Reptile Anesthesia and Analgesia
-
Upload
eric-cheah -
Category
Documents
-
view
222 -
download
0
Transcript of Reptile Anesthesia and Analgesia
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 1/43
AnalgesiaAnalgesia
David L. McRuer M.Sc., D.V.MDavid L. McRuer M.Sc., D.V.M.,.,
Dipl. ACVPMDipl. ACVPM
Wildlife Center of VirginiaWildlife Center of Virginia
,,
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 2/43
Reptilian resting metabolic rate (MR) is 1/10Reptilian resting metabolic rate (MR) is 1/10thth
to 1/3to 1/3rdrd
that of mammals of equivalent sizethat of mammals of equivalent size
Minimum and maximum OMinimum and maximum O22 consumption rates rangeconsumption rates range
from nearly 0 to that of mammalsfrom nearly 0 to that of mammals
A decrease in the cellular MR can result in reduction of A decrease in the cellular MR can result in reduction of
rug meta o sm an t ere ore ncreases n rug atencyrug meta o sm an t ere ore ncreases n rug atencyof onset, duration of effect, and time of recoveryof onset, duration of effect, and time of recovery
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 3/43
Ambient temperature is one of the main determinants of MRAmbient temperature is one of the main determinants of MR
↓↓ TempTemp → ↓ O→ ↓ O22 demand from tissues → ↓ in metabolicdemand from tissues → ↓ in metabolic
Species variation inSpecies variation in MR both between and withinMR both between and within taxataxa
Metabolic rate can increase 3Metabolic rate can increase 3--40 times after a meal and40 times after a meal and
..
It is unclear It is unclear whether this has any effect on reptile anesthesiawhether this has any effect on reptile anesthesia
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 4/43
In eneral:In eneral:
– – VaranidVaranid andand lacertidlacertid lizards have high MRlizards have high MR – – BoidBoid snakes and chelonians have lower MRsnakes and chelonians have lower MR
– –
MR than burrowing speciesMR than burrowing species
– – Lizards that eat insects or other vertebrates have higher MR thanLizards that eat insects or other vertebrates have higher MR than
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 5/43
Re tiles are ectothermsRe tiles are ectotherms – – ainin heat from environmentainin heat from environment
– – In warm conditions reptiles can increase HR and increase theIn warm conditions reptiles can increase HR and increase thedegree of leftdegree of left--toto--right shunting to send more blood to theright shunting to send more blood to the
eri her to be warmed thus ultimatel increasin core boderi her to be warmed thus ultimatel increasin core bod
temp.temp.
Large pythons and leatherback sea turtles are largeLarge pythons and leatherback sea turtles are large
movementmovement
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 6/43
Normal body temp is referred to as Preferred OptimalNormal body temp is referred to as Preferred Optimal
empera ure one or re erre o y empera ureempera ure one or re erre o y empera ure
(PBT) or Internal Thermal Set Point.(PBT) or Internal Thermal Set Point.
HypoxiaHypoxia--inducedinduced hyperthermia/hypothermia:hyperthermia/hypothermia:
– – At temperature extremes, a mismatch exists betweenAt temperature extremes, a mismatch exists between OO22 demanddemandand Oand O22 supply leading to hypoxia.supply leading to hypoxia.
– – ,,other activities such as dive times.other activities such as dive times.
h dration decreases PBTh dration decreases PBT
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 7/43
Cardiovascular system andCardiovascular system and
AnesthesiaAnesthesiaIntracardiacIntracardiac shuntin of blood occurs in theshuntin of blood occurs in the
noncrocodiliannoncrocodilian reptile ventriclereptile ventricle
This servesThis serves 3 functions:3 functions:
1)1) Stabilizes OStabilizes O22
content of the blood during respiratory pausescontent of the blood during respiratory pauses
-- --
systemic blood flowsystemic blood flow that facilitates the maintenance of bodythat facilitates the maintenance of body
temperature.temperature.
