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ECC analgesia/anaesthia - Coggle Diagram

- - - - restraint, analgesia, sedation, IM
  - - - butorphanol may not be effective in aggressive/responsive cats. Creates anxiousness and difficulty of restraint
        
        can lead to aggressive behaviour
      - to increase sedation/restraint
        
        ketamine
        
        or dexmedetomidine
        
        can lead to bradycardia and increased blood glucose concentrations
        
        can induce vomiting
- - - - mu agonist, kappa agonist
      - does not provide sufficient analgesia for severe pain
      - anti-emetic
    - - partial mu agonist
      - moderate pain
      - hard to reverse if adverse clinical events occur
  - - - unreliable anxiolytics, unless CNS depression
      - improved sedation w opioid or dissociatives
      - ACP --> hypotensive effect so use with caution
        
        useful for upper airway obstruction e.g. laryngeal paraylysis --> sedative and anti-anxiety
        
        minimal respiratory depressant effects
        
        up to 30 min for full effect, o2 supplementation whilst sedation achieved
  - - - provide analgesia peripherally and somatically
      - Ketamine
        
        IM or IV analgesic
        
        causes muscle rigidity
        
        combine with a benzodiazepine or alpha 2 agonist to provide muscle relaxation
        
        tachycardia, increases BP and has some respiratory depression properties
        
        will have a prolonged effect in cats with renal disease, as excretion is impaired
        
        use cautiously in azotaemic patients
        
        causes increases in intracranial and intraocular pressure
        
        not recommended for patients with traumatic brain injury
  - - - a decrease in CNS sympathetic outflow and circulating catecholamines also occurs
    - - IM, IV, CRI
      - side effects: vomiting, peripheral vasoconstriction and hypertension, a reflex bradycardia 2ry to hypertension
        
        adding ketamine to dexmedetomidine can help modulate the reflex bradycardia
        
        anticholinergics e.g. atropine