html5-img
1 / 34

Bovine Surgical Procedures Key Terms : Casting, Cosmetic Dehorning, Hemostasis, Horn Button, Myiasis, Scur, Supernumerar

Chapter 12. Bovine Surgical Procedures Key Terms : Casting, Cosmetic Dehorning, Hemostasis, Horn Button, Myiasis, Scur, Supernumerary teats, tipping. Objectives. differences between standing surgical procedures vs. general anesthesia procedures. Prepare a patient for surgery.

alannis
Télécharger la présentation

Bovine Surgical Procedures Key Terms : Casting, Cosmetic Dehorning, Hemostasis, Horn Button, Myiasis, Scur, Supernumerar

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Chapter 12 Bovine Surgical Procedures Key Terms: Casting, Cosmetic Dehorning, Hemostasis, Horn Button, Myiasis, Scur, Supernumerary teats, tipping

  2. Objectives differences between standing surgical procedures vs. general anesthesia procedures. Prepare a patient for surgery. Assist and/or perform induction and maintenance of anesthesia. Provide anesthetic monitoring. Manage the patient during recovery and immediate postoperative periods. Understand the basic risks and possible complications associated with anesthesia and surgery, and implement preventive measures when indicated.

  3. Bovine Surgery Chapter 12: Bovine Surgery • Valuable animals • High producing dairy female • Registered breeding stock • Pet animals Jan 2010: A two-year-old Aberdeen-Angus bull has been sold to an American buyer for what is believed to be a UK record price of 75,000gns

  4. Bovine Surgery • Standing • Lacerations/ punctures • Castration, c-section • LDA/ RDA • Enucelation, dehorning • Distal limb injuries • General anesthesia • Heavy sedation and casting • Limbs and feet After opening the sterile pack of surgical supplies and draping the cow, the patient is ready for a standing cesarean section via the left flank Utrecht (1975)

  5. LDA • Rumen • inspection, palpation • auscult – frequency & character • Ping (fluid-gas) • Abomasum: LDA • Rumen: normal unless otherwise (palpate for rumen) • 1-3/minute • 1º rumen/reticulum • 2º rumen only

  6. Preparation for Bovine Surgery • Facility: clean, dry and draft free • Sedation/ tranquilizers • Depress GI motility > bloat/ ruminaltympany • Regurgitation • Withdraw food: 12 – 24 hours • Withdrawal water: 6 hours • Local anesthesia/ blocks: in addition to sedatives • L Block, paravertebral block, cornual nerve block, IV regional analgesia, caudal epidural analgesia

  7. Preparation for Bovine Surgery • Local Block Drugs • Lidocaine (cheapest and safest) • lidocaine toxicity: muscular tremors, severe depression, hypotension , occasionally convulsions • Toxic dosage: > 13cc of 2% lidocaine per 100 lb or > = 13 mg/kg • mepivacaine, bupivacaine • Withdrawal time

  8. L Block Used for standing flank laparotomies Most common Procedure Complete surgical prep. Place anesthetic in an inverted L configuration using a 18 × 1 1/2- to 3-in needle. Anesthetic is placed: SQ, muscular layers Amounts of anesthetic: 60 – 100 ml of 2% lidocaine for adult cattle Allow 10 to 15 minutes to take effect.

  9. Paravertebral Block Use To create a large flank anesthetic zone Skin to peritoneum Blocks T13, L1, and L2 Prep Surgical prep Procedure Two approaches: Dorsal and lateral

  10. Paravertebral Block (cont’d) Dorsal approach/ Farquasonor Cambridge method/ proximal paravertebral method Near the intervertebral foramina A 16- or 18-gauge needle, 3 to 6 inches in length A 18- or 20-gauge for smaller ruminants Or placement of a 14-gauge × 1-in needle first and then insert an 18-gauge needle through the 14-gauge needle Place 20 ml per injection site Use 2 to 5 ml for sheep and goats Block: skin to the peritoneum, including the longissimus muscle Can create a temporary curvature of the spine (scoliosis, because of blocking lingissimus m.) , making it difficult to close the incision

  11. Paravertebral Block (cont’d) Lateral approach/ distal paravertebral method/ Magda or Cornell method Near the tips of the transverse processes of the lumbar vertebrae A 18-gague × 1 1/2- to 3-in needle 20-22 gauge × 1 for sheep and goats Use 10 to 20 ml per injection site Use 2 to 4 ml for sheep and goats

  12. Paravertebral Block (cont’d)

  13. Cornual Nerve Block Use Desensitization of the horn and horn base Preparation Surgical preparation Procedure Cattle Goats Cornual nerve: blocked halfway between the lateral horn base and the lateral canthus of the eye, horn is continuous with frontal sinus

  14. Cornual Nerve Block (cont’d) Single nerve Amount and depth Calves: 3 to 5 ml, 1 cm Adults: 5 to 10 ml, 2.5 cm (large adults) A 18- to 20-gauge × 1 to 1 1/2-in needle Well developed horns in adults: 2nd injection on base of horn and caudal aspect under the skin

  15. Intravenous Regional Analgesia (Bier Block) IV analgesia is considered superior to local nerve blocks/ ring blocks for most surgical procedures of the distal extremities. Preparation Surgical preparation Procedure Restrain, sedate, and cast. Apply tourniquet: Padding should be in place underneath. Cotton/ foam padding For feet procedures, place at midcarpus or midtarsus. For proximal procedures, place just proximal to carpus or tarsus.

