
      • Hypotension
      • Significance of hypotension
      • Causes and management
      • Crystalloids and colloids
      • Monitoring fluid infusion
      • Expansion capabilities of different colloids
      • Adverse effects of colloid administration
      • Points to remember
      • Blood loss
      • Fluid resuscitation
      • Blood product transfusion triggers
      • Intravenous lipid emulsion (ILE)
      • Inadequate anaesthesia
      • Muscle movements
      • Injury associated with anaesthesia
      • Contrast agents
      • Postoperative infection
      • Myopathy and nerve damage
      • Visual loss
      • References
      • 22 Cardiopulmonary cerebral resuscitation (CPCR)
      • History and introduction
      • Cerebral resuscitation
      • Prior to anaesthesia
      • Causes of cardiac arrest/risk factors for anaesthetic mortality
      • Cardiopulmonary cerebral resuscitation protocol
      • Basic cardiac life support 'A-B-C'
      • 'A & B' - airway and breathing
      • 'C' - circulation - cardiac compressions
      • Internal cardiac compressions
      • 'D' - advanced cardiac life support
      • Cardiac arrest rhythms and electrical shock
      • The CPCR algorithm
      • Defibrillation
      • Large animal resuscitation
      • Monitoring during CPCR
      • Medical therapies for cardiac arrest (see Table 22.4)
      • Routes of administration
      • Vasopressors
      • Anti-arrhythmic medication
      • Atropine
      • Amiodarone
      • Lidocaine
      • Other medication or therapy
      • Fluid therapy
      • Sodium bicarbonate
      • Mannitol
      • Glucose
      • Electrolyte abnormalities
      • Calcium
      • Hyperkalaemia
      • Hypokalaemia
      • Magnesium
      • Therapeutic hypothermia
      • Post resuscitation
      • Summary and future therapies
      • References
      • Suggested reading
      • Appendix
      • Abbreviations
      • Weights
      • Conversions
      • Units of pressure
      • Index
      • A
      • B
      • C
      • D
      • E
      • F
      • G
      • H
      • I
      • J
      • K
      • L
      • M
      • N
      • O
      • P
      • R
      • S
      • T
      • U
      • V
      • W
      • X
      • Y
      • Z
      Chapter 2

      Patient monitoring and clinical measurement


      Introduction 

      General considerations relating to monitoring 

      Clinical assessment of the patient 

      Monitoring the central nervous system 

      Eye position and reflexes 

      Anaesthetic gas analysers 

      EEG and Bispectral index 

      Monitoring the circulation 

      Pulse rate and rhythm 

      Heart rate monitors 

      Tissue perfusion 

      Arterial blood pressure 

      Central venous pressure 

      Left atrial pressure (pulmonary artery wedge pressure) 

      Cardiac output 

      Blood loss 

      Monitoring the respiratory system 

      Rate monitors and apnoea alarms 

      Tidal and minute volume monitors 

      Blood gas analysis 

      Pulse oximetry 

      Capnography 

      Transcutaneous CO2 analysis 

      Acid–base analysis 

      Blood gas and acid base values 

      Interpretation of acid base abnormalities 

      Monitoring body temperature 

      Hypothermia 

      Hyperthermia 

      Malignant hyperthermia 

      Monitoring urine volume 

      Monitoring blood glucose 

      Monitoring neuromuscular blockade 

      Introduction


      From the earliest days of anaesthesia, the anaesthetist has monitored the patient's pulse rate, pattern of breathing and general condition. Advances in electronic technology have made reasonably reliable, easily attached, non-invasive monitoring devices available for clinical practice. Observations and measurements of certain parameters before, during, and after anaesthesia provide important data to support the clinical assessment of the animal's condition and improve the chances of survival of the very ill by indicating what treatment is needed, as well as the response to treatment already given.

      It is necessary to know what to measure as well as how to measure it and not all anaesthetists may agree on the priority ranking of the monitoring devices available. However, for major surgery, for anaesthesia and surgery of poor-risk patients, and for equine anaesthesia, it would be difficult to defend the failure to use monitoring equipment, especially if it were available. Recommendations for monitoring of anaesthetized patients are available on the web sites for the Association of Veterinary Anaesthetists, American College of Veterinary Anesthesia and Analgesia, and the American Animal Hospital Association.

