Plus-Hex CLINICAL
In addition , the following items were prepared :
• Two large , padded mats
• Endotracheal tubes ( ETTs ) ( 14 mm and 16 mm ) with both cuffs lubricated with a sterile lubricant
• A bite block ( a piece of PVC pipe )
• Doppler arterial blood pressure measuring device and a range of cuffs with a sphygmomanometer and ultrasound transmission gel
• DRE multiparameter monitor for capnography and pulse oximetry
members were positioned to provide restraint and to guide the donkey into lateral recumbency on the padded mat as the induction took effect .
Once the donkey was on the mat in left lateral recumbency ( Figure 2 ), the halter was removed , the neck was extended and a bite block was placed between the teeth . A 16 mm × 700 mm lubricated cuffed ETT was fed through the bite block towards the pharynx . If resistance was felt at this point the tube was pulled back and twisted , then readvanced until no resistance could be felt during the advancement .
• One 5-litre bag of lactated Ringer ' s solution ( LRS ) with a primed 15 drop / ml set attached
• i-Stat Alinity ( Abbott ), CG4 + cartridge and a heparinised syringe and needle .
Preparation of the patient
The donkey was fasted for 6 hours [ 5 ] , but water was not withheld . A premedication of butorphanol at 0.05 mg / kg and xylazine at 2 mg / kg was injected intramuscularly into the neck muscles . While this took effect , the area over the left jugular groove was clipped and prepared with 2 % chlorhexidine and then alcohol . To place the intravenous ( IV ) catheter , 30 mg of lidocaine 2 % was injected subcutaneously over the proximal aspect of the jugular vein . The area was then prepared to achieve an aseptic field .
Wearing sterile gloves , a cut-down incision of 0.5 cm was made using a No . 15 blade – the size being necessary due to the donkey ' s thick skin . The jugular vein was then raised by blocking it along the jugular groove and a 14 G × 5.5 ”( 14 cm ) Mila IV catheter was directed through the incision into the vein . Once in place , the catheter was secured with nylon sutures . The catheter was then flushed with saline to confirm patency .
Sedation was noted as profound , due to penile prolapse and the head drooping with the nose touching the ground . The effect of the premedication on physiological parameters was noted ( Table 2 ). The donkey was induced with diazepam at 0.5 mg / kg and ketamine at 3 mg / kg via the IV catheter . The team
Table 2 . Patient ' s post-sedation examination parameters and results .
Parameter Heart rate Respiratory rate Capillary refill time Mucous membranes bpm , beats per minute .
Result 32 bpm 12 breaths / min 1 s Pale pink
Figure 2 . The anaesthetised and intubated donkey , with a bite block in place to protect the endotracheal tube , receiving IV fluids through a fluid administration set .
Confirmation of ETT placement was achieved by analysing the capnogram and observing EtCO 2 tracing on the monitor . The ETT ' s cuff was inflated to hold pressure within the breathing circuit at 20 cmH 2
O , with no leakage around the cuff . The donkey was allowed to breathe spontaneously .
O 2 flow was set at 6 l / min and the initial isoflurane setting of 2 % was based on a reported isoflurane MAC of 1.44 [ 11 ] . This value was multiplied by 1.5 to ensure the donkey maintained a surgical plane of anaesthesia ( stage 3 , plane 2 ) throughout the procedure .
Volume 40 ( 2 ) • April 2025
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