Table 1.

Dissociative Anaesthetic Drugs

Pharmacodynamics
Examples Mechanism/s of General Species specific and comments
Action Pharmacokinetics
Target Effects Unwanted Effects

Ketamine Predominantly Onset CNS CNS Cats

● NMDA-receptor ● rapid ● cataleptic state ● increased blood ● Renal compromise slows
antagonist Anaesthetic Duration ● analgesia flow/blood pressure removal of norketamine and
Also ● short ● emergence delirium can result in slow recovery
● opioid, Metabolism Sympathetic Horses
● MAO ● liver ● Stimulation ● Commonly used for
● muscarinc Cardiovascular maintenance (triple drip)
receptors ● Negative inotrope
Tiletamine ● Increased myocardial Dogs
oxygen demand ● Clear zolazepam faster
Respiration Cats
● Apneustic breathing ● Clear tiletamine faster
Muscle
● Rigidity
Table 2. Non-dissociative Injectable Anaesthetics
Pharmacodynamics
Examples Mechanism/s General Species specific and comments
of Action Pharmacokinetics
Target Effects Unwanted Effects

Propofol Predominantly Onset CNS Cardiovascular Formulation

● GABA-A ● rapid ● unconsciousness ● Decrease systemic vascular ● Discard in 12 hours due to
receptor Anaesthetic Duration ● anti-convulsant resistance risk of bacterial contamination
agonist ● short ● Decreased cardiac output (soy oil emulsion)
Metabolism Respiration Cats
● liver ● Depression/apnoea ● Repeated doses may cause
Muscle anaemia
● myoclonus Maintenance of Anaesthesia
● Suitable for maintenance of
anaesthesia in all species

Barbiturates Onset CNS Cardiovascular Slow Administration can result in

Thiopentone ● rapid ● unconsciousness ● Decrease systemic vascular violent stage 2 induction
Anaesthetic Duration ● anti-convulsant resistance excitement
● Short for single ● Decreased cardiac output Formulation
dose ● Arrhythmia ● Extremely alkaline and will
● Repeat doses result Respiration cause tissue damage if
in longer effects ● Depression/apnoea extravascular
Metabolism Muscle Maintenance
● liver ● myoclonus ● Not acceptable due to
prolonged recovery

Alfaxalone Onset CNS CNS Formulation

● rapid ● unconsciousness ● Occasional delirium ● Can be used for maintenance
Anaesthetic Duration ● anti-convulsant Cardiovascular and by Intramuscular routes
● Short for single ● Minimal dose-dependant
dose negative effects
Metabolism Respiration
● liver ● Minimal dose-dependant
negative effects
Table 3. Volatile Anaesthetic Drugs

Pharmacodynamics
Examples Mechanism/s of General Species specific and comments
Action Pharmacokinetics
Target Effects Unwanted Effects

Halothane Many sites Onset CNS Cardiovascular Skeletal Muscle Effect

● GABA-A receptor ● Slowest ● unconsciousness ● Decrease systemic ● Malignant hyperthermia in
● NMDA receptor Anaesthetic vascular resistance some pig and dog breeds
● AMPA receptor recovery ● Decreased cardiac Occasional Hepatotoxicity
● Glycine receptor ● slowest output
● Nicotine receptor Metabolism Respiration
● Voltage gated ● 20% by liver ● Depression/apnoea
sodium channels
Isoflurane ● Also likely interupt Onset Most common maintenance
normal neural ● faster inhalation agent used in veterinary
membrane Anaesthetic medicine
functions recovery
● Shorter
Metabolism
● 0.2 % by liver

