Ax\ Flashcards
Based on the american society of anesthesiologists physical status classification. Define:
P1 to P6
P1 A normal healthy patient
P2 A patient with mild systemic disease
P3 A patient with severe systemic disease
P4 A patient with severe systemic disease that is a constant threat to life
P5 A moribund patient who is not expected to survive without the operation
P6 A declared brain-dead patient whose organs are being removed for donor purposes
In The effectiveness of a long-acting transdermal fentanyl solution compared to buprenorphine for the control of postoperative pain in dogs in a randomized, multicentered clinical study
What pain scale was used?
With this scale what is the maximum score?
At what pain score were animals removed from this study.
modified Glasgow Composite Pain Scale with a dropout criteria of 8 and above; (20 maximum score)
True or false:
Spontaneous respirations are maintained independent of fentanyl concentration in dogs
True
Categorize the following patients for ASA status:
- controlled diabetes
- uncontrolled diabetes
- Extreme shock and dehydration
- GDV
- Emaciation
- skin tumour
- cryptorchidectomy
- moderate hypovolemia
- localized infection
- terminal malignancy
- Fever
- Anemia
- compensated cardiac disease
- Decompensated cardiac disease
- Severe fever
- Toxemia
- Uremia
- controlled diabetes – ASA 2
- uncontrolled diabetes – ASA 2
- Extreme shock and dehydration – ASA 5
- GDV – ASA 5 or E
- Emaciation – ASA 4
- skin tumour – ASA2
- cryptorchidectomy – ASA 2
- moderate hypovolemia – ASA 3
- localized infection – ASA 2
- terminal malignancy – ASA 5
- Fever – ASA 3
- Anemia – ASA 3
- compensated cardiac disease – ASA 2
- Decompensated cardiac disease – ASA 4
- Severe fever – ASA 4
- Toxemia – ASA 4
- Uremia – ASA 4 (any organ failre is 4)
True or false:
- Studies demonstrate slightly longer recoveries following both propofol and alfaxalone in Greyhounds.
- These results were initially ascribed to the large muscle mass and minimal adipose tissue found in Greyhounds and hence generalized to all sighthounds. However, more recent data have demonstrated that the Greyhound breed may have relative deficiencies in hepatic metabolism
Both TRUE
(Lumb and Jones)
True or False:
MAC of inhalent anesthetics seems to be lower in cats than dogs and horses.
Propofol clearance in cats is reported to be shorter than dogs.
TRUE - MAC is lower in cats
FALSE – propofol clearance in cats is slower –> reported to be at least twice as fast in DOGS as in CATS.
What effect causes higher doses of opioids to cause an increase HR, increased CO and increased BP in cats?
Increased catecholamine effect seemingly from increased doses of opioids in cats (biphasic effects)
In cats with tracheal rupture - what changes the prognosis whether treatment is likely successful (surgical and conservative)
Whether injury extends to carina. If does not extend into carina, then tx is usually successful.
What time period has the highest incidence of ax related deaths?
What percentage of cats, dogs and rabbits have reportedly died during this time period?
Within 3 hours of terminating a procedure
Cats - 60%
Dogs - 50%
Rabbits - 60%
In each of the following, state the approximate risk of Ax related death in percent:
Dog ASA 1-2 0.05%
Dog ASA 3-5 1.3%
Cat ASA 1-2 0.11%
Cat ASA 3-5 1.4%
Rabbit ASA 1-2 0.7%
Rabbit ASA 3-5 ~7%
Dog ASA 1-2
Dog ASA 3-5
Cat ASA 1-2
Cat ASA 3-5
Rabbit ASA 1-2
Rabbit ASA 3-5
What is the general risk of Ax death in small animals estimated to be?
In higher risk dogs and cats?
What is higher risk - dog or cat?
0.1-0.3%
1-4%
Cats appear at greater risk
True or false:
- In cats, increasing ASA grade, procedural urgency, major versus minor procedures, increasing age, extremes of weight, endotracheal intubation, and the use of fluid therapy were associated with increased odds of anesthetic and sedation‐related death Pulse and pulse oximetry monitoring were associated with a reduction in odds.
- In dogs, poorer health status (based on ASA grade), greater procedural urgency, major versus minor intended procedures, old age, and low weight were associated with anesthetic‐related death.
- Increasing duration of the procedure and the anesthetic induction and maintenance combination used were not associated with increased odds of anesthetic‐related death
- Halothane after IV induction had a 66 fold increase in odds of ax death than Isoflurane with IV induction.
TRUE
TRUE
FALSE (WERE associated)
TRUE
What factors make older patients more of a risk for ax?
More susceptible due to:
- depressant effects of ax
- impaired thermoregulatory mechanisms
- reduced metabolism –> prolonged rovery
True or false:
IV fluids during ax is associated with increased risk odds of ax related death.
True
Does respiratory acidosis and metabolic acidosis contribute to hyperkalemia in greyhounds under GA?
Yes.
BES is better a better fluid choice than NaCl due to NaCl having acidifying effects.
ETCO2 important to maintain.
