Premedication
Premedication should be provided to calm the patient and should provide analgesia. Pure opioids that are licensed for veterinary use are widely available now. They allow excellent analgesia to be given to patients. They have minimal cardio-respiratory effects and can be easily reversed if required.
Methadone has a short duration of action, 4-6 hours. It can be safely used intravenously (slowly) and will provide a similar level of analgesia to morphine.
Morphine can be used in GDV patients. It does have a tendency to cause vomiting but this is most often seen in patients that are not already in pain e.g. in pre-emptive analgesia. The dose and duration of action is very similar to methadone.
Fentanyl can be used as a premedication, it has a short duration of action, 20-30 minutes and so is best given shortly before induction.
ACP should not be used in any critical patient. It causes peripheral vasodilation and pooling of blood in the periphery reducing blood pressure by causing a relative hypovolaemia.
Dexmedetomidine should also not be used in GDV patients; it has potent cardiovascular effects including bradycardia and arrhythmias which may cause the patient to crash.
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