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Cover
Preface
Acknowledgements
About the Companion Website
1 Concepts and Mechanisms of General Anaesthesia
1. 1.1 Definitions
2. 1.2 The Depth of General Anaesthesia
3. 1.3 Mechanisms of Action of General Anaesthetic Drugs
4. References
5. Further Reading
6. Self‐test Section
2 Patient Safety
1. 2.1 Introduction
2. 2.2 Anaesthetic Risk
3. 2.3 Error
4. 2.4 Safety Culture
5. 2.5 Where to Get Help
6. Reference
7. Further Reading
8. Self‐test Section
3 Pain
1. 3.1 Introduction
2. 3.2 Evolution of Pain
3. 3.3 The Different Types and Qualities of Pain
4. 3.4 The Pain Pathway
5. 3.5 Analgesia
6. 3.6 Opioids
7. 3.7 Corticosteroids
8. 3.8 Non‐steroidal Anti‐inflammatory Drugs (NSAIDs)
9. 3.9 Paracetamol (Acetaminophen)
10. 3.10 Piprants
11. 3.11 Local Anaesthetics
12. 3.12 𝛂2‐Adrenoceptor Agonists
13. 3.13 Other Analgesic Drugs
14. 3.14 Pharmacogenetics
15. 3.15 Adjuncts to Analgesia
16. 3.16 Euthanasia
17. 3.17 Assessment of Pain
18. Further Reading
19. Useful Textbook Resources
20. Self‐test Section
4 Sedation and Premedication
1. 4.1 Premedication and Sedation
2. Further Reading
3. Self‐test Section
5 Injectable Anaesthetic Agents
1. 5.1 Overview
2. 5.2 Properties of an Ideal Injectable Anaesthetic Agent
3. 5.3 Advantages and Disadvantages of Injectable Drugs
4. 5.4 Response to Administration
5. 5.5 Pharmacokinetic Body Compartments
6. 5.6 Total Intravenous Anaesthesia (TIVA)
7. 5.7 Effects of Injectable Anaesthetic Drugs
8. 5.8 Substituted Phenols
9. 5.9 Neuro‐active Steroids
10. 5.10 Phencyclidine Derivatives/Aryl‐Cyclohexylamines
11. 5.11 Barbiturates
12. 5.12 Carboxylated Imidazoles
13. 5.13 Injectable Volatile (Inhalational) Anaesthetic Drugs
14. 5.14 Co‐induction
15. Further Reading
16. Self‐test Section
6 Analgesic Infusions
1. 6.1 Indications
2. 6.2 Opioids
3. 6.3 Others
7 Intravascular Catheters/Cannulae
1. 7.1 Veins for Catheterisation
2. 7.2 Arteries for Catheterisation
3. 7.3 Complications of Intravascular Catheterisation
4. Further Reading
5. Self‐test Section
8 Inhalation Anaesthetic Agents
1. 8.1 Introduction
2. 8.2 Properties of an Ideal Inhalation Agent
3. 8.3 MAC
4. 8.4 Administration of Inhalation Agents
5. 8.5 Uptake and Elimination of Anaesthetic Agents
6. 8.6 Halogenated Agents
7. 8.7 Nitrous Oxide
8. 8.8 Xenon
9. 8.9 Activated Charcoal
10. 8.10 Potential Toxicities
11. 8.11 Interaction of Inhalation Agents with CO₂ Absorbents
12. 8.12 Global Warming Potential
13. 8.13 Chemical Formulae
14. Further Reading
15. Self‐test Section
9 Anaesthetic Breathing Systems and Airway Devices
1. 9.1 Introduction
2. 9.2 Terminology
3. 9.3 Factors to Consider When Choosing a Breathing System
4. 9.4 Non‐rebreathing Systems
5. 9.5 Non‐rebreathing Systems Compared with Rebreathing Systems
6. 9.6 Heat and Moisture Exchangers (HMEs)
7. 9.7 Pop‐off or APL (Adjustable Pressure Limiting) Valves
8. 9.8 Bag Terminology
9. 9.9 Hybrid Systems
10. 9.10 Rebreathing Systems
11. 9.11 Rebreathing Systems Compared with Non‐rebreathing Systems
12. 9.12 Scavenging
13. 9.13 Endotracheal Tubes (ETTs) and Supraglottic Airway Devices (SGADs)
14. 9.14 Tracheal Extubation
15. Further Reading
16. Recommended Books
17. Self‐test Section
10 Anaesthetic Machines, Vaporisers, and Gas Cylinders
1. 10.1 Definitions
2. 10.2 Cylinders
3. 10.3 Pressure Units
4. 10.4 Gases in Cylinders
5. 10.5 Cylinder Safety
6. 10.6 Piped Gas Supplies
7. 10.7 Pressure Gauges
8. 10.8 The Anaesthetic Machine
9. 10.9 Flowmeters
10. 10.10 Vaporisers
11. 10.11 Vaporisation of Volatile Anaesthetic Agents
12. 10.12 Classification of Vaporisers
13. 10.13 Other Features of Vaporisers
14. 10.14 Safety Features of Vaporisers
15. 10.15 Desflurane Vaporiser
16. 10.16 Cassette Type Vaporisers
17. 10.17 VIC: Stephens Circle and Komesaroff Machine
18. References
19. Further Reading
20. Books
21. Self‐test Section
11 Anaesthetic Machine Checks
12 Local Anaesthetics
1. 12.1 Mechanism of Action
2. 12.2 Chemical Structure of Local Anaesthetic Agents
3. 12.3 Physicochemical Properties of Local Anaesthetics
4. 12.4 Uses of Local Anaesthetics
5. 12.5 Some of the Local Anaesthetics Available
6. Further Reading
7. Self‐test Section
