The Veterinary clinics of North America. Small animal practice
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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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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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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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Vet. Clin. North Am. Small Anim. Pract. · May 1999
ReviewDesflurane and sevoflurane. New volatile anesthetic agents.
Desflurane and sevoflurane, recently licensed for use in humans, have kinetics that result in rapid induction and easy maintenance of a stable level of anesthesia. Recovery is also rapid. ⋯ Metabolites of sevoflurane and breakdown products from its reaction with carbon dioxide absorbents theoretically could result in hepatic and renal damage, but such toxicity has not occurred despite extensive medical use. Clinical trials in animals are now in progress.