Anaesthesia

Pharmacokinetics
* GA is produced by action of anesthetics agents on

brain & spinal cord---- Depress CNS
Some inhalation anesthetics---- Metabolized wit in

body--- eliminated in faces & urine OR diffused
through Skin & mucous membrane.
Providing respiration & circulation---- Maintained--

-
Inhalation anesthetics are rapidly eliminated
from
body
Scanned with CamScanner

In contrast, Injectable anesthetics agents depend on
redistribution within body,
Biotransformation---Principally in liver & excretion via

kidney
Injectable anesthetics--- Less control over elimination

process
--- More dangerous than
Inhalant anesthesia
Anesthetics drugs--- Commonly administered by I/V

route & occasionally by I/M, S/C & Oral / Rectal route.

LV route--- Bypass the absorption phase of drugs
with the consequences that onset & intensity of
action are less variable.
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Risk of toxi
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The body may be considered to have multiple
compartment.
Like..
1.Vessel rich---- Brain, Liver, Heart & Kidney
2.Intermediate --- Muscle & skin
3.Fat--- Adipose tissue
4.Vessel poor---Residual tissue
This compartments differentiated by blood supply &

tissue blood partition coefficient
After |, V injection--- Mixing & dilution of drugs occurs

rapidly-------- Initial blood concentration of drug is
established.

The body may be considered to have multiple
compartment.
Like..
1.Vessel rich---- Brain, Liver, Heart & Kidney
2.Intermediate --- Muscle & skin
3.Fat--- Adipose tissue
4.Vessel poor---Residual tissue
This compartments differentiated by blood supply &

tissue blood partition coefficient
After I V injection--- Mixing & dilution of drugs occurs

rapidly-------- Initial blood concentration of drug is
established.

* Blood--- Become medium by which drug is delivered
to and removed from its site of action
* Factor affecting drug concentration & availability in

plasma also affect its concentration & availability at
the site of action.
Binding of drugs to plasma protein--- cannot rapidly

penetrate cellular membrane & removal of drug
stored in tissue, Metabolize & excreted them are both
important factors that lower the effective
concentration of drug at their site of action.

| CONT...
|
Binding is reversible fusion of small molecules.
Protein bindings varies with
--- Property of drug
--- Its concentration
--- Plasma PH
--- Protein concentration

¢ After initial dilution with vascular system,--- Drug j
distributed to various compartment according to their
perfusion, their capacity for drugs & partial pressure
gradient of drug between blood & tissue
° Vessel rich group of tissue archives equilibrium with

blood more rapidly than other tissue group.
* Change in tissue blood flow, solubility & blood -

tissue partial pressure gradient ----influences uptake
& distribution of I/V anesthesia.

Within) movement of tissue (drugs)--- Uptake,
Redistribution & elimination stared of drug
Circulation distribute drugs to vessel rich organ able
to biotransformation & or execrate it.
Liver--- Primary site for biotransformation
Kidney---Primarily responsible for excretion
Other organ --- occasionally involved —eg. Elimination
of morphine via GIT
Biotransformation---- Increase rate of disappearance
of drug from active site & convert (Anesthetics &
hypnotic drugs) Lipophilic Non polar compound to
Polar water soluble compound--- capable for
execration

Without such conversion----elimination of lipophilic
non volatile drugs ---prolonged & reabsorbed
--- metabolite produced by
biotransformation less active---toxic compound
production
Species variation in biotransformation may also

encountered eg. Duration & effect of lidocain in
Human, Dog, Guinea pigs, rates are differ.

Excretion subsequent to biotransformation
--- primarily function of Kidney.
Renal excretion --- Principal process by which

predominantly lonized drug, limited lipid solubility
drugs are eliminated.
Excretion rate determined by -

1.Renal blood flow
2.GFR
3.Tubular Secretion
4.Reabsorption

I/V anesthetics agent
Barbiturates
Narcotics
Tranquilizer
Non depolarizing relaxant..... excreted primarily by
kidney.
Inhalant agent--- primarily eliminated by Exhalation

--- Their metabolites are excreted largely
by kidney.

Factor Modifying Pharmacokinetics
Rate of administration
AYN os
Concentration of anesthetics
Physical status
Muscular development
Adiposity
Respiratory & circulatory status
Drug permeability coefficient
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Prior/ concurrent drug administration

Fear
. Recent feeding
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. Solubility of inhalant anesthetics in bags & hoes.

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Patient evaluation & Preparation
A thorough history should be recorded & a complete

physical examination performed before anesthesia
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Every animal should be categorized regarding its

physical status, health, pain, stress status and anesthetic
risk.

Classification of Physical status
hr
Normal healthy patient
—No discernible disease, OVH, Ear trim, caudectomy
or castration
Skin tumor, # with shock, uncomplicated hernia,

Patient with mild systemic disease
cryptochidectomy or localized infection
Patient with severe systemic disease Fever, dehydration, anemia, cachexia, moderate
hypovolemia
Patient with severe systemic disease that threat to life Uremia, toxemia, severe dehydration,
hypovolemia, anemia, cardiac depression or high
fever
Moribund patient not expected to survive 1 day with or without Extreme shock, dehydration, terminal malignancy
operation or severe trauma

Preanesthetic evaluation
Purpose--- to determine patient’s physical status
Physical status--- Py C or Avyb of disease, severity of

pain (if present)& level of stress.
The goal is to determine any deviation from the norm

that will affect anesthetic uptake, action, elimination &
safety.
Organ system of greatest concern are the Nervous,

Cardiopulmonary, hepatic & renal.

- Physical status--- aid in selection of anesthetic drug,
technique and arriving at preanesthetic prognosis.
¢ Physical status--- One of best determinants of

likelihood of cardiopulmonary emergency occurring
during anesthetic period.
Physical status--- Determined by

1.History--- Including assessment of pain
2.Inspection--- Condition, conformation, temperament,
stress/ distress
3.Palpation, percussion & Auscultation
4. Lab. Determine & special procedure eg. Radiograph

* If any abnormality—Noted & corrected by medicinal
treatment but if no improvement then patient overall
risk & prognosis can be determined.
* History & Physical examination are best

determinants of presence of disease.

i
| * Laboratory test should be done on the basis of
| physical exam & history |
Laboratory test---
1. CBC, Urine analysis, blood chemistry—kidney & liver
function test
2. Blood gas, PH, platelet count
3. Fecal, Filarial examination & blood electrolyte
determination
¢ The preliminary physical examination should be

done in owner’s presence if possible so that
prognosis can be given personally.

