Marcel Perret-Gentil, DVM, MS University Veterinarian & Director Laboratory Animal Resources Center The University of Texas at San Antonio

Similar documents
Anesthesia Types in Rodents. Injectable or Inhalation Anesthesia? Why Anesthetize an Animal. Injectable Anesthetics - Disadvantages

Inhalational Anesthesia. Munir Gharaibeh, MD, PhD, MHPE School of Medicine The University of Jordan February, 2018

General Anesthesia. Mohamed A. Yaseen

Pharmacology: Inhalation Anesthetics

INHALATION AGENTS 2013/05/28 1

ISPUB.COM. Review Of Currently Used Inhalation Anesthetics: Part II. O Wenker SIDE EFFECTS OF INHALED ANESTHETICS CARDIOVASCULAR SYSTEM

Chapter 25. General Anesthetics

Physiological normal values (Depends on age, strain, health status, type of anesthesia, etc.)

General anesthesia. No single drug capable of achieving these effects both safely and effectively.

Environmental Health & Safety Policy Manual

Pharmacokinetics. Inhalational Agents. Uptake and Distribution

Inhalation anesthesia. Somchai Wongpunkamol,MD Anes., CMU

ANESTHETIZING DISEASED PATIENTS: URINARY; NEUROLOGICAL; TRAUMATIZED

INHALATIONAL ANESTHETICS Nitrous Oxide (N 2 O)

General Anesthesia. My goal in general anesthesia is to stop all of these in the picture above (motor reflexes, pain and autonomic reflexes).

Volatile Anaesthetic Agents (Basic Principles)

Surgical Care at the District Hospital. EMERGENCY & ESSENTIAL SURGICAL CARE

May 2013 Anesthetics SLOs Page 1 of 5

General anesthetics. Dr. Shamil AL-Noaimy Lecturer of Pharmacology Dept. of Pharmacology College of Medicine

Anesthesia Monitoring. D. J. McMahon rev cewood

General Anesthetics. General Anesthesia Characteristics. Balanced Anesthesia. Types of General Anesthetics. Four Stages of Anesthesia

PCTH General Anaesthetics Nov 5 th 2013 (9:30-10:50) Location Woodward 6

PARACOD Tablets (Paracetamol + Codeine phosphate)

ISPUB.COM. Review Of Currently Used Inhalation Anesthetics: Part I. O Wenker INTRODUCTION HISTORY

Frederic J., Gerges MD. Ghassan E. Kanazi MD., Sama, I. Jabbour-Khoury MD. Review article from Journal of clinical anesthesia 2006.

Caveat. 1. All procedures performed on animals at UTSA must receive prior IACUC approval, including those described in this guideline.

Properties of Sevoflurane: Properties of Sevoflurane:

Acute Pain Management in Children an update

Pain & Sedation Management in PICU. Marut Chantra, M.D.

University of Utah Cases Expert Opinion of Dr. Ingrid Taylor, DVM

Chapter 19. Media Directory. Topical (Surface) Anesthesia. Spinal Anesthesia. Nerve-Block Anesthesia. Infiltration (Field-Block) Anesthesia

General Anesthetics Pharmacology

Core Safety Profile. Pharmaceutical form(s)/strength: 5mg/ml and 25 mg/ml, Solution for injection, IM/IV FI/H/PSUR/0010/002 Date of FAR:

1. IDENTIFICATION OF SUBSTANCE OXYMETAZOLINE & TETRACAINE TOPICAL Name: SOLUTION

Neuromuscular Blocking Agents

Feline Anesthesia Fluid Therapy Treatment of Anesthetic Complications

Anesthesia and Mitochondrial Cytopathies Bruce H. Cohen, MD, John Shoffner, MD, Glenn DeBoer, MD United Mitochondrial Disease Foundation, 1998

1. IDENTIFICATION OF SUBSTANCE PODOPHYLLUM RESIN 25-50% IN BENZOIN Name: TINCTURE

Overview. Normally, the process is completely reversible.

