post op check

Question 1

post op observations

Answer 1

record on anaesthetic record/hospitalisation sheet

every 5-10 mins until fully conscious

• heart rate
  -RR
  -MM Colour
• Temp
• time 02 was switched off
• extubation time
• time to sitting
• time to standing
• food offered
  -food eaten
• urination/defecation
• IV line patent
  -IVFT

Question 2

Pain management

Answer 2

intervene at 5/20 or 6/24 dependent upon scale

• discuss with the veterinary surgeon in charge of the case
• pain score at regular intervals on recovery - very patient dependent
• provide holistic pain management

Question 3

what is analgesia

Answer 3

loss of sensation of pain that results from an interruption in the nervous system pathway between sense organ and brain.

Question 4

analgesia terminology

Answer 4

Noiception - processing of noxious stimuli, such as tissue injury and temp extremes

pain pathway - pain pathway starts with noxious stimuli that may be mechanical, thermal, chemical, inflammatory, or tissue damage.

pre - emptive analgesia - the concept of diminishing postoperative pain by disrupting pain pathways pre - operatively

multi - modal analgesia - the use of more than one pharmacological class of analgesic medication targeting different receptors along the pain pathway with the goal of improving analgesia while reducing individual class - related side effects

Question 5

Opioids

Answer 5

• methadone
  -buprenorphine
• morphine
  fentanyl
• pethidin

Question 6

NSAIDs

Answer 6

-meloxicam
- carprofen
- robennacoxib
-firocoxib
-grapiprant

Question 7

Alpha - 2 - agonists

Answer 7

• Medetomidine
• dexmedetomidine
• xylazine
• bupivacaine
• ropivacaine

Question 8

Local

Answer 8

• Bupivacaine
  -lidocaine
• ropivacaine

Question 9

Shock

Answer 9

a clinical syndrome in which the circulation progressively deteriorates and ultimately results in vital organs being deprived of a goof blood flow, leading to widespread organ failure… and death.

or

a state of acute circulatory collapse where the circulation is unable to transport sufficient oxygen to meet the tissue needs

Question 10

Classification of shock

Answer 10

hypovolaemic shock -
results from a reduction in the circulating intravascular volume

cardiogenic shock - due to the inhability of the heart to pump efficiently

distributive shock - due to excessive vasodilation, vascular volume has not changed

Question 11

hypovalemic shock

Answer 11

causes
- haemorrhage
- burns
- neoplasia
- severe dehydration
- 3rd space fluid loss

Question 12

physiology of hypovolaemic shock

Answer 12

loss of blood pressure which increase in stroke

vasoconstriciton

rerouting blood to vital organs temp increase blood pressure for short term as coping method but need to replace fluid or blood pressure will reduce again

cardiac output pumps 70% of blood volume in one beat

Question 13

Hypovolaemic shock - treatment

Answer 13

• consider overload
• consider preventing managing further loss
• fluid replacement

Question 14

cardiogenic shock

Answer 14

causes - most commonly seen in degenerative conditions of heart muscles e.g. dilated cardiomyopathy, or in severe arrhythmias

treatment - depends on treating underlying heart disease. IVFT contraindicated in case as no loss of circulating volume

clinical signs -
may depends on nature of heart disease but include heart murmurs, irregular pulses and tachycardia or bradycardia

Question 15

Distributive shock

Answer 15

types and causes
- anaphlactic

• septic/ endotoxic

clinical signs
- tachycardia
- poor pulse quality
- red MM
- CRT initially rapid, progressing to slow
- reduced blood pressure
- warm extremeties blood

Treatment
- rapid identification and treatment of the underlying cause with medical or surgical intervention