Anaesthetic complication , bradycardia

RE: Anaesthetic complication , bradycardia

janine redman — Sat, 04 Jan 2020 00:10:55 GMT

Update on this case. He came in this week . Premed with very lose dose act plus methadone with atropine. Induction with alfaxan. Maintained on isoflo . No issues and routine surgery completed

RE: Anaesthetic complication , bradycardia

Lucy Fleming — Mon, 30 Dec 2019 08:50:17 GMT

[quote userid="9440" url="~/001/veterinary-clinical/small-animal/anaesthesia/f/discussions/28755/anaesthetic-complication-bradycardia/218463"]I always do intratesticular local anyway , I have even considered it in cat castrates, what do you think ?[/quote]

I use it in dog, cat and rabbit castrates (admittedly only done about 2 rabbits since I started using it routinely) and splashed onto ovarian pedicles in spays and have found it useful

RE: Anaesthetic complication , bradycardia

Iain Richards — Mon, 30 Dec 2019 08:04:43 GMT

That's a curious one, and like others, I'm inclined to think this is just a very fit dog, whcih, once relaxed, didn't need many bpm to function. The fact that your BP is maintained is comforting. I'd be inclined to go to with atropine added to your exsiting pre-med and consider inducing with alfaxan. I was thinking about methadone/alpha -2 but that's relatively bradycardic, even with micro doses of the alpha-2. I'd be wanting a capnograph on this one!

It would be interesting to get the owner to record the heart rate when he is asleep - just looking at the chest when he is flat out.

RE: Anaesthetic complication , bradycardia

janine redman — Sun, 29 Dec 2019 23:17:12 GMT

when I qualified and for abou15 years everything got atropine , then just dogs , now just ocular surgery but it has been suggested by an eminent Anaesthetist I asked about this case

RE: Anaesthetic complication , bradycardia

janine redman — Sun, 29 Dec 2019 23:14:53 GMT

I always do intratesticular local anyway , I have even considered it in cat castrates, what do you think ?

RE: Anaesthetic complication , bradycardia

janine redman — Sun, 29 Dec 2019 23:13:09 GMT

Dog had lots of stimulation and having anaesthetised large numbers of patients , I have not had this type of reaction before. He looked dead at one point , glassy eyed, non responsive to any stimulation , weak pulse , apnoeic and no PLR. I was not going to risk an anaesthetic death for a routine procedure and he is booked in again this week. I will change the premed and the anaesthetic agent and use atropine as a premedication as well . Fingers scrossed.

RE: Anaesthetic complication , bradycardia

Lindsey Edwards — Mon, 23 Dec 2019 22:34:46 GMT

Routine latrine seems to have fallen out of favour...I think there are concerns about excess cardiac workload and more of an emphasis on balanced techniques?

RE: Anaesthetic complication , bradycardia

Michael Woodhouse — Mon, 23 Dec 2019 22:18:21 GMT

I have seen similar but would likely have pushed on with the castrate. Sounds like the propofol wore off and he woke up. Some additional stimulation from clipping/moving/castration would have likely brought HR up. Perhaps wrong, but if enough staff I've always found further stimulation helps.

RE: Anaesthetic complication , bradycardia

Sarah Keir — Mon, 23 Dec 2019 15:16:18 GMT

VERY fit spaniels have huge hearts that barely need to beat to get enough cardiac output! They can also have more drastic reduction in an already low HR with any anaesthetic drugs. You didn't do anything wrong, just one of those things. Perhaps Ypazone until brave enough to anaesthetise again?

RE: Anaesthetic complication , bradycardia

Lindsey Edwards — Fri, 20 Dec 2019 01:43:04 GMT

I have come across a couple like these over years. Elected to change anaesthetic once fully recovered (2-3weeks). My preferred option would then be opioid, medetomidine and ketamine although I would imagine alfaxan or midaz/ket may be ok? As already said, good local analgesia will help also

RE: Anaesthetic complication , bradycardia

Virginia Campbell — Fri, 20 Dec 2019 00:14:14 GMT

I saw practice in one place years ago where they routinely added atropine to every dog's premed. You could look into that.

Also- whatever you use, it's worth doing intratesticular+sq local block once under so you can keep GA as light as possible.