      General considerations relating to monitoring


      Complications, including death, may occur in healthy patients at all stages of anaesthesia and monitors provide early warning of life-threatening developments. Anaesthetic mishaps may be caused by mechanical malfunction, disconnection of equipment, or human error. Judgemental error frequently occurs when the anaesthetist is in a hurry and circumvents basic practices and procedures, or when a decision must be made in an emergency. The prevalence of complications may also be associated with inadequate training or experience of the anaesthetist. Knowledge and experience are a function of the nature of the training received and the years of practice, but proper vigilance at all times can only be generated by self-motivation.

      Routines should be developed to ensure that each aspect of apparatus function is checked before use. Failure to follow a simple checklist in every case features high on the list of causes of anaesthetic disasters. All anaesthetic equipment, including monitoring devices, should be maintained in good functioning order. It should be a matter of course to maintain monitors with a battery back up fully charged in case of need in an area without a convenient electricity outlet nearby, failure of electricity supply, or the need to disconnect from the main supply to minimize electrical interference with other monitoring equipment.

      Proficiency with methods of electronic surveillance must be acquired during minor procedures so that they can be applied properly in circumstances where their use is mandatory (e.g. during major surgery or a cardiovascular crisis). Routine use ensures that probes, sensors, electrodes, etc. can be applied quickly to the animal and increases the likelihood that the information obtained is reliable.

      Although current practice is to establish monitoring only after the animal has been anaesthetized, it must be recognized that many complications occur during induction of anaesthesia. Ideally, especially for poor-risk patients, monitoring should begin when the drugs for premedication are administered. Dogs and cats may vomit after administration of an opioid and the quantity and content of the vomit may warn that the animal was fed recently and so may be at risk for regurgitation and pulmonary aspiration of gastric material. Brachycephalic breeds and animals with respiratory problems should always be observed after administration of preanaesthetic drugs because sedation may cause partial or complete airway obstruction or serious respiratory depression and hypoxaemia. In any animal, evaluation of the degree of sedation produced by premedicant drugs may indicate that the anaesthetic plan should be reassessed and either drug doses reduced or additional agents included.

      Careful observation of the patient during induction of anaesthesia may allow precise titration of drugs to achieve the desired depth of anaesthesia and ensure early recognition of a complication that requires immediate specific treatment, such as cyanosis, anaphylaxis, or cardiac arrest. Where possible, patients at risk for complications may be attached to specific monitoring equipment before induction of anaesthesia. Appropriate equipment for this would be the electrocardiograph (ECG), a device for measurement of blood pressure, or a pulse oximeter.

      Recording drugs, dosages and responses for each patient is essential and provides valuable information for any subsequent time that anaesthesia may be needed. Noting all measurements on an anaesthetic record provides a pictorial description of changes that can be used to predict complications and plan treatment (Fig. 2.1). Retrospective evaluation of difficult cases and of series of records, perhaps of patients with similar surgical procedures, or to compare different anaesthetic protocols, can be used to monitor the anaesthetist's performance and identify difficult situations that require further thought and improved management. For research purposes, data can be acquired into a computer for accurate data summaries.

      Figure 2.1 Anaesthetic record of a 61 kg, 6-year-old female Great Dane anaesthetized for exploratory laparotomy because of torsion of the spleen. Anaesthesia was induced by intravenous administration of ketamine, 200 mg, and diazepam, 10 mg, and maintained with isoflurane. Heart rate, blood pressure and respiratory rate were recorded at regular intervals to facilitate early recognition of adverse trends.

      Monitoring animals during anaesthesia must include observation of behaviour and reflexes and measurement of various physiological parameters at regular intervals to accomplish two objectives. The first objective is to ensure that the animal survives anaesthesia and surgery. The second objective is to obtain information that can be used to adjust anaesthetic administration and management to minimize physiological abnormalities, which is especially important for animals that have already compromised organ systems. The goal is to prevent development of preventable adverse consequences 1 hour, 12 hours, or even 3 days after anaesthesia.

      Monitoring should continue into the recovery period to determine the need for additional analgesic drugs, adequacy of ventilation, and to record serious deviations in body temperature. Mucous membrane colour should be checked for at least 20 minutes after the animal has been disconnected from oxygen as it may take that long for hypoxaemia to develop in animals that are moderately hypoventilating and breathing air.