13 Local Anaesthetic Techniques for the HeadSmall Animals
1. 13.1 Introduction
2. Further Reading
3. Self‐test Section
14 Local Anaesthetic Techniques for the Limbs
1. 14.1 Use of Local Anaesthetics
2. 14.2 Nerve Location and Ultrasound
3. 14.3 Neuraxial Anaesthesia
4. 14.4 Regional Anaesthesia for the Thoracic Limb
5. 14.5 Regional Anaesthesia for the Pelvic Limb
6. 14.6 Regional Techniques Relevant to Thoracic and Pelvic Limbs
7. References
8. Further Reading
9. Self‐test Section
15 Miscellaneous Local Anaesthetic Techniques
1. 15.1 Truncal Blocks
2. 15.2 Anaesthesia for Castration or Spay
3. 15.3 Pancreatitis
4. Further Reading
5. Self‐test Section
16 Local Anaesthetic Techniques
1. 16.1 Equine Limb Nerve Blocks
2. 16.2 Head Blocks
3. Further Reading
4. Self‐test Section
17 Muscle Relaxants
1. 17.1 Introduction
2. 17.2 Centrally Acting Muscle Relaxants
3. 17.3 Neuromuscular Blocking Agents
4. 17.4 Factors Affecting Neuromuscular Block
5. 17.5 Reversal of Non‐depolarising Neuromuscular Blockade
6. 17.6 Doses for Dogs (and Cats)
7. 17.7 Doses for Horses
8. 17.8 Notes
9. Further Reading
10. Self‐test Section
18 Monitoring Animals during General Anaesthesia
1. 18.1 Introduction
2. 18.2 Aims of Monitoring Physiological Status
3. 18.3 How to Monitor the Patient's Status
4. 18.4 What Should Be Monitored
5. 18.5 Multiparameter Monitors
6. 18.6 Summary
7. Further Reading
8. Self‐test Section
19 Troubleshooting Some of the Problems Encountered in Anaesthetised Patients
20 Inadvertent Peri‐operative Hypothermia
1. 20.1 Introduction
2. 20.2 Adverse Effects of Hypothermia
3. 20.3 Peri‐anaesthetic Heat Loss
4. 20.4 Risk Factors for Development of Hypothermia
5. 20.5 Minimising Heat Loss
6. 20.6 Increasing Heat Production?
7. Further Reading
8. Self‐test Section
21 Blood Gas Analysis
1. 21.1 Introduction
2. 21.2 pH
3. 21.3 PO₂ and PCO₂
4. 21.4 Interpreting Blood Gases
5. 21.5 Other Options
6. 21.6 Temperature Compensation
7. 21.7 Other Approaches to Blood Gas Analysis
8. 21.8 Examples
9. Further Reading
10. Self‐test Section
22 Lactate
1. 22.1 Pathways of Lactate Metabolism
2. 22.2 Lactate Balance
3. 22.3 Hyperlactataemia and Lactic Acidosis
4. 22.4 Lactate Measurement
5. 22.5 Lactate as Possible Prognostic Indicator
6. 22.6 Other Uses of Lactate
7. 22.7 Conclusions
8. References
9. Further Reading
10. Self‐test Section
23 Fluid Therapy
1. 23.1 Distribution of Fluid Within the Body
2. 23.2 The Endothelial Glycocalyx
3. 23.3 Types of Fluid Loss
4. 23.4 Response of the Body to Fluid Loss
5. 23.5 Clinical Evaluation
6. 23.6 Routes of Fluid Administration
7. 23.7 Types of Parenteral Fluids
8. 23.8 Devising a Fluid Therapy Plan
9. 23.9 ‘Surgical Maintenance’ Rates of IV Fluids for Patients under Anaesthesia
10. 23.10 Brief Notes on Fluid Therapy for Trauma/Haemorrhagic Shock
11. 23.11 Fluids for Sepsis
12. Further Reading
13. Self‐test Section
24 Electrolytes
1. 24.1 Introduction
2. 24.2 Sodium
3. 24.3 Potassium
4. 24.4 Chloride
5. 24.5 Phosphate
6. 24.6 Calcium
7. 24.7 Magnesium
8. 24.8 Guidelines for Intravenous Potassium Supplementation
9. 24.9 Guidelines for Intravenous Potassium Supplementation
10. Further Reading
11. Self‐test Section
25 Drugs Affecting the Cardiovascular System
1. 25.1 Methylxanthines (Theophylline Derivatives)
2. 25.2 Selective PDE Inhibitors (Also Called Ino‐dilators)
3. 25.3 Angiotensin I Converting Enzyme Inhibitors (ACEI)
4. 25.4 Digitalis Glycosides
5. 25.5 Classical Anti‐dysrhythmics (or Anti‐arrhythmics)
6. 25.6 Anticholinergics
7. 25.7 Other Drugs Used for Cardiovascular Support during Anaesthesia
8. 25.8 Notes
9. Further Reading
26 Shock, SIRS, MODS/MOF, Sepsis
1. 26.1 Introduction
2. 26.2 Main ‘Types’ of Shock
3. 26.3 The Final Common Path of Shock
4. 26.4 Responses to Shock
5. 26.5 Systemic Inflammatory Response Syndrome (SIRS) and Multiple Organ Dysfunction Syndrome/Multiple Organ Failure (MODS/MOF)
6. 26.6 Sepsis and Septic Shock
7. 26.7 Take Home Message
8. 26.8 Anaphylaxis
9. 26.9 Notes
10. Further Reading
11. Self‐test Section
27 Gastric Dilation/Volvulus (GDV)
1. 27.1 The Problems
2. 27.2 Approach
3. 27.3 Premedication
4. 27.4 Anaesthetic Induction
5. 27.5 Anaesthetic Maintenance
6. 27.6 Recovery
7. 27.7 When Is an Arrhythmia ‘Malignant’?