Pain
An aversive feeling or sensation as
sociated with
acute or potential tissue damage.
Pain system includes sensors, neural path

ways &
processing centers that are responsible for
detecting,
transmitting and activating animal’s biologica
l &
behavioral response to noxious events.
Pain warn animals of potential tissue damage &

protect them from further injury.

Physiological pains Ouch pain---- In the Absence of
tissue damage, pain
considered it.
Which warns & protects animal from tissue damage.
Pathological pain--- occurs when tissue or nerve are

damaged

Stress
Animal feel the pain, which affects their physiology,

quality of life and interaction with their environment.
Stress response--- When pain is severe or chronic,

increase sympathoadrenal & neuroendocrine activity
called stress response
Both acute & chronic pain produce stress

Preparation of the patient
¢ Proper preparation not only improve the patient’s
chance of survival but also prevent complications
during and after operation.
¢ When operation performed on healthy animals only

minimum preparation is required before
administration of GA.
¢ But operation on dehydrated, anemic, hypovolemic or

toxic patients should be under taken after careful
preoperative assessment & preparation.

. Food & Water
Food—Withheld from animal on the day it is to be undergo
operation under GA
--- Distended stomach may interfere with free movement of
diaphragm & hinder breathing
In Dog/Cat, Pig--- Full stomach predispose vomition under
anesthesia
In Horse--- Full stomach may rupture when horse fall to ground
as unconsciousness is induced.
. Fluid & Electrolyte
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Water & electrolyte balance of animal is most important factor

in determining uncomplicated recovery or otherwise after
operation.
. Hb Level: Hb level decrease operation delayed 2 or more week
Oral or parenteral administration of Iron may increase Hb level
. Diabetes mellitus

Preanesthetic agents
Agents are used to prepare the patient for administration of

anesthetic agents.
To reduce all secretions. Eg. Salivary sec
To reduce dose of general anesthetic required to anesthetize
patient
To reduce anxiety
Increase margin of safety
To smooth administration of anesthetics drugs
Fast & smooth recovery

Many preanesthetic agents produce analgesia, sedation or
narcosis and may permit minor surgical procedure without
use of GA.
In large animal, some of these agents in combination with

Local anesthesia (LA) allow successful completion of many
LE
surgical procedure.
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Preanesthetic agent can be Anticholinergic, Morphine,

Tranquilizer & Neuroleptanalgesic agents.
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Anticholinergic 1. Morphine
1. Atropine sulphate 2. Mepridine HCL Tranquilizer
es ycecna | (Pethidine) 1. Chlorpromazine (Largactil)
SS ca laemammnal — 3. Methadone 2. Triflupromazine
4. Fentanyl seal (Siquil)
s. Fentanyl derivatives 3. Promethazine
6.
; Etorphine (W(M-99) HClPhenergan}
| | 4. Promazine HCL (Sparine) _
*. Pentazocine s.Droperidol =
Pee. Methotripromazine
7 Acetyl promazine maleate
(Acepromazine)

Anticholinergic
1. Atropine sulphate
Y Belladona Alkaloid
Y Antisialogogue
To antagonize the unwanted muscarinic action of
anti-cholinesterase.
When administered rapidly I/V, initial bradycardia
may observed due to vagal stimulation which is then
followed by cholinergic blockage & tachycardia
Cross BBB & PB
Relaxation of iris sphincter muscle induce dilatation
of pupils. So contraindicated in patient with
glaucoma & synechia

* It 7 anatomical & physiological dead space
Antidote of overdose of cholinergic drugs

1. Neostigmine
2.Edrophonium.......... Also for organophosphate
poisoning
Dose
1. D/€ 0.02-0.04 mg/kg IV, VM, S/C
2. Small farm animal: 3-5 mg/kg VM
3, Horse: 40- 60 mg/Kg VM
Duration is between 60-90 minute

2. Hyoscine/ Scopalamine
¢ It blocks the action of acetylcholine liberated at

parasympathetic postganglionic nerve endings
¢ Depress CNS & Antisialogogue
° More potent
* When Injected S/C--- | HR

* When Injected I/V---- 7 HR
* It may produce considerable excitement in horse
Dose D/C: 0.01-0.02 mg/Kg

3 . Glycopyrrolate
Quaternary ammonium anticholinergic agent
Powerful & prolonged Antisialogogue activity
5 times more potent than atropine
Little CNS action, produce less effect on vision than

other anticholinergic agent
Duration Longer lasting 90-180 minute
Dose Dog: 0.01-0.02 mg/kg

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MORPHINE & ITS DERIVATIVES
1. Morphine
* Good sedation & good analgesic properties
* Depress respiratory center & produce bradycardia
Bradycardia reversed or potentiated with atropine
Cross PB & depress respiratory center foetus

In Cat—Maniacal excitement
When given at appropriate dose to reduce pain

morphine have sedative & calming effect in all
species of animals
VV route— excitement, reaction, Bradycardia &

Histamine release
Dog: 0.5 -0.75 mg/kg I/M or S/C

Horse: 60 mg/ IM or SC

2.Meperidine HCL (Pethidine)
* Less Hypnotic effect
* Relive pain without interfering with muscular activity
* Therapeutic dose have little effect on BP
Some degree of Respiratory depression
¢ Rapidly destroyed in liver
100 mg of pethidine are equivalent in terms of pain
relief to 10 mg of morphine
¢ 1:10 (Morphine: Pethidine) 1mg= 10 mg
Dog: 5-10 mg IM up to 150 mg

Cat: 5-10 mg IM up to 10 mg
Horse, Cattle: 1 mg IM up to 1gm

3. Methadone
¢ Synthetic analgesic & Narcotic agent
* Good analgesic
¢ Respiratory Depression--- Slight decrease in BP & PR
* When given alone, used for analgesia & narcosis for

minor surgical procedure
D: 0.1-0.5 mg/kg S/C IM

H: 6o mg/kg I/V or VM

| 4 Fentany! ;
| * 50 times potent as morphine
| ° Little effect on CV but cause bradycardia
Part of Neuroleptanalgesic mixture with Droperidol

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for Dog
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Popular post-operative analgesia

