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Surgical Preparation & Anesthesia

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Surgical Preparation & Anesthesia

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Surgical Preparation & Anesthesia

  1. 1. Surgical Preparation & Anesthesia EQUINE MEDICINE
  2. 2. Patient Exam & Laboratory Evaluation  Minimum:  Basic Physical Exam  Temperament & Manageability  General CBC & Chemistry Lab Work
  3. 3. Standing Surgery  Most large animal procedures  Criteria  Safe for horse & personnel  Sick, elderly, or large animals  Cost restrictions  Drawbacks  Decreased surgeon comfort  Compromised visualization  Possible patient motion
  4. 4. Standing Surgery  Patient Preparation  Depends on procedure  Restrict feed 6-12 hr prior if possible  Site  Clean, dry, dust free  Minimize external stimuli  Instruments accessible & off ground  Pain Control  Chemical restraint  Includes systemic and local anesthesia  Post Operative Care  NPO until swallow returns  Water first  Feed 1-2 hr later (hay)  Specific care varies with procedure
  5. 5. Standing Laceration Repair
  6. 6. General Surgery  Ventilation Problems  Intestines prevent normal lung expansion  Anticholinergics  May cause ileus  Minimizing Anesthetic Time  Surgical prep/clip  IV Catheterization  Equipment & supplies  Patient positioning
  7. 7. General Surgery  Mouth Cleaning  If horse will be intubated  Contamination Prevention  Patient grooming/hooves covered  Leg Protection  Bandages or wraps  Eye Protection  Padding, halter removal, BNP in eyes  Fluid Therapy  Correct imbalances before induction, adjust throughout surgery
  8. 8. Induction & Maintenanceof General Anesthesia  Compartment Syndrome  Primary cause of post-anesthetic myopathy  Clinical Signs  Difficulty or inability to stand  Hardening of muscles  Acute renal failure  Pain response signs  Prevention  Minimize anesthetic time  Maintain blood pressure  Anesthetic depth as light as possible  Adequate padding  Position properly
  9. 9. Induction & Maintenanceof General Anesthesia  Methods of Induction  Injectable drugs/injectable drugs  Injectable drugs/gas anesthesia  Gas anesthesia/gas anesthesia  Routes of Tracheal Intubation  Orotracheal  Nasotracheal  Direct Tracheal  Anesthesia Machines  Large % rubber competes with patient  Patient Monitoring  Similar to small animals  Recovery  Most dangerous portion of surgery

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