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VT 17 Induction and Patient Prep

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IV catheter and IV injection w/o catheter
What are the most common induction methods?
Assures IV administration of anesthetic, provides port for fluid administration and provides port for emergency drugs
What does an IV catheter provide?
Used for quick procedures, may precede IV catheter placement in difficult patients, and risk of perivascular injection
What does IV injection without catheter provide and used for?
Rapid, smooth induction and good control of anesthetic depth
What are the advantages of IV induction?
May not be practical with difficult patients
What are some disadvantages of IV induction?
Cardiac and respiratory depression
What will worsen with rapid administration of Thiopental?
Thiopental
What drug may be used for short procedures, provides no analgesia, and recovery is rapid but stormy?
2.5%
Thiopental is a powder mixed to what percent solution?
Perivascular injection leads to tissue necrosis
Why is IV catheter preferred when administrating Thiopental?
Induction in < 1minute
Why is Thiopental excellent for intubation?
To improve recovery
Why would one mix Propofol with Thiopental?
Ketamine-Diazepam
What drug has a duration of 5-10 minutes, provides some analgesia and recovery takes 30-60 minutes?
Ketamine 100mg/ml, Diazepam 5mg/ml in the same syringe
How is Ketamine Diazepam mixed?
Propofol
What drug is administered to effect, provides a smooth induction/recovery and no analgesia, with a duration of 5-10 minutes, and a recovery of 20-30 minutes?
Milky white
What color is propofol?
Thiopental, Ketamine-Diazepam, and Propofol
What induction drugs are administered intravenously?
Fractious domestic animals, zoo animals and wildlife immobilization
What are the uses of intramuscular induction?
Manual restraint, mechanical restraint
What are some common methods of intramuscular induction?
Pole syringe and dart syringe
What are some remote methods of intramuscular induction?
Squeeze cages, and catch poles
Name two mechanical restraint devices.
Handler safety, and minimize animal stress
What are some advantages of intramuscular induction?
Slow induction time, and minimal control of anesthetic depth
What are some disadvantages of intramuscular induction?
Ketamine, Ketamine-Midazolam, Tiletamine-Zolazepam, Alpha-2 agonisits and ultra-potent opioids (used in large zoo animals)
What drugs can be used in intramuscular induction?
Intramuscular injection, Midazolam is better absorbed IM.
When and why would one used Ketamine-Midazolam instead of Ketamine-Diazepam?
When IV induction is difficult, mildly uncooperative cats and small dogs, neonates, small mammals, birds, debilitated patients subject to the negative effects of premedications or induction drugs.
What are the uses of mask induction?
In patients with poor respiratory function and in highly fractious or fearful patients
When should one avoid mask induction?
Minimal stress with most patients, and excellent control of anesthetic depth.
What are some advantages of mask induction?
Human exposure, isoflurane odor is offensive to some animals, fearful animals release epinephrine that may lead to cardiac arrhythmias,difficult in medium to large dogs and risk of regurgitation
What are some disadvantages of mask induction?
Femoral pulse
What is the best way to monitor cardiac function during induction?
Positive Pressure Ventilation-Endotracheal tubes
What is PPV? When is it used?
Cole tubes, Magill tubes, and Murphy tubes
List three endotracheal tubes.
Cole tubes
What tubes expansion lodges at the glottis and is used for pediatrics, birds and reptiles?
Magill tubes
What type of tube is made of rubber, PVC or silicone and may be cuffed or uncuffed?
6mm
What endotracheal tube size would a 10 lb dog need?
15-30minutes after due to the trachea relaxing under anesthesia.
After inflating the endotracheal cuff when should one recheck the cuff and why?
12
California law requires PE within how many hours of anesthesia?
Neurologic, cardiovascular, and respiratory
One must assess an animals ability to withstand the negative effects anesthesia may have on which body systems?
To be able to assess the animals ability to eliminate anesthetic agents from the body
Why is an animals hepatic and renal function important to know during anesthesia?
Acepromazine (seizures), Xylazine (cardic and respiratory depression), Barbiturates (excitement/seizures), Ketamine (seizures)
What anesthetic drugs should be avoided with neurologic disease and why?
Anticholinergics (maintain bp), Diazepam (anticonvulsant), opioids, propofol and inhalation agents (safe for epileptics)
What anesthetic drugs should be included with neurological disease?
Acepromazine (vasodilation, hypotension), Xylazine (bradycardia, hypotension), Barbiturates (arrythmias), Methoxyflurane (depressive, slow) and Halothane (depressive)
What anesthetic drugs should be avoided with cardiovascular disease and why?
Anticholinergics (prevent bradycardia), Diazepam (minimal cardiac effects), Ketamine (minimal cardiac effects), Opioids (mild bradycardia, normal pressure), Propofol (very short acting, does dependent depression), Isoflurane and Sevoflurane (rapid control)
What anesthetic drugs should be included with cardiovascular disease and why?
Acepromazine (long duration), Xylazine (respiratory depression), Opioids (respiratory depression to apnea), Methoxyflurane (depressive, slow)
What anesthetic drugs should be avoided with respiratory disease and why?
Anticholinergics (dilates bronchioles), Diazepam (minimal respiratory effects), Ketamine (minimal respiratory effects), Propofol (very short acting, dose dependent depression), Isoflurane and Sevoflurane (rapid control)
What anesthetic drugs should be included with respiratory disease and why?
Acepromazine (long duration), Xylazine (metabolized in liver), Barbiturates (metabolized in liver), Ketamine (dogs-metabolized in liver), Methoxyflurane (50% metabolized in liver), and Halothane (25% metabolized in liver)
What anesthetic drugs should be avoided with liver disease and why?
Anticholinergics, Diazepam, Opioids, Propofol, Isoflurane and Sevoflurane
What anesthetic drugs should be included with liver disease
Acepromazine (hypotension), Xylazine (hypotension, renal excretion), Barbiturates (renal excreation), Ketamine (cats-renal excreation), Methoxyflurane
What anesthetic drugs should be avoided with kidney disease and why?
Anticholinergics, Diazepam, Opioids, Propofol, Isoflurane and Sevoflurane
What anesthetic drugs should be included with kidney disease?
Dogs: liver and Cats: kidneys
How is Ketamine metabolized in dogs? Cats?
Anticholinergic, sedative, and analgesic
Premedication should include what?
Atropine or Glycopyrrolate, Acepromazine, and Butorphanol
What is used for a routine surgery (e.g., OVH)
Atropine or Glycopyrrolate, Diazepam and Butorphanol
What should a patient with cardiac, respiratory, neurologic, kidney or liver disease be given as a premedication?