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Dog: 0.05-2 mg/Kg I/V, VM

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Horse: 0.2 mg/Kg

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5.Fentanyl derivatives
Sufentanyl: 10 times potent than Fentanyl
Carfentanyl: most potent opiods for elephant
6. Etorphine (M-99)
Potent derivatives of morphine
Generally used in Dart gun to immobilize wild animal
Dose: 2 pg/ Kg
Antidote: Diprenorphine HCL: 4 mg/kg counteract the

effect of morphine

7, Butorphenol
* For Cat, Dog, Horse analgesia
* Use sedative combination with alpha-2
adenoreceptor agonist
Horse: 0.1-0.4 mg/kg
Dog/Cat: 0.1-0.5 mg/kg VM S/C
s.Pentazocine
¢ Used for relief of colic pain in horse
H: 0.5 -4 mg/Kg orally

0.33 mg/kg I/V

Tranquilizer
* Useful in vicious and nervous animal &

produce a sedative and clamming effect.
¢ Antiemetic property & potentiate the action of
most of anesthetics & narcotics.
¢ Some agents have hypotensive effect due to
CENTRAL DEPRESSION & peripheral alpha
blockade.

| 1. Chlorpromazine HCL (Largactile)
* Antiemetic
* Central depression & vagolytic properties
* Enhance activity of sedation, analgesic &
anesthetics
In Cattle- Not given before GA
- Produced delayed recovery
* Great value along with local analgesic
¢ Administered ensure absence of narcotic
excitement during recovery from
: barbiturate anesthesia

Not preferred in Horse—Decrease BP, giving rise to
state of panic due to muscle weakness
D/C; 0.5 -1.0 mg/kg IM, IV

H: 0.4 MG/KG IM
C: 0.5-1.0 mg/kg IM
Pig: 1 mg/kg IM
$/G: 1-1.5 mg/kg IM

2. Triflupromazine HCL
10 times antiemetic effects of chlorpromazine

3 to 5 times traanquilizing potency
D: 1-2 mg/kg IM or IV 2-3 mg /kg IM

C: 3- 5 mg/kg IM
Cattle: 0.1-0.2 mg/kg IM or IV maximum dose of
4omg
H: 0.2-0.3 mg/kg IV or IM maximum dose of 100
mg

3. Promethazine HCL (Phenorgan)
Irritant to tissue
Injected deep into tissue
For I/V - Drug can be diluted with
isotonic saline--- By slow I/V
¢ Rapid I/V - Profound fall in BP which
may fatal in shocked animal
¢ Potent antihistaminic property

4. Promazine HCL (Sparine)
¢ Action similar to chlorpromazine

¢ Antihistaminic effect 1/5 to that of
chlorpromazine
* Horse under influence of promazine
appears to be hypertensive to Noise.
¢ D/H—1 mg/kg IM, IV

5. Droperidol
* Used with combination with Fentanyl to

produce neuroleptanalgesia
¢ Good tranquilizing property when used
alone.
¢ Dog- 0.1 to 0.4 mg/kg IM, IV

6. Methotrimeprazine
More effective than chlorpromazine as

a sedative
Quite recovery from anesthesia without
causing any marked increase in
recovery time
D/C—1mg/kg IM
H—o.s mg/kg IM

7. Acepromazine
Tranquilizer for choice of large animals and
small animals
CNS depressant
Antiemetic
Anticonvulsant
Hypothermic
Hypotensive
Antispasmodic property
Potent tranquilizer in veterinary practice
D/C—o.1-0.2 mg/kg IM
H/C—o.2 mg/kg IM
---- 0.025 = 0.05 mg/kg IV

| a2 Adenoreceptor agonist |
: 1. Xylazine |
20 mg/ml or 100 mg/ml
Potent thiazine derivatives
Sedative, analgesic & muscle relaxant
effect
Sedative & analgesic effect due to CNS
depression
Muscle relaxation due to inhibition of
intraneural transmission of impulse in CNS

Onset of effect within 3-5 min IV
5-10 min IM
After administration RR & HR are decreased
Cause laryngeal relaxation & cough suppression
Vomition frequently seen in Dog & Cat due to central a2
activation
Wide margin of safety, increase dose does not increase
degree of sedation but rather duration of effect
Marked ecbolic effect — Not used in last third trimester of
pregnancy
H—1 mg/kg IV
---2mg/kg IM
D/C—1-2 mg/kg IM or SC
Cattle---0.05 -o.2 mg/kg IM
Antidote -Yohimbin ---- 0.05- 0.3 mg/kg

2. Detomidine
Potent a2 agonist
Used in Horse for sedation
Animal may remain standing in low dose
Dose dependent sedation is produced
Less ecbolic effect than Xylazine
H—10-100 pg/kg IV, IM
----10-20 Ug/kg suitable for sedation
Cattle—30 pg/kg IV, IM

3. Medetomidine
Most potent
Selective agonist of «2 adenoreceptor in
CNS & PNS
It may cause marked ataxia in horse at
low dose
Dog—40-80 pg/kg IV, IM

Cat---80-120 pg/kg IM
Sheep—10-20 pg/kg IM

a2 antagonist
¢ Yohimbin
¢ Atipamezole
* Tolazoline
* Idazoxan
°° °~°~°»”
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Benzodiazepam derivatives
. Diazepam
Insoluble in water
Muscle relaxant and anticonvulsant property
No antiemetic property
Appetizer, antidistress, growth stimulating factor
Tranquilizer
IM _ injection--- Irritating to tissue, erratic absorption

IV injected slowly to prevent pain & venous thrombosis
Cattle, Sheep--- 0.5-1.0 mg/kg deep IM

Small animal—a-5 mg/kg deep IM
---2-3 mg/kg IV
---- 5 mg/kg oral
Dog—o.smg/kg
Antidote: Flumazenil

. Midazolam
¢ Water soluble
2-5 times more potent than diazepam
Due to good water solubility well
absorbed by IM or SC route
Dog, Cat--- 0.1-0.5 mg/kg
b
. Zolazepam
Used in combination with Tiletamine
(Telazole) (class-Il
Each vial contain powder of 250 mg of
zolazepam

| Stages of general anesthesia—4 stages
Stages-1 Stages of Voluntary excitement,
Stages of Induction
¢ Animal fully conscious & excited
¢- PR & RR accelerated
© Breadth holding may noticed
¢ Faces & urine may be passed

