Post-anesthetic Period Flashcards
Prevent hypothermia
bear huggers. Heating pads can burn
Put _____ on horse hooves to help traction when they wake up
elasticon
What to do when anesthetizing camellids?
keep head above body
keep intubated until they chew tube
Procedure for waking from anesthesia?
- turn off inhalant
- if normothermic, inc. oxygen flow will help them wake faster
- take off fluids unless there’s a reason to keep
- keep attached to breathing circuit until spontaneous respiration
- disconnect end tidal CO2 monitor form breathing circuit
- when patient swallows, deflate cuff and extubate
What do we do differently with horses regarding inhalant concentration?
titrate down during surgery as much as possible
how do we combat nasal edema in horses (obligate nasal breathers)
phenylephrine solution in the nose
When to extubate horses?
doctor preference
- tape it in place while they stand up
- extubate before hand as long as phenylephrine has been in the nose for at least 15 minutes
- extubate but add a naso-tracheal tube for recovery (less likely to kink)
After horse is breathing spontaneously?
give sedative (romifidine or xylazine) smooths the transition
look for ______ after surgery (horses)
horizontal nystagmus, like vertigo, dangerous to stand up with one
Once theyre standing check for
bilateral nasal flow
Apnea after you’ve extubated?
re-intubate, ventilate, discontinue any drugs (naloxone can treat narcotic OD)
airway obstructed after you’ve extubated?
re-intubate, ventilate, use suction, if all fails evaluate for tracheal collapse and treat medically (B agonist steroid or butyrol)
Last resort is
Tracheotomy
pleural space disease?
pulmonary edema?
thoracocentesis
furosemide, steroids, oxygen
hypothermia
<98 F
prolongs recovery and increases oxygen demand, increases clotting time
Risk of regurgitation (gastroesophageal reflux)
- alpha 2 adrenergic agonists and opioids both slow GI motility
- prokinetics (metachlopramide) or histamine blockers (decrease gastric acidity) can be used
- keep ET tube in and suction the pharynx until clear
Delayed return of consciousness?
- perform PE
- check bloodwork (hypoglycemia in puppies!)
- give fluids
- oxygen supplementation
- reverse alpha 2s, benzodiazepines, opioids
- flip patient, heat
emergence dysphoria
harsh vocalization after extubating, hard to differentiate with pain, can give opioid bolus to r/o pain
horses can get ______ after surgery.
tx?
Radial nervopathy
- splint leg, give banamine, takes time
usually euthanize if they cant stand post-surgery
