SA anesthesia recovery

Question 1

feline larynx considerations, how to deal with this

Answer 1

Larynx is Sensitive – prone to Laryngospasm
¢ More reactive airway (cats, rats, swine and rabbits)
¢ DO NOT intubate when too light
¢ Lidocaine spray used before attempt may blunt spasm
* But cat must be deep enough to spray

Question 2

do not touch what structure with laryngoscope

Answer 2

¢ Use laryngoscope - DO NOT touch epiglottis

Question 3

Prevent Laryngospasm in cats by:

Answer 3

¡ Appropriate depth during induction
¡ Gentle handling of tissues (don’t stretch too much)
¡ Topical lidocaine spray on larynx
÷ Ensure depth adequate before spray
¡ Not touching epiglottis with laryngoscope

Question 4

For cat:
Signs of too light on induction that mean stop trying and give additional drug:

Answer 4

÷ Cough
÷ Tongue curl
÷ Movement
÷ Lateral palpebral returns while intubating

Question 5

dogs who should be sedated for recovery

Answer 5

— Very anxious, or bad will benefit from sedation
- acepromazine
> If premed is dexmedetomidine the sedation is gone in recovery
and any dog personality will benefit from ace sedation
- dexmedetomidine in an aggressive animal

Question 6

if we are going to give additional sedation for recovery for dogs, when do we do so?

Answer 6

Additional sedation given once animal turned off inhalant and signs of recovery starting – slight medial
¡ Sedation may prolong recovery in dog

Question 7

Recovery Phase – Sedation in Recovery for cats
- when do we give?

Answer 7

• Acepromazine prior to turning animal off inhalant
  ¡ Elective cases
  ¡ Prevent dysphoria with opioid administration
  <><><>
  Dexmedetomidine 1-2 mcg/kg, IV can also be
  given in fractious cat prior to extubation
  ¡ Wait until animal off inhalant generally and slight medial obvious
  ¡ Or give once extubated if animal becoming excited or dysphoric
  ¡ Acepromazine might have already been given
  > no concerns mixing them

Question 8

Recovery Phase- Timeline

Answer 8

1. Assess depth on transfer table once in lateral
   ¡ Due to movement time, don’t expect to be able to turn inhalant <1.5% in cat;< 1% dog in elective cases
2. Back in induction room - Assess patients oral cavity ensure no evidence of reflux
   ¡ More likely to have in a Big dog > cat
3. Turn inhalant off, turn oxygen flow up if circle
   ¡ 100-150 mls/kg/min if circle – Bain 150-200 mls/kg/min
   ¡ Bain may already be high flow no need to adjust
4. Untie gauze and ensure it is not caught in teeth
5. Locate cuff syringe
6. Monitor for signs for extubation

Question 9

Recovery Phase- Canine Extubation

Answer 9

• Medial palpebral noted, put animal on room air
  ¡ Approx 8-10 minutes will elapse from turning ISO off
  <><>
  STRONG medial palpebral
  ¡ Talk to dog and you will see eye rotate up and look at you as
  strong medial returns
  ¡ Dog close to swallow with strong medial so deflate cuff then as remove tube dog will swallow
  ¡ May see swallow prior to extubation
  ÷ Otherwise moving the tube with a strong medial induces the
  swallow reflex in the dog
  ¡ May also see dogs stretch move legs or head and at this stage you can remove ET tube and they will swallow if they have not already

Question 10

Recovery Phase - Feline Extubation

Answer 10

• Once there is a slight medial palpebral then animal can be disconnected from anesthetic machine - on room air
• Ensure your ET tube gauze tie is pulled forward and not caught in the teeth
• ET tube cuff can be deflated now
   As you disconnect from machine and slightly move the ET tube it is typical to have induced a stronger medial palpebral
• Extubate when medial palpebral noted and consistent
  > This will induce tongue curl or cough
• Extubate for sure if you see tongue curl/movement
  § Look also for ear flick, whisker reflex however this can be hard to induce in some cats until after extubation