Anesthetic Complications

Question 1

What are the most common complications in dog and cat anesthesia?

Answer 1

Hypotension, Hypoventilation, hypoxemia, hypothermia, cardiac arrhythmias.

Question 2

What constitutes hypotension in an anesthetized patient?

Answer 2

A systolic blood pressure of < 80-90 mmHg, a mean blood pressure of < 60-70 mmHg and a diastolic blood pressure of < 40 mmHg

Question 3

If an anesthetized patient becomes hypotensive what is the first step that the staff member in charge of that anesthetic can do to correct the problem?

Answer 3

Check the anesthetic depth of the patient and if possible turn the vaporizer down.

Question 4

In the presence of hypotension if the vaporizer cannot be turned down what other steps can be taken to correct the problem.

Answer 4

An intravenous bolus of a crystalloid can be given over 5-15 minutes.

Question 5

What is the definition of bradycardia in the anesthetized dog and cat?

Answer 5

Heart rate (HR) of <100 beats per minute (bpm) in the cat and HR of < 60-70 in the dog.

Question 6

What can be given to a hypotensive, bradycardic dog or cat and why?

Answer 6

An anticholinergic such as glycopyrrolate or atropine. These drugs will cause an increase in heart rate which will increase cardiac output.

Question 7

What bloodwork abnormalities might predispose to hypotension in an anesthetized patient?

Answer 7

Hypoglycemia​, Anemia, Hypoproteinemia​ & Electrolyte imbalances.

Question 8

What monitoring device is needed to accurately recognize hypoventilation in the anesthetized patient?

Answer 8

A capnometer.

Question 9

What is the definition of hypoventilation in an anesthetized patient?

Answer 9

An end tidal CO2 (ET CO2) of >40-55 mmHg.

Question 10

What level of hypercarbia in the anesthetized patient requires correction?

Answer 10

An ET CO2 of > 60mmHg.

Question 11

What should be done to correct the problem when the ET CO2 exceeds 60mm Hg in an anesthetized patient?

Answer 11

Start positive pressure ventilation either manually or using a mechanical ventilator

Question 12

What is the definition of hypoxemia in a patient that is intubated and receiving 100% oxygen?

Answer 12

An oxygen saturation of </= 95%

Question 13

What steps should be taken on recognition of hypoxemia?

Answer 13

Check to see if the patient properly intubated? Check to see if the patient is connected to the oxygen source?​ Check to see if the supply of oxygen is adequate?

Question 14

What kind of patient factors can cause hypoxemia in the anesthetized patient?

Answer 14

Obesity, atelectasis, pneumonia, pleural effusion, diaphragmatic hernia, poor perfusion.

Question 15

What constitutes hypothermia in the anesthetized patient?

Answer 15

A temperature of less than <36.6 degrees centigrade or 98 degrees Fahrenheit.

Question 16

What effect can hypothermia have on the anesthetized patient?

Answer 16

It causes delayed drug metabolism, cardiovascular dysfunction​, Impaired perfusion​, respiratory compromise , cerebral depression and increased incidence of wound infection.

Question 17

What methods are used to assess for arrhythmias in the anesthetized patient?

Answer 17

ECG and monitoring for pulse deficits by listening to the heart and assessing whether every audible heart beat has a corresponding pulse​

Question 18

True of False. Every arrhythmia needs to be treated

Answer 18

False. The decision to treat an arrhythmia is based upon its severity, its effect on hemodynamic stability and the likelihood of it deteriorating.