Mosby Ch 19 Anesthesia

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Florida Institute of Animal Arts access

preemptive analgesia

taking steps to predict and prevent pain before it occurs

analgesia

reduction or absence of pain sensation (without loss of other sensations)

anesthesia

loss of bodily sensation (with or without loss of consciousness)

(4 types of) anesthesia

local, regional, spinal, general

(5) effects of pain

immunosuppression, increased tissue catabolism, reduced healing, increased autonomic activity, emotional distress

(7) signs of pain

protection of affected area, vocalization, licking or biting, scratching or shaking, restlessness or pacing, sweating increased respiratory or heat rate.

sedation

mild to profound degree of CNS depression (which the patient is drowsy but may be aroused by pain)

tranquilization

state of relaxation and calmness characterized by a lack of anxiety or concern without significant drowsiness

(goals of every) anesthetic-analgesic plan

to predict, prevent, recognize and correct any complications

(7) steps of anesthesia

patient history, patient preparation, prepare equipment and supplies, preanesthetic medication, induction, maintenance, recovery

five hypos

hypoxemia, hypoventilation, hypotension, hypovolemia, hypothermia

(before anesthesia) withhold food for

8-12 hours, water for 2-4 hours (pediatric or smaller patients 2-4 hours)

endotracheal intubation

ensures an airway, facilitates patient ventilation, provides easy delivery of volatile anesthetics

catheter size

18gauge for dogs >20lbs, 20 gauge for dogs <20lbs, 24 gauge for cats

Flow Meters

measure and deliver a constant gas flow to the vaporizer

Laryngoscope

facilitates visualization of the glottis as the endotracheal tube passes through into the trachea

Vaporizer

primary function is controlled enhancement of anesthetic vaporization

nonrebreathing circuits

do not have a carbon dioxide absorber (removal of carbon dioxide depends on fresh gas flow rates)

rebreathing circuits

circle system (amount of carbon dioxide rebreathed depends on the degree of absorption and the fresh gas flow rate)

anticholinergics

blocks the action of acetylcholine in the parasympathetic nervous system (also known as cholinergic blocking agents, antispasmodics, and parasympatholytic agents)

anticholinergics effects

increased heart rate, decreased salivation and bronchial secretions, mydriasis (dilated pupils), bronchodilation, decreased gastric and intestinal motility, reduced tear formation

(2) anticholinergics

atropine, glycopyrrolate (Robinul-V)

thiobarbiturate IV injection (used for induction)

pentothal (thiopental sodium)

nonbarbiturate (used for induction)

propofol

dissociative anesthestics

ketamine, tiletamine (in combo acepromazine, alpha 2 agonists, opioids or a benzodiazepine)

inhalant agents (used for induction)

isoflurane, sevoflurane

(? will) reduce anesthetic requirements

hypothermia, hypotension

Hypoxemia

insufficient oxygenation of the blood, a common sign of pulmonary compromise during anesthesia and reason for oxygen enrichment of inspired air

Hypoventilation

reduced rate and depth of ventilation as determined by increased arterial carbon dioxide levels (hypercarbia or hypercapnia)

Hypotension

inadequate arterial blood pressure, the most common sign of cardiovascular depression

Hypovolemia

insufficient circulating blood volume, a common cause of hypotension

Hypothermia

abnormally low body temperature, a sign of CNS and CV depression

hypothermia (responses)

decrease the anesthetic concentration, ensure adequate circulation, insulate from cold surfaces, dry the body surface, apply warm blankets, warm inspired air, and decrease fresh gas flow to minimum requirements.

tachycardia (responses)

decrease anesthetic concentration, increase oxygen flow, increase the rate of IV fluid delivery, support ventilation (if tachycardia persists, prepare for cardiac arrest)

bradycardia (opioid induced or alpha agonists responses)

anticholinergics

bradycardia (excessive anesthesia responses)

decreased anesthetic concentration and support with oxygen and fluids

hypotension (responses)

controlled by appropriate fluid administration and lowering the anesthetic concentration

hypercarbia and hypercapnea (responses)

managed by increasing ventilation (bagging) to remove carbon dioxide from the patient

hypercarbia

abnormally high level of carbon dioxide in the circulating blood

Hypercapnea

increased amount of CO2 in arterial blood

hypoexmia (responses)

increasing inspired oxygen concentration and ensuring adequate ventilation

immunosuppression, increased tissue catabolism, reduced healing, increased autonomic activity, emotional distress

(5) effects of pain

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