Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anesthesia > Equine Anesthesia > Flashcards

Equine Anesthesia Flashcards

1
Q

How is peripheral perfusion evaluated in equine patients?

A
  • jugular fill
  • temperature of ears and distal limbs
  • digital and facial artery pulse quality
  • mucous membrane color, texture, and CRT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are 5 pertinent parameters for the pre-anesthetic evaluation of equine patients?

A
  1. mentation and temperament - difficult handling, anxious, depressed, calm
  2. gait assessment - ataxia, lameness, pain
  3. accurate body weight
  4. medical history - concurrent medications, prior anesthetic record
  5. disease/condition-specific considerations - colic, blood loss, pregnancy, foal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What basic components of the CBC are necessary for equine anesthesia? What are some concerning findings?

A

PCV/TS

  • leukocytosis, neutrophilia = pneumonia, other infection
  • leukopenia = sepsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 4 aspects of a chemistry are the most important for equine anesthesia? When is a full panel performed?

A
  1. creatinine
  2. fibrinogen
  3. lactate for blood volume status
  4. electrolytes - Na, K, Cl, Ca, Mg

systemic disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is necessary prior to walking to the induction stall?

A

adequate anxiolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What food withdrawal period is recommended for horses? Why is it controversial?

A

4-12 hrs

  • increased acidity with prolonged fasting and slowed GI transit
  • decreased gastric size causes less pressure against the diaphragm = reduced atelectasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the water withdrawal period like for horses?

A

none —> free access to water recommended

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How are horses prepared before premedications are given?

A
  • pull shoes
  • clean feet
  • rinse mouth
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 4 components of an equine premedication protocol?

A
  1. phenothiazine - Acepromazine
  2. alpha-2 agonist - Xylazine, Detomidine, Medetomidine, Dexmedetomidine, Romifidine
  3. opioid - Butorphanol, Morphine, Methadone
  4. benzodiazepine - Midazolam, Diazepam
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why is there commonly a separate sedation stall offered for equine patients?

A

offers a quiet environment with reduced stimuli, which allows for increased effect of premedications and reduced doses required for pre-anesthetic sedation

  • give Acepromazine 15 mins prior to walking to the induction area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What pre-medication sedatives are recommended within the induction stall?

A

Xylazine +/- Butorphanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is done if a horse is not sedated enough for induction?

A
  • allow time for onset - give 5-7 mins!
  • additional Xylazine bolus up to 1 mg/kg
  • detomidine bolus
  • ensure the stall is quiet and minimize auditory/tactile stimuli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 3 major combinations for equine induction? Why/when are they used?

A
  1. Ketamine + Xylazine - muscle relaxation, less ataxia; good for short procedures
  2. Ketamine + MIdazolam - reliable muscle relaxation, reduced MAC
  3. Ketamine + Guaifenesin - allows for reduced alpha-2 agonist usage for colic cases and cesarean sections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is Ketamine + Guaifenesin induction given? What are the 3 steps?

A

with Guaifenesin in a pressure bag

  1. start with a slow drip for central sedation
  2. increased drip rate to a stream for central muscle relaxation - should see tremoring pectoral muscles and carpal knuckling
  3. inject Ketamine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the 4 most common restraint choices during equine induction?

A
  1. head/tail rope
  2. head rope only
  3. swing-gate
  4. sling
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How are equine ET tubes checked? What other equipment is used?

A

cuff leak check while inflated for 5 mins

  • sterile lubricant
  • air syringe
  • mouth gag PVC tube
17
Q

How can horses be nasally intubated?

A
  • lubricate a cuffed nasotracheal tube with Phenylephrine gel
  • insert the stylet
  • use the stylet to guide the tube into the trache
18
Q

What are the 8 steps of equine induction?

A
  1. rinse mouth
  2. add sedation as needed
  3. place head and tail rope, swing-gate, or sling
  4. induce anesthesia
  5. palpate pulse
  6. intubate
  7. lubricate eyes
  8. hoist to table
19
Q

What 3 inhalant anesthetics are used on horses? What 2 complications are common?

A
  1. isoflurane
  2. sevoflurane
  3. desflurane
  • hypoventilation - may need ventilator
  • hypotension - potent vasodilators
20
Q

What 5 MAC-sparing medications are recommended

A
  1. benzodiazepines
  2. alpha-2 agonists
  3. opioids
  4. lidocaine
  5. ketamine
21
Q

What locoregional blocks are commonly used on equine patients?

