Alexa's blog: Anesthesia

I've now completed my 3 week rotation in anesthesia. Also, I am now about 1/4 of the way done with my senior year! It's gone by pretty fast and I have learned a lot. I was very nervous a the beginning of the anesthesia rotation and by the end I was able to relax and enjoy it.

Me getting ready to induce my patient for a surgical procedure

I was able to get more comfortable anesthetizing animals for surgery or other procedures like CT or MRI scans. I gained knowledge about when to use certain drugs and when to avoid them. I also got to see the differences between anesthesia in dogs and cats versus horses. I got to practice placing IV catheters in dogs and got more confident at it. I was able to do an epidural in a dog and I placed arterial catheters in horses.

A typical day would go as follows: We would arrive in the morning with an anesthetic protocol that we created for a particular case that was going to need anesthesia for a procedure that day. (Each student would typically have 1 case for the day) The anesthesiologist would listen to our plan and make changes to it as needed. Then we would make sure everything was set up in advance for the procedure like the anesthesia machines and other things like fluid lines, blood pressure cuffs, catheter supplies, endotrachial tubes, etc. At the appropriate time we would pre-medicate the patient to sedate them for IV catheter placement, then we would induce them with more meds, place an endotracheal tube and hook them up to the inhalant anesthesia and a bunch of different monitoring equipment (ECG, blood pressure, ventilator, temperature, etc).

The induction room where animals would be prepared for surgery.

If the patient was getting a surgical procedure done they would be prepared for surgery at this time (hair shaved, epidural, surgical site scrubbed, etc). Then the patient would be rolled into an OR and hooked up to the anesthesia machine and monitoring equipment in there and positioned for surgery. Then we would monitor the patient while the surgery took place making adjustments as needed and administering drugs as needed. For this part you would be basically on your own with the anesthesia techs or residents ready to respond to a call on the walkie talkie if you had any questions or needed help. They could also monitor your patient from other rooms and usually would show up before you even had a chance to call them if they noticed something off.

When the procedure was over the patient would be disconnected from all the machinery and moved to its recovery destination. When they were awake enough we would remove their tracheal tube. We closely monitored body temperature and warm them up as needed.The whole thing would be documented with a computer program and when you were done you printed out a anesthetic record that a tech or resident would go over to make sure there were no errors. We would have rounds in the afternoon and talk about our individual cases and then get assigned a case for the next day.

Horse anesthesia was similar but different. The biggest difference was how we moved them. Moving anesthetized horses required a hoist system on a track in the ceiling to move them from the induction stall to the operating table and then to the recovery stall.

Inside one of the Large Animal ORs. Orange door = induction stall, Blue door = recovery stall. Part of the operating table is visible in the right of the image.

Large animal anesthesia machine. Big animals require big tubes!

Overall I was the primary anesthesia student for 2 horses, 7 dogs, and 1 goat. One procedure I did was an after hours emergency procedure and I got to see how they do a blood transfusion in a dog. The dog did well under anesthesia and surgery. I really enjoyed helping other students with their cases when I didn't have anything going on. I would help input data in the computer, help them set IV catheters by restraining their patient, and help with set up/clean up. They all did the same for me. I'm glad that I was with a really great group of students :)