Stage- 2 Stage of Involuntary excitement
¢ Consciousness lost/ unconscious

¢ RR- regular breath holding occurs
¢ Violent limb movement or muscular
rigidity followed by gradual relaxation
of muscle when animal enter in next
stage
Stage 1 & 2 can be shortened & pass off

smoothly by use of preanesthetics

1* plane of surgical anesthesia (light
anesthesia)
Breathing become normal
Limb movement stop
Eye ball movement from side to side but they
soon get fixed when enter in 2™ plane of
anesthesia
Palpebral, conjunctival and corneal reflex-
sluggish or almost absent
In Dog, peeal reflex- present Def: Pulling
away of limb when webs of foot is pinched
Minor surgical operation - abscess opening
can be done under light anesthesia

2"¢ plane of surgical anesthesia (medium
anesthesia)
Respiration more or less
Pedal reflex—sluggish
Muscular relaxation—become progressively
more pronounced
Eye ball—in C/H/P/S—central
---in Dog—may rotate downward

3" plane of surgical anesthesia
RR—Increase but depth of respiration

decrease
Pedal reflex—disappear
Eye ball- In Dog/Cat—once again become
central due to loss of tone of iris muscle
Generalized muscle relaxation

Stage: 4 Over dose
Administration should be stopped immediately
Pulse become rapid
Eye ball -Dry & pupil- dilated
Thoracic muscle paralyzed & during inspiration
movement of diaphragm cause bulging of
abdémen & inward movement of thorax
Movement of diaphragm - jerky & respiration—
Gasping
If proper counter measure not taken—Respiration
ceases
---Mucous membrane- cyanotic
---- Heart failure—ash grey colour of M. M.

Intravenous anesthetics agents/ Parenteral
Anesthetics agents

* Inducing anesthesia by IV administration
Advantage:
* Rapid & smooth induction of anesthesia
* Little equipment requirement
¢ Easy administration
Disadvantage:
* Difficult to retrieval of drugs once
administered
* Less control of depth & duration of anesthesia
* Lack of ventilatory support
* Poor tolerability in debilated/ dehydrated,
toxicated animal.

IV anesthetics agents
Propofol
Etomidate
Pentobsrbital Ate ceri)
Methohexital Chioral Hydrate
Chlioral Hydrate Mg sulphate
Chioral Hydrate Mg sulphate
¥ Thiobar biturat
. dates Pentobarbitone (Equithesin)
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Barbiturates (According to duration of
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Action)
1.Long acting e.g. Phenobarbital
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2.Short acting e.g. Pentobarbital
3.Ultra short acting e.g. Thiopental
Thiamylal
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Methohexital
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Barbiturate
| 1. Pentobarbital sodium
| * Short acting
_ + Oxy barbiturate
* Depress CNS
* Take appreciable time to cross BBB
_ * Depress respiratory center
* Slight fall in BP due to peripheral vasodilation
* Destroyed primary in liver & execrated in Urine
* Dog: 20-25 mg/kg IV
* Horse: 1 fo 2.24 gm or 15-20ml of 6.5 % IV

2. Methohexital
Ultra short acting

Oxy barbiturates
Less irritant
Metabolized in liver
Rapid injection may produced transient
hypotension
Rapid recovery
Small animal: 10 mg/kg (1%) to effect IV
Large animal: 25 mg/kg (2.5%) to effect IV

3. Thiopentone sodium
Thiobarbiturate
Ultra short acting
Produced brief period of unconsciousness
Cross PB with great speed
Myccardial depressant
Respiratory depressant
Its injection followed by period of apnea
Available in powder form required water to
dissolve
For only IV

* Very acidic, cause severe necrosis in accidental extra-
vascular administration (barbiturate slough) to avoid
this administered through catheter. Treat accidental
extra- vascular injection by injecting sterile saline
with either enzyme hyluronidase or local anesthetics
without epinephrine
* Low concentration practicable is used
Cat + 1.25 %, Dog—2.5 %
Horse, cattle — up to 10 %
* Higher concentration cause thrombophlebitis in vein
* Recovery slower
Dog: 20-25 mg/kg IV 2.5 % solution usually 7-8 mg/kg
injected rapidly & anesthesia further may prolonged by
small dose
Horse: 7-15 mg/kg IV anesthetics effect observed in 25-30

* Very acidic, cause severe necrosis in accidental extra-
vascular administration (barbiturate slough) to avoid
this administered through catheter. Treat accidental
extra- vascular injection by injecting sterile saline
with either enzyme hyluronidase or local anesthetics
without epinephrine
* Low concentration practicable is used
Cat +: 1.25 %, Dog—2.5 %
Horse, cattle — up to 10 %
* Higher concentration cause thrombophlebitis in vein
* Recovery slower
Dog: 20-25 mg/kg IV 2.5 % solution usually 7-8 mg/kg
injected rapidly & anesthesia further may prolonged by
small dose
Horse: 7-15 mq/kg IV anesthetics effect observed in 25-30

4. Thiamylal Sodium
Thiobarbiturate
Ultra short acting
Resemble to thiopentone
More potent than thiopental sodium
Less cumulative effect
Less:excitement during induction &
recovery
Premedication with atropine sulphate to
check salivation
Dog: 18-25 mg/kg IV

Non- barbiturate agents
. Propofol
Non- barbiturate
Non- dissociative
IV agent
Widely used in Dog & Cat
Insoluble in water, prepared as milky
white emulsion of containing
1omg of propofol,
100mg of soyabean oil,
12 mg of egg lecithin
22.5 mg of glycerol per ml

* Propofol provide no analgesia, so painful
operative procedure required high dose.
¢ This high dose produced apnea &
intubation with positive ventilation is
required.
¢ It is recommended to combine propofol
| with an analgesic agent (opiods or a2
| agonist) for painful procedure
* Dog: 6 mg/kg IV (Unpremedicated)

amg/kg IV (premedicated)
¢ Horse: 2 mg/kg IV

2. Etomidate (IV)
Ultra short acting non-barbiturate hypnotic
agent
Cardiopulmonary depression- minimal
Respiratory depression & apnea produced
Not popularly used in vet. Medicine because
Most expensive
Sneezing, reteching & myoclonic twitching
observed at induction
Hemolysis & hematuria observed in Dog
Painful upon injection due to its propylene
glycol preparation
Dose: Dog; Cat: 2-4 mg/kg IV

3. Saffan: Althesin
Mixture of two steroid

Alphaxalon (smg/ml) + Alphadolone (smg/ml)
in cremphor
Produced short duration of anesthesia and
rapid and complete recovery
Little respiratory depression and adequate
muscle relaxation
Not used in Dog b/q dose related
anaphylactic type of reaction
Cat- 4-6 mg/kg IM or IV