Sevoflurane Onset Small risk of renal toxicity from

● fastest flourine metabolites
Anaesthetic
recovery
● shortest
Metabolism
● 2-5 % by liver
Table 4 . Balanced Anaesthesia Considerations
Consideration
Sedation/Muscle Relaxation
Options Comments
Alpha-2 Agonist Drugs Provide sedation and analgesia,
● Xylazine resulting in a dose reduction
● Medetomidine requirement for anaesthetic drugs
● Detomidine Reversible with antagonists like
● Dexmedetomidine atipamezole
● Romifidine Newer drugs have better a2:a1
profile, resulting in less significant
cardiovascular side effects
These drugs can be titrated (you do
not need to give a full dose)
Acepromazine/ACP/Ace Tranquiliser that provides no
analgesia. Has long duration of
effect. Causes dose dependant
vasodilation. Reduces the dose
requirements of other anaesthetic
drugs
Benzodiazepines Partial agonists at the GABA-A
● Diazepam receptor, also provide good muscle
● Midazolam relaxation and reduction in dose
requirements of other anaesthetic
drugs. No Analgesia. Can cause
behavioural disinhibition and
agression. Best used in very young
and sick animals or as co-induction
drug
Cautions
Different species vary in their
response. Cattle require 1/10th the
dose that a horse requires. Dogs
and cats require less than horses
also. Rabbits are more like horses
than dogs and cats
These drugs can significantly slow
down recovery and circulation.
They produce diuresis and
hyperglycaemia
Can cause priapism or penile
paralysis in horses, so use with
extreme caution in males.
Diazepam is formulated in propylene
glycol. If given to fast it can cause
arrhythmia and if given IM can be
painful
Consideration Options
Analgesia Local anaesthetics
Tramadol
Anti-inflammatories (NSAIDS)
Paracetamol/Acetaminophen
Opiate Medications
Comments
Local anaesthetics can significantly
decrease the amount of anaesthetic
drugs you need to maintain
anaesthesia. Lidocaine can be
administered by infusion
intravenously, but you need to be
very careful of the dose rate that you
are giving it.
Acts on multiple receptors including
opiate, NMDA and serotonin
receptors to cause a degree of
analgesia, along with euphoria in
some instances.
Provide analgesia through
suppression of production of pro-
inflammatory chemicals
Useful analgesic medication for
some dog patients, particularly with
mild or chronic pain
A wide range of opiates available
globally. Vary in potency as
analgesics and sedative, duration of
effect and range of side effects. Very
effective analgesics and dose
sparers
Cautions
LIDOCAINE is the ONLY local
anaesthetic that should be given
intravenously. Double check your
dilutions, doses and infusion rates
before administering to patients.
Variable analgesia depending on the
metabolic profile of the patient and
their capacity to create the active
metabolite
Because they can interfere with
renal blood flow, probably best to
delay administration of NSAIDs until
the patient has recovered completely
from anaesthesia and is normally
hydrated
NEVER give paracetamol to a cat as
they are unable to metabolise the
drug correctly and this results in
acute hepatic necrosis and death.
Species vary in their response to
and side effects from opiates.
Consideration Options Comments Cautions

Supportive Care Cardiovascular Support Maintenance of perfusion of vital It is possible to overhydrate

● Intravenous fluids organs requires adequate circulatory
● Positive inotrope drugs function. Anaesthetic drugs often
interfere with this. Judicious fluid
therapy maintain perfusion and
clearance of anaesthetic drugs
anaesthetised animals. Keep fluid
rates maintained at 5 mg/kg/hr or
less, but preferably titrated to the
maintenance of normal blood
pressure.

Temperature Management Vasodilation, behavioural and central It is possible to overheat animals,

nervous system effects caused by
anaesthetic and sedative drugs can
result patients becoming rapidly
hypothermic. Hypothermic patients
have delayed metabolism and
clearance of drugs, delayed healing,
increased oxygen and glucose
demand and abnormal immune
responses and clotting function.
but this is unlikely if you are closely
monitoring their body temperature.
The aim is to keep a patient’s
temperature as close to their normal
temperature as possible whilst
anaesthetised, by using warming
techniques and preventing heat loss.

Airway support If at all possible, providing a secure airway with an endotracheal tube and
connection of the patient to a form of oxygen supplementation and carbon
dioxide scavenging can significantly increase patient safety and recovery
quality

Monitoring Many things can be monitored to help assess the normality of physiologic
responses. As a base line, monitor
1. Heart and Pulse Rate
2. Respiratory Rate, Rhythm and Depth
3. Temperature
If you have the capacity you should also monitor
1. Blood pressure
2. Blood oxygenation
3. Adequacy of ventilation (ETCO2)