Anesthesia Monitoring

CHAPTER 11. General and Local Anesthetics. Anesthetics. Anesthesia. Eliza Rivera-Mitu, RN, MSN NDEG 26 A

PCTH 400 Systematic Pharmacology

General OR Rotations GOALS & OBJECTIVES

Results of a one-year, retrospective medication use evaluation. Joseph Ladd, PharmD PGY-1 Pharmacy Resident BHSF Homestead Hospital

Agency 71. Kansas Dental Board (Authorized by K.S.A and (Authorized by K.S.A and

Chapter 24 Vital Signs. Copyright 2011 Wolters Kluwer Health Lippincott Williams & Wilkins

NEONATAL RODENTS SURVIVAL SURGERY

DRUGS THAT ACT IN THE CNS

ANNEX I SUMMARY OF PRODUCT CHARACTERISTICS

WARNING! FLAMMABLE. Keep away from open flame. WARNING! IRRITANT. May be irritating to skin and mucous membranes.

Goals for sedation during mechanical ventilation

Sedation For Cardiac Procedures A Review of

Pet owners are often very anxious about veterinary procedures that involve anesthesia. This handout attempts to alleviate some of these concerns.

8/20/12. Discuss the importance of thermoregulation in the neonate.

MATERIAL SAFETY DATA SHEET Sodium Lignosulfonate

F Br F C C H. F Cl Halothane

Special Topic: Drugs and the Mind

Material Safety Data Sheet This MSDS is prepared in accordance with OSHA 29 CFR

Optimal sedation and management of anxiety in patients undergoing endobronchial ultrasound (EBUS)

Material Safety Data Sheet According to ISO Page 1 of 6

Safety Data Sheet. Product Name: Product Number: Product Identity. 2. Hazardous Ingredients. Formaldehyde: CAS: Methanol: CAS:

Poison (Toxicant): any substance or agent capable of producing a deleterious response in a biological system or living organism.

DEEP SEDATION TEST QUESTIONS

Subspecialty Rotation: Anesthesia

Hazards in Healthcare

Proceedings of the 36th World Small Animal Veterinary Congress WSAVA

Advanced Medical Care: Improving Veterinary Anesthesia. Advanced Medical Care: Improving Veterinary Anesthesia

Physiology and Pharmacology

MATERIAL SAFETY DATA SHEET

January 27, 1992 to November 26, A total of 120 patients (60/site) were enrolled in the study as follows: PATIENT ENROLLMENT

Material Safety Data Sheet According to ISO Page 1 of 5 ; 1. IDENTIFICATION OF SUBSTANCE

Indications. Physical Properties of Nitrous Oxide. Nitrous Oxide/Oxygen Conscious Sedation in the Pediatric Patient. Steven Chussid, D.D.S.

MATERIAL SAFETY DATA SHEET

Anesthesia Final Exam

Anesthesia For The Elderly. Yasser Sakawi, M.D. Associate Professor Anesthesiology Department

Be courteous to your classmates! Please set your cell phones and/or pagers to silent or turn them off.

ANNEX III LABELLING AND PACKAGE LEAFLET

Anesthetic Gases in Veterinary Clinics

Malignant Hyperthermia: What the ICU Needs to Know

Control of Respiration

Introduction1. Introduction2. Introduction3. Thermoregulation2. Thermoregulation1

ANAESTHESIA EDY SUWARSO

Proceedings of the World Small Animal Veterinary Association Sydney, Australia 2007

It does not contain all the available information. It does not take the place of talking to your doctor or pharmacist.

Inhalational Anaesthetic Agents

Multi-center (5 centers); United States and Canada. September 10, 1992 to April 9, 1993

HOW LOW CAN YOU GO? HYPOTENSION AND THE ANESTHETIZED PATIENT.

BIPN100 F15 Human Physiol I (Kristan) Lecture 14 Cardiovascular control mechanisms p. 1

MATERIAL SAFETY DATA SHEET

ANESTHESIA EXAM (four week rotation)

Naloxone Intranasal EMT OPTIONAL SKILL. Cell Phones and Pagers. Course Outline 09/2017

The use of laryngeal mask airway in dental treatment during sevoflurane deep sedation

Material Safety Data Sheet CISPLATIN INJECTION SECTION 2 COMPOSITION, INFORMATION ON INGREDIENTS

Pheochromocytoma: Effects of Catecholamines

Capnography: The Most Vital Sign

Research Anesthesia Skills

MATERIAL SAFETY DATA SHEET

Research Technical Note

Material Safety Data Sheet 47Industrial Park, Lilydale, Victoria 3140 Phone: Fax:

