There are several specialised procedures which are routinely performed at the UCDVH. Many of these procedures require specialised training and equipment. Below are some examples of specialised procedures performed at the UCDVH, however this list is not exhaustive.
Regional anaesthesia
| Regional anaesthesia is a type of pain management that numbs the part of the body that has been treated. It is the most effective way of providing intraoperative analgesia and will be performed in most surgical patients if feasible. An example of regional anaesthesia which most people have experienced is the injection of local anaesthetic for tooth extraction while at the dentist. Regional anaesthesia for tooth extraction is commonly performed for dental procedures also in anaesthetised veterinary patients. Another form of regional anaesthesia is epidural anaesthesia (the deposition of local anaesthetic around the spinal cord), which causes loss of pain sensation in the hindquarters, providing excellent analgesia for painful hindlimb surgery. There are many other forms of regional anaesthesia, which can be performed to optimise pain relief in our surgical veterinary patients. These include nerve blocks that can be performed with the aid of ultrasound, such as forelimb (RUMM), abdominal (TAP), spinal (ESP) and hind limb (femoral and sciatic) nerve blocks.The use of ultrasound for precise needle placement and local anaesthetic administration is a specialised technique known to significantly enhance the safety and success of these blocks. This technique, routinely practiced in our anaesthesia department with a dedicated ultrasound machine, enables the anaesthetist to track the needle's path as it moves through tissues towards the targeted nerve. |
Epidural injection of morphine and local anaesthetic |
Invasive blood pressure
Invasive blood pressure is measured by placing a catheter in a distal artery and measuring the pressure within the artery using a pressure transducer. Invasive blood pressure is the gold standard technique for blood pressure measurement allowing continuous blood pressure assessment. High-risk patients undergoing general anaesthesia at UCDVH will have their blood pressure measured directly, using this invasive technique.
Central venous catheter placement
A central venous catheter is a catheter placed into a large central vein in the body, most commonly the jugular vein with the tip of the catheter lying close to the heart. Central venous catheters are placed under sterile conditions and can stay in place for a number of weeks, longer than that of ordinary intravenous catheters. Central venous catheters allow rapid fluid and drug administration and painless blood sample collection.
Blood product administration (blood, plasma, albumin)
The administration of blood products to veterinary patients in need of them can be lifesaving, for example, in cases of severe blood loss during surgery. A huge thanks must go to all the dogs, cats, horses and farm animals who have donated blood to our patients, and to their owners, who have given their time our Veterinary Blood Donor Programme.
The administration of donor blood is not without risk. Recipients of blood products in some cases will mount an immune response to the foreign blood. Patients receiving blood products are monitored closely for evidence of this immune response and blood product administration is stopped if such a reaction becomes evident; in some instances it is possible to restart the administration of donor blood at a slower administration rate.
Mechanical ventilation
Many of the drugs given during anaesthesia can have a negative impact on the patient's ability to breath. In some instances during anaesthesia the patient will require assistance to breathe. This breathing assistance is normally provided in the form of mechanical ventilation, in that a machine will breathe for the patient.
Total intravenous anaesthesia
General anaesthesia is normally maintained by the breathing in of anaesthetic gases (inhalational anaesthesia). However, these gases can have a dose-dependent negative impact on the cardiovascular system. Therefore, in some patients it is safer to maintain anaesthesia with the total intravenous method.
During total intravenous anaesthesia, general anaesthesia is maintained by the administration of anaesthetic drugs injected directly into the vascular system. Total intravenous anaesthesia is associated with better maintenance of cardiovascular function, meaning that the patient is less likely to develop low blood pressure during anaesthetic maintenance. However, total intravenous anaesthesia is considerably more expensive than inhalational anaesthesia; in addition, the recovery from intravenous anaesthesia is less smooth than the recovery from inhalational anaesthesia.
Neuromuscular blockade
Neuromuscular blocking agents stop the transmission of impulses along the nerves of muscles, leading to muscle relaxation. The muscle relaxation caused can improve surgical access and make it easier to realign fractured bone fragments. When neuromuscular blocking agents take effect, the patient will lose the ability to breathe, and assisted breathing must be provided by the anaesthetist through the use of mechanical ventilation (assisted ventilation). As the drug wears off, muscle function will gradually return and the patient will regain the ability to breath spontaneously. Return of muscle function is monitored closely during anaesthesia and assisted breathing is only removed when the anaesthetist is sure that there is a full return of breathing function.
After admission the specialist team will provide an internal referral request to our anaesthesia department requesting service for the required surgery or procedure. A member of our team will then perform, plan and deliver the most appropriate analgesia, sedation and anaesthesia plan as listed below for the patient.