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14 Cards in this Set

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What are some commonly used LAs
Lignocaine

Bupivicaine
How do you examine the eye in the cow and horse?
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
How do you desensitise the cornea?
- 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
How can you enucleate the eye in cows and horses?
- Perform a retrobulbar nerve anaesthesia
- Requires a curved needle
- Injection site = 2-3cm lateral to lateral canthus and direct needle ventrally and medially
How do you dehorn goats and cows?
- 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
How do you anaesthetise the upper jaw in dogs and horses?
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
How do you anaesthetise the lower jaw in dogs and horses?
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
How do you anaesthetise the lower limb?
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
Describe epidural
- 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
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)
When should you not perform an epidural?
- Obese patients
- After 3 unsuccessful attempts
- Skin disease
- Bleeding disorders
- Injury, wounds or bruising at site
- Sepsis
- Immuno-compromised
- Anatomic abnormalities (including trauma)
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
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
How do you desensitise the rostral part of the face (teeth, nose, skin)
- Infraorbital
- Mental
- Maxilla