Inhalation Anesthesia Systems for Rodents.docx
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Inhalation Anesthesia Systems for Rodents.docx
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InhalationAnesthesiaSystemsforRodents
InhalationAnesthesiaSystemsforRodents
Lesson1.Welcome
Welcome
WelcometoInhalationAnesthesiaSystemsforRodents.Thiscoursewillpresentanoverviewoftheprocessofinhalationanesthesia,withanemphasisonrodentanesthesiaandnonrebreathingsystems.Ifyouarealreadyusinginhalationanesthesia,youcanlearnmoreaboutyoursystemandandhowtouseitproperly.Ifyouarenewtoinhalationanesthesia,thiscoursewillhelpyoulearnthebasicsaboutthesystemandhowaprocedureisconducted.
Alwaysrememberthatanesthesiaisamedicalprocedurethatrequiresconcentratedattentionandknowledge.Ifyouareunsureofanypartoftheanestheticprocedure,askyoursupervisororfacilityveterinarianforhelp.
ThevideoclipsinthiscoursearebestviewedwithWindowsMediaPlayer10.IfyouhaveanolderversionofthePlayer,thevideosmaynotplaycorrectly.YoucandownloadWindowsMediaPlayer10byclickinghere.
Pleaseclickheretoviewcreditsforthiscourse.
Lesson2.Overview
CourseObjectives
Thiscoursewillreviewtheprinciplesofarodentgasanesthesiasystemusingaprecisionvaporizer.Thereareanumberofmodelsonthemarket,howeverwecannotcovervariationsofeachmachinewithinthescopeofthiscourse.Onlynon-rebreathingsystemswillbedescribedbecauseofthefocusonrodentspeciesinthiscourse;suchsystemsaretypicallyusedonsmallspecies.
Theprinciplesdiscussedwillgenerallyapplytomostgasinhalationanesthesiasystem,butyoumustbethoroughlyfamiliarwiththestandardoperatingproceduresforthespecifictypeandmodelmachineyouareusinginyourfacility.
Thelearningobjectivesforthiscourseareto:
1.Providebackgroundinformationaboutinhalationanesthesiaagentsandadvantagesanddisadvantagesofeachagent.
2.Identifyimportantconsiderationsintheuseofinhalationanesthesiasystems.
3.Identifythecomponentsoftheinhalationanesthesiamachineanddevelopanunderstandingofhowthesystemoperates.(Pleasenote:
Therearemanymachinemodels,andthevariationsofeachmachinearebeyondthescopeofthiscourse.)
4.Reviewsafetyissuesrelatedtotheproperuseofinhalationanesthesiaystems.
Whatisinhalationanesthesia?
Inhalationanesthesiaisaformofgeneralanesthesia,inwhichthereisalossofsensationtothewholebody.
Forsimplicity,considergeneralanesthesiaastatewheretheanimaldoesnotfeel,anddoesnotrespondto,stimulationbutcanbeawakenedsoonafterceasingtheadministrationoftheanesthetic.Themechanismofactionforinhalantanestheticsisnotpreciselyknown,althoughthesedrugsdoenterthecentralnervoussystemandactonthebrain."
ConsiderationsfortheUseofAnesthesia
Beforedecidingonanyanesthesiaprotocolanumberoffactorsshouldbeconsidered.Theprimarygoalshouldalwaysbetolessentheanimal’sdiscomfortasmuchasispossible.
Whenplanningforananestheticepisode,youmustconsiderthefollowingfactors:
∙Typeofproceduretobeperformed.
∙Animalspeciestobeanesthetized.
∙Locationoftheprocedure.
∙Requirementforveinsinastudy;someinjectableagentsmaycauseirritationandinflammationinbloodvessels.
∙Durationoftheanestheticepisode.
∙Invasivenessoftheprocedure.
∙Whetherthesurgeryisasurvivalornon-survivalsurgery.
Anestheticdepthwillbedeterminedbytheinvasivenessoftheprocedure.Ifaprocedureispainfulandinvasive,itisimperativethatthedepthofanesthesiabeappropriateandverywellmaintained.Assumingthatgeneralanesthesiaiscalledfor,thechoiceistheninjectableorinhalation.
Aconsiderationintheselectionofanestheticsisthepotentialcomplicationswiththeresearchbeingperformed.Thephysiologiceffectsoftheanestheticagentsshouldbeconsideredinrelationtotheparticularstudybeingdone.Ifthoseeffectsareunknownoruncleartotheinvestigator,literaturecheckscanbedoneonlineandaveterinaryanesthesiologistshouldbeconsulted.
Ifthephysiologiceffectsofbothinjectableandinhalationagentsaredeterminedtobesimilar,thechoicemaybebasedoneaseofuseanddegreeofpossiblehumanerror.
Studygoalsmayinfluencethetypeofanesthesiaselectedandwilldefinitelyimpactthetypeofgasanesthesiaequipmenttobeused.Also,ensuringthatthelogisticsofgettingthegasdeliveredtotherespiratorysystemofthepatientsdonotinterferewiththestudygoalsmaysometimesbeachallenge.
Forexample,inastudywhereaccesstotheeyeisessential,thegasconduitstothepatientmaygetinthewayorinterferewiththestudyproceduretobeperformed.
Also,ifperipheralveinsareneededforastudy,itmaybemoreexpedienttouseinhalantagentsforanesthesia.
