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 Options Comments Cautions

Sedation/Muscle Relaxation Alpha-2 Agonist Drugs Provide sedation and analgesia, Different species vary in their
● Xylazine resulting in a dose reduction response. Cattle require 1/10th the
● Medetomidine requirement for anaesthetic drugs dose that a horse requires. Dogs
● Detomidine Reversible with antagonists like and cats require less than horses
● Dexmedetomidine atipamezole also. Rabbits are more like horses
● Romifidine Newer drugs have better a2:a1 than dogs and cats
profile, resulting in less significant These drugs can significantly slow
cardiovascular side effects down recovery and circulation.
These drugs can be titrated (you do They produce diuresis and
not need to give a full dose) hyperglycaemia

Acepromazine/ACP/Ace Tranquiliser that provides no Can cause priapism or penile

analgesia. Has long duration of paralysis in horses, so use with
effect. Causes dose dependant extreme caution in males.
vasodilation. Reduces the dose
requirements of other anaesthetic
drugs

Benzodiazepines Partial agonists at the GABA-A Diazepam is formulated in propylene

● Diazepam receptor, also provide good muscle glycol. If given to fast it can cause
● Midazolam relaxation and reduction in dose arrhythmia and if given IM can be
requirements of other anaesthetic painful
drugs. No Analgesia. Can cause
behavioural disinhibition and
agression. Best used in very young
and sick animals or as co-induction
drug
Consideration Options Comments Cautions

Analgesia Local anaesthetics Local anaesthetics can significantly LIDOCAINE is the ONLY local
decrease the amount of anaesthetic anaesthetic that should be given
drugs you need to maintain intravenously. Double check your
anaesthesia. Lidocaine can be dilutions, doses and infusion rates
administered by infusion before administering to patients.
intravenously, but you need to be
very careful of the dose rate that you
are giving it.

Tramadol Acts on multiple receptors including Variable analgesia depending on the

opiate, NMDA and serotonin metabolic profile of the patient and
receptors to cause a degree of their capacity to create the active
analgesia, along with euphoria in metabolite
some instances.

Anti-inflammatories (NSAIDS) Provide analgesia through Because they can interfere with
suppression of production of pro- renal blood flow, probably best to
inflammatory chemicals delay administration of NSAIDs until
the patient has recovered completely
from anaesthesia and is normally
hydrated

Paracetamol/Acetaminophen Useful analgesic medication for NEVER give paracetamol to a cat as

some dog patients, particularly with they are unable to metabolise the
mild or chronic pain drug correctly and this results in
acute hepatic necrosis and death.

Opiate Medications A wide range of opiates available Species vary in their response to
globally. Vary in potency as and side effects from opiates.
analgesics and sedative, duration of
effect and range of side effects. Very
effective analgesics and dose
sparers
Consideration Options Comments Cautions

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

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

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

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

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)