8. Further Reading
28 Equine Sedation and Premedication
1. 28.1 Introduction
2. 28.2 Phenothiazines
3. 28.3 Thioxanthenes
4. 28.4 Benzodiazepines
5. 28.5 α2 Adrenoreceptor Agonists
6. Further Reading
7. Self‐test Section
29 Equine Heart Murmurs
1. 29.1 Physiological/Functional/Flow Murmurs
2. 29.2 Young Racehorses in Training
3. 29.3 Aortic Regurgitation
4. 29.4 Mitral Regurgitation
5. 29.5 Tricuspid Regurgitation
6. 29.6 Ventricular Septal Defects
7. Further Reading
30 Equine Anaesthesia
1. 30.1 Introduction
2. 30.2 Factors Influencing Anaesthetic Risks
3. 30.3 Preparation for Anaesthesia
4. 30.4 Premedication/Sedation
5. 30.5 Induction of Anaesthesia
6. 30.6 The Recovery Period
7. 30.7 Anaesthesia of Foals
8. 30.8 Fractures
9. 30.9 Head/Eye Injuries
10. 30.10 Colics
11. Further Reading
12. Self‐test Section
31 Equine Intravenous Anaesthesia in the Field and Standing Chemical Restraint
1. 31.1 Field Anaesthesia
2. 31.2 Prolonged Sedation for Procedures on the Standing Patient
3. 31.3 Difficult‐to‐handle Horses
32 Donkeys
1. 32.1 Introduction
2. Further Reading
3. Self‐test Section
33 Ruminants
1. 33.1 General Anaesthesia
2. 33.2 Sedation/Premedication
3. 33.3 Intravenous Access
4. 33.4 Anaesthetic Induction
5. 33.5 Anaesthetic Induction Using Inhalation Agents
6. 33.6 Breathing Systems
7. 33.7 ET Intubation
8. 33.8 Positioning
9. 33.9 Maintenance of Anaesthesia
10. 33.10 Monitoring the Anaesthetised Patient
11. 33.11 Recovery
12. 33.12 Analgesia
13. 33.13 Local Anaesthesia
14. References
15. Further Reading
16. Self‐test Section
34 Lamoids (South American Camelids)
1. 34.1 Introduction
2. 34.2 Drugs and Details for Anaesthesia
3. Reference
4. Further Reading
5. Self‐test Section
35 Pigs
1. 35.1 Special Considerations
2. 35.2 Approach to Chemical Restraint: Sedation and General Anaesthesia
3. 35.3 Analgesia
4. Reference
5. Further Reading
6. Self‐test Section
36 Rabbit Anaesthesia
1. 36.1 Risk of Peri‐anaesthetic Morbidity
2. 36.2 Approach to Rabbit Anaesthesia
3. Further Reading
4. Self‐test Section
37 Neonates/Paediatrics
1. 37.1 Definitions
2. 37.2 Physiological Differences
3. 37.3 Pharmacological Considerations
4. 37.4 Considerations for Chemical Restraint (Sedation/Anaesthesia)
5. Further Reading
6. Self‐test Section
38 Senescent/Geriatric Patients
1. 38.1 Ageing Changes
2. 38.2 Approach to Anaesthesia
3. Further Reading
4. Self‐test Section
39 Pregnancy and Caesarean Sections
1. 39.1 Physiological Changes during Pregnancy
2. 39.2 Aorto‐caval Compression Syndrome/Supine Hypotensive Syndrome
3. 39.3 Placental Transfer of Drugs
4. 39.4 Caesarean Sections (C‐sections)
5. Further Reading
6. Self‐test Section
40 Obesity
1. 40.1 Introduction
2. 40.2 General and Pharmacokinetic Complications of Obesity
3. 40.3 Approach to the Obese Patient
4. Further Reading
5. Self‐test Section
41 Dental and Oral Considerations
1. 41.1 Analgesia
2. 41.2 Nerve Blocks
3. 41.3 Supra‐periosteal Local Anaesthesia
4. 41.4 Other Supplementary Techniques
5. 41.5 Airway Access and Protection
6. 41.6 Haemorrhage
7. 41.7 Hypothermia
8. 41.8 Mouth Gags and Post‐anaesthetic Blindness
9. 41.9 Air Drills
10. 41.10 Nutrition
11. 41.11 Post‐anaesthetic Deafness
12. 41.12 Pain Scoring
13. Further Reading
14. Self‐test Section
42 Ocular Surgery Considerations
1. 42.1 Introduction
2. 42.2 Changes in IOP
3. 42.3 Factors Altering CVP (and Jugular Venous Pressure)
4. 42.4 Changes in Pupil Size
5. 42.5 Oculocardiac Reflex (Trigemino‐vagal Reflex, Aschner's Reflex)
6. 42.6 Anaesthetic Agents and IOP
7. 42.7 Positive Pressure Ventilation and IOP
8. 42.8 Requirements for Eye Surgery
9. Further Reading
10. Self‐test Section
43 Orthopaedic and Neurosurgery Considerations
1. 43.1 Analgesic Considerations for Orthopaedics
2. 43.2 Spinal Surgery Considerations
3. 43.3 Emboli
4. Further Reading
5. Self‐test Section
44 Renal Considerations
1. 44.1 Normals
2. 44.2 Useful Values
3. 44.3 Chronic Renal Failure
4. 44.4 Clinical Problems Associated with Renal Disease
5. 44.5 Ruptured Bladder Foals (Uroperitoneum)
6. 44.6 ‘Blocked’ Cats
7. Further Reading
8. Self‐test Section
45 Hepatic Considerations
1. 45.1 Normals
2. 45.2 Hepatic Dysfunction
3. 45.3 How Does Liver Disease Affect Our Choice of Drugs and Technique?
