Calculation of veterinary medications, with the data of the case (you have to look for the concentration of the medications mentioned) can be found in the photos of the medications or in the Plumbs.
Calculation of veterinary medications, with the data of the case (you have to look for the concentration of the medications mentioned) can be found in the photos of the medications or in the Plumbs.
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Calculation of veterinary medications, with the data of the case (you have to look for the concentration of the medications mentioned) can be found in the photos of the medications or in the Plumbs.
Transcribed Image Text:What would be your anesthetic approach for the surgery in the case described?
In the case presented, premedication consisted of intravenous (IV) administration of 0.2 mg/kg of
methadone (Senfortan, Dechra, AE Bladel). Prior to anesthetic induction, the patient was
preoxygenated for 5 minutes with a 100% oxygen flow of 200 mL/kg/min. After induction, carried out
with propofol (3 mg/kg; Propofol lipuro, B. Braun, Melsungen) and midazolam (0.3 mg/kg; Midazolam
B. Braun, B. Braun, Melsungen) IV, orotracheal intubation of the patient with a 9 mm internal diameter
endotracheal tube. Anesthetic maintenance was performed with isoflurane (Isoflo, Zoetis, Louvain-la-
Nouve) and a fresh gas flow of 20 mL/kg/min. FiO2 was maintained at 0.4 throughout the anesthetic
procedure, maintaining an SpO2 greater than 97%. A fluid therapy regimen was established with
lactated Ringer's and an infusion rate of 5 mL/kg/h. The patient was mechanically ventilated in volume
control mode with a Tidal volume of 15 mL/kg and a respiratory rate of 14-18 rpm, which allowed
EtCO2 levels to be maintained between 35 and 45 mm Hg, and a PEEP of 4 was established. cm of
H20. The driving pressure was maintained between 10 and 12 cm H20 throughout the procedure. As
part of a multimodal anesthetic approach, a bilateral quadratus lumborum plane block was performed
at the level of L1. Anesthetic monitoring included heart rate (HR), respiratory rate (RR), invasive blood
pressure (BP) by catheterization of a dorsal pedal artery, SpO2, EtISO and EtCO2. These parameters
were recorded immediately before starting the surgical stimulus and, once surgery began, every 5
minutes. The anesthetic record was divided into the following phases: skin incision, removal of the
abdominal mass, removal of the gastric mass, partial hepatectomy and synthesis of the laparotomy. It
was established that, with the patient in an adequate plane of unconsciousness, a 20% increase in
mean HR, RR and/or BP with respect to preincisional levels would involve the administration of rescue
analgesia with fentanyl (Fentanest, Kern Pharma, Terrassa ) IV (3 µg/kg).
During surgery, HR was maintained at values between 120 and 127 bpm, RR between 14 and 18 rpm,
and mean BP between 77 and 91 mmHg. Administration of fentanyl was not necessary during surgery.
EtISO levels were maintained between 0.88 and 1.01%. The anesthetic time was approximately 1 hour,
while the surgery lasted 45 minutes.
M
Expert Solution
Step 1: Preanesthetic Assessment
The first step in any anesthetic procedure is a thorough preanesthetic assessment. This includes a complete physical examination and evaluation of the patient’s medical history. In this case, the patient was premedicated with methadone.
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