Anesthesia Flashcards
What is the difference between a sedative and a tranquilizer?
Sedation is a state of calm or drowsiness
Tranquilization is a state of relaxation and reduced anxiety
Student #11 ML
McCurnin 10th ed pg 927
What are the objectives of general anesthesia?
Loss of sensation
Muscle relaxation
Analgesia
Altered consciousness
Student #11 ML
McCurnin 10th ed pg 927
Why would we utilize Balanced Anesthesia?
To minimize the adverse effects of anesthetic drugs, especially on the cardiovascular and respiratory system
Student #11 ML
McCurnin 10th ed pg 927
What ASA classification would you assign a patient undergoing anesthesia for an abdominal explore to correct a gastric dilatation-volvulus?
ASA VE: moribund patient that is not expected to survive without the operation
Student #11 ML
McCurnin 10th ed pg 930
What is the main adverse effect of Acepromazine?
Hypotension
Student #11 ML
McCurnin 10th ed pg 930
What are the fasting recommendations for withholding food and water prior to an anesthetic event in dogs and cats?
Food: 8-12 hours
Water: 2-4 hours
Student #6, AF, McCurnin 10th ed. pg 929
What ASA score would be assigned to a normal, healthy patient undergoing an elective procedure
ASA I
Student #6, AF, McCurnin 10th ed. pg 930
What is the reversal agent for benzodiazepines (benzodiazepine antagonist)?
Flumazenil
Student #6, AF, McCurnin 10th ed. pg 930
What is a laryngoscope used for?
Visualization of the larynx while placing endotracheal tubes
Student #6, AF, McCurnin 10th ed. pg 934
Stage II of anesthesia is characterized by what?
Loss of voluntary control, irregular breathing pattern, involuntary reactions in the form of vocalizing and reflex struggling or paddling, elevated heart rate, dilated pupils, marked muscle tone, and intact reflexes
Student #6, AF, McCurnin 10th ed. pg 948
What are the main theraputic effects of alpha 2 agonists?
Sedation, analgesia, and muscle relaxation.
Student #8 KH, McCurnin 10th ed. pg 931
_______is the reversal agent to Xylazine, and ________ is the reversal to Dexmedetomidine.
Yohimbine; Antisedan
Student #8 KH, McCurnin 10th ed. pg 931
Which opiods are classified as pure agonists?
Morphine, Fentanyl, oxymorphone, and hydromorphone.
Student #8 KH, McCurnin 10th ed. pg 931
What is MAC?
MAC is the percent concentration of an agent required to prevent a response to surgical stimulation in 50% of patients and therefore is a measurment of potency of an agent.
Student #8 KH, McCurnin 10th ed. pg 934
In what two species is intubation performed blindly?
Horses and adult cattle.
Student #8 KH, McCurnin 10th ed. pg 946
What are dissociatives used for?
Immobilize patients for minor or brief procedures.
Student #16 ER
McCurnin 10th Edition pg 933
Fasting requirements for neonates?
-Fasting is not recommended
Student #4, BE, Pg 1011
Side effects of administering a dissociative?
-Increased muscle tone, sensitivity to light and sound, intact reflexes, increased HR, and increased BP.
Student #4 BE, Pg 1017
Which species is the laryngoscope most often utilized for intubation?
-small ruminants, camelids, swine, dogs, and cats
Student #4, BE, Pg 1019
What precautions must be followed to prevent injury when using gas cylinders?
-Never leave unattended when unsupported or laying on its side.
-Do not attempt to remove the valve or index pins
-Keep skin and eyes clear of valve
-do not use near any ignition sources
Student #4, BE, Pg. 1023
Complications of intubation?
-Tracheal or larynx irritation or trauma
-Perforation or rupture of mucosa
-Failure to protect airway
Student #4, BE, Pg 1033
define tachycardia
rapid heart rate
Student #10 AJ, McCurnin 9th ed. pg 1013
define tachypnea
fast, shallow breaths
Student #10 AJ, McCurnin 9th ed. pg 1013
What are dissociative used for?
Dissociative drugs are used to immobilize patients for minor or brief procedures.
Student #10 AJ, McCurnin 9th ed. pg 1017
What are barbiturates commonly used for in anesthesia?
Barbiturates are used for induction and Maintenace.
Student #10 AJ, McCurnin 9th ed. pg 1017
What is the drug Etomidate used for?
Etomidate is a short-acting, injectable drug used for induction.
Student #10 AJ, McCurnin 9th ed. pg 1017
What are some techniques you can utilize when checking to see that the endotracheal tube was properly placed?
Palpate the neck and see if you are able to feel one firm structure, watch for expansion and contraction of the reservoir bag, is the patient is able to vocalize the tube is not in the correct location (mostly for dogs), look at the ETCO2 and make sure there is a normal wave length.