4. Further Reading
5. Self‐test Section
46 Endocrine Considerations
1. 46.1 Diabetes Mellitus
2. 46.2 Insulinoma
3. 46.3 Addison's Disease (Hypoadrenocorticism)
4. 46.4 Cushing's Disease (Hyperadrenocorticism)
5. 46.5 Canine Hypothyroidism
6. 46.6 Feline Hyperthyroidism
7. 46.7 Phaeochromocytoma
8. 46.8 Paraneoplastic Syndrome Hypercalcaemia (Pseudo‐hyperparathyroidism)
9. 46.9 Diabetes Insipidus
10. 46.10 Hyperaldosteronism (Conn's Syndrome)
11. Further Reading
12. Self‐test Section
47 Background to Neuroanaesthesia for the Brain
1. 47.1 Introduction
2. 47.2 The Monro–Kellie Doctrine
3. 47.3 The Cerebral Circulation
4. 47.4 Aims of Anaesthetic Management
5. Further Reading
6. Self‐test Section
48 Cardiac Considerations
1. 48.1 General Anaesthetic Aims
2. 48.2 Some Particular Problems
3. Further Reading
4. Self‐test Section
49 Respiratory Considerations
1. 49.1 Brachycephalic Obstructive Airway Syndrome (BOAS)
2. 49.2 Bronchoscopy (and Broncho‐alveolar Lavage [BAL])
3. 49.3 Laryngeal Paresis/Paralysis
4. 49.4 Tracheal Collapse
5. 49.5 Thoracotomies
6. 49.6 Diaphragmatic Ruptures
7. 49.7 Equine Asthma
8. Further Reading
9. Self‐test Section
50 Respiratory Emergencies
1. 50.1 Respiratory Insufficiency
2. 50.2 Diagnostic Workup
3. 50.3 Oxygen Supplementation
4. References
5. Further Reading
6. Self‐test Section
51 Cardiopulmonary Cerebral Resuscitation (CPCR)
1. 51.1 Introduction
2. 51.2 Types of Arrest
3. 51.3 Prevention Is Better Than Cure
4. 51.4 What Can We Do?
5. 51.5 Basic Life Support
6. 51.6 Advanced Life Support (ALS)
7. 51.7 External or Internal Compressions/Cardiac Massage?
8. 51.8 Open Chest CPCR
9. 51.9 Post‐resuscitation Problems
10. 51.10 Overall
11. 51.11 New Ideas
12. Further Reading
13. Self‐test Section
Appendix A: Canine Emergency Drug Doses
Appendix B: Feline Emergency Drug Doses
Appendix C: Equine Emergency Drug Doses
Answers to Self‐test Questions
Index
End User License Agreement

List of Tables

