Week 5 Anaesthesia Recovery

Question 1

What period carried the greatest risk of morbidities adn mortalities?

Answer 1

RECOVERY

most anaesthetic-¬‐related morbidities are identified during the recovery period

Question 2

Why does recovery pose greater risk then when anaesthetised ?

Answer 2

In recovery….
Level of monitoring greatly reduced (no longer HR, BP, RR, Cap, ECG, Oximeter etc….)
Physiological support greatly reduced: fluids, drugs, intibation when GA
Some problems manifest themselves after delay e.g. myopathy large animal won’t be noticed until tried to stand

Question 3

What are the most common recovery problems due to?

Answer 3

• Hypothermia  can being in SA in pre med! Large animals less so as stand and still mooch around. Fluid cold, clip, scrub etc…….
• Emergence delirium = Happens during recovery. Some drugs make them more likely. Not smooth calm recovery: excitation to violent responses!
• Hypoxaemia
• Hypotension/ hyper

Note hypothermia, hypoxaemia, hypotension all begin during anaesthesia but only noticed in recovery.

Question 4

What is the most common anaesthetic related morbidity.

Causes and consequences?

Answer 4

HYPOTHERMIA
• Causes: anaesthesia, surgical prep, cold rooms,…, drugs depress thermoregulatory centre, drugs promote vasodilation, open body cavities
• Consequences: delayed recovery, shivering, delayed wound healing, coagulopathies, … increased risk of death

Question 5

How can we prevent hypothermia from occuring?

Answer 5

• Proactive steps to reduce heat loss, fluids room temp, blankets, hot pads, bubble wrap around extremities, bear hug (hot air blower) Hot hands (fluid with hot water)
• Earlier these steps are taken the more successful
• Warning – warming aids can cause hyperthermia and/ or burns
• Always monitor temp NEVER allow direct contact between patients skin and heating device

Question 6

Emergence delirium
In people…
in animals occurs more in…

Answer 6

• In people = ‘state of dissociation of consciousness where the patient is incoherent, inconsolable, irritable and uncooperative’
• Risk of injury to animal and handlers
• Can occur in all animals -¬‐ more obvious in non-¬‐prey species, more social animals. More so C&D vs horses and cows.
• Often nutty animal initially!
• 5-15 mins  animal losing plot

Question 7

Emergence delirium

Prevention and treatment

Answer 7

• Chemical (sedation/anaesthesia alpha 2 agonist.) or physical restraint
• E.g. horse acepromazine as has such a long duration of action, hopefully lasts into recovery to help make calmer and quieter
• Chemical restraint is much less stressful than physical
• Reduce stimulation, reduce noise and light level
• Ensure adequate analgesia