Bovine Field Anesthesia

Kathy Whitman, DVM, MS

Great Plains Veterinary Educational Center
Refer to…
• Dr. Hostetler ppts and documents on thumb drive
• Veterinary Clinics of North America, Food Animal Practice 2008, 24:2-3
• Merck Veterinary Manual
• Food Animal Surgery, J.L. Noordsy, 1994
• Large Animal Urogenital Surgery, Wolfe and Moll, 1999
• Plumb’s Veterinary Drug Handbook, 2005
• https://
instruction.cvhs.okstate.edu/vmed5412/pdf/14LocalAnesthesia2006b.p
df
• http://vet.uga.edu/lam/teaching/mueller/lams5385/Bovine_Field_Anes
th_lecture.swf
Common anesthesia/analgesia for common
procedures
• Reproductive
• Teaser bull, testicular, prolapses
• Abdominal
• C-section, DAs, toggles, rumenotomy, explores, hernias
• Mammary gland
• Obstructions, lacerations
• Head
• Dehorning, enucleation
• Feet
• Amputation, tenotomy
Goals
• Focused (local/regional) anesthesia
• Standing procedures
• Combination with other anesthetics
• Tranquilization/Sedation
• Standing procedures
• Recumbent anesthesia
• Duration needs to be considered
• Gas induction
• +/- recumbency
• Shorter acting-gas takes over
Local anesthetic drugs
• 2% Lidocaine or 2% mepivacaine (20mg/ml)
• 0.1ml epinephrine (5l/ml):20ml local increased potency and duration
• Risk of tissue necrosis and spinal cord ischemia-don’t use for epidurals
• Toxic dose is roughly 4.5-5mg/lb (~250 ml for 1000 lb cow)
• Xylazine can be used in combination with locals for epidural
anesthesia
• 20 mg + 3-5 ml lidocaine for caudal epidural in adult cow
• Combo with opioids is an option, but rarely used
• Ethyl alcohol-permanent “salvage” block
• Any concerns??
Local Anesthesia Procedures
• Ring/line blocks
• Castrations, laparotomy, toggle, dehorning, mammary, etc.
• Epidural
• Perineal procedures (caudal); abdominal (lumbar)
• Paravertebral
• Pudendal
• Peterson; retrobulbar; auricular palpebral
• Cornual
• Regional limb perfusions-Bier block
Line/Ring blocks
• For all line/ring blocks…
• 18g needle, 1-1.5”-length is determined by depth of your incision
• Place a leading bleb
• Can buffer with 1:9 bicarb:lidocaine
• Do not infuse directly over incision site
• Distortion
• Hemorrhaging
• Possible healing delay
• Versatile, simple, safe
Line (Regional) block-Inverted L
• Laparotomies Block
Incision
• Same concept bilaterally Nerve pathways

• Infuse as much as needed

• 100-300ml
• Paralumbar fossa
• Line just below transverse
processes
• Line just behind last rib
• As long as your incision
• Deep enough to get through
muscles-infuse as you pull out
Caudal epidural
• Perineal anesthesia
• Desensitizes tail
• +/- reduced straining
• 1ml 2% lidocaine/200 lb to keep standing
• 18 g 1.5” needle
• Clip and clean area if possible
• “Pump” tail with one hand while palpating
midline of coccygeal vertebra
• Large gap=needle placement
• On midline, vertical to space
• “Hanging drop” technique
• Administer if little resistance is met
Proximal Paravertebral •
•
Surgical prep
1.5-2” lateral to midline
• 4-5” spinal needle, +/- stab incision
• Walk off transverse process cranially
• 10-15 ml lidocaine infused per site
• Expect scoliosis
Distal Paravertebral
• Surgical prep
• 1.5-2” lateral to midline
• 1.5-2.5” hypodermic needle
• Direct needle dorsally over transverse process and liberally infuse, “fan” over
process, then repeat ventrally without pulling out needle
• 20-30 ml lidocaine infused per transverse process
• Expect scoliosis
Internal pudendal • Procedures similarly blocked by epidurals
• Penile relaxation
• Clipped, scrubbed, superficial block
• 14g guide needle inserted in ischiorectal fossa
• 18g 4-5” spinal needle inserted and directed rectally to the nerve
identified lying on the sacrosciatic ligament-20-50 ml lidocaine
 Head anesthesia-Cornual
Crest of frontal bone
Cornual nerve

5-10 ml lidocaine SQ
 Head anesthesia-Auriculopalpebral
Crest of frontal bone
Auriculopalpebral nerve

