Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MODULE 14 - Patient Support > ANAESTHESIA - Standing Sedation and Equine Anaesthesia > Flashcards

ANAESTHESIA - Standing Sedation and Equine Anaesthesia Flashcards

1
Q

What can be done as an alternative to general anaesthesia in horses for particular procedures?

A

Standing sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Where should you carry out a standing sedation in a horse?

A

Carry out the sedation in a quiet room and avoid stimulations such as light, noise and other horses. It can also be useful to put a blinder on the horse and swabs in their ears once they are sedated to reduce stimulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Why are equine standing sedations commonly converted to general anaesthesia?

A

Equine standing sedations often result in the sedation not working or there being oversedation and recumbency, both of which require conversion to general anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How should you prepare for the possibility of converting a standing sedation to general anaesthesia?

A
  • Have induction drugs at hand and doses already calculated
  • Move the horse to an appropriate area for recovery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which phenothiazine is licensed as a sedative in horses?

A

Acepromazine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the clinical use of acepromazine in equids?

A

Acepromazine provides light sedation with no analgesia and thus tends not to be a sufficient sedative in horses when used on it’s own. However, it can be very useful to reduce the excitatory and locomotor effects of opioids as well as reduce α2 agonist doses required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which α2 agonists are licensed as sedatives in horses?

A

Xylazine
Detomidine
Romifidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two routes of administration of xylazine in horses?

A

Intravenous (IV) (has to be done under the cascade)
Intramuscular (IM)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the three routes of administration for detomidine in horses?

A

Intravenous (IV)
Intramuscular (IM)
Oral transmucosal gel (Dormosedan)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the route of administration for romifidine in horses?

A

Intravenous (IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Why is romifidine the best α2 agonist for procedures on the horse’s head?

A

Romifidine has the least muscle relaxing properties resulting in reduced ataxia which is ideal for head procedures

However not all practices have romifidine so detomidine is also a good choice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Which α2 adrenoreceptor agonist provides the most reliable sedation in horses?

A

Detomidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which opioid is commonly used in combination with α2 agonists in horses?

A

Butorphanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why is butorphanol commonly used in combination with α2 agonists in horses?

A

Butorphanol has a potent synergistic effect on α2 agonists

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When would you not want to use butorphanol in horses?

A

Butorphanol can cause head shaking and twitching so is not ideal for head procedures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Why should you be cautious of when administering opioids to healthy horses?

A

Opioids cause increased excitability and locomotion in healthy horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Why are general anaesthetics particularly challenging in horses?

A

General anaesthetics can be challenging due to a horse’s fight or flight response. They tend to react before they think which can result in dangerous situations for both the handlers and the horse itself, especially when they are recovering from anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What information should you gather when taking a history prior to equine anaesthesia?

A

Signalement
Passport
Medical history
Information about previous anaesthetics and how the patient responded
Time of last meal
Any allergies/intolerances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the maximum amount of time in which you should carry out field anaesthesia in horses?

A

You should carry out field anaesthesia for no more than 90 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should you do if you anticipate equine field anaesthesia to take longer than 60 - 90 minutes?

A

Consider moving the horse to an equine hospital for anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why is it not always necessary to fast a horse prior to anaesthesia?

A

Horses do not vomit so the risk of aspiration is not considered a primary risk when undergoing anaesthesia. Allowing the horse to eat prior to undergoing anaesthesia maintains normal gut motility which can decrease the risk of post-operative colic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When should you never fast a horse prior to anaesthesia?

A

You should never fast a suckling foal prior to anaesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What should you carry out to prepare for equine field anaesthesia?

A

Get a patient weight
Establish intravascular access
Wash out the mouth with water

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which three methods can you use to obtain a horse’s weight?

A

Weighing scales
Measuring band
Calculate using a formula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the formula that can be used to calculate a horse’s weight?

A

Body weight (kg) = (Girth (cm2) x Length (cm)) / 11,877

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Why should you wash out a horse’s mouth prior to anaesthesia?

A

This is done to prevent the endotracheal tube carrying food material into the trachea and lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the standard premedication combination for horses?

A

α2 agonist and Butorphanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Which two analgesia techniques are good to use in combination in horses?

A

Systemic analgesia
Locoregional analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Which drug classification do you use for locoregional anaesthesia?

