Sample Anesthesia Protocols

Anesthesia protocols vary by patient age, condition, morbidity factors, length and type of procedure. Local anesthetics are used on all dental surgical cases where tissue is incised.

Premedication/Induction/Maintenance

An intravenous catheter is placed and fluids administered in all patients undergoing anesthesia.

Premedication

For healthy dogs our first choice is hydromorphone 0.1 to 0.2 mg/kg or morphine 0.5 to 1.0 mg/kg combined with acepromazine 0.010 to 0.040 mg/kg. For more debilitated or aged patients we shift towards hydromorphone 0.1 to 0.2 mg/kg alone or with midazolam 0.2 to 0.4 mg/kg. No anticholinergic is administered unless there is a specific need.

For healthy cats our first choice is hydromorphone 0.2 mg/kg or butorphanol 0.2 mg/kg combined with medetomidine 0.010 to 0.015 mg/kg., plus atropine. As cats become more debilitated or aged we use butorphanol 0.2 mg/kg or hydromorphone 0.2 mg/kg with 0.2 to 0.4 mg/kg midazolam. For fractious cats presenting without feline hypertrophic cardiomyopathy (HCM), ketamine 1 to 5 mg/kg is administered as needed; for those with HCM, low-volume medetomidine (0.005 mg/kg) is administered instead.

Induction

Agents such as ketamine/diazepam, Propofol or etomidate are given intravenously to effect after premedication.

Maintenance

Anesthesia is maintained with isoflurane or sevoflurane and oxygen. Little isoflurane or sevoflurane is metabolized. The insolubility of the inhalants allows for a speedier induction and recovery. Patient temperature is controlled in many ways, including the use of blankets, warm intravenous bottles placed next to the patient under the blankets, or a warm-air Bair Hugger®.