The Veterinary clinics of North America. Small animal practice
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A fluid therapy plan for a patient is developed prior to surgery and is designed to meet each patient's needs. The volume and type of fluid are dependent on the patient's physical status; the acid-base, fluid, and electrolyte status; the surgical procedure; and the expected losses occurring during the procedure. No one fluid regimen is ideal for all patients. ⋯ Balanced replacement fluids may be used to replace blood loss at a ratio of 3:1 and are added to maintenance and replacement requirements. Blood loss of 20% to 25% of the calculated blood volume or hematocrit values less than 20% are indications for colloids or blood replacement at a ratio of 1:1. The optimal fluid therapy regimen for a patient may involve a combination of crystalloids as well as natural and synthetic colloids, using each type of fluid to obtain and maintain perfusion and oxygenation to the tissues.
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When used properly, anesthesia machines, breathing systems, anesthesia ventilators, and ancillary equipment allow the safe and efficient use of the inhalant anesthetics. Several veterinary anesthesia machines and ventilators have been introduced over the last few years. This article includes a discussion of some of these new pieces of anesthesia equipment, with particular emphasis on changes and innovations in the design of the equipment. In addition, principles of use and care of various anesthetic equipment is included where appropriate.
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There has been a substantial increase in the use of analgesics for pain management in the last 10 years. Traditionally, veterinarians have not been trained in the identification of or monitoring of patients that are in pain, even though an evaluation of pain is inherent in assessing improvement in many medical and surgical diseases. Until recently, the physiology and pharmacology of opioids, NSAIDs, local anesthetics, and alpha 2 agonists were taught, but the therapeutic role of these drugs was generally believed to be related to restraint, anesthesia, or control of inflammation rather than to pain management.
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Vet. Clin. North Am. Small Anim. Pract. · May 1999
ReviewNewer neuromuscular blockers. Is the practitioner ready for muscle relaxants?
Current research on the development of new neuromuscular blocking agents is directed towards producing agents that have a rapid onset of action and predictable duration of action and recovery times, with minimal hemodynamic effects. For the veterinary practitioner, these newer agents should be considered when muscle relaxation is required for certain surgical procedures. ⋯ Vigilant monitoring should exist during the recovery period for the development of muscle weakness from residual blockade and the ability to reverse the effects of neuromuscular blockade. The use of neuromuscular blocking agents in veterinary patients should continue to increase as newer drugs and better monitoring techniques are developed.
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Although questions may still remain regarding the use of this unique sedative-hypnotic drug with anesthetic properties in high-risk patients, our studies have provided cardiopulmonary and neurological evidence of the efficacy and safety of propofol when used as an anesthetic under normal and selected impaired conditions in the dog. 1. Propofol can be safely and effectively used for the induction and maintenance of anesthesia in normal healthy dogs. Propofol is also a reliable and safe anesthetic agent when used during induced cardiovascular and pulmonary-impaired conditions without surgery. ⋯ Because propofol does not have marked analgesic effects and its metabolism is rapid, the use of local anesthetics, nonsteroidal anti-inflammatory agents, and opioids to provide postoperative analgesia improves the quality of recovery after propofol anesthesia. 6. The cardiovascular depressant effects of propofol are well tolerated in healthy animals, but these effects may be more problematic in high-risk patients with intrinsic cardiac disease as well as in those with systemic disease. In hypovolemic patients and those with limited cardiac reserve, even small induction doses of propofol (0.75-1.5 mg/kg i.v.) can produce profound hypotens