VTNE Studying > Anesthesia > Flashcards

Anesthesia Flashcards

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1
Q

What are the anesthetic signs that a patient is too light?

A

Ventral rotation of the eyes, tachycardia, tachypnea, increased jaw tone, very strong pulses, palpebral reflexes, marked muscle tone, constricted pupils, present pupillary light reflex

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2
Q

What are the anesthetic signs that a patient is too deep?

A

Mydriasis (Dilated, centrally located pupils), bradycardia, bradypnea, no jaw tone, absent pupillary light reflex, absent tear production, flaccid muscles

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3
Q

Which phase of the anesthetic cycle corresponds to stage 3 of anesthesia?

A

Maintenance

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4
Q

Describe Stage 1 anesthesia.

A

Period between administration of an anesthetic and loss of consciousness
Respiratory efforts change as anesthesia deepens
Animal is awake and respiration may be quite rapid due to the excitation of being handled, respirations evenly apportioned between the chest and abdomen, is quite regular

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5
Q

Describe Stage 2 anesthesia.

A

Period after the loss of consciousness, which may include actions such as uncontrolled movement, delirium, and vocalization
Muscles tone decreases
Breathing still even apportioned between chest and abdomen but is less regular and breath-holding may occur

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6
Q

Describe Stage 3 anesthesia.

A

Level at which surgery can be performed

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7
Q

Describe Stage 4 anesthesia.

A

Crisis; respiratory arrest and death from circulatory collapse is imminent

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8
Q

What actions should be taken in the anesthetic recovery of South American Camelids?

A

Keep nose lower than the pole to prevent aspiration
Provide oxygen supplementation for 5-10 minutes after ceasing anesthetic delivery
Place animal in sternal recumbency
Keep endotracheal tube cuffed during extubation to prevent aspiration

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9
Q

Describe Stage 3, Plane 1 anesthesia.

A

“Light” anesthesia - animal still has blink and swallowing reflexes and regular respiration

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10
Q

Describe Stage 3, Plane 2 anesthesia.

A

“Surgical” anesthesia - the animal has lost blink reflexes, pupils become fixed, and respiration is regular

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11
Q

Describe Stage 3, Plane 3 anesthesia.

A

“Deep” anesthesia - the animal starts losing the ability to use respiratory muscles and breathing becomes shallow, may require assisted ventilation

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12
Q

What is the appropriate endotracheal tube size range for adult horses and cattle?

A

22 to 30 mm

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13
Q

Why is inhalant anesthesia not likely to be used for chelonian induction?

A

Chelonian patients do not breathe for long periods and would inhale an inconsistent and likely insufficient amount of anesthetic

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14
Q

What are normal anesthetic blood pressures in small animal patients under anesthesia?

A

Systolic: 100 to 160 mmHg
Diastolic: 50 to 70 mmHg
MAP: 60 to 90 mmHg

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15
Q

What are normal anesthetic blood pressures in equine patients under anesthesia?

A

Systolic: > 80 mmHg
Diastolic: > 50 mmHg
MAP: 60 to 90 mmHg
Hypertension: > 140 mmHg

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16
Q

What size endotracheal tube would be appropriate for an adult sheep?

A

7 to 12 mm

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17
Q

What size endotracheal tube would be appropriate for foals?

A

9 to 16 mm

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18
Q

What size endotracheal tube would be appropriate for calves?

A

9 to 18 mm

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19
Q

What size endotracheal tube would be appropriate for swine?

A

6 to 12 mm

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20
Q

What size endotracheal tube would be appropriate for cats?

A

3 to 4.5 mm

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21
Q

Why is there a risk for bloat in ruminants during general anesthesia?

A

Medications administered for anesthesia can negatively impact GI motility, and continued degradation of foodstuffs within the rumen and reticulum leads to gas buildup, which can cause bloat

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22
Q

What is a challenge associated with intubating guinea pigs and chinchillas?

