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There Are Four Classic Stages of Anesthesia; Disorientation, Excitement, Anesthesia

There Are Four Classic Stages of Anesthesia; Disorientation, Excitement, Anesthesia

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Published by: dine4ya on Dec 05, 2009
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01/12/2013

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There are four classic stages of anesthesia; disorientation, excitement, anesthesia and moribund.
Stage 1
The animal is disoriented. The respirations can range from normal to panting. The heart rate isunchanged and the animal has good muscle tone and all reflexes are present.
Stage 2
The animal becomes excited. They may struggle, vocalize, chew and yawn. The breathing becomesirregular and they may hold their breath or hyperventilate. The heart rate increases and the animalhas good muscle tone and all reflexes are present and may be exaggerated.
Stage 3
Includes 4 planes of anesthesia.Plane 1 - the animal is under light anesthesia. The breathing becomes regular and the heart rate iswithin normal ranges. The animal may respond to surgical manipulation. They have good muscletone and reflexes are diminished.Plane 2 - the animal is in light surgical anesthesia. The breathing is regular and may be shallow.The heart rate is within the lower end of the normal range, the pulse is strong and the heart rateand respiration rate may increase with surgical manipulation. The muscle tone is relaxed. Inrodents, the toe pinch reflex may be present. In other species, the patellar, palpebral and cornealreflexes may be present.Plane 3 - the animal is under deep surgical anesthesia. The respirations are shallow and at the lowend of the normal range, the heart rate is slowed and the capillary refill time is increased. Themuscle tone is greatly reduced. They have no response to surgical manipulation and all reflexes arediminished or absent.Plane 4 - the animal is in an overdose stage of anesthesia. The respirations are jerky, the heartrate is below normal values. The capillary refill time is prolonged and the mucous membranes arepale. The animal has flaccid muscle tone and no reflex activity.
Stage 4
The animal is moribund. The respirations are apneic, there is cardiovascular collapse and theanimal is dying. The muscle tone is flaccid and there is no reflex activity.
Objectives
The objectives of the section on anaesthesia are:
To introduce the student to the administration of anaesthetics to laboratory animals
To discuss anaesthesia under the following broad headings:
o
Preanaesthesia
 
o
Effects of anaesthetic agents
o
Anaesthetic administration
o
Anaesthetic emergencies
o
Recovery from anaesthesia
To provide information on the effects of drugs used during anaesthesia
To consider the consequences of anaesthesia and the surgical procedures on recovery
To discuss anaesthetic emergencies and their treatment 
Introduction
"Animals must not be subjected to unnecessary pain or distress. The experimental design must offer themevery practical safeguard whether in research, in teaching or in testing procedures…" (Ethics of AnimalInvestigation, CCAC 1989)In this module we will discuss the alleviation of pain during painful procedures such as surgery, through theuse of anaesthetic drugs. Anaesthesia is also used for producing muscle relaxation, suppressing reflexes, andproducing loss of consciousness for purposes other than prevention of pain perception. For example,anesthesia is required for MRI, CT scans and in some cases for radiology.Because of the wide variability of laboratory animal species, strains, and strains, as well as anaestheticagents, an appropriate anaesthetic regimen should be developed in consultation with a veterinarian prior tothe commencement of any study.
Related Information Covered in Other Modules
The relief of pain after a surgical procedure, or at other times, is covered in the module "Analgesia". The signsof pain and distress in animals are covered in the module "Pain and Distress and Endpoints". Readers canrefer to these modules for further information.The need to use an anaesthetic to perform a procedure implies that the procedure would be painful for anawake animal. In addition there may be some residual pain after the animal recovers from the anaestheticand analgesics should be used. Some drugs described here appear in both the anaesthesia and analgesiamodules.
 
Preanaesthetic Treatments
There are several reasons why the use of preanaesthetic agents should be considered:
to reduce apprehension in the animal
to allow a reduction in the dose of anaesthetic required
to reduce some of the side effects of the anaesthetic agent
to provide some analgesia after the anaesthetic has worn off The preanaesthetic agent should allow a reduction in the dose of anaesthetic required. This applies particularlyto injectable anaesthetics where control of the depth and duration of anaesthesia is often more challengingthan with inhaled anaesthetics. The combination of preanaesthetic and anaesthetic drugs must providesufficient pain blocking so that the animal does not feel pain during the surgical procedure.Most anaesthetic agents do more than produce unconsciousness and pain relief. They are potent drugs thatmay affect every system in the body. The effects on the respiratory and cardiovascular systems may beparticularly significant during the anaesthetic period, however effects on other organ systems may be more
 
significant depending on the goals of the research. While some preanaesthetic agents may reduce anaestheticside effects, more often it is the reduction in anaesthetic dose that provides the greatest relief from the sideeffects.An ideal preanaesthetic agent should provide some analgesia after the surgery. Some analgesics are quiteshort acting in animals and depending on the length of the surgery may not last into the recovery period. It isimportant to ensure that analgesia continues through the surgical period, into and beyond recovery.The effects of the ideal preanaesthetic as described above are not to be found in a single agent. Sometimesmore than one drug is used but with care the undesirable side effects do not outweigh the potential beneficialeffects.
Summary
The ideal preanaesthetic agent should:
Reduce apprehension
Allow a reduction in anaesthetic doses
Reduce or eliminate some of the undesirable side effects of anaesthetics
Provide some analgesia after the anaesthetic has worn off 
 
ypes of Preanaesthetic Drugs
The major groups of preanaesthetic drugs are analgesics (particularly the opioids), tranquilizers andanticholinergic drugs. Paralytic or neuromuscular blocking drugs are also used as adjuncts to anaesthesia,particularly in human surgery.
Analgesics
Some analgesics, as well as providing pain relief, also have a desirable sedative effect. They calm the animalsand allow a reduction in the amount of anaesthetic required along with a smoother recovery from anaesthesia.Moreover, a pre-emptive strike against pain is thought to result in a reduced need for analgesics after thesurgery. For these reasons, some analgesics may be given as preanaesthetic agents. Of the analgesics, theopioids are commonly used as preanaesthetic agents.
Opioids
Among the effects of opioids that make them useful as preanaesthetic agents are analgesia (they make painmore tolerable without abolishing it completely) and CNS depression (there is usually depression althoughsome opioids may produce excitation and convulsions in some species). As a general rule, the suitability of any drug for a given species should be checked before using it.The combination of analgesia and CNS depression are both desirable for anaesthesia. This allows for areduction in the dose of anesthetic agent and provides pre-emptive analgesia.
Tranquilizers
The principal drugs in this group are the phenothiazine derivatives (e.g., acepromazine, chlorpromazine), thebenzodiazepines (e.g., diazepam, midazolam), and the butyrophenones (e.g., droperidol, fluanisone). Thealpha 2 adrenergic receptor agonists (e.g., xylazine, medetomidine) could be considered as tranquilizers aswell as analgesics but they are seldom used for their tranquilizing effect alone because of their profoundcardiovascular effects.

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