Anesthesia

Question 1

Important pre-anesthesia questions

Answer 1

Fasting?
Current condition?
Changes in condition since scheduling?
Current in preventive care?
What is the Scheduled procedure?
Medications?

Question 2

Effects of anesthesia

Answer 2

Light to heavy sedation, local anesthesia, general anesthesia, muscle relaxation, analgesia, combination

Question 3

General anesthesia

Answer 3

Unconsciousness and insensibility to feeling and pain induced by administration of anesthetic agents given alone or in combination

Question 4

Uses of general anesthesia

Answer 4

General surgery or painful procedures without patient movement or personnel injury

Question 5

Anesthetic induction

Answer 5

The process used to take the patient from a state of consciousness to general anesthesia

Question 6

Anesthetic maintenance

Answer 6

The process used to keep the patient under general anesthesia until recovery

Question 7

Local anesthesia

Answer 7

Loss of sensation in a localized body region or part induced by administration of a drug or other agent without loss of consciousness

Question 8

Use of local anesthetic

Answer 8

Used for procedures that do not require the patient to be unconscious and for adjunct pain control

Question 9

Premedication (preanesthesia)

Answer 9

Administration of an agent or agents before induction of general anesthesia to calm and relax the patient, ease induction and recovery, minimize adverse effects, reduce the amount of general anesthetic needed, provide muscle relaxation, provide pain control

Question 10

Sedation

Answer 10

A state of calm or drowsiness

Question 11

Tranquilization

Answer 11

A state of relaxation and reduced anxiety

Question 12

Neuroleptanalgesia

Answer 12

State of profound sedation and analgesia produced by simultaneous administration of an opioid and a tranquilizer

Question 13

Uses of neuroleptanalgesia

Answer 13

Perform minor procedures such as wound treatment or radiography, and to induce general anesthesia in compromised patients

Question 14

Balanced anesthesia

Answer 14

Concurrent administration of two or more anesthetic drugs with complementary effects

Question 15

Reasons patient preparation is important

Answer 15

• Minimize the likelihood of preventable complications (i.e. aspiration)
• All tx of any problems that may endanger the patient (i.e. Dehydration)
• Allow the vet to make anesthetic drug choices based on facts about the patient’s condition
• make the anesthetist aware of potential problems that the patient may experience during the procedure

Question 16

Fasting recommendations

Answer 16

Dogs and cats: 8-12 hours food, 2-4 water
Horses: 8-12 food, 0-2 water
Cattle: 24-48 food, 8-12 water
Small ruminants: 12-18 food, 8-12 water

Question 17

Physical assessment

Answer 17

Focus of nervous, cardiovascular, pulmonary systems.

• level of consciousness/mentation
• general body condition (BCS, hydration)
• weakness, abnormalities, recumbency
• parasites, wounds, tumors, external lesions
• body orifices for external signs of dz: diarrhea, nasal discharge, hematuria, vaginal discharge
• Vital signs/TPR stats
• respiratory effort
• auscultate lungs
• palpate pulse and auscultate heart

Question 18

Purpose of diagnostic tests w/anesthesia

Answer 18

Uncover abnormalities that may impair the patient’s ability to compensate, that may lead to unanticipated complications, or that may impair the patient’s ability to eliminate the anesthetics

Question 19

Patient stabilization

Answer 19

Tx/correction of dehydration, anemia, cardiac arrhythmias, respiratory compromise, major organ failure, electrolyte/acid-base imbalance.

May involve antibiotics, analgesics, fluids, blood, oxygen, etc.

Question 20

Physical status classification: P1

Answer 20

Minimal risk. Normal healthy patient.

Patients undergoing elective procedures

Question 21

Physical status classification: P2

Answer 21

Low risk. Patient w/mild systemic disease.

Neonatal, geriatric, obese, brachycephalic patients.
Mild dehydration.
Skin tumor removal.

Question 22

Physical status classification: P3

Answer 22

Moderate risk. Patient with severe systemic disease.

Anemia. Moderate dehydration. Compensated major organ disease.

Question 23

Physical status classification: P4

Answer 23

High risk. Patient with severe systemic disease that is a constant threat to life.

Ruptured bladder, internal hemorrhage, pneumothorax, pyometra

Question 24

Physical status classification: P5

Answer 24

Extreme risk. Moribund patient that is not expected to survive without the operation.

Severe head trauma. Pulmonary embolus. GDV. End-stage major organ failure.

Question 25

Objective of anesthesia

Answer 25

Produce loss of sensation in the whole body, or a specific body part or region, and to provide muscle relaxation and alteration of consciousness appropriate to the procedure. Patient safety must be preserved and adverse effects minimized. Pay special attention to respiratory and cardiovascular

Question 26

Anesthetic depth stage 1

Answer 26

Conscious/disoriented
HR/RR normal to increased
Eyes central pupils normal size
PLR's normal
All reflexes present

Question 27

Anesthetic depth stage 2

Answer 27

Excitement stage.
Struggling, vocalizing, paddling
Patient can release epinephrine due to stress causing cardiac arrhythmias

Question 28

Anesthetic depth stage 3: plane 1

Answer 28

Light anesthesia
Unconscious 
May be gagging/swallowing, but decreased
HR/RR normal w/strong pulse
Eyes may rotate or stay central
Pupil size normal/partially constricted 
PLR's decreased
palpebral/pedal reflexes decreased

Question 29

Anesthetic depth stage 3: plane 2

Answer 29

Surgical anesthesia
Immobilized
HR/RR/BP slightly decrease
RR may be shallow
Eyes often ventromedial
Pupil size normal
PLR's slow
Reflexes decreased or absent

Question 30

Anesthetic depth stage 3: plane 3 or 4

Answer 30

Deep anesthesia or near death 
Immobilized 
HR/BP decreased
Weak pulse 
Shallow breaths
CRT increased
Pale MM
Eyes central
Pupils moderately dilated 
PLR's slow or absent
Reflexes absent and muscle tone flaccid

Question 31

Anesthetic depth stage 4

Answer 31

Moribund - anesthetic overdose
Immobilized
Cardiovascular collapse
Weak pulse, barely palpable