A

Limited range of motion of the mouth
Presence of the palatal ostium - makes visualization of the glottis physically impossible

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23
Q

What is the palatal ostium?

A

A tiny donut-shaped opening that exists between the posterior and anterior oropharynx

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24
Q

Name non-rebreathing systems.

A

Ayre’s T-piece
Jackson-Rees
Norman elbow
Bain coaxial

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25
How are TIVAs used?
For short procedures via IV bolus (5-10 minutes) Long term-anesthesia via CRI
26
What can be seen with TIVA usage in horses?
Increased palpebral reflexes Maintaining higher blood pressures Improved breathing
27
In horses, how is recovery from TIVA affected by procedure length?
Recoveries generally very smooth with procedures less than 1-1.5 hours Longer surgical times can have rougher recoveries than gas anesthetics
28
What is a normal heart rate for anesthetized horse?
28 to 40 bpm
29
What is a normal heart rate for anesthetized cow?
50 to 80 bpm
30
What is a normal heart rate for anesthetized cat?
120 to 180 bpm
31
What is soda lime made of?
Calcium hydroxide
32
What color are vaporizers designed sevolfurane?
Yellow
33
What color cylinders are those storing oxygen, nitrous oxide, helium, and carbon dioxide?
Oxygen - green Nitrous oxide - blue Helium - black Carbon dioxide - grey
34
How long should avian species be pre-oxygenated before anesthetic induction?
2-5 minutes
35
What is etomidate?
A short-acting, sedative-hypnotic induction agent in dogs and cats that is reserved for moderate to severe cardiopulmonary dysfunction
36
What are the benefits of etomidate?
Minimal changes to cardiopulmonary systems Beneficial to patients in shock Wider safety index than propofol Crosses placental barrier, but has minimal effects and rapid clearance Decreases both intracranial and intraocular pressures Can be given as single dose or continuous infusion
37
What are some concerns with etomidate?
May cause excitement upon induction or recovery Rapid injections or repeated doses can trigger hemolysis Not used in in horses or cattle due to seizure induction or the production of excessive muscle rigidity No analgesic properties
38
In what phase of anesthesia would a horse's mouth be rinsed out with water?
Sedation and pre-medication phase
39
In what phase of anesthesia would hobbles be placed on a horse?
Induction phase
40
What basic formula can be used to determine endotracheal tube size in dogs?
20kg dog receives 9.5 to 10mm tube Size increases or decreases by 1mm for each 5kg above and below 20kg
41
What species require blind intubation?
Rabbits, horses, and adult cattle
42
When checking for leaks in the low-pressure system using a non-rebreather system, you can say there are no leaks when the bag remains inflated for at least how long?
10 seconds
43
Describe ASA I.
Minimal risk Overtly healthy procedures, generally undergoing routine elective procedures
44
Describe ASA II.
Low risk Mild systemic diseases (obesity, healthy neonates or geriatrics, low-grade heart murmurs, minimal dehydration)
45
Describe ASA III.
Moderate risk Involves patients with significant systemic disease/organ dysfunction such as kidney diseases, anemia, or moderate dehydration
46
Describe ASA V.
Extreme risk Involves patients that remain moribund/obtunded, who without surgical intervention will die Includes those with end-stage liver/kidney disease, GDVs, pulmonary embolism, or patients with severe head trauma
47
What is a patient's tidal volume?
The amount of air that passes in and out of the lungs with one normal breath
48
What is a patient's minute volume?
The volume of air inspired and expired in 1 minute
49
What is a patient's residual volume?
The amount of air remaining in the lungs after maximum expiration
50
Ferrets under anesthesia must be closely monitored for what complication?
Hypothermia
51
At what level should the liquid anesthetic by at a minimum at all times?
One-half full
52
What is most commonly used for the induction of anesthesia in avian patients?
Isoflurane
53
