U of MN Spay and Neuter Rotation - Anesthesia review/rules of thumb sheet-
Nov 2023
Oxygen settings- Minimum for all breathing systems is 500ml/min
Based on metabolic need: flow rate> metabolic need
DO NOT press the Oxygen Flush Valve when an animal is connected to it….high risk for
barotrauma in small patients. In this rotation, we call this the BAROTRAUMA BUTTON.
This delivers oxygen at 35-75L/min.
Oxygen Flush valve can be used to flush out gas levels into the scavenger system when
disconnected from patient or when pressure testing your machine.
We prefer to turn up the oxygen instead of using the flush valve to flush out the
gas
Circle (semi-closed) rebreathing system (Universal F-piece)
metabolic need calculation = 22-44 ml/kg/min (Avg 30ml/kg)
INDUCTION - Start at 1-3 L/min (depending on patient metabolic need)
Watch that pop-off valve remains open at all times especially at higher flows!
MAINTENANCE - 0.5L - 1L/min (based on calculated value and animal needs,
types of premedication, Sp02, EtC02 etc)
Non-rebreathing systems (Bains/Modified Jack Reese, SafeSigh)
Oxygen flow rate prevents rebreathing of CO2.
Recommended flow rate = 100-600ml/kg/min
Average 300ml/kg
Used in animals < 6 kg for UMSN rotation
INDUCTION – 1 to 1.5 L/min or calculated need
MAINTENANCE - 0.5L - 2.0 L/min (based on patient needs) ETC02 values will
help with this.
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Isoflurane settings - Average MAC in cats and dogs is 1.3% for Isoflurane
1. Isoflurane settings after INDUCTION :
Start DOGS at 1.5 to 2%
Start CATS at 0.8 %
Note: These are just starting points based on patient drug effects
following induction and/or premedication results.
Adjust according to need!
2. Start at lower Isoflurane level if animal is very deep or wait to turn gas on if
animal is apneic and/or pale.
3. MAINTENANCE- Rebreathing Circle system (1 – 2.5%)
Non-rebreathing system (1 – 2.0%)
a) Adjust gas in small increments as patient lightens or deepens by ¼ - ½ %
b) Increase Oxygen flow 2-3L/min if patient is light and VENTILATE, VENTILATE,
VENTILATE. Watch that bag does not overfill and pop-off valve is open.
c) During induction, you may give more induction agent to your patient to get to the
appropriate level of anesthesia versus increasing Isoflurane levels above 2.5 %.
d) If your patient needs a higher than 2.0 - 2.5 % of Isoflurane setting to maintain
anesthesia once surgery begins: it is best to address pain and consider opiods, splash
blocks, and/or ketamine etc. WE PREFER ISOFLURANE LEVELS BELOW 3% AT ALL TIMES
TO MINIMIZE DECREASES IN BLOOD PRESSURE.
e) Ketamine can be given IV at 0.5-1 mg/kg. Can use up to 2mg/kg for tough
cases along with an opiod. Can repeat ketamine every 15-30 mins as
needed.
Breaths- Alert staff when values are approaching below minimums.
Adult/mature---minimum 8 breaths/min Pediatric--- minimum 16 breaths/min
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a) If your animal is apneic, gently support ventilation, but keep moving (team effort),
Stimulation will help initiate spontaneous ventilation. If animal is breathing less than 4
breaths/min for adult/mature animals and less than 8 breaths a minute in pediatric, you
should ventilate the patient at 4 breaths/min. Adjust Isoflurane level !!!
b) IACUC protocol- ventilate manually if less than 8 breaths/min in animals less than 15kg,
and if less than 4 breaths/min in greater than 15kg.
c) ALWAYS assume patient is hypo-ventilating so give all patients at least 1 breath every
2-3 minutes throughout the surgery! Lungs can become atelectatic over time.
Heart Rate-
U of MN Spay and Neuter Rotation minimum values= alert staff when nearing these values:
Adult/Mature dogs: 90-100 bpm
Adult Cats: 120 bpm
Pediatric patients: 120 bpm
a) IACUC Bradycardia values=HR less than 60 bpm in patients less than 15kg, HR less than
45 bpm in patients greater than 15kg.
b) Remember to take the morning pre-anesthetic HR into consideration when deciding
whether to include Atropine for bradycardia.
c) All pediatrics will receive atropine in the Premeds. For Adults/Mature animals the
atropine is not administered unless warranted for bradycardia. We have a quick drug
chart to use to determine atropine dose.
d) Anti-cholinergics DO NOT decrease the amount of fluids produced they just make the
secretions more viscous. Doesn’t necessarily mean it is an Anti- SLUD drug.
EtC02:
Normal values: ADULTS 35-45; PEDS and patients on a non-rebreathing system 18-22 may be
normal but watch the trend (see additional information on Anesthesia resource sheet at each
anesthesia station for more information)
Blood pressure: Minimum systolic 100 mm for all ages (>200=retinal
detachment)
a) Normal systolic 100-130 mm Hg in mature animals, 70-82 mm Hg in Peds
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b) Normal diastolic 50-80 mm Hg in mature animals, 40-52 in Peds. Shoot for less than 90
in all animals.
c) MAP>60 (less than 60 there is not adequate organ perfusion/Peds can achieve this at
56-66 mm Hg.
d) If patient is hypotensive (SAP <80 or MAP < 60mmHg) please follow handout for
managing hypotension. If fluids are needed, they should be given as a bolus at 5 -
10mls/kg over 15 min in mature animals with no heart issues. We do not have inotropes
(dobutamine, dopamine, ephedrine) to increase contractility for this class.
e) Pediatric bolus fluids= 2mls/kg slowly over 15 minute for hypotension.
f) Give syringe boluses of fluid in all animals (when calculated amount is less than
25mls/hr). You are responsible for having syringes ready to go before surgery. Please
use 12 ml syringes or 6 ml syringes depending on patient size and refill syringes from
fluid bag as needed. Use new needles when drawing from fluid bag.
g) Doppler system: wait 3 minutes between multiple readings.
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