General anesthesia
Definition:
Anasthesi derived from Greek an-"no, no" and aesthētos, "perception, the ability to feel"), which generally means an act of relieving pain such as reversible amnesia, analgesia, loss of consciousness, loss of skeletal muscle reflexes and decrease the stress response and decreased respiratory and circulatory systems Cardiovascular.
General Anasthesia be applied in injection, inhalation or a combination of both.
Drugs for the relief of pain was divided into 2 groups, the analgesic and anesthetic. Analgesic pain relief is without loss of overall pain. Animals that were given analgesic remain in a conscious state. Analgesic does not always eliminate all the pain, but always relieve the pain.
Several types of anesthesia cause loss of consciousness, whereas other types only remove the pain from a particular body part and the animals remain conscious.
Some types of anesthesia are:
• general anesthesia - a total loss of consciousness
• local anesthesia - loss of feeling in certain areas you want (in a small area of the body).
• regional anesthesia - loss of feeling in part of the wider body by selective blockade of spinal or nerve tissue associated with
Anesthesia is required for many surgical procedures on animals, but it can be used also for certain diagnostic procedures such as endoscopy or abdominal respiratory tract, bone marrow sampling, and sometimes ultrasound. Aggressive animals may require anesthesia to treat and perform a physical examination and the blood-making procedures for testing, while taking X-rays (for birds or other animals are difficult to handle). Anesthesia is also required for the handling catheterization to relieve urinary obstruction, tumor biopsy, or remove fluid from the eye to treat glaucoma.
Division of anesthesia.
A. Inhalation anesthetic
Safer and more potent than the anesthetic injection, because it is very easy to control depth and residues pembiusannya expelled through your breath cure this process will reduce dependence on drugs for dimetabolis in the body, so that the process of low toxicity. Inhalation anesthetic groups, among others: Diethyl ether, Halothan, Isoflurane, Methoxyflurane, Enflurane, Sevoflurane, Desflurane, Nitrose Oxide.
B. Anesthetic injection.
Because injection of anesthetic agent is metabolized by the liver and kidneys then anesthetic injection is not recommended to be given to animals impaired kidney and liver.
The process of drug revenues through a subcutaneous injection (SC);
Intramuscular (IM) and Intravenous (IV).
The various groups who use drugs by injection / injection, among others:
• Group Barbiturates: Sodium thiopental, Sodium Thyamilal,
Pentobarbital Sodium, Methohexital.
• Group Cyclohexamine: Ketamine hydrochloride, Tiletamin and propofol.
• Group Neuroleptanalgesik.
• Group of local anesthesia: Procaine, bupivicaine, lidocaine,
Propaicaine,
Barbiturates.
a. Phenobarbital, an anesthetic that is Longest acting, its use only for sedation and antikonvulsi.
b. Phentobarbital, is short acting and used as the sole anesthetic or analgesic is given intarvena. 50-70% of injected drugs in animals will cause an instant loss of consciousness followed by a relaxation of the jaw muscles (indication for intubation) (onset) while the duration of this drug long enough to 45 to 120 minutes.
c. Thyamilal thiopental and ultra-short acting nature similar to methohexital with duration of about 15 - 20 minutes, usually used as induction drugs for intubation will be performed during inhalation anesthesia delivery.
d. The nature of this barbiturate class work is pressing the central nervous system that can be used as a drug or anastesia analgesia. Death due to provision of anesthesia in this group can not do because of serious treatment. Barbiturates will suppress mikrosomal liver enzymes and may increase the metabolic rate of other drug doses should be given attention.
e. Barbiturates less soluble in water and applied effectively only IV (and IP in laboratory animals). Because of the nature of the acid can cause irritation when injected IP, and the resulting IV injection nekrosa if its leaking / seeping.
Cyclohexamine.
Ketamine is an anesthetic and Tiletamin not suppress the central nervous system. Ketamin dosage is 100 mg / ml while Tiletamin combined with zolezepam, this drug can be applied in the IM, IV, IP and applied apaibila IM or IP will be sore. Induction of IM may take 3 to 5 minutes. Drugs can be added according to the dose given.
Patient Evaluation
Patients prior to anesthesia should be done prior examination of the age, body temperature, physical appearance and general condition. Is the age of the animal was old / young? Animals in a state of fear or not? Animals are angry / not? And others.
A veterinarian should explain openly to the owner of all securities and anastesia process, that any given drug will cause side effects in animals even worst as death from shock effects biuspun administration should be described, therefore, should vet / veterinary clinic / hospital are advised to prepare for surgery consent form as media / proof approval the owner (info concern) that it explains the side effects and operations processes to be carried out and stated that the owner has to understand all the risks that will happen.
The data from patients need to know who will be in anasthesia:
1. History of Animals
2. Complete physical examination
3. Procedural provision of anasthesia
4. Tests supporting dignostik
History of Animals
Please note whether the animal is old or not and whether've never had surgery before, whether a disease or metabolic disorder, and whether these animals are allergic to the medicine.
Physical Examination
General physical examination performed on animals include animals such conditions are overweight, kaheksia, dehydration, weakness or are pregnant. In the provision of animal fat can sometimes lead anasthesi so dyspnoe drug dosing in obese animals should be calculated based on ideal body weight is the size of the animal.
In animals that are pregnant should not be young xylazine as anasthesi or analgesi because it can cause miscarriage.
Indication of cardiovascular function can be detected by inspecting CRT (capillary Refill Time) on the mucous membranes of gums, conjunctiva, vulva or prepucium end.
