Test 3 Flashcards
1
Q
4 main causes of anesthetic death
A
Human error
Anesthetic agent
Anesthetic machine
Patient related problems
2
Q
Examples of human error anesthetic deaths
A
Failure to do a PE
Failure to take a complete history
Lack of knowledge
Wrong administration of drugs
3
Q
Anesthetic machine errors
A
Vaporizer (full?)
Oxygen tank (full?)
Soda lime (exhausted)
ET tube placement and cuff
Anesthetic machine assembled properly?
POP OFF VALVE
4
Q
Patient related problems
A
Geriatric
Brachycephalic
Neurological
Cardiovascular
Obese
C-section / neonate
Hepatic and renal disease
5
Q
What organ does dental infection go to first?
A
Heart
6
Q
Pre-diagnostics for geriatric patients
A
Bloodwork
Radiographs
ECG
7
Q
It is best to —? geriatrics before surgery
A
Pre-oxygenate
8
Q
Anesthetic drugs are —? in geriatrics due to possibly decreased kidney/ function or disease
A
Less efficient
9
Q
Drugs to avoid with geriatrics
A
Acepromazone
Dexmedetomidine
10
Q
What does acepromazine do in geriatrics?
A
Causes hypotension
Lowers seizure threshold
11
Q
What does dexmedetomidine cause in geriatrics?
A
Bradycardia
12
Q
Drugs to consider with geriatrics
A
Opioids
Propofol
Alfax
Inhalants
Low dose ket/val
13
Q
Concerns in pediatrics
A
Hypoglycemia
Hypothermia
Liver and kidney functions
14
Q
Drugs to avoid in pediatrics
A
Acepromazine
Alpha-2 agonists (dexmedetomidine)
15
Q
Drugs that are safe to use with pediatrics
A
Inhalant
Opioids
Diazepam
Anti-cholinergics
Low dose propofol and ket/val
16
Q
Issues that are most likely in brachycephalics
A
Hypoxemia
Cyanosis
Hypercarbia
17
Q
Techniques to overcome respiratory concerns in brachycephalics
A
Pre-oxygenating for 3-5 mins
Avoid masking
Keep animal sternal and extend head
Prolonged ET tube extubation
Use respiratory safe drugs (propofol, alfax, diazepam, ace, and opioids)
18
Q
What drugs especially cause long recoveries in sighthounds?
A
Thiopental
(Sometimes) propofol
19
Q
What drug is exactly like dexmedetomidine but is made for large animals
A
Xylazine
20
Q
Does fat have high or low blood supply?
A
Low
21
Q
Since anesthetic drugs are lipophilic, what weight should you dose obese animals on?
A
Lean body weight
22
Q
Drugs that cause prolonged recovery
A
Ketamine
23
Q
Caution with fluid —? post op with obese animals
A
Overload
24
Q
Which drugs to avoid in all animals when there are trauma and neurological issues
A
Acepromazine
Ketamine
25
Which drugs to avoid in cats when there are trauma and neurological issues
Morphine
26
Drugs to consider when doing a c-section
Epidurals
Opioids (can reverse babies with naloxone under tongue)
Diazepam
Inhalants
Propofol
Alfaxalone
27
Should you premed c-section animals?
No
28
Most anesthetic cause some degree of —?
Cardiovascular depression
29
What kind of drugs should you avoid in cardiac disease patients?
Anticholinergics
Alpha-2 agonists
Ketamine
30
Which kind of drugs are usually best for cardiac disease patients?
Opioids
Propofol
Inhalants
31
List 4 respiratory problems during anesthesia
Diaphragmatic hernia
Pneumonia
Pleural effusion
Pneumothorax
32
List one way to check for respiratory problems before an operation
Thoracic radiographs
May need a ventilator
33
What kind of drugs should you avoid with renal/hepatic disease patients?
Ones that required significant organ metabolism or excretion
34
What kind of drug doses should you use with renal/hepatic disease animals?
Low
35
What kind of recovery should you expect when anesthetizing a renal/hepatic patient?
Slow
36
Which organ does ketamine affect in dogs?
Liver
37
What organ does ketamine affect in cats?
