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Anesthesia > Swine Anesthesia > Flashcards

Swine Anesthesia Flashcards

1
Q

How are anesthetic agents used in swine?

A

off label

(extra-label use of drugs permitted when animal health is threatened, per FARAD)

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2
Q

How are large pigs typically handled?

A

don’t typically tolerate physical restraint (LOUD) - chute, sling, boards

  • forking may make them lay down and relax
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3
Q

What 5 conditions are pigs susceptible to under anesthesia? How are their respiratory systems especially affected?

A
  1. ventricular arrhythmias
  2. vasospams - challenging to intubate, put lidocaine on larynx
  3. decreased FRC
  4. increased V/Q mismatch
  5. hypoventilation, hypoxemia
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4
Q

What should the ventilator pressure be set at for pigs? Why?

A

no more than 22 cm H2O pressure

lungs are especially susceptible to damage

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5
Q

How are pigs fasted prior to an anesthetic event?

A
  • 6-12 hour fast
  • free access to water until sedation
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6
Q

What is the most common mode of administration of premeds and sedation in pigs? What are the 4 most common combinations?

A

IM —> pigs do not tolerate the handling necessary for IV

  1. Ketamine + Xylazine + Midazolam
  2. Ketamine + Xylazine + Butorphanol
  3. Ketamine + Midazolam
  4. Ketamine + Acepromazine
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7
Q

What alpha-agonist is most commonly used for premedication in pigs? What kind of dose do they tolerate? What side effect is seen?

A

Xylazine - not typically effective sedation if used alone

higher doses compared to other farm animals

vomiting

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8
Q

What is the most common opioid used in premedication in pigs? How do pigs typically respond? Which ones are avoided?

A

Butorphanol - less sensitive to opioids

Morphine, Fentanyl, Hydromorphone - causes excitement and respiratory depression

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9
Q

What family of drugs provide the most reliable sedation in pigs?

A

benzodiazepines (Midazolam)

  • no distribution
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10
Q

What access is used for induction in pigs? What drugs are most commonly used?

A

ear veins

  • propofol*
  • ketamine*
  • alfaxalone
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11
Q

How can smaller pet pigs be induced when there is poor venous access? What are the 2 main categories of maintenance?

A

inhalant induction

  1. inhalants
  2. CRIs of ketamine, lidocaine, midazolam, alpha-2 agonists, fentanyl, or combinations
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12
Q

What 3 things make intubating pigs difficult? What is required to make it easier?

A
  1. pigs are nasal breathers
  2. soft palate is anterior to the epiglottis
  3. pigs have a blind pouch in the pharynx - pharyngeal diverticulum

angling of the ETT

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13
Q

How are pigs intubated?

A
  • ensure the patient is at the adequate depth and place in dorsal or sternal recumbency
  • apply 2% lidocaine to the arytenoids
  • use ETT size up to 16 mm and special long laryngoscope blades
  • use ETCO2 to confirm placement

smaller pigs are more challenging

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14
Q

What causes malignant hyperthermia? What breeds of pigs are susceptible? Less susceptible?

A

stress/anesthesia causes Ca to be released into the sarcoplasmic reticulum and a mutation of ryanodine receptors impedes homeostasis = generalized skeletal muscle contraction

Pietrain, Poland China, Landrace

Large White, Yorkshire, Hampshire

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15
Q

What are the most common clinical signs associated with malignant hyperthermia?

A
  • hyperthermia
  • muscle rigidity
  • tachypnea, rising ETCO2
  • arrhythmias, tachycardia
  • metabolic acidosis
  • myoglobinuria, renal failure
  • death
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16
Q

What are the 3 main triggers of malignant hyperthermia?

A
  1. stress
  2. halogenated anesthetics - Iso, Sevo
  3. depolarizing neuromuscular blocking drugs - succinylcholine
17
Q

What are the main 2 purposes of using neuromuscular blocking agents? What is important to note about their action?

A
  1. ophthalmologic procedures, like phacoemulsification of cataracts that require complete stillness of the eyes
  2. orthopedic procedures

paralyze the patient, but do no provide anesthesia or analgesia

18
Q

What is the main depolarizing neuromuscular blocking agent used in veterinary medicine? How does it work?

A

succinylcholine

binds to postsynaptic cholinergic receptors on the motor endplate and causes rapid depolarization, fasciculation, and flaccid paralysis within 1 min, lasting 7-15 mins

19
Q

What are the 2 classes of non-depolarizing neuromuscular blocking agents? How do they work?

A
  1. steroidal - Rocuronium, Vecuronium, Pancuronium
  2. benzylisoquinoline - Mivacurium, Atracurium, Cisatracurium

competitive ACh antagonists that bind directly to nicotinic receptors on postsynaptic membrane, blocking ACh binding and depolarization of the endplate = muscular paralysis

20
Q

What monitoring is recommended when using neuromuscular blocking agents?

A

train-of-four stimulation where consecutive 2Hz stimuli are applied to nerve innervating a muscle group and TOF ratio indicates recovery of blockade

21
Q

What reversal is used for neuromuscular blocking agents? Why must it carefully be used? What can be added to increase safety?

A

neostigmine (anticholinesterase)

indiscriminate —> can have cardiac effects that lead to profound untreatable bradycardia

pretreatment with glycopyrrolate (anticholinergic)

22
Q

What monitoring is most commonly used in swine patients? Where is an arterial line commonly placed?

A

ECG, SpO2, BP, ETCO2 —> hypoventilation, hypoxemia, hypotension, hypothermia, bradycardia, tachyarrhythmias

auricular artery (IBP)

23
Q

What depth signs are the best indicators for swine anesthetic depth?

A
  • jaw tone* - chewing = too light
  • palpebral reflexes
24
Q

Why must pigs be carefully ventilated?

A

peak inspiratory pressure must remain low due to fragility of lungs

  • helps treat decreased FRC, atelectasis, and increased V/Q mismatch
25
Q

What 4 forms of analgesia are recommended in pigs?

A
  1. epidurals, local/line blocks
  2. IM, SQ, or transdermal Buprenorphine
  3. Fentanyl CRI or patch
  4. NSAIDs - Ketoprofen, Phenylbutazone, Flunixin, Carprofen**
26
Q

What must be monitored in pigs recovering from anesthesia? What commonly causes slow recovery?

A
  • ventilation
  • pig remaining sternal with head up until extubation

hypothermia

27
Q

How can smaller and larger pigs be carefully recovered?

A

swaddle in a towel/blanket until able to stand

assist to stand as needed

(padding!)

28
Q

What are the 3 most easily observed signs of malignant hyperthermia?

A
  1. hyperthermia
  2. hypercarbia
  3. muscular rigidity

(can pretreat with Dantrolene, but $$$)

Anesthesia (40 decks)

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