Sedation and Anaesthesia of Respiratory Patient

Question 1

A patient in respiratory distress comes in, what is the first thing you should do?

Answer 1

1 - Give supplementary oxygen and monitor closely - DO NOT WALK AWAY
Reduce stress/anxiety in the area
Have multiple ET tubes prepared
Calculate doses specific to each case

Question 2

How is pulmonary function monitored during anaesthesia?

Answer 2

Resp rate/rhythm
Capnograph - ETCO2 (tissue perfusion)
Pulse oximetry - SPO2
Blood bas analysis
Colour of mucous membranes
ECG

Question 3

Common pre-medication protocols for DOGS ASA III-V (Respiratory compromise only)

Answer 3

1 - Low dose dexmedetomidine and opioid (butorphanol if non-painful)
2 - ACP and opioid
3 - Just opioid
4 - Micro dose ACP (good for laryngeal paralysis)

Question 4

What other drugs may be considered for an animal in respiratory distress?

Answer 4

Omeprazole, maropitant, metoclopramide
Xylometazoline to decongest
NSAIDs or paracetamol
Steroid if doing BOAS surgery (dexamethasone reduces swelling)

Question 5

Common pre-medication protocols for CATS ASA III-V (Respiratory compromise only)

Answer 5

1 - ACP and opioid (butorphanol if non-painful)
2 - Dexmedetomidine and opioid (lower ASA scores)
3 - Midazolam and ketamine
4 - Midazolam and alfaxalone and opioid
5 - Opioid alone if very compromised

Question 6

Induction of anaesthesia for ASA III-V

Answer 6

Use as minimal as possible and
administer very slowly
Use alfaxalone instead of propofol
Can use ketamine - bronchodilation

Intubate IMMEDIATELY