bexie

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midazolam! no analgesia but good anxiolysis/sedation in the right patient. - Minimal cardiovascular effects - Fully reversible - Maybe anterograde amnesia your patient starts freaking out after midaz? take it away — flumazenil 0.01 - 0.02 mg/kg IV or try low-dose propofol if appropriate. May favs are: - midaz + opioid +/- dexmed or alfax for sedation - propofol + midaz sandwich induction (1 mg/kg prop then midaz 0.2 mg/kg then prop to effect) #fyp #vetmed

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Replying to @SASHAYEO premedication cocktails (part 2?). Individualized premedication is ideal for patient safety, experience and outcomes. 1. Opioid (do you need mild analgesia, moderate, or profound? Then choose an opioid based on that. Have limited options? Don’t worry, get creative with multimodal analgesia like locoregional blocks and adjunctive CRIs). 2. Sedative/Anxiolytic (e.g., dexmedetomidine, acepromazine, sometimes midazolam, alfaxalone. Think about the effects— do you need short, reversible sedation or long-lasting sedation? Do you want to potentiate your opioid analgesia — using dexmed or ace, kinda maybe midaz and alfax.) 3. OPTIONAL: “3rd agent” for fractious or incredibly energetic, anxious, or fearful animals (something you haven’t used already— commonly ketamine, alfaxalone of midazolam) For specific cocktails and example protocols, checkout my book! Link in my bio

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is your hospital using methadone? note: i didn’t make it clear enough that the NMDA blocking effects are MINIMAL and clinical implications are unknown in veterinary medicine. One should still treat the patient with ajdunctive analgesics. also methadone likes to make dogs PANT. usually not as much as something like hydromorphone. #fyp #anesthesia