      A variety of methods using inexpensive or expensive equipment can be used to monitor parameters determined by the species of animal to be anaesthetized and by the abnormalities already present in the patient. Not all monitoring techniques need to be applied to every patient. A recommendation for three levels of monitoring is presented in Table 2.1; level 1 monitoring information should be obtained from all anaesthetized animals, level 2 monitors are affordable and recommended for routine use in some groups of patients, and level 3 monitors individually offer improved monitoring for patients with specific problems.

      Table 2.1

      Prioritization of monitoring

      This chapter will describe the techniques of monitoring using a systems approach, and offer guidelines for interpretation of the information obtained. Further recommendations are given in the chapters devoted to species anaesthesia and the chapter on management of complications.

      Clinical assessment of the patient


      Monitoring the central nervous system


      Monitoring the...

      Dateiformat: EPUB
      Kopierschutz: Adobe-DRM (Digital Rights Management)

      Systemvoraussetzungen:

      Computer (Windows; MacOS X; Linux): Installieren Sie bereits vor dem Download die kostenlose Software Adobe Digital Editions (siehe E-Book Hilfe).

      Tablet/Smartphone (Android; iOS): Installieren Sie bereits vor dem Download die kostenlose App Adobe Digital Editions (siehe E-Book Hilfe).

      E-Book-Reader: Bookeen, Kobo, Pocketbook, Sony, Tolino u.v.a.m. (nicht Kindle)

      Das Dateiformat EPUB ist sehr gut für Romane und Sachbücher geeignet - also für "fließenden" Text ohne komplexes Layout. Bei E-Readern oder Smartphones passt sich der Zeilen- und Seitenumbruch automatisch den kleinen Displays an. Mit Adobe-DRM wird hier ein "harter" Kopierschutz verwendet. Wenn die notwendigen Voraussetzungen nicht vorliegen, können Sie das E-Book leider nicht öffnen. Daher müssen Sie bereits vor dem Download Ihre Lese-Hardware vorbereiten.

      Weitere Informationen finden Sie in unserer E-Book Hilfe.


      Dateiformat: PDF
      Kopierschutz: Adobe-DRM (Digital Rights Management)

      Systemvoraussetzungen:

      Computer (Windows; MacOS X; Linux): Installieren Sie bereits vor dem Download die kostenlose Software Adobe Digital Editions (siehe E-Book Hilfe).

      Tablet/Smartphone (Android; iOS): Installieren Sie bereits vor dem Download die kostenlose App Adobe Digital Editions (siehe E-Book Hilfe).

      E-Book-Reader: Bookeen, Kobo, Pocketbook, Sony, Tolino u.v.a.m. (nicht Kindle)

      Das Dateiformat PDF zeigt auf jeder Hardware eine Buchseite stets identisch an. Daher ist eine PDF auch für ein komplexes Layout geeignet, wie es bei Lehr- und Fachbüchern verwendet wird (Bilder, Tabellen, Spalten, Fußnoten). Bei kleinen Displays von E-Readern oder Smartphones sind PDF leider eher nervig, weil zu viel Scrollen notwendig ist. Mit Adobe-DRM wird hier ein "harter" Kopierschutz verwendet. Wenn die notwendigen Voraussetzungen nicht vorliegen, können Sie das E-Book leider nicht öffnen. Daher müssen Sie bereits vor dem Download Ihre Lese-Hardware vorbereiten.

      Weitere Informationen finden Sie in unserer E-Book Hilfe.


      Download (sofort verfügbar)

      90,43 €
      inkl. 19% MwSt.
      Download / Einzel-Lizenz
      ePUB mit Adobe DRM
      siehe Systemvoraussetzungen
      PDF mit Adobe DRM
      siehe Systemvoraussetzungen
      Hinweis: Die Auswahl des von Ihnen gewünschten Dateiformats und des Kopierschutzes erfolgt erst im System des E-Book Anbieters
      E-Book bestellen

      Unsere Web-Seiten verwenden Cookies. Mit der Nutzung dieser Web-Seiten erklären Sie sich damit einverstanden. Mehr Informationen finden Sie in unserem Datenschutzhinweis. Ok