Advanced anaesthesia and analgesia

image of Advanced anaesthesia and analgesia
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If fortunate enough to be designing a practice from scratch, the first thing to consider is the layout of space to facilitate safe anaethesia. The mortality rate in veterinary anaesthesia is much higher than in human anaesthesia and when designing a new practice it is important to look at the reasons for this, and how this situation might be improved. It is usually considered that the greatest risk of anaesthesia are during induction and recovery. The chapter considers Equipment; Scavenging; Balanced anaesthesia; Ventilators; and Aids to monitoring.

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7.2 Provision of a separate enclosed area can minimize disturbance and distress during induction.
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7.3 Three wall-mounted anaesthetic machines in a busy preparation room. (Reproduced from the )
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7.4 The Humphrey ADE system. Without the canister and with parallel breathing tubing and reservoir bag. With soda lime canister attached. Top view. (Reproduced from the )
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7.7 An activated charcoal anaesthetic agent scavenger cylinder (‘Aldasorber’) with scavenging tubing attached. (Reproduced from the )
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7.8 An active scavenging system. (Courtesy of Coltronics Systems)
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7.11 Anatomical landmarks for performing maxillary, infraorbital, inferior alveolar and mental nerve blocks in dogs. (Reproduced from the ). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and are printed with her permission.
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7.13 The epidural site is clipped and prepared aseptically.
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7.14 Palpating the depression between L7 and S1.
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7.15 Correct placement of a Tuohy needle.
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7.16 Use of a low-resistance syringe to test for correct needle placement.
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7.18 Peripheral nerve stimulator with needle electrodes. Placement of needle electrodes over the ulnar nerve on the medial aspect of the elbow. Stimulation of the peroneal nerve can be achieved by electrode placement over the lateral head of the fibula. Needle electrodes placed over the facial nerve as it exits the infraorbital foramen. (Reproduced from the )
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7.19 Four equal twitches before the onset of neuromuscular blockade. Early blockade: twitches diminishing. More profound blockade: twitches diminished or absent. (Reproduced from the )
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7.21 An example of an in-line bacterial filter. (Reproduced from the )
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7.22 Sensor of a pulse oximeter. On the tongue. On a non-pigmented toe. (Reproduced from the )
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7.23 Close-up of a connector for sampling gas (sidestream capnograph). (Reproduced from the )
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7.24 Capnograph tracing of a normal breath.
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7.25 Capnograph tracing showing rebreathing. Note that the carbon dioxide levels never return to zero (0%).
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7.26 Capnograph tracing of two breaths showing a leak in the breathing system. Note the rapid fall in carbon dioxide after exhalation.
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7.27 Capnograph tracing showing increased respiratory resistance. Note the slow rise in carbon dioxide during expiration.
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7.28 A monitoring screen displaying respiratory gas concentrations on the left-hand side of the screen.
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