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23 spring anesthesia > Test 2: 18 recovery > Flashcards

Test 2: 18 recovery Flashcards

1
Q

when does recovery end

A

achievement of an ambulatory, alert, normothermic state

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2
Q

recovery plan should consider what aspects

A

Species
* Personality of the animal
* Age
* Co-morbidities
* Procedure and duration of anesthesia
* Elective vs. emergency procedure

Recovery planning begins when you prepare for a case and develop your anesthetic protocol

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3
Q

steps of recovery

A
  • Discontinuation of all anesthetic drugs
  • Transportation the patient to a dedicated area for monitoring
  • Positioning of the animal into normal position
  • Oxygen supplementation
  • Drug administration
    • Cardiovascular support
    • Reversal agents
    • Sedatives
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4
Q

what stage of anesthesia is most frequent for complications

A

recovery

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5
Q

overall goal of anesthetic recovery is to minimize — and create a safe and — environment

A

risk of complication development

quiet

patient monitoring and re-assessment

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6
Q

Goals of anesthetic recovery
* Overall: Minimize risk of complication development
* Maintain — function
* Restore and/or maintain normal —
* Assess pain and provide —

A

cardiovascular, respiratory and ventilatory

body temperature

analgesia

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7
Q

what equipment might you need during recovery

A

O2 supplementation
thermal support- bear hugger
emergency supplies: airway, CPR drugs, re-induction agents

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8
Q

— can be used to reduce environmental pollution and occupational exposure

A

scavenging (F/air canisters)

horses can’t be left attached to anesthesia machine, only O2

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9
Q

patient monitoring post op should include re-assessment of

A
  • Cardiovascular system
  • Respiratory system
  • Temperature
  • Neuro/mental
  • Pain
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10
Q

how to re-assess CV system during recovery

A

Physical examination
* Mucous membrane color + CRT
* Heart rate and rhythm (EKG)
* Pulse quality

Additional monitoring devices
* Blood pressure: Doppler, NIBP
* Lactate measurements

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11
Q

respiratory compromise during post op can be caused by

A
  • Pain
  • Diaphragmatic/respiratory muscular dysfunction
  • Muscular weakness
  • Residual pharmacologic effects
  • Patient position

If not recognized, conditions can be fatal

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12
Q

how to monitor respiratory system post op

A

monitoring oxygenation

  • pulse ox
  • arterial blood gas analysis

monitoring ventilation

  • respiratory effort and pattern
  • listen
  • capnography
  • arterial blood gas analysis
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13
Q

when to extubate

A

airway protected
* minimize aspriation/obtruction
* prevent endotracheal tube foreign body

depends on species and pt

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14
Q

how to flush system after procedure

A
  • Disconnect patient from breathing circuit
  • Occlude patient end of the circuit
  • Empty the reservoir bag into the scavenge system
  • Flush O2 through the system
  • Do not press flush valve when small patient is attached to the system
  • Reconnect system to the patient for continued O2 delivery
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15
Q

horses are provided post op O2 by

A

nasotracheal tube

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16
Q

forms of heat loss during anesthesia

A
  • Radiation (majority)
  • Convection
  • Evaporation
  • Respiration
17
Q

Hypothermia impairs — and suppresses — function

A

coagulation

immune

18
Q

hypothermia prolongs — and shivering increases —

A

recovery
oxygen consumption

19
Q

panting from hyperthermia can cause

A

increased work of breathing

20
Q

hyperthermia is associated with what drugs in cats

A

opioids

21
Q

— is a potentially fatal condition when pts become too warm

A

malignant hyperthermia

digs, pigs, horses

22
Q

what are some neurologic complications associated with anesthesia

A
  • Blindness
  • Thromboembolic event
  • Seizures

uncommon but potentially life-threatening

23
Q

If no signs of pain at surgical site but patient is still showing signs of discomfort, consider other source:

A
  • Full bladder
  • Constipation
  • Orthopedic pain from positioning during surgery
  • Other pre-existing source of pain (OA, pancreatitis)
24
Q

acute and fluctuating alteration of mental state of reduced awareness and disturbance of attention

A

Postoperative delirium

25
Q

profound state of unease due to extreme agitation and anxiety

A

Dysphoria

26
Q

what are some things that might indicate pt will have dysphoria during recovery

A
  • pt anxious or agitated preop
  • some species/breeds (huskies and sighthounds)
  • high doses of opioids
  • older pts
27
Q

what are some drugs you can give to prevent dysphoria

A
  • Alpha-2 agonist (dex, xylazine) (small dose) → administered prophylactically
  • Propofol titration (small dose)→ may need to Re-intubate
  • Acepromazine
  • Trazodone

you can also reverse drugs → keep in mind if you reverse opioid, you also reverse pain relief

28
Q

how to reverse opioid

A

Small doses of naloxone or butorphanol can be titrated

29
Q

how to decide pain vs dysphoria

A

can give analgesic
* if they get better it was pain
* if they get worse →dysphoria, can give reversal to try to fix

30
Q

what are some complications of post op nausea and vomiting

A
  • Aspiration pneumonia
  • Esophagitis, esophageal
    stricture
  • Sinusitis
31
Q

what to do if pt regurgitates when intubated

A

maintain anesthesia:
* Ensure ETT cuff is inflated properly
* Suction mouth and esophagus
* Sinus/nares lavage with warm water
* Extubate with cuff inflated or partially inflated (not recommended for cats)

32
Q

what is important during handoff of pt

A

communication

all medications administered

23 spring anesthesia (40 decks)

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