Procedural Sedation. Conscious Sedation AAP Sedation Guidelines: Disclosures. What does it mean for my practice? We have no disclosures

Transcription:

Marcel Perret-Gentil, DVM, MS University Veterinarian & Director Laboratory Animal Resources Center The University of Texas at San Antonio marcel.perret@utsa.edu

Anesthesia Types in Rodents Injectable (e.g. ketamine cocktails) Volatile gas (e.g. isoflurane) Physical (e.g. hypothermia)

Why Anesthetize an Animal 1 or more reasons: Avoid pain (loss of sensation) Immobilize (muscle relaxation) Avoid distress (loss of consciousness)

Injectable or Inhalation Anesthesia?

Injectable Anesthetics - Advantages Simple Cheap Minimal equipment Many routes (IM, SQ, IP, IV)

Injectable Anesthetics - Disadvantages Higher morbidity & mortality when compared to inhalants Easier to overdose Slow and variable absorption Longer recovery times Variable effects from a single dose Strain and gender differences

Lovell, 1986b Pentobarbital 60 mg/kg

Rats

Inhalant Anesthetics - Advantages Usually suitable as sole agents to reach balanced anesthesia Loss of sensation Loss of consciousness Muscle relaxation

Inhalant Anesthetics - Advantages Precise control over anesthetic depth Rapid recovery Delivery of agents usually involves oxygen Greater consistency between strains and genders = experimental consistency

Inhalant Anesthetics - Disadvantages Anesthetic delivery system - $ but eventually cheaper Requires a scavenging system Requires yearly calibration (unless otherwise specified by manufacturer)

Volatile Anesthetics Ether Halothane Methoxyflurane Enflurane Isoflurane Desflurane Sevoflurane

Isoflurane Decreases rate of production of cerebrospinal fluid (CSF) while increasing the rate of its absorption Most commonly used gas anesthesia in rodents

Isoflurane - Advantages Rapid induction & recovery Can manipulate depth of anesthesia easily & rapidly Non-irritant, non-explosive & nonflammable Main advantage: Nearly 100% eliminated in exhaled air minimal interference in drug metabolism Inexpensive eventually

Isoflurane - Disadvantages Some respiratory depression but cardiovascular (CV) depression is minimal Pungent odor may lead to breath holding in rabbits, but does not appear to be a problem in other spp Decreases CSF production / increases CSF absorption A factor in central nervous system (CNS) studies???

Sevoflurane - Advantages Rapid induction & recovery Major advantage: Nonirritating to airways and well accepted, lending itself to mask or chamber inductions Becoming increasingly more popular in rodents

Sevoflurane - Disadvantages Undergoes slightly greater hepatic metabolism than isoflurane Cost has been higher than isoflurane but price coming down now that it is off patent (generics)

Anesthetic Gas Recovery as Metabolite 1 Methoxyflurane: 50% Halothane: 20-25% Sevoflurane: 2-5% Enflurane: 2.4% Isoflurane: 0.17% Desflurane: 0.02-0.2% 1 Humans

Somnosuite (Kent Scientific) Integrated digital vaporizer Pre-warmed isoflurane gas Tissue oxygen-hemoglobin concentration (SpO 2 ) Heart rate Respiration rate Ventilator

Somnosuite 6 lbs Warm gas Typical Anesthesia System 30+ lbs Cold gas

The Savings Somnosuite Traditional Isoflurane 1 Waste Gas Canister Isoflurane 38 Waste Gas Canister 1:38 9 1:36 325

Physiosuite (Kent Scientific) Homeothermic (warms rodent at exact temp through far infrared warming that goes beyond cutaneous warming by heating deep into rodent s body with temp feedback) Pulse Oximeter and Heart Rate Automatic Ventilator (ventilate animals from 3g to 500g, enter weight and press run) End Tidal CO 2 Monitor

Open Drop Pathology cassette with isoflurane or sevoflurane soaked material Centrifuge tube Depth of anesthesia can be controlled by moving the nose cone closer or farther away from the nostrils Wire or plastic grate Absorbent material soaked with anesthetic

Open Drop Used for short term anesthesia (vs. calibrated vaporizer) Prolonged use = deaths

