Royal Veterinary College
Dr Sadler has set up a link with the Royal Veterinary College (RVC) based in Potters Bar, Hertfordshire. The RVC have anaesthesia residents who will visit Royal London Hospital, to observe us at work and we can send trainees to the RVC for a day to observe animal anaesthesia.
Toby Reynolds and Dr Sadler made the first visit on 25th October. The whoppers Toby has in his hands are an ETT, a 50L reservoir bag and a tracheostomy tube for a horse!
We saw a horse anaesthetised for hock arthroscopies. Lots of premedication using alpha2 agonists and induction in a padded stable using propofol/ketamine. Blind intubation was performed once the horse was down without use of muscle relaxants and an ear at the end of the tube to help placement. An arterial line was sited in a facial artery as it crosses the mandible. Fortunately no requirement for sliding sheets since they use hoists to move the horse into a supine position on the operating table.
We also saw a labrador for craniotomy and a cocker spaniel for external auditory canal ablation. The latter included an auricular nerve block.
The veterinary anaesthetists told us about their use of a new preparation of Alfaxalone, a steroid anaesthetic that causes minimal cardiovascular depression (particularly important in cats). Alfaxalone was used in humans in the 1970s but was withdrawn because of the histamine releasing properties of the solvent it was prepared with. The new preparation has the drug chelated in a cyclodextran to get around this problem. Keep a eye open for this drug as its manufacturers are keen to get a human license again and are preparing for a phase 2 trial.
If you are post-fellowship and would like to visit the RVC on a Tuesday, Wednesday or Thursday (better chance of seeing large animal anaesthesia) then contact Lucy with a date and we will try and organise this for you.