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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.

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