A

Local anaesthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Which three local anaesthetics are lisenced in horses?

A

Lidocaine
Bupivacaine
Mepivacaine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is the standard anaethesia induction protocol for horses?

A

Ketamine and Benzodiazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which benzodiazepine is licensed in horses?

A

Midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Which induction protocol would you use for short procedures (less than 20 minutes)?

A

Standard protocol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Which induction protocols are recommended for intermediate procedures (20 to 40 minutes)?

A

Standard protocol
Triple drip induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What induction protocol is recommended for longer procedures (30 to 90 minutes)?

A

Triple drip induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Which three drugs are used for triple drip induction?

A

α2 agonist (usually the same one that you used for the premedication)
Ketamine
Guaifenesin (GGE)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the purpose of guaifenesin (GGE) in the triple drip?

A

Guaifenesin is a muscle relaxant which counteracts the increased muscle tone caused by ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the main advantages of a triple drip?

A

Easy
Increases cardiovascular and respiratory function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the two main disadvantages of a triple drip?

A

Can only be used for up to 90 minutes
Horse will appear light due to dissociative anaesthetic affect of ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Why can you only use a triple drip for up to 90 minutes?

A

Due to the risk of drug accumulation and a prolonged and more ataxic recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

How is anaesthesia maintained in equine field anaesthesia?

A

Total Intravenous Anaesthesia (TIVA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the two advantages of intubating horses for field anaesthesia?

A
  • Allows for airway maintenance and protection
  • Intermittent positive pressure ventilation (IPPV) is possible if you have a large animal ventilator available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the two disadvantages of intubating horses for field anaesthesia?

A
  • Large animal endotracheal tubes are expensive
  • May not have a large animal ventilator available for intermittent positive pressure ventilation (IPPV)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

According to veterinary evidence, identify nine risk factors that can increase anaesthetic risk in horses

A

Patient ASA grade
Procedural urgency
Major procedures
Duration of procedure
Patient signalement (age, breed, body weight/conditon)
Concurrent disease
Patient temperament
Inadequate pain management
Level of monitoring and degree of intervention by anaesthetist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Which two horse breeds are susceptible to more difficult anaesthetic recoveries?

A

Thoroughbreds
Arabian

Arabian horse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

How does inadequate pain management increase anaesthetic risk in horses?

A

Horses are flight animals and pain will result in an increased stress and flight response during the recovery period which increases their risk of post-operative injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What are the three classifications of complications associated with equine inhalant anaesthesia?

A

Intra-operative complications
Post-operative (recovery) complications
Post-recovery complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What are the three main organs systems affected by inhalant anaesthetic agents in equids?

A

Cardiovascular system
Respiratory system
Neuromusculoskeletal system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

How should you assess a horse for cardiac arrhythmias prior to an anaesthetic?

A

Carry out a thorough auscultation on both sides of the heart. If you hear anything abnormal, use an ECG for further investigation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How can you tell the difference between physiological and pathological murmurs in horses?

A

Physiological murmurs tend to be low grade and localised over the base of the heart, whereas pathological murmurs and usually louder towards the apex of the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

How do you determine if the second degree atrioventricular (AV) heart block is physiological or pathological in a horse?

A

The arrhythmia should stop during exercise, if the arrhythmia continues, this suggests that it is a pathological rather than physiological arrhythmia and an ECG should be carried out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

When would a racehorse be classified as tachycardic?

A

A racehorse would be classified as tachycardic with a heartbeat above 40bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

When would a small pony be classified as tachycardic?

A

A small pony would be classified as tachycardic with a heartbeat above 60bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

How does tachycardia affect cardiac output?

A

Tachycardiac decreases cardiac output as the increased heart rate doesn’t allow for sufficient ventricular filling, resulting in decreased stroke volume and cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

When would a racehorse be classified as bradycardic?

A

A racehorse would be classified as bradycardic with a heartbeat below 28bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

When would a small pony be classified as bradycardic?

A

A small pony would be classified as bradycardic with a heartbeat below 30-35bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Why is bradycardia particularly concerning in horses under anaesthesia?

