Lesson 1Principles of balanced anesthesia and multimodal analgesia for dogs and catsThis section outlines principles of balanced anesthesia and multimodal analgesia, integrating sedatives, opioids, local blocks, and adjuncts to reduce inhalant requirements, improve stability, and enhance comfort in canine and feline neuter patients.
Concept of balanced anesthesia in neuteringDesigning multimodal analgesia plansReducing inhalant MAC with adjunct drugsCombining systemic and local techniquesProtocol examples for dogs and catsEvaluating depth versus analgesia adequacyLesson 2Analgesic dosing in dogs versus cats and timing for pre-emptive analgesiaThis section compares analgesic dosing and timing in dogs and cats, emphasizing species differences, pre-emptive administration, redosing intervals, and integration with local blocks to maintain effective perioperative pain control for neuter surgeries.
Species differences in opioid dosingNSAID selection and dose adjustmentsTiming of pre-emptive analgesic administrationRedosing intervals and duration of effectCombining systemic drugs with local blocksAvoiding overdose and drug stacking errorsLesson 3Perioperative analgesia: opioids, NSAIDs, local blocks (e.g., intratesticular, spermatic cord, line blocks), and adjunctsThis section focuses on perioperative analgesia for neutering, covering opioid and NSAID use, local anesthetic techniques such as intratesticular and line blocks, plus adjuncts like ketamine and lidocaine infusions to achieve multimodal pain control.
Opioid choices for intraoperative analgesiaNSAID timing, selection, and safety checksIntratesticular and spermatic cord blocksLine blocks for ovariohysterectomy incisionsAdjunct infusions: ketamine and lidocaineMonitoring for local anesthetic toxicityLesson 4Recovery and post-anesthetic monitoring: criteria for extubation, pain scoring, and when to escalate careThis section explains safe recovery practices after neutering, including extubation criteria, pain scoring systems, thermoregulation, and when to escalate care or re-anesthetize, ensuring smooth transition from anesthesia to full ambulation.
Extubation criteria and airway protectionPositioning, thermoregulation, and nursing careUse of pain scales in dogs and catsRecognizing dysphoria versus true painWhen to escalate monitoring or re-anesthetizeDischarge criteria and client instructionsLesson 5Managing anesthesia-related complications: hypotension, hypoventilation, bradycardia, arrhythmias, hypothermiaThis section addresses recognition and management of common anesthesia complications in neutering, including hypotension, hypoventilation, bradycardia, arrhythmias, and hypothermia, with stepwise interventions and criteria for aborting the procedure.
Identifying and treating hypotensionApproach to hypoventilation and apneaBradycardia: when to treat and howRecognition and response to arrhythmiasPrevention and treatment of hypothermiaWhen to pause or abort the procedureLesson 6Monitoring during anesthesia: parameters (HR, RR, SpO2, EtCO2, blood pressure, temperature), equipment and interpretationThis section covers intraoperative monitoring for neutering, including heart rate, respiratory rate, SpO2, EtCO2, blood pressure, and temperature, with guidance on equipment setup, troubleshooting, and interpretation to detect early anesthetic complications.
ECG and heart rate monitoring basicsRespiratory rate, capnography, and EtCO2Pulse oximetry setup and artifact handlingNoninvasive and invasive blood pressureTemperature monitoring and active warmingRecording trends and responding to changesLesson 7Induction agents: propofol, alfaxalone, ketamine combinations—indications and dosing examplesThis section details induction agent choices for neutering, including propofol, alfaxalone, and ketamine combinations, with indications, contraindications, dose examples, titration techniques, and adaptations for compromised or pediatric patients.
Propofol dosing and titration to effectAlfaxalone protocols in dogs and catsKetamine-benzodiazepine combinationsInduction in pediatric and geriatric patientsManaging hypotension during inductionIV access, preoxygenation, and airway controlLesson 8Maintenance strategies: inhalant anesthesia (isoflurane/sevoflurane) vs TIVA—settings and practical considerationsThis section compares inhalant maintenance with isoflurane or sevoflurane to total intravenous anesthesia, discussing vaporizer settings, infusion protocols, equipment needs, and practical decision-making for neutering in varied clinical settings.
Setting and adjusting vaporizer concentrationsCircuit choice and fresh gas flow ratesTIVA protocols and infusion calculationsTransitioning between TIVA and inhalantsManaging depth changes during surgeryEquipment checks and oxygen supply planningLesson 9Premedication options: sedatives, analgesics, anticholinergics—drug choices, routes, and dose rangesThis section reviews premedication planning for neutering, covering sedatives, opioids, alpha-2 agonists, anticholinergics, and adjuncts, with emphasis on drug selection, routes, dose ranges, and tailoring protocols to patient status and procedure length.
Choosing sedatives by temperament and healthOpioid selection and dose rangesAlpha-2 agonists: pros, cons, and reversalsAnticholinergic indications and contraindicationsIM, IV, SC, and oral premedication routesAdjusting doses for age and ASA status