4. Chloral hydrate
Drug of choice in adult cattle for producing
Hypnosis, Narcosis
When narcosis attain its depth, Respiration and
pulse rate are not appreciable altered.
It is not always without danger to use chloral
hydrate for producing GA
Solution is very irritant and dose not infiltrate into
perivascular connecting tissue
Horse: 6.5gm/sokg (6-8% solution) IV to effect
Cattle: 90-100 mg/kg IV
Calf: 140 mg/kg IV
Cattle/Horse: 6-10gm/sokg by stomach tube

5.Chloral hydrate magnesium sulphate
Chloromag
¢ Mixture of 2 part of chloral hydrate +
one part of magnesium sulphate
¢ Less irritant
¢ Horse/Cattle: 5 gm/50 kg, 10% solution IV
to effect

6. Chloral hydrate magnesium sulphate
Pentobarbitone
Equithesin
* General anesthesia in Horse
° Low toxicity
* Excitement during induction is negligible
¢ Good muscular relaxation
* Rapid recovery
* Animal regain consciousness at about the same
rate as muscular coordination is restored.
* There is no struggling during recovery period

Composition of Equithesin
Chloral hydrate----- 28 gm
Magnesium sulphate—14 gm
Pentobarbitone sodium--- 6.5gm
2
Distilled water--- 1o0oml

y
Horse: 67oml/4sokg IV

Dissociative agent

1. Ketamine
Depress the thalamocortical system, an

association region in cerebral cortex while
stimulating reticular activating and limbic
system
Posses better somatic analgesia than visceral
analgesia
Oral and swallowing reflex are present and
eyes remain wide open
After its administration respiration become
apneustic in nature
Dog/Cat: 10-20 mg/kg IM
5-10 mg/kg IV

2. Tiletamine
Used in combination with zolazepam

Telazol—Tiletamine+ Zolazepam
Tiletamine—Analgesia & immobilization
(somg/ml)
Zolazepam—muscle relaxant &
tranquilization (somg/ml)
Telazol used extensively in Exotic large
animal (large cat, pig) as darting agent for
immobilization.

INHALANT ANESTHETIC AGENT
Chloroform
Diethyl ether
Halothane
Methoxyflurane
Trichloroethylene
Nitrous oxide
Cyclopropane
Enflurane
. Isoflurane

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Comparison between Inhalant
and Injectable technique
Expensive equipment Cheap (Needle & syringe)

¢| :
( LY cece icin Gs uit Once given suffer the
era | consequences
LFV SeC Ty Only through metabolism &
excretion

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Ideal properties of Inhalant
anesthetics
Non- explosive
.
Non- inflammable
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Non-Toxic
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e
Safe with carbon dioxide absorbent

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.
Potent
wu
.
Pleasant to inhale
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.
Minimal metabolism
ys
.
Low blood gas solubility

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Good analgesia
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.
. Good shelf life

om
&
. Minimal organ depression

ons
=
Inexpensive
pay
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1.“Chloroform
¢ Powerful anesthetic agent |

¢ 0.035% concentration in blood cause
anesthesia
0.06% concentration in blood is * fatal
¢ 1.5 to 2.0 % concentration of chloroform
in air necessary to anethestize animal
in 10 to 20 minute
¢ Irritant to skin and M.M

Cardiac failure may occur at during stage of
induction
Dose related cardiac pressure & respiratory

depression
Toxic effect on liver & kidney
Incidence of post anesthetic pneumonia are

higher in cattle after its administration

2. Diethyl ether
Highly inflammable
Not used in any place in which electrical
equipment used .
Excellent analgesia & muscle relaxation
Pungent smell & irritant to MIM
It cause copious salivation & bronchial
secretion, so that atropine must be used
for premedication

Respiratory depressant but cardiovascular
function well maintained at clinically suitable
level of anesthesia
15 to 20 % of ether vapor needed for induction

of anesthesia .
Given by open, semi open, closed or semi

closed method
Safest general anesthetics

3. Halothane
Volatile anesthetic agent

Produced smooth and rapid anesthesia
with a vapour concentration of 2- 4 %
halothane in inspired air
Anesthesia can be maintained in
concentration of 0.8 to 2.3 % in inspired air
Minimum alveolar concentration (MAC)
0.765%
Recovery is rapid and free form of
excitement

Respiration is depressed, leading to decrease
in tidal volume
Its administration cause slow pulse & fall in

BP
b
Rapid administration result in greater
respiratory depression & apnea
Minimal effect on liver & kidney

4. Methoxyflurane
Most potent
Non-explosive
Non- inflammable
Poor induction agent
Ultrashort acting barbiturate used to induce
aesthesia before maintenance with
methoxyflurane
MAC 0.16 %
Dose dependent depression of respiration
HR & rhythm not altered until anesthesia
become very deep
Good muscle relaxation

5. Trichloroethylene
Resemble to chloroform
Non-explosive
Non-inflammable
Less potent & toxic "
Administered in semi closed circle system
with mixture of nitrous oxide and oxygen
Not used with soda lime---because as
breakdown fo toxic product like
Phosgene, Dichloroethylene HCL

6. Nitrous oxide
Non-explosive
Non-toxic & weak anesthetics
Can be used satisfactory, if animal are
premedicated and have received IV agent
such as thiopentone sodium to abolish
consciousness
Rapid recovery without any post-
operative complication
Non-irritant to respiratory mucosa

¢ If air pockets exist anywhere in body, nitrous
oxide will diffuse into pockets as nitrogen is
reabsorbed during denitrogenation of body.
Thus, nitrous oxide is used in air embolism &
presence of air pocket in the body may
constitute major hazards.
b
* Nitrous oxide cause diffusion hypoxia during
recovery. A 5-10 minutes of 100% oxygen
supplementation should prevent diffusion
hypoxia.

7, Cyclopropane
Potent & quick acting anesthetics
Effective concentration of 15-30 % with
oxygen
Non- irritant to M.M
Respiratory depressant
Due to vasodilatation effect--- increase
haemorrhage at the operative site
Little adverse effect on liver
Quickly eliminated & recovery after
prolong administration is quick

8. Enflurane
MAC-.--- 2%
Halogenated ether
It depress cardiovascular function in
dose dependent manner
Produced negative inotropic effect on
heart of intact dog
Depth of anesthesia rapidly changes &
recovery also be rapidly attain after
enflurane administration.

