Anaesthesia Flashcards
ASA 1 protocol
Anaesthetic protocols should ideally be tailored to the individual patient and procedure to be performed.
For your first surgical rotation, we have provided a baseline protocol which is suitable for routine procedures in ASA 1 patients (cats and dogs).
Premedication:
Medetomidine 0.01mg/kg (a2, analgesic, reliable, reversible, reduces need for iso BUT cardio vascular effects vaso constriction then dilation, increased urine output, rhythm changes. Transient hypoglycaemia, reduced drug metabolism, mild increase in intraocular pressure, decrease in intracranial pressure, will induce vomiting in non starved animals)
+
methadone 0.3mg/kg IM- full mu agonist opiod, partially reversible , great pain relief, mild sedation especially in combination, can be topped up, MAC sparing BUT respiratory depressant, apnea, can cause panting, decrease heart rate, slows GI, can cause hyperthermia but better than other opioids for this
Induction:
Propofol (non barbiturate induction agent: fast onset, can be topped up, short duration, fine in hepatic and renal insufficiency BUT short duration, apnea if given too fast, excitability on recovery if given too fast, slows heart, to for TIVA in cats
Or
Alfaxalone (neuroactive steroid- can be given in or IM, good in snakes IM BUT excitable recoveries in cats, more expensive, extended duration in hepatic insufficiency)
to effect
Maintenance:
Isoflurane via an endotracheal tube (volatile anaesthetic agent- rapid adjustment, cheaper BUT bad in exotics as it leads to breath holding as it stings, bad for environment , slows cardio and causes hypotension,
Use of local blocks can reduduce pain during surgery and so makes anaesthesia smoother
What could happen during an anaesthetic procedure which may require your intervention?
Hypoxaemia (decreasing SPO2)
Hypercapnia (increasing ETCO2)
Hypoventilation
Tachypnoea
Airway obstruction
Apnoea/respiratory arrest
Cardiac arrythmias
Cardiac arrest
Hypotension
Hypertension
Hypothermia
