Incorporating ERAS in Anesthesia & Analgesia

Nutrition is often a forgotten aspect of the overall animal healthcare experience, especially when compared to the more "sexy" specialties such as ECC and Anesthesia. However, nutrition plays a VITAL role in effecting almost all specialties and body systems of our patients. Today we talk to Robin Saar, a VTS (Nutrition) to talk about how nutrition plays a role specifically in post op recovery, and pain managment! Resources mentioned in this episode: Chaitman J, Ziese AL, Pilla R, Minamoto Y, Blake AB, Guard BC, Isaiah A, Lidbury JA, Steiner JM, Unterer S, Suchodolski JS. Fecal Microbial and Metabolic Profiles in Dogs With Acute Diarrhea Receiving Either Fecal Microbiota Transplantation or Oral Metronidazole. Front Vet Sci. 2020 Apr 16;7:192. doi: 10.3389/fvets.2020.00192. PMID: 32363202; PMCID: PMC7182012. Martini, S. E., Schmidt, T., Huang, W., Blake, A. B., Cavasin, J. P., Suchodolski, J. S., & Swanson, K. S. (2025). Effects of Metronidazole on the Fecal Microbiota, Fecal Metabolites, and Serum Metabolites of Healthy Adult Cats. Pets, 2(2), 19. https://doi.org/10.3390/pets2020019 https://www.amazon.ca/Veterinary-Small-Animal-Microbiomes-Nutrition/dp/1119862604 https://todaysveterinarynurse.com/wp-content/uploads/sites/3/2022/11/TVN-2023-01_Nutrition_Microbiome.pdf About Robin: Robin is a vintage registered veterinary technologist with a Veterinary Technician Specialty in Nutrition. Her professional experience includes working in small and mixed animal practices as an RVT, and a Practice Manager, developing a nationwide nutrition program for a Canadian veterinary corporation, and gaining sales and customer education skills at a start-up microbiome-focused company. Currently, at Royal Canin, Robin is a Sr. Scientific Communications Technician and she is completing her masters in Animal Nutrition at the University of Glasgow. Robin is a peer-reviewed, published author and was the lead author on the first dedicated textbook “Small Animal Microbiomes and Nutrition”. She enjoys supporting the veterinary community and volunteers on multiple organization boards.

Sure you have used the vent, but are you always using PEEP? Should we always be using PEEP? This episode features Erin Czerwonka who is not only and RVT but also and RRT (Registered Respiratory Therapist!!! While her primary focus has always been referral anesthesia, Erin has also gained valuable experience working in the Ophthalmology, Cardiology, and ICU departments. In 2015, she took a significant detour from veterinary medicine to pursue an Advanced Diploma in Respiratory Therapy. In January 2018, she successfully challenged the Canadian board examination to become a Registered Respiratory Therapist (RRT). Although she no longer maintains her RRT status, the knowledge and skills she acquired during that time continue to enrich her anesthesia practice every day. A lifelong nerd at heart, Erin has always had a passion for learning. Her current professional interests include locoregional anesthesia, difficult airway management, mechanical ventilation, and pain management. She is currently pursuing certification as a Certified Veterinary Pain Practitioner (CVPP) through the International Veterinary Academy of Pain Management (IVAPM). Outside of work, Erin enjoys kayaking and watching tennis with her husband, Mason. She also delights in showering affection—sometimes aggressively—on her dog, Auzi, and her two cats, Bruce Wayne and Hazel. Resources: Journal Article: Setting the optimal positive end expiratory pressure: a narrative review (veterinary) https://www.frontiersin.org/journals/veterinary-science/articles/10.3389/fvets.2023.1083290/full Journal Article: Perioperative high inspired oxygen fraction induces atelectasis in patients undergoing abdominal surgery: A randomized controlled trial (human) https://www.sciencedirect.com/science/article/abs/pii/S0952818021001240 Video: EMTprep - PEEP (human) https://www.youtube.com/watch?v=Gu4sChU9eBo Video: Respiratory Coach - How does PEEP affect oxygenation? (human) https://www.youtube.com/watch?v=nP9DDRdGmPw Video: Respiratory Coach - What is PEEP? (human) https://www.youtube.com/watch?v=n6_lzL8qQDs

With all the buzz around climate change, you may not have stopped to think how our work in anesthesia contributes to the overall warming of the planet. But, Toby Trimble is here to break it down for us. In this episode we discuss some of the ways the anesthesia industry contributes to environmental issues. Volatile anesthetics are potent greenhouse gases, meaning they trap heat in the atmosphere and contribute to global warming. Lets discuss ways we can keep our patients (and the earth) as safe as possible. Toby is the founder of Trimble Group, a veterinary led creative consultancy company reinventing education for animal health, making it less like PowerPoint and more like Netflix. He focuses on making education engaging, visual, and memorable. With his team, Toby has created over one thousand CPD videos and live broadcasts in the UK, Europe, Asia and Australia. Resources: https://www.trimblegroup.io/ https://www.researchgate.net/publication/349057447_Measurement_of_anesthetic_pollution_in_veterinary_operating_rooms_for_small_animals https://www.asahq.org/about-asa/governance-and-committees/asa-committees/environmental-sustainability/greening-the-operating-room/inhaled-anesthetics#:~:text=By%20definition%2C%20the%20GWP%20of,%2C%20and%20sevoflurane%20(144).&text=These%20factors%20are%20routinely%20updated%20as%20atmospheric%20chemistry%20is%20continuously%20changing.

