LAMS 5220 - Large Animal Anesthesia
(Spring semester 2004-2005)
Instructor information
Instructor: Dr. Cynthia M. Trim
Office hours: By appointment
Office location: H-318
Telephone number: 542-6318
E-mail address: ctrim@vet.uga.edu
Course information
Prerequisites: LAMS/SAMS 5203 Principles of Anesthesia
Objectives:
These objectives are relevant to horses, ruminants, and pigs. At the completion of the course the student shall be able to:
PREANESTHETIC EVALUATION AND PREPARATION
1. identify potential problems for anesthetic management from patient signalment (species, breed, age, sex, weight), laboratory data, and a brief description of the proposed medical or surgical procedure.
2. suggest further required essential information and treatment needed before induction of anesthesia.
3. make a plan for anesthetic management relevant to the species involved, including ideal goals, anesthetic drugs, appropriate monitoring, and supportive therapy.
4. describe guidelines for food and water before anesthesia of horses, ruminants, and pigs.
5. identify any potential drug interactions between drugs that the patient receives before anesthesia with anesthetic agents.
6. describe the impact of age on anesthetic administration
7. assign anesthetic risk classification.
ANTICHOLINERGICS, SEDATIVES, TRANQUILIZERS, OPIOIDS
1. describe the reasons to use and when not to use anticholinergics.
2. describe behavioral and pharmacologic effects of sedatives, tranquilizers, and opioids.
3. choose specific sedatives and drug combinations appropriate to the species.
4. describe the various routes of administration of sedatives and opioids for pain control
5. list drugs with antagonists and name the antagonist
BARBITURATE AND DISSOCIATIVE ANESTHESIA, PROPOFOL, GUAIFENESIN
1. describe the behavioral and pharmacologic effects, and method of administration
2. choose appropriate preanesthetic medication for thiopental, ketamine, Telazol or propofol
3. discuss prolongation of anesthesia beyond the time provided by a single administration
4. describe the pharmacologic effects and method of administration of guaifenesin
5. anticipate the disadvantages of each drug in these species
INHALATION ANESTHESIA
1. describe the pharmacologic effects of inhalants relevant to their administration
2. describe the impact on monitoring
3. describe endotracheal intubation in each species
4. list potential complications of endotracheal intubation
ANESTHESIA MACHINES AND CIRCUITS
1. draw the basic design of an anesthesia machine and a circle circuit, labeling components
2. state pressures in gas cylinders and in other parts of the system
3. describe oxygen flow rates
4. describe the relationship between the vaporizer, oxygen flow rate, circuit anesthetic concentration and patient concentration
5. describe the design and function of a mechanical ventilator
MONITORING DURING ANESTHESIA
1. describe signs of anesthesia during injectable anesthesia and during inhalation anesthesia
2. describe breathing rates, patterns, and depth
3. explain the values obtained from capnography, pulse oximetry, and anesthetic agent analyzers
4. describe the information obtained from membrane color, CRT, ECG, blood pressure, and blood pressure waveform and their relevance in evaluation of the circulation
5. describe methods of measurement of blood pressure
6. state sites for intravenous and arterial catheterization
COMPLICATIONS
1. identify hypoventilation and hypoxemia from signs and laboratory data
2. describe the application of controlled ventilation and justify the choice of parameters
3. describe the monitoring abnormalities of inadequate circulation
4. state routine fluid therapy for inhalation anesthesia
5. describe methods for improving cardiovascular function during anesthesia
6. evaluate data from an anesthetic record, identify the complication(s), and make recommendations for treatment
7. describe expected effects and use of dobutamine, dopamine, and ephedrine
8. describe impact of blood loss and appropriate treatment
9. describe potential complications during equine recoveries, their prevention and treatment
10.describe the relevance of temperature monitoring in pigs
NERVE BLOCKS
1. have sufficient knowledge of available nerve blocks to make rational selection for intraoperative or postoperative analgesia.