Student #14 SP, McCurnin 10th ed. pg 946
How do you check that you have inflated the cuff enough?
You listen for gas leaking around the tube, and you will slowly inflate the cuff until the leaking just ceases at a pressure of 20 cm H20. Just be careful about overinflating the cuff.
Student #14 SP, McCurnin 10th ed. pg 947
How often should body temperature be monitored during anesthesia?
15-30 Mins
Student #14 SP, McCurnin 10th ed. pg 952
What is the palpebral reflex, and what can it tell us during anesthesia?
The palpebral reflex is done by gently tapping the skin at the medial or lateral canthus of the eye with a finger. This can indicate that the animal is too light.
Student #14 SP, McCurnin 10th ed. pg 953
Doppler ultrasound probes are very expensive, and should be handled carefully. How do you properly clean a doppler ultrasound probe?
Wipe gently with a gauze sponge, and gently clean with tap water. The probe should not be immersed, scrubbed, or autoclaved.
Student #14 SP, McCurnin 10th ed. pg 954
What are common Benzodiazepine
Diazepam, Midazolam and Zolazepam
Student #20
McCurnin 10th ed. pg 930
What should you check for in E-tube?
Check for blockage, holes, inflate the cuff to make sure it holds and other damage
Student #20
McCurnin 10th ed. pg 945
How do you prevent laryngospasm in a cat when placing an ET tube
Apply 2% injectable lidocaine right into the glottis before placing an ET tube
Student #20
McCurnin 10th ed. pg 9
Where can a doppler be placed
Tail head, Dorsal medial portion of the hock and Proximal to the metatarsal pad
Student #20
McCurnin 10th ed. pg 955
When is the most common place for anesthesia related complication to occur?
During the recovery phase
Student #20
McCurnin 10th ed. pg 961
If the endotracheal tube is placed in too far or too short, which of the following could occur?
Hypoxia
Student # 16 ER
McCurnin 10th Edition pg 935
Which type of drugs are used to counteract the effects of parasympathetic nervous system stimulation when anesthetic agents are used?
Anticholinergics
Student #16 ER
McCurnin 10th Edition pg 929
A state of profound sedation and analgesia produced by simultaneous administration of an opioid and a tranquilizer is referred to as what?
Neuroleptanalgesia
Student #16 ER
McCurnin 10th Edition pg 927
What is the approximate anesthetic duration of propofol?
2-5 minutes
Student #16 ER
McCurnin 10th Edition pg 932
How should hypotension be addressed during anesthesia?
Treatment often includes IV fluid therapy (bolus), decreased anesthetic, administering more oxygen, warming the patient, and drug therapy.
#18 BKS
McCurnin 9th ed. pg 1058
“Paddling limbs” of a horse in recovery of anesthesia is a sign that the horse will try to stand too soon. What are two things you can do to prevent the horse from having a rough recovery?
- Administer Xylazine IV for sedation
- Maintain control of the head by keeping it off of the ground unless it is unsafe for the anesthetist to do so.
#18 BKS
McMurnin 9th ed. pg 1053
Use of a non-rebreathing system is recommended for patients weighing less than _________
7kg
#18 BKS
McCurnin 9th ed. pg 1026
What are some signs that the CO2 granules are saturated and need to be exchanged for new ones?
- They become hard to break
- Turn off-white color
- If they have pH indicator, they temporarily turn blue or purple
#18 BKS
McCurnin 9th ed. pg 1028
Pediatric Y-tubes are intended for patients between _______kg and ________kg.
2.5 kg and 7 kg
#18 BKS
McCurnin’s 9th ed. pg. 1029
What are the two most commonly used Anticholinergics?
Atropine and Glycopyrrolate
Student #3, S.C
McCurnin 10th Edition Page:929
What are tranquilizers and sedatives used for?
To provide patient restraint for minor procedures
Student #3, S.C
McCurnin 10th Edition Page:930
What is the criteria of an ASA 5 patient?
The patient is expected not to make it
Student #3, S.C
McCurnin 10th Edition Page:929
What are the fasting recommendations of food for cats and dogs?
8-12 hours
Student #3, S.C
McCurnin 10th Edition Page:928
What are the normal blood pressure values during anesthesia for small animals?
Systolic: 100-160 Diastolic: 60-90 Mean: 60-90
Student #3, S.C
McCurnin 10th Edition Page:956
What is the recommended fasting time for horses?
Food: 8-12 hours, water: 0-2 hours
#13 KM, McCurnin 10th ed. pg. 928
Activated charcoal cartridges should be changed how often?
Every 12 hours or when they increase in weight by 50 grams.
#13 KM, McCurnin 10th ed. pg. 944
How often should blood gas values be checked on a horse under anesthesia?
Every 30 minutes, or more frequently if warranted.
#13 KM, McCurnin 10th ed. pg. 964
What are two signs a horse may have a rough recovery?
