0 ratings0% found this document useful (0 votes) 231 views29 pagesAnesthesiology Salahuddin Sir
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Sedative YS Foanquilizer 5 ¢ t
Ntarze ‘ous
a_i pees eee a _ pdurrativr F sleep
points Sedative _Trenguilizen
Defyni tion Ane Pm agers Prakack | Ame the agents that
& depressomts and have! ots an depressent
6 ability to achan:
omalgesic droug
High low
Ailey im move Not ed 4o move | ‘May have he ability
ane
i
|
te move
Exlennal : | Unaacme 6} the
“4 ents Phenothi ezime denivatives
Pog feat, 1+1— 6.6 Mgikg , 1M
, ’ P.romazine hyde chloride.
Frenqui ter Dafeat 2 “6 myiK TM ortv
Chl erprothixene.
deg. 22-44 mglks tv /im-
MOA,
Ginds with spectfics GABA Receptor
on bea
vL
Evhonce GABA activity
wy
op eriong e|- channe} -
vu
Influx sf} et
wt
Myper planizeion f tHe cel]
membrane
wb
Depre 51 s} ens Dissociative Anes taste aii B
Ane the class pychedelic, doug Aa? Wrnd usr @
Shyqnce Dike state, denying which a persm feel disso cake
fosm theln body am surpounding s-
Velewineny Importonce | Essect
© Rapid onsek cmd Short duration action.
@ muscle pelexatim: *
@ Anelgesia-
DM mryymeal Tesplpcckony depression -
® Lowen tisk Gf combiovanculan depression.
types Bissoctetive. angthe tics
TWIGSS or NS
O ketene ty cause halfucinalins and ouk 6
bedyJ expemie ces
hay both amal gesi ¢ aud omestretic
prepevtes -»
@ Pheneyclidine (PeP) 1 cause hallucinations, delusions
i [ and. psychotic. Sperptems-
)
Use ap esthetic oad reerteah'ow
v ese
Arugs.
® pextro-methr phan =D Produce hallucination and Aissach ative
; Stete
Famd- In over counfen cough
Suppte ssants. ee dra Ch
eambinahin Gf todo
® filetamine -» nl do Ketamine
® 2olarepan— > . provide sedation and.
muse tcdaration:
Moa.
Arply methetics
ee ,
block the NMDA: Keceptor, im bain
we
prevent twas scien of fan signal.
we
1 produce anestheh ¢ & analgesic effeot
4b
produce Jeelirng of detachment
oom, semracn Bing ard otete of
Gis 50 ciatim.
Dwwys:
6 Ketamine # 2-1org)kg
@ ep hence cldine : tO. Specifre dose
@® Tiietomize selaseparr. 1-$rg leg 2/30.
Recrag be
© Ketemine: os
® Tiletemine tleveeer! 9, 2 S-foy ig IVIEM - : Muscle: Relaxants * *
A type “go = hak is wed doecelam-the wmistles dnd.
Kaluee tensions Stiffness amd-patn. ba fsorvtetn
Types— ~~
0} Antispash city agents. «pre vents /reduce spasms.
Example: © Dachjen © Tizanidine
© Diarepon @ Dantwivrr,
deuemeus cular blocking agents: TyPY—-2-
One apalereig ‘agents:
ex: © Traepiun/. Athacunium
® Nov earon/ Ve cumsrinm -
© 2emunrm / Recunsniom -
O Depolovising r= Suceinglehsire
sterenen PUBS .
E Dog OS" Zz rg lke 7
© Riazepen se o25-2 mg ls PO
Remiermonts 3 5-15 gly TA/tv
@ Atracuraem + Deg/cak 5 2-2-6 ng leg TV
@ Ve &U fo NUM? Deg! cat 2 eG ry ley rm
® Reeunomium » og: *6-h 2 mpllg tv
i eat’ 06-08 m/ke TY | Anesthetics; Gienenal AnestheHcs,
Local Anesthetics. Ibalafion Anesthetics
Anesthetics: Are the émgs thak “died to neduce en elérninack
Jecling duvng medicat procedure «
om: ane “he “ogents shat produce a meversille’ loss fb
conciousness and emalgesia trperug hort tre, bedy-
Use! @® used +o previde — pain relics dering surgery:
@ Used to imdece a Stee Se uncenefusness:
@ usel gor euthamsia.
