Male Sprague

The aim of this case study is to analyse and evaluate the anaesthetic and recovery care delivered to a patient undergoing an Adenotonsillectomy. To do this I will outline the process of ensuring the provision of safe and effective care for the patient, give a description of the procedure and equipment used in the anaesthetic room including the drugs used for this particular case and rationale for their use. I will also give a brief description of the surgical procedure including the anaesthetic and recovery care provided. Finally, I will summarise with an evaluation of the care that the patient received. For the purpose of this study, the patient will be referred to as ”the patient”. In doing so, the patients’ right to confidentiality will not be breached and it is also within the boundaries and guidelines set out in local trust policies G10, the Health and Care Professions Council Code of Conduct & Ethics for Students (HCPC 2012 pg 9), the Data Protection Act (1998) & the Caldecott Principles (2013).

Martini, Frederic, Judi L. Nath, and Edwin F. Bartholomew.Fundamentals of Anatomy & Physiology. 9th ed. San Francisco, CA: Benjamin Cummings, 2012. Print.

~ There were more than 20,000 uses of anesthetic agents by surgeons on both sides during the

The patient was sedated with diazepam and hydromorphone, appeared to be sedated, and a successful reduction took place. After the procedure, the

Panizzi L, Pang D, Paterson J. 2011. Successful treatment of hyperkalemic periodic paralysis in a horse during isoflurane anaesthesia. Veterinary Anesthesia and Analgesia. 38. 113-120.

The students will first perform surgery on the rats. Each animal with be anesthetized. Following standard surgical procedures, an incision will be made in the scalp and two holes drilled in the animal's skull. Electrodes will be lowered into the brain to create lesions on each side. The animals will then be allowed to recover.

Whole mount preparations were prepared using nerves which were harvested from animals sacrificed using Ketamine 40-100 mg/kg IP and Xylazine 5-13 mg/kg IP. Animals underwent transcardial perfusion with 500 ml of 0.9% saline, followed by 500 ml of ice-cold 4% paraformaldehyde in 0.1 M phosphate buffer.

This is due to the fact that the muscles must be paralyzed so the patient does not move around during the procedure. Fentanyl, Diazepam, and Propofol were administered to put CB to sleep, paralyze her muscles, and provide relaxation and memory loss of the procedure (Deglin). Potential post-operative complications from this procedure include malignant hypertension, hypoventilation, and nausea.

Numerous studies have been conducted on the use of local anesthetic agents with adjuvants such as clonidine (a partial α2-adrenoreceptor agonist) and tramadol3, 4 for a brachial plexus block to improve the quality and duration of anesthesia, and these studies have shown that the adjuvants may prolong anesthesia and analgesia. Moreover, dexmedetomidine is a α2-receptor agonist that has more selectivity than clonidine and has analgesic and sedative properties.5, 6 Although several studies have described the effects of dexmedetomidine on neuroaxial and peripheral nerve blocks,7, 8, 9 to date, there is only 1 study available, performed by Esmaoglu et al,10 on the effect of adding dexmedetomidine to levobupivacaine for an axillary brachial plexus block. In view of the idea that decreasing the dose of dexmedetomidine may help to reduce side effects such as bradycardia and hypotension, we wanted to evaluate the effect of dexmedetomidine at a lower dose than that used in their study and the results. We think that more studies on this issue are needed.

Opioid-free anesthesia, as the name indicates, is the avoidance of opioids in pain treatment pre-operatively, intra-operatively, and post-operatively in an attempt to reduce opioid-induced respiratory complications without sacrificing patient comfort. Some of the reasons to avoid opioids, besides respiratory depression, include: “muscle weakness, excessive somnolence, post-operative nausea and vomiting, ileus and constipation, urinary retention, dizziness, obstructive breathing, negative inotropism, and the possibility of tolerance and addiction” (Mulier, 2012). Post-operatively, the patient’s respiratory system may be too depressed to pass extubation criteria. If able to extubate, early mobilization may be difficult if the patient is too

This feature also enables the use of this technique into the postoperative period for analgesia, using lower concentrations of local anaesthetic drugs or in combination with different agents.

The preanesthetic drug consisted of 0.1 to 0.2 mg / kg of midazolam administered orally 35 minutes before surgery. Anesthetic induction was performed with 0.2 to 0.3 mg / kg of etomidate, 3 to 5 μg / kg of fentanyl, 0.05 mg / kg midazolam and 0.1 mg / kg intravenous pancuronium. Maintenance was performed with isoflurane combined with a mixture of oxygen and compressed air, and fentanyl if necessary. During cardiopulmonary bypass, additional doses of midazolam and pancuronium were used on demand.

- I tested the isoflurane induction and stereotaxic mounting using the new anesthesia system and the stereotax, and I observed the rat's breathing pattern and body temperature while under anesthesia; I will schedule a demonstration surgery with John next week.

The first step was to obtain the White Rat and to tie it in the supine position, anterior surface facing up in side the dissection pan. To tie the animal, we used butcher’s twine and secured the front and hinds legs using a “lasso”

“For procedures, refer to Lab 6, Activity 2, in the Anatomy and Physiology Lab Manual.”