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Questions and Answers
What is a primary advantage of using acepromazine as a sedative in male horses, as suggested in the material?
What is a primary advantage of using acepromazine as a sedative in male horses, as suggested in the material?
- Prolongation of analgesic effects compared to other sedatives.
- Reduction of the risk of anesthetic-induced hypertension.
- Mitigation of penile prolapse. (correct)
- Enhancement of muscle relaxation during anesthesia.
Which sedative is known for having the longest clinical effect in equine anesthesia?
Which sedative is known for having the longest clinical effect in equine anesthesia?
- Detomidine (correct)
- Acepromazine
- Romifidine
- Xylazine
Which of the following best represents the mechanism by which ketamine provides anesthesia?
Which of the following best represents the mechanism by which ketamine provides anesthesia?
- Partial agonism of mu-opioid receptors, providing analgesia and sedation.
- Selective agonism of GABA receptors, leading to CNS depression.
- Antagonism of NMDA receptors, resulting in a dissociative anesthetic state. (correct)
- Inhibition of acetylcholinesterase, prolonging acetylcholine's action at synapses.
How does guaifenesin contribute to equine anesthesia when used in conjunction with ketamine?
How does guaifenesin contribute to equine anesthesia when used in conjunction with ketamine?
In equine anesthesia, what is the significance of xylazine being referred to as the 'gold standard'?
In equine anesthesia, what is the significance of xylazine being referred to as the 'gold standard'?
What is the primary reason for limiting the number of re-bolus administrations of ketamine and xylazine during equine anesthesia?
What is the primary reason for limiting the number of re-bolus administrations of ketamine and xylazine during equine anesthesia?
Why is it important to administer proper sedation before ketamine in equine anesthesia?
Why is it important to administer proper sedation before ketamine in equine anesthesia?
What impact does epidural morphine have on GI motility in horses?
What impact does epidural morphine have on GI motility in horses?
How does total intravenous anesthesia (TIVA) primarily differ from traditional inhalant anesthesia in horses?
How does total intravenous anesthesia (TIVA) primarily differ from traditional inhalant anesthesia in horses?
In a 'GKX' triple drip protocol, what is the role of guaifenesin beyond its muscle relaxant properties?
In a 'GKX' triple drip protocol, what is the role of guaifenesin beyond its muscle relaxant properties?
What is the clinical significance of the relatively short duration of analgesia provided by xylazine in equine anesthesia?
What is the clinical significance of the relatively short duration of analgesia provided by xylazine in equine anesthesia?
When using a GKX protocol with a 5% guaifenesin solution, what is the typical quantity of xylazine added per liter?
When using a GKX protocol with a 5% guaifenesin solution, what is the typical quantity of xylazine added per liter?
In the context of equine anesthesia, what is the main advantage of Total Intravenous Anesthesia (TIVA) using propofol?
In the context of equine anesthesia, what is the main advantage of Total Intravenous Anesthesia (TIVA) using propofol?
Which of the following best describes the benefit of local blocks in conjunction with general anesthesia in horses?
Which of the following best describes the benefit of local blocks in conjunction with general anesthesia in horses?
What is a key consideration when using propofol as a Continuous Rate Infusion (CRI) in foals for maintaining anesthesia?
What is a key consideration when using propofol as a Continuous Rate Infusion (CRI) in foals for maintaining anesthesia?
Consider a horse undergoing colic surgery. Which of the following is LEAST likely to influence the anesthetic plan?
Consider a horse undergoing colic surgery. Which of the following is LEAST likely to influence the anesthetic plan?
A horse under anesthesia is demonstrating apneustic breathing. Which drug is MOST likely contributing to this?
A horse under anesthesia is demonstrating apneustic breathing. Which drug is MOST likely contributing to this?
Which of the following parameters is LEAST important to consider in a pre-anesthetic planning for horses?
Which of the following parameters is LEAST important to consider in a pre-anesthetic planning for horses?
If a veterinarian wants to use a sedative with a medium duration and is also quick acting, which would be MOST appropriate?
If a veterinarian wants to use a sedative with a medium duration and is also quick acting, which would be MOST appropriate?
Following general anesthesia, a horse is placed in a hydro-pool recovery system. What is the MOST likely primary goal of this recovery method?
Following general anesthesia, a horse is placed in a hydro-pool recovery system. What is the MOST likely primary goal of this recovery method?
Which of the following is the MOST concerning side effect associated with alpha-2 agonists in equine anesthesia?
Which of the following is the MOST concerning side effect associated with alpha-2 agonists in equine anesthesia?
You are planning to perform a short procedure (less than an hour) on a horse and want to use a 'triple drip'. Which would be MOST appropriate?
You are planning to perform a short procedure (less than an hour) on a horse and want to use a 'triple drip'. Which would be MOST appropriate?
Why might midazolam be added to a ketamine-xylazine solution?
Why might midazolam be added to a ketamine-xylazine solution?
