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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
Q

What are some advantages of ketamine over propofol for induction?

A

Adds analgesia
HR doesn’t drop as much
Doesn’t slow down breathing

26
Q

What does the triple IM combination compose of in cats?

A

Medetomidine, ketamine + butophanol (or other opioids)

27
Q

What does the quad IM combination compose of?

A

Medetomidine, ketamine, buprenorphine and midazolam

28
Q

What are some of the cardiovascular physiological changes that are induced by pregnancy

A
  • HR increases
  • CO increases
  • Blood volume increases
  • Plasma volume increases
  • PCV, TP and Hb decrease
  • ABP normal
  • CVP normal but increases during labour
29
Q

What are the complications of HR and CO increases

A

Hypotension and hypoperfusion

30
Q

What is the complication of plasma volume increases?

A

Relative anaemia of pregnancy

31
Q

What are the actions that need to be taken to address cardiovascular physiological canges induced by pregnancy?

A
  1. BP monitoring
  2. IV fluids - pre, intra and post op
  3. Appropriate anaesthesia
32
Q

What are the physiological changes of the respiratory system that are induced ny pregnancy?

A
  • Minute volume increases
  • O2 consumption iuncreases
  • pH and PaO2 normal
  • PaCO2 decreases
  • Total lung and vital capacity normal
  • FRC decreases
33
Q

What is the complication of a increase in minute volume?

A

Respiratory alkalosis

34
Q

What is a consequence of FRC decrease?

A

Atelectasis

35
Q

What are some actions that need to be carried out to reduce complications of the respiratory system?

A
  • 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
Q

What are some of the gastrointestinal physiological alteration induced by pregnancy?

A
  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
Q

What is a complication of increased intragastric pressure and oesophgeal sphincter tone decreased?

A

Regurg and aspiration on induction or recovery causing aspiration pneumonia with increased pulmonary damage

38
Q

What actions can be done to prevent complications of the gastrointestinal system induced by pregnancy?

A
  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
Q

What are the progesterone and metabolities physiological changes that are induced by pregnancy?

A

Increased

40
Q

What are the epidural and CSF volume physiological changes that are induced by pregnancy?

A

Decreased

41
Q

What are the complications of increased P4 and metabolites?

A

Anaesthetic overdose more likely as they are positive allosteric modulators of GABA receptors

42
Q

What are the complications of large gravid uterus?

A

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
Q

Why should you avoid constant rate infusions in the pregnant animal?

A

A CRI or administration of an inhalant results in continuous transfer of the drug and accumulates in the fetus

44
Q

What are some actions that need to be carried out when performing a C section?

A

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
Q

What drugs should you avoid when doing a C section?

A

Benzodiazepines - causes fetal depression

46
Q

Why should the pregnanct mare be tilted off the midline for the C section?

A

Reduces pressure of the gravid uterus on the vena cava, hence BP monitoring essential

47
Q

How do you prepare a bitch for a c section?

A
  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
Q

Why is Nitrous oxide not indicated in a c section?

A

MAC really high

puppies can get diffusion hypoxia

49
Q

What do you do as part of the resuscitation team if a pup is not as vigorous as anticipated?

A
  1. Oxygen
  2. Vigorous rubbing
  3. Intubate
  4. Clear airways
  5. Naloxone under tongue
  6. Dopram ?

REPRO2 (31 decks)

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