LA Pre-Operative Assessment & Preparation (17)

Question 1

What should you communicate to the client before surgery?

Answer 1

• risks of the surgery itself
• risks of anesthesia
• intra-operative communication
• outcomes
• progress of post-op recovery
• financial decisions
• insurance

Question 2

What do you do before a surgery with the insurance company?

Answer 2

elective: owner needs to call
emergency: veterinarian calls

Question 3

What are the risk factors for large animal anesthesia?

Answer 3

Question 4

What should you do before anesthetizing ANY animal?

Answer 4

owner needs to sign a consent form

Question 5

What should you do about possible surgical outcomes?

Answer 5

communicate all possible negative outcomes to the client before surgery

ask intended use for the horse

Question 7

What are the pre-op risks for surgery - inherent risks vs. variable factors?

Answer 7

inherent: signalment and medical history

variable: primary disease (physical and cardiovascular status), elective vs emergency surgery, extent of procedure

Question 8

At what ages are horses more at risk for surgical complications?

Answer 8

foals <1 year
geriatric >20 years

Question 9

What does emergency surgery increase?

Answer 9

morbidity/mortality

Question 10

What are the types of operative risks?

Answer 10

• increased complexity
• decreased surgeon experience
• increased surgical time
  = increased morbidity and mortality

Question 11

Review ASA - LA

Answer 11

Question 12

What are the pre-operative medications?

Answer 12

• elective vs emergency surgery
• clean vs contaminated procedure
• prophylactic antibiotics if necessary & then started at the start of surgery

Question 13

Review the types of surgery that are considered clean, clean-contaminated, contaminated, and dirty (helps with antibiotic decisions)

Answer 13

Question 14

What are some pre-operative treatments?

Answer 14

Question 15

When do you delay surgery - elective?

Answer 15

• fever, other systemic illness
• abnormal bloodwork
• wound near surgical site
• cardiopulmonary abnormalities

Question 16

When do you delay surgery - emergency?

Answer 16

try to make stable, if possible waiting to do surgery during normal business hours

Question 17

How should you prepare equines for general anesthesia?

Answer 17

• fast overnight
• free choice water
• groom and pick feet
• place jugular catheter

Question 18

How should you prepare ruminants for general anesthesia?

Answer 18

• fast for 24-48 hours (decrease rumen volume to lower regurgitation)
• withhold water for 24 hours

Question 19

How should you prepare camelids for general anesthesia?

Answer 19

• fast overnight
• free choice water
• place jugular catheter

Question 20

When do you do standing surgery?

Answer 20

common in cattle, equine depends on the procedure

cattle: best as an abdominal approach

equine: laparoscopy, enucleations, mass removals

Question 21

What are the types of nerve blocks done in LA surgery?

Answer 21

regional: common in cattle - paravertebral

local: horses or cattle

Question 22

During standing surgery, how should you drape?

Answer 22

movement of the patient is challenging - they can feel the towel clamps

• adherent drapes, glue, duct tape, skin staples

Question 23

What are the characteristics of surgery on a tilt table - cattle?

Answer 23

good restraint for foot/distal limb procedures

sedated or general anesthesia

be fast! - bloat, neuropraxia