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> 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.
Cerenia: 1 mg/kg IV diluted 1:3 with 0.9 % saline to prevent irritation of the vein upon injection
Buprenorphine: 0.02 mg/kg IV
<p> INDUCTION: <br>
Propofol or Alfaxalone 4-6 mg/kg IV
Please provide supplemental oxygen via face mask to Zoe for 5 minutes before induction.
<p> MAINTENANCE: <br>
<p> FLUID THERAPY: <br>
Balanced crystalloid – 3 mls/kg/hr
pulse oximetry, ECG, noninvasive blood pressure, end-tidal CO2 and temperature
<p> LOCOREGIONAL TECHNIQUES:<br>
Dental blocks with Lidocaine or Bupivicaine, 1 mg/kg total dose
<p> POSTOPERATIVE PLAN:<br>
If Zoe is painful upon extubation, she may receive another dose of Buprenorphine at 0.01 mg/kg IV. If Zoe is dysphoric, please give Acepromazine 0.005-0.01 mg/kg IV.
<br><br>Please continue to monitor the patient 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/>