Dose:
“O Ketwmin es cattle: BS vg ley gv/T 04», Lad sins
De 2-4rgdKg Dvw/om 5 4-15 wiors
@. Meenas eatite: a2 ng ley x ¥/se/ sey Sle nins.
Pegi ted mg leg gusts se 1 S-le mens.
© poop sfel! Deg: 0-5-2578 Veg, AM/IV 4 10-Se mins
Local Anesthe Hest Ave the dug s “that produce <
reversible 185 Ef sensatim/edneiovaness im a specitic
_ &ren’ | bras.
O Used + provide temporary relief Srem pain.
, USeA fo mMinop surgical /Riagrsstre procedure
@D Used to help minimize the Alsconfert- ey
Dregs: =
. lo-aome 1 hea, IM/zu/fse
1\O Lido e aine: cattle:
~ doa: 5-10 mg Thy IM/su/se
® Bupiva cine; Cacttte: 2-8 lg Tol se
{ : 228: 2-3 ng ley oT MISE
@® Mepivactne: 4. joj wig heg” 20/5 -
| Tnbelahim Anesthe tes Ave dnigs Buak ane mated.
+o duce aeveret emeSthesia.
indesee Unie tous ne 95, Teeduce pam
use;
—_@ Used +e
Lk Provide: anascle Relexcort-
B® Used +o uUthenlde arimals.
@_ Used, da penjenm 4-na- Lltpa sounds endosegy:
Qwegs:
\ o Halothane: Cette: (4279 “HHrer -LO— 30 Wins
Blows _ tine:
‘Dog! O-S- 2% -forr Prduchion ? re
1-390 gor -marertenance
@ ,
bas Tseglarene! Cattle: 1-297 5 Time, 20-30 ming.
Dog: 2-€9, for induchin 25-10 hr
LSD for Mmamfermee—_ jor gormin, Ppe-cpepatve peti Mand-ement medicine
OD medicahmr ASAT Ds _
@ NSALDs> Y Dintase oF
@ w ‘el f +pauma
Doma leg but
2eKg €a GY «= 2 malig veo),
i , & dom Mey
Wane bm:
= Ami kee
Pharma cologi cot dose x bint
Be ee ah
concentration:
Dosing
a vial
| maien toi Ace Mein dose
4 Sema of
Lyapiti gation “The process bs which the, viral
SUSPENHIO, are cheonged Snare
Liquid +o cake Jormatio -Pamagh Pre sgu tle
eb. mérntarm 1©7o ma@i supe. ange
tren heat : Neat thecara
4$t aos require = goml/ke dag
amd Ag equi rs . Lomi lea dey,
see
ar : = \oml /ieg tbay
Zales wdy Weigh -
\ex Go 2 Seem
loxas + 2d m)
Tete 2 Foo mal / 209 196) 3
Avimal marntenmee ASS = Loom -
tHagmon, 4 eo > sen.
hal dere = (Foy 200). ™!
4 mlz 20 drops - Fen a4
ooomls Wx 20~ (Boda Msps
Time = Shoss.
Cx BERS 2 24,608.
Drsps pep 41sec = eae = OR dvsps.
Avene —> gdreps per ISec Role of Fluid thenapy!-DorneeHon of novmal ongoing,
ce . #lufd losses -
1) Support of com thiovasevlaw fimeHon:
in) Corneetion oF major aefd ~buve jm bel aneg .
WW) Counber Vormalizatton of 02 delivery,
V) counteri Prevent negative phystolog se effect by
anesthetic agent? (hypotension vasodilator »
Lenemal prince ips and patient assessment
Assess for following tenes types of Huta dis tur banoy,
1) Chamge in volume (detydralion, blood los -
W) Chang.2g “In content (hyper karemia)
Hii) C bomgez Indi steldutfon (Pleural effusfon ,
Cleusiticaton of fluid amd elec troly het
a) Tsotonie crystals df - Hots mann’s soluHon 2OR ate
Oy). Yue)»
b) Colloids: Denton Zo, meladin »
C) Hypen tontc satin:
Estimation of Flufa duwiag a fon curing dehydnahiy,
| there ome 3 elements to consider
) Replocemen} h) hain }enom(e & Ongoing leroy
HS Saline — Plecheotyte balane-¥ -
> Tocnewse Hufd in blood . So, ‘vac tert)
‘Nood ov doxim concentration deom-cesed Reeoery of anesthesia:
Recovery: of anesthesiats defined af fire OC Of velurnin
an animal to anommal phy sfologfea!
