Anaesthesiology Flashcards
The flow of the preanesthetic assessment and preparation?
The reasons for preanesthetic fasting and what are the recommendations for cats and dog?
Fasting is the withholding of food or water
Fasting is carried out to
- reduces the risk of vomiting and regurgitation with subsequent aspiration (inhalation of vomit) or reflux esophagitis (damage to the esophagus)
- also acts to reduce the weight of the GI tract, hence reducing respiratory stress and hypoxemia, hypercapnia.
A full digestive tract exerts pressure upon the diaphragm and chest while the animal is in lateral recumbency)
Special care needs to be taken in Gi diseased and heavily pregnant patients which are at increased risk of regurgitation and aspiration.
In these patients induction should be carried out with the head up position, secure the airway and cuff up prior to lateralization.
The timing of fasting in cats and dogs
Dogs and cats No food > 6 - 8hrs prior to anesthesia with ad lib availability to water until premeds are provided.
Describe the American society of anesthesiologist ASA grading system for assessing preoperative health status.
ASA grading system
This system uses a
numerical scale to summarise patient assessment and help
identify at-risk patients, with higher numbers indicating
“sicker” patients.
Determination of “anaesthetic risk” aids in the selection of different anaesthetic
agents and techniques for a particular patient and provides an indication of the likelihood of
anaesthetic complications.
Describe how you would interpret PCV, TP and BUN values ?
Every patient should ideally have a CBC and biochemistry profile prior to anaeshesia
Due to financial restraint in young and healthy patients <7 years requiring a short general anaesthesia. (The blood may be collected with no extra effort at the time of cathertization)
Interpretation of
PCV = packed cell volume
TP = total protein
BUN = blood urea nitrogen
Initially interpret the values independently
Up TP = Hyperproteinemia chronic infection inflammation
Low TP = Hypoproteinemia liver disease, enteropathy, malnutrition
High PCV = polycythaemia chronic hypoxaemia, splenic contraction
If TP and PCV values are within normal limits compare paired value balance.
If any abnormality is detected, further diagnostics are required eg full blood work, ECG, radiograph
Why would the interpretation of PCV and TP be reduced in young animals compared to older animals?
PCV and TP is often reduced in young animals
Since very young patients’ body
components have higher water content, generally their PCV and TPP are lot less than the normal
adult value; therefore, when a 3-4 month old patient shows a normal range of PCV and TPP, then the
patient is usually dehydrated.
Describe the factors as well as the process important for developing an anesthetic protocol for a given
patient ?
The anaesthetic technique should be planned after careful consideration of the patient’s
preoperative evaluation and likely anaesthetic risk.
- understand the pathophysiology of the condition requiring anesthetic or any concurrent diseases
- patient factors
- procedure factors
Factors that may influence the choice of anaesthetic agents and the development of the overall
anaesthetic plan(or limitation) include: -
What does general anesthesia include ?
Define anesthesia?
What are the benefits of premedication ?
The benefits of premedication
The administration of drugs prior to the induction of general anesthesia
- sedate, make them easier to handle and improve quality of anaesthesia
- may also be used for restraint during minor procedures
- reduce stress
Achieve balanced anaesthesia
- reduction in agents drug/s
- reduction in maintenance agent
- good analgesia during and post anaesthesia
minimizing or counteracting side effects
What could be the potential disadvantages of premedication?
What is induction and why is it considered a high risk period ?
Induction
The period of consciousness to unconsciousness - short lived high risk phase
Induction is a high risk period because
- pervascular injection injury
- apnea
- excitement
- cardiac arythmia/depression
- hypotension
- regurgitation + aspiration
- hypoxaemia
What is the advantage/disadvantage of using a intravenous agent for induction?
What is the advantage/disadvantage of using a inhalation agent for induction?
How do we carry out induction to effect?
When are the specific risk associated with anesthesia in cats?
Describe how you would go about confirming correct intubation ?
Describe the physiological process of anaesthesia recovery?
Drug administration ceases and the patient awakens
Anaesthesia recovery is not due to metabolism or clearance of drug from the body.
Recovery is due to redistribution, where the drug concentration in the brain is reduced and resdistributed into muscle and the fat group.
Describe what is wash out?
Describe the stages of anaesthesia ?
