<p>Anesthetic Considerations:<br>
Based on the history, Zoe received 10 mcg/kg of dexmedetomidine (0.5 mg/ml) and 0.02 mg/kg buprenorphine (0.3 mg/ml) with propofol titrated to effect. A partial reversal of the dexmedetomidine was provided with 0.04 mls antipamezole (5 mg/ml). <br> If a catheter can be placed with oral sedation, I do not believe we would require dexmedetomidine in her anesthetic protocol. </p>
<p>Preoperative Medications: <br>
Gabapentin: 10 mg/kg PO 2-3 hours before the procedure to help facilitate the placement of the catheter if Zoe is difficult to restrain. <br>
Cerenia: 1 mg/kg IV diluted 1:3 with 0.9 % saline to prevent irritation of the vein upon injection <br>Buprenorphine: 0.02 mg/kg IV </p>
<p> Induction: <br> Propofol or Alfaxalone 4-6 mg/kg IV <br>
Please provide supplemental oxygen via face mask to Zoe for 5 minutes before induction. </p>
<p>Maintenance: <br> Isoflurane 1-2% </p>
<p> Fluid Therapy: <br> Balanced crystalloid – 3 mls/kg/hr </p>
<p> Monitoring: pulse oximetry, ECG, noninvasive blood pressure, end-tidal CO2 and temperature </p>
<p> Locoregional Techniques: Dental blocks with Lidocaine or Bupivicaine, 1 mg/kg total dose </p>
<p> Postoperative Plan: If Zoe is painful upon extubation, she may receive another dose of Buprenorphine at 0.01 mg/kg IV. <br>
If Zoe is dysphoric, please give Acepromazine 0.005-0.01 mg/kg IV. <br> Please continue to monitor Zoe with pulse oximetry in the postoperative period for 30 minutes. If her SPO2 reading falls below 95%, please provide supplemental oxygen via face mask. <p/>