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Anesthesia 2 > Exotic Anesthesia > Flashcards

Exotic Anesthesia Flashcards

1
Q

Differences with exotics compared to dogs and cats

A

-higher metabolic rate, smaller reserves of glycogen predisposes to hypoglycemia
-higher oxygen consumption reduces tolerance to hyoxemia
-hypothermia

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2
Q

Hypothermia of exotics

A

-high body surface area to volume ratio
-radiant heat loss-cover patient
-evaporative heat loss so clip minimally and minimize use of scrub and alcohol solution

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3
Q

Respiratory system of rabbits

A

-hard to see larynx
-prone to laryngospasm
-obligate nasal breathers
-thoracic cavity is small so small tidal volume
-be careful of positioning because large abdominal organs push against diaphragm

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4
Q

Respiratory disease in rabbits

A

-be aware for anaesthesia
-Pasteurella multocida

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5
Q

Digestive system of Rabbit

A

-allow water up until premed
-cannot vomit
-fast rabbits 1-2hrs to reduce presence of food in oral cavity. Make sure you check before and clean with cotton swabs
-encourage to eat post anesthetic

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6
Q

Post operative ileus in rabbits

A

common
-predisposed if: pain, starvation, stress, diet change, drugs

-can develop corneal ulcers, injury to backs, ileus, hypoglycemic and hypothermia

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7
Q

Considerations for accurate dosing of drugs

A

-accurate body weight
-dilute drugs if needed
-use appropriate syringe size

**don’t extrapolate anesthetic protocols from other species

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8
Q

Thoracic cavity considerations

A

Be careful of compression from hands, instruments, drapes

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9
Q

Blood volume

A

50-78ml/kg

Therefore less tolerant to hemorrhage.

*Cotton tip= 0.17ml blood and 4x4 gauze=7ml blood

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10
Q

Anesthetic mortality

A

-overall risk of anesthetic related death 1.39-4.8%

-sick rabbits: 7.37%

-post-anesthesia mortality= 64%

-peri-anesthetic GI complications= 38%

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11
Q

What increases anesthetic risk?

A

-stress (species of prey,use premed, minimize handling, pain management)

-underlying disease (malnourishment, dehydration, Pastereurellosis, uterine carcinoma)

-failure to address perioperative issues

-lack of expertise (size, EET, fewer veins for catheter, pain)

-hypothermia risk

-prolonged procedures= anesthesia and ileus potential

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12
Q

Pre op blood tests

A
  1. PCV: 34-43%
  2. TP: 5-7.5 g/dL
  3. BG: 4.1-8.2 mmol/L
    *indicates disease and stress
  4. BUN 15-30 mg/dL
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13
Q

Normal rabbit vitals

A

HR: 200-300
RR: 32-60
Temp: 38.5-39.5

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14
Q

Premed for rabbits

A

-reduce stress, allow for induction and pre-oxygenation, anesthetic sparing, analgesia

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15
Q

Premed options

A

-Acepromazine
- Midazolam
-Dexmedetomidine
-opioids

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16
Q

Acepromazine in rabbits

A

-long duration, not reversible= prolonged recovery
-peaks 30-45mins
-only in healthy animals; honestly not great for rabbits

Leads to hypotension (peripheral alpha 1 receptor block=vasodilation)

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17
Q

Midazolam in rabbits

A

**good choice for rabbits
-water soluble so can be given IM (unlike diazepam)
-moderate sedation and muscle relaxation
-min cardiopulmonary effects
-combine with opioid

Reversal: Flumazenil IV or IM

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18
Q

Dexmedetomidine

A

**alternative for midazolam if not on hand
-mild to profound sedation
-resp and cardiovascular depression, and peripheral vasoconstriction (so harder for catheter)
-combine with opioid

-Reverse: Atipamezole

19
Q

Possible Opioids

A

Analgesia and increase sedation
Reverse with Naloxone

Select based on level of pain:
-Buprenorphine, butorphanol, hydromorphone, methadone

20
Q

Anticholinergic drugs

A

-not really used as premed
-used to treat bradycardia but negative effects on motility

-includes atropine (can be broken down in rabbits) and glycopyrrolate (slow onset time)