A

Bradycardia is a precursor to asystole in horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

(T/F) CPR is almost always successful in treating cardiopulmonary arrest in horses

A

FALSE. CPR is very rarely successful in horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

How do inhalant anaesthetic agents cause hypotension in horses?

A

Anaesthetic agents decrease cardiac contractility, decrease heart rate and decrease systemic vascular resistance (most significant change), all of which contribute to hypotension

60
Q

What is the ideal mean arterial pressure (MAP) for horses?

A

Between 70 - 90mmHg

61
Q

At what mean arterial pressure (MAP) will you begin to be concerned about muscle hypoperfusion in horses?

A

Mean arterial pressure (MAP) of less than 70mmHG

62
Q

At what mean arterial pressure (MAP) will you begin to be concerned about organ hypoperfusion in horses?

A

Mean arterial pressure (MAP) of less than 60mmHG

63
Q

Which disease are horses at a greater risk of developing if they have been hypotensive under anaesthesia?

A

Post-anaesthetic myopathy

64
Q

How does hypotension during anaesthesia increase the risk of equine post-anaesthetic myopathy in horses?

A

Hypotension results in tissue hypoperfusion which reduces oxygen delivery to the cell resulting in a shift in the cells from aerobic to anaerobic metabolism resulting in lactate production which increases the risk of post-anaesthetic myopathy

65
Q

What is the preferred method for monitoring blood pressure during equine anaesthesia?

A

Direct blood pressure monitoring by placing an arterial catheter and connecting the catheter to a pressure transducer

66
Q

Which arteries are used for direct monitoring of arterial blood pressure in horses?

A

Facial artery (most common)
Metatarsal artery

67
Q

Why is it important not to insert an arterial catheter in the region of the facial artery near the eye?

A

The area needs to be surgically prepped to place an arterial catheter and the surgical sterilisation solutions can cause irritation and damage to the eye

68
Q

What are the advantages of direct arterial blood pressure monitoring?

A

Allows for continuous, accurate blood pressure monitoring
Permits arterial blood sampling for blood gas analysis

69
Q

What are the three main risks of direct arterial blood pressure monitoring?

A

Haemorrhage
Infection
Damage to the periosteum and risk of sequestra

70
Q

Interpret this arterial pressure waveform

A
71
Q

What is represented by the ascending slope of an arterial pressure waveform?

A

The slope of the ascending part of the curve represents myocardial contractility, if it is very steep the myocardium is contracting maximally and thus a higher systolic pressure is produced, if it is much more flat then this is a sign of reduced contractility as there is a lower systolic pressure

72
Q

What is represented by the descending slope of an arterial pressure waveform?

A

The slope of the descending part of the waveform represents systemic vascular resistance. A steep downstroke with a low dicrotic notch indicates a low systemic vascular resistance (e.g. hypotension). A high dicrotic notch implies a high systemic vascular resistance (e.g. hypertension)

73
Q

Which non-invasive technique can you use to monitor equine blood pressure?

A

Oscillometric blood pressure

74
Q

Where can you place the cuff for oscillometric blood pressure monitoring in horses?

A

Tail
Distal limb

75
Q

What is the main advantage of oscillometric blood pressure monitoring?

A

Oscillometric blood pressure monitoring is non-invasive

76
Q

What are the main disadvantages of oscillometric blood pressure monitoring?

A

Oscillometric blood pressure monitoring is less accurate and doesn’t allow for continuous monitoring

77
Q

What can you do to treat hypotension in horses under inhalant anaesthesia?

A

If possible, decrease the anaesthetic depth
Goal directed fluid therapy
Administer ionotropic and vasoconstrictive drugs

78
Q

Give three examples of drugs you can administer to treat hypotension in anaesthetised horses

A

Dobutamine
Ephedrine
Phenylephrine

79
Q

How does dobutamine help to treat hypotension?

A

Dobutamine is inotropic and thus increases cardiac contractility which will help to increase blood pressure

80
Q

How does ephidrine help to treat hypotension?

A

Ephedrine is inotropic and a vasoconstrictor so increases cardiac contractility and systemic vascular resistance which increases bood pressure

81
Q

How does phenylephrine help to treat hypotension?

A

Phenylephrine is a vasoconstrictor so increases systemic vascular resistance which increases blood pressure

82
Q

Which two factors increase the risk of hypoventilation in anaesthetised horses?