Other tests are pupillary reflex (kontriksi or dilatation), heart and lungs (normal Heartbeats dog is 60 to 180 beats per minute, a small dog will be much faster than the big race. The cat 110-120 beats per minute) animal stress fear or completed training heart rate usually will be faster than normal. Pulsus can dipemeriksa through a. femoral, a.metacarpal / tarsal to determine systolic blood pressure, if the weak showing pulsusnya hypotension.
Laboratory examination
Before doing anesthesia should be performed as well as a reference laboratory for feasibility anesthetized animals.
The laboratory tests should be done; Examination CBC, Hematology, blood chemistry and urine analysis.
CBC including PCV, Hb, TPP, WBC, RBC and Platelet while blood chemistry tests including a liver function (ALT, ALP and TP), renal function (BUN, Creatinin, U), blood glucose and serum electrolytes.
Other diagnostic examination is necessary radiology and EKG.
Implementation Phase anesthesia
Pre anesthetic
Animal after clinical and laboratory examination is recommended to fast for 8 - 12 hours before giving anesthesia, this one due to the effects of drugs can cause reactions are vomiting, resulting in animals will have to choke (slick pneumonia) because the channel is blocked breathing.
Preanastesi drugs commonly given prior to anesthesia include: Acepromazine, Atropine sulfate, Xylazine, Medetomidine, Diazepam, and other agents opoid.
There is no preanastesi drugs that have no side effects. All gifts should be done after preanastesi condition inspection of animals (animal species, physical status, the temperament of animals).
Preanastesi drugs
Atropine sulfate
An anticholinergic which has the effect of the neurotransmitter receptors in suppressing acetyl alkaline. Atropine works after 20 minutes of SC injected.
Effect of atropine, among others:
- Inhibit the vagus nerve stimulation so that the effect is to accelerate the provision of employment atropine heart rate (tachycardia).
- Reduce the production of saliva.
- Reduce the gastrointestinal peristaltic activity
- It causes dilation of the pupil (mydriasis)
- Reduce the secretion of tears, so animals must be injected atropine eye ointment to prevent dry eye.
- It causes dilatation of bronchus
- Increasing production of mucus secretion in the respiratory tract (happened to the cat) would be a predisposing inhibit respiratory tract. It is therefore not advisable to give atropine in cats as preanastesi drug.
Glikopirolat is another anticholinergic drug that has effects similar to atropine only slightly tendentious glikkopirolat have the effect of tachycardia and arrhythmia than atropine, glikopirolat therefore suggested for preanastesi drug dog has the symptoms of tachycardia.
Anticholinergic drugs should not be given to the animals who have constipation or blockage of the ilium interference reduces its intestinal peristaltic reaction.
Antidota for atropine overdose is physostigmin 0:02 mg / kg or a maximum of 0.5 mg / animal injected IV and repeated every 5-10 minutes if necessary to reach a dose of 2 mg / animal.
Tranquilizer / Sedativa
Group tranquilizer drugs are the ones phenotiazine, benzodiazepines, and thiazine, working on the central nervous system that produces calmness and Tranquil, but these drugs can also cause ataxia and membrane nictitans prolapse and most of these drugs are not analgesic effect.
Group Phenotiazin is Acepromazine maleate, chlorpromazine hydrochloride, tri flupromazine HCl. Preanastesi class of drugs used was not sebgai sedation and respiratory mendepresi are having minimal effect on the heart so that it is effectively used in all animal species. Applications of SC, IM, OV (with supervision). Clinical effects of this drug class sedation, anti-vomiting, antiaritmia, antihistamines, vasodilatation of peripheral blood vessels, can cause seizures.
Group benzodiazepines are diazepam, and lorazepam midozolan. The effect of this class of drugs inhibits GABA (gamma aminobutiric acid) and inhibits neurotransmitter animals, anti-anxiety, muscle relaxation, Anticonvulsants, minimal effects on respiratory and cardiovascular systems. Not recommended to be given to newborn animals and animals suffering from liver dysfunction because this drug class is very difficult in the metabolisir by the liver.
Thiazine groups include xylazin, medetomidin, deltomidin, romitidin classified as alpha-2 adrenoreceptor agonist that stimulates the receptor alpha-2 adrenoreceptor which causes a decrease in levels of neuro norepinephrin transmission in the brain that produces the effect of sedation and analgesia, muscle relaxation occurs because of reflex inhibition in order sayaraf central (CNS).
Xylazin packaged in the form of a solution of 2% (20 mg / ml) for small animals, can be used singly or in combination with Ketamine, opoid with IM or IV application. Xylazin is Antidota yohimbine at a dose of 0.1 mg / kg of IV.
Can be applied Medetomidin IM or IV, the onset of IV 1 minute and 5 minutes if given IM, whereas the duration for 45-90 minutes. Antidota medetomidin to be given atipamezol with doses from 0.1 to 0.4 mg / kg of IM / IV.
Medetomidin combination with ketamin analgesia effect and muscle relaxation is better than the combination xylazin or ketamin with ketamin with diazepam. But it should be noted that the combination ketamin with medetomidin can cause hipoksemia, so that oxygen delivery should be performed.
Stages of anesthesia Treatment Process
To obtain a general anesthesia can be achieved by stages. The success of the treatment process of anesthesia depends on each stage:
Stage I: Induction or analgesia
At this stage the animal will experience dizziness, loss of orientation, is less sensitive to touch and pain. Sensitive to the sense of hearing voices
Stage II: Excitation
Began to experience loss of consciousness. But there is still a reflex, pupillary dilatation, there is still a patient's mouth movements such as chewing pain is still there. Irregular breathing
.
Stage III: anesthesia
Patients had lost consciousness, and reflex pain was not felt, breathing regularly, pupils and eyeballs kontriksi was spun down at this stage surgery can be done
Stage IV: Toxic
If stage III would be increased danger to the patient, the patient will collapse, breathing and heartbeat will stop and death.
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