Episode 204 - Heavy Sedation in Veterinary Anesthesia with Ketamine & Alfaxalone

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Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

In this episode of The Vet Dental Show, Dr. Victoria Lukasik, DVM, DACVAA, delves into the art of combining drugs for effective sedation and induction. They discuss the use of heavy sedatives like Acepromazine and Dexmedetomidine, multi-drug induction protocols, and the unique properties of Alfaxalone. Learn how to tailor drug combinations to individual patient needs, minimize side effects, and optimize anesthetic outcomes.

What You’ll Learn: 
✅ Understand the peak effects of Acepromazine and how it influences anesthetic planning. 
✅ Discover strategies for minimizing cardiovascular effects with Dexmedetomidine. 
✅ Simplify multi-drug induction protocols for balanced anesthesia. 
✅ Apply best practices for Ketamine administration to increase heart rate. 
✅ Master the use of Alfaxalone, including its unique properties and versatility. 
✅ Recognize the importance of pre-oxygenation and monitoring during induction.

Key Takeaways: 
✅ Acepromazine's peak effects occur 30-60 minutes post-administration; adjust vaporizer settings accordingly. 
✅ Combining Dexmedetomidine with other drugs allows for lower doses and reduced cardiopulmonary side effects. 
✅ Pre-oxygenate and initiate monitoring before administering induction drugs to address potential complications proactively. 
✅ Ketamine can be used as an IV bolus to increase heart rate by 10-20 beats per minute. 
✅ Alfaxalone is a cardiac and respiratory stable induction drug suitable for unstable and critical patients.

Questions This Episode Answers:
❓ When should you choose moderate vs. heavy sedation in veterinary dental patients?
❓ How can you safely combine Acepromazine or Dexmedetomidine with other drugs to reduce side effects?
❓ Why don’t Acepromazine’s sedative effects peak immediately—and how should that change your anesthetic plan?
❓ How do you adjust vaporizer settings when sedatives are still peaking during induction?
❓ When is a single-drug induction appropriate versus a multi-drug induction protocol?
❓ How can Ketamine be strategically used to increase heart rate during anesthesia?
❓ Why is pre-oxygenation and monitoring before induction critical for patient safety?
❓ How does Alfaxalone compare to Propofol in fragile, unstable, or critical patients?
❓ Can Alfaxalone be safely used IM, IV, or as a CRI—and in which species?
❓ How do you minimize cardiovascular, respiratory, and thermoregulatory compromise during anesthesia?

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Questions? Leave a comment below with your thoughts, experiences, or cases related to veterinary dentistry!

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KEYWORDS: Veterinary Dentistry, IVDI, Brett Beckman, Dog Dental Care, Cat Dental Care, VetTech Tips, Animal Health, Veterinary Education, Veterinary Dental Practitioner Program, Vet Dental Show, Sedation, Anesthesia, Induction Protocols, Acepromazine, Dexmedetomidine, Ketamine, Alfaxalone, Drug Combinations, Pre-oxygenation, Patient Monitoring