5-10 ml lidocaine SQ
 Head anesthesia-Retrobulbar
• Surgical scrub (if enucleating)
• Mild sedation and proper head restraint Upper eyelid
• Begin with ring block +/-
auriculopalperbral block to desensitize
eyelid Optic nerve
• +/- topical corneal anesthesia Globe
(proparicaine)
• 5” needle-14g catheter needle works
well
• 2pt or 4pt placement
• 15 ml lidocaine per placement
• Use finger to deflect orbit, follow along
the bone of the socket
Head anesthesia-Peterson block
• More challenging?
• Safer?
• Direct an 18g 4-5” needle into the
cranioventral aspect of the notch
Coronoid through 14g “cannula”
process • Advance to the coronoid process
• Walk off the cranial aspect of the
Zygomatic coronoid process
arch • Advance until bony contact, or conus
of the eye is penetrated (“pops”)
Supraorbital • 20 ml lidocaine
process
 Foot anesthesia
• Can do similar to equine nerve
blocks-just appreciate
anatomical variations
• Ring block or specific nerve
blocks may be useful when
venous access is impaired
• Local infusion is more common-
access to any venous structure
should suffice
• 20 ml lidocaine via 20g needle or
butterfly catheter
• Tourniquet provides hemostasis
and can be left on for up to 1
hour
• Opportunity for permanent
blocks?
Mammary anesthesia
• Ring blocks are most common
• Clip and scrub
Gland cistern
• Sedation advisable
• Short, fine needles for lidocaine
Teat cistern
infusion
• Enough lidocaine to make a bleb
Streak canal
• Infusion into streak canal if mucosal and sphincter
desensitization is required
Indications for chemical restraint
Standing sedation/tranquilization
• Intractable cattle
• Standing procedures
• Euthanasia
• Facilities may dictate
• Safety
Recumbency
• Invasive surgery
• Ventral c-section, penile
translocation, terminal procedure
• Duration of surgery
• Flexibility to use gas
• Safety of patient and surgeons
• Uncooperative patient
• Poor handling facilities
Routes of administration for chemical
restraint
• IV
• Jugular
• Tail
• Auricular
• Milk vein-caution
• Cephalic
• IM/SQ
• BQA-neck administration
• Delayed onset/Longer duration of action
• Safety
Sedative drug options and doses (mg/100lb)
• Xylazine 100mg/ml: 0.34-2.25 IV; 0.7-4.5 IM (0.0034-0.025 ml/100lb IV; 0.007-0.045 ml/100lb IM)
• 1/10 equine dose, for reference
• Acepromazine 10mg/ml: 1.0-25 IV, IM, orally (0.1-2.5 ml/100lb)
• Combinations
• Xylazine+ace: reduce both doses, can combine in same syringe
• Xylazine+Butorphanol: add up to 2.25mg/100lb (~0.2 ml/100lb)
• Standing Ket-stun IV
• 0.9-4.5 Butorphanol 10mg/ml (0.09-0.45 ml/100lb)
• 0.9-1.25 Xylazine (0.009-.0125 ml/100lb)
• 2.2-4.5 Ketamine 100mg/ml (0.02-0.05 ml/100lb)
• Standing Ket-stun IM/SQ (5-10-20 technique) – for 1000lb cow
• (SQ preferred to minimize recumbency)
• 5 mg Butorphanol (0.5ml)
• 10 mg Xylazine (0.1ml)
• 20 mg Ketamine (0.2ml)
Injectable drugs and doses (mg/100lb) to
achieve recumbency
• Xylazine: 25-50 (0.25-0.5ml/100lb; 3ml for 1000lb cow is generally sufficient)
• Xylazine+Ketamine
• IV administration: 2.25 mg (0.2ml/100lb) xylazine first, 180 mg (1.8ml/100lb) ketamine after marked sedation or
recumbency is achieved
• IM administration: 2.25-4.5 mg (0.2-0.45ml/100lb) xylazine + 180 mg (1.8ml/100lb) ketamine (can be combined in
same syringe)
• Ket-stun IM/SQ
• 1.15 mg (0.15ml/100lb)
• 2.25 mg (0.02ml/100lb)
• 4.5 mg (0.045ml/100lb)
• Recumbent Ket-stun IV
• 2.25-4.5 mg (0.2-0.5ml/100lb) Butorphanol
• 1.15-2.25 mg (0.01-0.02ml/100lb) Xylazine
• 13.5-23 mg (0.15-0.25ml/100lb) Ketamine
• BXK Stock solution
• Mix 100mg xylazine (1ml) + 10mg Butorphanol (1ml) into bottle of unconstituted ketamine (1000mg)
• 1ml/45lb IM
Reversal drugs
• Alpha 2 antagonists
• Yohimbine-traditional, not for use in food animals, effectiveness?
• Tolazoline 100mg/ml-labeled for horses, ELDU in cattle
• 80mg-200mg/100lbs (0.8-2.0 ml/100lbs)
• Slow IV administration
• Lower end for reversal, higher end for emergency
Analgesics
• No longer an option
• Make it a part of your protocol and work in the cost
• Anesthetic drugs may/may not be sufficient
• Xylazine and ketamine have some/acepromazine NONE
• Consider premed with antibiotics and anesthetics
• Reduce wind-up, reduce anesthetic dose, lengthen anesthesia
Analgesic drug options/dosages (mg/100lb)
• Flunixin 50mg/ml: 50-100mg IV (0.5-1.0ml/100lb)
• Meloxicam 15mg tabs: 45mg PO (3 tabs/100lb)
• Butorphanol: 2.25 IV(0.2ml/100lb, have not used over 2ml)
• Good when combined with other sedatives/anesthetics
• Appetite stimulant
• Margin of safety
• Local anesthetic:
• Lidocaine can provide short duration analgesia
• Carbocaine for longer duration, still short lived
Areas of concern….
• Legality of drugs From 1997; From 2003
• ELDU
• AMDUCA/FARAD
• Drug safety
• Bloat and regurgitation if recumbent
• Lethal dose of lidocaine
• Alpha 2 sensitivity
• Analgesic toxicity
• Emergency preparedness 4 24
• Orogastric tube on hand
• Endotracheal tube on hand
• Alpha-2 antagonist drawn up Tolazoline 2.0-4.0, IV 8 48