Download Anesthesia, Surgery, Post-Op

Rodent Anesthesia, Surgery, and Post-op Log
Procedure Title:__________________________________________________________________________________________
Date:___________________________
PI:____________________________
Protocol #:____________________
Species:_______________________
Anesthetist:_________________ Surgeon:______________________
Animal
ID(s):_______________________________________________________________________________________________
Weight(s):_________________________________________________________________________________________________
Anesthesia Start Time:______________________
Anesthesia Stop Time: ____________________________
Pre/Intra-operative Medication(s) (e.g., fluids, rescue drugs):
Medication
Lot #/Vial ID
Dose
Volume
Route
& Exp. Date
mg/kg
mL
Anesthetic Agent–Inhalant:
Drug
Lot #/Vial ID &
Exp. Date
Anesthetic Agent–Injectable:
Drug
Lot #/Vial ID & Concentration
Exp. Date
%Gas
Dose
mg/kg
O2L/min
Volume
mL
Route
Anesthesia Notes: (e.g., depth, respiration Y/N, mucus membrane color)
Note
RARC Veterinary Staff
June, 2017
Time
Initials
Time
Initials
Time
Initials
Time
1
Rodent Anesthesia, Surgery, and Post-op Log
Description of Surgical Procedure: (Describe the surgical procedure; Typically includes the
approach taken, type of suture, and closure technique)
Post-operative Medications: (e.g., analgesia, fluids, other therapeutics)
Medication
Lot #/Vial ID &
Dose
Volume
Route
Time
Exp. Date
mg/kg
mL
Initials
***After anesthesia/ surgery an animal may only be left alone when it is: awake, stable, analgesia is
provided as per protocol, and the animal can lift its head and remain sternal or upright***
Any complications or deaths? (If so–list the animal ID, add details of the event and contact your
RARC veterinarian)
Post-Operative/Procedure Monitoring: Animals should be monitored for long-term recovery
from anesthesia/ surgery according to the timetable in the approved animal use protocol, utilizing
the monitoring and endpoint criteria described in the aforementioned document.
Animal
Date
Time
Observations
Medications Given
Initials
ID(s)
(drug, dose,
volume & route)
RARC Veterinary Staff
June, 2017
2