Kidneys
38
Possible concerns during anesthesia with the liver
Clotting issues
39
Signs of respiratory and cardiac arrest
Decreased HR
Decreased RR (gasping and irregular)
Weak and irregular pulse
Cyanotic MM
Prolonged CRT
Central and dilated pupils
40
Steps to decrease patient cardiac arrest
Turn off vaporizer
Ensure airway and ET tube are patented
Pure oxygen (bag q 6 sec)
Reversal ?
Increase/bolus fluids
Drugs
41
Balanced anesthesia include what kind of drugs?
Sedatives and tranquilizers
42
How do sedatives and tranquilizers help when doing anesthetic on large animals?
Aid in handling
Decrease the amount of induction agent needed
Allow smoother inductions and recoveries
43
Xylazine dose in horses
1-2 mg/kg
44
Intubation tube sizes for horses
15, 20, 25, 30mm
45
ET tube size for neonate horses
7-9mm
46
Foal ET tube sizes
9-11mm
47
Oxygen maintenance flow rate for horses
4-5L/min
48
What kind of anesthetic are major horse surgeries done under?
Inhalant
49
How long do you fast horses for?
Food : 8-12hrs
Water : 2hrs
50
Fluid rate for horses
5mg/kg/hr
51
Things to do when prepping horses for surgery
Remove shoes
Clean hooves
Rinse mouth
Shave surgery site if possibly
52
Why can you not give atropine to horses?
It decreases intestinal peristalsis
It can cause colic and ileus
53
Alpha-2 agonists drugs used with horses
Detomidine
Xylazine
54
What does detomidine do in a horse?
Excellent analgesia and sedation
55
Xylazine in horses
It is a tranquilizer with some analgesia
Used alone or with acepromazine
56
What can acepromazine cause in some horses?
Can cause permanent penile prolapse in stallions
57
Diazepam in horses
Mild tranquilizer
58
Butorphanol in horses
Mild sedation
Good analgesia
59
Equine induction cocktails
Detomidine/ketamine
Xylazine/ketamine
Diazepam/ketamine
60
Steps for equine induction
Give tranquilizer IV
Wait 3-5 mins for sedation
Then give ketamine IV
MASK DOWN FOALS
61
Guaifenesin in horses
Muscle relaxant that causes drowsiness
May be combined with barbiturates or propofol
62
How long does it take to see a depth change in horses?
About 20 mins
63
Heart rate in anesthetized horses
~28bpm or higher
64
Body temperature in anesthetized horses
Rectally
Rises with time
65
What are the reflexes in anesthetized horses
Palpebral and corneal reflexes maintained until deep under GA
66
Define myositis
Inflammation of the muscles
67
Why do neurological injuries occur in horses?
Occurs due to the weight of the musculoskeletal system and pressure on nerves
68
What can a horse rearing backwards after anesthesia cause?
Fracture of skulls or rupture of vertebral artery
Paralysis or death
69
Define phlebitis
Inflammation of a vein
70
What does pheblitis look like?
The vein looks like a rope and is tender and swollen
71
Why does pheblitis occur?
Lack of aseptic technique
Perivascular injection of barbiturates
72
How do you prevent pheblitis?
Sterile catheter placement
Avoid hematomas
73
Excitement with recovery - what can it cause?
Eye trauma (remove halters and provide padding)
Injuries to horse and handlers
74
What kind of drugs are most used during ruminant surgery?
Local analgesics and sedatives
75
What type of anesthetic is less commonly used in ruminants?
Inhalants
76
How long do you fast ruminants from roughage?
48hrs
77
How long do you fast ruminants from grain?
24hrs
78
How long do you fast ruminants from water?
12hrs
79
What does gut stasis cause ruminants?
Bloat
80
Why do we avoid atropine in ruminants?
Causes bloat
81
Why do we avoid acepromazine in ruminants?
It is ineffective
82
Why do we use Xylazine in low doses?
It is very potent
83
Why must ruminants be intubated during anesthesia?
To prevent aspiration
84
What drugs do we use for ruminant anesthesia induction?
Xylazine
Gauifenesin
Chloral hydrate 7% solution
85
What concentration of isoflurane do you use for ruminants?
1-3%
86
What reflexes do we use for ruminants under anesthesia?
Palpebral and corneal (lost when under deep anesthesia)
87
Eye position for ruminants under anesthesia
Eyes medially rotated (central when deep)
88
How is recovery in ruminants?
Usually smooth
89
Which drug is a common premed in small ruminants?