Chapter 1
1. Table 1.1 Summary of effects of general anaesthesia.
2. Table 1.2 Stages of ether anaesthesia in the dog, after Guedel.
Chapter 2
1. Table 2.1 Peri‐anaesthetic risk of mortality (%) reported for various species...
Chapter 3
1. Table 3.1 Comparison of opioid receptor effects.
2. Table 3.2 Relative receptor affinities of some opioids.
3. Table 3.3 Relative analgesic efficacies (partly explained in terms of access ...
4. Table 3.4 Relative effects of common corticosteroids at ‘equivalent’ doses.
Chapter 4
1. Table 4.1 Receptor selectivity of the common α2 agonists.
2. Table 4.2 Location of adrenoceptors in the cardiovascular system and results ...
3. Table 4.3 The relative activities of some of the different opioids available ...
4. Table 4.4 Relative analgesic potencies of common opioids.
Chapter 5
1. Table 5.1 Symptoms of extrapyramidal dysfunction.
Chapter 7
1. Table 7.1 Pathogens associated with bacterial colonisation of catheters in a ...
2. Table 7.2 Drug pH values.
Chapter 8
1. Table 8.1 Some properties of actual inhalation agents (based upon humans).
2. Table 8.2 Some MAC values.
3. Table 8.3 The environmental impact of inhaled anaesthetic agents commonly use...
4. Table 8.4 A summary of various physicochemical and clinical characteristics o...
Chapter 9
1. Table 9.1 Fresh gas flows, in multiples of minute ventilation (MV), required ...
2. Table 9.2 Examples offresh gas flows (FGFs) required to prevent CO₂ rebreathi...
3. Table 9.3 Illustration of fresh gas flows required for a 30 kg patient, with ...
Chapter 10
1. Table 10.1 Basic cylinder data.
2. Table 10.2 Cylinder size and valve fitments (UK).
3. Table 10.3 Cylinder and pipeline colour.
4. Table 10.4 Volatile agent boiling points.
Chapter 12
1. Table 12.1 Physicochemical properties of commonly used local anaesthetic agen...
2. Table 12.2 Relationship between physicochemical properties and clinical effec...
Chapter 14
1. Table 14.1 Comparison of true spinal (intrathecal) and epidural (extradural) ...
2. Table 14.2 Commonly used needle sizes for lumbo‐sacral extradural injections.
3. Table 14.3 Commonly used drugs and doses for extradural injection.
4. Table 14.4 Nerves and corresponding motor responses for electro‐neuro‐locatio...
5. Table 14.5 Nerves and corresponding motor responses for electro‐neuro‐locatio...
Chapter 16
1. Table 16.1 Comparison of commonly available local anaesthetic drugs for diagn...
2. Table 16.2 Drug doses for epidural (extradural) injection for a typical 500 k...
Chapter 17
1. Table 17.1 Features of common non‐depolarising neuromuscular blockers.
2. Table 17.2 Succinylcholine in different species. Onset of block is within 30–...
Chapter 19
1. Table 19.1 Hypertension with tachycardia. Hypertension is defined as mean art...
2. Table 19.2 Hypertension with bradycardia. Hypertension is defined as MAP > 12...
3. Table 19.3 Hypotension with tachycardia. Hypotension is defined as MAP < 60–7...
4. Table 19.4 Hypotension with bradycardia. Hypotension is defined as MAP < 60–7...
5. Table 19.5 Hypercapnia. Hypercapnia is defined here as ETCO₂ tension > 60 mmH...
6. Table 19.6 Hypocapnia. Hypocapnia is defined here as ETCO₂ tension < 30–35 mm...
7. Table 19.7 Hypoxaemia. Hypoxaemia is defined here as PaO₂ < 100 mmHg (13.3 kP...
8. Table 19.8 Hypothermia. Hypothermia is defined here as temperature <37 °C.
9. Table 19.9 Hyperthermia. Hyperthermia is defined here as temperature >39.5 °C...
Chapter 21
1. Table 21.1 Typical haemoglobin P₅₀ values for various mammals (with ranges, i...
2. Table 21.2 Typical blood gas values for dogs (and where values differ signifi...
3. Table 21.3 Ability of increasing F_IO₂ (%) alone to correct hypoxaemia caused ...
4. Table 21.4 Expected compensatory changes.
Chapter 23
1. Table 23.1 Guide to compartment volumes.
2. Table 23.2 Assessment of ‘dehydration’. Note that percentages refer to percen...
3. Table 23.3 Characteristics of common crystalloid solutions. Note that normal ...
4. Table 23.4 Characteristics of colloid solutions.
Chapter 24
1. Table 24.1 Electrolyte concentrations for common species.
2. Table 24.2 Sodium disturbances.
3. Table 24.3 The potassium and sodium content of red blood cells.
4. Table 24.4 Potassium disturbances.
5. Table 24.5 ECG changes with potassium imbalances.
6. Table 24.6 Chloride disturbances.
7. Table 24.7 Phosphate disturbances.
8. Table 24.8 Calcium disturbances.
9. Table 24.9 Magnesium disturbances.
Chapter 25
1. Table 25.1 Distribution of adrenergic receptors in the cardiovascular system....
2. Table 25.2 Relative activities of commonly used drugs at adrenergic receptors...
Chapter 26
1. Table 26.1 Variables to monitor to help guide fluid therapy.
Chapter 28
1. Table 28.1 Results of diazepam administration to horses.
2. Table 28.2 Uterine effects of α2 agonists in non‐pregnant mares.
3. Table 28.3 Features of the three common α2 agonists when administered at ‘equ...
4. Table 28.4 Examples of drug doses for continuous infusion for standing proced...
5. Table 28.5 Quick guide to setting up an infusion.
Chapter 34
1. Table 34.1 Benzodiazepine‐based sedation.
2. Table 34.2 α2 agonist‐based sedation.
3. Table 34.3 Opioid doses.
4. Table 34.4 Injectable combinations for field anaesthesia.
Chapter 36
1. Table 36.1 Pre‐anaesthetic medication and induction doses taken from studies ...
Chapter 46
1. Table 46.1 Causes, signs, and treatment of glucose disturbances.
2. Table 46.2 Differentiation of hypo‐ and hyper‐glycaemia.
Chapter 47
1. Table 47.1 Modified Glasgow Coma Scale.
2. Table 47.2 Interpretation of modified Glasgow Coma Scale scores.
3. Table 47.3 Effects of anaesthetic agents on intracranial pressure.
Chapter 48
1. Table 48.1 Cardiovascular effects of common anaesthetic induction agents. Not...
Chapter 50
1. Table 50.1 Grades of hypoxaemia.
2. Table 50.2 A guide to which chest tube size to use in small animals.

List of Illustrations

