RODENT ANESTHESIA RECORD
This procedure template may be used as written, modified, or as guidance for recordkeeping in a lab notebook. Recordkeeping should be
consistent with the specific requirements described in the related IACUC protocol.
Date of Procedure:
Protocol Number:
Person Performing Procedure:
Cage Bar Code:
Description of Procedure:
Animal
ID
Initial
Body
Weight
Anesthetic Agent
Name:
Route of
Vol./%
Admin.
Admin.
Dose:
Time
Given
Analgesic Agent
Name:
Volume
Route of
Admin.
Admin.
Anesthetic depth assessed prior to start of procedure (toe pinch/corneal reflex)?
Heating device used to maintain body temperature?
Yes
Dose:
Time
Given
Time
Procedure
Completed
Time Recovered
from anesthesia
(awake and sternal)
Yes
Intra-operative Monitoring Notes:
Assessments taken included:
anesthetic depth (toe pinch)
temperature
heart rate
respiratory rate
Other:
Frequency of assessments conducted within individual surgery:
Additional fluids, emergency agents (if applicable, including dose/route/time) and any complications and actions taken:
Immediate post-operative monitoring:
Record observations and care during the day of the procedure.
Time
Comments
(include clinical observations, any drugs administered post-procedure)
Initials