UNIVERSITY OF MINNESOTA
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC)
Appendix F
Surgery
Please complete a separate Appendix F for each surgical procedure.
Note: Survival surgery for all species must be performed in a pre-approved area properly designed
and maintained to enable adherence to the principles of aseptic technique. Surgery on non-rodent
mammals must be done in a dedicated surgery area approved by the IACUC.
Note:
Pharmaceutical grade anesthetics, analgesics, and euthanasia agents must be used
whenever they are available, even in acute procedures.
For more help see: Surgery Requirements, Guidelines for the use of Anesthetics, Analgesics, and
Tranquilizers in Laboratory Animals & Post-Operative Care Procedures
1. Surgical procedure is:
2.
Non-survival
Survival
Species:
3. a. Title of Surgery:
b. Description of Surgical Procedure:
4. Building/room location of surgical procedure:
Building:
Room number:
5. Name of surgeon(s): NOTE – Only the personnel listed below will be approved to perform
surgery on this protocol. The IACUC must review and approve the addition of new surgical
personnel.
6. For each individual performing surgery or anesthesia, please provide relevant training and
experience with the surgical and/or anesthesia procedures being used. For example: "In
[Month/Year] [Name of individual performing surgery] was trained to perform the [Name of
surgery] by [Name of the trainer] who has [X number] years of experience with the technique.”
Appendix F
rev September 2011
UNIVERSITY OF MINNESOTA
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC)
Client owned animals used in clinical studies. Procedures are performed by Veterinary Medical
Center personnel that are either board certified specialists or residents in training supervised by board
certified specialists. If checked, skip to Question 13.
7. For survival surgery, please describe aseptic technique: instrument sterilization methods,
surgical incision/site preparation, etc. http://www.ahc.umn.edu/rar/surgery.html#Preparation
8. Anesthesia:
a. Please provide the drug(s), dose (in mg/kg or % range for gas anesthetics), administration route
and frequency:
b. If appropriate, please list other drugs that may be used during the surgical period (as either
support drugs, like atropine, and/or emergency drugs, like epinephrine):
c. Please indicate methodology and physiological parameters used to assess depth of anesthesia.
Note that while monitoring of the animal should be performed continuously, documentation of the
assessment in the anesthetic record should be done at a minimum of 15 minute intervals.
d. Please identify the anticipated acceptable ranges of each of the parameters to be measured in
8.c. above (eg. respiratory rate range of 60-80 per minute, or heart rate of 100-150 bpm] and
specific steps that will be taken in the case that any of the measured values are outside the
acceptable ranges:
9. Use of neuromuscular paralytics
No
Yes. If yes, complete the following:
Include dose/route/frequency and criteria for judging depth of anesthesia. Your plan must
specify which physiological parameters will be monitored to judge depth of anesthesia, the
variances which will be tolerated, and the steps to be taken if any parameter varies outside of the
expected range.
Appendix F
rev September 2011
UNIVERSITY OF MINNESOTA
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC)
10. Anesthesia, Surgery, and Post-Operative Records. All animals experiencing anesthesia or
surgical procedures must have a concurrently recorded and readily available record detailing
anesthesia data, intra-operative monitoring, and post-procedural care. Do your recordkeeping plans
comply with the IACUC Policy on Anesthesia, Surgery and Post-Procedural Records? (Also see
www.research.umn.edu/iacuc/guidelines/AnesthesiaRecords1008.pdf and sample recordkeeping
forms on the IACUC Website at www.research.umn.edu/iacuc/guidelines (lower right). Note that
although surgical/anesthetic monitoring should be performed continuously, documentation of the
assessment in the surgical/anesthetic record is expected be recorded at a minimum of 15 minute
intervals. Post-operative/procedural records are expected to be recorded daily for a minimum of 3
days; if you need an exception to these requirements, please explain and justify.
Yes.
No. If you answered No, please describe your recordkeeping plans and forms:
Survival Surgery
Note: Survival surgery is defined as any surgery from which an animal is expected to recover from
anesthesia for any duration. Aseptic technique must be used on all survival surgical procedures.
11. How long will animals be maintained after surgery?
12. Postoperative care. Check one of the following boxes. If unsure which one to check, please call
RAR at 612-624-9100.
This Appendix F covers major survival surgery on dogs, cats, nonhuman primates or farm
animals housed on the Minneapolis Campus and therefore post-operative care will be provided
by RAR or under direct RAR supervision (eg. nonhuman primates). The rest of item 12 does not need
to be completed unless this study has requirements for specific analgesic, antibiotic, or other postoperative care practices that RAR Post-Op will need to follow. If that is the case, list those
requirements in the textbox below and on the intake form when animals are brought to RAR Post-Op.
If study specified care regimens will require care outside of normal post-op hours, study personnel will
have to provide that care or arrange with RAR for special service.
This survival surgery does not meet the mandatory RAR post-op care definition above.
Describe below the postoperative care to be given over the 72 hours immediately following surgery:
Include analgesics, including dose, route of administration and interval between doses, (must be
administered for at least 72 hours unless an exception is justified below and approved by the IACUC).
Also state the physiological parameters assessed (eg. hydration, body temperature, parameters used to
determine evidence of pain), frequency of monitoring, and any other post-procedural care details.
Appendix F
rev September 2011
UNIVERSITY OF MINNESOTA
INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE (IACUC)
13. Will any animal undergo more than one survival surgical procedure? This includes surgeries
the animals may have had on another protocol or at another institution.
No.
Yes. If yes, please provide an appropriate scientific justification. Multiple survival
procedures on the same animal are not permitted, unless the procedures are essential components of the
same project. Include in your justification any pain, distress or functional deficit that may result and
describe how such distress will be minimized. Indicate the estimated time between each survival
surgery.
Appendix F
rev September 2011