A

Inhaled anaesthetic agents
Positioning the horse in dorsal recumbency

83
Q

How do inhaled anaesthetic agents cause hypoventilation in anaesthetised horses?

A

Inhaled anaesthetic agents cause dose-dependent respiratory depression in horses through reducing the sensitivity of the respiratory centres in the brainstem and the chemoreceptors in the carotid body to changes in partial pressure of CO2 (PaCO2). This can result in a decreased tidal volume, resulting in hypoventilation

84
Q

How does positioning in dorsal recumbency cause hypoventilation in anaesthetised horses?

A

In dorsally recumbent horses, thoracic wall movement is restricted and the lungs are compressed by the abdominal organs, leading to the atelectasis and collapse of the alveoli, resulting in hypoventilation

85
Q

What are the consequences of hypoventilation?

A

Hypoventilation results in hypercapnia and respiratory acidosis as well as hypoxaemia and eventually hypoxia

86
Q

What is the main cause of ventilation perfusion (V/Q) mismatching in anaesthetised horses?

A

Atelectasis and thus alveolar collapse due to dorsal recumbent positioning is the main cause of a ventilation perfusion (V/Q) mismatch in anaesthetised horses

87
Q

What are the consequences of a low ventilation perfusion (V/Q) mismatch in anaesthetised horses?

A

A low V/Q ratio develops when the perfusion exceeds ventilation of the alveoli, resulting in hypoxaemia due to the decreased oxygen levels within the alveoli which subsequently decreases the oxygen levels in the blood. A low V/Q ratio however has little impact on the removal of CO2

88
Q

What are the consequences of a high ventilation perfusion (V/Q) mismatch in anaesthetised horses?

A

A high V/Q ration develops when the ventilation of the alveoli is greater than the perfusion. This can result in difficulties regarding CO2 removal from the blood, resulting in hypercapnia, however, will have minimal influence on blood oxygen levels

89
Q

Which physiological compensatory mechanism is used to correct a ventilation perfusion (V/Q) mismatch in horses?

A

Hypoxic pulmonary vasoconstriction which shunts blood away from unventilated alveoli to well ventilated alveoli to correct the V/Q mismatch

90
Q

How is hypoxic pulmonary vasoconstiction affected by inhalant anaesthetic agents?

A

Hypoxic pulmonary vasoconstriction is abolished by inhalant anaesthetic agents

91
Q

Which pieces of equipment are used to monitor the respiratory system in horses under anaesthetic?

A

Capnography
Blood gas analysis

92
Q

What is the normal EtCO2 in horses?

A

40mmHg

93
Q

What is indicated by this capnography waveform?

A

This indicates increasing EtCO2

94
Q

What is indicated by this capnography waveform?

A

This indicates decreasing EtCO2

95
Q

What is indicated by this capnography waveform?

A

This indicates rebreathing of CO2

96
Q

What is indicated by this capnography waveform?

A

This indicates breathing system or airway obstruction

97
Q

What can be done to treat hypoventilation in anaesthetised horses?

A

If possible, decrease the anaesthetic depth
Intermittent positive pressure ventilation (IPPV)

98
Q

What can be done to reduce the risk of a ventilation perfusion (V/Q) mismatch in anaesthetised horses?

A
  • Place the horse in lateral recumbency rather than dorsal recumbency however there is still a risk of atelectasis
  • Intermittent positive pressure ventilation (IPPV)
99
Q

What are the three benefits of intermittent positive pressure ventilation (IPPV) in equine anaesthesia?

A
  • Can prevent a decrease in tidal volume
  • Can help control CO2 levels and prevent hypercapnia and respiratory acidosis
  • Allows for the use of positive end expiratory pressure (PEEP)
100
Q

What is positive end expiratory pressure (PEEP)?

A

Positve end expiratory pressure (PEEP) is a pressure applied to the ventilator at the end of a breath to reduce alveolar collapse and even reinflate already collapsed alveoli to increase the surface area for gaseous exchange

101
Q

What is the main disadvantage of intermittent positive pressure ventilation (IPPV)?

