Ortho/Spinal Anaesthesia Flashcards
what are the main anaesthesia considerations for elective orthopaedic surgery?
often otherwise healthy - examine carefully regardless
procedures are painful
surgery often takes a long time, imaging often required before/after/during
patient positioning important - care not to exacerbate OA
temperature management important in scopes
which blocks can be useful during orthopaedic procedures?
femoral and sciatic nerve blocks
what anaesthetic considerations might we have for a facial trauma case?
intubation issues - debris in pharynx analgesia important, pharyngostomy intubation
difficulty monitoring due to lack of access to face
extubation - equipment prepared for re-intubation
post-op nutrition (tube) and fluid therapy
how many people are required for pharyngostomy intubation?
at least 3 - one for positioning of tube, one to manipulate head, surgeon to make cut for tube
what is important to remember about anaesthesia for MRI?
no metal object should be taken into scanner - monitoring equipment, metal in/on staff or patient
monitoring anaesthesia can be challenging
what issues might arise during anaesthesia for MRI?
noisy environment - rousing
remote monitoring can be temperamental
cold, air-conditioned environment - hypothermia
contrast admin can result in hypotension and lightening of anaesthesia
if magnet ‘quenched’ in an emergency, the helium released can result in a hypoxic environment
what anaesthetic considerations should we have during myelography?
care flexing neck - ET tube easily kinked/compressed
risk of seizures due to injection of contrast - most commonly after cisternal myelography during recovery
how can we reduce risk of seizure after constrast injection during myelography?
keep head elevated
close monitoring during recovery period
what do we need to consider during intubation for spinal surgery?
positioning may be different - lateral/dorsal, especially care if there is cervical instability
what should we be aware of if a ‘head down’ position (or patient taping) is required for spinal surgery?
ventilation may be compromised
potential for kinking of ET tube
nasal oedema if nose lower than body
in which animals should extra care be taken with a ‘head down’ position during surgery?
obligate nasal breathers - head down position can cause nasal oedema and block nasal passages
why is there potential for haemorrhage in spinal surgery?
bleeding sometimes comes from vessels which are not easily ligated
why is there potential for problems with ventilation during spinal surgery?
if head down position
surgery involving innervation to the diaphragm
why might we see body twitches during spinal surgery?
they are reflex twitches during direct nerve stimulation - independent of anaesthetic depth
when might bradycardia occur during anaesthesia for spinal surgery?
vagal stimulation during surgery around the neck
