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Spinal,epidural and caudal anesthesia [email_address]
HISTORY ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Cousins & Bridenbaugh, 3rd Edition
Current Role ,[object Object],[object Object]
Indications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contraindications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contraindications ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
Segmental level required for surgery
Segmental level required for surgery ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
 
 
 
Local Anesthetics ,[object Object],[object Object],[object Object],[object Object],[object Object]
Local Anesthetics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Local Anesthetics ,[object Object],[object Object],[object Object],[object Object],[object Object]
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Spinal anesthesia ,[object Object],[object Object]
Spinal anesthesia ,[object Object],[object Object],[object Object],[object Object]
Spinal anesthesia ,[object Object],[object Object],[object Object],[object Object]
Spinal anesthesia ,[object Object],[object Object]
Spinal anesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spinal anesthesia ,[object Object],[object Object]
Spinal anesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Spinal anesthesia ,[object Object],[object Object],[object Object]
Epidural anesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidural anesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidural anesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Epidural anesthesia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Caudal anesthesia ,[object Object],[object Object]
Caudal anesthesia
Caudal anesthesia
[object Object]
Fossum, Fundamentals of orthopedic surgery and fracture management, p. 825 Techniques in Small animal Surgery , 2 nd  Edition, 2002.  Drug Dose Onset (min) Duration (hours) Lidocaine 2% 1 ml/ 3.4 -4.5 kg 10 1-1.5  Bupivacaine (0.25 or 0.5%) preservative free 1ml/4.5kg 20-30 4.5-6 Fentanyl 0.001 mg/kg 4-10 6 Oxymorphone 0.1 mg/kg 15 10 Morphine (preservative free) 0.1 mg/kg 0.03 mg/kg (cats) 23 20 Buprenorphine 0.003-0.005 mg/kg  diluted w/saline 30 12-18
Techniques of Administration ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Needle Selection con’t… Patient size Gauge and length Alternative gauge and length Cats and small dogs 25 G; 1” 22 G; 1.5” Medium to large dogs 22 G; 2.5” 21 G; 2.5” Very fat, large or giant breed dogs 21 G; 3”
Injection/dose precautions ,[object Object],[object Object],[object Object],[object Object],[object Object]
Post injection ,[object Object],[object Object]
Agents ,[object Object],[object Object],[object Object],[object Object]
Preservatives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Local Anesthetics:  Disadvantages ,[object Object],[object Object],[object Object],[object Object]
Local Anesthetics  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Lidocaine: Dosages ,[object Object],[object Object],[object Object],[object Object]
Bupivacaine: dosages ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Duration of action ,[object Object],[object Object],[object Object],[object Object]
Toxicity  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Opioids  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Opioids mechanism of action ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Opioid Agents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Morphine ,[object Object],[object Object],[object Object],[object Object]
Other Opioid Agents ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Side Effects of Opioids ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Intrathecal Injections ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Opioids and MAC ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Synergism of Opioids and Locals ,[object Object],[object Object],[object Object],[object Object]
α 2 -agonists ,[object Object],[object Object],[object Object],[object Object]
α 2 -agonists dosages ,[object Object],[object Object],[object Object],[object Object]
Dissociatives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Combinations ,[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions ,[object Object],[object Object],[object Object]

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5 regional anesthesia

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  • 54. Fossum, Fundamentals of orthopedic surgery and fracture management, p. 825 Techniques in Small animal Surgery , 2 nd Edition, 2002. Drug Dose Onset (min) Duration (hours) Lidocaine 2% 1 ml/ 3.4 -4.5 kg 10 1-1.5 Bupivacaine (0.25 or 0.5%) preservative free 1ml/4.5kg 20-30 4.5-6 Fentanyl 0.001 mg/kg 4-10 6 Oxymorphone 0.1 mg/kg 15 10 Morphine (preservative free) 0.1 mg/kg 0.03 mg/kg (cats) 23 20 Buprenorphine 0.003-0.005 mg/kg diluted w/saline 30 12-18
  • 55.
  • 56. Needle Selection con’t… Patient size Gauge and length Alternative gauge and length Cats and small dogs 25 G; 1” 22 G; 1.5” Medium to large dogs 22 G; 2.5” 21 G; 2.5” Very fat, large or giant breed dogs 21 G; 3”
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