Open Drop Formula Approximate Volume of liquid agent/ concentration of 1000 ml chamber volume isoflurane 0.05 ml 1% 0.1 ml 2% 0.2 ml 4% 0.3 ml 6% Replenish isoflurane every 3 mice Emory University

Pentobarbital - Advantages Placental transfer of barbiturates occurs rapidly. However, when used in proper induction doses, excessive depression of the fetus does not occur Administered IV or IP Neither hepato- or nephrotoxic

Pentobarbital - Disadvantages Pharmaceutical grade very pricey High cost renders it unavailable in pharm grade *** Chemical grade use must be addressed & justified *** NIH statement 2013

Pentobarbital - Disadvantages Prolonged recovery esp. if additional doses administered Severe CV & resp depression Anesthetic & lethal doses close to each other high mortality possible

Ketamine Exact mechanism of action not established Thought to be a specific antagonist of N-methyl- D-aspartate glutamate receptors (NMDA) "Cocaine-like" effect in that it inhibits uptake of catecholamines into postganglionic sympathetic nerves Cleared by hepatic metabolism Alone it is a poor anesthetic and analgesic in rodents (when used alone) must be used with other agents ( cocktail )

Ketamine CV effects resemble sympathetic nervous stimulation - i.e. increased arterial BP, HR, CO, cardiac workload & myocardial oxygen consumption Such effects obtunded by prior or coadministration of tranquilizers or sedatives ( cocktail ) Transient increase of norepinephrine & epinephrine in plasma

Ketamine - Advantages In hypovolemic patients, arterial BP is maintained with ketamine because of peripheral vasoconstriction No significant effect on hepatic or renal function Useful in cocktail preps with sedatives & tranquilizers Increases myocardial contractility

Ketamine - Disadvantages Increased airway & salivary secretions in some species (mild in mice & rats) Induces epileptiform bursts in thalamus & limbic system, but w/o spread to cortical areas may increase seizure threshold in rats & mice Some respiratory depression following anesthetic doses in rodents

Ketamine Cocktails Safer, more balanced anesthesia than pentobarbital or ketamine alone Ketamine/xylazine Ketamine/dexmedetomidine Ketamine/xylazine/acepromazine Other combinations

Ketamine Cocktail Reversal Antagonist atipamezole shortens recovery of ketamine/xylazine & ketamine/dexmedetomidine Atipamezole (0.5-1 mg/kg SC, IP, IM, IV) partially reverses xylazine & dexmedetomidine (not ketamine) Early reversal (10 20 minutes after induction) associated with undesirable behavioral disturbances due to effects of ketamine

Ketamine Cocktails Use of yohimbine for reversal of ketamine/xylazine no longer recommended due to yohimbine s reported side effects For cocktail doses refer to http://vpr.utsa.edu/files/larc/rodentsurgeryap plicationhandouts.pdf

Avertin Combination of 2,2,2 tribromethanol & tertiary amyl alcohol (amylene hydrate) Adequate anesthesia up to 30 min Repeat doses not recommended due to abdominal irritation & peritonitis reports Degrades in presence of heat or light refrigerate, wrap in foil Non-pharmaceutical grade compound

Urethane Ethyl ester of carbamic acid

Urethane - Advantages IP Administration results in long-lasting unconsciousness of 6-10 hr Respiratory & cardiopulmonary functions minimally affected, including blood pressure due to effects on catecholamine release Good analgesia for surgery in rodents

Urethane - Disadvantages Peritoneal effusion & hemolysis Mutagen/carcinogen Readily absorbed through skin pre-neoplastic changes in skin targets multiple organs suppresses bone marrow readily crosses the placenta fetal tumor formation (in utero)

Urethane - Disadvantages Strict guidelines (gloves, mask, prepare in fume hood) Requires safety approval Non-pharmaceutical grade compound Not used for survival surgeries

Resources Presentations, References & Useful Notes http://research.utsa.edu/researchfunding/laboratory-animal-resourcescenter/training/

Marcel Perret-Gentil, DVM, MS University Veterinarian & Director Laboratory Animal Resources Center (LARC) The University of Texas at San Antonio San Antonio, Texas marcel.perret@utsa.edu http://research.utsa.edu/researchfunding/laboratory-animalresources-center/