the Influence -of omestives! fe. s Stake’ af bew fehng un den
$1398! 1) Emengence From omestteHas.-id begink hen pre_
anesires(a i$ discontinued and animal stort tor-eg ah,
CONSCIOUS NLS |.
i) Recovery From anctthertar During om this stage, amiral
TS awake but yay SHIl be Avowsy.omd disoriented .
m) Post operakye core? Animal pecomen € d from he
eo
immidvate effeehs of omesthoara and tromsfened FO
reeeive post operative cave sve OS parr MANageney ,
wound come »Phys{cal ther ary »
Gx Dyrahon to Pecovienr?
General onesthes{ar~ kelaimine, propode? , Hiopente,
Cot— to-20 min for 0-02-O.1 my) kg »
Cotte 15-35 min- for 2-b mg) ey ~
DOs -1o-30 Min -fow 0.0) ~ 012 my lle y
Goad) 12-3G min. for 12-825 minor O1- bk Frolkg
Loca) oncsexsa) Lidocaine, Bupi vacatne, Meps Vacaine
Cat, 009, cate »goat ~ L28s tham 90 minuby . NSAIDS pe duce pasn )-decneuse Intlomimat,
loeme ate even . ’
Sarhentterrti=atert -
Trdication? Pre -opemative pain momag-crmner
— Int lammmapomy conditton .
Poracetamo)® Rumbrat cathe? Gomy ky PO follo wre d by
Sa
“some leg tut Po 6h:
gor godt! Loma lee bur ;
contra indica’ cot, dog, {menal snsodffereney ).
Mmeloricom ~ Cattle) OGmg [Ney °
goat! O29 Ika .
Tol fenasms € Aefd - 2-4 mole gy TG.
_ Pages ¢3— Post 0 penaive parnimsnagemeny
Te
Lekiess — v-Lied Hs relieve PW -
ketone 2 Dog! oFs/h- CRI + Ch Bu} 10.5 *
Cat toprorofh CRI.
Oposds - Ininacpenatve payne
am Thomagemeg-
> Traveation? Pain perief ) ome shesta, COQ deppresror,
Freatmont of dfownecrg “CEB- Peni -procedura)
mor phing Pain managen
Doses Boe Img lkyFO 5 o.1-1mp/eg zy.
Femeapr=b Cat! omg lg Po ,
Fen tony f - Dog. 0 005-0'0) SC, Amesthosiology
Classi ficattons- ee : savers
Anesthetic agents ame twotypes: - i
A) Agents. for general Anesthesia,
®D Agents for local Anesthasie . 5
| Zeneral onesthetic cgents are “2types:- .
1) Tntravenovs omesthetfe Sern a aie entone Sodium
tento bette
. ms henirome ws
os Tahalotion ag-x6 thetic agent \ sequin ca eee
£9! Chlowo form, FH] chloride > EUpens!, Propofol mstomite
Dieteyl iter; Holotane, steed Hee Be Fina
“ATsoflurane, methory flu fond iat ton a on tah forate
Witroas. ox ide ') .g eseus ee alive agent. Dt rae
y , Famine hy oh
D Local anesthetics s- eeenettonl de .
4. Cocatm bydvoehlorid ¢-— used for eye Sungenry (7 Cocaine byetroe hlert Be)
| 2.2% Procaime hydrochloride 3-27. Ligmocaine bydroehlon/ de
05% Gupivacame hydroehlooide BMepvacain 2 6. Cinchocame
‘Anesthesias The tanm anesthesia is derived from the greek work consti,
fanalstacsia meaning'in sensi bility’ is used +o, desenibe the loss of
Serigation fo the entine om amy-pomt Of Hhebody. Anestresiais induced
by drugs that depres the achvity of nenvous pissue locally, reprorally
On witin the centra) nervous systems
Ressons for Administering anesthesia’ a
1) To alleviate pain Induce muscle reloxction @& costentia) for So!
