Balanced Anesthesia Flashcards

1
Q

what are the desired effects of anesthesia

A
  1. unconsciousness
  2. amnesia
  3. immobility and muscle relaxation
  4. analgesia
  5. autonomic stability
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2
Q

what are the desired effects are produced by inhalants

A

amnesia
immobility & muscle relaxation
+/- unconsciousness

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3
Q

what are the CV effects of inhalants

A

vasodilation
hypotension

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4
Q

what are the respiratory effects of inhalants

A

decreased response to CO2
decreased respiratory rate

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5
Q

what are additional characteristics of inhalants

A

hyperalgesia
narrow therapeutic margins (compared to IV)
global warming + greenhouse gases

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6
Q

what is balanced anesthesia

A

using multiple drugs to achieve anesthesia so that each drug is used at a lower dose than if used alone

results in less adverse effects

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7
Q

PIVA

A

partial intravenous anesthesia

combining inhalant + injectable anesthetics

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8
Q

what are the goals of balanced anesthesia

A
  1. approach an “ideal drug” by combining drugs that have different main effects
  2. decrease inhalant requirement (to decrease CV and respiratory depression)
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9
Q

main effect of hypnotics

A

unconsciousness

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10
Q

main effect of benzodiazepines

A

amnesia

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11
Q

main effect of NM blocking agents

A

muscle relaxation

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12
Q

main effects of opioids

A

analgesia + autonomic stability

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13
Q

what qualities are ideal for an IV drug used in balanced anesthesia

A
  1. reduces inhalant requirement
  2. improves CO
  3. improves BP
  4. improves ventilation
  5. causes no to minimal CV depression
  6. causes no to minimal respiratory depression
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14
Q

what injectable drugs are used with inhalants to achieve balanced anesthesia

A
  • local anesthetics
  • nitrous oxide
  • opioids
  • ketamine
  • IV lidocaine
  • alpha-2 agonists
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15
Q

effects of opioids as balanced anesthetic

A
  1. reduces MAC (dogs > cats)
  2. minimal CV depression
  3. respiratory depression (dogs > cats)

butorphanol is MORE effective in cats than full mu agonists

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16
Q

effects of ketamine as balanced anesthetic

A
  1. reduces MAC
  2. improves CV function (dogs > cats)
  3. minimal respiratory depression
  4. prevents hypothermia
17
Q

effects of IV lidocaine as balanced anesthetic

A
  1. reduce MAC
  2. CV depression (cats only; no effect in dogs)
  3. antiarrhythmic
17
Q

effect of dexmedetomidine as balanced anesthetic

A
  1. reduces MAC
  2. CV depression (cats > dogs)
  3. analgesia + blunts autonomic response
18
Q

what is the ideal balanced anesthesia in dogs

A

large dose opioids

ex. inhalant + fentanyl CRI

19
Q

what is the ideal balanced anesthesia in cats

A

none - possibly ketamine but can have a dysphoric wake up