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Pharmacology II > Lecture 28: Peri-Anesthesia Monitoring and Complications-1 > Flashcards

Lecture 28: Peri-Anesthesia Monitoring and Complications-1 Flashcards

1
Q

What is the % anesthetic related deaths in dogs with ASA 1-2 and 3-5

A

ASA 1-2: 0.05%
ASA 3-5: 1.33%

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2
Q

What is % anesthetic related death in cats with ASA 1-2 and 3-5

A

ASA 1-2: 0.11%
ASA 3-5: 1.4%

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3
Q

What is % anesthetic related death in horses for elective cases and colics

A

Elective cases: 0.63-0.96%
Colics: 1.6-11.7%

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4
Q

What are some important components for patient preparation for anesthesia

A

Fasting, stabilization, hydration, medications to give or not to give, understanding patients status

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5
Q

What is the most important part of anesthesia

A

Monitoring

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6
Q

When during anesthesia do the highest mortality rates occur (2)

A
  1. During maintenance
  2. First 3hrs post anesthesia
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7
Q

What is the key to maintaining good anesthetic depth

A

Balance between degree of stimulation and pain management provided

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8
Q

What is the preferred depth of anesthesia when good analgesia is provided

A

Lighter medium

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9
Q

What is the goal of maintaining a good depth of anesthesia

A
  1. Comfortable- not painful and stressed
  2. Immobilized and hypnotized
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10
Q

What is anesthesia

A

A drug induced loss of consciousness during which patients are not arousable even by painful stimulation

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11
Q

What are the 4 stages of anesthesia

A
  1. Stage 1- disorientation
  2. Stage 2- excitation/delirium
  3. Surgical anesthesia with subplanes 1(light), 2 (medium), 3 (deep)
  4. Stage IV- extreme CNS depression
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12
Q

What are the preferred stages for surgical anesthesia

A

Stage 3- substages 1-2

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13
Q

Describe the reaction to surgical stimulus, jaw tone, palpebral reflex, eye position, HR and RR during stage 3 light anesthesia

A
  1. +/- reaction to sx stimuli
  2. Slightly tensed jaw
  3. Present palpebral
  4. Eyes central
  5. Increase HR and RR
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14
Q

Describe the reaction to surgical stimulus, jaw tone, palpebral reflex, eye position, HR and RR during stage 3 medium anesthesia

A
  1. Absent reaction to sx stimuli
  2. Relaxed jaw
  3. Absent palpebral
  4. Eyes medioventral
  5. Decrease HR and RR
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15
Q

Where are the eyes of dogs, cats, ruminants and pigs during stage 3, plane 2 (medium)

A

Medioventral

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16
Q

Where are horses eyes in stage 3/plane 2 (medium) depth

A

Stay center, may “rove”

17
Q

Indicate the anesthetic depth in A-F

A

A. Awake
B. Light (III-1)
C. Lighter medium (III-1.5)
D. Medium III-2
E. Deep III-3
F. IV- too deep- central and pupils dilated

18
Q

What sign can be seen in horses eyes that are too light

A

Nystagmus

19
Q

If you see nystagmus in anesthetized horse what do you do

A

Given injectable anesthetic immediately

20
Q

Are horses eyes open or closed during SIII-P2 or deeper

A

Wide open

21
Q

Why do you not keep touching eye repeatedly to assess palpebral reflex

A

Desensitization

22
Q

At what stage should palpebral reflex disappear

A

Stage III-plane II

23
Q

T of F: you should always keep corneal reflex present

A

True

24
Q

At what stage does corneal reflex disappear

A

Stage IV- too deep

25
Q

What species tear/ lacrimation in lighter depths

A

Horses

26
Q

What species is jaw tone useful vs not useful for

A

Small animals, not able to assess in horses and cattle (always tight)

27
Q

What procedures is assessing anal tone useful for

A

Head or neck- because eye and jaw signs might be unavailable

28
Q

How should anal tone be in a medium plane

A

Relaxed, reflex absent

29
Q

What muscles/ tone can be evaluated in large animals

A
  1. Neck muscles
  2. Eyelid tones
30
Q

What is the most sensitive physiological parameter that changes first with inappropriate depth and/ or analgesia

A

Respiratory pattern/rate

31
Q

If HR and RR increase together what is depth of horse

A

Light/feeling pain

32
Q

What are some appropriate response if patient is a LITTLE lighter than ideal

A
  1. Given some deep breaths
  2. More analgesic- if painful and MAC sparing effect
  3. Increase vaporizer setting by 0.25%
33
Q

When increase vaporizer setting to increase depth, what is max % change at a time

A

0.25% or less

34
Q

How long do you wait for changes to occur after increasing vaporizer %

A

At least 5 minutes

35
Q

If patient is way too light- moving limbs, head, nystagmus (horse) what do you do

A
  1. Give IV anesthetic (propofol, ketamine, alfaxalone)
  2. Add more analgesic
  3. Increase vaporizer by 0.25%
36
Q

What is dose for propofol and ketamine if patient is getting way too light

A

1mg/kg IV

37
Q

What is the dose for alfaxalone if patient is getting way too light

A

0.5mg/kg IV

38
Q

If patient is really waking up what do you need to do

A

Grab the muzzle to avoid extra action and protect the endotracheal tube

Pharmacology II (36 decks)

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