PhasesofAnesthesia
Induction:
Theinductionphaseputstheanimalintothestateofgeneralanesthesia.Inductioncanbeaccomplishedwithaninjectableanestheticorwiththeuseofagasagentandaninductionchamberorfacemask.
Maintenance:
Anestheticmaintenanceistheperiodoftimeduringtheperformanceoftheprocedurewhentheanimalismaintainedinaplaneofsurgicalanesthesia.Inthisstage,theanimalwillbenon-responsivetosurgicalstimuli,suchasaskinincision.Animalscanbemaintainedwithinjectableanesthesiaorwithgasanesthesiadeliveredviafacemaskornosecone.Theanimalmayalsobeintubatedfordeliveryofthegasagent.
Theanestheticdepthhastobemonitoredcontinuously.Thephysiologicparametersarealsomonitoredcontinuouslybecausetherespiratorysystem,thecirculatorysystem,andtheheartneedtobefunctioningwellforgasanesthetictobedeliveredtothecentralnervoussystem.Itisnecessaryduringthismaintenanceperiodtoprovidesupportivecarebykeepingtheanimalswarmandsupportingbodytemperature,ventilation,oxygenationandfluids.Eventhesmallestpatientcanbemonitoredvisuallyorwithequipment,suchaselectrocardiogram(ECG)machines,pulseoximeters,andend-tidalcarbondioxide(CO2).
Recovery:
Anestheticrecoverybeginsoncetheanestheticdeliveryishalted.Whilewearefocusinginthiscourseontheperiodwhenanesthesiaisbeingdelivered,theperiodwhentheanimalwakesupisequallyimportant.Veryoftenlessattentionisspentonpostoperativemanagementthanonmaintainingthesurgicalplane.
Postoperativemanagementshouldinclude:
∙Monitoringthepatientforbodytemperature,heartrate,respiratoryrate,etc.
∙Turningthemtokeeptheircardiorespiratorysystemfunctioningoptimally.
∙Providingappropriateanalgesics,antibiotics,andothersupportiveagentssuchasfluidsasneeded.
∙Preventingself-traumawhentheanimalexperiencesexcitatorymovementsasittriestoregaintheabilitytoholditselfupright.
∙Providingnutritionalsupport.
∙Returningtheanimalsafelytothehomecageortothefieldsituationasthesituationwarrants.
Lesson3.Pre-anestheticAgents
UsesofaPre-Anesthetic
Pre-anesthetics,suchasatropine,phenothiazinetranquilizers,andxylazine,areusuallygivenpriortotheadministrationoftheanesthetic.
∙Tranquilizersgivenaspre-anestheticsmayreducetheanimal'sanxietythusmakingtheanimaleasiertorestrainandinducinganesthesiamoresmoothly.
∙Anticholinergics,likeatropine,canreducesalivaandtrachealsecretionsthushelpingtopreventaccidentalchokingwhileanesthetized.
∙Agentslikexylazine,whichhaveanalgesicproperties,willaddtotheanalgesiceffectofthegeneralanesthetic,forthedurationofactionforthatagent.
Forthepurposeofendotrachealintubation,anesthesiamaybeinducedwithacombinationofapre-anesthetic(e.g.,xylazine)andashort-terminjectableanesthetic(e.g.,ketamine).Followingintubation,anesthesiawouldbemaintainedusinganinhalantagent.
Lesson4.AnestheticAgents
Isoflurane
Thecommoninhalantagentsbelongtoagroupofchemicalswithsynonymsofhalogenatedhydrocarbons,halogenatedethers,andhaloforms.Thesehalogenatedagentsarenon-flammableandnon-explosive.Alltheseagentsworkdirectlyonthebraintoproduceanesthesia.
Isofluraneisthemostcommonlyusedinhalantinlaboratoryanimalmedicineandinprivateveterinarypractice.Itissoldundernumeroustradenames.Introducedin1981,itisanisomerofenfluranebutwithoutthesamerespiratorydepressionorelectroencephalogram(EEG)effectsofenflurane.Itscostisrelativelylowincomparisontosevofluraneanddesflurane.
Duetohighvolatility,isofluranerequirescomplexequipmentforsafeandcontrollabledeliverytothepatient.Ifdrippedorpouredonacottonballorgauzespongeinaclosedcontainer,theairsaturationcanandusuallydoesquicklyreach33%.Aratormousewoulddieafter5or6breathsof33%isoflurane.
Isofluraneisnonflammable.Itisslightlylesspotentthathalothanebuthasafasterinductionandrecoveryfromanesthesiathanwithhalothanebecausethesolubilityislowerthanhalothane.Advantagesofusingisofluraneincludecardiovascularstability,althoughbloodpressuremaybesignificantlydecreased,andlowbiotransformationbytheliver(lessthan0.2%ofthedosemetabolized).
Sevoflurane
Aneweranestheticapprovedforuseinveterinarymedicineforinhalantgasanesthesiaissevoflurane.SevofluraneissoldunderthetradenameSevoFloRandUltaneR.Ithasthefastestonsetandoffsetafterdesflurane.Thisagentismoreexpensivethanisoflurane.
Sevofluraneisunstableinsodalime,producingatoxiccompoundcapableofofcausingrenalandhepaticinjury.
Itislesspotentthaneitherhalothaneorisoflurane.Sinceitislesspotentandhasalowerbloodsolubilitythanisoflurane,inductionandrecoveryaremorerapid.Rapidchangesi
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