Sungeny,
Ww) Restrainina, amtma) WD Safe ‘troms port UD) evthomesfa ,
Typ of euthen-esia lees on novfe of: -odmni's reqtion [typeof drugs)
| 1) Tubalation CD Trjechabl-e ( ovale» recks) oy Flecronay,
|) Fras citomeevs 2 lectricalnenve sti mulation vp) Local emd Conduetion
vit)Aeupunetvre vei) Hypothermsey Tewmt
vy Anagesia’ - Refers to freedom from ov absence pain,
t) “Franquilizatiuny enquihization nefers in behomoral
change wherein anxiety is velteved omd the pation} beams
betoxed bub remesns awome of itt Surnoundings.
w) Sedation: Sedation 1s a state ehcoraetenized by contra]
depression aceompanted bydwoassinag - “Tecpatient is generally
Op aware of f}s suuerowndings bok nearer to. painfo)
monipulaton .
ty) Nadesis nesses: Nancosss ‘is acinus induced state of seep deep sleep
from whieh: the patient Coon: notbe -croused |
v) Hypnosis: “FS "gondition of ombificfalty’ Induced sheep resvl ting,
fron Tr feneste depression of the crys from wie ee tepakent,
Is readily amoused -
vi) Local amesthesiar is a toss of sensation in tietumseribed
body asnen -
wi) Regionalonasthesia: is insensibllity in allormger frog.
Almited , body ave (2:g* Pomulumber nerve bloele ) -
vu) General anesthesia: is a. dug induced Uneonse fowsnees
Hat ig Chamactenized by controlled ond vevensitie depresn
OF He ENS ond omnal g-05fos + Ganena| onestresa,
I
Defy CIS depragemt, Chanactenized by loss of Conscious ness , loss of
sendution Fadequate . muscle relaration « .
E «Spb Stages of ene heen ‘ ilee
Stoye ls Tndvetion slage or stage of Volumbeny eneitemensor”
JB The animal i$ conscious and-mdy imulde foe ible effirds to arora
camesthe h7-ed. Brecthingy is entinely Volitiona) and breath held
MOY OCEYY. ~MHeneowe IMM pinatw y and ple va te i dilaton of
the pupils. Unine and Faecs may be voided »
: imvol antexaien-ent or delinum +
Stugeds “w stage of Manali Fe nel read
> loses Consciousness abovprty on ) Ne als ppd
> Resprration is Imre gulom. 9 Phowyrgeal rediex plusent . >
cough meflan ht presen, — Limb movement “became Bviokent
stage 3° Stage of Sunateal omeshesian _
Plone” pasvation ORF itt potievt
oelar Laveyngea} on
1g : P
Relexetton
a)
Regujeer , Ex.aball vioviy |Vowitingsstouig| Limb muses
Taora.coablomin palpebra) AbSen1 5 Couphpncens oly
2 foreatuw| PEEPS Peguley | Bye bulls Axel Cough-pensitts | teak (wot
Trova. coabdemin| Cmed doun 7 fo middle of iw mie
Ampli hul-e Lexy ward) lon &
Eyal Fined 4 tovyhabynt | Abdoninat
amd eentral in museres
All omrmaly Ye loaned ,
Abdeming),
vamntmal aryl’
‘minimal onl
rage ds 2 of medullary pemalysis vv overdue:
= “ sane pocnatysis of tke Twerooei & mujelas Ts Complete,
and eniy sdfaphnagmate aehvity Vemalns'. The pols (pecom.cg
sPapid md pupils dilated wile the eyeball present Figk eyo!
appeomenre ducto Cossatun of laerimal seeretion« » ftMeew7 ol i
of aluteanede + |
befor efrevlation 5
on
or va
mechanism of action!
ther DOABA
Ny “A d —t ‘ «“
E Most of the omesthett.es ‘stop vespirehiom
While ehlorodorm stops respiration with ‘ai reviotion s
ofometthele depends on its Solubility’
“Ja the onset of action
blood, thus s | '
© No hoy tow Solubility Brapid onsed owl. :
mmethory flare boy golubility & delayed onset » ;
Halothome }
Dd} von “inPlommable non explosive
)) Won- Foritent Produces beoncho dilaton Bee :
‘ Bisodvemtage:-Weale ‘analgesia > Weale¢ Ke beta): muse le.
ever Pelagent 3 Comaiibenie a-epato we ‘ oe
q BOs Non Anflegnmma ble Smor-aiplosive 21) Non then-
) To0d analgesics im labour av) Good omalgesies in labour.
Disodve i) Weal emestelie-n) Weak Sketokal musare Ye lowe
4) Produces affoston hypoxia 1) Maalobleuhie anemic
) Temategenic #0 boln padient & dee for
MB te 2a .