9. Isoflurane
Administration with oxygen / Nitrous
oxygen or oxygen mixture
Dose dependent respiratory and C.V
depression
Highly volatile& low blood solubility
Has lower partition co-efficient
Rapid induction & recovery
Easy control on depth of anesthesia
Great muscle relaxant
MAC—1.3 %

10. Sevoflurane
Low blood / gas solubility lower than

isoflurane
Induction and recovery is quick
¢ Non-irritant to M.M.
MAC in Horse 2.36%

* Several features of local anesthesia render it
particularly useful in veterinary practice.
* Many surgical procedures can be carried out

satisfactorily under local anesthesia (e.g.,
Caesarian section in cows).
¢ Whether or not sedation is necessary as an

adjunct will depend on the species,
temperament and health of the animal, and
on the magnitude of the procedure

¢ In adult cattle, many operations are
performed on standing animals and since
sedation may induce the animal to lie down,
it is better avoided.
* Enabling operation in standing animals also

eliminates the dangers associated with
forcible casting and restraint, and prolonged
recumbency.

¢ In other animals, sedation is often employed
to facilitate cooperation from animals by
reducing fear and anxiety.
* The sedation also reduces the likelihood of

sudden movement in animals.

| Preemptive local anesthesia in animals
undergoing general anesthesia will.....
* reduce the amount of general anesthetic,
© minimizing the cardiopulmonary depression
* Quicker recovery.
It provides a useful pain relief, even beyond the

; full recovery from general anesthesia.

Preemptive local anesthesia in animals
undergoing general anesthesia will.....
* reduce the amount of general anesthetic,
* minimizing the cardiopulmonary depression
¢ Quicker recovery.
It provides a useful pain relief, even beyond the

full recovery from general anesthesia.

¢ In some situations with extremely depressed
animals when they will tolerate, performing
a surgical procedure under local anesthesia
may be safer as well as more economical.
¢ The techniques are not difficult to learn and

do not involve the use of expensive or
complicated equipment.

—
¢ Local anesthetics (LAs) consist of a lipophilic

and a hydrophilic portion separated by a
connecting hydrocarbon chain
* An ester (-CO-) or an amide (-NHC-) bond

links the hydrocarbon chain to the lipophilic
aromatic ring.
* The hydrophilic group is usually a tertiary
amine, such as diethylamine, whereas the
lipophilic portion is usually an aromatic
ring, such as para-aminobenzoic acid.

¢ Some examples are;
Esters: procaine, cocaine, chloroprocaine,
and tetracaine.
Amides: lidocaine, bupivacaine

Mechanism of action
* LAs block nerve conduction by inhibiting

influx of sodium ions through ion-selective
sodium channels in nerve membrane leading
to impairment of the generation of action
potential.
The sodium channel itself is a specific receptor

for local anesthetic molecules.

oe — eee -os as — —_
Systemic and toxic effects of local anesthetics
Accidental intravenous injection--- Most

common cause
In severe cases if can cause cardiac arrest.
Always draw back on syringe to check not in

vein before injecting local anesthetics.

¢ Signs of overdose are initial sedation,
followed with increasing dosage by
twitching, convulsions, coma and death
* toxic dose of Lidocaine would be s mg/kg

(much lower in the cat, 2mg/kg) and 4 mg/kg
of Bupivacaine
¢ prilocaine, benzocaine, lidocaine and

procaine---produce methemoglobinemia in
some animals

* Signs of overdose are initial sedation,
followed with increasing dosage by
twitching, convulsions, coma and death
* toxic dose of Lidocaine would be s mg/kg

(much lower in the cat, 2mg/kg) and 4 mg/kg
of Bupivacaine
* prilocaine, benzocaine, lidocaine and

procaine---produce methemoglobinemia in
some animals

Local anesthetic agent
Cocaine
=
Procaine HCL
N
Butacaine
W
Amethocaine
BF
Tetracaine
WU
Lignocaine HCL
A
Mepivacaine HCL
nu
Bupivacaine HCL
oOo
Ethyl chloride
oO

Cocaine
¢ Good surface anesthetic for corneal &

conjunctiva
¢ Cause vasoconstriction of superficial vessels,
mydriasis & corneal irritation
b

Procaine HCL 2-4%
Most widely used LA

older drug
slow onset of action and poor spreading
powers
lb
Non-irritant to tissue
Non-toxic
Poor penetration power in mucous
membrane

Butacaine
¢ Surface anesthetic agent for eye, nose &

throat
¢ Used for ophthalmic solution for short
duration
by

Amethocaine
Desensitize mucous membrane 1.0%
1.0% instillation in eye
2% pharynx, larynx and nasal MM
well absorbed by surfaces and is used on
mucous membranes
Tetracaine
¢ Drug of choice for corneal anesthesia

Lignocaine HCL 2 %
OE
as S
en
err
Surface as well as injectable anesthesia

IG eee. nn
Rapid onset of action

ee Se
More intense action

kee
Longer duration of anesthesia than procaine

le
Ue hCUc eel
EEE

Mepivacaine HCL
Carbocaine
Most widely used in horse
Little swelling and edema in the area of
injection lacks vasodilatory action.
Rapid onset of action
e b e
Diagnosis of equine lameness b/q less post

injection edema

Bupivacaine HCL
¢ 4 time more potent as lignocaine

° 0.5 % solution equivalent in nerve blocking
activity to 2.0% lignocaine
¢ Prolonged duration of action (s hrs) when
combined with epinephrine

Ethyl chloride
¢ Surface anesthetics for short duration

¢ Remove the heat and freeze the area
¢ Long time application cause irreversible
freezing of tissue
b

Prilocaine
¢ It has slower onset of action, and spreads
less well compared to lidocaine
¢ The unique ability of prilocaine to cause dose

dependent methemoglobinemia limits its
clinical usefulness
¢ The main use is in the horse as it causes less

swelling but great accuracy is needed when
doing specific nerve blocks

Drug administration with LA
Epinephrine
Prolong the action of anesthetic without large
quantity of LA
1: 50,000 fo 1:2,00006 added in solution
Cause constriction of vessels and decrease

rate of absorption thereby localizing the
anesthetics agent at the site

ee
2. Hyaluronidase
es
ee
¢ Mucolytic agent
eee
¢ Capable hydrolyzing the intracellular cement

thereby increase diffusion into tissue result in
desensitization of large area
ee
ee
Disadvantage b
eee
¢ Adding hyaluronidase to anesthetic decrease

See
duration of anesthesia
* 150-200IRU is added to 50-100ml of anesthetic
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agent

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Methods of inducing local anesthesia

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Surface, topical anesthesia

ee
Infiltration anesthesia
2
Field block
=
Regional anesthesia
~
Intrasynovial anesthesia
Intravenous retrograde anesthesia (IVRA)
ee
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1.Surface, topical anesthesia
* Agent which cause freezing of superficial

layer of skin
* Ice- simplest agent
* Generally volatile substance which cause
freezing by their rapid volatisation from
surface of skin are used
Eg. Ethayl chloride
Ether spray
Carbolic acid spray

When it used freely cause— Necrosis
Topical — one or two drops of solution should
be instilled at a time & its instillation repeated
several times at approximately one minute
interval in order to have maximum effect for
topical anesthesia of eye
After the :* instillation at least 5 min should
be allowed for the anesthetic effect to reach
its proper level
4% procaine, 2% lignocaine or
0.5 % proparacaine.

