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Anesthesiology > Recovery > Flashcards

Recovery Flashcards

1
Q

Small animal extubation

A
  1. Sternal recumbancy
  2. Ensure clean airway
  3. Deflate cuff and remove after cough or swallow
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2
Q

What should be done if regurge has occurred?

A
  1. Position the head lower
  2. Swab the pharynx
  3. Remove ET tube with cuff inflated (deflate a small amount if needed)
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3
Q

Small animal recovery monitor

A

Continue physiologic monitoring until sternal and upright

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4
Q

Small animal supportive care

A

Continue to use warming to maintain body temp and stimulate as needed to increase level of consciousness

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5
Q

Common recovery complications

A
  • Pain
  • Dysphoria
  • Hypo-hyperthermia
  • Hypoventilation
  • Hypoxemia
  • Prolonged recovery
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6
Q

Recognizing pain

A

1 TPR changes

  1. Vocalization
  2. Posture/gait
  3. Interaction with caregivers
  4. Guarding of painful site
  5. behavior change
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7
Q

Consequences of pain

A
  1. Increased cardiac work load
  2. Hypo or hyper ventilation, hypoxemia
  3. Ileus
  4. Oliguria
  5. Risk of thromboembolism
  6. Impaired immune function
  7. Anxiety or fear
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8
Q

Should pain level be anticipated and treated based on procedure?

A

Yes

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9
Q

What will a dysphoric patient become with additional opioids?

A

More distressed

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10
Q

What will a painful patient become with additional opioids?

A

Quiet

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11
Q

What are some considerations when differentiating pain from dysphoria?

A
  1. What analgesics have been administered?
  2. What kind of procedure??
  3. Patient temperament and breed
  4. Surgical site pain
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12
Q

Strategies to differentiate pain from dysphoria?

A
  1. Short acting opioids (worse or better?)
  2. Alpha-2 agonists
  3. Acepromazine
  4. Benzodiazepine
  5. Opioid antagonist (butorphenol good)
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13
Q

Consequences of short term hypothermia

A

Increased O2 demand
Prolonged recovery
Discomfort

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14
Q

Consequences of long term hypothermia

A

Delayed healing

Infections

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15
Q

Hyperthermia causes

A

Opioid use in cats, MRI with obese furry dogs

Can reverse if severe

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16
Q

Treatment of hypoventilation

A

delay extubation and continue IPPV as needed
Clear airway
Reverse drugs

17
Q

Treatment of hypoxemia

A
  1. Address underlying cause
  2. Position properly
  3. Warming
  4. O2 support (increased FiO2)
18
Q

Causes of prolonged recovery

A
  1. Hypothermia
  2. Hypotension
  3. Hypoglycemia
  4. Electrolyte derangement
  5. Anemia
  6. Hypoventilation.hypoxemia
  7. Drugs
  8. Neurologic disease
19
Q

Treatments of prolonged recovery

A

Address underlying cause before reversing analgesic drugs

20
Q

Equine recovery

A

Most dangerous time for equine anesthesia

Potential for injury of horse or personnel

21
Q

Types of recovery

A

Free recovery- short procedures or dangerous horses

Assisted recovery- long procedures or unstable patients, orthopedic disease

22
Q

Types of assisted recovery

A

Personnel on hand, ropes inside/outside recovery stall, Sling recovery, pool recovery

23
Q

Equine sedatives

A

Recovery from triple drip usually uneventful

Need sedative to recovery from gas anesthesia- Alpha-2 agonist +/- acepromazine

24
Q

What should be used to control pain in equines?

A

NSAIDS
Alpha-2 agonists
Butorphanol (visceral)
Morphine/meperidine (somatic pain)

25
Q

Equine hypothermia

A

Maintain body temp through procedure so that there is no nead to warm during recovery

26
Q

Is hypoxemia common during equine recovery?

A

Yes, supplemental O2 recommended to required for all equine patients via tube or nasal flow by

27
Q

Airway obstruction in equine recovery

A

Check for nasal edema before recovery, apply intranasal phenylephrine

28
Q

Equine weakness recovery

A

Hypocalcemia, hypokalemia, hypoglycemia, anemia- can lead to fatal injury

Check bloodwork prior to recovery and correct disturbances

29
Q

Rhabdomyolysis myopathy

A

Horses muscle injury secondary to hypoperfusion- hard muscles, sweating, tembling, myoglobinuria, pain

Tx: fluids analgesics

30
Q

Ruminant recovery

A

Do not try to stand prior to ready
Regurg +/- aspiration and bloat are common complications
Maintain sternal recumbency
Delayed extubation and keep cuff inflated
Pass stomach tube to relieve gas bloat

Anesthesiology (27 decks)

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