3- Complications during anaesthesia

Question 1

List 3 factors that might cause bradycardia under anaesthesia?

Answer 1

Drugs - volatile agent, alpha 2-agonist, induction, opioid

Toxaemia

Co-morbidities

Heart problems

Hypoxia

Question 2

Canine patient normally has a HR of 96bpm.
They are ASA 2 (Has another disease).
Under anaesthetic, HR drops to 42, BP is on the low side and other values are fine.

What would you do?

Answer 2

HR has dropped quite a bit & BP is low so
switch ISO down as likely too deep

Up fluids to see if it helps?- as this would expand the circulating volume

Question 3

Horse is undergoing a long painful surgery.
Given sevoflurane at 3.1%
HR was 40 before surgery and is now 30.( still in prep stage)
CO2 has risen slightly too much (67).

What would you do?

Answer 3

Horse has gone too deep causing depression

Switch sevo down and allow HR to rise

May need ketamine to hand, in case horse reacts to any painful parts of the surgery

Question 4

What type of drug cannot be used in a blocked cat?

Answer 4

Alpha 2 agonist- as will increase urine production

Question 5

2 options of anticholinergics to be used in bradycardia

Answer 5

Atropine
Glycopyrrolate

Question 6

2yr old canine. HR 96bpm prior to surgery.
Induced with propofol & maintained on iso.
2 mins after incision, HR has increased to 157.

What do you do?

Answer 6

Very high HR but occurred in incision
Suggest animal is too light and ISO needs to be upped

Can also add extra analgesia instead

Question 7

Is 209 a normal HR for a rabbit?

Answer 7

Yes

Question 8

What is a ventricular/atrial ectopic beat?

Answer 8

Extra beats

Question 9

List 3 causes of ventricular/atrial ectopic beats?

Answer 9

Circulating catecholamines (stress)
Hypoxia or hypercapnia
Hypovoleamia or hypotension
Anaesthetic drugs
Myocardial inflammation
Trauma
Major organ diseases

Question 10

What are 2 common treatments options when your patients has hypotension in surgery?

Answer 10

Reduce Volatile/inhalation agents (TIVA/PIVA)
Increase IVFT

Question 11

Commonest causes of hypotension during anaesthesia

Answer 11

Anaesthetic drugs
Hypovolaemia and haemorrhage
Cardiac insufficiency

Question 12

When faced with bradycardia in a patient during anaesthesia what should you consider

Answer 12

what is normal for the animal
is it causing a problem with perfusion and oxygen delivery - check SPO2% and the ABP