88 terms

Anesthesia

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acepromazine
phenothiazine tranquilizer
main advantage is calmness
no analgesic
causes peripheral vasodilation which leads to hypotension
known to reduce seizure threshold
may cause permanent penile prolapse in horses
may be used as an antiemetic
atropine
anticholinergic
emergency drug of choice to treat bradycardia
fast onset
short duration of effect
diazepam
benzodiazepine tranquilizer
not water soluble
provides excellent skeletal muscle relaxation
commonly used with ketamine or propofol for induction
prevents seizures
give IV SLOWLY
atipamazole
reversal agent specific for dexmedetomidine
reverses ALL effects (good and bad)
pur mu agonist
includes morphine, hydromorphone, oxymorphone, fentanyl, and meperidine
stimulate opioid receptors
effective in reading visceral and somatic pain
may cause vomiting
propofol
ultra-short acting
non-barbiturate anesthetic
provides smooth and rapid induction and recovery
IV ONLY
causes significant respiratory depression especially if administered too fast
ketamine
dissociative anesthetic
causes catalepsy, intact reflexes, and the eyes remain open
pupils will be central and dialated
may increase HR, cardiac output, and BP
minimal respiratory depression
may be used alone or in combination with a benzodiazepine or propofol for induction
tiletamine
cyclohexamuine drug
sold ONLY when mixed with zolazepam
in TELAZOL
etomidate
ultra-short acting
non-barbiturate
little to no side effects on cardiovascular, respiratory, hepatic, and renal systems
contraindicated in patients on long term steroid therapy and patients hypoadrenocorticism (Addison's) due to suppression of the adrenal cortex
alfaxalone
neuro-active steroid anesthetic
IV for induction
IM for chemical restraint in cats
give slowly to prevent apnea and cardiac depression
does not contain a preservative
blood gas partition
indication of the speed of induction, changes in anesthetic depth, and recovery
MAC (minimum alveolar concentration)
the measure of the potency
vapor pressure
the property that determines the type of vaporizer
(precision vs non-precision)
sevoflurane
high vapor pressure
low blood gas partition coefficient
best choice for mask inductions because less irritating to tissue and less pungent order
recommended use at 2.5% to 4%
desflurane
highest vapor pressure
highest minimum alveolar concentration
lowest blood gas partition coefficient
requires a special precision vaporizer
dysphoria
an emotional state characterized by anxiety, depression, or unease
hyperalgesia
lowering the pain threshold resulting in less stimulation required to produce pain
multimodel analgesia
the use of 2 or more analgesic drugs to alter more than one phase of the pain pathway
opioid agonist-antagonist
Butorphanol
behavior signs of pain in dogs
restlessness
whipering
uninterested in surroundings
crying
groaning
noloxone
drug used to reverse the effects of buprenorphine
fentanyl
most effective analgesic
tramadol
is a non-opiate
activity at the my receptor
used for mild to moderate pain especially when the NSAIDs are contraindicated that can be administered orally
hypotensive
You are running anesthesia on a 4 yr Boston and the readings fro the Doppler are constantly below 80mmHg.
What is the term to describe the patient's condition?
patients with increased risk to anesthesia
pediatric
brachycephalic
geriatric
pregnant
nothing, this is an acceptable HR for this patient
You are running anesthesia on a 32kg, 7 yr, mixed breed with PE WNL (HR 100, RR 20, T 101F). During anesthesia the HE maintains between 88 and 92. What do you do?
the patient is too light
Vet made their first incision and the HR increases to from 88 to 120 bpm, RR increases 12 to 29 and BP is SAP:150, MAP:100, DAP 80.
What is the likely cause for these changes?
Dobutamine
is an inotropic drug that increases the force of myocardial contractions
assess anesthetic depth
your patient becomes hypotension
what is your FIRST step?
