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44 Cards in this Set
- Front
- Back
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Inhalent anesthetic |
Diethyl Ether Halogenated Organic Compounds Nitrous Oxide |
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Halogenated Organic Compounds |
Isoflurane Sevoflurane Carried to lungs with oxygen Concentration gradient of anesthetic causes it to move easily from lungs to blood. Metabolized in lungs |
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MAC |
Minimum Alveolar Concentration Lowest concentration of agent that 50% of patients show no response to stimulus |
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Isoflurane |
Most common Halogenated Organic Compound Higher vapor pressure, stable at room temperature MAC = 1.3% - 1.63% |
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Sevoflurane |
Second most common Halogenated Organic Compound Lower vapor pressure than Iso (still high) MAC = 2.34% - 2.58% |
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Nitrous oxide |
Used mixed with O2 (67% to 33% o2) Reduces MAC of other anesthetic agents (20%-30%) More useful with older halogenated organic compounds (methoxy- or halothane) |
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Physical Status Classification |
P1 - normal/healthy - minimal risk P2 - mild systemic disease (includes healthy neonates/geriatrics) - Low P3 - severe systemic disease - moderate P4 - systemic disease that is constant threat to life - high P5 - not expected to survive -extreme |
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Preanesthetic evaluation factors |
Physical Status Classification Hydration Level of consciousness Reflexes Body condition score Body temperature Heart rate and rhythm, murmurs Respiratory rate and character Lab work |
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Anesthesia Induction/Mantenance Methods |
IM (limited time for procedure, no control) IV (ultra-short acting agents) TIVA (total intravenous anesthesia) Inhalant agent IV induction/inhalant maintenance |
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Steps of anesthesia |
Preanesthetic Induction Maintenance Recovery |
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Elements of recovery |
Extubation Oxygen administration Temperature Pain control |
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Stages of Anesthesia |
Stage I Stage II Stage III (Plane 1, Plane 2, Plane 3, Plane 4) Stage IV |
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Stage I of anesthesia |
Reduced sensitivity to pain Reflexes intact Conscious but disoriented HR and RR increase |
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Stage II of anesthesia |
Loss of consciousness = start of stage II = excitement stage Irregular breathing Conscious with involuntary excitement, muscle tone All reflexes exaggerated |
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Stage III of anesthesia |
Loss of spontaneous muscle control = start Stage III 4 planes Includes surgical anesthesia |
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Plane 1 of anesthesia |
Part of stage III of anesthesia "light" - inadequate for surgery Eyes ventral Regular respiration Swallow and gag reflexes gone Other reflexes slow |
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Plane 2 of anesthesia |
Part of Stage III of anesthesia "medium" - good for most surgical procedures Shallow, regular respiration Muscle relaxation HR and BP mild decrease Palpibral reflexes gone, slow papillar response |
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Plane 3 of anesthesia |
Part of stage III of anesthesia "deep" - excessive for surgery Respiratory and cardiovascular depression (severe) CRT increase Weak or absent reflexes Eyes central |
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Plane 4 of anesthesia |
Part of stage III of anesthesia "too deep" - overdose Abdominal breathing Decrease in respiratory effort/effect No muscle tone Pale MM/ prolonged CRT Dramatic drop in HR and BP |
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Stage IV of anesthesia |
Loss of all reflexes and cardiopulmonary collapse = start of stage IV Death |
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Parameters of Monitoring |
Vital Signs Reflexes Other |
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Vital signs monitored |
Heart rate Heart rhythm Respiratory rate Respiratory depth Mucous membrane color Capillary refill time Pluses strength Blood pressure Temperature |
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Reflexes monitored |
Palpebral (blink) Corneal (eye retraction) Pedal Swallow Laryngeal PLR (pupillary light reflex) |
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Types of heart rhythms |
Normal sinus arrhythmia Sinus arrhythmia Sinus tachycardia Sinus bradycardia AV heart block Premature complexes (SPC, VPC) Supraventricular tachycardia (3 SPC) Ventricular tachycardia (3 VPC) Fibrillation Atrial fibrillation Ventricular fibrillation |
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Types of large animal anesthesia |
Standing chemical restraint -heavy sedation with local block Field anesthesia -"on location" general anesthesia General anesthesia -anesthesia in vet clinic |
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Anticholinergics in equine anesthesia |
Don't use: Reduced GI motility, colic risk |
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Equine intubation |
Nasotracheal - foals, oral/neck procedures Orotracheal |
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Common equine anesthesia risks |
Hypoventilation Hypotension (inhalants especially over 1 hour) Hypoxemia Broken limbs (recovery) Nasal obstruction (recovery) Tying up |
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Ruminant anesthesia considerations |
Fasting important: fermentation only slightly slowed (bloat), saliva not slowed and regurge common (aspiration) Small = hypothermia risk |
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Swine considerations |
Drug resistance Periferal veins not easily accessible Difficult/stubborn species |
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Pocket pet consideration |
Premeds not needed Gas/chamber induction |
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Oxygen flow rate for mask induction |
1-3L/min under 10 kg 3-5 L/min over 10 kg |
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Semiclosed, rebreathing system oxygen flow rates: Induction/recovery/depth change Maintenance |
50-100 ml/kg/min (max 5 L/min) 20-40 ml/kg/min (min 250 ml/min) |
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Tidal volume of an anesthetized animal |
10 ml/kg |
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Prep patterns |
Target - holding scrub by corners, move in circular motion from incision sight out. Orthopedic - wrap end of foot (glove, tape and vet wrap), suspend limb, scrub distal to proximal and circumferentially Perineal - purse string suture in anus, 3 target pattern (right of the anus, left of the anus then the anus itself |
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Surgical scrub solutions for surgeon |
Chlorhexidine 4% Iodophors 7.5% Alcohol Parachilormeta-xylenol (PCMX) |
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-ectomy |
Removal |
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-otomy |
Cutting into |
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-ostomy |
Creating a permanent hole |
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-pexy |
Attachment by suturing |
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-plasty |
Reconstruct tion/remodeling |
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-rraphy |
Closure/repair |
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Common surgery incision types |
Ventral midline - dorsal recumbency, incision is midline over lines alba Paramedian incision - parallel to midline. Usually to accesses only one side of animal Flank incision - perpendicular to long axis of body Paracostal incision - parallel to last rib. Stomach/spleen exposure |
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Fracture types |
Transverse - across Oblique - at angle Spiral - curve around center point Comminuted reducible - many prices that can be re-aligned Comminunted nonresucible - many pieces that can not be realigned Articular - involve joints |
