12 Jun Local and regional anesthesia
A while ago I realized that, mainly thanks to intubation and anesthesia monitoring, anesthesia is no longer the part of my largest exotic patients’ surgery that scares me te most. As I usually tell the owners, my biggest concern is not the surgery, since with an ET tube and an IV catheter we can practically do everything for our patient: make it breathe if it’s not breathing, alter its cardiac frequency, blood pressure, etc. Worries begin when your patient must resume all the vital functions by itself: breathing, keep the heart beating at a nice pace, keep the blood pressure up, regain consciousness and eat.
At this point in the history of veterinary medicine it’s quite obvious that minimizing intraoperative pain, using low doses of anesthetics and analgesics, reducing the duration of the porcedure, and (IMO) using a careful surgical technique, leads to a faster and more pleasant (for all parts involved) recovery.
To fulfill this goal I find local and regional analgesia and anesthesia very useful techniques. Epidurals (in mammals), cranial and testicular blocks (in rabbits), or a simple incissional block allow reducing anesthetic doses (one can even remove cutaneous masses just using deep sedation), make the anesthetist life easier (has anybody found out why during surgery anesthetised rabbits always move first and then they show tachycardia?), and notably reduce postoperative recovery time.
On the last issue of Clinanesvet, which can be accessed here for free (text in spanish), I present a review of the local and regional anesthetic techniques that have been described in exotic animal medicine.