Surgery module – general principles Adapted from “Guide for the care and use of laboratory animals”, NRC. NDSU-IACUC

Presurgical planning Input from surgery team members Identify personnel, roles, training needs, equipment and supplies Location and nature of facilities Preoperative health assessment and postoperative care NDSU-IACUC

Surgical procedures Major Minor Penetrates and exposes a body cavity or produces substantial impairment of physical or physiologic functions Laparotomy, thoracotamy, craniotomy Minor Does not expose a body cavity or cause physical impairment Wound suturing, peripheral vessel cannulation, castration, dehorning, prolapse repair NDSU-IACUC

Surgical procedures Minor procedures still require aseptic technique, instruments and appropriate anesthesia Nonsurvival surgery Animal euthanatized before recovery At a minimum clip the surgical site, wear gloves, and clean instruments and surrounding area NDSU-IACUC

Sterilization methods Autoclaving Gas sterilization Liquid chemical sterilants need adequate contact times Rinse instruments with sterile water or saline before use Alcohol is neither a sterilant or a high-level disinfectant NDSU-IACUC

Good surgical technique Asepsis Gentle tissue handling Minimal dissection of tissue Appropriate use of instruments Effective hemostasis Correct suture material and patterns Knowledge of species anatomy and physiology NDSU-IACUC

Aseptic technique Reduce microbial contamination to lowest possible practical level Input and cooperation of all in surgery setting Preparation of patient, hair removal, disinfection of operative site, preparation of surgeon, surgical scrub, surgical gloves, sterilization of equipment and supplies, and use of techniques which reduce likelihood of infection NDSU-IACUC

Patient evaluation Identification Health status Heart rate Respiratory rate Body temperature Mucous membrane color Hydration status NDSU-IACUC

Preoperative procedures Withhold food for 8 to 12 hours prior to surgery Atropine 30 minutes before procedure reduce vagal tone and anesthetic induced secretions Open airway Bland ophthalmic ointment on cornea May need preanesthetic tranquilizer Acepromazine, xylazine Warm surgical area (30-35o C) Hot water pad, hot water bottle, incandescent lamp NDSU-IACUC

Anesthesia Specific tranquilizers, anesthetics, analgesics, and protocols will be decided upon by the Primary Investigator with consultation by the Attending Veterinarian NDSU-IACUC

Anesthesia Inhalant anesthetics Injectable anesthetics Face mask, nose cone, covered chamber Injectable anesthetics Intraperitoneal Aspirate back on syringe to insure an organ has not been hit Intravascular Intramuscular Subcutaneous Anesthetic machines NDSU-IACUC

Anesthesia Intubation Endotracheal tube Lubrication Stylet Laryngoscope May need topical anesthetic to prevent laryngospasm (spasm of the larynx) Secure tube NDSU-IACUC

Depth of anesthesia Increased depth of respiration Slowed respiratory rate Relaxation of jaw and abdominal musculature Mucous membrane color Slowed nictitating membrane reflex NDSU-IACUC

Anesthetic overdose Diaphragmatic breathing Gasping Loss of pupillary reflex Loss of corneal reflex Cyanosis Protrusion of eyeball NDSU-IACUC

Surgical monitoring Check anesthetic depth Check physiologic function Heartbeat, respiration Assessment of clinical signs Ocular reflexes Maintenance of body temperature Blanket Heating pad Monitor for body burns NDSU-IACUC

Post surgical care – before anesthetic recovery Observation of the animal; Intervention as necessary Turning of body every 30 minutes to prevent congestion of tissues Clean, dry area Attention to thermoregulatory, cardiovascular and respiratory function Attention to postoperative pain and discomfort Possible administration of fluids, analgesics or other drugs Care of surgical sites Record keeping NDSU-IACUC

Post surgical care – after anesthetic recovery Attention to basic biologic functions Intake and elimination Behavior signs of pain Monitor for post surgical infections Monitor surgical site Bandage as appropriate Timely removal of sutures, clips, staples NDSU-IACUC