Manual of Equine Anesthesia and Analgesia. Группа авторов

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Patient Preparation

       Tanya Duke‐Novakovski

      I Preparation of the horse

      A Evaluation

       History and physical examination findings help with evaluation of health.

       Many emergency cases, especially intestinal emergencies, are in cardiovascular shock and must be stabilized as much as possible prior to induction of anesthesia.

      B Laboratory tests

       In normal horses undergoing elective surgery, there is generally no value in performing extensive laboratory tests.

       In emergency cases, performing laboratory tests such as electrolyte and metabolic acid‐base status may be vital to the management of the case (e.g. a foal with uroabdomen).

      C Physical examination

       During the examination, attention should be directed to the neurological, cardiovascular, and respiratory systems.

       Musculoskeletal problems, which may affect recovery, should be considered, and a plan should be made to assist recovery if deemed necessary.

      D History

       May reveal information that affects case management.

       A recent history of coughing may indicate a viral infection of the airway, in which case elective surgeries should be postponed until one month following resolution of clinical signs.

       Owners might report that the horse previously had a “bad” or “over” reaction to an anesthetic or sedative drug. These concerns should be investigated.

      E Fasting

       Fasting (~12 hours) was previously advised because of the potential benefits for lung function and the reduced risk of stomach rupture from trauma at induction or recovery.

       Many equine hospitals do not fast horses prior to elective surgery. In one study, the PaO2 values during anesthesia were not significantly better in fasted versus non‐fasted horses, and not fasting might reduce the incidence of postanesthetic colic due to changes in gastrointestinal motility.

       However, it is generally the case that grain is removed.

       Water should be made available up to the time of surgery.

F Medications

       It is best to administer all ancillary drugs (e.g. antimicrobials, anti‐inflammatories) prior to sedation. Sodium penicillin can reduce systolic arterial pressure by 8–15 mmHg in anesthetized horses. If antimicrobials are administered during the anesthetic event, this effect can be minimized by administering the drug slowly.

      G Jugular catheter

       An intravenous (IV) catheter should always be placed prior to anesthesia.

       This reduces the likelihood of perivascular injection and provides ready access for further IV anesthetic or emergency drugs.

      H Flushing the oral cavity

       It is important to flush food debris from the oral cavity, especially if the airway is to be intubated (see Figure 1.1).

      I Removal of shoes

       Removal of shoes prevents damage to the horse and hospital flooring.However, removal of shoes is not popular with owners. An alternative is to apply bandage material or tape to improve grip and to cover metal points.

       Certainly, loose shoes and nails