EES
2.Infiltration anesthesia
aaa
ee as
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It affects at nerve endings at the actual site of

en
ee
operation
aS ee
Minor operation
es
ee a
ee a
Technique also useful in conjunction with

basal narcosis for major operation which are
OT Oeese ee
poor surgical risk
Infiltration never carried out through or into

ES ee ee i
infected or inflammed tissue

ae

¢ The limits of the area to be infiltrated are
conveniently defined & marked for
subsequent recognition by use of intra
dermal wheel.
¢ Intra dermal wheel performed with short

needle started from cranial dorsal surface of
site of incision
¢ The needle is inserted in the skin at the angle

of approximately 20 degree.

As soon as it placed properly in intradermal
tissue 0.5 -1 ml solution deposited which will
raise a wheal approximately 1 cm _ in
diameter.
S/C tissue infiltrated by introducing needle
through the skin at the site of intradermal
wheal b
To infiltrate several layer of tissue procedure
to inject one puncture site. 1** S/C tissue then
advancing needle in several layer
About 1 ml of solution is required for every
cm of incision

¢ Can be performed either in form of linear
infiltration or inverted L or T form

3. Field block
Anesthesia in larger area _ than local
infiltration
More satisfactory method
Making fanwise, injection in certain plane of

body to block all nerve across the plane of
their way to the operation field
The block may form in different field

Eg. Ring block around extremities or teat

4. Regional anesthesia
Blocking by conduction in the sensory or
nerve innervating the region where
operation to be performed
Sensitivity is abolished & good analgesia
results from use of small quantity of local
anesthetic solutidn
The solution is however, brought in contact
with nerve (Not contact - Fascia) which is to
be blocked
May be achieved by field block or Epidural
Lda al

5. Intrasynovial anesthesia
Relief of pain arising from _ pathological
process involving Joint & tendon sheath,
lameness diagnosis
Solution injected into synovial cavity &
dispersed thraughout the cavity by
manipulation of limb
If synovial cavity distended with fluid--- drain
first to ensure that injected solution not
excessively diluted
Anesthesia develop within 5-10 min & persist

6. Intravenous retrograde anesthesia
(IVRA)
¢ A needle or catheter is
inserted in to vein of
distal extremities of a
limb
* A tourniquet is tied at
the top of limb to
occlude arterial blood
supply
* Local anesthetic injected

into vein

¢ Analgesia of limb upto the lower limit of
tourniquet comes rapidly & once tourniquet
released it wears off with almost equal
rapidity
¢ Safe & simple for operation of a digits or

below elbow, heck or carpal / tarsal region

* Inhalation anesthetics --- absorbed, transformed
| & eliminated --- body without change
| * This is not with all inhalation anesthetics
| Eg. Halothane- metabolized & excreted via kidney
_ Main reason of relative safety of Inhalation

anesthesia.....
1. Anesthetics effects can be reversed by
elimination through lung
2. No detoxification is necessary

¢ Inhalation anesthetics --- absorbed, transformed
& eliminated --- body without change
¢ This is not with all inhalation anesthetics
Eg. Halothane- metabolized & excreted via kidney
Main reason of relative safety of Inhalation

anesthesia.....
1. Anesthetics effects can be reversed by
elimination through lung
2. No detoxification is necessary

¢ Whereas, none of IV anesthetics agent -
voluntarily eliminated they require metabolic
alteration or elimination via kidney or liver
¢ Inhalation anesthetics are comparatively

expensive & require inhalation equipment
* However, most controable method for

anesthesia & Depth of anesthesia are easily
changed

¢ Inhalation agent
High partition co-efficient --- slow induction &
recovery
Low partition co-efficient --- Faster induction &
recovery
Inhalation anesthetics grouped into three
1. Pulmonary phase
2. Circulatory phase
3. Tissue phase

1. Pulmonary phase
Gas/ vapour Lung ——- pulmonary
endothelium
Capillary endothelium
Blood

2. Circulatory phase
Gas/ vapour ————— circulation
body tissue CNS
effect
3. Tissue Phase
Gas/ vapoue enter in tissue and produce effect

¢ Body have different compartment
Vessel rich, intermediate, fat & vessel poor
° Vessel rich & intermediate ( muscle group-

skeletal muscle)---- primarily involved in
uptake of inhalation anesthetics
¢ Alveolar concentration is readily measured

index of brain anesthetics tension
¢ So anesthetic level in brain cannot be
reached until equilant alveolar concentration
is achieved.

In order to induced & maintain anesthesia,
uptake of anesthesia by various tissue should
be met properly.
Alveolar concentration is influenced by

Ventilation
Blood flow
Uptake of anesthesia by rubber breathing
system

Once induction is achieved, vaporizer
concentration should be adjusted to proper
level to maintain anesthesia
Recovery from anesthesia can be hasten by

Assisted ventilation
Increase oxygen flow
Frequent flushing of anesthetic system
Stimulation of patient

¢ A useful standard by which _ inhalation
anesthetics may be compared is MAC
° MAC--- it is the anesthetics concentration

required to prevent gross muscular
movement in response to painful stimuli

Advantage of inhalation anesthesia
1. Agents are not metabolized therefore the
recovery is not depend upon _ body
detoxification mechanism
Closed system available for thoracic surgery
Good control over level of anesthesia
Early recovery of patient
Deeper and safe anesthesia available for
long surgical procedure

Disadvantage of inhalation anesthesia
1. Some of inhalation anesthetics agent are
flammable & when mixed with oxygen are
explosive
Few irritant to respiratory system
Required constant surveillance by
anesthetics