33 Ri htRi ht--toto--left shunt directs blood awa from lun s durin divinleft shunt directs blood awa from lun s durin divin
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 8/43
Cardiovascular system andCardiovascular system and
AnesthesiaAnesthesiaImplications for anesthesia:Implications for anesthesia:
– – Shunting is controlled by cholinergic and adrenergic factorsShunting is controlled by cholinergic and adrenergic factors – – Can effect the systemic arterial OCan effect the systemic arterial O22 content and uptake and eliminationcontent and uptake and elimination
of inhaled asesof inhaled ases
Large rightLarge right--toto--left shunts limitleft shunts limitamount of as u take earl inamount of as u take earl in
anesthesia and slow anestheticanesthesia and slow anesthetic
elimination during the end of elimination during the end of
anesthesiaanesthesia
Changes in level and directionChanges in level and direction
of shunting can account for of shunting can account for
unrepentant awakening duringunrepentant awakening during
surgerysurgery
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 9/43
Cardiovascular system andCardiovascular system and
AnesthesiaAnesthesiaBlood ressure controlled similar to mammalsBlood ressure controlled similar to mammals
Systemic arterial blood pressures vary considerably inSystemic arterial blood pressures vary considerably in
reptiles depending on species.reptiles depending on species.
and habitat), activity levels, and size of the reptile.and habitat), activity levels, and size of the reptile.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 10/43
Respiratory System andRespiratory System and
AnesthesiaAnesthesiaLower OLower O consum tionconsum tion rate than mammalsrate than mammals
Large tidal volume but small surface area for gasLarge tidal volume but small surface area for gasexchangeexchange
No diaphragm therefore active inspiration and expirationNo diaphragm therefore active inspiration and expiration
Many muscles that control ventilation are alsoMany muscles that control ventilation are also
anesthesiaanesthesia
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 11/43
Variable across s eciesVariable across s ecies
More than 4% COMore than 4% CO22 causes ancauses an ↑ in tidal volume and a ↓ ↑ in tidal volume and a ↓
in resp frequency and minute ventilationin resp frequency and minute ventilation
-- 22
resp pattern.resp pattern.
High concentrations of OHigh concentrations of O22 can decrease resp. rate.can decrease resp. rate.
Therefore some studies have shown it is faster toTherefore some studies have shown it is faster to
recover rep es on room a r.recover rep es on room a r.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 12/43
Liver has a slower MR than mammals and ma accountLiver has a slower MR than mammals and ma account
for the prolonged excretion of drugs (including somefor the prolonged excretion of drugs (including someanesthetic drugs) from the body.anesthetic drugs) from the body.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 13/43
Drug Administration RoutesDrug Administration RoutesIM injectionIM injection
– – First pass effect in kidneys from rear limb injection is moreFirst pass effect in kidneys from rear limb injection is more
eore ca an a prac ca concern.eore ca an a prac ca concern.