A
  • epidural
  • distal limb blocks
  • maxillary/mandibular blocks
22
Q

What combination is recommended for TIVA in equine patients? What bolus can be added? When is this most commonly done?

A

triple drip - Guaifenesine, Ketamine, Xylazine +/- Midazolam

2:1 Ketamine/Xylazine —> monitor anesthetic depth closely!

shorter procedures 45 mins to 1 hr, like castrations and imagining studies —> still require intubation and supplemental O2

23
Q

What are the 3 major analgesic opioids used in equine patients?

A
  1. Butorphanol - kappa agonist/mu antagonist for mild-moderate pain
  2. Morphine - mu agonist for moderate-severe pain
  3. Methadone
24
Q

Why must morphine be given to equine patients carefully?

A

may increase MAC - associated with excitement

25
Q

What NSAIDs are commonly added to the anesthetic protocol in horses?

A
  • Flunixin meglumine
  • Phenylbutazone
26
Q

How do alpha-2 agonists provide analgesia? What 2 are commonly used?

A

act on the alpha-2 receptors in the brainstem, dorsal horns of the spinal cord, and peripheral nerves

  1. Dexmedetomidine
  2. Xylazine
    - administer premedication dose over 1 hour up to 0.7 mg/kg/hr
27
Q

What agents are most commonly used for analgesic locoregional blocks? What can be added? What affects cranial spread?

A

Lidocaine vs. Mepivacaine vs. Bupivacaine

  • Xylazine = local anesthetic + sedative (perineal anesthesia)
  • Morphine

injection site and total volume

28
Q

What complications are commonly seen during recovery in horses?

A
  • fractures
  • upper airway obstruction
  • myopathy
  • myelopathy
29
Q

What are 4 aspects to ideal equine recovery? How can this be achieved?

A
  1. slow
  2. minimal ataxia
  3. good muscle strength
  4. one coordinated attempt to stand

careful free recovery, head/tail rope, sling, or pool

30
Q

What considerations should be taken during equine recovery?

A
  • physical condition - signalment, pain status
  • temperament
  • duration of general anesthesia
  • positioning
  • anesthetic protocol - use of inhalants or infusions
  • anesthetic complications - hemorrhage, hypotension
  • surgery performed
  • sedation and reversal drugs given
31
Q

What 3 additional sedatives can be given to horses as they finish up with surgery to ensure recovery is smooth?

A
  1. Acepromazine - during closure
  2. Xylazine - in recovery stall after the start of spontaneous ventilation
  3. Detomidine - if particularly excitable or difficult to sedate
32
Q

What are the 2 major reversals used in equine patients? What do they do?

A
  1. Flumazenil - reverse BZD, recommended early in recovery to improve ventilatory drive (better elimination of inhalants)
  2. Tolazoline - reverse alpha-agonists, recommended when sitting sternally and calm (better pharmacokinetics in horses compared to Atipamazole and Yohimbine)
33
Q

What kind of environment is recommended for recovery in equine patients?

A
  • quiet room +/- ear plugs
  • low lighting
  • recovery mat (requires more coordination to roll off)
  • head rope, tail rope
34
Q

When are endotracheal and nasotracheal tubes taken out? When are they commonly left in longer?

A
  • ET = when swallowing
  • NT = when spontaneously ventilating

if supplemental oxygen is needed —> leave secured in diastema until standing

35
Q

Which of the following is NOT an important component in your pre-anesthetic evaluation?

a. temperament
b. prior sedation drugs administered
c. cardiopulmonary auscultation
d. full lameness exam

A

D

36
Q

Which of the following is an important component in the recovery plan?

a. airway management
b. method of restrain or support
c. environmental stimuli
d. all of the above

A

D

37
Q

Which of the following does NOT provide analgesia and should NOT be included in the analgesia plan?

a. Acepromazine
b. Xylazine infusion
c. Locoregional anesthesia
d. Morphine

A

A

38
Q

Why is “in-stall premedication” beneficial to the anesthetic protocol?

a. increased efficacy of sedation drugs
b. more convenient to anesthetist
c. reduces amount of ketamine needed for induction
d. increases the amount of xylazine required for premedication in the induction stall

A

A

39
Q

Which of the following is a benefit of total intravenous anesthesia (TIVA) based protocols?

a. shorter recovery time due to minimal accumulation of drugs
b. anesthesia machine not requires to maintain anesthetic plane
c. reliable sedation regardless of animal temperament
d. ability to reverse drug to quicken recovery time and improve recovery quality

A

B

Anesthesia (40 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions