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anesthesia rotation notes > Old anesth good to know notes > Flashcards

Old anesth good to know notes Flashcards

1
Q

Anesthetic drugs work at the level of ? to produce reversible CNS depression

A

Spinal cord

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2
Q

Unconscious animals can produce complex movements at the level of the ? or ? when anesth

A

brainstem or spinal cord

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3
Q

T/F pain is a conscious experience therefore anesthetized animals DO NOT feel pain

A

True

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4
Q

What are the ASA stauses?

A

ASA 1- normal healthy p, routine procedure or simple fx
ASA 2- brachycephalic dog, has systemic issue but fully compensated and under control,
ASA 3- serious systemic illness, stable vital signs
ASA 4- involved, hospitalized, serious systemic dz not compensating at all
ASA 5- gonna die like GDV or perf/septic FB

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5
Q

What are some factors increasing MAC???

A

hyperthermia, CNS stimulants, chronic drug use, red hair in humans

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6
Q

Why is the amount of inhalant needed to produce unconsciousnes less than 1/2 the amount needed to produce immobility?

A

Because the primary site of anesthesia to produce immobility is in the SC not the Brain

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7
Q

Low B:G means more or soluble or insoluble in blood?

A

INSOLUBLE

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8
Q

T/F anesthetized p can do respond physiologically and anatomically to noxious stimuli?

A

T

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9
Q

Can noxious stimulation cause movement in unconscious animals?

A

YESSS

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10
Q

deep anesth will decrease what 3 things?

A

will decrease CO, BO, and tissue/organ perfusion

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11
Q

Doppler is ___ but oscillometeric BP is ____

A

indirect; direct

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12
Q

Blood pressure =

A

Q x R
Q is flow and R is resistance

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13
Q

What are normals for adult animals systolic, diastolic, and MAP?

A

Systolic= 100-160
Diastolic= 60-90
MAP= 60-100

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14
Q

Does oscillometric or doppler provide systolic, diastolic, MAP and HR?

A

Oscillometric BP

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15
Q

Doppler only provides _____ valves

A

systolic

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16
Q

Arterial BP =

A

HR x SV x SVR

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17
Q

90% of SpO2 means ___ PaO2

A

60 PaO2

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18
Q

Capnographs are accurate predictors of ____ in ventilated p

A

PCO2

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19
Q

How do we know p is in stage 3?

A

loss of righting reflex

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20
Q

What is a possible cause of VPC’s?

A

Catecholamine release from high stress patient

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21
Q

propofol side effects?

A

Vasodilation/hypotension, bradycardia, impaired baroreceptors (p hypotensive and cannot compensate with increasing HR), decreased RR and TV (apnea)

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22
Q

What is a good premed and induction choice for puppy ASA status 1?

A

Ace + methadone IM, IVC, induce with prop and maintain on Iso and O2

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23
Q

premeds for healthy colt undergoing castration?

A

Premeds Xylazine and torb, induce with ketamine and midazolam IV and maintain on Sevo and O2

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24
Q

What is the best induction for greyhounds?

A

Propofol

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25
Q

T/F Pain is always subjective, unpleasant, detrimental to health and necessitates tx?

A

TRUE

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26
Q

T/F one must be conscious to perceive pain.

A

Trueee

27
Q

What is the main MOA of opioids?

A

bind to opioid receptors and activate anti-nociceptive neurons

28
Q

What is the difference between full agonist opioids and partial agonist opioids??

A

Full agonist opioids- bind to and activate, without ceiling effects
partial agoinst- activates some or all of the receptors, HAS A ceiling effect

29
Q

MAP =
CO =

A

MAP= CO x SVR
CO= HR x SV

30
Q

how can we increase MAP

A

1st- turn down inhalant if p too light
2nd- give IV fluid bolus of crystalloids (25% of 1 blood volume to start)

90 mL dog
60 mL cat

31
Q

use crystalloid bolus to increase ____ and use colloid bolus to increase _____

A

HR; vasculature

32
Q

unlike crystalloids, colloids increase ?

A

plasma oncotic pressure

33
Q

hypertonic saline is most useful in what situation? How does it work and how much do we need?

A

useful in acute hemorrhage; use small volume like 4mL/kg and causes rapid increase in plasma volume by pulling water from interstitial space into the vascular space

BUT INTERSTITIAL SPACE NEEDS TO BE REPLACEDDD

34
Q

What if MAP is low and crystalloid, colloids, and hypertonic saline all do not work??