Enflunane: As halothune byt noi hepatic toxieiby Ses
Sensitization of beccr? to Cadfécholoom ines .
Metrexy Plunune! Cosrdfotoxte & Waplrotert ¢ -
Bedamied ath-esthest, . 10: tr Halotheore yninimal alvectave anesthetic eoncentmation (MA)
Tr ig themininal alveolar .amestiet et scomcen tration ab wwe oy, of
patents, donot respond to a syrgiea) shmojys.
Tmpovtamces THis a measume of amestuetic potency, iris small for
Patent omestehics: suck oS halotrone “8 lange for weak onesitel
as tv, 0: : ; .
Te Anesthesin
OO .
8 pecovery > VO explosive
Advomtages : oEasy - > Rapid inde tion
| Syo imitation to vespinatony traet'-5 Wo sensitization o ae
Cathe tolamines ,
| Disedvembogyes® Once injected, Cam mot 4s withdrawn
Ulirathor} beenbihnate (thiopental, metio,
meties® B— Rapidly absemrbed ~ Passes blood bnun teoteiE Pocpaial
‘ ner,
(> Fate: Redistnibution & stow ynetabotism > Aceomvlation « as
| Aetions : CNNS!. Sedation — hypyrosi = emnestreal eg
| ~ Potentiote onalgeses .
LMS. Lomge dose > sudden hypotension due to HY ceendine Contractility,
Roppiv ution ) ~ Bron Chospasm ~'+Re.
stm ~ veloration
| Uses Induction of general ames
Side effects $ _> Respimatowy comprication > Apnea —. bronchospatm.
+> Hypotension 738 owed
> Tenritamt*. Phlebitts - Tor om bophle bitis - Palm te A
fi
i
| +> Contratmajeated im aevte Inter wittent Porply nin,
Hesion” > Ainhiconvelsonty. ” Ketamine
“Aretions:” Produces dissociative Sefative emeshasia to of-sen siden Bo
motor activity + Promo tAnal gasioy wo! ihnout loss of.
Consclous views.
Used "TO provide “omalgesia for minoy procedure
-espectally inehi laren + '
Side effects! * reson fy in Kalua Mabon duving recovery
Vo SBNTOCT ss > Top. .
Com tra imadication 1. mental disonders 0 HOF Ter .
a ype eater W) flaucoma . :
; Pre_omestnelic medication
Benifts. 4.T8, produces Sedation; omnesta, omalgesia ;
1. Te reduce! a) ‘amount of omesthessa »
%) Post anesthetic complications .
° Pornasympathe tic supply to lungs ssalivery
he es _ lend F heomt »
Dewys used t s rtatt
L. Womtelies mal gesicht - Monphing gromereine oss
a heen Bon bitvwide, Benzodiazepine chiorarhyanate
OW. leptie Phenvthiacine Erewp
As oe ermpatcljHs Atropine & Byose ne,
—_— Local ovrestnesien
“Locei) enesthelies ame aoups that eae mevensiore bloe oF Nene,
Conduction prodveimg transient Joealized Omestta without
Signi fieantHy affecting consciousness.
Stovetuve F chemical aspects !> “Mey ame weak bus-e rent of
Lipophylie group connected to vonizable hydmophilf¢ gvoup by
an intermediate Chain:
_Cisssifieation ;
A) Bosed on Chemical strvetu re
L.A
ot
Amite Esters
—Lidoeaine 1]! _ —_
2 mepivacaine Bempicraeld ene esters
> Bupivocaine L todame eCaINe
~Bemtocaime .
b) Recording to thew solubility omd ea application Inte!
L.A Pas gaat ee
\Solvble L: A, Svitable
fem ingeetion
b inlet ased 3. Insoluble LA -
e A on platy + Bemzotalret
* Lidocaine »
. Procaine ¥ Cocaine. «Ov the form
+ Pibveaine + Phenacalne v
* Tetrocuime + Bulocalne Used 08 Ses el
. om-egstheHes in
Bete, Can prodyie. “iain used fo praure forth of fusders
Face ames thes x topical cones thes, ond ointments oP
excep Peocatne of eye wounds
COmyinzection), .
