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54
RECOVERY
Patients need to be supported and monitored in the
immediate post-operative period. It is also vitally important to
provide appropriate analgesia.(Table 4) The administration of
analgesics to pediatric patients is often overlooked or
inappropriately under dosed because these patients do not
show overt outward signs of pain due to survival instincts.
The need for post-operative analgesia cannot be overlooked
because of the pediatric patients lack of overt, outward signs
of pain. Analgesic protocols should be devised based upon
the invasiveness of the surgical procedure and the
anticipated degree of pain postoperatively. Analgesics should
be provided for a minimum of 48 to 72 hours.
Table 1. Drugs Used for Premedication. Balanced premedication combinations usually include one drug
from each group based upon individual patient needs.
Group
Drug
Dose
Route
Comments
Anticholinergics
Glycopyrrolate
0.01 0.02
IM, IV
Does not cross blood-brain
barrier
Atropine
0.02 to 0.04
IM, IV
Therapy
for
profound
bradycardia
Tranquilizers
Midazolam
0.1 to 0.3
IM, IV
IM
uptake
rapid
and
complete
Diazepam
0.1 0.4
IV
IV only, IM uptake not
reliable
Xylazine
0.5 2
IM, IV
Not in patients under 12
weeks
Medetomidine
0.005 0.02
IM
More potent than xylazine
Acepromazine
0.005 0.03
IM
Not in patients under 8
weeks or in dehydration
Opioid Analgesics
Morphine
0.05 0.25
IM
Emesis common
Hydromorphone
0.03 0.075
IM, IV
Good analgesic
Oxymorphone
0.03 0.075
IM, IV
Good analgesic
Buprenorphine
0.01 0.05
IM
For mild pain only
Butorphanol
0.2 to 0.4
IM, IV
Very poor analgesia, good
sedative properties
Table 2. Induction Drugs
Drug(s)
Propofol
Diazepam/Ketamine
Etomidate
Dose mg/kg
14
0.15-0.3/1.5-3
1-2
Dose mg/kg
0.1
0.2 to 0.4
0.01 to 0.1
Route
IV
IV
IV
Route
IV
IM
IM, IV
Comments
Apnea and hypotension common
Retain laryngeal reflexes
Good in unstable cardiac patients
55
Dose mg/kg
Canine
Oxymorphone
Morphine
Methadone
Buprenorphine
0.02 0.05
0.2 0.5
0.2 0.5
0.005 0.01
Oxymorphone
Morphine
Methadone
Fentanyl
0.05 0.1
0.5 - 1
0.5 - 1
0.005 0.01
Cats
Oxymorphone
Morphine
Buprenorphine
0.02 0.05
0.05 0.1
0.005 0.01
Oxymorphone
Morphine
0.05 0.1
0.1 0.3
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