Anesthesia analgesia deck Flashcards
Who has a higher basal metabolic rate
Small dogs (need more drugs)
What age of animal is most sensitive to drugs
Young and older
3month-12 months are the least sensitive
List body compartments based on tissue perfusion? Highest to lowest
Vessel Rich:
Brain,kidney,liver,heart
Intermediate:muscle, skin
Fat: adipose tissue
Vessel poor: residual tissue
Biotransformation typically happen where?
Liver
Excretion typically happens?
Kidneys
How are inhalants excreted
Primarily thourght exhalation and small amt through the feces/urine/
Carbon monoxide is produced highest in what 2 inhalants
Desflurane and Iso
Why is seve nephrotoxic
Causes the greatest increase in the anesthestic temp. Degrading to a nephrotoxic vinyl ether… rarely happens in less the soda lime has been desiccated
Aninoglycosides can cause what side effect with some drug interactions
Neuromuscular blockade
Hyperthyroid has a higher or lower metabolic rate
Higher
Needs more drugs
MAC
Minimum Alveolar Concentration
MIC
Minimum inhibitory concentration
Stages of anesthesia
1: stage of voluntary movement
2: stage of delirium
3: surgical stage (4 planes)
4: CNS extremely depressed resp cease
ASA
American Society of Anesthesiologist
List the catagories of physical status
Stage 1: normal healthy patient (spay/neuter)
Stage 2 mild systemic disease (fracture wo shock, tumor removal)
Stage 3 severe systemic disease (anemic, fever, dehydrated)
Stage 4 severe systemic disease w constant threat to life ( uremia, anemia/ hypovolemia, crdiac decomp)
Stage 5 not expected to survive 24 hr ( extreme shock/ dehydration, terminal malignancy, severe trauma)
How often should a patient be checked
5 min
10 min recorded
Vessel rich tissues
Liver, kidney, brain, heart
Anesthetic categories
General: Induces a state of unconsciousness and varying amount of analgesia, amnesia, muscle relaxation, and loss of reflexes (sensory and autonomic) and is achieved by IV or inhalation
Regional: local. blocks pain sensations in specific areas of the body without loss of consciousness
Balanced: combination of drugs to induces anesthesia with each used for its specific effect.
Types of anesthesia
Inhalation, injectable, oral/rectal, local, hypnosis, acupuncture, hypothermia, TENS, electronarcosis
When was ether first discovered
1540
When was what was the first animal anesthestic
Nitrous oxide
ACVA
American College of Veterinary Anesthesiologist
Late 1960 early 1970
ASVA
American Society of Veterinary Anesthesia
AVMA
American Veterinary MEdical Association
ECVA
European College of Veterinary Anesthesiologist
Analgesia
Freedom from or absence of pain
Tranquilization vs sedation
Tranq: behavioral change, anxiety reduced, still aware of surrounding
Sedation: central depression w/ drowsiness/ unaware of surroundings but responsive to pain
Narcosis
Drug induced state where patient can’t be easily aroused
Local anesthesia
Loss of sensation in a circumscribed body area
Regional analgesia/ anesthesia
Insensibility in a larger but limited body area
Paralumbar nerve blockade
Stages of Anesthesia
I - amnesia/analgesia
II - Delirium/ excitement
III - surgical anesthesia (4 phases)
IV - overdose
ASA Status assignment: Patient physical status classification
- used to assess risk of anesthesia before anesthetizing an animal; based on signalment, history, physical exam, & lab data.
Class I : normal, healthy patient; no systemic dz
Class II : mild compensated systemic dz
Class III : serious systemic dz. stable vital signs
Class IV : serious systemic dz, decompensated
Class V : moribund, requires intensive life support;
patient not expected to live more than 24
hrs w/ or w/o surgery
Small animal Oxygen flow rates (Circle)
- Induction 100-200 ml/kg/min
- Maintenance: 40-60 ml/kg/min
- Minimum = 0.5 L/min
What is this graph in anesthesia and what are the letters depicting
Capnograph
AB baseline
BC exhalation
D point of ETco2
DE inspiration
Capnograph
a device that measures expired CO2 levels by IR spectrometry
Anticholinergics include which drugs
Atropine
Glycopyrrolate
Scopolamine
Acepromazine, Chlorpromazine, promazine
are what type of drugs
phenothiazides Major tranquilizers
high first pass metabolism from oral absorption
good absorption other routes
hepatic metabolism and urinary excretion
No antagonist
Diazepam, Midazolam, , Zolezapam are all what class of drugs?
benzodizaepines
Xylazine, detomidine, medetomidine, romifidine, dexmedetomidine
a2 agonist
sedation and analgesia can get rare aggression
hepatic metabolism
dec release of NE
inc vagal tone, muscle relaxation, local anesthetic with epidural
Mechanism of action of alpha 2 agonist
CNS depression by stimulating presynaptic alpha 2 adrenoreceptors in the CNS and peripheral, decreases Norepi, net result is a decrease in sympathetic outflow and decreases in circulating catecholamines and other stress related substances
Where are the alpha 2 receptors related
Dorsal horn of the spinal cord
Actions of opioids
Analgesia
Euphoria
Respiratory depression
Depression of cough
Miosis
Stimulates emesis
Constipation
Hypotension (large dosis)
Histamine release
Morphine
Meperidine
Oxymorphone
Fentanyl
Butorphanol
Buprenorphine
What class and score ?
Opioids
Morphine 1
Meperidine .5
Oxy 5-10
Fentanyl 100
Butorphanol 2-5
Buprenorphine 3-5
Pentazocine, butorphanol, buprenorphine antagonize the effects of which other opioids
Morphine, meperidine, oxymorphone, fentanyl
Neuroleptanalgesia
profound state of sedation & analgesia induced by simultaneaous admin of opioid & tranquilizer
dexmedetomidine and butorphanol
Halothane Side Effects
H alothane
H epatitis : Cumulative over years
H yperthermia : Malignant
H eart Arrthymias : Increased Catecholamine effects
trifluoroacetic acid
Ions fluoride, bromides and chlorides
Isoflurane Side Effects
Concentration dependent decreases in BP due to decreased peripheral resistance, decrease in alveolar ventilation, relaxes smooth muscle and not recommended for labor and delivery, increases ICP
Recommend O2 flow rates for closed systems, semiclosed systems, and Bains system
Closed system 2-3ml/lb/min o2
Semi-closed system 5-20 ml/lb/min o2
Gains 100-150ml/lb/min o2
Rebreathing bag sizes by body weight in pounds
15 40 120<300= 5L