2. describe the role of epidural nerve blocks in anesthesia
3. describe paravertebral nerve block and its use
4. describe intravenous regional analgesia
Topical outline:
. Topical Outline
Lecture 1 Wednesday April 6, 1 pm
Sedation and Analgesia in Horses
We will review the pharmacology and expected effects of sedatives and analgesics in horses. This lecture will describe the drug combinations used for sedation in standing horses undergoing medical or surgical procedures. The limitations of opioid use will be discussed.
Lecture 2 Wednesday April 6, 5 pm.
Intravenous General Anesthesia in Horses
This lecture will describe pharmacologic effects, onset and durations of action, indications and contraindications of several intravenous drug combinations in horses. Common complications of total intravenous anesthesia (TIVA) will be discussion with recommendations for prevention or treatment.
Lecture 3 Monday April 11, 1 pm
Preanesthetic Evaluation of Horses
We will discuss evaluation of the patients before anesthesia and the importance of facts or abnormalities detected in the history, physical examination and diagnostic work up with respect to anesthetic drug choice and management.
Lecture 4 Wednesday April 13, 2 pm
Specific Problems of Equine Anesthesia
This lecture will address the potential hazards of equine anesthesia relating to the size, temperament, and anatomy of the patients. Modifications of facilities, equipment and management are necessary to reduce the mortality rate in horses.
Lecture 5 Thursday April 14, 2 pm
Inhalation Anesthesia in Horses
This lecture will discuss administration of inhalation anesthesia, including endotracheal intubation, anesthetic circuit gas concentrations, and monitoring of anesthetic depth, adequacy of ventilation, and cardiovascular function.
Lecture 6 Wednesday April 20, 1 pm
Equine Anesthesia AQS
Students will be given information about several patients requiring anesthesia. The students will be asked to come to the lecture prepared to discuss assessment of these patients for anesthesia, selection of appropriate anesthetic agents and management, and prepared plans for recognition and treatment of complications.
Examination Wednesday April 20, 3 pm
Examination
(42% of the grade)
Lecture 7 Friday April 22, 1 pm
Local Analgesia Techniques in Large Animals
The indications and expectations for epidural analgesia, paravertebral analgesia, nerve blocks, and intravenous regional analgesia will be discussed.
Lecture 8 Monday April 25, 2 pm
General Anesthesia in Cattle
This lecture covers the preanesthetic preparation, common anesthetic drug protocols, and perianesthetic management for adult cattle,
Lecture 9 Wednesday April 27, 1 pm
General Anesthesia in Small Ruminants
This lecture will review common anesthetic protocols used for anesthesia in calves, sheep, goats, and llamas, positioning, fluid therapy, and recovery management.
Lecture 10 Wednesday April 27, 4 pm
AQS Anesthesia of Ruminants
Students will be given information about several patients requiring anesthesia. The students will be asked to come to the lecture prepared to discuss assessment of these patients for anesthesia, selection of appropriate anesthetic agents and management, and prepared plans for recognition and treatment of complications.
Lecture 11 Friday April 29, 1 pm
Sedation and Anesthesia in Pigs
This lecture covers the preanesthetic preparation, common anesthetic drug protocols, and perianesthetic management for pigs,
Lecture 12 Tuesday May 3, 1 pm
Recognition and Treatment of Circulatory Failure
This lecture focuses on troubleshooting causes of hypotension and treatment of blood loss, anesthetic induced hypotension, and electrocardiographic abnormalities.
Lecture 13 Wednesday May 4, 1 pm
Complications: Recognition, Prevention, Treatment
We will discuss problems of hypoxemia and hypoventilation, and use of mechanical ventilators. Assessment and management of recovery problems will be reviewed.
Lecture 14 Thursday May 5, 2-4 pm
Laboratory
The content of this practical session will be announced at the start of the course. If possible, we will anesthetize several horses with different anesthetic drug protocols.
Lecture 15 Friday May 6, 10:00 am
General AQS and catch up
Examination Wednesday May 11, 1-3 pm
Final Examination
(58% of the course grade)
Students are expected to abide by the academic honesty policies and guidelines outlined in the College of Veterinary Medicine Student Handbook.
Details of authorized assistance allowed during examinations:
No authorized assistance
All academic work must meet the standards contained in 'A Culture of Honesty'. Each student is responsible to inform themselves about those standards before performing any academic work.
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