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Hypothermia, Electro-anesthesia &  Acupuncture   MUDASIR BASHIR  MVSC SCHOLAR
Hypothermia, Electro-anesthesia &  Acupuncture   Shongsir Warson Monsang Ph. D, Scholar Hypothermia <ul><li>Artificially p...
Principle <ul><li>Body temp. falls  </li></ul><ul><li>↓ </li></ul><ul><li>Decreased metabolism  </li></ul><ul><li>↓ </li><...
<ul><li>Heart ,brain ,liver (vital organs) can survive at low temp. for a long period when deprived of blood supply </li><...
Shivering <ul><li>Imp. mechanism in protection against cold </li></ul><ul><li>Induced by ↑ temp. gradient b/w cold recepto...
Methods of whole body cooling <ul><li>1. Surface cooling  </li></ul><ul><li>By immersing the unprotected body in ice water...
2. Body cavity cooling <ul><li>By pouring cold saline soln. into the open thoracic cavity (Blades and Pierpont, 1954) </li...
3. Extracorporeal cooling <ul><li>By running blood from a cannulated artery via a heat exchanger  </li></ul><ul><li>Cold t...
Disadvantage <ul><li>Hemolysis  </li></ul><ul><li>Interference with blood coagulation mechanism </li></ul><ul><li>Thrombos...
Factors/reasons for hypothermia <ul><li>Anesthetic drugs - relaxing muscles </li></ul><ul><li>Evaporation from skin surfac...
Hazards of hypothermic anesthesia <ul><li>The circulatory system  </li></ul><ul><li>The skin & internal organs  </li></ul>...
Contd. <ul><li>Blood changes </li></ul><ul><li>↑ clotting time,↓platelets no. </li></ul><ul><li>hemoconcentration with slu...
Benefits/Uses of hypothermia <ul><li>Surgery of heart & great vessels ,brain & spinal cord  </li></ul><ul><li>Treatment of...
Induction of hypothermia in dog <ul><li>Phenothiazine tranquilizer given I/V  as preanaesthetic  </li></ul><ul><li>Thiobar...
Placement/ positioning <ul><li>Animal positioned in sink /bathtub/container with head above water </li></ul><ul><li>Electr...
Contd <ul><li>Dog is removed from bath before reaching of desired temp. </li></ul><ul><li>After removed, place in inactive...
Prevention/Treatment of hypothermia <ul><li>First – placing pads/blankets with circulating warm water or air </li></ul><ul...
<ul><li>Towels or blankets warmed in dryer and wrapped around patient to trap heat </li></ul><ul><li>Rewarm water bottle f...
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Hypothermia, Electro Anesthesia & Acu puncture ,DR.MUDASIR BASHIR

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FROM DR.MUDASIR BASHIR
VETERINAREY SURGERY AND RADIOLOGY
I.V.R.I

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Transcript of "Hypothermia, Electro Anesthesia & Acu puncture ,DR.MUDASIR BASHIR"