Mechemnism -of aetiont
They act inside the nemve § inhibit dhe nenve & imbibit Wo vee
mem me
9 Fibens ame affected in tals Sequence (sensury, Cold) fever, j Sati Feedon
ESS
glastly moter) ’§ Uw myelinated before mye linated me
— Reevveny oeeurs Inthe wevente direct om : —'
mates OP adwmbilitpalion: MSurdce amesthasiq OO TT
Ai) Ta filtration omes treat iy) Merve block oes trog A In}. close he |
ot S
AORSR ©) Sympathetic Boek a) eonvetrfebral blbek Epldumer se
Cn “3 a sey 0 oon = HX osround. eee ,
ORG onout ns of ne storbotnaltres
SERRE aC 0 ARERR enn, Spkois
\s Batracellulor PH & Foeneasea Pt Dactin dyetp daghnomfanbted
thelr absor| tion fo act from
ORD AAG : . Tmebe ansenp Aside Ble
2, , Extrocellulom Jongh Deas! anfogonize the action:
- MK = @nkamce theaehom it
3. Radrenatine s Prolmngation ofacHon © 18
Ye Hyaluwonidaye enzyme > O Tncacasef onset sdepisof actor .
AeKMA roca) anesthetic Aetiim L- “CNS! Stimulation followed bY
a depression .
3. Blond vowel: Re: Vosotlilution sexeept cooaine whieh pro Jue,
wesocens truth
As Smooth musele! Spasmolytic . a
Tonicltys Astemierd.Miemgy 2. Cus ! Heweek *
Local! Poin ative site ot Ingeelin oedema, Haematoma .,
oferty Spiral ames Hatin) as Bowly 7 Hypotension » Respiretony paralysis
bs Lopes Menipgstis , Headache . 2% “he (me Talelad anf Or 2h 2 amepivacaine b dvochbuade
axe onan cme cues heal ane.
pBecaune’ of bbws don and hl aa
Avenifleria a 10 dohogs
Neve took ' ty nee book . Dove Sto lo ml 2% Iidoabive 0%
Broreh’ bu ivacal
rd ‘in Br bch hedoa wage ama tempura nose P vate
pre ed ese Anextrenia ingeed § ord vel between He midfve of.
ri confer ond i" of a iat LA
ion \ In 6 preven Ing_ingwey , eari|
ft se tp ible nut if op al
., Sl none bok - {« (desing, ele a
ceduse* OSem on aline appuosi 0'F em
repino oP the are bd ah 7° om ea Eh idee.
bd een ste Melee canthry and easel re, celles a
helocaine cwhieh Hock onl He Jowese pad of te “gy val ae Ve
book + fr “ppen fel Appteabin | Ti abril ie
“Rebobrlban’ ox 4 port bleok * ah helesied opt 2 Sel at 4 point
| wocedune To the bare of’ medial and Indoscal aanthuy ond upper
ond, Bowe eyeli in veo bfo ISmlof 2% Idocaine*
leading “Yo ents. dhe coienen , seiadin , perl ai4
> Used fore enckalin of he ee a aT % Wek a ale so
| preirmase) H wife in vo te - uel
. pina, Heo } ee ou woudl i je %
‘vee, 1 Ge ro ane ie Vide bese.)
ia in sak “inh Ma Vane muted
to. pe aite in an hnvescted | v’ patton
f in We 9a bloat n'a The ied pa
dube Toe a aulgesuery - Uni e, Oe
‘needle ies Sml of il ode in baiedh
i ‘Cue ae muneuel oe costello the i
bare ok- ve. cs
Trvescled L plea! in a nonapedihie ve gine ek
bud Heoky he tinue booredese ad Coes del anpect of
the. Hicteensh vib ana “rie / of de
eHene 9d Ceny of ern bas vescte bsae_..
upto | Joo wil Deal anehedran mm wht ile te i
Aiten inks the tinue baud
onloge je Simple +b poks b perchrem =>) Doen vu Inforue atl
tion: % mininleer tabi nional edna a mas!
inaslvard je >in Ata 4 inenerred @
> pomible draisily Tiel bh ki! Bhele in the ail of une esl:
prample ris blook, inveclel ‘i voli ha Eo
bloeK , In of .[ocal Ye
in non anesG b dhe: ineinisn aite
Fox a fne blak OF alo he ubed * onl i2e «ooh
prea of she Pascalumbax Forma
all SF silent of -lo.ml of focal odd) auton
om Px deep murele Henn’ ‘omlaeellanaice y a a
I > Reaveckebual pore bheok v
0) Qaim paeay ve Pheal » Bleck Deeniitiee Ty3 ond L; “Ly
(2 dal pesacechba) Ta, b-L Ly
proceduve > ** :
bile! Needle ploed dhecough the skin at the anlerinre edge b the
serge proces & L, sty § Le'spinal needle “is, yassed ventrally
unlill i} posged though deere process.