Xylazine
90
Common induction agents for small ruminants
Xylazine/ketamine
Propofol/barbiturates
Masking inhalant
+/- guaifenesin in combo
91
What kind of reactions do swine have to anesthesia?
Unusual
92
Is intubation and induction hard or easy in swine?
Both are difficult
93
What inhalant anesthetic should you avoid in swine?
Halothane
94
What does halothane cause in swine?
Malignant hyperthermia
Temp >41°C
Blotchy skin
Muscle rigidity
Tachycardia
95
Why do we avoid Xylazine in swine?
It is not effective
96
Suitable anesthetic injectable drugs in swine
Acepromazine
Atropine
Ketamine
Azaperone (Stresnil - approved tranquilizer in swine)
97
Where does local analgesia work?
Only on the peripheral nerves or in one area of the spinal cord
98
What do local analgesics cause?
Loss of sensation
Loss of movement
Muscle relaxation
99
What organ metabolizes local analgesics?
Liver
100
Do both sensory and motor nerves get blocked during local analgesia?
Depends on the type of block
101
Where do you insert the needle for small animal epidurals?
Between L7 and S1
102
How much lidocaine is injected for small animal epidurals?
1mL/10lbs (4.5kg)
103
How long do small animal epidurals last?
About 1 hours of paralysis and analgesia
104
Why should you keep the animals head up when you’ve given an epidural?
The local analgesic may flow forward in the spinal cord which may cause respiratory depression
105
What gauge needle and amount do we use for minor skin surgery local analgesics?
23G
1-2mL of lidocaine
106
What nerves does the paravertebral block in cattle block?
The nerves supplying the paralumbar fossa
107
What surgical procedures is the paravertebral block used for?
When repairing left displaced abomasums and c-sections
108
What vertebrae is lidocaine injected near for a paravertebral block?
Next to the transverse processes of T13 and L1
109
What nerves does the inverted L block, block?
Paralumbar fossa
110
How much lidocaine is injected for the inverted L block?
10-15mL
111
Is the paravertebral block or inverted L block easier to perform?
Inverted L block is easier, but uses more lidocaine
112
What is the ring block used for?
Teat surgery
113
What are the steps when injecting lidocaine INSIDE the teat?
Tourniquet is placed at the base of the teat
10mL of 2% lidocaine is then injected into the teat
114
When is the cornual nerve block used?
To provide analgesia when dehorning cattle
115
Where is the cornual nerve block palpated?
The frontal crest, between the eyes and the ear
116
What gauge needle and amount is used for the cornual nerve block?
18G 1-1.5inch
5-10mL of 2% lidocaine
117
Where does the cattle epidural block provide analgesia to?
The tail, birth canal, and perineum
118
Why do we use epidural blocks in cattle?
To perform obstetrical procedures
Correct rectal and vaginal prolapses
119
What vertebrae is used for an epidural in cattle?
The space between the 1st and 2nd coccygeal vertebrae
120
What size needle and amount is given for cattle epidurals?
18G 1.5 inch
5mL of 2% lidocaine
121
How to perform an epidural in cattle
Needle is inserted along the midline then pushed though the ligamentum flavum until you feel a pop
2cc of air is then injected, which should have no resistance
Then lidocaine is injected
122
What is the intravenous block used for?
Amputation of a digit as the result of severe foot rot
123
What is the intravenous block also known as?
Bier block
124
Steps to performing an intravenous block in cattle
Apply a tourniquet to the site of amputation
5-10mL of lidocaine is then injected into any vein distal to the tourniquet
125
What are the most common uses of local analgesics in equines?
Intra-articular blocks
Lameness exams
Line blocks
126
What are intra-articular blocks used for?
Used to diagnose lameness within a joint
127
When doing an intra-articular block, what does it show?
It removes sensation from the site, if the joint is the source of lameness, the horse will then seem sound
128
When should intra-articular blocks not be used?
Before a race or to treat a diagnosed lameness
129
What does the digital nerve block anesthetize?
Navicular bone
Frog
Sole
Laminae of the foot
130
What does the sesamoid nerve block anesthetize?
Sesamoids
Suspensory ligaments
Superficial digital flexor
Pastern
131
What does the high palmar block anesthetize?
Fetlock
132
What is the line block used for?
Repairing lacerations
133
What are horses sedated with before performing a line block?
Xylazine
Detomidine
134
Which drugs are used for line block?
Lidocaine
Epinephrine
