Veterinary Anesthesia & Surgical Procedures

• The study notes cover anesthesia, surgical procedures, pharmacology, patient monitoring, and post-operative care.

Anesthesia & Surgical Preparation

• Scrub the surgical site at least three times with antiseptics.
• HR, BP, SpO2, ETCO2, and RR should be monitored during anesthesia.
• Esophageal placement, over/under-inflation, and obstruction are complications that can occur during endotracheal intubation.

Anesthetic Depth Stages

• Stage I involves voluntary movement.
• Stage II involves involuntary excitement.
• Stage III (Plane 2) is the ideal surgical depth.
• Stage IV can result in overdose with possible respiratory/cardiac arrest.

Common Anesthetic Drugs

• Acepromazine can cause hypotension.
• Dexmedetomidine can cause bradycardia and can be reversed with Atipamezole.
• Propofol can cause transient apnea after induction.
• Opioids cause sedation and analgesia and can be reversed with Naloxone.

Oxygen Delivery & Monitoring

• Pulse oximetry monitors oxygen saturation of hemoglobin.
• Capnography measures expired CO2 (ETCO2).
• The oxygen flush valve delivers pure oxygen, bypassing the vaporizer.

Fluid Therapy & Patient Monitoring

• Administer standard IV fluids at a rate of 5 mL/kg/hr for maintenance during anesthesia.
• Normal Mean Arterial Pressure (MAP) should be 60-90 mmHg.
• Hypotension can be treated by reducing vaporizer setting or bolusing fluids.
• Provide ample bedding and heat support and wait before feeding for surgical recovery.
• Monitor for pale mucous membranes (possible blood loss), cyanosis (oxygenation issue), and decreased HR & BP (anesthetic overdose) post-op.

Surgical Instruments, Sutures, & Techniques

• Absorbable sutures include PDS, Vicryl and Chromic gut.
• Non-absorbable sutures include Nylon, Prolene and Silk.
• Horizontal mattress sutures reduces tension.
• Simple interrupted sutures create a secure closure.
• Ford interlocking sutures provide strength and stability.
• Pass instruments handle-first into the surgeon's palm, and curved instruments should have the curve facing up.
• Strike-through is when drapes get wet, increasing the risk of infection.
• Sterile zones include the front of the gown from shoulders to waist.

Pharmacology & Drug Calculations

• Naloxone reverses opioids.
• Atipamezole reverses Dexmedetomidine.
• Flumazenil reverses benzodiazepines.
• The formula for the dose calculation is: Concentration = Drug amount per mL.
• As an example, if a patient needs 0.4 mg/kg IM of Butorphanol 10 mg/mL, calculate dose accordingly.
• Bupivacaine should NOT be used for laryngeal desensitization and lidocaine should be used instead.
• Acepromazine should be avoided in hypotensive patients.

Emergency & Complications Management

• Confirm ET tube placement and manually ventilate at 12 breaths per minute if a patient stops breathing under anesthesia.
• Check anesthetic depth and reduce vaporizer setting if needed.
• Manually ventilate the patient to reduce CO2 buildup if the capnograph reads high (ETCO2 > 60mmHg).
• Check the ET tube for obstructions.
• Check depth of anesthesia to rule out deep planes causing hypoventilation.
• Reduce vaporizer setting, bolus IV fluids, and consider administering drugs like Epinephrine if blood pressure drops.

Surgical Procedures & Special Considerations

• Common Surgeries & Prep Areas:
• Spay (Ovariohysterectomy): Midline ventral abdomen.
• Castration (Orchiectomy): Pre-scrotal area in dogs, scrotal in cats.
• Declaw (Onychectomy): Removal of the distal phalanx.
• Cystotomy: Bladder surgery to remove stones, flush urinary tract before closure.
• Autoclave Sterilization Minimum Standard: 250°F at 15 psi for 13 minutes.

Radiology & Diagnostic Monitoring

• Rebreathing Bag Size Calculation: 3-6 times the patient's tidal volume.
• A 5kg dog needs a 0.5L bag as an example.

ECG Monitoring

• The black lead goes to the left forelimb.
• The white lead goes to the right forelimb.
• The red lead goes to the left hindlimb.
• The green lead goes to the right hindlimb.

Common ECG Abnormalities

• Ventricular tachycardia requires immediate intervention.
• Atrial fibrillation causes an irregular heartbeat and requires treatment.
• Ventricular fibrillation is lethal and needs defibrillation.

Post-Operative Care & Client Education

• Signs that require immediate veterinary attention are wet, loose, or irritating bandage, excessive licking of surgical site, swelling, discharge, or signs of infection.

Penrose Drain Instructions

• E-collar is required to prevent licking.
• The wound should be cleaned regularly.
• The drain should NOT fall out on its own and needs removal by a vet.