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Induction and Maintenance Agents > Induction and Maintenance > Flashcards

Induction and Maintenance Flashcards

1
Q

What two general anaesthesia can be divided into?

A
  • Intravenous

- Inhalational

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2
Q

Why is it important to monitoring?

A

To understand the nature of the drugs and to try avoid complications from occurring.

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3
Q

What 7 things to consider for an anaesthetic?

A
  • Species & Breed
  • Age & Health
  • Temperament
  • Facilities Available
  • Skill of the anaesthetist & surgeon
  • Post op considerations
  • Duration of operation
  • Nature of operation.
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4
Q

When is injectable anaesthetic agents used ?

A
  • Induction of anaesthesia
  • Supplement to inhalation anaesthesia when additional rapid control is required.
  • Sole anaesthetic agent for short periods
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5
Q

Adv of using injectable anaesthesia?

A
  • Simple technique
  • Minimal apparatus required/needed.
  • Rapid onset of anaesthesia
  • Non-irritant to the airways.
  • No explosion or pollution hazards
  • Rapid deepening if required.
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6
Q

Disadv of using injectable anaesthesia?

A
  • Superficial veins may be difficult to locate
  • Struggle during administration
  • Once administered, it cannot be withdrawn.
  • Possible apnoea on injection.
  • Unsuitable for major surgery.
  • Agents may be cumulative
  • Agents may be irritant if given perivascularly.
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7
Q

What to consider when administering IV catheter?

A
  • Good restraint and technique
  • Rapid response
  • Useful in emergency situations
  • May be the only route
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8
Q

What to consider when administering IM injection?

A
  • Certain drugs may not be absorbed.

- 3 times that of an IV dose is required.

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9
Q

Why are IV agents administered directly into the vein?

A

To pass rapidly to the brain as it has a very rich blood supply.

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10
Q

What happens when concentration of drug is high?

A

If high enough, there is a loss of consciousness and the drug then travels to other organs.

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11
Q

Most injectable anaesthetic drugs are metabolised by the liver, true or false?

A

True

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12
Q

What is the process of metabolising drugs?

A
  • Converts lipids into water soluble molecules.
  • Excreted easily in Bile
  • Exit the body via urine and faeces.
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13
Q

Name 3 Barbiturates drugs?

A
  • Thiopentone Sodium (Thio)
  • Methohexitone Sodium (Breital)
  • Pentobarbitone Sodium (Pentojet, Saggital).
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14
Q

Why are Barbiturates rarely used?

A
  • Cumulative so top-ups result in prolonged recovery.
  • Tremors and shaking on recovery.
    Readily absorbed into fat - recycling of drugs occurs.
  • Highly alkaline - skin sloughing if given perivascular
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15
Q

What clinical uses involve Barbiturates drugs?

A
  • involve seizure control (Phenobarbitone)

- Euthanasia (Pentobarbitone)

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16
Q

What is Alphaxalone/Alphadolone (Saffan)?

A

These 2 steriods are insoluble in water & are dissolved in the solvent cremephor EL

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17
Q

What does Alphaxalone cause?

A

Causes histamine release in dogs which causes severe hypotension, this agent is therefore not safe to use with dogs.

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18
Q

What is Alphaxalone solvent responsible for?

A
  • Causing the mild anaphylactic reactions seen in cats which are usually not problematic unless laryngeal/pulmonary oedema occurs.
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19
Q

Name 7 properties of Alfaxan.

A
  • Admin IV or deep IM
  • Common in premeds
  • Can be used in Dogs
  • Wide safety margin
  • Good muscle relaxation
  • Must be discarded at the end of the day, once used.
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20
Q

Name 5 properties of Propofol.

A
  • Milky, white water soluble phenol.
  • Good bacteria media
  • Toxic in cats!
  • Reduce pain on IV inj
  • Open Ampoules/bottles must be discarded after 24hrs.
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21
Q

What 4-5 properties of Phenol Anaesthetic?

A
  • Short acting & rapid duration, only 2-3 mins

- Causes dose dependant CV depression and apnoea!

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22
Q

What is the most important thing not to do while giving phenol anaesthetic?

A

DO NOT ADMINISTER AS A RAPID BOLUS!!!!!

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23
Q

What is Phenol Anaesthetic good for?

A
  • Animals are conscious 30 mins after a single IV injection - so good for C- SECTION
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24
Q

What are the properties of Ketamine?

A
  • This agent induces a state of almost total analgesia combined with superficial sleep.
  • Can be used in reptiles & birds on its own to produce sedation.
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25
Q

What occurs in dog & cats when using ketamine?

A

It will produce muscle rigidity making surgery impossible.

26
Q

What can be combined, when using Ketamine?

A

Combined with Domitor or Benzodiazepines to relax muscles.

27
Q

How can Ketamine be administered?

A
  • Give either IV or IM route - some transmucosal absorption.
  • Slow acting.
28
Q

What are the adv for injectable anaesthesia?

