Anesthesia and Analgesia for Veterinary Technicians John A. Thomas Phillip LerchePublished by Mosby Elsevier, 2010, paperback, 414 pages, Price £36.99, ISBN-13: 978-0323055048
Version of Record online: 2 JUL 2012
© 2012 British Small Animal Veterinary Association
Journal of Small Animal Practice
Volume 53, Issue 7, page 428, July 2012
How to Cite
Pang, D. and Lawrence, T. (2012), Anesthesia and Analgesia for Veterinary Technicians John A. Thomas Phillip LerchePublished by Mosby Elsevier, 2010, paperback, 414 pages, Price £36.99, ISBN-13: 978-0323055048. Journal of Small Animal Practice, 53: 428. doi: 10.1111/j.1748-5827.2012.01208.x
- Issue online: 2 JUL 2012
- Version of Record online: 2 JUL 2012
- Manuscript Revised: 14 MAY 2012
- Manuscript Accepted: 14 MAY 2012
- Manuscript Received: 17 JAN 2012
This is the fourth edition of this book following a gap of 8 years. There have been numerous amendments, including the expected updates in drugs and techniques, the inclusion of step-by-step procedural guides, “technician note(s)” (a key point summary of the adjacent text) and 6 appendices (covering diverse topics such as the use of nitrous oxide, the American College of Veterinary Anesthesiologists monitoring guidelines and operation of a closed breathing system). Additionally, many of the figures are available to download for free following registration at the publisher's website.
A very brief (4 pages) introductory chapter covers the history of anesthesia and defines basic, but often misunderstood, terminology. The chapter ends with a nice section describing the role of the veterinary technician in the practice of anesthesia, emphasising the responsibility that comes with administering anesthetic agents.
The remaining 12 chapters are broadly split in to the fundamentals of anesthesia (chapters 2–7) followed by their application in species specific chapters. Each chapter, including the first, follows the same format, opening with a chapter outline, key terms and learning objectives, and ending with test questions and a selected reading list. This organised approach is extremely useful, as it allows information to be found quickly (chapter outline) and facilitates use of the text as a basis for studying alone or in groups (review questions). The inclusion of “key terms”, while perhaps of questionable value, do link with a glossary. The clearly stated, well-written learning objectives, are tested with relevant review questions (primarily multiple choice). Finally, the selected reading list has been carefully compiled with a mix of review articles and books, with page numbers specified.
The fundamental chapters (Patient Preparation, Anesthetic Agents and Adjuncts, Anesthetic Equipment, Anesthetic Monitoring, Special Techniques, Analgesia) are clearly written, with judicious use of colour figures and “technician note(s)”. A particular strength is the step-by-step procedural guides, covering a wide range of procedures, from calculating fluid rates to locoregional analgesic techniques. Many of these are described with the use of high quality, annotated colour photographs. The breadth of information provided in these fundamental chapters is at times surprising for a text aimed at veterinary nurses/-technicians. However, topics such as the application of time constants, physiology of oxygen transport and interpretation of the capnogram are clearly explained with the use of examples, making their inclusion relevant and appropriate. One notable omission in the analgesia chapter is inclusion of a validated pain scoring system, such as that developed by the University of Glasgow.
The species specific chapters (8–11; canine and feline, equine, ruminant and swine, rodent and rabbit) understandably reflect an American bias when discussing anesthetic protocols in terms of the drugs available (e.g. Telazol), though this is in addition to more universally available agents. The inclusion of techniques such as mask and chamber induction are tempered with a description of the associated pros and cons. A novel and welcome addition are several figures describing the “anatomy” of sedation and general anaesthesia from induction to recovery, in terms of predicted changes in anaesthetic depth over time. This overview is often a difficult concept to appreciate when learning by experience alone. It would be unrealistic to expect in-depth coverage of each species in the space provided in each species-specific chapter; each of these adequately covers the major species differences and provides a foundation for anesthesia of the healthy patient.
The final two chapters cover problems and emergencies, and workplace safety. Commendably, potential causes of complications includes a discussion of human factors such as fatigue. This is followed by a discussion of those patient types potentially associated with a higher anesthetic risk, complications by organ system, and cardiopulmonary resuscitation. Workplace safety is approached with useful summaries of the available evidence on side-effects of anesthetic agent exposure and role of techniques and scavenging in addressing workplace pollution.
Throughout the text, a recurring theme is the use of guidelines for when to seek advice from the supervising veterinarian, the importance communication skills, documentation of information and problem solving. This approach emphasises a team approach, while acting as a reminder that ultimate patient responsibility lies with the veterinarian. The guidelines employed often reflected the preferences of the author, but appeared reasonable.
In summary, this text can be recommended as an extremely useful addition to a nurse's/technician's personal or practice library. The clarity of explanation and breadth of topics also lend it well as a refresher for practising veterinarians.
Following training in the UK and Canada, Daniel became a Diplomate of the European and American Colleges of Veterinary Anaesthesia in 2006 and 2007, respectively. After a PhD in mechanisms of anaesthesia (Imperial College, London) he joined the University of Calgary as an assistant professor in 2010. His interests include spinal cord injury and neuropathic pain, and the effect of the ICU environment on behaviour.
Tracey is a Registered Veterinary Technician (1996) and certified as a Veterinary Technician Specialist in both Emergency and Critical Care (2005) and Anesthesia (2010). She is currently practising at the Western Veterinary Specialist and Emergency Centre in Calgary. Her interests include pain management and critical care nursing.