Anesthesia and Surgical Nursing for Veterinary Technicians

Anesthesia and Surgical Nursing for Veterinary Technicians
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Question One
Surgical procedures are usually very painful and it is almost impossible for patients being operated to stay still or remain calm throughout the whole ordeal. It is based on that fact that anesthetics were developed to help patients. Anesthetics are administered to numb particular parts that are being operated or to put the patients in medically induced coma to allow surgeons to operate on patients without any discomfort or constant irritation. It is essential to note that anesthetics are administered either intravenously or inhaled. Intravenous anesthetics are mostly preferred because their reaction is quick as it takes about 20 seconds compared to inhaled anesthetic agents. Anderson et al. (2014) reiterates that position and shares that “Intravenous anesthetics are a group of fast-acting compounds that are used to induce a state of impaired awareness or complete sedation”. There are several types of injectable anesthetics used by surgeons worldwide and which also have various side effects.
Propofol: It is identified by other names including Diprivan and milk of amnesia. It is an anesthetic that is commonly used for induction and sedation in ICU because it reacts very fast and allows surgeons to operate without any challenges. It usually results in not only decreased levels of consciousness but also lack of memory of the events that transpired. It is estimated that the above effects take about two minutes after it has been administered and last 5 to 10 minutes. Nonetheless, propofol also has several side effects including irregular heartbeat and low blood pressure (Anderson et al., 2014). In some cases, the administration of propofol has resulted in seizures and infections. Overuse of the drug causes addiction and propofol infused syndrome.
Etomidate: According to Talaat & El-Azzazi (2014), “it is an intravenous anesthetic used by patients with hemodynamic instability. It is deemed to be the only IV anesthetic that does not affect the cardiovascular system. It is used to sedate patients for short procedures such as reduction of dislocated joints and electroconvulsive therapy. Medical reports have shared that continuous infusion of etomidate usually leads to adrenal suppression and adrenocortical dysfunction. Patients exposed to the anesthetic for more than 5 days are likely to die from infections such as pneumonia. It is also associated with severe cases of nausea and vomiting after the operations.
Ketamine: It is an anesthetic that induces a trance-like state in patients, sedates them and offers pain relief from the surgical procedures. Talaat & El-Azzazi (2014) share that “ketamine plays a key role in emergency medicine because of its strong dissociative, sympathomimetic, and analgesic effects”. It is used mostly for short painful procedures such as fracture reduction. Ketamine has several side effects including high blood pressure, hallucinations, muscle tremors and agitation among others. There are also instances patients have reported rashes at the injection sites and dependence particularly after long-term use.
Question Two
Castration of horses is not an easy procedure and veterinarians have to be tactful to get the job done properly. Veterinarians have different medical procedures that they employ during castration and in some cases, there are those that may require to perform the surgery with the horse in lateral recumbency and using a “triple dip”. Nonetheless, they are mandated and obligated to ensure that whichever procedure they use is safe and painless to the animals.
Preparation of the Horse: It is highly essential to ensure that the horse is rested and comfortable before performing the procedure to avoid agitating the animal and causing adverse complications. The horse undergoing surgery should be fasted overnight but provided with water until the point of sedation. The surgical site which is the region surrounding the testes is clipped of hair to ensure proper visibility during the surgery. Furthermore, it is vital to assess physiological values such as heart and respiratory rates to ensure that the horse is of good health. These vital signs are assessed or determined with the horse in standing position and before they were administered with sedatives. The vitals are also determined again once the horse has been placed lateral recumbency and a few minutes after the administration of anesthetics. It is also important to assess the vitals during the removal of the each testis and when the wound is being closed up.
Site Selection: Considering that the surgical procedure is a castration, the injection site should be the area around the testes. Since at least three anesthetic injections will be administered to sedate the animal, it is recommended that they are injected on either side of the testes, that is, one on the left and the other on the right then the last one above the testes. The initiative will ensure that a vast region around the testes is numbed and as such, the horse won’t be in any pain or discomfort during the surgical procedure. It is also vital to ensure that the site is free of any hair or fur that will impede the visibility of the surgeon.
Induction Agents: For castration surgical procedures, a local anesthetic called lidocaine is recommended because it works effectively in blocking nerve signals in the body and around the testes regions. According to Talaat & El-Azzazi (2014), “lidocaine HCL should be divided into three equal doses and administered by the surgeon into each testis, and then, subcutaneously, on the midline, cranially to the scrotum. Testicular injections were made by inserting a 25-gauge, 16-mm needle at the median raphe and then directing the needle, from its subcutaneous location into the parenchyma of each testis without withdrawing the needle through the skin between injections”. It is essential to ensure that the lidocaine is administered in the right dosage because any excessive amounts can have fatal side effects on the horse. It is also vital to determine whether the horse is allergic to any type of sedative and anesthetic.
Maintenance and recovery: The open castration was performed with the horse in lateral recumbency and using a prescrotal approach. With the lateral recumbency positioning, the upper pelvic limb of the horse will be elevated in a flexed position. The move provides the surgeon with more room to conduct the surgical procedure and to complete the operation in record time. It also limits any movements ...