A/S Lect Test 1 - intro info
Terms
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- Definition of Anesthesia (local & general)
- The loss of feeling or sensation. Local-acts where applied, no effect on brain. General-complete unconsciousness.
- Def. of Analgesia
- Relief from pain.
- Def. of Opioids
- Synthetic morphine derivative drugs that produce sedation and pain relief.
- Def. of Opiates
- Natural morphine derivative druges that produce sedation and pain relief.
- Def. of Narcotic
- Opioid or opiate that induces physical dependence and addiction.
- Def. of Neuroleptanalgesia
- Combination of narcotic with a tranquilizer.
- Def. of Preanesthetic
- Any drug given within 1 hour prior to induction.
- Def. of Induction
- Administration of fast-acting drugs (usually IV) to cause loss of consciousness.
- Def. of maintenance
- Administration of drugs to keep patient under anesthesia.
- Def. of Surgical Anesthesia
- Depth of anesthesia under which surgical procedures can be safely and effectively performed (adequate muscle relaxation) without pain to the patient.
- Def. of Tranquilization/Sedation
- A state of calmness associated with some CNS depression.
- What are 6 reasons for using anesthesia?
- Restraint, examination, manipulation, general surgery, seizure control and euthanasia.
- What are the 5 goals of anesthesia?
- Relax skeletal muscles, produce protective reflexes (laryngeal reflex), induce unarousable sleep, produce amnesia, provide analgesia.
- How do you check for signs of anesthesia? (what signs of pain?)
- Increased heart rate, increased resp. rate, gross movement, vocalization, abdominal pressing (tense abdominal muscles).
- What are 4 techniques for producing general anesthesia?
- Progressive CNS depression (barbiturates, propofol, gas anesthetics) and Dissociating CNS (cataleptoid anesthetics).
- What is balanced anesthesia?
- You combine general anesthetic with other drugs to minimize negative effects caused by general anesthetic. It lowers the amt of general anesthetic needed. The most common technique used.
- What are for general considerations you need to take into factor when giving anesthetics?
- Species, breed and individual variations and the classification of anesthetic risk.
- What are some species variations that can affect anesthesia?
- The same anesthetic drug may have different effects in different species.
- What are some breed variations that can affect anesthesia?
- The same anesthetic drug may have diff. effects in diff breeds (sighthounds-sensitive to barbituates), smaller breeds have higher metabolic rates than larger, brachycephalic breeds have elongated soft palate.
- Why do you need to leave the endotrach tube in as long as possible during recovery for brachycephalics?
- The elongated soft palate obstructs the airway.
- Why does individual variations have an affect on anesthesia?
- The same anesthetic drug may have diff effects of diff individuals. (poor condition, age, reproductive status, disposition)
- What are the 4 classifications of anesthetic risk?
- Normal, moderate (organ abnormality doesn't affect overall health), poor (organ ab. does affect health), grave (organ av. makes anes life threatening).
- What are the 4 vital signs you use to assess the depth of anesthesia?
- Respiratory, heart rate/rhythm/pulse, CRT, MM color.
- What are normal respirations for an anesthetized animal?
- 8-20 rpms.
- When are respirations a problem for an anesthetized animal?
- When they get to 10, at 8 they're too deep.
- What is Tidal Volume?
- The volume of air inspired with each breath (they get less 02).
- How does anesthesia affect tidal volume?
- It decreases the tidal volume.
- When does the heart rate become a problem for an anesthetized patient?
-
When it drops to <70bpm dog
<100bpm cat - Where do you take a pulse from?
-
Small animal-femoral lingual artery.
Large animal-facial, digital, coccygeal artery. - What methods can you use to monitor the heart rate?
- Palpate, esophageal stethoscope, ECG, pulse oximeter, blood pressure monitor.
- Where can you check the CRT?
- Conjunctiva, oral MM, vulva/prepuce.
- What does brick red MM color indicate?
- Endotoxic shock
- What does pale white or gray MM color indicate?
- Poor perfusion (shock).
- What does blue/purple MM color indicate?
- Cyanosis (decreased 02).
- What are 5 reflexes to check for anesthetic depth?
- Palpebral, pinnal, jaw tone, pedal, corneal.
- Where do you check the palpebral reflex?
- Inside of the eye, use your finger to touch.
- Where do you check the pinnal reflex?
- Stimulate outer ear canal by lightly touching hair or blowing, the pinna will move.
- How do you check the jaw tone relfex?
- Pull down on mandibula -resistance if not deep, no resistance if deep.
- Where do you check the pedal reflex?
- Toe pinch, thumb nail into nail bed - check for withdrawal.
- How do you check for the corneal reflex?
- Use index finger to tap on cornea with eyes closed to check for deceased patient - you should always get it.
- Can you rely on on reflex or vital sign to determine a patients anesthetic depth?
- No, patient and anesthetic protocal may alter individual reflexes and/or signs.
- How many stages are there of anesthesia?
- 4
- What is Stage 1 anesthesia?
- It's from the start of anesthetic administration to loss of consciousness.