– – However, still best to avoid nephrotoxic drugs and drugs mainlyHowever, still best to avoid nephrotoxic drugs and drugs mainlymetabolized by the kidneys when giving rear limb injectionsmetabolized by the kidneys when giving rear limb injections
– – SnakesSnakes – – epaxial muscleepaxial muscle
– – LizardsLizards – – forelimb, hindlimb, and tailforelimb, hindlimb, and tail
Caution: some animals can autotomize their tailsCaution: some animals can autotomize their tails
– – Chelonians: tricepsChelonians: triceps
Caution: avoid cranial surface of forelimbCaution: avoid cranial surface of forelimb –– radial nerveradial nerve
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 14/43
IV administrationIV administration
– – Snakes & lizardsSnakes & lizards –– ventralventral coccygealcoccygeal veinvein – – Freshwater turtles & tortoisesFreshwater turtles & tortoises – – dorsaldorsal coccygealcoccygeal veinvein
– –
IVIV injections decreaseinjections decrease the variabilitythe variability compared to IMcompared to IMinjections in reptilesinjections in reptiles
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 15/43
IO catheterizationIO catheterization
– – Best suited for lizardsBest suited for lizards – – Placed in femur or tibiaPlaced in femur or tibia
– –
given IV or IOgiven IV or IO
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 16/43
PremedicationPremedication
General purpose of premeds::
-- to ac tate an ng,to ac tate an ng,
catheterization, reducecatheterization, reducehandlin stress, and reducehandlin stress, and reduce
side effects caused by higher side effects caused by higher
doses of induction anddoses of induction and
De endin on the remedDe endin on the remed
drug(s), you may or may notdrug(s), you may or may notproduce sedation or decreaseproduce sedation or decrease
drugsdrugs – – therefore choosetherefore choose
according to your goals.according to your goals.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 17/43
Anticholiner icsAnticholiner ics
– – Ex: atropine,Ex: atropine, glycopyrrolateglycopyrrolate – – Increase salivary viscosity predisposing patient toIncrease salivary viscosity predisposing patient to endotrachealendotracheal
– – Can alter intraCan alter intra--cardiac shunt fractions thereby altering responsecardiac shunt fractions thereby altering response
to inhaled anesthetics.to inhaled anesthetics.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 18/43
PhenothiazinesPhenothiazines
– – Ex: acepromazineEx: acepromazine
– –
doses and have prolonged effectsdoses and have prolonged effects ––
not often usednot often used
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 19/43
Phenc lidinePhenc lidine
– – Ex:Ex: ketamineketamine,, telazoltelazol
e am nee am ne
– – AtAt subanestheticsubanesthetic levels, it produces analgesic effects andlevels, it produces analgesic effects and
sedationsedation – – Animals are in a cataleptic state marked by uncoordinatedAnimals are in a cataleptic state marked by uncoordinated
voluntary and involuntary muscle movementsvoluntary and involuntary muscle movements
– – KetamineKetamine does NOT PRODUCE Adoes NOT PRODUCE A SURGICALSURGICAL PLANE by itself PLANE by itself
– – Often combined with benzodiazepines or Often combined with benzodiazepines or αα22--antagonists toantagonists toproduce muscle relaxationproduce muscle relaxation
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 20/43
Phenc lidinePhenc lidine
TelazolTelazol ((tiletaminetiletamine andand zolazepamzolazepam))
– – Produces variable results in reptilesProduces variable results in reptiles
– – Less desirableLess desirable thanthan KetamineKetamine andand midazolammidazolam due to the longer due to the longer
duration of effect and longer recoveries.duration of effect and longer recoveries. – – Occasionally used in large lizards to reduce theOccasionally used in large lizards to reduce the injectableinjectable
volumevolume
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 21/43
PremedicationPremedication
BenzodiazepineBenzodiazepine
– – Ex:Ex: midazolammidazolam diaze amdiaze am
DiazepamDiazepam – – Not to be used IM as absorption is very poor Not to be used IM as absorption is very poor
MidazolamMidazolam
– – Often used in conjunction withOften used in conjunction with ketamineketamine for sedation and induction of for sedation and induction of
anesthesia inanesthesia in chelonians (turtles)chelonians (turtles)
– – Does not provide significant sedation when used alone in snappingDoes not provide significant sedation when used alone in snapping
turtles and painted turtles.turtles and painted turtles.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 22/43
αα--anta onistsanta onists
– – provide sedation and muscle relaxationprovide sedation and muscle relaxation – – Clinical impressions suggest some degree of analgesia although notClinical impressions suggest some degree of analgesia although not
– – Medetomidine has a higher Medetomidine has a higher αα22::αα11 binding ratio than xylazine andbinding ratio than xylazine and
produces better anesthetic depth for intubations.produces better anesthetic depth for intubations. – – , ,, , ,
↓ ventricular pressures,↓ ventricular pressures,
– – Can be reversed with atipamazole given IM (not IVCan be reversed with atipamazole given IM (not IV –– hypotension)hypotension)
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 23/43
O ioidsO ioids
– – Poor sedatives in reptilesPoor sedatives in reptiles – – Commonly used for analgesia although few studies in reptiles.Commonly used for analgesia although few studies in reptiles.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 24/43
Induction of AnesthesiaInduction of AnesthesiaPropofolPropofol (drug of choice if (drug of choice if IV catheter IV catheter
is present) can be used IO however is present) can be used IO however
has been associated with a nea inhas been associated with a nea in
green iguanasgreen iguanas
Induction with as anesthesia variesInduction with as anesthesia varies
due to breath holding.due to breath holding.
