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Anaesthesia and analgesia

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Abstract

This chapter deals with the recognition of pain and provision of analgesia. It covers the commonly used analgesic and anaesthetic drugs and their potential effects on patient physiology. Anaesthesia protocols, intubation, monitoring are addressed, together with pre- and post-anaesthetic care and the management of problems. Includes self-assessment questions.

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Figures

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7.2 Acquiring an accurate bodyweight is essential in pre-anaesthetic assessments and when preparing anaesthetic and emergency drugs and making fluid therapy calculations.
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7.3 Shallow warm water baths (e.g. using seed propagators) can be useful prior to anaesthesia of reptiles, such as this marginated tortoise, to allow full clinical assessment and rehydration. Care should be exercised in patients that should be receiving nil by mouth.
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7.4 Collecting a pre-anaesthetic blood sample from a rat using the lateral tail vein.
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7.9 Some species of tortoise, such as this African spurred tortoise, will resist examination of the head, making jugular access challenging in the conscious animal.
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7.10 A common pipistrelle bat induced and maintained using sevoflurane and a Spigot connector for an Ayre’s T-piece breathing circuit.
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7.11 The glottis of a swan. Note the surrounding tracheal crests.
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7.12 An intubated red cornsnake showing the rostrally positioned glottis.
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7.13 Clean and protected storage of a variety of ETTs for exotic patients. A Cook ETT.
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7.14 Using a laryngoscope to visualize the glottis in a raccoon. (Courtesy of Job Stumpel)
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7.15 Equipment required for rabbit intubation: an auriscope; local anaesthetic; small forceps; an ‘introducer’; a selection of uncuffed ETTs; ETT adaptors for capnography with side-sampling ports; and a tie. Measuring the ETT length required for successful intubation. Positioning the head of a rabbit ready for intubation. The view down the cone of an auriscope of an open glottis in a rabbit prior to intubation. Applying local anaesthetic by allowing it to drip down the auriscope on to the larynx. The tracheal introducer in place, ready to guide the ETT into position. The ETT being threaded on to the tracheal introducer. Securing the tube in position using bandage material, and with capnography readings to confirm its position.
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7.16 Intubation using an ETT in an African grey parrot (Courtesy of Kevin Eatwell) and an eagle owl.
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7.17 An example of an anaesthetic and recovery record for exotic and wildlife patients.
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7.18 An anaesthetized peach-faced lovebird having its heart rate monitored by a flexible transducer Doppler probe. Note the position of the bird in dorsal recumbency, as opposed to the preferred lateral recumbency, owing to the nature of the surgical site over the keel.
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7.19 An intubated and recovering spur-thighed tortoise having its heart rate monitored using a rigid Doppler probe placed at the thoracic inlet. (Courtesy of Kevin Eatwell)
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7.20 Monitoring biological parameters during the initial recovery stages in a rabbit immediately following surgery. The rabbit is still intubated, is in sternal recumbency and the chest has been slightly raised. This photo shows the continued use of capnography, thermometer probes and heart rate monitor (Doppler), with the option of IPPV (via ventilator or breathing circuit) should the rabbit become apnoeic. Rapid/sudden recoveries are not uncommon and an anaesthetist/assistant should place a hand on the rabbit until it is extubated and has been secured in an incubator or cage.
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7.21 Using a pulse oximeter, Doppler ultrasound probe and long thermometer probe during endoscopy of a lovebird where access to the patient is limited.
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7.22 Blood pressure monitoring of an anaesthetized ferret using the forelimb. Measuring the blood pressure of an eagle owl using a Doppler ultrasound probe and sphygmomanometer.
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7.24 Corneal reflex testing in a Harris’ hawk, using a wet cotton bud.
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7.25 Sick birds can have extended recoveries, such as this African grey parrot, which is recovering from an anaesthetic in an incubator, supported in a towel in a doughnut shape. Note the jugular catheter and recovery monitoring sheet.
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7.26 Supportive nutritional and hydration therapy in various exotic species. Rabbits and chinchillas can be syringe-fed recovery formulas. Hand-feeding, such as with this marginated tortoise, can also be an effective, yet simple, technique. The flexibility and reasonably non-invasive extension adaptors that can be attached to intravenous catheters allow fluid therapy to be administered with relatively little disturbance to the patient, even while it is being tempted to eat some parsley.
Image of A cornsnake drinking water from a bowl while recovering from an anaesthetic.
A cornsnake drinking water from a bowl while recovering from an anaesthetic. A cornsnake drinking water from a bowl while recovering from an anaesthetic.
Image of A cornsnake in the initial stages of recovery following an anaesthetic. Snakes can be gently heated up using a hairdryer, but a hand should be placed in the line of the airflow to ensure overheating or burns do not occur.
A cornsnake in the initial stages of recovery following an anaesthetic. Snakes can be gently heated up using a hairdryer, but a hand should be placed in the line of the airflow to ensure overheating or burns do not occur. A cornsnake in the initial stages of recovery following an anaesthetic. Snakes can be gently heated up using a hairdryer, but a hand should be placed in the line of the airflow to ensure overheating or burns do not occur.
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7.28 The emergency kit should contain all emergency drugs and equipment required for anaesthesia.
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7.32 A rat in recovery in an incubator having its temperature assessed.
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7.33 Abdominal discomfort in a rabbit patient suffering from gut stasis and gastric bloat. Note the upright, hunched or tense posture.
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7.34 Visual signs of pain in a tortoise. Note retraction of the head and limbs tucked up against the body. (Courtesy of Matthew Rendle)
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