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Anaesthesia > Monitoring Anaesthesia > Flashcards

Monitoring Anaesthesia Flashcards

1
Q

What are the aims of monitoring anaesthesia?

A
  • Providing appropriate depth of anaesthesia for the procedure (Keep them asleep)
  • Maintain normal physiological function of the patient (Keep them alive)
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2
Q

What 6 things do we monitor to assess cardiovascular function?

A
  • HR and rhythm
  • Pulse quality and BP
  • CRT
  • MM colour
  • Hb Saturation
  • Perfusion
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3
Q

What are the normal values for HR in dogs and cats

A
  • Dog: 70-140bpm

- Cat: 100-200bpm

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4
Q

What must we consider when assessing HR in patients under GA?

A

That some drugs may affect HR e.g. alpha 2s can cause bradycardia

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5
Q

What does a stethoscope measure?

A

Monitors heart rhythm and rate, valve function and contractility

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6
Q

What a sinus arrhythmia?

A

Normal variation in HR that occurs during respiration- the pulse is ‘regularly irregular’
During inspiration, the HR increases
During expiration, the HR decreases

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7
Q

What 2 ways can we measure pulse quality (BP)

A

Indirect

Direct

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8
Q

What are the 3 indirect ways to measure BP

A
  • Palpation of an artery
  • Oscillo-tonometry - pneumatic cuff around limb
  • Ultrasonic - doppler
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9
Q

How can BP be measured directly?

A

Transducer inserted via intra-arterial catheter

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10
Q

What is normal CRT

A

<2 seconds

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11
Q

What can cause a delayed CRT?

A

Hypotension
Vasoconstriction
Haemorrhage or unable to maintain CO

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12
Q

What does very bright pink MM mean?

A

Hypercapnia (excess CO2)

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13
Q

What does blue MM mean?

A

Cyanosis- inadequate Hb saturation

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14
Q

What does white MM mean?

A

Hypotension, blood loss, anaemia

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15
Q

What is petechiation?

A

Clotting problems

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16
Q

If an animal has septicaemia, what colour will the MM be?

A

Brown/ red

17
Q

How can Hb saturation be measured?

A

Using a pulse oximeter.

It uses a red infrared light beams to detect the presence of oxygenated arterial blood.

18
Q

What is perfusion?

A

The passage of blood through the capillary bed of the tissues

19
Q

How can perfusion be measured?

A
  • pulse oximeter
  • CRT
  • Visible signs of blood at surgical site
  • Core: Peripheral Temperature difference
  • Urine output of >1mls/kg/hr
20
Q

How can the CNS function be monitored during GA?

A
  • Cranial Nerve Reflexes
  • Rate and Pattern of respiration (controlled by the pons and the medulla oblongata)
  • Autonomic responses ( action of smooth muscle and cardiac muscle)
  • Skeletal muscle tone and response to toe pinching
21
Q

Describe some Cranial Nerve Reflexes

A
  1. Palpebral reflex - should be absent once surgical plane reached
  2. Jaw Tone - should be loose
  3. Eye position - reliable unless had a muscle relaxant or ketamine. Central at induction, rolls ventromedial as anaesthesia deepens, then back to central
  4. Pupil diameter - constrict light; dilate deep
  5. Salivation - profuse in inadequate anaesthesia
22
Q

What is the normal respiratory rate of dogs and cats?

A

Dog: 10-30bpm
Cat: 20-30bpm

23
Q

What is the normal respiratory rate of dogs and cats under anaesthesia?

A

Dog: 8-30bpm
Cat: 20-30bpm

24
Q

What is the lowest RR that is safe in dogs ?

A

8 breaths per minute

25
Q

What are the autonomic responses?

A

HR, BP, Pupil diameter, CRT

26
Q

Apart from your eyes, what ways can we monitor respiratory function?

A

Wright’s respirometer - placed in the circuit and records minute volume
Pulse oximeter - measure oxygenation
Ap alert
Capnograph - small tube placed between ET tube and circuit

27
Q

What does a Capnograph measure?

A

Measures exhaled CO2 (measures the partial pressure of CO2 levels in the patients arterioles which correlates well with the level of Co2 in the blood )
Useful to detect hypoventilation and circuit problems

Anaesthesia (15 decks)

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