Introduction to Anesthesia Ch.1 Objectives Flashcards
List two North American professional organizations that offer specialization in anesthesia and analgesia to credentialed individuals, and summarize the aims of each.
The Academy of Veterinary Technicians in Anesthesia and Analgesia (AVTAA), recognized in 1999 by the National Association of Veterinary Technicians in America–Committee on Veterinary Technician Specialties (NAVTA-CVTS), offers specialization to credentialed veterinary technicians with an interest in veterinary anesthesia and analgesia, through completion of an arduous set of requirements that demonstrates competency in the advanced practice of anesthesia and analgesia.
American College of Veterinary Anesthesia and Analgesia (ACVAA), (formerly known as the American College of Veterinary Anesthesiologists [ACVA]), recognized by the American Veterinary Medical Association (AVMA) in 1975, offers specialization to credentialed veterinarians.
Define Anesthesia
The term anesthesia (derived from the Greek word anaisthesia which means “without feeling” or “insensibility”) may be defined as “a loss of sensation.”
Define Topical Anesthesia
Topical anesthesia is the loss of sensation of a localized area produced by administration of a local anesthetic directly to a body surface or to a surgical or traumatic wound.
Define Local Anesthesia
Local anesthesia refers to loss of sensation in a small area of the body produced by administration of a local anesthetic agent in proximity to the area of interest.
Define Regional Anesthesia
Larger areas can be targeted by use of regional anesthesia, which refers to a loss of sensation in a limited area of the body produced by administration of a local anesthetic or other agent in proximity to sensory nerves. Regional anesthesia can be produced with a variety of techniques including nerve blocks and epidural anesthesia.
Define General Anesthesia
General anesthesia may be defined as a reversible state of unconsciousness, immobility, muscle relaxation, and loss of sensation throughout the entire body produced by administration of one or more anesthetic agents. While under general anesthesia, a patient cannot be aroused even with painful stimulation. For this reason, general anesthesia is commonly used to prepare patients for surgery or other acutely painful procedures.
Define Surgical Anesthesia
Surgical anesthesia is a specific stage of general anesthesia in which there is a sufficient degree of analgesia (a loss of sensitivity to pain) and muscle relaxation to allow surgery to be performed without patient pain or movement.
Define Sedation
Sedation refers to drug-induced CNS depression and drowsiness that vary in intensity from light to deep. A sedated patient generally is minimally aware or unaware of its surroundings but can be aroused by noxious stimulation.
Define Tranquilization
Tranquilization is a drug-induced state of calm in which the patient is reluctant to move and is aware of but unconcerned about its surroundings. Although the terms tranquilization and sedation are not exactly the same in meaning, they are often used interchangeably.
Define Hypnosis
Hypnosis is a drug-induced sleeplike state that impairs the ability of the patient to respond appropriately to stimuli. This meaning of this term is somewhat imprecise, as it is used to describe various degrees of CNS depression. In this text, hypnosis will be used to mean a sleeplike state from which the patient can be aroused with sufficient stimulation.
Define Narcosis
The term narcosis refers to a drug-induced sleep from which the patient is not easily aroused and that is most often associated with the administration of narcotics.
Explain the concept of balanced anesthesia and the advantages of this approach.
When anesthetics are administered, it is common practice to administer multiple drugs concurrently in smaller quantities than would be required if each were given alone. This technique, termed balanced anesthesia, maximizes the benefits of each drug, minimizes adverse effects, and gives the anesthetist the ability to produce anesthesia with the degree of CNS depression, muscle relaxation, analgesia, and immobilization appropriate for the patient and the procedure. Premedication with acepromazine, anesthetic induction with a combination of ketamine and diazepam, maintenance with isoflurane, and administration of a morphine and lidocaine infusion for analgesia is one example of balanced anesthesia.
List common indications for anesthesia.
Anesthesia is used daily in most veterinary practices to provide sedation, tranquilization, immobility, muscle relaxation, unconsciousness, and pain control for a diverse range of indications. Ex: Palpebral response, jaw/anal tone, muscle stiffness, ocular depth, otoscopic response
Describe fundamental challenges and risks associated with anesthesia.
Most anesthetic agents have a very narrow therapeutic index, so the consequences of a calculation or administration error may be serious. Therefore care and attention to detail are critical when dosages are calculated and rates of administration are adjusted.
* Most anesthetic agents cause significant changes in cardiovascular and pulmonary function (e.g., decreased cardiac output, respiratory rate, tidal volume, and blood pressure), which can be dangerous or lethal if not carefully assessed and managed. These changes often occur quickly and without much warning. Consequently, vital signs and indicators of anesthetic depth must be closely monitored.
* The anesthetist must accurately interpret a wide spectrum of visual, tactile, and auditory information from the patient, anesthetic equipment, and monitoring devices. To do this successfully, he or she must be able to assess rapidly multiple pieces of information and distinguish those that require action from those that do not.
* The anesthetist must have a comprehensive understanding of the significance of physical parameters (e.g., heart rate, respiratory rate, and reflex responses) and machine-generated data (e.g., blood pressure and oxygen saturation readings). The anesthetist must also be able to use his or her knowledge to make rapid and decisive judgments regarding patient management and to carry out corrective actions quickly and effectively.
* The potential for patient harm during administration of anesthetics is relatively high when compared with many other procedures. When serious anesthetic accidents occur, they are often devastating not only for the patient, but also for the client and the anesthetist. In addition, after an accident, clients may choose to pursue legal action or file a complaint with the state veterinary medical board if they feel negligence was involved.
List the qualities and abilities of a successful veterinary anesthetist.
The anesthetist must approach any anesthetic procedure with a genuine willingness to take personal responsibility for the well-being of the patient.
Ultimately, competence and confidence are acquired only with much study, practice, persistence, an attitude of caring, and a dedication to excellence. Only then can the accomplished anesthetist use his or her skills and knowledge to protect and improve the life of each and every patient in a way that is infinitely gratifying and unique to this complex and challenging discipline.
