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2020/2021

Surgery and Anaesthetics

Code: 102675 ECTS Credits: 8
Degree Type Year Semester
2502445 Veterinary Medicine OB 3 A
The proposed teaching and assessment methodology that appear in the guide may be subject to changes as a result of the restrictions to face-to-face class attendance imposed by the health authorities.

Contact

Name:
David Prandi Chevalier
Email:
David.Prandi@uab.cat

Use of Languages

Principal working language:
catalan (cat)
Some groups entirely in English:
No
Some groups entirely in Catalan:
Yes
Some groups entirely in Spanish:
No

Teachers

Félix Angel García Arnás
Maria Teresa Peña Giménez
Cristina Costa Farré
Adria Aguilar Catalan
Anna Maria Andaluz Martinez
Xavier Moll Sánchez
Laura Fresno Bermejo

Prerequisites

There are no official prerequisites to take the course, although it is advisable that the student has taken and passed Morphology I, Morphology II and Structure and Function of the Nervous System and Physiology.

Objectives and Contextualisation


The subject of General Surgery and Anesthesia is a compulsory third year subject that introduces the student for the first time in the study of surgical treatment diseases and in anesthesiology. It is essential and basic for subsequent clinical studies. He teaches the basics of asepsis, wound treatment, skin reconstruction and the handling of surgical equipment as well as different suturing techniques. In addition, it lays the foundations for clinical anesthesia and analgesia in different animal species and the fluid therapy techniques common in the surgical patient. The training objectives of the subject are: Have knowledge of pathophysiology applied to surgical diseases Know and be able to respect the concept of asepsis and sterile area in the operating room. To know in a theoretical and practical way the most commonly used suturing techniques and materials. Recognize and know how to use basic surgical instruments appropriately. Be able to use the usual anesthetics and anesthesia machine. Be able to monitor an anesthetized animal. Be able to use the most common skin reconstructive surgery techniques. Know the basics of fluid therapy and be able to apply it to the clinical situations explained.

Competences

  • Apply scientific method to professional practice, including medicine
  • Attend to emergencies and perform first aid in veterinary science.
  • Collect, preserve and issue all types of samples with the corresponding report.
  • Comunicar la informació obtinguda durant l'exercici professional de manera fluïda, oralment i per escrit, amb altres col·legues, autoritats i la societat en general.
  • Demonstrate knowledge and understanding of structural and functional disorders of the animal organism.
  • Demonstrate knowledge and understanding of the general bases of medical and surgical treatments.
  • Make clinical records and accurate and complete clinical exploration of animals.
  • Perform the most common medical and surgical treatments of animals.
  • Prescribe and dispense medicines correctly and responsibly in accordance with legislation, and ensure that the medicines and waste are stored and eliminated properly.
  • Properly apply the principles of sterilisation of surgical equipment and the principles of surgical asepsis.
  • Safely perform sedations and regional and general anaesthesia, and evaluate and control the pain.
  • Treat and handle animals in a safe and humanitarian manner, and instruct other people to properly employ these techniques.
  • Work effectively in single or multidisciplinary teams and show respect, appreciation and sensitivity for the work of others.

Learning Outcomes

  1. "Choose the most suitable suture materials for each intervention; type of material and thickness and type of needle."
  2. Apply any measures needed to restrain animals: protecting the veterinarian without causing them injury or stress, and be aware of the risks involved in handling animals.
  3. Apply haemostasis and drainage techniques.
  4. Apply scientific method to professional practice, including medicine
  5. Communicate information obtained during professional exercise in a fluid manner, orally and in writing, with other colleagues, authorities and society in general.
  6. Define the bases for the treatment of wounds and their complications.
  7. Describe the methods for administering hospital nutrition.
  8. Distinguish the bases of fluidotherapy and apply them to the explained clinical situations.
  9. Employ the most common reconstructive surgery techniques.
  10. Explain the cardiopulmonary resuscitation techniques to be applied to anaesthetic complications.
  11. Explain the methods of disinfection and sterilisation and their limitations.
  12. Explain the surgical pathology of different systems of the organism.
  13. Identify biopsy techniques applicable for obtaining samples from different organs and tissues, as well as knowing their limitations, complications and methods to preserve samples and enable later analysis.
  14. Identify the anaesthetic particularities of different animal species.
  15. Identify the limitations on the use and prescription of some anaesthetic and/or analgesic agents.
  16. Interpret the principles for the manipulation of tissue and surgical dissection, as well as the concept of atraumatic surgery.
  17. Monitor animals during anaesthesia.
  18. Perform pre-anaesthesia estimations of surgical patients.
  19. Perform the most frequent suture techniques, as well as knotting techniques with suture materials.
  20. Properly recognise, order, pass, take and use general surgical instruments.
  21. Properly use and wear a cap, mask and gaiters without losing the sterility of the surgical gown and gloves (open and closed techniques).
  22. Recognise the generalities of post-operation cures applicable to any type of surgery.
  23. Respect the concept of asepsis and sterile area in the operating theatre.
  24. Secure animals before examinations, treatment or sample taking, causing the minimum possible stress.
  25. Show knowledge of pathophysiology applied to surgical diseases.
  26. Use anaesthesia apparatus.
  27. Use anaesthetics and analgesics.
  28. Work effectively in single or multidisciplinary teams and show respect, appreciation and sensitivity for the work of others.