– – Stroking the lateral thorax mayStroking the lateral thorax may
promote breath takingpromote breath taking
Mean induction time onMean induction time on isofluraneisoflurane isis
20 min.20 min.
Muscle relaxants (Muscle relaxants (succinylcholinesuccinylcholine &&
atracuriumatracurium) work well for ) work well for
or amnesic propertiesor amnesic properties –– avoid regular avoid regular
use in anesthesiause in anesthesia
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 25/43
Easil visualized in most re tilesEasil visualized in most re tiles
RostralRostral in snakes, behind thein snakes, behind thetongue in lizards and chelonianstongue in lizards and chelonians
Complete tracheal rings inComplete tracheal rings in
chelonians andchelonians and crocidilianscrocidilians,,
therefore usetherefore use uncuffeduncuffed endotrachealendotracheal tubestubes
Thick mucous in retiles can plugThick mucous in retiles can plug
u esu esRostralRostral bifurcation of trachea inbifurcation of trachea in
– –
intubationintubation
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 26/43
MACMAC
– – IsofluraneIsoflurane – – reptiles range = 1.54%reptiles range = 1.54% – –3.14%3.14%
– – – – ’’ == ..
0.5%0.5%
– – MAC values can vary based on techniqueMAC values can vary based on technique
, ,, ,
species differences, and rightspecies differences, and right--toto--leftleft
intracardiacintracardiac shuntingshunting
– – -- --
from the lungsfrom the lungs – – therefore less gas can betherefore less gas can beabsorbed.absorbed.
– –
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 27/43
IsofluraneIsoflurane
DoseDose--dependant cardiovascular depressiondependant cardiovascular depression MAYMAY occur occur
in reptilesin reptiles
A doseA dose--dependant sevoflurane study with desertdependant sevoflurane study with desert
tortoises did not show a decrease in ventricular bloodtortoises did not show a decrease in ventricular blood
..
4X MAC with isoflurane in green iguanas does not4X MAC with isoflurane in green iguanas does not
induce cardiovascular arrest.induce cardiovascular arrest.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 28/43
OO rate = 50rate = 50--100 ml/k /min for rebreathin s stem100 ml/k /min for rebreathin s stem
OO22 rate = 200rate = 200--300 ml/kg/min for Bain system300 ml/kg/min for Bain systemFor most vaporizersFor most vaporizers – – 200ml/min is required for 200ml/min is required for
vaporizer accuracy.vaporizer accuracy.
Ventilators = often necessaryVentilators = often necessary – – use one designed for use one designed for
..
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 29/43
Reflexes:Reflexes:
– – When induced with inhalent anesthesia, muscle relaxation startsWhen induced with inhalent anesthesia, muscle relaxation startsat midbody, then cranially, then caudally.at midbody, then cranially, then caudally.
– –
– – Corneal reflex should still be present (not in snakes and someCorneal reflex should still be present (not in snakes and some
lizards due to the spectacle).lizards due to the spectacle).
