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VET433: Gastroenterology > Anesthesia in GI Patients > Flashcards

Anesthesia in GI Patients Flashcards

1
Q

anticholinergic drugs

A

atropine
glycopyrrolate

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2
Q

indications for anticholinergics

A
  • sinus bradycardia
  • vagally mediated 1st and 2nd degree AV block
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3
Q

GI side effects of anticholinergics

A

reduced secretions
decreased GI motility
decreased LES tone
increased gastric pH

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4
Q

H2 blocker drugs

A

famotidine

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5
Q

indications for H2 blockers

A

used with H1 blockers in patients with MCTs

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6
Q

GI side effects of H2 blockers

A

decrease gastric acid secretion
increase gastric pH

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7
Q

proton pump inhibitor drugs

A

pantoprazole
omeprazole

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8
Q

indications for PPI

A

prevent esophagitis in patients at risk of GER or regurgitation

decrease severity of aspiration pneumonia

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9
Q

GI side effects of PPIs

A

decrease gastric acid secretion
increase gastric pH

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10
Q

what antiemetic drug is used most commonly with anesthesia

A

maropitant

reduces opioid induced emesis

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11
Q

indications for opioids

A

sedation - premed
analgesia

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12
Q

GI effects of opioids

A

decreased GI motility
initial vomiting followed by antiemetic properties
decreased LES tone
increased risk of regurg

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13
Q

GI effects of acepromazine

A

antiemetic
delays gastric emptying
decreased GI motility
decreased LES tone
increased risk of regurg

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14
Q

GI effects of dexmedetomidine

A

vomiting (cats)
decreased LES tone
increased risk of regurg
decreased GI motility

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15
Q

GI effects of benzodiazepines

A

MINIMAL GI EFFECTS

decrease LES tone
increased risk of regurg

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16
Q

GI effects of propofol

A

antiemetic
decreased gastric empting/GI motility

17
Q

GI effects of alfaxalone

A

decreased LES tone

18
Q

GI effects of ketamine

A

MINIMAL GI EFFECTS

decreases GI motility

19
Q

GI effects of inhalants

A

decreased LES tone
increased risk of regurg
decreased GI motility

20
Q

3 anesthetic considerations for vomiting patients

A
  1. head position down
  2. suction mouth prior to intubation
  3. rapid induction
21
Q

3 anesthetic considerations for regurgitating patients

A
  1. head position upward
  2. suction mouth prior to intubation and extubation
  3. rapid induction
22
Q

where do refluxed contents go in patients with gastroesophageal reflux

A

nose

esp. brachycephalics

23
Q

what are risk factors for GER during surgery

A
  1. age (older > younger)
  2. abdominal procedures
  3. long pre-op fasting period
  4. drugs - phenothiazines, atropine, morphine
24
Q

do position and type of inhalant used affect GER

A

NO

25
Q

what medications can be used to reduce the risk of GER

A

high dose metoclopramide CRI
OR
cisapride

26
Q

what drugs should not be used for induction when a rapid induction is required

A

inhalants or opioids

27
Q

what complications can occur from vomiting, regurgitation, or reflux under anesthesia

A

esophagitis
aspiration pneumonia

28
Q

how to prevent esophagitis under anesthesia

A

suction frequently
lavage esophagus with high volume saline

can add bicarbonate to lavage fluid

29
Q

what factors increase risk of developing aspiration pneumonia

A
  1. hydromorphone
  2. history of regurgitation
  3. surgery type
  4. megaesophagus
  5. history of neuro or respiratory disease
30
Q

what is the goal in order to prevent postoperative ileus

A

maintain intestinal oxygenation and blood flow

31
Q

steps of ileus prevention

A
  1. perioperative analgesia - limit opioid use while still providing good analgesia
  2. surgical technique - minimize handling of intestines
  3. postoperative care - get patient eating and walking quickly, use laxatives, peripheral opioid antagonists, prokinetics
32
Q

components of an anesthesia anticipated problem list

A
  1. anesthesia related problems
  2. procedure related problems
  3. disease related problems
33
Q

anesthesia related problems

A

hypotension
hypoventilation
hypothermia
+/- bradycardia

34
Q

procedure related problems

A

pain
bleeding
stomach distention
esophagitis

35
Q

disease related problems

A

vomiting
regurgitation
electrolyte imbalances
esophageal perforation

VET433: Gastroenterology (16 decks)

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