- What are signs of Stage 1?
- R-regular, P-responsive to light, Eye pos.-central, Reflexes-all present.
- What is Stage 2 anesthesia?
- The excitatory stage.
- What are signs of stage 2?
- R-irregular, breath holding, hyperventilation, P-dilated, Eye pos-central(~nystagmus), R-all present, tachycardia, chewing/yawning/vocalization, vomitin &/or defication.
- How many planes are there in Stage 3 anesthesia?
- 4
- What is Stage 3, Plane 1 anesthesia?
- Restraint anesthesia.
- What are signs of Stage 3, Plane 1 anesthesia?
- R-increase rate & depth (because of pain), P-responsive to light, Eye pos- central moving to ventro-medial, R-all present starting to lost palpebral, laryngeal gone, H-regular and strong.
- In what stage does the first reflex leave? And what is it?
- In Stage 3, Plane 1 - it's the laryngeal reflex.
- What is Stage 3, plane 2 anesthesia?
- The surgical plane.
- What are signs of Stage 3, plane 2 anesthesia?
- R-regular rhythm & rate, decreased tidal volume, P-slightly dilate, Eye-pos-ventro-medial, R-All reflexes gone, H-mild decreased in pressure & heart rate (no pain
- What is Stage 3, plane 3 anesthesia?
- The orthopedic plane.
- What are signs of Stage 3, plane 3 anesthesia?
- R-slow & shallow, P-moderately dilated, PLR diminished, Eye pos-moving centrally or central, R-diminished or absent, H-decreased output, weak pulse, delayed CRT.
- What is Stage 3, Plane 4 anesthesia?
- Too deep.
- What are signs of stage 3, plane 4 anesthesia?
- R-irregular/jerky/shallow, P-dilated & fixed, Eye pos-central, R-absent, H-pale MM, prolonged CRT, weak pulse, muscles flaccid.
- What do you do for Stage 3, plane 4 anesthesia?
- Inform the vet. Lighten anesthesia: turn vaporizer off or down, ventilate at 8-12 rpm.
- What is Stage 4 anesthesia?
- The terminal stage.
- What are signs of Stage 4 anesthesia?
- Respiratory arrest, cardiac arrest (60-90 s after resp. arrest).
- What do you do for Stage 4 anesthesia?
- Begin emergency procedures: turn off vaporizer, flush system 3X's with pure 02, begin CPR, give epinephrine.
- What are two emergency drugs you can use?
- Doxapram (analeptic agent) & Epinephrine (catecholamine).
- When do you use Doxapram?
- During respiratory arrest, it stimulate CNS & respiration.
- When do you use Epinephrine?
- During cardiac arrest, it stimulate sympathetic nervous system & heart.
- When is epinephrine contraindicated?
- When the heart is beating, it can cause tachycardis (a fatal arrhythmia).
- What are 2 manual ways of monitoring an anesthetized patient?
- Visual (eye position, resp, MM, CRT) & palpation (pulse, reflexes).
- What are 5 mechanical method for monitoring an anesthetized patient?
- Esophageal stethoscope, ECG, pulse oximeter, doppler blood pressure monitor, capnography (CO2 monitor).
- What are some respiratory signs of anesthetic overdose?
- Decreased tidal volume, irregular and/or exaggerated respiration, danger if under 8rpms.
- What are some cardiac signs of anesthetic overdose?
- A prolonged CRT, cyanotic MM, weak pulses, watch out for bradycardia.
- What are 5 areas that can indicate an anesthetic overdose?
- Respiratory, Cardiac, Hypothermia, Puplis, Reflexes.
- What's a sign of an anesthetic overdose in the pupils?
- There is decreased pupillary light reflex, dilated.
- What sign do the reflexes give for an anestheic overdose?
- They are greatly diminished or absent.
- What are 3 ways the body elimates anesthetics from the body?
- Through exhalation, redistribution, and liver metabolism.
- How are anesthetics exhaled through the body?
- Gas anesthetics are exhaled chemically unaltered.
- How are anesthetics redistributed through the body?
- The anesthesia leaves the blood & enters other tisses (ex. fat).
- How does the liver metabolize anesthetics?
- Before leaving the body, most injectable drugs are metabolized by the liver.
- The longer the anesthetic period the longer/shorter the recovery period?
- Longer
- What route of drug administration takes the longest to leave the body?
- IM > IV > inhalation.
- What are some signs of anesthetic recovery?
- Resp. rate & depth increase. Eyeballs rotate to next shallower stage, reflexes return in reverse order of loss, shivering, tongue movement/chewing, movement, lifting of head, attempt to stand.
- When do you remove the endotrach tube from the animal?
- After the patient is able to swallow.
- What is the order the reflexes return?
- Coronary, palpebral, jaw-tone, pinnal, pedal, laryngeal. (reverse order of loss).
- Why do you use preanesthetic drugs?
- To calm or sedate (smooth induction & recovery), to reduce or eliminate adverse effects of gen anes., to reduce the amt of gen anes. required, to decrease pain during and after surgery.