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 30/43
Cardiovascular:Cardiovascular:
– – Small bell stethoscope on wet gauze placed on the animalSmall bell stethoscope on wet gauze placed on the animal – – Esophageal stethoscope advanced slowing to the point of Esophageal stethoscope advanced slowing to the point of
..
– – Ultrasonic Doppler device with a pediatric probeUltrasonic Doppler device with a pediatric probe
– – The Doppler can also be used for measuring changes in bloodThe Doppler can also be used for measuring changes in blood
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 31/43
ECGECG – – measures heart rate and rh thm. Re tiles havemeasures heart rate and rh thm. Re tiles have
an SV wave proceeding the P wave.an SV wave proceeding the P wave.LizardsLizards – – place left and right forelimb leads on cervicalplace left and right forelimb leads on cervical
reg on o ncrease s gna s rengreg on o ncrease s gna s reng
SnakesSnakes
– – --
– – Place leads two heart lengths in front of and behind the heartPlace leads two heart lengths in front of and behind the heart
CheloniansChelonians
– – Leads placed on the skin between neck and forelimbs.Leads placed on the skin between neck and forelimbs.Attaching leads to needles or a stainless steel loop mayAttaching leads to needles or a stainless steel loop may
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 32/43
Re tiles do not breath well on their own under Re tiles do not breath well on their own under
anesthesiaanesthesia
Recommendation:Recommendation:
– – Mechanical ventilation at 2Mechanical ventilation at 2--6 breaths/min, 156 breaths/min, 15--30 ml/kg tidal30 ml/kg tidal
volume, peak airway pressure less than 10 cm Hvolume, peak airway pressure less than 10 cm H22OO
Only one study has shown a relationship betweenOnly one study has shown a relationship betweenhemoglobin saturation from pulse oximetry and arterialhemoglobin saturation from pulse oximetry and arterial
hemoglobin saturation (green iguanas). Other studieshemoglobin saturation (green iguanas). Other studies
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 33/43
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 34/43
Best to reh drate before anesthesiaBest to reh drate before anesthesia
IV or IO is best however, IP and SQ may be usedIV or IO is best however, IP and SQ may be usedReptiles have a higher % of there body water in theReptiles have a higher % of there body water in the
intracellular space compared to mammalsintracellular space compared to mammals
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 35/43
Best to kee animals in the hos ital at the u er ran eBest to kee animals in the hos ital at the u er ran e
of the POTZ.of the POTZ.
At lower environmental temperatures, you can seeAt lower environmental temperatures, you can see
pro onge rug e ec s, mpa re mmune s a us an ra epro onge rug e ec s, mpa re mmune s a us an ra e
of healingof healing
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 36/43
Preemptive analgesia:Preemptive analgesia: ↓ central sensitization, facilitate↓ central sensitization, facilitatehealing, prevent detrimental neurohumeral response to pain, ↓ healing, prevent detrimental neurohumeral response to pain, ↓
amount of maintenance drugs during anesthesiaamount of maintenance drugs during anesthesia
Neuroanatomy consists of endogenous antinociceptiveNeuroanatomy consists of endogenous antinociceptivemechanisms, demonstrable modulation of pain by drugs,mechanisms, demonstrable modulation of pain by drugs,
neural tract in the brain and spinal cord that suggest a meansneural tract in the brain and spinal cord that suggest a meansof mediating descending inhibition of nociception.of mediating descending inhibition of nociception.
O ioid rece tors are found in re tiles and involved withO ioid rece tors are found in re tiles and involved with
reproduction and thermoregulation.reproduction and thermoregulation.
..
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 37/43
Im ortant to know normal s ecies behaviors to knowIm ortant to know normal s ecies behaviors to know
what behaviors may be interpreted as pain or stress.what behaviors may be interpreted as pain or stress.
Three main classes of analgesic drugs:Three main classes of analgesic drugs:
1)1) Local anestheticsLocal anesthetics
2)2) NSAIDSNSAIDS
3)3) OpioidsOpioids
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 38/43
– –Interu t nocice tion from the level of the nocice tor toInteru t nocice tion from the level of the nocice tor to
the spinal cord.the spinal cord.