A

Gas always takes the path of least resistance so it is likely that during intermittent positive pressure ventilation (IPPV), that the gas will flow into the already inflated alveoli and not into the collapsed alveoli. This will result in an increase in intrathoracic pressure which will impede venous return, contributing to the ventilation perfusion (V/Q) mismatch

102
Q

Which bronchodilator drug is commonly used in anaesthetised horses with a ventilation perfusion (V/Q) mismatch?

A

Salbutamol

103
Q

(T/F) Salbutamol is not licensed in horses

A

TRUE.

104
Q

List six common post-anaesthetic complications seen in horses?

A

Equine post-anaesthetic myopathy (EPAM)
Neuropathy
Traumatic injury
Airway obstruction
Post-anaesthetic colic
Catheter complications

105
Q

When do the clinical signs of post-anaesthetic myopathy become evident?

A

The clinical signs of post-anaesthetic myopathy may become evident as soon as the horse tries the stand or the clinical signs may be delayed by a few hours

106
Q

What are the six possible clinical signs of equine post-anaesthetic myopathy (EPAM)?

A

Swollen muscle
Hard muscle
Painful muscle
Hot muscle
Myoglobinuria in severe cases
Increased serum creatine kinase (Ck) levels

107
Q

Why do you get myoglobinuria in severe equine post-anaesthetic myopathy cases?

A

When the muscle breaks down, this releases myoglobin into the blood which will be excreted as urine, resulting in myoglobinuria

Myoglobinuria
108
Q

Why do you get increased serum creatine kinase (Ck) levels in equine post-anaesthetic myopathy?

A

Creatine kinase is released into the bloodstream when there is muscle damage

109
Q

What causes equine post-anaesthetic myopathy?

A

Equine post-anaesthetic myopathy is cause by muscle hypoperfusion

110
Q

Which four factors increase the risk of post-anaesthetic myopathy?

A
  • Increased duration of anaesthetic
  • Hypotension
  • Hypoxaemia
  • Positioning of the horse resulting in muscle and blood vessel compression and stretch occlusion which reduces blood flow to the muscles
111
Q

Which three things can you do to prevent post-anaesthetic myopathy?

A

Minimise the duration of anaesthesia
Carefully position and pad the patient
Maintain the mean arterial pressure (MAP) above 70mmHg can be done using fluid therapy

112
Q

What can you do to manage and treat post-anaesthetic myopathy?

A
  • Analgesia as myopathy is very painful
  • IV fluid therapy to maintain blood pressure and muscle perfusion as well as increase renal excretion of myoglobins as myoglobins can cause renal tubular necrosis if they build up in the kidneys
  • Place splints on the legs if the patient is unable to support their own weight
113
Q

Give three examples of genetic muscular diseases

A

Equine polysaccharide storage myopathy (EPSM)
Hyperkalaemic periodic paralysis (HYPP)
Malignant hyperthermia

114
Q

What causes equine polysaccharide storage myopathy (EPSM)?

A

Equine polysaccharide storage myopathy (EPSM) is caused by a mutation is the glycogen processing gene

115
Q

What causes hyperkalaemic periodic paralysis (HYPP)?

A

Hyperkalaemic periodic paralysis (HYPP) is an inherited autosomal dominant disorder which affects sodium channels in the muscle and the ability to regulate blood potassium levels

116
Q

What are the consequences of hyperkalaemic periodic paralysis (HYPP)?

A

Hyperkalaemic periodic paralysis (HYPP) causes tremors, paralysis and sudden death due to hyperkalaemia induced bradycardia and asystole

117
Q

What can trigger hyperkalaemic periodic paralysis (HYPP)?

A

Stress (i.e. can be triggered due to anaesthetic stress)

118
Q

What causes malignant hyperthermia?

A

Malignant hyperthermia is caused by an inherited Ryanodine receptor mutation

119
Q

What are the consequences of malignant hyperthermia?

A

Malignant hyperthermia causes fasciculations, stiffness, hyperthermia and sudden death

120
Q

What two factors can trigger malignant hyperthermia?

A

Stress (i.e. can be triggered due to anaesthetic stress)
Inhalant anaesthetics

121
Q

What are the two classifications of neuropathies?

A

Peripheral neuropathy
Central neuropathy

122
Q

What is peripheral neuropathy?

