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35 Cards in this Set

  • Front
  • Back
Analgesia
Freedom from or absence of pain
Tranquilization
Behavioral change wherein anxiety is relieved and the patient becomes relaxed but is aware of its surroundings
Sedation
State characterized by central depression accompanied by drowsiness
Narcosis
Drug induced state of deep sleep from which the patient cannot easily be aroused
Hypnosis
Artificially induced sleep or trance resembling sleep
Local Anesthesia
Loss of sensation in a circumscribed area of the body
Regional Anesthesia
Insensibility in a larger, though limited area of the body
General Anesthesia
Drug induced unconsciousness that is characterized by controlled but reversible depression of the CNS
Surgical Anesthesia
State or plane of general anesthesia that provides UNCONSCIOUSNESS, MUSCULAR RELAXATION AND ANALGESIA required for painless Sx

"The Triad"
Balanced Anesthesia
The use of multiple drugs from different classes to specifically attenuate individual components of the anesthetic state
Dissociative Anesthetics
Dissociation of the thalamocortic and limbic systems characterized by a cataleptoid state in which the eyes remain open and the swallowing reflex remains intact.

Commonly seen with Ketamine
What is the overall/general anesthesia plan?
Formulate a Plan
Premedicate
Induction
Maintenance
Monitoring
Supportive Care
Recovery
What are the 5 categories we place patients in prior to Sx?
I - Normal Healthy Patient

II - Patient has mild or local Systemic Dz

III - Patient has severe systemic dz

IV - Patient has severe systemic dz that is a constant threat to life

V - Moribound patients not expected to live 1 day with or without Sx
What are the BIGGEST anesthetic complications and concerns?
Hypothermia
~ Most common complication

Hypotension
~ Most anesthetics cause vasodilation
~ Inhalents are very potent vasodilators

Hypoventilation
~ Common secondary to anesthetic and analgesic drugs

Bradycardia
~ Secondary to increased vagal tone from drugs such as Opiods, Alpha-2-agonists, and inhalents

Pain
Purpose of premedications and some examples.
Reduce anxiety and stress
Provides analgesia
Reverses unwanted side effects
Reduces induction and inhalant requirements

Alpha-2-agonists, Opiods, Benzodiazepines, Phenothiazines, Anticholinergics, Dissociatives
What to do after premedicating patient.
Wait 15-20 minutes for drugs to take effect

Place IV cath

Prepare for induction
~ Prepare induction agent
~ IV flush solution (Hep/saline)
~ Endotrach tubes, Laryngescope, gauze ties, lube
~ IV fluids
~ Pre-Oxygenate patient!! (about 10 min) especially since we are using propofol
How to induce.
Prior to induction
~ Thoracic auscultation and determine HR

Administer Induction Agent
~ In Jx its propofol, SLOWLY

Determine if depth is adequate for intubation
What do induction agents do and what are some examples?
Produce smooth induction with rapid progression through excitement stage (Stages I and II)

Allows for rapid control of airway

Propofol, Thiopental, Ketamine, Etomidate, High dose Opiods, Inhalants
MAC for:
Isoflurane
Sevoflurane
Iso - 1.3
Sevo - 2.3
Surgical MAC for:
Isoflurane
Sevoflurane
MAC x 1.5

Iso - 2%
Sevo - 3.45%
How to increase alveolar concentration. The three alveolar inflow factors...
Vaporizer Setting

Fresh Gas flow rate
~Set flow meter to 2 L/min

Breaths per minute
Stage I of Anesthesia
Starts as soon as syringe enters cathater

Stage of coluntary movement

Lasting from initial administration of loss of conciousness
Stage II of Anesthesia
Stage of delirium or involuntary movement

Lasting from loss of consciousness to the onset of a regular pattern of breathing
Stage III of Anesthesia
Stage of SURGICAL ANESTHESIA

Further divided into planes 1 to 4

Stage III, plane 2 provides adequate muscle relaxation and analgesia for most surgical procedures

Plane I (light anesthesia)
Plane II (medium anesthesia)
Plane III
Plane IV (deep anesthesia)
Stage IV of Anesthesia
Extremely depressed CNS

Respiratory Ceases

Heart beats for only a short time

Cardiovascular collapse and shock

Death occurs quickly unless CPCR is begun
How to monitor patients under anesthesia
Physical Signs
~ Jaw tone
~ Palpebral reflex
~ Corneal reflex
~ Normals (HR, RR, Systolic mean and diastolic BPs)

Equipment
~ ECG
~ BP
~ SPO2
~ ERCO2
Supportive care during anesthesia
IV Crystaloid Fluids
~ Lac Ringers, Normasol or 0.9% NaCl
~ 10ml/kg/hr then convert to drops/sec
~ Helps w/ vasodilation caused by anesthesia. The fluids will help inc BP

Supplemntal heat
Stage III of Anesthesia
Stage of SURGICAL ANESTHESIA

Further divided into planes 1 to 4

Stage III, plane 2 provides adequate muscle relaxation and analgesia for most surgical procedures

Plane I (light anesthesia)
Plane II (medium anesthesia)
Plane III
Plane IV (deep anesthesia)
Stage IV of Anesthesia
Extremely depressed CNS

Respiratory Ceases

Heart beats for only a short time

Cardiovascular collapse and shock

Death occurs quickly unless CPCR is begun
How to monitor patients under anesthesia
Physical Signs
~ Jaw tone
~ Palpebral reflex
~ Corneal reflex
~ Normals (HR, RR, Systolic mean and diastolic BPs)

Equipment
~ ECG
~ BP
~ SPO2
~ ERCO2
Supportive care during anesthesia
IV Crystaloid Fluids
~ Lac Ringers, Normasol or 0.9% NaCl
~ 10ml/kg/hr then convert to drops/sec
~ Helps w/ vasodilation caused by anesthesia. The fluids will help inc BP

Supplemntal heat
Reflex behavior at proper anesthetic depth
Palpebral: dogs may have no reflex at adequate surgical depth

Corneal: should always be present

Nystagmus: Excitement or light

Lacrimation: parasympathetic stim, light plane

Medioventral eye position: most desirable, central is too deep

Jaw tone: moderate to loose
Most reliable signs of anesthetic depth

Also somewhat reliable signs of depth
Most:
Gross purposeful movement
Reflex movement
Immediate hemodynamic response
Immediate resp response

Somewhat:
Hx of vaporizer setting (MAC)
Muscle tone
Pupillary, Palpebral, Corneal reflexes
Moist Cornea
Eye Position
Less reliable signs of anesthetic depth
HR
RR
BP
The most effective anesthetic depth is on that....
Obliterates the animals response to noxious stimuli without depressing circulatory and respiratory systems