Content

The learning process of the contents of the subject takes place in an integrated way by attending the theoretical or master classes and the practical sessions, as well as by the development of self-learning activities. The theoretical-practical contents are specified below.
										
											
										
											(*)
										
											
										
											Theoretical contents:
										
											
										
											BLOCK 1: GENERAL SURGERY (15 hours)
										
											
										
											Topic 1: Introduction. Principles of surgical asepsis. Sterilization and disinfection. Asepsis in the operating room, equipment and staff. Preparation of the surgical patient.
										
											Topic 2: Surgical material. Type and use. Tissue manipulation. Surgical dissection. Classification of surgical interventions.
										
											Topic 3: Hemostasis. Drains.
										
											Item 4: Sutures I: Generalities and indications. Instrumental. Suture materials. Techniques, indications ..
										
											Topic 5: Sutures II: Types of sutures. Practical applications. Complications of sutures.
										
											Topic 6: Trauma: stages of healing. Types of wounds. Thermal and electrical burns. Bite wounds. Treatment protocols.
										
											Topic 7: Bandages
										
											Item 8: Taking biopsies. Oncological surgery (resection of tumors, margins, ..). Cryosurgery and laser techniques. Principles and indications
										
											Item 9: Postoperative management of the surgical patient: generalities, complications and their treatment. Surgical infections. Choice of antibiotic
										
											Item 10: Food (enteral-parenteral nutrition).
										
											Item 11: Reconstructive skin surgery I (tension lines, pendants)
										
											Item 12: Reconstructive skin surgery II (pendants, grafts)
										
											Item 13: Fluid Therapy I
										
											Item 14: Fluid therapy II
										
											Item 15: Fluid therapy III

BLOCK 2: ANESTHESIA (15 hours)
										
											
										
											The theoretical contents of this block will be taught during the first semester in a non-contact format.
										
											
										
											Item 16: Pre-anesthetic assessment. Patient preparation.
										
											Item17: Anesthetic premedication
										
											Item 18: Pain I: Pathways of pain. Opiate analgesics
										
											Topic 19. Pain II: NSAIDs. Postoperative analgesia. Neuroleptoanalgesia
										
											Topic 20: Concept of general anesthesia. Injectable anesthetic agents
										
											Item 21: Maintenance of general anesthesia. Inhalation anesthesia.
										
											Item 22: Ventilation I. General concepts. Spontaneous ventilation, physiology. Mechanical ventilation Complications of mechanical ventilation. Neuromuscular relaxants
										
											Item 23: Monitoring I (respiratory)
										
											Item 24: Monitoring II (cardiovascular)
										
											Item 25: Anesthetic complications. Cardiopulmonary resuscitation
										
											Topic 26: Loco-regional anesthesia.
										
											Item 27: Anesthetic considerations in dogs and cats
										
											Item 28: Anesthetic considerations in small mammals
										
											Item 29: Anesthetic considerations in ruminants and pigs
										
											Item 30: Anesthetic considerations in horses
										
											Practical contents:
										
											
										
											GENERAL SURGERY PRACTICES (LABORATORY): practices lasting 2 hours each.
										
											PRACTICE 1: Surgical block. Asepsis. Behavior in the operating room. Instrumental
										
											PRACTICE 2: Sutures I. Approach and eversion
										
											PRACTICE 3: Sutures II. Investment sutures. Empty viscera
										
											PRACTICE 4: Skin reconstruction
										
											PRACTICE5: Biopsies. Placement of drains. Feeding tubes. Catheters
										
											PRACTICE 6: Wound care. Bandages
										
											ANESTHESIA PRACTICES: 4 hours face-to-face workshops; anesthesia in OHE (4 h) and Module (probably 5 hours) pending to define the organization for health reasons. (*)
										
											ANESTHESIA WORKSHOPS (LABORATORY): Workshop lasting two hours each. These workshops will be given in person.
										
