Anaesthetic Recovery Flashcards
What is the recovery period?
Period between disconnection of anaesthetic administration to the time whent he animal can maintain unsupported recumbency
Why is the role of monitoring recovery important?
- 60% of anaesthetic mortality occurs during recovery
- Often neglected time of anaesthesia
- Other staff may be dealing with next patient
- Patient is still under your care
What does the duration of recovery depend on? Name 3
- Length of anaesthesia
- Condition of patient
- Age of patient
- Type of anaesthesia and route of admin
- Patients body temp
What are the 4 main stages of recovery?
- HR increase
- RR increases and volume increases
- Eye position rotates centrally
- Reflexes become stronger e.g. palpebral, pedal, earf flick
What should you give your patient before disconnecting them from the anaesthetic machine? And what benefit is there to us
Pure oxygen
Benefit: Reduces pollution of volatile agent
When do you remove the ET tube from a patient?
- When the patient regains the swallow reflex
What patients do you remove the ET tube earlier in and why?
Cats due to potential laryngospasm
Do you wait longer or remove the ET quicker in brachycephalics
Wait longer
What position should the patient be in when removing the ET tube?
Lateral or sternal recumbency with neck extended
When removing an ET tube from the cat what should you also do?
Ensure cats tongue is at least partially out
What must you remember to do before removing the ET tube?
- Check for reflex
- Untie mouth tape
- Deflate cuff
What reflex do you look for in cats when wanting to remove the ET tube?
Ear flick
How are anaesthetics eliminated (injectables, and inhalationals)
- Injectables - liver metabolises and excreted by kidney
- Inhalational - respiratory tract
What can you give to speed up recovery?
Analeptics (reversal drugs)
Name 2 things that affect pain in the recovery period?
- Surgical procedure
- Perioperative analgesics used
- Surgical technique
Name 2 reasons why prolonged recovery may occur?
- Severe pain
- Persistent drug activity
- Hypothermia
- Too much or too little pain relief
What can we do to ensure prolonged recovery does not occur?
- Adequate analgesia
- Keep animal warm
- Reverse the effects of drugs if possible
Name the antagonist to opioids
Naloxone
Name the antagonist to alpha-2-agonists
atipamezole
Name the antagonists to benzodiazepines
flumazenil
Name 2 common recovery problems
- Excitation (stormy recovery)
- Hypoxia
What is a sign of excitation (stormy recovery)
- Pain
- Convulsions / epilepsy post myelography or in epileptic patients
What would you do to monitor potential hypoxia in brachycephalics
Keep a pulse oximeter on the patient
Remain with it and ensure they are well ventilated
Provide oxygen
Name 1 method you could use if the patient is hypoxic?
- Mask
- Intranasal catheter
- Tracheostomy tube
- Oxygen tent
How often should you turn a patient that is unable to maintain sternal recumbency and why
- every 2 hours
- Reduce the risk of hypostatic congestion
What can cause hypothermia in a patient during recovery
- anaesthetic used
- Prolonged procedure
How do combat / prevent hypothermia
- Keep warm from pre-med onwards
- Supplementary heating e.g. heat pads and blankets
- Monitor patients temperature regularly
- Efficient and quick procedure as possible
What should you ensure you do prior to the patient leaving the surgery
- Ensure patient has fully recovered from anaesthesia
- Clean patient up as much as possible before returning to owner
- Ensure they are leaving with analgesics if necessary
- Advise owner on any post-op complications that may occur and what is ‘normal’
- Ensure owner understands all information and provide contact details
name the main things to do during post-operative monitoring
- Check vital signs
- Maintain observations
- Oxygenate
- Avoid hypothermia
- Manage pain
- Reverse drugs if necessary
- Turn recumbent patients
- Monitor wounds