  1. 1. Hypothermia, Electro-anesthesia & Acupuncture MUDASIR BASHIR MVSC SCHOLAR
  2. 2. Hypothermia, Electro-anesthesia & Acupuncture Shongsir Warson Monsang Ph. D, Scholar Hypothermia <ul><li>Artificially produced in entire body or portion </li></ul><ul><li>of body such as heart and head </li></ul><ul><li>Greatest usefulness in surgery of heart </li></ul><ul><li>and CNS (Swan et al . 1953) </li></ul>“ heat loss exceeds heat production”
  3. 3. Principle <ul><li>Body temp. falls </li></ul><ul><li>↓ </li></ul><ul><li>Decreased metabolism </li></ul><ul><li>↓ </li></ul><ul><li>Decreased need of O 2 </li></ul><ul><li>Oxygen uptake reduced by 50% @ 30ºC & 65% @ 25ºC </li></ul><ul><li>Bigelow et al .(1950) </li></ul>
  4. 4. <ul><li>Heart ,brain ,liver (vital organs) can survive at low temp. for a long period when deprived of blood supply </li></ul><ul><li>Small lab animals can be cooled to below 0ºC </li></ul><ul><li>Neonates, very lean animals & geriatric animals are @ greater risks </li></ul><ul><li>Control of shivering is necessary to induce hypothermic state quickly </li></ul>
  5. 5. Shivering <ul><li>Imp. mechanism in protection against cold </li></ul><ul><li>Induced by ↑ temp. gradient b/w cold receptors in the skin & centers in the hypothalamus </li></ul><ul><li>Hypertonicity of skeletal muscles – cause ↑ </li></ul><ul><li>Metabolism /Heart rate / Resp. rate </li></ul><ul><li>Prevented by deep anaesthesia or light anaesthesia with curarization or tranquilization (phenothiazine ) </li></ul>
  6. 6. Methods of whole body cooling <ul><li>1. Surface cooling </li></ul><ul><li>By immersing the unprotected body in ice water or placing in mattress via which water is circulated </li></ul><ul><li>Hyperventilation maintained throughout procedure to keep blood pH on alkaline side </li></ul><ul><li>No anaesthesia needed below 28ºc </li></ul><ul><li>Cooling stopped when approx. ⅔ of desired temp. fall is accomplished </li></ul>
  7. 7. 2. Body cavity cooling <ul><li>By pouring cold saline soln. into the open thoracic cavity (Blades and Pierpont, 1954) </li></ul><ul><li>Disadvantage </li></ul><ul><ul><li>Slow process </li></ul></ul><ul><ul><li>Requires large volume of saline soln. </li></ul></ul>
  8. 8. 3. Extracorporeal cooling <ul><li>By running blood from a cannulated artery via a heat exchanger </li></ul><ul><li>Cold tap water is used as a cooling medium </li></ul><ul><li>Heparin used to prevent thrombosis </li></ul><ul><li>Used to lower brain temp. below normal body temp </li></ul>
  9. 9. Disadvantage <ul><li>Hemolysis </li></ul><ul><li>Interference with blood coagulation mechanism </li></ul><ul><li>Thrombosis </li></ul><ul><li>Advantage </li></ul><ul><li>Best control over body temp. </li></ul><ul><li>Rewarming carried out quickly & efficiently by running water through heat exchanger </li></ul>
  10. 10. Factors/reasons for hypothermia <ul><li>Anesthetic drugs - relaxing muscles </li></ul><ul><li>Evaporation from skin surface has cooling effects on body </li></ul><ul><li>Adm. of room temperature fluids </li></ul><ul><li>Cold gases inspired </li></ul><ul><li>Body cavity opened & internal organs exposed to ambient temperature </li></ul>
  11. 11. Hazards of hypothermic anesthesia <ul><li>The circulatory system </li></ul><ul><li>The skin & internal organs </li></ul><ul><li>The metabolism </li></ul><ul><li>The circulatory system </li></ul><ul><li>↓ BP , ↓ C.O , ↓ heart rate( depn. of SA node & bundle of His) </li></ul><ul><li>↑ Peripheral vascular resistance </li></ul><ul><li>Prolonged PR interval , ↑ST interval ,spreading of QRS complex (ECG) </li></ul>
  12. 12. Contd. <ul><li>Blood changes </li></ul><ul><li>↑ clotting time,↓platelets no. </li></ul><ul><li>hemoconcentration with sludging </li></ul><ul><li>↓ Eosinophil , leucocyte count & Mean corpuscular Hb. concentration (MCHC) </li></ul><ul><li>Knocker (1955) – damage to liver, kidneys & adrenal glands in dog @ 25ºC for hours </li></ul>
  13. 13. Benefits/Uses of hypothermia <ul><li>Surgery of heart & great vessels ,brain & spinal cord </li></ul><ul><li>Treatment of shock ,stroke ,cerebral & spinal contusion </li></ul><ul><li>Prevention of brain damage following severe hypoxic episode </li></ul><ul><li>Repair of cardiac anomalies & removal of heartworms in dogs (use not widespread) </li></ul>
  14. 14. Induction of hypothermia in dog <ul><li>Phenothiazine tranquilizer given I/V as preanaesthetic </li></ul><ul><li>Thiobarbiturate (G.A); Endotracheal catheter is inserted </li></ul><ul><li>Inhalant anaesthetic for maintainance </li></ul><ul><li>Slow I/V drip of RL / Dextrose 5% & muscle relaxant given </li></ul><ul><li>Controlled respiration is started </li></ul>
  15. 15. Placement/ positioning <ul><li>Animal positioned in sink /bathtub/container with head above water </li></ul><ul><li>Electronic thermometer is placed in eosophagus @ heart level & rectum </li></ul><ul><li>Electrodes of ECG machine attached to feet – constant monitoring required </li></ul><ul><li>Ice water used for rapid cooling </li></ul>
  16. 16. Contd <ul><li>Dog is removed from bath before reaching of desired temp. </li></ul><ul><li>After removed, place in inactive heating pad during operative period </li></ul><ul><li>Rewarming started at start of surgical wound closure </li></ul>
  17. 17. Prevention/Treatment of hypothermia <ul><li>First – placing pads/blankets with circulating warm water or air </li></ul><ul><li>Supplement – warm water bottles and bags </li></ul><ul><li>Warm s/c or i/v fluids approx. 98-99ºF </li></ul><ul><li>Water filled balloons or latex gloves used instead of bottles </li></ul>
  18. 18. <ul><li>Towels or blankets warmed in dryer and wrapped around patient to trap heat </li></ul><ul><li>Rewarm water bottle frequently </li></ul><ul><li>Cautions </li></ul><ul><li>Electric heating pad should not be used </li></ul><ul><ul><li>Severe thermal skin burn may occur </li></ul></ul><ul><ul><li>Skin sloughing can be serious complications </li></ul></ul>
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