Chapter 3
1. Figure 3.1 Simplified pain pathway.
2. Figure 3.2 Gate control theory.
3. Figure 3.3 Pathway of central sensitisation. AMPA and NMDA receptors are glu...
4. Figure 3.4 Some descending pathways.
5. Figure 3.5 Site of corticosteroid action. The principal eicosanoids (arachid...
6. Figure 3.6 Site of NSAID action.
7. Figure 3.7 Short form of the Glasgow composite measure pain scale for dogs....
8. Figure 3.8 The Glasgow Composite Measure Pain Scale (CMPS)‐Feline.
Chapter 5
1. Figure 5.1 The time lag between IV injection of an anaesthetic agent and the...
Chapter 7
1. Figure 7.1 Catheterised cephalic vein in a conscious dog (a) and lateral sap...
2. Figure 7.2 Catheterised medial saphenous vein in an anaesthetised horse (a) ...
3. Figure 7.3 Catheterised jugular (a) and dorsal metatarsal (b) veins in sedat...
4. Figure 7.4 Catheterisation of a marginal ear vein in a rabbit (a); connectio...
5. Figure 7.5 Equine left lateral thoracic vein and branches (a); right lateral...
6. Figure 7.6 Catheterised auricular artery in an anaesthetised rabbit (a), alp...
7. Figure 7.7 Catheterised transverse facial artery in an anaesthetised horse....
8. Figure 7.8 Catheterised mandibular artery connected to rigid pressure tubing...
9. Figure 7.9 Catheterised palmar carpal arch artery in an anaesthetised dog.
10. Figure 7.10 Catheterised dorsal/lateral metatarsal artery in an anaesthetise...
11. Figure 7.11 Catheterised dorsal metatarsal arteries in anaesthetised dogs us...
12. Figure 7.12 Catheterised dorsal metatarsal artery (a) and vein (b) in two di...
13. Figure 7.13 ‘No‐touch’ aseptic preparation of the skin using 2% chlorhexidin...
14. Figure 7.14 Catheter secured using tape with a small swab placed underneath ...
15. Figure 7.15 Over‐the‐needle safety catheter (a) and standard catheter (b).
16. Figure 7.16 Re‐advancing the stylette may damage the catheter tip, which may...
17. Figure 7.17 (a) Peel‐away sheath over needle. The sheath is first inserted a...
18. Figure 7.18 The components required for insertion of a catheter over a flexi...
Chapter 8
1. Figure 8.1 Kety curve. I is the initial rise: represents anaesthetic agent d...
2. Figure 8.2 ‘Wash‐in’ of anaesthetic agent (uptake). F_A/F_i, alveolar concentr...
3. Figure 8.3 ‘Wash‐out’ of anaesthetic agent (elimination). F_A/F_AO, alveolar c...
Chapter 9
1. Figure 9.1 Exhaled gases.
2. Figure 9.2 A Magill system.
3. Figure 9.3 The coaxial Lack system.
4. Figure 9.4 The parallel form of the Lack system.
5. Figure 9.5 Movement of gases within the Magill system during spontaneous bre...
6. Figure 9.6 Movement of gases within the Magill system during artificial vent...
7. Figure 9.7 Ayre's T‐piece (Mapleson E).
8. Figure 9.8 Jackson Rees modification of Ayre's T‐piece (Mapleson F).
9. Figure 9.9 Movement of gases within a T‐piece during spontaneous breathing. ...
10. Figure 9.10 Modification at patient connector (Y‐piece).
11. Figure 9.11 Cape Town arrangement.
12. Figure 9.12 Functional apparatus dead space is greater with (a) the original...
13. Figure 9.13 Mapleson D system.
14. Figure 9.14 Bain system.
15. Figure 9.15 Adjustable pressure‐limiting (‘pop‐off’) valves in (a) the open ...
16. Figure 9.16 To and Fro.
17. Figure 9.17 Problems with horizontal canisters. (a) A small channel, empty o...
18. Figure 9.18 Circle system.
19. Figure 9.19 F circuit (first described by Dr Fukunaga from Japan).
20. Figure 9.20 Passive scavenging ‘receiver’ system with safety valves.
21. Figure 9.21 Active scavenging receiver system, often called a Barnsley recei...
22. Figure 9.22 Different types of endotracheal tube. From the top: silicone rub...
23. Figure 9.23 Armoured tube (see metallic spiral which prevents tube from kink...
24. Figure 9.24 Laryngeal mask airway (sometimes referred to as a ‘Brain airway’...
25. Figure 9.25 Cat v‐gel showing dorsal aspect with inflatable ‘cushion’ and in...
Chapter 10
1. Figure 10.1 An oxygen concentrator manifold comprising two units.
2. Figure 10.2 Pin index safety system. (a) A cut‐away diagram through a pin in...
3. Figure 10.3 (a) Pin hole positions on O₂ cylinder (e.g. size E) valve block....
4. Figure 10.4 The functional parts of a pressure regulator. D, diaphragm; S, s...
5. Figure 10.5 Schrader probes on an anaesthetic workstation (a): black, medica...
6. Figure 10.6 Bourdon gauge.
7. Figure 10.7 Flow of gases through the anaesthetic machine.
8. Figure 10.8 The path of oxygen through an anaesthetic machine.
9. Figure 10.9 Different types of ‘indicator floats’, usually made of glass or ...
10. Figure 10.10 Old flowmeter system.
11. Figure 10.11 Newer flowmeter system.
12. Figure 10.12 Electronic flowmeter display of the GE Healthcare Aisys anaesth...
13. Figure 10.13 Basic vaporiser construction. The rotary valve alters the propo...
14. Figure 10.14 Saturated vapour fills the vaporisation chamber.
15. Figure 10.15 Temperature compensation achieved with variable curvature of bi...
16. Figure 10.16 Temperature compensation achieved by variable expansion of ethe...
17. Figure 10.17 Isoflurane Aladin™ cassette vaporiser being filled. Note the de...
Chapter 12
1. Figure 12.1 Voltage‐gated sodium channels may change between the states of r...
2. Figure 12.2 Zones of desensitisation following local anaesthesia of a periph...
3. Figure 12.3 Sites of action of local anaesthetic agents at excitable membran...
