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28 Cards in this Set

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When are cardiac dysrhythmias significant under anesthesia
can occur @ any time while under
significant only if hemodynamics are affected
-reduced CO
-sustained tachycardia
-electrical instability (life threatening)
Usual suspects for causing cardiac dysrhythmias
preexisting medical conditions

drug administration
(All inhalant anesthetics are myocardial depressants)
Usual dysrhythmias caused by anticholinergics
(atropine, glycopyrrolate)

-sinus tachycardia
-2 AV block
Usual dysrhythmias caused by ACE
-sinus tachycardia
Usual dysrhythmias caused by Opioids
-bradycardia
-2 AV block
Usual dysrhythmias caused by Barbituates
-tachycardia
-bigeminy
Sinus braycardia
electrical impulses generated by the SA node are slower than normal
<60-70 for dogs
<100-120 for cats
Most common disrhythmia under anesthesia
Signs of sinus bradycardia
palpable pulses
slow, regular rhythm
normal ECG
What causing/contributes to sinus bradycardia?
↑ PNS act.= ↑ vagal tone
↓ SNS act.
drugs, hypothermia, hypothyroid, Addison's, too deep planes
How to treat a sinus bradycardia?
Anticholinergics-if vagal tone is the cause
Opioid cause-reverse
may try warming & fluids
What is Sinus Tachycardia?
Electrical impulses from SA node are generated faster than normal
>160-180 for dogs
>220 for cats
Signs of Sinus Tachycardia under anesthesia
Palpated pulses & heart rate are rapid
ECG is normal
What factors could contribute to sinus tachycardia?
sympathetic response to surgery (pain)
hypovolemia
shock
hypercarbia
underlying uncontrolled disease
How to treat Sinus Tachycardia under anesthesia
↑ vaporizer/analgesics to ↓ pain
fluids-for hypovolemia
ventilate-for hypercarbia
uncontrolled disease-should have treated before anesthesia
What to do about "other" supraventricular dysrhythmias?
Most well tolerated, but try to treat/control before anesthetic if possible
Most common ventricular dysrhythmia under anesthesia?
PVC-premature ventricular contraction
electrical impulses orginating below the AV node/AV junction
Signs of PVCs under anesthesia
Variable HR & Pulses
+/- pulse deficits
ECGs: Ps & QRSs not associated
Causes of PVCs under anesthesia
electrolyte imbalances
acid/base imbalances
hypoxemia
hypothermia
bradycardia
trauma/myocardial bruising
Treatment for PVCs
Find & treat underlying cause if hemodynamic cause
-lidocaine
-O2/ventilate
-analgesics
Range for hypothermia in small animals
<38C / 100.5F
Signs of hypothermia
extermities feel cold
pink area look blue
MMs blanched
Causes of Hypothermia under anesthesia
convestion
evaporation
change in thermoregulatory mechanism
(greatest loss in first hour of anesthesia)
Clinical significance of hypothermia
MAC ↓ 5-7% /1C ↓ in body temp

<32C =no more shivering
<28C =cardiac arrest
Other problems associated w/ hypothermia
shivering ↑ metabolic O2 demand by 200-300%
↑ CO & minute ventilation
Treatment for hypothermia under anesthesia
PREVENT...
cover/heating pads/↑ ambient temps
warm IV fluids
fresh gas
careful prep.
Managing post-operative hypothermia
re-warm
-safe, warm packs
-Bair hugger
-cover
-MONITOR carefully
Causes of recovery excitement
-Disorientation=too rapid
-Dysphoria=too much opioids
-Pain=not enough pain meds
How to prevent recovery excitement
-adequate pain management
-recover quietly
-minimal stimulation
-warm
-"TLC"