Test 2: 19 case discussion

Question 1

Midway through the procedure, you notice that the patient’s respiratory rate has increased from 8 breaths per minute to 20 breaths per minute

• You assess your patient and your equipment
• During your patient assessment, you observe that the dog’s jaw tone is quite tight

what is depth of anesthesia?

Answer 1

too light

Question 2

would you expect HR to increase with RR if anesthesia is too light?

Answer 2

maybe

depends on drugs given and species

Question 3

if pt too light what meds can you use to deepen anesthesia in dog neuter

Answer 3

propofol
ketamine
iso
alfaxalone

Question 4

Following propofol administration, the dog’s respiratory rate slows and he becomes apneic

• After a period of apnea, the dog resumes spontaneous ventilation
• Initially, the respiratory rate is 8 breaths per minute but then increases to 20 breaths per minute
• This time, the patient’s jaw tone is very relaxed and loose

why is there increased RR?

Answer 4

period of no breathing, increased the amount of CO2, pt trying to ↑RR to get rid of excess CO2

high temp

pain- surgical stimulation

Question 5

what are some things you can check to assess sudden increase in RR

Answer 5

body temp
SpO2
ETCO2
PaCO2

Question 6

which machine issues could cause an increase in respiratory rate in a pt?

Answer 6

fresh gas flow knob turned off accidently
oxygen tank empty
endotracheal tube kinked
bair hugger too high

Question 7

how can the recovery phase be optimized for anxious pt?

Answer 7

Pharmacologic intervention
* Alpha-2 agonist (small dose) → Can be administered prophylactically
* Propofol titration (small dose)→ Re-intubation supplies available
* Acepromazine
* Trazodone

Question 8

15 mins into recovery post neuter, pt starts to hypersalivate and appears nauseous and agitated.

What should you do?

Answer 8

anti-nausea- cerenia and ondansetron

PCV/TP- bleeding?
lactate

Question 9

Midway through the procedure, you notice that the patient’s mean arterial blood pressure has increased from 70mmHg to 105mmHg

• You assess your patient and your equipment
• During your patient assessment, you observe rapid nystagmus in both eyes, tearing, and increased neck tension in the horse

what is the anesthesia depth?

Answer 9

too light

Question 10

how to deepen anesthesia in horse during surgery

Answer 10

ketamine IV

adjust iso
increase O2 flow rate

Question 11

how to optimize recovery for horse post neuter

Answer 11

padding
quiet room
O2 supplementation
Xylazine- to reduce exicatory
head and tail rope
lots of people