Dose: 27. lidocaine or bupivacaine inject upto' 2-3 mf
Sie: Needle punched, of the ovtertion edge S the verbreal to the
Hraraverse proce and coudal to the bis by 8 Ly verlelaa.. pees eae ci
> Cucdal _opid dual neve look
High re dal epidunad neve. bah Loam
aopnee (5 - 0, , deneenifiien tb
rower (5B, $4, $5
Lewy anudal epideaal rt dak Coal aay
olnerast r2e Aae abe (5% 5)
* Staind hog ee the osw , de bil shoubl be eed upod
wn do healle fwa dehween te laf sacral! acho und
at cocey bal Wid fen 0K between G, BRIO. debe.
tue onl of 27, hdsesine /ig lady ol
potas ehocll be'clowed + shin hoinkebd > needle imadel
inels He skin > Phoe the anethhe aoledion inthe heb of
: He needle —> Necdle” rer advanced fy ly unl! He aalten
ig down ints & e epr dusal apace 7a pe Her alfached
ty needle n ane 12. mn «4
Se cnendaca tattle i \
rlexnal pudendal neweve Hoek
Ire," Tn female cade ay veheve hating cause ly eae
val NNR ) ip
>» Brsajieal procedure of penin: > Rpoive (pedbpoer
I potent! dan yhemeral of penile popillomay axl
> Odpore mnavax ausgecien of penio ond prepuce; ae
Done’ “20n) P heal anethele oo
Te a rt
level ot weint ard trgerny dince leseallt and v
‘ ‘tS idenh He le = adate Pond of
when Me Lrcmrer in idol Bed. send idedblthe Neve _
+
he pina needle a) held inthe pours y band. and
itheodueed hee a canufa in the inchtoneote! bina,
54s Jom me Shen oped pee eee the needle
. +
20 ml of “heal anentedia 5 depovifel od, the
nexwve ,
to.
L. Then the need /e its widhdraur S
; de
' Redicected, He nee dle Q to Bom mae a
and loml, of anendete deposited to desensif;
cg a teecenn une aot deadly
NUMA 7% heal on
‘Bull : 5 tee nt
Horne 4 GA > eee, I Iregl
| aie
e amine | a any
Newhec “Bg (0) mo yl + ys lazing $1’ me
ne.) OF
Geo) + aphtre- " “ir
Reborn 5-1 ng] Kg
apesialion Bid lest > 24 lidocaine Hel oh :
Ovaseis- byolenechay Lspeyi gor Gl, (cen) (un) gen Neg
Ketasnine ‘Aral le
sage) et talk
; Aetemine 5 Seale
B Coreelin ach a Cw Cuavodebeal neseve Lek) 24. lidocaine
3 (to-te!’) , L. Gm), L Gel
» Ewe (oame) - Dore’ to (- Teal) jLilb= fmt)
a
by 5 £5enl
—» Bileh [queen > (va) 7 ae -"
= Doe (paverlebral oe Uk) ig, ai oath te d] Medial pubellax destiny > (cHle, —> 27, Trdocaine
25 Bibl oy Tabbed
sane in horn foes]
(P Ampudion of Ls | > dys) es a "pple
Wi Bull Jattle (caudal epidhacal anerdheria_) |
sone otal
k Cliheal Henin —, Male cal? _y, GeA ! Kylazine —o
Cole awiné Legal ', 22 hdbesine > Zul tf Hen
ted'y’
(9) Alscerria Ani > Gly. o> Couds epidinal anesdferia ‘ee
(nneso ~c ee goed apse) QF Iideesine- 15m)
(io) bad chineane-y Sheep [bead > bef, ot, lidocaine He] Fm b/c :
W Us +Odtle, sheep baat + beeed Conrnual ewe book,
je animal | 24 bdecaine fom]
5 animal’ on Sm
(2 Depaul > Cttle> 27, tcbesine 110 vPlange Anion]
(i-i51))
(8 Anertberia.o eye Cattle» 2» Lidseaine He)
] -> Loge animal (10-15) )
~ Line block
