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26 Cards in this Set
- Front
- Back
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What are the 3 types of surgery?
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Elective surgery
Eg 1: BAS (pugs, bull dogs, cavalier king Charles spaniels), Eg 2: tracheal collapse (toy breeds eg chihuahua). Emergency airway management. Foreign bodies Allergic reaction eg bee sting Severe laryngeal paralysis Surgical correction of airway disease |
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Give 2 examples of disgnostic procedures?
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Diagnostic procedures
endoscopy broncho-alveolar lavage |
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How does anaesthesia worsen respiratory function?? 5
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Impaired ability to protect airway
Increased risk of obstruction Trauma/irritation of airway/lung Respiratory depression and poor ventilation (recovery!!) Exacerbation of hypoxaemia |
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2. How does respiratory disease affect anaesthesia ??
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Decrease anaesthetic agent uptake
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What are the 2 peri- operative examination of the airway ?
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1. Distant exam (before disturb animal)
Respiratory rate and effort Obvious noise 2. Close examination Air movement Less obvious noises Auscultation: URT and thorax Body temperature |
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What are 3 Other diagnostic techniques?
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Other diagnostic techniques
Pulse oximetry Blood gas Chest radiograph |
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How would you stabilise a patient for an elective procedure?
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Airway disease:
Specific treatment May not be possible e.g. BAS Asthma: bronchodilation Reduce symptoms Ensure not overheated Ensure adequately hydrated Minimise stress Oxygen?? Maximise weight loss for obese patient. |
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What would you do in an emergency upper airway disease?
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Upper airway disease:
Mild obstruction/dynamic collapse Anxiolytics Oxygen?! Cooling Severe/ Complete obstruction INTUBATE |
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How would you handle an emergency pulmonary disease?
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Pulmonary disease
Oxygen supplementation Intubation and 100% oxygen Ventilation: PEEP +/- IPPV NB.1 and 2 under GA Pleural disease Thoracocentesis |
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What are the 2 opiods for pre meds? For which types of respiratory distress?
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acepromazine
(low dose in CV stable, anxious animal with dynamic airway collapse) midazolam (unstable animal requiring extra sedation) |
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Why do we want pure mu agonist for painful procedures?
What should you avoid? |
1. No effects of URT muscles
2. MInimal respiratory depression at low doses 3. Short acting agents titrated to effect >> Morphine. |
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Which opiod should we consider for non painful procedures?
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Butorphonol
- good sedative -minimal respiratory depression - anti- tussive |
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What are the premed you should use with care?
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Medetomidine
1. Profound skeletal muscle relaxation 2. Profound sedation 3. Occasional Vomiting Ketamine is good for minimal respiratory depression BUT 1. Pain on injection. |
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What do you do for pre med in an obstructed animal?
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Intubate immediately! THere is no time for premed
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What is better medication and method for induction? Why is inhalational bad?
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Intravenous
- less stressful - more rapid control of airway Inhalational - stressful - poor gas delivery - less control of airway |
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What induction agent should you avoid ? why ? 2
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1. Ketamine is depressent in a unstable animal and dysphoria after recovery
2. Thiopentone > Arrthymogenic = slower recovery |
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How would you intubate? 4
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Avoid further trauma to airway.
Perform intubation carefully Inflate cuff carefully. Lubricate ETT before induction. Secure ETT to prevent movement |
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How would you intubate difficult airways in small animals?
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Small animals
Use laryngoscope Use smaller ETT. Stillettes help guide ETT into the airway. NB be prepared to perform a tracheotomy. |
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How would you intubate difficult airways in horses?
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Horses
eg laryngeal paresis Position horse’s head dorsally, Stomach tube or endoscope used to guide ETT into trachea. |
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What is your maintenance protocol?
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Iso / sevo
If painful Add analgesia! |
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What are 4 supportive care would you provide?
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1. Ventilation
2. Warmth 3. Fluids 4. Care to prevent further damage |
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Give 3 examples of peri-operative analgesia ? What are their good qualities?
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Morphine, Methadone
, Fentanyl. MInimal respiratory depression and clinical doses |
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What are 2 alternatives to pure mu agonist? WHy?
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1. Butorphanol - Anti- tussive
2. Lignocaine CRI- provide sedation |
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What should u use with care?
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NSAIDS
1. It may excarcebate renal disease secondary to hypoxaemia 2. Many URT given steroids |
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How would you maintain good recovery?
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Maintain intubation as long as possible.
Recover with minimal stimulation Judicious use of anxiolytics Adequate analgesia BE PREPARED for obstruction on extubation. Have all equipment available |
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What supportive care should be done during recovery?
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Continue IVFT: maintain hydration of airway
Warm Supplemental oxygenation (thoracic disease) |