A

Peripheral neuropathy is the temporary or permanent loss of motor and sensory function due to peripheral nerve compression/traction

123
Q

What is the main cause of periperal neuropathy due to equine anaesthesia?

A

Positioning of the horse resulting in compression/traction of the peripheral nerves

124
Q

What can you do to prevent peripheral neuropathy in horses?

A

Carefully position and pad the patient

125
Q

Give an example of a central myopathy

A

Spinal cord myelomalacia

126
Q

(T/F) Spinal cord myelomalacia is very rare in horses

A

TRUE

127
Q

What is the signalement that is more prone to spinal cord myelomalacia?

A

Young, male horses

128
Q

Give three examples of common musculoskeletal injuries that can occur post-anaesthetic

A

Skin abrasions/cuts
Fractures
Disarticulations

129
Q

Give three examples of common ocular injuries that can occur post-anaesthetic

A

Ocular bruising
Ocular foreign body entrapment
Dessication of the cornea

130
Q

How can you prevent dessication of the cornea in anaesthetised horses?

A

Apply eye lubricant regularly during anaesthesia to prevent dessication of the cornea

131
Q

What are the five possible signs of an post anaesthetic airway obstruction in a horse?

A

Stridor
Stertor
Nostril flaring
Paradoxical breathing
Absence of airflow at the nostrils

132
Q

What are the four possible causes of a post anaesthetic airway obstruction in a horse?

A

Nose stuck in the corner of the recovery stable
Nasal congestion
Laryngeal paralysis
Airway swelling

Horse with nose stuck in the corner of the recovery stable
133
Q

Why do horses experience nasal congestion due to anaesthesia?

A

When horses are positioned in dorsal recumbency, gravity causes blood to pool in the nasal region causing an increase in the hydrostatic pressure in the nasal vascular beds, resulting in nasal oedema and congestion

134
Q

Which technique can be used to reduce nasal congestion in anaesthetised horses?

A

Administer a vasoconstrictive intranasal spray 10 minutes before recovery

135
Q

Which vasoconstrictive intranasal spray can be administered to horses to reduce nasal congestion?

A

Diluted phenylephrine intranasal spray

136
Q

What are the three possible causes of laryngeal paralysis in horses?

A

Pre-existing condition
Due to manipulation of the larynx during intubation
Due to over stretching of the laryngeal nerve when the horse is positioned in dorsal recumbency

137
Q

Which six techniques can be used to reduce the risk of post-anaesthetic airway obstruction in horses?

A

Gentle intubation and extubation
Elevate the head during anaesthesia
Prevent overextension of the neck during anaesthesia
Administer diluted phenylephrine intranasal spray
Carefully position the horse in the recovery stable
Diligent monitoring of the horse during recovery

138
Q

How should you treat a post-anaesthetic airway obstruction?

A

Re-intubate
Emergency tracheostomy

139
Q

How long should you monitor a horse for post-anaesthetic colic?

A

You should monitor a horse for post-anaesthetic colic for 24 hours

140
Q

What are the ten requirements for a recovery stable?

A

Quiet
Adjustable lighting
Padded and non-slip
No corners
Facilities for observation
Close to the operating theatre
Oxygen supplementation
Scavenging system
Escape route for staff
Wall rings and ceiling hooks for if you have to secure the horse

141
Q

How much oxygen should you provide a horse during anaesthetic recovery?

A

15 litres of oxygen per minute

142
Q

List two examples of anaesthetic recovery methods in horses

A

Hand recovery
Head and tail ropes recovery

143
Q

Describe the hand recovery method

A

Hand recovery involves people assisting the horse in recovery. This can be done in a field or large area and usually involved two or three people who are experienced and can work well together. This technique cannot be done in a confined space as it will risk the safety of the personnel involved

144
Q

Describe the head and tail ropes recovery method

A

The head and tail ropes method requires a tight fitting head collar attached to a rope through a high ring and pulley system and a second similarly run rope tied to the tail. One person usually takes each rope and supports and guides the horse as it stands, allowing for support and some restraint from a safe distance. This is not a suitable method for lifting a horse that cannot stand on its own.

145
Q

What should you provide horses with post anaesthetic recovery?

A

Allow free access to water
Withold food for 3-4 hours after recovery and reintroduce slowly

MODULE 14 - Patient Support (25 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions