L8: Post-op Anesthesia Care (Gatson)

Question 1

objective of recovery

Answer 1

stabilize the patient as they transition from surgical depth of anesthesia to a conscious state

Question 2

recovery area for large animal

Answer 2

• down leg pulled forward to avoid radial n. paralysis
• cover eyes to decrease stimulus from light source
• often don’t extubate horses until standing

Question 3

what to monitor for SA in recovery

Answer 3

RR
BP
RR
ETCO2 (end tidal CO2)
mm color
SPO2
temp

Question 4

takes horses longer than SA to wake up from anesthesia

Answer 4

T

Question 5

neo-synephrine spray

Answer 5

used to open up nasal passages and dec. chance of post-op obstruction (since horses obligate nasal breathers

Question 6

usually give sedative in post-op period to horses to make smoother transition into consciousness

Answer 6

:)

Question 7

monitoring horses in recover

Answer 7

HR
RR
mm color
anesthetic depth

Question 8

horses commonly develop horizontal nystagmus when emerging from anesthesia

Answer 8

(when slows down, horse getting closer to standing up)

Question 9

complication of pool recovery

Answer 9

pulmonary edema

Question 10

ventilatory complications

Answer 10

apnea
airway obstruction
hypoventilation (monitor for by monitoring pulse oximeter)
pleural space disease
pulmonary dz

Question 11

what to do if patient apneic

Answer 11

• first check pulse
• intubate p again, then ventilate
• may need to reverse p

Question 12

CS of airway obstruction

Answer 12

INTUBATED:
-high Peak Inspiratory Pressure (PIP) to expand chest
-absence of EtCO2 despite mechanical ventilation
-cyanosis
EXTUBATED:
-stridor
-dyspnea
-chest movement w/o air movement
-cyanosis

Question 13

EtCO2

Answer 13

end tidal CO2; lvl of CO2 released at end of expiration

Question 14

causes of airway obstruction

Answer 14

• kinking of E-tube
• obstruction of E-tube (mucous, blood, aspiration)
• endobronchial intubation
• airway edema
• broncho/laryngospasm
• obstruction of airway
• collapsing trachea
• laryngeal paralysis

Question 15

what to do when airway obstructed and p intubated

Answer 15

• intubate and ventilate again

- give drugs to stimulate breathing

Question 16

what to do when airway obstructed and p extubated

Answer 16

1) provide oxygen
2) intubate if not enough and ventilate
3) emergency tracheostomy

Question 17

tx of pleural space/pulmonary disease

Answer 17

• ascult thorax (will be difficult to hear airway sounds if pneumothorax, pleural effusion)
• supplement oxygen
• pleural space dz: thoracocentesis
• pulmonary edema: give furosemide, steroids

Question 18

CS of CV complications

Answer 18

weak pulses
tachycardia/bradycardia
CRT >3s
cold extremities
cyanosis/hypoxemia
pale mm
hypotension

Question 19

tx of CV complications

Answer 19

1) provide oxygen
2) fluids (crystalloids, colloids, blood)
3) +/- BP meds (ie. dopamine)
4) try to reverse p with dexmedetomidine (sp?)

Question 20

hypothermia below what temp in dogs

Answer 20

98 F

Question 21

hypothermia increases/decreases oxygen demand

Answer 21

increases

Question 22

causes of delayed return of consciousness

Answer 22

• drug overdose/residual drug effect
• deep plane of anesthesia
• hypothermia
• hypoglycemia
• hypotension
• dec. drug metabolism
• CNS dz
• hypoventilation

Question 23

tx of delayed return of consciousness

Answer 23

• PE
• check bloodwork, esp. blood glucose
• supportive fluids
• provide flow of oxygen
• give partial reversal dose
• stimulation

Question 24

sedative has synergistic effect with opioid

Answer 24

:)

Question 25

negative effects of pain

Answer 25

• inc. CO
• inc. myocardial oxygen consumption
• delayed healing
• hypoventilation
• ileus
• water retention
• excitation