Anaesthesia of the ECC patient Flashcards
What was the risk of anaesthetic and sedation-related death in dogs according to the CEPSAF study?
Approximately 0.17%
This figure highlights the importance of evaluating patient health prior to anaesthesia.
What was the risk of anaesthetic and sedation-related death in cats according to the CEPSAF study?
Approximately 0.24%
This risk is higher in sick patients, emphasizing the need for careful preoperative assessment.
What are the ASA classifications for patients and their associated risks in anaesthesia?
Healthy patients (ASA 1-2) have risks of 0.05% (dogs) and 0.11% (cats); sick patients (ASA 3-5) have risks >1%
This indicates that critically ill patients face significantly higher risks during anaesthesia.
What is balanced anaesthesia?
A technique using different drugs combined to achieve desired effects while minimizing side effects
Essential for unstable or severely compromised patients.
What are the three elements of general anaesthesia?
- Unconsciousness
- Muscle relaxation
- Analgesia
What should be prepared before starting an anaesthetic?
All drugs should be ready, including emergency drugs, and equipment should be checked
Following checklists from the Association of Anaesthetists is recommended.
What is the shock dose of crystalloids for dogs?
90 ml/kg
only given in separate boluses of 5-10ml/kg
For cats, the shock dose is 40-60 ml/kg.
What are the priorities in managing a patient with circulatory compromise?
- Gain venous access
- Provide analgesia
- Administer fluids
- Supply oxygen
What is permissive hypotension during anaesthesia?
A mild hypotension tolerated for the time required to stop bleeding surgically
This approach may be necessary when controlling hemorrhage under general anaesthesia.
What are the priorities in managing patients with upper airway disorders?
- Sedation
- Gain IV access
- Provide oxygen supplementation
What are some possible sedation protocols for patients with upper airway disorders?
- Acepromazine: 0.01-0.03mg/kg IM
- Medetomidine: 3-5 μg/kg IM
- Butorphanol: 0.2-0.4 mg/kg IM
What should be done before inducing general anaesthesia in patients with lower airway disorders?
Drain the chest if fluids or air are present
This helps prevent hypercapnia and hypoxaemia.
What is the normal range of serum sodium in dogs?
Approximately 140-150mmol/L
For cats, it’s 150-160mmol/L.
What are the signs of hyperkalaemia?
- Peaking T-waves
- Broadening P-waves
- Broadening QRS-complex when K+ >7.0mmol/L
What should be monitored during anaesthesia?
- SPO2
- ETCO2
- ECG
- Body temperature
- Blood pressure
What are the clinical signs of hypercalcaemia (ionised >1.5mmol/L)?
- PUPD
- Thirst
- Vomiting
- Constipation
- Neuromuscular signs (twitches, stiffness to weakness)
- Lethargy
- Fatigue
- Bradycardia
- Hypertension
- Arrhythmias
- Seizures
- Coma
These symptoms indicate elevated calcium levels in the blood.
What is the treatment for hypercalcaemia?
Diluting and inducing diuresis with 0.9% sodium chloride with or without furosemide and/or administering bisphosphonates
These treatments help to lower calcium levels in the body.
What are the signs of hypocalcaemia (ionised <0.8 mmol/L)?
- Twitches
- Spasm
- Tetanus
- Weakness
- Paresis
- Tachycardia
- Hypotension
These signs indicate low calcium levels and can worsen with anesthesia and analgesia.
What is the initial treatment for hypocalcaemia?
Supplementing calcium intravenously
This is necessary to quickly correct low calcium levels.
What is one of the most important functions of albumin?
Maintaining oncotic pressure within vascular compartments
This prevents the leaking of fluids into extravascular spaces.
What can low levels of albumin lead to regarding drug levels?
Increase in the free fraction of various drugs
This can increase the risk of toxicity or other deleterious effects.
What should be avoided if hypoalbuminemia and hypoproteinaemia are present?
Drugs with high protein binding
Awareness is needed that a higher concentration of active drug can be available.
What approach should be adopted for perioperative fluid therapy in patients with hypoalbuminemia?
A more conservative approach
This is due to the diluting effect of fluids.
