Post-anesthetic Period

Question 1

Prevent hypothermia

Answer 1

bear huggers. Heating pads can burn

Question 2

Put _____ on horse hooves to help traction when they wake up

Answer 2

elasticon

Question 3

What to do when anesthetizing camellids?

Answer 3

keep head above body

keep intubated until they chew tube

Question 4

Procedure for waking from anesthesia?

Answer 4

1. turn off inhalant
2. if normothermic, inc. oxygen flow will help them wake faster
3. take off fluids unless there’s a reason to keep
4. keep attached to breathing circuit until spontaneous respiration
5. disconnect end tidal CO2 monitor form breathing circuit
6. when patient swallows, deflate cuff and extubate

Question 5

What do we do differently with horses regarding inhalant concentration?

Answer 5

titrate down during surgery as much as possible

Question 6

how do we combat nasal edema in horses (obligate nasal breathers)

Answer 6

phenylephrine solution in the nose

Question 7

When to extubate horses?

Answer 7

doctor preference

1. tape it in place while they stand up
2. extubate before hand as long as phenylephrine has been in the nose for at least 15 minutes
3. extubate but add a naso-tracheal tube for recovery (less likely to kink)

Question 8

After horse is breathing spontaneously?

Answer 8

give sedative (romifidine or xylazine) smooths the transition

Question 9

look for ______ after surgery (horses)

Answer 9

horizontal nystagmus, like vertigo, dangerous to stand up with one

Question 10

Once theyre standing check for

Answer 10

bilateral nasal flow

Question 11

Apnea after you’ve extubated?

Answer 11

re-intubate, ventilate, discontinue any drugs (naloxone can treat narcotic OD)

Question 12

airway obstructed after you’ve extubated?

Answer 12

re-intubate, ventilate, use suction, if all fails evaluate for tracheal collapse and treat medically (B agonist steroid or butyrol)

Question 13

Last resort is

Answer 13

Tracheotomy

Question 14

pleural space disease?

pulmonary edema?

Answer 14

thoracocentesis

furosemide, steroids, oxygen

Question 15

hypothermia

Answer 15

<98 F

prolongs recovery and increases oxygen demand, increases clotting time

Question 16

Risk of regurgitation (gastroesophageal reflux)

Answer 16

• 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

Question 17

Delayed return of consciousness?

Answer 17

1. perform PE
2. check bloodwork (hypoglycemia in puppies!)
3. give fluids
4. oxygen supplementation
5. reverse alpha 2s, benzodiazepines, opioids
6. flip patient, heat

Question 18

emergence dysphoria

Answer 18

harsh vocalization after extubating, hard to differentiate with pain, can give opioid bolus to r/o pain

Question 19

horses can get ______ after surgery.

tx?

Answer 19

Radial nervopathy
- splint leg, give banamine, takes time
usually euthanize if they cant stand post-surgery