4. Figure 12.4 Typical systemic toxicity described for lidocaine.
Chapter 13
1. Figure 13.1 Nerves relevant to dental and oral surgery.
2. Figure 13.2 Sub‐zygomatic approach to the maxillary nerve for dog (a) and ca...
3. Figure 13.3 Maxillary tuberosity, intra‐oral approach to the maxillary nerve...
4. Figure 13.4 Infraorbital canal, intra‐oral approach (a) and extra‐oral appro...
5. Figure 13.5 Transorbital approach to maxillary nerve block: (a) gentle retro...
6. Figure 13.6 Infraorbital nerve block in a dog.
7. Figure 13.7 Infraorbital nerve block in a cat.
8. Figure 13.8 Extra‐oral approach to the inferior alveolar nerve at the mandib...
9. Figure 13.9 Intra‐oral approach to the inferior alveolar nerve at the mandib...
10. Figure 13.10 Mental nerve block.
11. Figure 13.11 Retrobulbar, intraconal block.
12. Figure 13.12 Sub‐Tenon block.
13. Figure 13.13 Auriculotemporal (rostral site) and great auricular (caudal sit...
14. Figure 13.14 A wound soaker‐catheter.
Chapter 14
1. Figure 14.1 Electro‐neuro‐locator (a); insulated stimulating needle with inj...
2. Figure 14.2 Location of the lumbo‐sacral space determined by forming a trian...
3. Figure 14.3 Slightly different needle insertion sites in the lumbo‐sacral sp...
4. Figure 14.4 Location of lumbo‐sacral needle placement site for dog.
5. Figure 14.5 Patient in sternal recumbency. (a) Hindlimbs are initially frog‐...
6. Figure 14.6 Position used to tense the interarcuate ligament for lumbo‐sacra...
7. Figure 14.7 The structures traversed during needle placement for extradural ...
8. Figure 14.8 Mini epidural kit.
9. Figure 14.9 Anatomical site for brachial plexus block injection.
10. Figure 14.10 Repeated or continuous infusion of local anaesthetic at the sit...
11. Figure 14.11 Approaches described for thoracic limb nerve blocks.
12. Figure 14.12 Lateral view of forelimb illustrating technique for radial nerv...
13. Figure 14.13 Medial view of forelimb illustrating technique for ulnar, muscu...
14. Figure 14.14 Approaches described for pelvic limb nerve blocks.
Chapter 15
1. Figure 15.1 The intercostal nerves are closely associated with the caudal bo...
2. Figure 15.2 Incisional block; an initial injection of local anaesthetic enab...
Chapter 16
1. Figure 16.1 Anatomical landmarks of the horse head.
2. Figure 16.2 Representation of location of peri‐orbital nerves.
3. Figure 16.3 Sites for (auriculo‐) palpebral nerve block. See text for detail...
Chapter 17
1. Figure 17.1 The neuromuscular junction.
2. Figure 17.2 The normal sequence of muscle block quoted for the dog.
3. Figure 17.3 Representation of ‘fade’.
4. Figure 17.4 Elimination pathways for atracurium.
5. Figure 17.5 Fisher & Paykel Innervator 272™ peripheral nerve stimulator with...
6. Figure 17.6 Two different forms of electrical stimulation: train‐of‐four sti...
7. Figure 17.7 Muscle twitch responses recorded with train‐of‐four (TOF) stimul...
8. Figure 17.8 Acetylcholinesterase's esteratic site and nearby anionic site.
9. Figure 17.9 Interaction of acetylcholine with acetylcholinesterase.
Chapter 18
1. Figure 18.1 Ventral rotation of the globe during ‘surgical’ plane of anaesth...
2. Figure 18.2 Cardiovascular and respiratory factors that should be considered...
3. Figure 18.3 Oesophageal stethoscope (three sizes available).
4. Figure 18.4 The course of one of the paired palatine arteries is shown in th...
5. Figure 18.5 Doppler ultrasound blood flow probe. Blood flowing towards the t...
6. Figure 18.6 Oscillometric non‐invasive blood pressure monitor; cuff placed o...
7. Figure 18.7 LifeVet P™ portable pulse oximeter displaying the pulse rate (74...
8. Figure 18.8 Pressure veil™ attached to aneroid manometer.
9. Figure 18.9 Two electronic pressure transducers mounted so that their height...
10. Figure 18.10 Under‐damping.
11. Figure 18.11 Excessive damping.
12. Figure 18.12 Critical damping.
13. Figure 18.13 Optimal damping.
14. Figure 18.14 Typical CVP waveform. a, atrial contraction; c, tricuspid valve...
15. Figure 18.15 Typical capnograph trace (called a time capnogram) from high sp...
16. Figure 18.16 A trend capnogram; obtained when recording speed is slow (25 mm...
17. Figure 18.17 Interpretation of common capnogram waveforms.
18. Figure 18.18 Colorimetric CO₂ detector (Easy‐Cap II™) being used for a dog....
19. Figure 18.19 V3402™ pulse oximeter with transmittance probe attached to cat'...
20. Figure 18.20 Pulse oximetry algorithm for determination of percentage SpO₂ v...
21. Figure 18.21 The screen display of a Mindray PM‐9000Vet™ multiparameter moni...
Chapter 20
1. Figure 20.1 Stages of core hypothermia following induction of anaesthesia. Δ...
2. Figure 20.2 Heat and moisture exchangers (HME) may be combined with antimicr...
3. Figure 20.3 JorVet™ in‐line IV fluid warmer.
4. Figure 20.4 Bair Hugger^TM forced warm air ‘blanket’ used to warm a foal in i...
5. Figure 20.5 HotDog^TM unit (a) and blanket (b).
Chapter 21
1. Figure 21.1 Portable analyser with printer and single‐use cartridge.
2. Figure 21.2 A bench‐top analyser with its quality control solutions in the t...
3. Figure 21.3 Haemoglobin–oxygen dissociation curve.
Chapter 22
1. Figure 22.1 Dissociated lactic acid (C₃H₅O₂ + H⁺): lactate is half a glucose...
2. Figure 22.2 Basic biochemical pathways. ADP = adenosine diphosphate; ATP = a...