a 7 yr doberman under anesthesia suddenly becomes apnic
inform the vet
check the HR
ensure O2 flow is adequate (check the flowmeter and tank pressure)
ensure the airway is not obstructed
ruminants
are more prone to
-bloat
-regurgitation
-hypoventilation
DO NOT USE
anticholinergics on ruminants
IV sedation
is virtually impossible in healthy pigs
cattle require 1/10 the dose of xylazine than horses
because they are much more sensitive
"double drip" in large anima
guaifenesin and ketamine
using a stylette
helps to intubate calves and pigs
recover ruminants in
sternal recumbency
PE is difficult in swine because
-difficult to restrain
-best to observe RR rate and character from a distance
-blood draws and assessment of cards function are difficult to impossible to assess
aural
IV placement in swine
treatment of porcine stress syndrome
-deliver oxygen
-give dantrolene
-stop anesthsia
LRS given to SMAMS
should be warmed to body temp to avoid hypothermia
use glycopyrrolate in rabbits
because rabbits have high levels of atropines
so atropine is ineffective
because eye position does not change
you can't assess anesthetic depth with the eyes in rodents
SMAMS anesthetizes with injectables
should be given O2 because most anesthetics depress respiration
they will not eat or drink
if post-op pain is not alleviated in rabbits
do not withhold food and water from rabbits and rodents
because they do not vomit and it may lead to dehydration
does not function high enough
most monitoring equipment is no designed for rodents and rabbits because it
when intubating rabbits
-needs to loose chew reflex
-lyrngoscope/otoscope can be helpful to visualize the larynx
-uncuffed tubes are preferred
inhalants are often chose to induce SMAMS because
simple and convenient
rapid recovery
with a tube placed in the esophagus
the unidirectional valve doesn't move
when a patient is ready to intubate
-unconscious
-relaxed (not lost) jaw tone
-decreased/absecent swallow reflex
MAC
-lowest concentration and which 50% of patients show no pain response
-used to determine average vaporizer setting
-measures potency
surgical plane
vaporizer
1.5 x MAC
benzodiazepines
cause muscle relaxation
provide analgesia
provide sedation in healthy patients only
an inhalant anesthetic with a low MAC
is considered to be more potent and therefore requires a lower vaporizer setting
administration of acepromazine
may lead to vasodilation which may lead to hypotension
adaptive pain
promotes survival by preventing injury and by promoting healing of the injured body part
QRS complex
is produced during ventricular depolarization
T wave
ventricular repolarization
P wave
atrial depolarization
HR is
cardiac output x stroke volume
Stage II
excitement stage
when still conscious and having involuntary movements
respiratory acidoses
is a condition that occurs when the lungs can't remove enough of the carbon dioxide (CO2) produced by the body. Excess CO2 causes the pH of blood and other bodily fluids to decrease, making them too acidic.
ventricular fibrillation
is a heart rhythm problem that occurs when the heart beats with rapid, erratic electrical impulses. This causes pumping chambers in your heart (the ventricles) to quiver uselessly, instead of pumping blood
ECG placement
Red
Black
White
Green
VPC
a normal rhythm that is interrupted by 1 or more wide and bizarre QRS complex's
PaO2 < 80mmHg
indicates hypoxemia in anesthetized patients
2nd degree heart block
lone P wave
1000lbs or 454.4kg
average size of adult horse
horses are more prone to atelectasis
because when in dorsal the excess weight of the diaphragm and limit their brething
remove a horses halter during surgery
to prevent the risk of facial nerve damage
must maintain adequate blood flow to muscle in horses under anesthsia
or risk myopathy
damage to the muscle
during the PA period on horses
be sure to rinse the mouth to prevent aspiration of feed during intubation
IVC used in average horse
14g 15" OTN
placed in the jugular
to intubate a horse
extend the neck and head
pull tongue to the side
insert mouth gag
slowly insert tube (blindly)
horses are more prone to these under anesthesia
hypotension
hypoventilation
reduction of cardiac output
positive inotrope
strengthens myocardial contracions
positive intorto-e used in horses
Dobutamine
monitoring of horses
use direct/arterial BP mointor
ensure blood gas
ECG
caphnograph
demand valve
small piece of equipment hooked up to oxygen to use in equine recovery to give a single breath
arteries commonly used to measure direct BP in horses
facial artery
transverse facial artery
dorsal metatarsal artery
BP lows for horses under anesthesia
SAP 90
MAP 70
DAP 50
what drug us commonly used in combination with ketamine in horses
diazepam
-or- guaifenesin (GG)
tachycardic
an anesthetized horse with a HR of 65bpm would be
large animal anesthesia machine
has many difference parts and components that a small animal machine
avoid anticholinergics in horses
because decrease gut motility
may lead to colic
to avoid myopathies and neuropathies in horses under anesthesia
remove halter
use padding
place bottom limb more cranial than top limb
if a horse becomes excited after PA with xylazine
anesthetist should
allow the horse to calm down before proceeding
cover eyes and ears
may need to give sedative