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14 Cards in this Set
- Front
- Back
What are some commonly used LAs
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Lignocaine
Bupivicaine |
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How do you examine the eye in the cow and horse?
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Paralyse the eyelide to prevent closure
- Auriculopalpebral nerve block - Injection site: dorsal point on zygomatic arch - Injection site: depression caudal to ramus of mandible Desensitisation of upper eyelid - Upper eyelid sensory is supraorbital nerve, lacrimal nerve and infratrochlear nerve - Injection site for supraorbital = supraorbital foramen - Injection site for lacrimal nerve = lateral canthus - Injection site for infratrochlear nerve = medial canthus Desensitisation of lower lid - Zygomatic nerve supplies this area - Injection site = lateral aspect of ventral orbit at point where rim starts to rise towards lateral canthus |
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How do you desensitise the cornea?
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- LA = proxymethacaine
- Swabs for culture need to be taken before application of LA (kills them off) - Squeeze into eye (1-2 drops) Used for - Examination of the eye - Biopsy - Removal of FB |
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How can you enucleate the eye in cows and horses?
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- Perform a retrobulbar nerve anaesthesia
- Requires a curved needle - Injection site = 2-3cm lateral to lateral canthus and direct needle ventrally and medially |
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How do you dehorn goats and cows?
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- 2 nerves that need to be blocked
- The cornual branch of zygomaticotemporal nerve (corneal branch 1) - The cornual branch of infratrochlear nerve (corneal branch 2) - Branch 1 injection site = midway b/w lateral canthus of eye and lateral margin of base of horn - Branch 2 injection site = midway between medial canthus of eye and medial margin of base of horn |
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How do you anaesthetise the upper jaw in dogs and horses?
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Horses
- Infraorbital nerve at the infraorbital foramen Dogs - Infraorbital nerve (in infraorbital foramen) - In front of molar tooth - Desensitises: - upper lip, - skin of face up to infraorbital foramen, - roof of nasal cavity and teeth up to level of premolar - Can do EXTRAORALLY or INTRAORALLY - Maxillary nerve (just before entering maxilla) - Desensitises - maxilla, - upper teeth, - palate, - nose, - upper lip and - skin up to level of eye - Bend the needle - Insert site: point of entry of nerve into the maxilla - Percutaneous or intra-oral approach |
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How do you anaesthetise the lower jaw in dogs and horses?
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Horses
- Mental nerve - Will desensitise the lower lip - Insert site = mental foramen DOGS - Mental nerve - Desensitises: - manible, - lip, - teeth up to the level of the premolar teeth - Insert site = mental foramen - Mandibular nerve - Insert site = mandibular foramen (medial aspect of the mandible ventral part of ramus of mandible - Intra-oral or percutaneous approach |
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How do you anaesthetise the lower limb?
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Techniques
1. Ring block 2. Bier block 3. Specific nerve blocks Ring block - Inject 4 points around the limb Bier block - Place IV catheter - Apply tight bandage to limb starting at toes - Undo bandage - leaving a tourniquet proximally - Inject local into catheter Brachial plexus block in dog and cat - Nerves blocked: musculocutaneous, median, ulnar, radial and maxillary - desensitises forelimb up to and including the elbow - Injection site = costochondral junction of first rib |
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Describe epidural
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- Site of injection in cow and horse = sacrococcygeal space or C1-C2 interspace (caudal epidural)
- Site of injection in dog and cat = lumbosacral space (cranial epidural) Drugs used for epidural: - Local anaesthetics (all animals) - Opioids (horse, dog and cat) - Alpha 2 agonst (cow and horse) Technique in dog - Place dog in lateral or sternal recumbency - Landmarks (dorsal spinous process of L6 and L7) - Locate L7 - Locate LS space (caudaul to L7 dorsal process) and cranial to sacrum - Insert spinal needle perpendicular to skin surface - Advance slowly - Decreased in resistance = needle entering spinal canal - Hanging drop test!! - Tail twitch = in right space - Loss of anal tone = block worked - If you see blood, try again Horses and cows - Lignocaine, bupivicaine and xylazine are used for perineum, vulva, vagina and rectal procedures Horse - Morphine primarily goes to hindquarter and hindlimb Cattle - Xylazine is used for flank laparotomy |
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Discuss the use of pre-meds in the horse.
What is used? |
Acepromazine
- Sedation only - Slow onset, long duration - Uncommon to use alone - Low doses useful to use with alpha 2 agonists to improve sedation Alpha 2 agonists - Analgesia and sedation - Used in conjunction with LA - Rarely cause recumbency - Potent CV effects Opioids - Adjunct ONLY to standing sedation protocols - Combined with alpha 2 agonists - Analgesia quesitonable? - Butorphanol is used the most, then methadone (morphine) |
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When should you not perform an epidural?
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- Obese patients
- After 3 unsuccessful attempts - Skin disease - Bleeding disorders - Injury, wounds or bruising at site - Sepsis - Immuno-compromised - Anatomic abnormalities (including trauma) |
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How do the different drugs work with epidural?
What are their advantages and disadvantages? |
LAs
- Block Na channels - Loss of sensation - Rapid onset Opioids - Bind to opioid receptors - Reduces pain sensation Alpha 2 agonists - Bind to alpha 2 receptors - Loss of sensation - Slow onset - Sedation |
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What do the following desensitise?
Epidural morphine Epidural LA Epidural combination (LA and opioid) |
Morphine
- Analgesia up to and including the forelimb LA - Anaesthesia of hindquarters up to umbilicus Combination - Anaesthesia and analgesia to the hindquarter and analgesia up to and including the forequarter |
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How do you desensitise the rostral part of the face (teeth, nose, skin)
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- Infraorbital
- Mental - Maxilla |