A

Start inotrope infusion (improves perfusion, may increase MAP by increasing heart contractility)
dobutamine, dopamine are most commone

35
Q

Are iontropes and vasopressors the same thing? How are they different??

A

Intropes are to improve heart contractility whereas vasopressors are used to change the pipe/vessel size

pressors are ephedrine, phenylephrine, vasopressin, norepi, high doses of dopamine

intropes are dobutamine and dopamine

36
Q

The abdomen is filling w blood, what do we do?

A

Maintain circulating volume with quick crystalloid infusion, prolong crystalloid with colloid, blood transfusion if needed

37
Q

Hypoventilation is PaCO2 less than __mmHg
Hypoxemia is SPO2 less than _____; PaCO2 less than ____ mmHg
Hypotension is MAP less than ___ mmHg

A

Hypoventilation is PaCO2 less than 45mmHg
Hypoxemia is SPO2 less than 85-90% PaCO2 less than 60-80 mmHg
Hypotension is MAP less than 60mmHg

38
Q

What is brachycephalic syndrome?

A

Stenotic nares. elongated soft palate, everted laryngeal saccules, hypoplastic trachea, high vagal tone, excessive pharyngeal tissues

39
Q

premeds and induction agents for larpar dog:

A

Ace and torb
Induce with prop

40
Q

___ is better to increase BP than ____ (fluids)

A

Colloids; crystalloids

41
Q

Plan to tx hypotension!! ***

A

Decrease inhalant
give crystalloid bolus (3-10ml/kg) repeat x1 if necessary

then give colloids (5ml/kg) over 5-10 minutes

if that did not help and P DID NOT lose any blood, give a vasopressor (ephedrine. phenylephrine)

42
Q

Avoid ____ (a drug) in Boxer dogs

A

Acepromazine

43
Q

how is the neonatal circulatory system different than adults?

A

low pressure, volume, and peripheral resistance

44
Q

What drug does not have much affect on neonatal p?

A

Atropine (reverse the drug if causing too low of HR)

45
Q

neonatal BP is lower or higher than adults?

A

Lower

46
Q

what are the negative consequences of hypothermia?

A

Bradycardia, decreased CO and BP, prolonged recovery and drugs are not as effective usually

47
Q

Cardiac ____ progressively decreases with older age but ___ stays the same

A

cardiac output; contractility

48
Q

premeds of geriatric p:

A

Opioids +/- low dose ace or benzo
Alpha 2 agonists
low dose ket in cats

49
Q

in heart disease DOGS DO NOT use this drug but can use in CATS with HCM

A

Alpha-2’s

50
Q

T/F all anesthetic meds are nephrotoxic but dexmed is able to protect against AKI (having said this most injectable drugs do not directly affect the kidneys)

A

Trueeee

51
Q

How do inhalant anesth agents acutely affect renal function?

A

no direct effect but indirectly reduces GFR and RBF

52
Q

T/F urine output is normal in anesth. dogs and does not reflect decreased renal profusion

A

T

53
Q

What are the ECG effects of high K+?

A

Brady, atrial standstill, T wave may or may not be large

54
Q

What e’lyte can be administered to counteract K+?

A

calcium salts

55
Q

target MAP around __ of baseline of awake BP in neonatal p

A

80%

56
Q

What do we assess to test the synthesis of liver function? What about regulation?

A

Plasma proteins, coagulation factors, glucose;
urea, BUN, lactate

57
Q

Liver failure may be present w normal liver enzymes, instead what factors will be abn in reduced liver function?

A

Albumin, glucose, BUN, bile acids, coag.

58
Q

what is the main liver test?

A

serum albumin

59
Q

DO NOT use what drug(s) with hepatic encephalopathy?

A

Benzos (mid/diazepam)

60
Q

Anesthetic rules of thumb for p with CV issues–>

A

avoid increased myocardial oxygen demand, avoid fluid overload, maintain adequate oxygen delivery, maintain HR, inotropes are great for poor contractility, do not change cardiac meds suddenly

61
Q

Do not use ___ or ____ or ______ in p with HCM or CHF

A

acepromazine or dissociatives (ketamine in high doses); positive inotropes

62
Q

What are good drugs for p with CV issues?

A

Benzos (mid/diazepam), opioids, local anesth.

63
Q

Good anesthetic plan for DCM p:

A

opioid and benzo
preoxygente
prop or fent or ketamine/diazepam induction

64
Q

Puppy with PDA plan

A

opioid + low dose ace or benzo
anticholinergics to maintain HR
Induction with low dose propofol or ketamine/diazepam
intercostal block with bup

anesthesia rotation notes (7 decks)

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