Breathing circuits
¢ Purpose of breathing circuits of anesthetics

apparatus .....
1. Convey oxygen & anesthetics to the patient
2. To ensure removal of carbon dioxide

produced by patients

Classification of breathing circuit
breathing
raimatity
I
I
Open a. Closed
Semi method with
open Co2 absorption Semiclosed }
method method
1. fo & Fro
system without Co2
: absorption
2. Circle system
b. Semi closed
method with
CO2 absorption

Methods of administration of inhalation
anesthesia
1. Open method
* Cones, towels, cotton
& open drop or jar are —
used in open method |.
of administration.
¢ Ether & chloroform---
less expensive and
can be used by this
method

ll. Semi open method (non- rebreathing)
* Can be used for small patient

¢ There is minimum resistance to breathing &
minimum dead space
¢ Non-rebreathing circuit either with stepen-
slatter valve, Ayer T pices—No valve or magill
circuit--- one way exhaustion valves are used

moO VALVE
i ———_>
-_.- —
PATICNT
| tl. aesemnvons. TUBE aa re
imMre_ow
'- AVRES®S T - PIECE
RescRvor BAG
ouTF.Low VALWE
J ?
FPF LO
——-s a _——— a
TENT SSF
———— Ne Fee”.
2- MAGILL APPARATU >
Non Rebreathing system

NO VALVE
JT
ae ee a ee QuT Fic
| t | ReseRvore TUBE titted
INFLOW
'- AVRES' T - PIECE
OuT FLOW ReserRvor BAG

ft i. ome VALVE
PATIENT =— oe er! -_- | oa
EE L Ow
aCe oe reworrs TUBE ee, 4
Z- MAGILL. APPARATUS
Non Rebreathing system

Components of semi open system
O2 & No2 cylinder
Pressure reducing valve (regulator)
flow meter
Breathing tube
Vaporizer
Non- breathing circuit either Ayer’s T piece
No valve, Stephen slatter valve or Magill
circuit with one way exhustation valve fitt
to reservoir hag.

Components of semi open system
O2 & No2 cylinder
Pressure reducing valve (regulator)
flow meter
Breathing tube
Vaporizer
Non- breathing circuit either Ayer’s T pieces-
No valve, Stephen slatter valve or Magill
circuit with one way exhustation valve fitted
to reservoir hag.

Ill. Closed method-- rebreathing
* To & fro and circle system are examples of
closed method of administering inhalation
agent
* There is minimum air way resistance and
minimum dead space & Co2 absorption both
inspired and expired gases pass through
soda lime

a. To & fro system
Temperature remains
constant
No valves are
necessary
Adv: soda lime
canister &
rebreathing bags are
close to patient
Methoxyflurane can
not be administered
with system
To & Fro System

To & Fro System

b. Circle system
Used for all volatile anesthetics provided a

proper vaporizer for that agent is used
Apparatus kept away from operating table
Comparatively more resistant to proper
ventilation and costly anesthetic apparatus is
used
Two type
Vaporizer outside circle (VOC)
—_
Vaporizer inside circle (VIC)

we

1.Vaporizer outside circle (VOC)
¢ Change in ventilation
will not affect output
of vaporizer
* Increase ventilation
reduced inspired
concentration
because increase
uptake of anesthesia
by animal and
constant output of
vaporizer

2.Vaporizer inside circle (VIC)
Increase ventilation --- increase inspired
concentration
Sudden change in it produced alarmingly
high inspired concentration
High efficacy vaporizer- VOC
Low efficacy vaporizer-- VIC

EI
Components of circle system

rs a 0S
eee ee
Oxygen & No2 cylinder

ee
Pressure reducing valve (regulator)- to

ee
lower pressure from regulator

ee
Flow meter for each gas- control amount of

eee
gas enter in system .

eaEeEeein
ee ae
Breathing tube
Two unidirectional valve to control flow in
.
one direction
]
eee
Rebreathing bag

OS
Cont....
aE
aS 808080
7. Coz absorbent- remove Co2 from expired

gas
ee
s. POP- off valve- release excessive pressure

eee
from system
ee
9. Vaporizer : 1 Glass vaporizer .

eee eee ee
2 Precision vaporizer for halothan

& Methoxyflurane
ee
ee
10 O2 flush valve to flush O2 into system &

eee
pressure manometer to indicate pressure within

eee
system
ee
Se

IV semi-closed method : partial
rebreathing
A portion of expired gas escape usually
through POP-off valve
Safe system .
Less economical
Like semi open system, high flow rates are
used
Flow should be sufficient for fresh gas &
dinitrogination

Anaesthesia

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Anaesthesia

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Pharmacokinetics

* GA is produced by action of anesthetics agents on

Some inhalation anesthetics---- Metabolized wit in

Providing respiration & circulation---- Maintained--

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Biotransformation---Principally in liver & excretion via

Injectable anesthetics--- Less control over elimination

Anesthetics drugs--- Commonly administered by I/V

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This compartments differentiated by blood supply &

After |, V injection--- Mixing & dilution of drugs occurs

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This compartments differentiated by blood supply &

After I V injection--- Mixing & dilution of drugs occurs

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* Factor affecting drug concentration & availability in

Binding of drugs to plasma protein--- cannot rapidly

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° Vessel rich group of tissue archives equilibrium with

* Change in tissue blood flow, solubility & blood -

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Species variation in biotransformation may also

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Renal excretion --- Principal process by which

Excretion rate determined by -

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Inhalant agent--- primarily eliminated by Exhalation

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Prior/ concurrent drug administration

. Solubility of inhalant anesthetics in bags & hoes.

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A thorough history should be recorded & a complete

Every animal should be categorized regarding its

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Skin tumor, # with shock, uncomplicated hernia,

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Purpose--- to determine patient’s physical status

Physical status--- Py C or Avyb of disease, severity of

The goal is to determine any deviation from the norm

Organ system of greatest concern are the Nervous,

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¢ Physical status--- One of best determinants of

Physical status--- Determined by

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* History & Physical examination are best

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¢ The preliminary physical examination should be

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Pain system includes sensors, neural path

Pain warn animals of potential tissue damage &

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Pathological pain--- occurs when tissue or nerve are

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Animal feel the pain, which affects their physiology,

Stress response--- When pain is severe or chronic,

Both acute & chronic pain produce stress

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¢ When operation performed on healthy animals only

¢ But operation on dehydrated, anemic, hypovolemic or