42 terms

Mosby Ch 19 Anesthesia

Florida Institute of Animal Arts access
preemptive analgesia
taking steps to predict and prevent pain before it occurs
reduction or absence of pain sensation (without loss of other sensations)
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.
mild to profound degree of CNS depression (which the patient is drowsy but may be aroused by pain)
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
facilitates visualization of the glottis as the endotracheal tube passes through into the trachea
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)
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)
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
insufficient oxygenation of the blood, a common sign of pulmonary compromise during anesthesia and reason for oxygen enrichment of inspired air
reduced rate and depth of ventilation as determined by increased arterial carbon dioxide levels (hypercarbia or hypercapnia)
inadequate arterial blood pressure, the most common sign of cardiovascular depression
insufficient circulating blood volume, a common cause of hypotension
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)
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
abnormally high level of carbon dioxide in the circulating blood
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