Listen in to this episode of the Veterinary Anesthesia Nerds podcast for a crucial discussion with Dr. Gianluca Bini on the evolving landscape of perioperative pain management. This episode dives into the potential overuse of opioids in veterinary medicine and explores the exciting possibilities of incorporating Enhanced Recovery After Surgery (ERAS) protocols. Dr. Bini highlights the strategic use of local and regional anesthetic blocks as a key component of ERAS, demonstrating how these techniques can significantly reduce opioid reliance, improve patient outcomes, and pave the way for a more balanced approach to veterinary anesthesia. References: https://www.vaajournal.org/article/S1467-2987(18)30023-0/abstract https://pubmed.ncbi.nlm.nih.gov/36108100/

Have you been thinking about taking that next step in your tech anesthesia journey? Join Darci Palmer and Tasha McNerney as they break down the specifics of what is involved in the VTS journey. Visit https://www.avtaa-vts.org/application-forms.pml for more information.

You think your anesthesia plan needs an opioid (and you're probably right) but which one to choose? From receptors to duration, join Stephen, Darci, and Tasha as they discuss which opioids to consider, why they work the way they do, and when to change plans if needed. further reading: https://pubmed.ncbi.nlm.nih.gov/21952398/ https://bmcvetres.biomedcentral.com/articles/10.1186/s12917-020-02364-w

Ever wondered about the difference between oxygenation and ventilation? 🫁💨 Join us as Veterinary Technician Specialist Meagan Crowley breaks it down in a way that’s both practical and engaging! Useful for every anesthesia case you perform, we’ll explore why understanding this distinction is critical for patient care. Hypoxemia, hypoventilation, physical monitoring parameters, and physiology will be discussed. Whether you’re a vet tech, vet, or student, this episode is packed with insights you won’t want to miss!

We are all taught in school that if a patient become hypotensive, they should receive a fluid bolus. But, does that make sense for all patients? When do you reach for an anticholinergic? When do you start that dopamine or norepi? Amanda Shelby RVT, VTS (Anesthesia & Analgesia) is here to explain it all to us. Resources mentioned in this episode: 1. Harro C, Foster JD. The effect of circumferential tape applied to the cuff during blood pressure measurement in cats. Abstract presented at: 40th American College of Veterinary Internal Medicine Forum; June 16, 2023; Philadelphia, PA. 2. Martinez AB, Cochran LA, Ishak AM, Keys DA, Frederick SW. Secondary fastener (tape) placement on a blood pressure cuff causes interindividual Doppler blood pressure measurement variability in healthy large-breed dogs. Journal of the American Veterinary Medical Association. 2024 Aug 30;1(aop):1-6. 3. Cerejo SA, Teixeira‐Neto FJ, Garofalo NA, Rodrigues JC, Celeita‐Rodríguez N, Lagos‐Carvajal AP. Comparison of two species‐specific oscillometric blood pressure monitors with direct blood pressure measurement in anesthetized cats. Journal of Veterinary Emergency and Critical Care. 2017 Jul;27(4):409-18. 4. Garofalo NA, Neto FJ, Alvaides RK, de Oliveira FA, Pignaton W, Pinheiro RT. Agreement between direct, oscillometric and Doppler ultrasound blood pressures using three different cuff positions in anesthetized dogs. Veterinary Anaesthesia and Analgesia. 2012 Jul 1;39(4):324-34. 5. CAULKETT NA, CANTWELL SL, HOUSTON DM. A comparison of indirect blood pressure monitoring techniques in the anesthetized cat. Veterinary Surgery. 1998 Jul;27(4):370-7. 6. Acierno MJ, Seaton D, Mitchell MA, Da Cunha A. Agreement between directly measured blood pressure and pressures obtained with three veterinary-specific oscillometric units in cats. Journal of the American Veterinary Medical Association. 2010 Aug 15;237(4):402-6. 7. Shih A, Robertson S, Vigani A, Da Cunha A, Pablo L, Bandt C. Evaluation of an indirect oscillometric blood pressure monitor in normotensive and hypotensive anesthetized dogs. Journal of Veterinary Emergency and Critical Care. 2010 Jun;20(3):313-8. 8. Moll X et al. Validity and reliability of Doppler ultrasonography and direct arterial blood pressure measurements in anaesthetized dogs weighing less than 5 kg. VAA 2018;45:135-144. 9. Vachon C, Belanger MC, Burns PM. Evaluation of oscillometric and Doppler ultrasonic devices for blood pressure measurements in anesthetized and conscious dogs. Research in veterinary science. 2014 Aug 1;97(1):111-7. 10. Acierno MJ et al. ACVIM consensus statement: Guidelines for the identification evaluation, and management of systemic hypertension in dogs and cats. J Vet Intern Med. 2018;32(6):1803-1822. 11. Ateca et al. Evaluation of the relationship between peripheral pulse palpation and Doppler systolic blood pressure in dogs presenting to an emergency service. J Vet ECC 2018;28(3)226-231. Link to the book Small Animal Anesthesia Techniques 2nd ed. https://onlinelibrary.wiley.com/doi/book/10.1002/9781119710868

Join all 3 Veterinary Anesthesia Nerds as we geek out over Alpha 2 drugs! Darci Palmer, Stephen Cital, and Tasha McNerney give you a breakdown of the different alpha 2's you may come across in practice. There are so many alpha two options out there, it can get confusing. From tried and true's like xylazine to newer on the market drugs like ZenAlpha, today we discuss how alpha 2's work and why we love them. Check out the veterinary anesthesia nerds resources page for a write up on the medications mentioned here: https://www.veterinaryanesthesianerds.com/resources

ERAS (enhanced recovery after surgery) are gaining ground in human anesthesia ad surgery, but what do they mean for veterinary medicine? Today I discuss the key ERAS concepts we use when creating a balanced and multi modal protocol. Visit the anesthesia nerds website and check resources for the PDF that goes along with this episode: https://www.veterinaryanesthesianerds.com