Pay special attention to toxic dose as you are oftenPay special attention to toxic dose as you are often
wor ng w sma pa en s.wor ng w sma pa en s.
Lidocaine and Bupivicaine (longer Lidocaine and Bupivicaine (longer--lasting 1lasting 1--2 mg/kg) are2 mg/kg) are
most often used.most often used.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 39/43
--Act to modulateAct to modulate nociceptionnociception in the periphery and spinal cordin the periphery and spinal cord
Central nervous system is not as complex, therefore centralCentral nervous system is not as complex, therefore central
..
Several recent studies have tested NSAIDS on reptiles:Several recent studies have tested NSAIDS on reptiles: – – TrnkovaTrnkova S. et.al.S. et.al. EffectEffect of nonof non--steroidal antisteroidal anti--inflammatoryinflammatory drugs ondrugs on the blood profile in the greenthe blood profile in the green
iguana (iguana (Iguana Iguana iguana iguana). ). Veterinarni Veterinarni Medicina Medicina, 52, 2007 (11): , 52, 2007 (11): 507 507– –511511
– Hernandez-Divers, S. J. Meloxicam and reptiles - a practical approach to analgesia. Small animal and
exotics. Proceedings of the North American Veterinary Conference, Volume 20, Orlando, Florida, USA, 7-11
January, 2006 2006 pp. 1636-1637
Assume sideAssume side--effects as per other species.effects as per other species.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 40/43
--Does not tend to induce statisticall si nificant chan esDoes not tend to induce statisticall si nificant chan es
in physiological parameters.in physiological parameters.
DoseDose--dependant response observed with morphine anddependant response observed with morphine and
meper ne n croco es w ce ng e ec s.meper ne n croco es w ce ng e ec s.
– – Latency of action = 30 min, Duration = 2Latency of action = 30 min, Duration = 2--2.5 hours.2.5 hours.
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 41/43
--Buprenorphine:Buprenorphine:
– – PartialPartial µ agonist with someµ agonist with some κκ antagonist propertiesantagonist properties
– – Unpublished studies indicate that this is a much better analgesicUnpublished studies indicate that this is a much better analgesicin turtles compared to butorphanol.in turtles compared to butorphanol.Kummrow: Pharicokinetical basis for dru recommendations of Kummrow: Pharicokinetical basis for dru recommendations of Burenorphine in redBurenorphine in red--eared sliders, 2006 AAZV conferenceeared sliders, 2006 AAZV conference
ButorphanolButorphanol:: – – StrongStrong κκ agonist and weak µ antagonistagonist and weak µ antagonist
Slavky: Morphine but not butorphanol causes analgesia and not respiratorySlavky: Morphine but not butorphanol causes analgesia and not respiratorydepression in reddepression in red--eared sliderseared sliders , 2006 AAZV conference, 2006 AAZV conference
Fleming: Use of thermal threshhold test response to evaluate theFleming: Use of thermal threshhold test response to evaluate theantinociceptive effects of butorphenol in juvenile green iguanasantinociceptive effects of butorphenol in juvenile green iguanas , 2006 AAZV, 2006 AAZVconferenceconference
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 42/43
CasesCasesMyiasis in an Eastern Box TurtleMyiasis in an Eastern Box Turtle
Ketamine 10 mg/kgMedetomidineMedetomidine 0.2 mg/kg
.
Isoflurane
8/3/2019 Reptile Anesthesia and Analgesia
http://slidepdf.com/reader/full/reptile-anesthesia-and-analgesia 43/43
Black rat snakeBlack rat snake
Ketamine 12 mg/kg
MedetomidineMedetomidine 0.3 mg/kg
Buprenorphine 0.04 mg/kg
Isoflurane