A
  • Provides rapid onset and good conditions for intubation.
29
Q

How can anaesthesia be maintained?

A
  • Can be achieved by top up doses or IV fluids.
30
Q

What considerations be in place before administering agent?

A

Depends on patient consideration, the procedure performed, equipment available & cost.

31
Q

What 2 rapid metabolised agents used?

A
  • Alfaxan

- Propofol

32
Q

What 2 Slow metabolised agents used?

A
  • Pentojet

- Ketamine

33
Q

What are inhalational Agents?

A

These agents can be used to induce anaesthesia, but are generally used to maintain anaesthesia.

34
Q

Name a gaseous agent.

A

NO2 - Nitrous Oxide

35
Q

Name 3 Volatile Agents?

A
  • Halothane
  • Isoflurane
  • Sevoflurane
36
Q

What are Chamber anaesthesia?

A

A closed space that can be filled rapidly with volatile agent, to ensure a smooth induction.

37
Q

What species if Chamber anaesthesia used in?

A

“Small Furries”

38
Q

How should a Chamber anaesthesia be filled?

A

Should be filled from the bottom.

39
Q

How long is induction using a chamber anaesthesia?

A

Induction is generally complete in 2-3 minutes.

40
Q

What consideration is in place when using Chamber induction?

A
  • Recovery is rapid, therefore for longer procedures anaesthesia may need to be maintained via a face mask.
41
Q

Why is it risky using a chamber to induce?

A

Health and safety risks are greatly increased with the use of either mask or chamber induction.

42
Q

What is the main adv to use inhalational agents?

A

That the animal is intubated enabling a protecting airway.

43
Q

What are the Pharmacokinetics of inhalational agents?

A
  • Gases pass into the lungs
  • Then diffuses into the pulmonary circulation.
  • Then travels around the body & is distributed to the tissues.
  • Then diffuses back into the blood stream and be eliminated from the lungs.
44
Q

What gases carry the volatile agents into the lungs?

A
  • Oxygen
  • Nitrous Oxide
  • Carbon dioxide
45
Q

What 3 properties of Oxygen are there?

A
  • Supplied in black cylinders with a white neck..
  • Heavier than air and strongly supports combustion
  • Colourless and Odourless.
46
Q

What 3 properties of Carbon Dioxide are there?

A
  • Supplied in Grey cylinders.
  • Not commonly used
  • But useful to stimulate respiration.
47
Q

What 4 properties of Nitrous Oxide are there?

A
  • Supplied in Blue cylinders
  • Weak anaesthetic, but potent analgesic
  • Delivered at 50:50 or 2:1 with Oxygen.
  • 2nd Gas effect - enhances effect of both gas and volatile agent.
48
Q

What are volatile agents ?

A

Describes the liquid anaesthetics that are vaporised into gases, the inhalation of which produces anaesthesia.

49
Q

What is required when using volatile agents? (equipment)

A

A vaporiser is a device that adds volatile agent to a carrier gas at a specific temperature.

50
Q

Name two properties of Halothane?

A
  • Catecholamine sensitive

- Malignant Hyperthermia

51
Q

Name 2 properties of Isoflurane?

A
  • Smells, so breath holding common.

- Resp depression, hypotensive, arrhythmia.

52
Q

Name 2 properties of Sevoflurane.

A
  • Only licensed in Dogs, non-irritant.

- Resp depressant and hypotensive.

53
Q

Name a properties of Desflurane.

A

Human use only

54
Q

What does MAC stand for?

A

Minimum Alveolar Concentration

55
Q

What is MAC?

A

This is the lowest concentration that produces no response in 50% of the patients exposed to painful stimuli.

56
Q

What is the “Calculations” of MAC?

A

1 X MAC = Light Anaesthesia
1.5 X MAC = Surgical Anaesthesia
2 x MAC = Deep Anaesthesia

57
Q

What is BGS (Blood)?

A

Blood Gas Solubility?

58
Q

Why is BGS measured?

A

Is a measure of the distribution of the inhalational agent between the blood and gas phases within the body.

59
Q

What does it mean having a low solubility ?

A

An agent with low solubility tends to remain in the gas phase in the alveoli/blood - it is carried more readily to the brain resulting in a rapid induction.

60
Q

What does low solubility mean?

A

Low solubility = rapid induction/recovery.

61
Q

What are the MAC/BGS of volatile agents?

A 
Halothane = MAC 0.87 BGS 2.5 
Isoflurane = MAC 1.2 BGS 1.5 
Sevoflurane = MAC 2.3 BGS 0.63
62
Q

Name 4 properties of Inhalational Anaesthetics (summary)?

A
  • Inhalational anaesthesia requires more equipment than injectable.
  • Recoveries tent to be faster after prolonged procedures.
  • A provision of oxygen is present - IPPV if needed.
  • Isoflurane is the most widely used agent.

Induction and Maintenance Agents (1 decks)

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