3. Figure 22.3 Regulation of pathways involved in lactate production and utilis...
Chapter 23
1. Figure 23.1 Distribution of body water.
2. Figure 23.2 Dissociation curves for red‐cell bound haemoglobin (solid line) ...
Chapter 24
1. Figure 24.1 Transcellular H⁺/K⁺ exchange.
Chapter 25
1. Figure 25.1 Cardiac action potentials in cardiomyocytes from different regio...
Chapter 26
1. Figure 26.1 How different types of shock can co‐exist. MDF, myocardial depre...
2. Figure 26.2 Important players in the delivery of oxygen to the tissues. Hb, ...
3. Figure 26.3 Consequences of reduced cellular oxygen availability. ^**Cell swe...
4. Figure 26.4 Gram‐negative bacterial endotoxin.
5. Figure 26.5 Brief summary of coagulation pathways.
6. Figure 26.6 Summary of the initiation phase of coagulation in the cell surfa...
7. Figure 26.7 Summary of the ‘thrombin burst’ part of the propagation phase of...
Chapter 30
1. Figure 30.1 Abdominal viscera compress and ‘splint’ the diaphragm, especiall...
2. Figure 30.2 Ventilation/perfusion mismatching is outlined in this diagram sh...
Chapter 33
1. Figure 33.1 Cow's head inclined over a support to allow saliva and regurgita...
2. Figure 33.2 Local anaesthetic techniques used for bovine heads.A = local...
3. Figure 33.3 Nerve blocks for dehorning goats.A = cornual branch of lacri...
4. Figure 33.4 Retrobulbar block. With needle placement through the medial cant...
5. Figure 33.5 Peterson eye block (A), with (auriculo)palpebral block (B).a...
6. Figure 33.6 Hindlimb ‘proximal’ nerve blocks.A = common peroneal nerve; ...
7. Figure 33.7 Forelimb ‘proximal’ nerve blocks.A = musculocutaneous nerve;...
8. Figure 33.8 Nerve blocks of the lower forelimb.
9. Figure 33.9 Nerve blocks of the distal hindlimb.
10. Figure 33.10 Forelimb IVRA: superficial veins.a = common dorsal metacarp...
11. Figure 33.11 Hindlimb IVRA: superficial veins.d = lateral saphenous vein...
12. Figure 33.12 Epidural (extradural) injection into inter‐coccygeal space Co1–...
13. Figure 33.13 Goats and sheep: sites for epidural injection.
14. Figure 33.14 Udder innervation.A, B, C, and D = inguinal nerves; E = per...
15. Figure 33.15 Local anaesthetic techniques for teats.
16. Figure 33.16 Nerves and vessels on medial surface of bovine pelvic wall....
17. Figure 33.17 Left pudendal and caudal rectal nerve block performed from left...
18. Figure 33.18 Right pudendal and caudal rectal nerve block performed from the...
19. Figure 33.19 Paravertebral block.
20. Figure 33.20 When the paravertebral block has worked, the spine bows out on ...
21. Figure 33.21 (a) Injection sites for performing ‘reverse 7’ block. (b) Line ...
Chapter 34
1. Figure 34.1 Sagittal section through lamoid head. The nasopharyngeal diverti...
2. Figure 34.2 Alpaca skull showing infra‐orbital foramen (a), mental foramen (...
Chapter 35
1. Figure 35.1 Pig larynx in sagittal section.
2. Figure 35.2 Insertion of a curved ET tube without the assistance of a bougie...
3. Figure 35.3 Porcine epidural injection site and the extent of block possible...
Chapter 36
1. Figure 36.1 Showing marginal ear vein and central auricular artery.
2. Figure 36.2 A mask can be used to pre‐oxygenate a rabbit before endotracheal...
3. Figure 36.3 Optimal positioning of the rabbit's head for endotracheal intuba...
Chapter 37
1. Figure 37.1 Water distribution in the adult (dog/horse). Daily water require...
2. Figure 37.2 Water distribution in the neonate. Daily water requirement is c....
Chapter 41
1. Figure 41.1 Armoured tube placed via pharyngotomy incision.
Chapter 47
1. Figure 47.1 Intracranial compliance curve, illustrating how changes in intra...
2. Figure 47.2 Cerebral blood flow regulation by arterial blood pressure and bl...
3. Figure 47.3 Vicious circle of raised intracranial pressure.
Chapter 50
1. Figure 50.1 Bubble humidifier and flowmeter attached to oxygen regulator.
2. Figure 50.2 Oxygen therapy kennel doors with humidifier and thermometer/hygr...
3. Figure 50.3 ICS‐DT oxygen cages in use at Royal Veterinary College.
4. Figure 50.4 Nasal oxygen prongs (child: size 1).
5. Figure 50.5 (a) Nasal oxygen catheter and (b) softer naso‐oesophageal feedin...
6. Figure 50.6 Paramedian section through cat's head. Although a naso‐oesophage...
7. Figure 50.7 Mini‐tracheotomy tube and introducer.
8. Figure 50.8 Needles can be attached to ET tube adapters for connection to an...
9. Figure 50.9 Non‐cuffed ‘single’ tracheotomy tube with its obturator.
10. Figure 50.10 Needle thoracentesis and removal of purulent fluid from the ple...
11. Figure 50.11 Different types of chest tubes.
12. Figure 50.12 MILA™ guidewire‐insertion type chest drains showing the kit in ...
13. Figure 50.13 Typical position of chest tube in situ.
14. Figure 50.14 Chest drain in situ in a horse. A condom has been placed over t...
15. Figure 50.15 Tunnelling of chest drain beneath skin.
16. Figure 50.16 Insertion of chest drain into thoracic cavity at eighth interco...
17. Figure 50.17 Chest drain secured in place with sutures.
18. Figure 50.18 Standard size Heimlich valve. Actual size: about 16 cm long (in...
19. Figure 50.19 Underwater seal. The tube is normally submerged about 2 cm belo...
20. Figure 50.20 Three‐bottle system. A trap or collection bottle can be interpo...

Veterinary Anaesthesia

Principles to Practice

Preface

Acknowledgements

About the Companion Website