Introduction to anaesthesia

Question 1

Compare general anaesthesia to local anaesthesia

Answer 1

GA: total lack of sensations
LA: lack of sensation in localised part of body

Question 2

Define general anaesthesia

Answer 2

State of unconsciousness produced by process of controlled, reversible intoxication of CNS, whereby patient neither perceives nor recalls noxious stimuli

Question 3

What is balanced anaesthesia?

Answer 3

Achieving desired components of anaesthetic by using multiple drugs which allows more conservative dose for each drug, thus reducing side effects

additional factor involved in reducing drug doses is reducing patient-stress

Question 4

What is the triad of anaesthesia?

Answer 4

*becoming outdated

Question 5

What is the myriad of anaesthesia?

Answer 5

Question 6

what are the 3 anaesthetic events?

Answer 6

Induction, maintenance & recovery

Relative importance of each component depends on patient & procedural factors

Question 7

What are the 3 steps in drug decision-making?

Answer 7

1. know your patient
2. know the procedure
3. know drugs

Question 8

Fill in the table on balanced anaesthesia

Answer 8

Question 9

Apart from survival, what else are we striving for in successful anaesthesia?

Answer 9

Normal physiology
Minimal loss of temperature
Minimal pain
Good organ function
Bp maintained
Less cardiovascular depression
Less cerebral hypoxia
Less dysrhythmias

Question 10

What affects risk?

Answer 10

Question 11

What are some important considerations & what can you do about them to reduce risk?

Answer 11

Question 12

Why are checklists important?

Answer 12

One of many tools that help identify areas for improvement

Often updated following clinical audit

Thus using checklists, reduces risk

Question 13

What is clinical auditing

Answer 13

Process that examines current practice to identify problems & instigate improvement

Question 14

How do you prepare owners as part of patient preparation

Answer 14

Ensure consent form & explain procedure & risks

ID patient

Make sure they know to withhold food if required

Give them toilet opportunity before procedure

Make sure they are clean

Question 15

How long should the following fast before routine procedures:

1. Adult dog
2. Adult cat
3. Kittens & puppies
4. Rabbits
5. Horses

Answer 15

1. Adult dog: 4-6h
2. Adult cat: 3-4h
3. Kittens & puppies: 1-2h
4. Rabbits (& most small furries): NO FASTING (can interfere with GI tract & result in gut stasis (ileus) = life threatening)
5. Horses: depends on procedure & positioning of horse

Question 16

What are the risks of not fasting?

Answer 16

Gastro-oesophageal reflux (GOR) (movement of gastric contents into oesophagus) caused by relaxation of oesophageal sphincter

can result in oesophagitis, oesophageal stricture & regurgitation which puts patient at risk of aspiration pneumonia

In horses also post-operative colic

Question 17

Why is it important to take a patients temperament into consideration?

Answer 17

May influence drug/dose choices

Reduce stress as much as possible

Question 18

What is ASA classification

Answer 18

ASA (American Society of Anesthesiologists) Classification assesses animal’s physical status before anesthesia

Can be subjective

Question 19

What questions should you ask yourself when choosing drugs

Answer 19