Nystagmus and paddling of limbs are signs that a horse may try and get up to soon. These patients may need some additional sedation.
#13 KM, McCurnin 10th ed. pg. 965
In which species is laryngospasm the most likely to occur?
Cats, swine, and small ruminants.
#13 KM, McCurnin 10th ed. pg. 947
Define Anesthesia
An absence of sensation that affects the whole body or an isolated part or region of the body
#12 JL, McCurnin 10th ed. pg.927
Define Local Anesthesia
The loss of sensation in a localized body part or region induced by administration of a drug or other agent without loss of consciousness
#12 JL, McCurnin 10th ed. pg.927
ASA III Criteria
Patient with severe systematic disease
#12 JL, McCurnin 10th ed. pg.929
What opioid is described as a partial agonist?
Buprenorphine
#12 JL, McCurnin 10th ed. pg. 931
Duration of Action for Buprenorphine
Buprenorphine has a long duration of action and so is only given every 8 - 24 hours
#12 JL, McCurnin 10th ed. pg.932
True or False?
When using a Phenothiazine Tranquilizer, like Acepromazine, increasing the dose will increase the level of sedation in the patient?
False
Using a higher dose will not increase the level of sedation but will worsen hypotension.
Student #2 vc
McCurnin 10th ed. pg 930
What is a disadvantage to using a rebreather circut?
Infectious agents may be transferred from patient to patient via microbe-laden moisture that condenses inside the machine parts and is inhaled by subsequent patients.
Student #2 vc
McCurnin 10th ed. pg 942
Obstruction of what system will have the same effect as a closed pop-off valve?
What effects are seen on the machine during that obstruction?
Obstruction of the scavenging system.
You may see a full resevoir bag or pressure buildup in the circut.
Student #2 vc
McCurnin 10th ed. pg 944
What are the three groups of vital signs that the ACVAA recommends for monitoring anesthetized veterinary patients, and ways to monitor them?
Oxygenation- pulse ox and blood gas analysis
Circulation- HR, heart rhythm, mm color, CRT, pulse strength, and BP
Ventilation- RR, respiratory effort, capnograph and blood gas analysis
Student #2 vc
McCurnin 10th ed. pg 951
What are 3 ways to monitor recovery of a horse after anesthesia?
Take pulses from the facial artery, assess the eye for depth of anesthesia and watch respirations as they are lying down.
Student #2 vc
McCurnin 10th ed. pg 965
What is the duration of action and onset time for propofol?
The onset time is 30 secs to 1 minute. The duration of action is 3-5 minutes.
Student #17 TAS-R
McCurnin 10th ed pg. 932
How do we titrate propofol?
Administer 25% of the dose over 30 seconds. Repeat until the patient is relaxed enough to be intubated. Student #17 TAS-R
McCurnin 10th ed pg. 933
What are negative side effects of propofol?
Apnea with fast administration, bradycardia, decreased contraction strength, hypotension, seizure-like symptoms, allergic reactions, Transient excitement plus muscle tremors can occur if the patient is not pre-medicated or if the drug is given slowly. Cat side-effects: Heinz body anemia, anorexia, lethargy, and diarrhea.
Student #17 TAS-R
McCurnin 10th ed pg. 933
Ruminants are hypersensitive to which drug, requiring only 10% of the dose used for horses?
Xylazine
#1, MA
McCurnin 10th ed. pg 931
Which is more potent, Diazepam or Midazolam?
Midazolam is more potent than Diazepam
#1, MA
McCurnin 10th ed. pg 930
Why is fasting recommended?
Patients may experience nausea or vomiting during anesthetic procedures, as well as their swallowing reflex becomes sluggish, and their lower esophageal sphincter tone decreases
#1, MA
McCurnin 10th ed. pg 928
Adverse effects of Acepromazine in horses?
Excitement, sweating, tachypnea, and penile prolapse
#1, MA
McCurnin 10th ed. pg 930
An anesthetic machine consits of which following general systems?
1) Gas supply
2) Anesthetic vaporizer
3) Breathing circuit
4) Scavenging system
#1, MA
McCurnin 10th ed. pg 937
What are the adverse effects of gas anesthesia?
5 SF
hypothermia, dose-dependent respiratory depression and hypotension, irritation to mucous membranes
McCurnin’s 9th ed. pg 1018
How can the pupils be used to determine the patient is in the surgical plane of anesthesia?
5 SF
Pupils will be dilated, and the pupillary light reflex will be lost in the surgical plane of anesthesia. In light anesthetic depth, the pupils are central; in surgical anesthesia, the pupils are ventromedial; the pupils return central in deep anesthesia
McCurnins 9th ed. pg 1034 and 1039
What are the responses to surgical stimulation that indicate the anesthesia is too light?
