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28 Cards in this Set
- Front
- Back
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When are cardiac dysrhythmias significant under anesthesia
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can occur @ any time while under
significant only if hemodynamics are affected -reduced CO -sustained tachycardia -electrical instability (life threatening) |
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Usual suspects for causing cardiac dysrhythmias
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preexisting medical conditions
drug administration (All inhalant anesthetics are myocardial depressants) |
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Usual dysrhythmias caused by anticholinergics
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(atropine, glycopyrrolate)
-sinus tachycardia -2 AV block |
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Usual dysrhythmias caused by ACE
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-sinus tachycardia
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Usual dysrhythmias caused by Opioids
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-bradycardia
-2 AV block |
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Usual dysrhythmias caused by Barbituates
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-tachycardia
-bigeminy |
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Sinus braycardia
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electrical impulses generated by the SA node are slower than normal
<60-70 for dogs <100-120 for cats Most common disrhythmia under anesthesia |
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Signs of sinus bradycardia
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palpable pulses
slow, regular rhythm normal ECG |
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What causing/contributes to sinus bradycardia?
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↑ PNS act.= ↑ vagal tone
↓ SNS act. drugs, hypothermia, hypothyroid, Addison's, too deep planes |
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How to treat a sinus bradycardia?
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Anticholinergics-if vagal tone is the cause
Opioid cause-reverse may try warming & fluids |
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What is Sinus Tachycardia?
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Electrical impulses from SA node are generated faster than normal
>160-180 for dogs >220 for cats |
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Signs of Sinus Tachycardia under anesthesia
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Palpated pulses & heart rate are rapid
ECG is normal |
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What factors could contribute to sinus tachycardia?
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sympathetic response to surgery (pain)
hypovolemia shock hypercarbia underlying uncontrolled disease |
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How to treat Sinus Tachycardia under anesthesia
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↑ vaporizer/analgesics to ↓ pain
fluids-for hypovolemia ventilate-for hypercarbia uncontrolled disease-should have treated before anesthesia |
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What to do about "other" supraventricular dysrhythmias?
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Most well tolerated, but try to treat/control before anesthetic if possible
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Most common ventricular dysrhythmia under anesthesia?
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PVC-premature ventricular contraction
electrical impulses orginating below the AV node/AV junction |
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Signs of PVCs under anesthesia
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Variable HR & Pulses
+/- pulse deficits ECGs: Ps & QRSs not associated |
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Causes of PVCs under anesthesia
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electrolyte imbalances
acid/base imbalances hypoxemia hypothermia bradycardia trauma/myocardial bruising |
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Treatment for PVCs
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Find & treat underlying cause if hemodynamic cause
-lidocaine -O2/ventilate -analgesics |
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Range for hypothermia in small animals
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<38C / 100.5F
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Signs of hypothermia
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extermities feel cold
pink area look blue MMs blanched |
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Causes of Hypothermia under anesthesia
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convestion
evaporation change in thermoregulatory mechanism (greatest loss in first hour of anesthesia) |
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Clinical significance of hypothermia
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MAC ↓ 5-7% /1C ↓ in body temp
<32C =no more shivering <28C =cardiac arrest |
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Other problems associated w/ hypothermia
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shivering ↑ metabolic O2 demand by 200-300%
↑ CO & minute ventilation |
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Treatment for hypothermia under anesthesia
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PREVENT...
cover/heating pads/↑ ambient temps warm IV fluids fresh gas careful prep. |
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Managing post-operative hypothermia
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re-warm
-safe, warm packs -Bair hugger -cover -MONITOR carefully |
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Causes of recovery excitement
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-Disorientation=too rapid
-Dysphoria=too much opioids -Pain=not enough pain meds |
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How to prevent recovery excitement
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-adequate pain management
-recover quietly -minimal stimulation -warm -"TLC" |
