Lecture 29: Peri-anesthesia Monitoring and Complications-II Flashcards
To evaluate HR under anesthesia it is very important to first know the ___
Resting heart rate of each patient
What is resting HR for large dogs under anesthesia
35-100bpm
What is resting HR for medium dogs under anesthesia
50-120bpm
What is resting HR for small dogs under anesthesia
80-150
What is resting heart rate for cats under anesthesia
90-160
What is resting HR for horses under anesthesia
25-45
If severely bradycardia or arrhythmia how long do you count to get accurate HR
20-30 seconds
What does ECG tell you
Only electrical signal not the function
What is the first monitoring equipment you place
Capnograph and/or pulse ox
What is the standard lead for small animals and where is it placed
Lead 2- placed between right arm and left leg
What is the standard lead for horses and cows
Base-apex lead
What is the deflection direction if traveling from - to +
Positive
What is deflection direction if traveling from + to -
Negative
Which animals is a negative deflection QRS normal for
cows, horses, and birds
T or F: you treat all arrhythmias
False
What is the most common arrhythmia under anesthesia
Sinus bradycardia
What is sinus bradycardia for cats under anesthesia
<90bpm
What is sinus bradycardia for small dogs (except dachshunds) under anesthesia
<80-100bpm
What is sinus bradycardia for medium dogs and mini dachshunds
<50-80bpm
What is sinus bradycardia for large dogs
<35-50bpm
Identify the arrhythmia
sinus bradycardia
What are the causes of sinus bradycardia
- Vagal
- Non-vagal
What are the vagal causes of sinus bradycardia
Anesthetic, opioids, sedatives, hypothermia, abdomen, neck, eye manipulation
What are the non-vagal causes of sinus bradycardia
- Cardiac dz
- Endocrine dz
- Neurological dz
- Electrolyte abnormality
- Beta-blocker, Ca2+ channel blocker
When do you treat sinus bradycardia
If hypotension or very young
Why do you need to treat sinus bradycardia in very young animals
They have a fixed SV (CO=SV xHR) so if decrease HR, decrease CO which will then decrease BP (BP=CO xSVR)
What is the treatment for sinus bradycardia that applies to both causes
- Decrease inhalant
What is tx for vagal bradycardia
- Atropine
- Glycopyrolate
Anticholinergics
Atropine or glycopyrolate: most likely causes tachycardia
Atropine
Atropine or glycopyrolate: increase HR to high normal
Glyco
Which is not used for emergencies: atropine or glycopyrolate
Glyco
Why do you not want to use alpha 2 agonists with anticholinergics within 1hr of each other
Alpha 2 agonists will vasoconstrict and anticholinergics will increase HR—> increase resistance and workload on heart and can lead to cardiac arrest
You give dexmedetomidine, how long do you have to wait to give atropine?
60 minutes
T or F: anticholinergics can cause paradoxical bradycardia and/or AV block
True
T or F: paradoxical bradycardia likely resolves on own in few minutes
True