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REPRO2 > Reproductive Anaesthesia > Flashcards

Reproductive Anaesthesia Flashcards

1
Q

What are the aims of pre-med?

A

Sedation and anxiolysis facilitating handling of the animal
Reduction of the stress for the animal
Reduction the amount of other anaesthetic agents
Provision of a balanced anaesthesia technique
Provision of analgesia
Counter the effects of other anaesthetic agents to be administered during the anaesthesia procedure e.g. atropine to prevent an opioid mediated bradycardia
Contribute to a smooth, quiet recovery after anaesthesia

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2
Q

What are the features of alpha 2 agonists?

A

Profound sedation

Good analgesia

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3
Q

What are some examples of alpha 2 agonists?

A

Xylazine, detomidine and romifine,dexmedetomidine

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4
Q

What is the alpha 2 agonist of choice in small animals?

A

Dexmedetomidine

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5
Q

What is the duration of analgesia of dexmedetomidine (10ug/kg)

A

Aprox 1 hour

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6
Q

What effect do alpha 2 agonists have on ABP?

A

Biphasic effect - inital increase followed by a return to normal or slightly below normal values

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7
Q

What effect do alpha 2 agonists have on HR and CO

A

Decreases HR

Decreases CO

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8
Q

What effect do alpha 2 agonists have on the respiratory system in healthy animals?

A

Minimal effects?

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9
Q

What effect do alpha 3 agonists have on urine production?

A

Increased due to a reduction in vasopressin and renin secretion

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10
Q

What can be used to reverse alpha 2 sedation and analgesia?

A

Atipamezole

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11
Q

What is an example of a phenothiazine?

A

ACP commonenst/ licensed one

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12
Q

What are features of phenothiazines?

A

Dopamine agonist
Sedation and anxiolysis, does not provide analgesia
Less reliable sedation cf dexmedetomidine

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13
Q

What breed of dogs are very sensitive to ACP and thus doses should be <0.01mg/kg?

A

Boxers

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14
Q

What species are phenothaizines contraindicated in?

A

Breeding stallions - can cause paralysis of the retractor penis muscle

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15
Q

What are some examples of benzodiazepines?

A

Midazolam or diazepman

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16
Q

What are the features of benzodiazepines?

A

Produce minimal or no sedation alone in healthy cats and dogs
May cause excitation due to loss of learned inhibitory behaviour

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17
Q

What combination of drugs can be used as a premed in cardiovascular compromised dogs?

A

Benzodiazepines and an opioid.

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18
Q

What is used with benzodiazpines in cats instead of an opioid?

A

Ketamine

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19
Q

What drugs could you use for ASA 1 in dogs?

A

ACP + opioid

Dexmedetomidine + opioid

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20
Q

What drugs could you use for ASA 2 in dogs?

A

ACP + opioid
If ASA 2 is not assigned because of a disease that affects cardiovascular system or liver function-can use dexmedetomidine

21
Q

What drugs can you give to an ASA 1 cat?

A

dexmedetomidine

22
Q

What drugs can you give to an ASA 2 cat?

A

Acepromazine + Opioid
If ASA 2 is not assigned because of a disease that affects cardiovascular system or liver function-can use dexmedetomidine

23
Q

What options are available for inducing anaesthesia?

A

Propofol, alfaxolone, ketamine or zoletil

24
Q

What maintenance options are available?

A

Isoflurane and sevoflurane

25
What are some advantages of ketamine over propofol for induction?
Adds analgesia HR doesn't drop as much Doesn't slow down breathing
26
What does the triple IM combination compose of in cats?
Medetomidine, ketamine + butophanol (or other opioids)
27
What does the quad IM combination compose of?
Medetomidine, ketamine, buprenorphine and midazolam
28
What are some of the cardiovascular physiological changes that are induced by pregnancy
- HR increases - CO increases - Blood volume increases - Plasma volume increases - PCV, TP and Hb decrease - ABP normal - CVP normal but increases during labour
29
What are the complications of HR and CO increases
Hypotension and hypoperfusion
30
What is the complication of plasma volume increases?
Relative anaemia of pregnancy
31
What are the actions that need to be taken to address cardiovascular physiological canges induced by pregnancy?
1. BP monitoring 2. IV fluids - pre, intra and post op 3. Appropriate anaesthesia
32
What are the physiological changes of the respiratory system that are induced ny pregnancy?
- Minute volume increases - O2 consumption iuncreases - pH and PaO2 normal - PaCO2 decreases - Total lung and vital capacity normal - FRC decreases
33
What is the complication of a increase in minute volume?
Respiratory alkalosis
34
What is a consequence of FRC decrease?
Atelectasis
35
What are some actions that need to be carried out to reduce complications of the respiratory system?
- Be prepared to IPPV/ventilate if decrease in resp rate - pre-oxygenate - oxygen supplemntation during surgery - intermittent sighs to prevent atelactasis - pay vigilant attention to anaesthetic depth
36
What are some of the gastrointestinal physiological alteration induced by pregnancy?
1. Gastric emptying time delayed 2. Intragastric pressure increased 3. Oesophageal sphincter tone decreased 4. Gastrin levels increased 5. Gastric motility is decreased 6. BUN and creatnine decreased
37
What is a complication of increased intragastric pressure and oesophgeal sphincter tone decreased?
Regurg and aspiration on induction or recovery causing aspiration pneumonia with increased pulmonary damage
38
What actions can be done to prevent complications of the gastrointestinal system induced by pregnancy?
1. Rapid induction technique and protection of airway 2. Anti-emtic prophylatic 3. Epidural anaesthesia 4. Extubate when laryngeal reflexes presnt 5. Cuff tube 6. Keep pressure over larynx 7. Keep head elevated
39
What are the progesterone and metabolities physiological changes that are induced by pregnancy?
Increased
40
What are the epidural and CSF volume physiological changes that are induced by pregnancy?
Decreased
41
What are the complications of increased P4 and metabolites?
Anaesthetic overdose more likely as they are positive allosteric modulators of GABA receptors
42
What are the complications of large gravid uterus?
Compression of vena cava, hypoventilation, hypotension Increases gastrin  lowered pH Reduced lung volumes Increased risk of regurg and aspiration during induction or recovery Increased pulmonary damage following accidental aspiration
43
Why should you avoid constant rate infusions in the pregnant animal?
A CRI or administration of an inhalant results in continuous transfer of the drug and accumulates in the fetus
44
What are some actions that need to be carried out when performing a C section?
Choose drugs with a short duration of action Choose drugs with specific antagonists (if poss) Use the lowest possible dose (parturients need less 30-60%) Provide oxygen and intubate if GA Use local anaesthetics if possible to reduce MAC & provide analgesia Monitor ABP, administer fluids
45
What drugs should you avoid when doing a C section?
Benzodiazepines - causes fetal depression
46
Why should the pregnanct mare be tilted off the midline for the C section?
Reduces pressure of the gravid uterus on the vena cava, hence BP monitoring essential
47
How do you prepare a bitch for a c section?
1. IV access 2. Fluid therapy - Hartmann's (twice maintenance) 3. Pre-oxygenate 4. Analgesia- opioids and NSAIDs (if not hypovolaemic) 5. Theatre preparation
48
Why is Nitrous oxide not indicated in a c section?
MAC really high | puppies can get diffusion hypoxia
49
What do you do as part of the resuscitation team if a pup is not as vigorous as anticipated?
1. Oxygen 2. Vigorous rubbing 3. Intubate 4. Clear airways 5. Naloxone under tongue 6. Dopram ?

REPRO2 (31 decks)

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