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Local Anesthetic Techniques For Perineal Procedures

Canine or feline sacrococcygeal or coccygeal epidural INDICATIONS: Canine and feline tail amputations, perineal urethrostomies, anal sacculectomies, catheterization for relief of urethral obstruction, perineal relaxation for delivery of puppies/kittens, and other surgeries of the penis or perineal region. INSTRUCTIONS: For either dogs or cats, use 0.1 mL/kg of either lidocaine, bupivacaine, mepivicaine, or ropivacaine. A dose of 0.1 mL/kg is usually sufficient but up to 0.2 mL/kg is reported. The average volume in a cat or small dog is 0.5 mL. To find the sacrococcygeal site, move the tail up and down in a “pumping” motion while palpating the sacrococcygeal region of the patient (1). The first movable space at the caudal end of the sacrum is either the sacrococcygeal or intercoccygeal space (2). Either site is appropriate for injection and there is no need to differentiate what site is being palpated. Insert a 25- or 22-gauge hypodermic needle through the skin ON MIDLINE at ~45° angle to the skin surface. Proceed slowly until the needle enters the space (3). If bone is encountered (it usually is), withdraw the needle a few millimeters, redirect slightly (steeper or flatter angle), and reinsert (“walking” off the bone). b. Repeat this process until the needle is inserted between the vertebrae to enter the intervertebral space. A “pop” may be felt and there should be no resistance to injection. † CONSIDERATIONS: (1) Pelvic limbmotor function is not blocked unless the volume of local anesthetic is large, causing cranial spread to the motor nerves of the pelvic limbs. Stay at or below the 0.2 mL/kg volume. (2) If tail/anus relaxation does not occur within 5 min (within 8–10 min with bupivacaine or ropivacaine), the injection may have been made subcutaneously. Try again!

Premedication and Sedation

Use this chart to determine which drug-class combinations may benefit your individual patients based on their health, demeanor, and the reason they require medication, including simply to calm their nerves.

Anesthesia Discharge Template

Save time and decrease stress! Complete the following form to create customized, printable discharge instructions for your anesthesia patients.

2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats

The objective of these guidelines is to make the anesthesia period as safe as possible for dogs and cats while providing a practical framework for delivering anesthesia care before, during, and after the anesthetic procedure. The guidelines are intended to be comprehensive but neither all-inclusive nor a single source for information and clinical recommendations.

Resource Center

Resources from the 2020 AAHA Anethesia and Monitoring Guidelines for both veterinary teams and pet owners.

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