When using PIVA (Partial Intravenous Anesthesia), which of the following drugs is LEAST likely to be included?
When using PIVA (Partial Intravenous Anesthesia), which of the following drugs is LEAST likely to be included?
What is the MOST significant advantage if local anesthesia if used during a surgical procedure?
What is the MOST significant advantage if local anesthesia if used during a surgical procedure?
Flashcards
Hydro-pool system
Hydro-pool system
A system used for horse recovery after general anesthesia.
Colic Factors
Colic Factors
Issues that could affect horses, such as Intravascular volume, Endotoxin, Pain, GI motility, and Tympany.
TIVA
TIVA
Anesthesia created through intravenous drugs.
Ketamine
Ketamine
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Acepromazine Concern
Acepromazine Concern
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Detomidine
Detomidine
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Dexmedetomidine
Dexmedetomidine
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Alpha 2 Agonist Side Effects
Alpha 2 Agonist Side Effects
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Opioids
Opioids
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Ketamine Characteristics
Ketamine Characteristics
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JSL Drug Combination
JSL Drug Combination
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Maintaining Anesthesia
Maintaining Anesthesia
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GKX
GKX
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Guiafenesin
Guiafenesin
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GKX benefits
GKX benefits
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Alternatives to GKX
Alternatives to GKX
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Propofol
Propofol
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PIVA meaning
PIVA meaning
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Goals for
Goals for
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Pre-anesthetic planning
Pre-anesthetic planning
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Study Notes
Equine Anesthesia
- This is an introduction to the concepts of equine anesthesia.
- Dave Rankin, DVM MS DACVAA, is the presenter.
Colic
- Intravascular volume, endotoxin, pain, GI motility, and tympany should be considered.
- Guaifenesin is a consideration for treatment?
TIVA
- TIVA stands for total intravenous anesthesia
Variations on the ketamine theme
- Ketamine needs proper sedation.
Sedatives
- Acepromazine may be used in male horses.
- Xylazine is the gold standard sedative.
- It provides 20 minutes of analgesia, with longer sedation.
- Romifidine has a medium duration of effect and is quick acting.
- Detomidine has the longest clinical effect.
- Dexmedetomidine is short acting.
Sedatives – Alpha 2 agonists
- Can cause side effects
- Can affect hemodynamics, GI, and respiratory systems.
Opioids
- Morphine is an opioid.
- Hydromorphone is an opioid.
- Butorphanol is an opioid.
- Opioids can affect Gl motility
- Opioids can have respiratory effects.
- Epidural morphine has a long onset and duration.
Ketamine
- Ketamine is a short-acting dissociative anesthetic.
- Reflexes are fairly well maintained with ketamine.
- Apneustic breathing can occur with ketamine.
- Normotension may be maintained with ketamine.
- The effects of ketamine last about 15 minutes.
- Ketamine is an NMDA receptor antagonist.
- Ketamine provides analgesia.
Example: JSL
- Acepromazine at 0.03 mg/kg IV can be used.
- Xylazine at 1.0 mg/kg can be used.
- Midazolam at 0.05-0.2 mg/kg can be used.
- Ketamine at 2.2 mg/kg can be used.
- More is needed in smaller animals
- A local block can be administered.
- Patients tend to ventilate better than with inhalants.
Not long enough?
- Re-bolus with 1/3 the original doses of ketamine and xylazine.
- Re-boluses should not be done more than twice (anecdotal).
- GKX is also known as triple drip
- This is usually for procedures less than an hour?
- Altering the ratio of xylazine and ketamine in the bag can reduce the total dose of guaifenesin (aka GG).
Support oxygenation with GKX
- Hypoventilation may occur.
- Use 1 liter of 5% guaifenesin, 1-2 g ketamine, and 0.5 g xylazine.
- Administer at 1-2 ml/kg/hour.
Guiafenesin
- A centrally acting muscle relaxant
- "the great equalizer"
- Helps to blunt the excitatory effects of ketamine
- May cause prolonged recovery?
GKX
- Tends to reliably produce good recoveries
- Used for shorter procedures
- Cast change, cryptorchid, etc
What if not GKX?
- Other recipes include variations of midazolam, xylazine, ketamine, propofol, or other combinations.
- Midazolam can be administered at 0.1 mg/kg/hour.
Propofol?
- It is very short-lived as an induction agent.
- It is useful in foals? As a CRI?
PIVA
- PIVA uses injectables to augment and reduce inhalant use
- It can be helpful in transitioning into recovery?
- GKX can be used in PIVA
- Dexmedetomidine can be used in PIVA
- Ketamine can be used in PIVA
- Lidocaine can be used in PIVA
Equine Anesthesia Plan
- Goals for:
- Premedication
- Induction
- Maintenance
- Recovery
- Pre-anesthetic planning includes:
- History
- Physical exam
- Lameness
- Neurologic dysfunction
- Upper airway pathology
- Medications
- Etc...
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