  16. Intravenous Regional Analgesia Procedure Inject IV into any large superficial vein. Dorsal metatarsal/ metacarpal vein Plantar/ palmar MT/MC vein Cattle: 18- to 20 G Small ruminants: 22- to 25 G Use 10 to 30 ml: 2% lidocaine/ mepivacaine Wait for 10 to 15 minutes. Do not leave tourniquet in place for longer than 2 hours. Slowly release tourniquet: anesthetic wear off 5 to 10 min.

  17. Caudal Epidural Analgesia Common in obstetrics and prolapses: uterus, vaginal, rectum Blocks: anus, perineum, vulva, caudal vagina,caudal aspects - thighs Preparation Surgical preparation Procedure Placement on the dorsal aspect of the tail base at the first intercoccygeal space; the sacrococcygeal space is less common Palpate tail up and down for proper placement. A 18 × 1 1/2-in needle at a 45-degree angle. Use 1 ml/100kg: 2% lidocaine, mepivacaine, xylazine Allow 10 to 20 minutes for effect; lasts 1 to 2 hours. CAUTION: can cause HL ataxia with too much anesthetic

  18. Cranial epidural: L-S space are not common: difficult to perform, posterior paralysis “splay legs”

  19. For prolonged anesthesia: small diameter epidural catheter • DA: kinking catheter/ plugged with tissue/ fibrin

  20. General Anesthesia • Anesthetic risks: uneventful recoveries • Prone to regurgitation • Aesthetic drugs relax smooth muscle • Aspiration pneumonia • Withdraw food and water • Cuffed ET tube • Quick intubation • Don’t roll ruminants Preputial surgery: http://www.drostproject.org/en_bovrep/12-56/itemtop15.html

  21. General Anesthesia (cont’d)

  22. General Anesthesia • Anesthetic risks • Prone to distention of the rumen (bloat) • Fast • Have equipment ready in case you have to treat • Prone to hypoventilation • Fast • Appropriate anesthetic depth • Compartment syndrome • Myopathy, neuropathy • Padded stall • Uneventful recoveries

  23. General Anesthesia (cont’d) Preanesthetic preparation Preanesthetic evaluation: PE Preanesthetic drugs Acepromazine : Phenothiazine derivative. Calms animal Prolonged penile relaxation 2 -4 hrs. tranquilization (not great tranquilizer) Don’t use in dehydrated patients: hypotension

  24. General Anesthesia (cont’d) Preanesthetic preparation Xylazine: use 20 mg/ml; alpha2 agonist Dosage: 0.05 – 0.1 mg/kg IV; 0.1 – 0.5 mg/kg IM Very sensitize: 1/10 dose; Hereford/ Brahman Effects: bloat, bradycardia, resp. depression, hyperglycemia (osmotic diuresis); uterine contractions (premature labor); transmammary transmission Reversal: Yohimbine, Tolazoline

  25. General Anesthesia (cont’d) Preanesthetic preparation Detomidine/ Medetomidine: alpha 2 agonists Reversal: atipemazole Anticholinergics: atropine, glycopyrrolate Antisialogues Reduce incidence of bloat

  26. General Anesthesia (cont’d) Induction Drugs: Inhalant gases (< 150 lb. face mask: halothane: 3-4%; isoflurane: 4-6%; sevoflurane: 4-6%) Thiobarbiturates: not is < 3 months, crosses placenta Ketamine: combo with xylazine or acepromazine Guaifenesin: combo as muscle relaxant; not > 5%: hemolysis; triple drip: xylazine/guaf/ketamine bit has cardio and resp .challenges Telazol: tiletamine – zolazepam; calves and small ruminants Propofol: anesthesia for 10 minutes

  27. General Anesthesia (cont’d) • DON’T USE Nitrous oxide • After induction than pass et TUBE • Direct visualization: laryngoscope, sternal recumbency: stylet • Palpation of epiglottis KNOW table 12 -1 and 12 -2

  28. General Anesthesia (cont’d) • Maintenance of anesthesia • Short: injectable drugs/ inhalants and long procedures > 60 mins. : general anesthesia • Depth • Ocular reflex: corneal reflex has to be present and palpebral reflex is delayed • Eyeball position • Light: ventromedial • Deep: central • Pupil size: mydriasis: overdose of inhalant • Muscle movement: none when scalpel is used • Monitoring of anesthesia • Ventilation • RR and tidal volume (depth): 20-40 / min. • Mm color • Blood gas monitor • Circulation • Pulse strength: coccygeal, median, auricular, femoral • Mm • CRT • HR: 60-120 bpm • BP: MAP > 70 mm Hg if less than 60 hypotension • Monitor temp.

  29. General Anesthesia (cont’d) • Fluids • IV fluids : LRS: 5-10 ml/kg/hr.; neonates may need dextrose • Oxygen supplementation • Recovery: usually eventful • Start with 100% oxygen • Sternal recumbency • Remove tube after swallowing reflex with partial cuffed ET tube

  30. References • K Holtgrew-Bohling , Large Animal Clinical Procedures for Veterinary Technicians, 2nd Edition, Mosby, 2012, ISBN: 97803223077323 • http://www.drostproject.org/ • http://www.cvmbs.colostate.edu/clinsci/callan/bovine.htm • http://www.farad.org/index.asp • http://informedfarmers.com/control-and-prevention/

More Related