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VM 737 Anesthesia > Final > Flashcards

Final Flashcards

1
Q

why is anemia/GI bleeds a concern w/ anesthesia?

A

PCV affects CaO2 which impacts DO2

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2
Q

why is GI stasis/ileus a concern w/ drugs

A

can predispose to rupture, peritonitis, and torsion, colic GDV

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3
Q

what GI function should you worry about if considering giving oral meds?

A

decreased absorption

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4
Q

How does pain affect anesthetic choices

A

more drug may be required b/c more neuro activity

pain predisposes to ileus/stasis

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5
Q

Common GI complications induced by anesthesia/surgery/analgesics (x8)

A 
megacolon
GDV
constipation from ileus/GI stasis
emesis/nausea
gastroesophageal reflux
diarrhea & gas distention
GI ischemia
aspiration pneumonia
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6
Q

what does post-op ileus predispose to?

A

colic, GDV, constipation

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7
Q

what drug class are emetics for dogs? for cats?

A

dogs - opiods

cats - alpha 2’s

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8
Q

most effective antiemetic for drug-induced emesis, and best for treating nausea

A

Maropitant

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9
Q

what does gastroesophageal reflux predispose to?

A

esophagitis, aspiration pneumonia progressing to esophageal stricture (poor/guarded prognosis)

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10
Q

how do you prevent GI reflux?

A

gi protectants (sucralfate, antacids)
lavage esophagus
balloon stricture

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11
Q

how do you avoid GI tract ischemia? Why are we worried about GI ischemia?

A
  • maintain BP - hypotension decreases GI bloodflow b/c non-essential organ
  • concern is mucosa death allowing bact/toxin translocation
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12
Q

When do you not fast an animal for anesthesia?

A

young, diabetic, or emergency

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13
Q

2 components involved in pain response

A

sensory - nociception

affective - pain perception

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14
Q

concerns with acute pain (x4)

A
  • predisposes to chronic and/or maladaptive pain, cardiac dysrhythmias
  • affects sleep/normal func
  • facilitates catabolic state
  • emotional component
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15
Q

how does treatment vary for acute vs. chronic pain

A

acute - eliminate pain

chronic - quality of life, not elimination

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16
Q

steps for pain assessment (x5)

A
  • observe w/o interaction
  • observe while interacting
  • observe while freely moving
  • response to palpation
  • scoring system
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17
Q

how do you assess pain/nociception in an anesthetized patient? (x4)

A
  • patient conscious response or reflex (anesthetic plane)
  • increased RR
  • increased BP (usually early response)
  • increased HR
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18
Q

allodynia

A

something is painful that didn’t used to be (e.g. sunburn)

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19
Q

chronic pain

A
  • extends beyond expected time to heal, no physiological benefit
  • chronic pain scores include activity level, focus on QOL
20
Q

how does emotion affect pain

A

emotional toll can worsen pain

anxiety, stress, depression, anger, fatigue

21
Q

what is the point of pre-emptive analgesia?

A
  • treat for anticipated level of pain ahead of time

- potentially more effective at managing pain vs. starting after stim has occurred

22
Q

What pre med drugs are often used with pre-emptive sedation and analgesia?

A
  1. alpha 2’s - most common sedative/analgesic for emergencies, drug of choice for EQ
  2. Ace or benzo’s - but no analgesia
  3. Opioids but lots of side effects
  4. NSAID’s
23
Q

NSAID’s and analgesia

A

Most common analgesic in vet med
Can predispose to renal dz, GI ulcers, liver dz
Meloxicam, Robenacoxib in cats
Grapiprant/Galliprant for adult dogs w/ OA

24
Q

drugs often given for systemic analgesia during GA

A

opioids + CRI of fentanyl, ketamine, lidocaine or dexmedetomidine

25
Q

Drugs commonly used for acute pain management (x7)

A 
opioids
alpha 2's
ketamine
lidocaine
NSAID's or steroids
PO - gabapentin, tramadol
26
Q

Behavior drugs that may help w/ pain management

A

anxiolytics
anti-depressants
sleep enhancers
muscle relaxers

27
Q

how do local anesthetic doses differ between dogs and cats?

A

cats more sensitive, need 1/2 to 1/3 of the dose

28
Q

infiltration analgesia

A

most common local anesthesia technique

inject around painful site

29
Q

what are options for longer continuous local infiltration anesthesia?

A

balloon pump + diffusion catheter

nocita/bupivicane - currently dog only, lasts 3-4 days

30
Q

ring block

A

SQ local anesthesia all the way around a limb

not as profound block as nerve block, but good for laceration repair etc.

31
Q 
Bier block
aka IVRA (intravenous regional anesthesia)
A

tourniquet limb, then give IV anesthesia of lidocaine
only limitation is time - tourniquet causing ischemia
also minimizes blood loss

32
Q

local anesthetics MOA

A

block voltage-gated Na channels

stop AP’s and motor func

33
Q

epidural

A

most “global” of local anesthetic techniques
usually local anesthetic + adjuvant like opioids
affects ability to stand/walk and causes urinary retention

34
Q

Common location for an epidural

A

in caudal lumbar or cranial caudal spaces

35
Q

why is lidocaine used in bier block

A

b/c if ineffective tourniquet and anesthetic goes systemic, lidocaine is least cardiotoxic vs. other local anesthetics

36
Q

best pre-med drugs to give for a mitral/tricuspid valve dz dog

A

opioids
benzo’s
+/- anticholinergics - would be helpful for MMV

37
Q

pre-med drugs to avoid for a MVD dog

A

Acepromazine or alpha 2’s

if had to give one, choose Ace b/c it decreases afterload (thus decreases regurge)

38
Q

Options for induction of an MVD dog

A

opioid + benzo (e.g fentanyl + diazepam)
propofol/alfaxalone/etomidate
low dose ketamine

39
Q

How to maintain an MVD dog during anesthesia

A

inhaled anesthetic combine w/ CRI to keep IA at low dose (other wise get vasodilation, decreased contractility)
CRI - fentanyl, lidocaine, or low dose ketamine

40
Q

How would you counter bradycardia/hypotension in a valve dz dog

A

positive inotrope or anticholinergic to increase contractility (need to counter chamber hypertrophy)
NOT vasoconstrictor - will increase afterload, thus regurge

41
Q

T/F it’s ok to give an anticholinergic in at cat w/ HCM

A

False

increased contractility + decreased ventricular size = decreased CO

42
Q

How would you counter bradycardia/hypotension in a HCM cat

A

vasoconstrictor (like phenylephrine) to avoid changing contractility
can use inotrope or anticholinergic to bring up HR

43
Q

pre-med drugs to avoid for a HCM cat

A

Acepromazine or alpha 2’s

if had to give one, choose Dexmedetomidine b/c it decreases HR some (allows for more filling time)

44
Q

Induction commonly used for HCM cats

A

Etomidate b/c minimal CV effects

45
Q

Minimum pre-op workup for a cardiac dz patient

A

PE + auscultation
CBC, Chem
Chest rads
If warranted: ECG, echocardiography (gold standard)

46
Q

What additional drug should you plan for a dog with pulmonary stenosis

A

treatment is ballooning

have antiarrhythmic like lidocaine on board

47
Q

Why is gappirant/galliprant different from other NSAID’s

A

blocks PGEP4, not cox

VM 737 Anesthesia (4 decks)

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