Anaesthesia for airway dental and occular procedures Flashcards

1
Q

What must be considered when completing an anaesthetic for a patient undergoing rhinoscopy trache-broncoscopy

A

Very stimulating procedure
Adequate depth anaesthesia (deep plane)
Antisussive drugs (butorphanol)

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2
Q

Why may the ET tube be removed in a rhinoscopy patient and what steps should be taken if the
Is takes place?

A

To observe further down the larynx
Preoxygenate
Laryngeal mask
Total infused Voltaire anaesthetic (propofol CRI) unable to use volatile

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3
Q

What condition associated with cats may be of concern when completing a rhinoscopy and what can be done to prevent it?

A

Laryngeal spasm
(Bronchoconstriction)
Pre-treat glycopyrrolate(anti-cholinergenic)
Beta 2 agonists inhaler for acute asthmatic crisis (salbutamol terbutaline)
Monitor recovery until breathing fully

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4
Q

Why should a BOAS case not be left alone after their pre med?

A

Soft tissues may block the airways

Upper airway obstruction due to muscle relaxation

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5
Q

What difficulties at a BOAS dog provide you with during induction?

A

Difficult intubation (soft tissues surrounding larynx)
Narrow trachea
Laryngeal collapse
Pre-oxygenate!!!
Have hands ready consider urinary catheter as guide

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6
Q

What problems may occur during surgery in a BOAS dog?

A

Risk of regurgitation
(Keep in sternal, extubate late, cuff tube, extubate mildly cuffed tube)
Manipulation of the surgical field may kink et tube or increase soft tissue swelling

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7
Q

Why should BOAS dogs be monitored closely in recovery?

A
Upper airway obstruction due to muscle relaxation 
Hang from canines 
Monitor SpO2 
Check breathing pattern 
Extubate late 
Corticosteroids 
Tracheostomy 
Use sedatives
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8
Q

Why may laryngeal surgery be required?

A

Laryngeal paralysis horses and dogs

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9
Q

What may dogs with laryngeal paralysis present with?

A

Obstructive breathing
Tracheostomy
Sedatives to calm

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10
Q

What complications may arise during laryngeal paralysis surgery?

A

Tube may be in surgical field(make surgeon aware) have spare tube
may need to extubate
Pre-oxygenate TIVA
Blood in upper airway extubate mildly inflated cuff

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11
Q

Why may dental surgery cause problems with the ET tube?

A

Awkward positioning may kink or block the tube (reinforced tube)
Traction of the tube when moving over (disconnect patient)

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12
Q

Why is it important to consider the side effects of a mouth gag in dental procedures?

A

Cats of mouth opened too wide can cause blindness

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13
Q

What must be considered during the dental procedure?

A

Hypothermia

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14
Q

What must be considered when recovering a dental patient?

A

Tartar and water in the oropharynx
Extubate mildly inflated cuff
Pack with gauzes (count at the end of the procedure)

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15
Q

What loco-regional techniques can be used in the dental patient?

A

Maxillary
Inferior alveolar nerve
Infraortibal nerve
Mental

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16
Q

Why is positioning a problem when monitoring ocular procedure anaesthetics?

A

Kinking of the ET tube (reinforced tube)
Torsion from movement of the ET tube
Accessibility to the patient is difficult (can’t rely on palpebral reflexes, avoid cephalon vein IV)

17
Q

What is used in ocular procedures to make the eye stay central?

A

Stay sutures
Sub tendons injection with local anaesthetic
Use of NMBA (atracurium, vecruronium)

18
Q

What should be avoided during ocular surgery?

A
High intraocular pressure 
Avoid hypercalcemia
Ventilate 
Avoid jugular vein obstruction 
Optimise positioning of the patient(elevated head)
19
Q

What must be considered during recovery of the ocular patient?

A

Slow recovery sedation to avoid damage to the eye
Quiet recovery
Empty bladder
Elizabethan collar( get used to before surgery)

20
Q

What loco-region techniques can be used to block the eye?

A
Enucleation
Retrobulbar block
Sub tendons block
Four point block 
Super-orbital nerve 
Lacrimal nerve 
Infratrochlear nerve 
Zygomatic nerve
(Loss of sensation to eye and adnexa) 
Local infiltration of eye lids
21
Q

What loco-regional blocks can be used in the ocular surgery for the standing horse?

A

Auriculo-palpebral nerve

Only blocks motor no block sensation