**rabbits have special enzyme that destroys atropine so only works for small periods

21
Q

Induction of anesthesia

A

-always preoxygenate and monitor during induction and intubation
-IV catheter preferred, mask induction is stressful, human exposure and not much time

22
Q

Injectable anesthetics for rabbit induction

A

**Titrate to effect to avoid induction apnea!

-Ketamine- combine with benzodiazepine; need high doses

-Propofol- IV

-Alfaxalone- can be given IM; large colume

23
Q

Volatile agents for induction of rabbits

A

-Pungent so rabbits will hold breath, can lead to bradycardia/apnea
-Stressful and can result in struggling/injury

-can use isoflurane or sevoflurane

24
Q

Isoflurane

A

MAC 2.5%
-pungent smell= breath holding more likely
-induction apnea

25
Q

Sevoflurane

A

MAC 3.5-4.1%
-less pungent so better tolerated
-faster induction
-induction apnea

26
Q

Face mask selection

A

Close fitting
-reduce environment contamination
-avoid inhalation of room air
-diaphragm can be adapted with glove
-low volume to minimize dead space

27
Q

Anesthesia induction chambers

A

smaller chamber to better fit the size of animal will allow for best induction
-less dangerous during excitement phase

28
Q

Lidocaine use

A

-constant rate infusions
-improved food intake and fecal output in rabbits following ovariohysterectomy
-anesthetic sparing
-analgesic, anti inflammatory/anti endotoxin

29
Q

Rabbit airway management

A

Options:
-mask
-V-gel (supraglottic airway device)
-intubation (blind or could use laryngoscope)

30
Q

benefit of intubation

A

-protect airway
-allow oxygen supplement
-allow positive pressure ventilation
-reduce human exposure

31
Q

Intubation process in rabbits

A

-Sternal with hyper extended neck (nose up at ceiling) to align larynx and trachea with oropharynx

-monitor HR

-prone to laryngospasm so use lidocaine

-don’t overinflate cuff

32
Q

Blind intubation method

A

Easy and quick when experienced
-premeasure ETT/atomizer (for spray of lidocaine)
-insert tube to premeasured point, condensation indicates expiration
-instill lidocaine
-gently advance during inspiration

-Damage to glottis or risk of laryngospasm and risk of aspiration if food present
-avoid repeated attempts of intubation!

33
Q

Confirmation of tracheal intubation

A

-ventilate and listen for resp signs on both sides of thorax
-capnograph
-coughing
-watch for condensation

34
Q

Laryngoscope intubation method

A

-direct visualization
-can more soft palate and expose glottis
-difficult and can cause tissue damage

Steps:
-sternal and hyperextend neck
-need assistance opening mouth
-pull tongue out of mouth
-insert ET tube

35
Q

Endoscopic intubation method

A

-direct visualization allowing for rapid and accuracy
-no risk of aspiration or soft tissue damage
-expensive equipment needed

36
Q

Complications of rabbit intubation

A

-difficult to place
-laryngospasm
-trauma to oropharyngeal soft tissue
-tube dislodgement, occlusion, kinking
-postintubation oropharyngeal swelling

37
Q

Supraglottic airway device: V-gel

A

-always used with capnograph
-can be dislodged when animal moves
-fast
-less trauma than blind intubation

38
Q

IV access in rabbits

A

-apply local anesthetic cream
-cephalic, lateral saphenous, marginal auricular vein
-do not use central auricular artery

39
Q

Fluids for rabbits

A

10ml/kg/h

40
Q

determining anesthetic depth of rabbit

A

-palpebral reflex and eye positiion (stays central) are unreliable because nictitans membrane will move cornea
-corneal reflex should be maintained

41
Q

Monitoring cardiovascular system

A

-auscultation
-doppler
-pulse oximetry (ear, tongue, digit)
-ECG
-temperature

42
Q

Post op care

A

-NSAIDS: meloxicam
-OPIOIDS: buprenorphine, hydromorphone, butorphanol
-stress free environment
-always monitor
-feed as soon as possible

43
Q

What to look for during prolonged recovery?

A

-hypothermia
-hypoglycemia
-residual drug effects

Anesthesia 2 (17 decks)

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