											WORKSHOP 1: Routes of administration, IV route placement, infusion pump operation, blood draw, continuous infusions
										
											WORKSHOP 2: Operation of anesthesia machine and systems, endotracheal intubation, oxygen administration with probe or mask.
										
											ANESTHESIA PRACTICES ANESTHESIA MODULE 1 WEEK AT FHCV (20 HOURS) in small groups.
										
											OHE (4H) ANESTHESIA PRACTICE IN SMALL GROUPS
										
											
Self-learning:
										
											
										
											Material uploaded to the virtual campus before internships. It is mandatory to consult it before coming to the internship
										
											
										
											“* Depending on the restrictions that may be imposed by the health authorities depending on the evolution of the pandemic, it will be possible to carry out reductions or prioritization of the contents of the subject. ”
 

Methodology

Learning will be taught in a combined way, with theoretical teaching given in the form of classes
										
											
										
											master classes and with practical teaching (*). In this way the bases will be provided that the students will have to extend with the reading and consultation of the suitable bibliography. This teaching will also be the basis for the student to be able to solve clinical cases properly.
										
											
										
											The teaching material used in the subject will be available on the Virtual Campus platform- moodle classrooms.
										
											
										
											Theoretical teaching. Master classes
										
											
										
											The master classes will be given with the help of power point schemes so that the student can follow the explanations. Due to the importance of the practical contents of this subject, the presentations will often be accompanied by videos.
										
											
										
											The necessary and basic information will be given so that, later, the knowledge and learning can be completed with the consultation of suitable texts.


Practical teaching. The practical sessions serve to apply and fix the knowledge that the students have acquired in the theory. The student will develop the ability to observe and the ability to integrate knowledge. General surgery and anesthesiology practices (laboratory) The practical classes will consist of 2-hour sessions in the laboratory and will be conducted on biological models or corpses. Surgery: First of all, aseptic and operating room techniques will be taught in surgery (practice 1) and suturing techniques (practices 2 and 3). Subsequently, the practices of plastics (Practice 4), basic surgical procedures (Practice 5) and wound and bandage care (practice 6) will be performed. Anesthesia: these are workshops aimed at getting the student to know the basic procedures before interacting and performing them in a live animal. Anesthesia practices (module) HCV practices will deal directly with patients who need to undergo sedation or general anesthesia (whether for surgery or other complementary tests or procedures). In these practices students will learn the main anesthetic techniques and proper monitoring in different animal species (especially dogs, cats, equines and exotic animals) as well as the postoperative care to be provided to surgically treated animals. Self-learning work. Students will develop and solve cases and discuss them with their peers. Cases of anesthesia will be discussed on a daily basis during the module week. 
“* Depending on the restrictions that may be imposed by the health authorities depending on the evolution of the pandemic, it will be possible to carry out reductions or prioritization of the contents of the subject. ”

Activities

Title Hours ECTS Learning Outcomes
Type: Directed      
Autoaprendizaje 24 0.96 4, 5, 10, 15, 14, 17, 23, 24, 28, 21, 27, 26
Practical teaching 12 0.48 1, 3, 6, 9, 11, 13, 16, 19, 22, 20, 23, 21
Practical teaching. Anesthesia practices (practice laboratory) 4 0.16 10, 17, 28, 26
Theorethical teaching. 30 1.2 1, 3, 6, 25, 7, 8, 9, 11, 12, 10, 15, 14, 13, 16, 17, 19, 22, 20, 23, 24, 21, 27, 26
Type: Autonomous      
Practical teaching 40 1.6 8, 15, 14, 17, 27, 26
Theoretical teaching 86 3.44 1, 3, 6, 25, 7, 8, 9, 11, 12, 10, 15, 14, 13, 16, 17, 19, 22, 20, 23, 21, 27, 26

Assessment

The assessment will be developed throughout the course, which will monitor the teaching and learning process, encourage continued effort throughout the semester and verify whether the competencies assigned to the subject in the curriculum
										
											
										
											In order to be able to sum or obtain the final mark, it is necessary to have passed both the practical exam and the two theoretical ones independently. Attendance at internships and self-study are also compulsory.
										
											
										
											Written exams. There will be two partial written exams (one for block 1 and one for block 2). The written exams will account for 60% of the final grade of the subject (the two exams have the same weight, ie each exam will represent 30% of the final grade). A minimum grade of 5 points out of 10 will be required in each of these exams to be able to average with the other grades and pass the subject. The written exams will allow to evaluate the integration of the theoretical knowledge with the acquired in the practical sessions of the asignatura, the capacity to relate concepts and of analysis and, in definite, show the final maturity of the student.
										
											
										
											The topics in block 2 taught by David Prandi will be evaluated continuously during their teaching; the grade obtained will be integrated into that of the theoretical examination of the other topics in the block in proportion to the total number of topics in this block 2.

Evaluation of practices. Internships will be assessed as follows:
										
											
										
											         - General surgery practices: a practical exam will be performed. This exam will account for 20% of the final grade of the subject. The exam assesses the acquisition of knowledge and skills. The following grades can be obtained in the exam:
										
											
										
											                            . Suspended = failed minimum skills. The subject will be suspended.
										
											
										
											                            .0.1- 2 points on the final grade: depending on the skills you have acquired
										
											
										
											         - Practical teaching of anesthesia (module, OHE practice and workshops): they will be evaluated continuously during their performance and will be evaluated in conjunction with the anesthesia self-learning (see how to evaluate later, self-learning section ).
										
											
										
											Attendance at all internships will be mandatory.
										
											
										
											Self-learning work.
										
											
										
											The self-learning work will consist of two parts:
										
											
										
											          - Preparation and discussion of daily cases of anesthesia during the week of internships at the FHCV. The teacher will evaluate the acquisition of knowledge through questions during the completion of the module.
										
											
										
											          - Preparation of laboratory practices independently with the material deposited by teachers before attending the practice. During the practice it will be valued that the student has completed the self-learning
										
											
										
											The grades obtained in self-learning will account for 20% of the final grade (2 points out of 10, one point for anesthesia and the other for surgery). No minimum grade should be taken. If the score is good, 2 points out of 10 can be obtained, but there is no participation or self-learning, no points will be added.
										
											
										
											Students who do not pass the practical exam or one of the two partial written exams will have the opportunity to retake them during the end-of-semester exam period.
										
											
										
											Practice controls and self-learning work are not recoverable.
										
											
										
											A student who has taken a midterm exam and then fails any more exams will be considered suspended.
										
											
										
											* "The proposed assessment may be subject to change depending on the attendance restrictions imposed by the health authorities."


Assessment Activities

Title Weighting Hours ECTS Learning Outcomes
Partial written test - Block 1 (the note will include the continuous assessment of the topics taught by David Prandi). 30% 1 0.04 10, 15, 14, 17, 24, 27, 26
Partial written test - Block 2 30% 1 0.04 1, 3, 2, 6, 9, 11, 13, 16, 19, 18, 22, 20, 23, 28, 21
Practical test 20% of the final grade 1 0.04 1, 3, 6, 25, 7, 8, 9, 11, 12, 13, 16, 19, 22, 20, 23, 21
Self-learning 20% 1 0.04 4, 5, 7, 15, 14, 13, 17, 28, 27, 26

Bibliography

  • ANDERSON W. D., ANDERSON B. G. (1994). Atlas of Canine Anatomy. Ed. Lea & Febiger. Pennsylvania.
  • AUER J., STICK (2005). Equine Surgery. Thrid Edition. Saunders.
  • BOJRAB M. J. (1998). Current Techniques in Small Animal Surgery. Ed. Lea & Febinger. Philadelphia.
  • FOSSUM T. W. (2002). Small Animal Surgery. Second Edition. Ed. Mosby. Missouri.
  • GOURLEY I. M., VASSEUR P. B. (1985). General Small Animal Surgery. J. B. Lippincott Company. Philadelphia. Pennsylvania.
  • GRIMM K., TRANQUILI W., LAMONT L. (2011). Essentials of Small Animal Anesthesia and Analgesia. Second Edition. Wiley-Blackwell. Oxford.
  • HARARI J. (2004). Small Animal Surgery Secrets. Second edition. Ed. Hanley & Belfus. Philadelphia, Pennsylvania.
  • LIPOWITZ A., NEWTON C. D., CAYWOOD D. D., SCHWARTZ A. (1996). Complications in Small Animal Surgery. Ed. Williams & Wilkins. Pennsylvania.
  • SEYMOUR C., GLEED R. (2001). Manual de Anestesia y Analgesia en pequeños animales. Colección BSAVA. Ediciones S. Barcelona
  • SLATTER D. (2003). Texbook of Small Animal Surgery. Third edition. Ed. Saunders. Philadelphia, Pennsylvania.
  • TAYLOR R., McGEHEE (1995). Manual of Small Animal Postoperative care. Ed. Williams & Wilkins. Pennsylvania.
  • WILLIAMS J., MOORES A (2009). Manual of Canine and feline Wound Management and reconstruction. Second Edition. Ed. BSAVA.