5 SF
If heart rate, respiration rate, or blood pressure suddenly increase in response to cutting or manipulation of viscera, anesthesia is too light.
McCurnin’s 9th ed. pg 1039
What must be done before turning a patient on the surgical table and why?
5 SF
The ET tube must be temporarily disconnected in order to prevent trauma to the trachea
McCurnin’s 9th ed pg 1048
In brachycephalic dogs, when should extubation be performed?
5 SF
Once the patient is able to lift their head unassisted
McCurnin’s 9th ed. pg 1049
What does stimulation of mu-opioid receptors cause?
analgesia, euphoria, miosis, hypothermia and respiratory depression.
#19 MW
McCurnin 10th ed. pg 931
In regards to opioids, what does Kappa-receptor stimulation produce?
Kappa-receptor stimulation produces analgesia, miosis, and sedation.
#9 KJ
McCurnin’s 10th ed. pg 931
Dissociatives increase _______ and ____________ without decreasing cardiac output.
HR and blood pressure
#19 MW
McCurnin 10th ed. pg. 933
In regards to opioids, what does mu-receptor stimulation produce?
Stimulation of mu receptors produces analgesia, euphoria, miosis, hypothermia, and respiratory depression.
#9 KJ
McCurnin’s 10th ed. pg 931
What size tube is generally chosen for a 20kg patient?
9.5-10mm
#19 MW
McCurnin 10th ed. pg. 945
In regards to opioids, what does sigma-receptor stimulation produce?
Stimulation of sigma receptors produces dysphoria, hallucinations, respiratory and cardiac stimulation, and mydriasis.
#9 KJ
McCurnin’s 10th ed. pg 931
What can happen as a result of laryngospasm?
hypoxia and cyanosis
#19 MW
McCurnin 10th ed. pg. 947
What does a pulse oximeter detect?
Changes in oxygen saturation of hemoglobin
#9 KJ
McCurnin’s 10th ed. pg 955
What health issues can cause cardiac arrhythmias?
Hypoxia, GDV, hypercarbia, pre-existing heart disease and trauma.
#19 MW
McCurnin 10th ed. pg. 951
When inducing general anesthesia through an intravenous route, what does it mean to give the drug “to effect”?
“To effect” means that the patient can be intubated, or the patient is at an adequate plane of anesthesia for completion of the procedure. The entire dose may or may not be given
#9 KJ
McCurnin’s 10th ed. pg 958
What are the advantages of propofol?
Anesthesia, decreases intracranial and intraocular pressure, muscle relaxation, anti-emetic, anti-seizure.
Student #17 TAS-R
McCurnin 10th ed pg. 933
What anesthesia meds should we avoid in patients with cardiac disease?
Acepromazine for patients with congestive heart failure. Alpha-2 agonists, mask/chamber induction, Ketamine/Telazol.
Student #17 TAS-R
McCurnin 10th ed pg. 962
What is the difference between and an active scavenging system and a passive scavenging system?
An active scavenging system uses a vacuum pump or a fan to remove the waste gas, while a passive scavenging system will work by gravitational pulls.
#15
HP
McCurnin 9th ed pg 1029
When can nonprecision vaporizers be used?
Nonprecision vaporizers are used with Low vapor pressure anesthetics.
#15
HP
McCurnin 9th ed pg. 1026
What is the difference between atropine and glycopyrrolate?
Glycopyrrolate has a longer duration and a slower onset than atropine
#15
HP
McCurnin 9th ed. pg 1013
Xylazine and dexmedetomidine are what class of drugs?
Alpha 2 agonists
#15
HP
McCurnin 9th ed pg. 994
Acepromazine blocks what type of receptor?
Alpha 1 adrenergic receptors
#15
HP
McCurnin 9th ed pg. 1013
Differences between isoflurane and sevoflurane?
Isoflurane is irritating to mucous membranes and causes less hypotension.
Sevoflurane has a more rapid induction and recovery, depth can be changed more rapidly. Requires a more vigilant monitoring.
Student #7, HHS
McCurnin 10th edition, pg:927
When should anesthesia be used for a patient?
For surgery, dentistry, endoscopy, and procedures that require immobility, unconsciousness, and pain control.
Student #7, HHS
McCurnin 10th edition, pg:927
What are the reversal agents for opioids?
Naloxone (Narcan)-full reversal
Butorphanol-partial reversal
Buprenorphine-partial reversal
Student #7, HHS
McCurnin 10th edition, pg:932
Common adverse effects of anticholinergics in small animals?
Tachycardia, arrhythmias, mydriasis, ileus, bronchodilation.
Bronchodilation can cause hypoventilation and hypoxemia
Student #7, HHS
McCurnin 10th edition, pg:929
When is chamber induction used?
In feral, intractable, or aggressive animals. In patients that cannot be handled.
Student #7, HHS
McCurnin 10th edition, pg:937
