Colic Surgery Complications Flashcards
how frequently to monitor CBC/fibrinogen/lactate/electrolytes post colic sx
q24 hours
prokinetics for post colic surgery?
- lidocaine CRI
- metoclopromide
what electrolytes to add to fluids post colic surgery?
Ca, Mg, K
when to discontinue meds post colic surgery?
- when eating
- afebrile
- normal CBC
frequency of ileus post colic sx
10-20% of cases (accounts for 40% of deaths)
how frequently to do PE post colic surgery
q1-3 hours
how to give lidocaine CRI
-loading dose + CRI
NEVER bolus -> seizures
adhesions: more common in foals or adults
foals
anti-endotoxin therapy (5)
- flunixin meglumine
- biosponge during enterotomy
- polymixin B
- Plasma
- heparin in case of DIC
how much K to add to fluids post colic surgery?
add 80 meq/5L bag
NEVER exceed 0.5 meq/kg/hr
MOA of lidocaine CRI (5)
- decreases catecholamines and free radicals
- stimulates SM
- decreases afferent neurons
- inhibits PGs -> decreased inflammation
- decreases granulocyte migration
NEVER exceed ______ K per hour
0.5 meq/kg/hr
most important thing about fluid therapy post colic surgery
volume!! is most important
what indicators at presentation tell you a patient is a greater risk for ileus post colic sx
- > 10 yo
- PCV > 45%
- high TP/albumin
- hyperglycemia
- anesthesia >2.5 hours
- sx>2 hours
- ischemic IS injury
what to remember when dealing with hernias
- need belly band!
- wait 3 months to repair
how frequently to monitor TP/PCV post colic surgery
q6 hours
fluid maintenance for a horse
50 ml/kg/day
most common lesion associated with post op ileus
strangulating SI lesion
how to diagnose peritonitis
- blood-belly glucose difference >50 mg/dL OR
- peritoneal pH <7.2 + peritoneal glucose < 30 mg/dL
left shift, hypoproteinemia, thrombocytopenis, toxic WBCs
decompress stomach how freuqently?
q2-3 hours as needed
why are fluids so hard to maintain post colic sx?
mucosal damage -> increased capillary permeability -> fluid/protein loss to interstitium
goal of fluid therapy post colic surgery
maintain vascular volume
HR <80 bpm; TP >4.1; PCV <50%
what parameters suggest your fluid therapy post colic surgery is adequate?
HR <80 bpm; TP >4.1; PCV <50%
adhesion prevetion (7)
- DMSO
- heparin
- CMC 3% (belly jelly/carboxyl methyl cellulose)
- HA
- NSAIDs, antibiotics
- omenectomy (REMOVE IT)
- peritoneal lavage (SUCTION)
second most common cause of repeat surgery following colic surgery
adhesions
side effects of lidocaine CRI and metoclopromide
seizures
lidocaine CRI is used for _____(3) post colic surgery?
- pain management
- anti-inflammatory
- to treat post op ileus
pain manangement post colic surgery?
- flunixin meglumine
- lidocaine CRI
number one sequelae following incision issue
hernia
signs of ileus
- reflux
- decrease gut sounds
- increased HR, TP, PCV
- electrolyte derangement
signs of endotoxemia
- edema
- gi distension
- reflux
- thrombosis coag issue
- tachycardia
