CENTRAL VETERINARY SOCIETY
Minutes of a General Meeting of the Society held on Monday 4th April 2005 at Royal Holloway College, Egham, Surrey.
Present: the President Mr. B. Hoskin and 15 Fellows and guests.
Apologies for absence had been received from 20 Fellows.
Minutes of the meeting held on 3rd March 2005 had been circulated and were approved.
Matters arising: none.
Any Other Business: none.
The President then welcomed the speaker, Dr. Kathy Clarke of the Royal Veterinary College, who delivered the Centenary Prize Address entitled "What's New in Anaesthesia". She began by remarking that in fact very little is truly new, and that most advances are in fact developments of established procedures - new drugs, new equipment, and unavoidably, new fashion areas. However, does new mean better? 'New' includes new laws such as the Medicines Act and the OFT rules, which can create problems for farm animals in particular. The Medicines Act is stopping new advances, in that anaesthetists may now be prosecuted if new human anaesthetic agents are used, especially as there is always a mortality risk in such cases. It is simply uneconomic to license new products for animals.
Some new drugs have become available, including α-2 agonists, volatiles, new formulations of propofol (which are coming down in price), alphaxolone, NSAIDs and locals. Rocuronium is an interesting development, incorporating a cyclodextrin antagonist which wraps itself around the active molecule giving a predictable reversal. If this becomes licensed, neuromuscular blocking agents might become more acceptable.
Equipment has not changed much in its essentials, but has become prettier. Semi-disposable instruments are now available but are arguably over-used. The use of silver ions ('Silver Knight') which disrupt bacterial enzymes and are 99% bacteriostatic efficient has proved helpful in dealing with MRSA and similar organisms. Nitrous oxide is on the way out, and halothane may be close to the end of its useful life, with isoflurane, sevoflurane and perhaps most promisingly desflurane set to take over. Dr. Clarke demonstrated how differences in the physical properties of these related compounds affect their use, and the design of the vaporisers required. Although desflurane is expensive, and requires an expensive vaporiser, because the system is closed the overall cost is not prohibitive, and the agent is particularly good for brachycephalic breeds. Fellows were introduced to xenon, the volatile of the future. Unfortunately, however, as this is an element it cannot be manufactured, only fractionated from air. It is thus prohibitively expensive, and its use may forever be restricted to anaesthesia of the rich and the famous.
Dr. Clarke then pointed out that in spite of all the advances, mortality rates had changed very little over the past 20 to 30 years - dogs 1 in 1000 (perhaps 1 in 1400 now), cats 1 in 500 (perhaps 1 in 700 now) and horses 1 in 100 (excluding colic surgery, which would make the figures even worse). Perhaps the most significant advance has in fact been the pulse oximeter, but in the final analysis there are no safe drugs, and no safe equipment, only safe anaesthetists.
The President then presented Dr. Clarke with her Prize Certificate and Centenary Prize cheque. He also presented the new-format 2004-05 McCunn Prize to Mark Gull, current President of the RCVS Students Union, who was present as the guest of the Society.
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