Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Wren — Thu, 25 Jun 2015 08:51:29 GMT

Sorry, didn't come back to this post earlier - yes, if you want actual standing sedation then CRI of detomidine in saline is used, depth of sedation controlled by rate of drip. It's not that common outside of hospitals for the very reason that the surgery that requires such lengthy sedation (eg. molar extraction, resection of 'kissing' spinous processes, ovariectomy, some fracture repair etc. etc.) is not really suited to being performed in the field.

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Beats — Tue, 23 Jun 2015 19:01:37 GMT

Thanks everyone - I'm guessing that what Michael describes might well be what it's getting at, perhaps just not that common outside fancy horse hospitals. I'll mention about the "triple-drip" anaesthetic also.

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Michael Woodhouse — Tue, 23 Jun 2015 18:00:39 GMT

I'm not a horse vet but Saunders "Equine Formulary" talks of 'detomidine drip sedation'.

Indicated for prolonged standing procedures eg frontal sinus trephine, thorocoscopy, ovariectomy.

IV cannula

Give 6 micrigrams/kg detomidine & 0.05-0.1mg/kg butorphanol.

12mg of detomidine to 500ml saline

500kg horse 4 drops per second - adjust accordingly

Pre-empt level of sedation needed as 1-2 minute lag

When adequate sedation reduce to 1-2 drops per second

Horse can leave stocks 15 mins after drip stopped.

(page 467/8 if you have the same book)

May help?

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Hannah Wynne Richards — Tue, 23 Jun 2015 16:50:25 GMT

PS to above. I always do horse castrations closed and down, giving either domosedan/butorphanol followed by ketamine (large horses) or rompun /butorphanol followed by ketamine (mountain ponies) I don't rely on it for analgesia, but immediately infuse local. This will then have taken effect by the time the colt and I are both scrubbed and prepped.

Wynne

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Hannah Wynne Richards — Tue, 23 Jun 2015 16:38:54 GMT

Beats You're obviously too young to have experienced the bad old days of neurleptanalgesia with Immobilon. I'm often accused of seeing the past through rose-tinted glasses - but definitely NOT where Immobilon was concerned. Dreadful for the animals, let alone it's potentially fatal effect on humans!

Wynne

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Hannah Wynne Richards — Tue, 23 Jun 2015 16:34:12 GMT

Is this a little too theoretical? Since all sedation/anaesthetic drugs are the veterinary surgeon's legal responsibility, then, surely, the nurse's role is monitoring depth of sedation/anaesthesia as opposed to selection of agents?

Wynne

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Beats — Tue, 23 Jun 2015 11:48:29 GMT

Does anyone do continuous infusion sedation in horses then? What about something done in referral clinics maybe then where they have a lengthy procedure to do but can be done standing if sedation kept going for long enough?

I guess I imagine a sedated horse to still be standing? it might be a typo in syllabus, but I think it mentions TIVA elsewhere and there is a section about terminology and the nurse is meant to know the difference between sedation and general anaesthesia, so I guessed I imagined that this was something that was done these days without ketamine and the horse still standing (I'm not sure I ever saw a horse made recumbent that I wouldn't have classes as anaesthesia)?

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Wren — Tue, 23 Jun 2015 11:02:57 GMT

Ditto, not something I currently use for GAs, but quite commonly used combination of the three drugs mentioned. Definitely for GA rather than standing sedation. Quite flexible and can be used in the field.

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Thomas Johnson — Tue, 23 Jun 2015 08:56:45 GMT

[quote user="Braden Collins"]

Been a lot of years since I used an infusion in a horse but used to use guafenesin, xylazine and ketamine combination. Would use it for umbilical hernia repairs and other shortish procedures.

[/quote]

We used that combination at Vet School, it was known as 'triple drip'. Induces general anaesthesia rather than sedation, can't remember the concentrations, but depth of anaesthesia could be varied by altering the drip rate.

Re: Use of continuous infusion sedation in equine practice (Veterinary Nursing Q.)

Braden Collins — Mon, 22 Jun 2015 23:50:48 GMT

Been a lot of years since I used an infusion in a horse but used to use guafenesin, xylazine and ketamine combination. Would use it for umbilical hernia repairs and other shortish procedures.