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Author: Admin | 2025-04-28
1) RECOMMENDATIONS a) General i) Total volume of 0.1 ml/kg for average case (1) Many set a maximum volume is 0.2 ml/kg; some will go up to 0.3 ml/kg injected very slowly to achieve higher effect for thoracic or foreleg surgeries(a) If using high volume, do not use local anesthetic unless you are planning extended mechanical ventilation(2) Q.s. with lidocaine, bupivacaine, ropivacaine or 0.9% saline if needed ii) 20 - 22 gauge spinal needles are used @ 1.5” to 3.0” length b) Indications i) Useful to reduce systemic anesthetic need in older or debilitated patients ii) To provide substantial, long term analgesia without major systemic effect c) Procedure i) Remember spinal cord ends at L5-6 to L6-7 in dogs and L7-S1 in cats ii) Place patient in sternal recumbancy with rear legs pulled forward (1) Lateral recumbancy for certain fracture cases or if personal preference iii) Clip and prep area as you would for surgery iv) Use sterile gloves +/- sterile drape (1) If a drape is not used, the prepped area must be larger v) Draw up sterile saline in a “test” syringe (1) Assistant handles fluid bag (2) Volume should be different, smaller volume than medication syringe (3) Leave an air bubble in syringe to help in judging proper placement at injection vi) Draw up medication aseptically in second syringe (1) Assistant handles vial (2) If using glass ampoules, consider using a sterile filter straw to remove glass particle contaminants (3) Make sure volume in syringe is clearly more than test syringe (4) Leave an air bubble in syringe to help in judging proper placement at injection (5) Some prefer to use different size syringes to decrease likelihood of switching the syringes in error (6) Some prefer to use same size syringes to provide the exact same feel as the test syringe but test syringe volume must be significantly less than medication containing syringe vii) Palpate the wings of the right and left ileum – the dorsal spinous process of L7 should be even with an imaginary line drawn across the dorsoiliac wings but can be just cranial
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