If a "triple drip" is being used as IV maintenance of general anesthesia in horses, what drugs are being administered?
Xylazine, ketamine, and guaifenesin
54
What does a "double drip" consist of in ruminants?
Ketamine and guaifenesin
55
What does anesthesia stand for?
Minimum alveolar concentration
56
When providing pressure-assisted ventilation in a small animal patient your manometer should not exceed what pressure?
20 cm H2O
57
When providing pressure-assisted ventilation in a small animal patient your manometer should not exceed what pressure?
20cm H20
58
What is the standard pressure for a full oxygen cylinder?
2,200 PSI
59
What are the disadvantages to non-rebreathing systems?
Failure to conserve gases, moisture, and body heat Manual ventilation is more challenging because many do not have an adjustable pop-off valve or pressure manometer
60
Prior to an anesthetic procedure, how long should food and water be withheld from a cow?
Food: 24-48 hours (roughage - 24, grains/concentrates - 48) Water: 8-12 hours
61
How long should food be withheld in dogs, cats, and horses prior to an anesthetic procedure?
8-12 hours
62
How long should small ruminants have food withheld prior to an anesthetic procedure?
12-18 hours
63
At what phase of anesthesia would a horse's mouth be rinsed out with water?
Sedation and pre-medication phase (Phase I)
64
Describe Phase I of horse anesthesia.
Occurs in induction area where patient is sedated/pre-medicated Mouth is rinsed to remove debris and particles
65
Describe Phase II of horse anesthesia.
Induction occurs and patient becomes recumbent Endotracheal tube is placed Hobbles and hoist are placed Surgical site clipping and prepping occurs
66
Describe Phase III of horse anesthesia.
Inhalant anesthesia and partial intravenous anesthesia used (PIVA)
67
What combinations may be used for TIVA in horses?
Dissociative with alpha2 agonists +/- guaifenesin Ketamine + benzodiazepine Propofol
68
What are some general recommendations for anesthetizing patients with significant liver disease?
Use reversible drugs whenever feasible Maintain with sevo or isoflurance Maintain blood pressure and fluid balance Preoxygenation
69
How long should avian species be preoxygenated before anesthetic induction?
2-5 minutes, ideally alongside premedication with a sedative/analgesic (butorphanol) and anxiolytic (midazolam)
70
What other benchmark besides weight gain can be used to determine the need to change the scavenging system?
12 hours of usage
71
In anesthesia where recumbency is required, what is the position of choice to minimize the risk of aspiration and bloat in cattle?
Right lateral or sternal to place the rumen "up"
72
What is the first step when intubating an adult cow? Why?
Placing a math gag due bind intubation - the larynx cannot be directly visualized
73
Why are ferrets more at risk for hypoglycemia if fasted for long periods before anesthesia? How long should they be fasted?
Ferrets have short GI transmit times and should only be fasted for a maximum of 3-4 hours
74
What does the oxygen flush valve do?
Delivers pure oxygen to the breathing circuit, bypassing the flowmeter and vaporizer
75
At what rate does an oxygen flush valve deliver pure oxygen?
35-75 L/minute
76
How quickly can propofol take effect? How long does it last?
Can take effect as quickly as 30 seconds Only lasts 2-5 minutes
77
What pressure does the flowmeter reduce oxygen flow to?
15 PSI
78
What type of drugs are most anesthetic agents used in veterinary medicine?
Agonists
79
What factors of an inhalant affect its concentration of gas?
Vapor pressure (how volatile it is, how readily it can change from a liquid to gaseous state) Boiling point (temperature where atmosphere pressure - vapor pressure) Type of anesthetic system Ventilation Solubility (how easily the gas is taken up into the lungs and able to enter the bloodstream)
80
What patient factors affect the variance of inhalant potency?
Age Disease state Additional CNS-depressant drugs on board Pregnancy Temperature
81
Palpebral, pedal, and laryngeal reflexes remain intact with what injectable anesthetics?
Dissociatives, most commonly ketamine and tiletamine
82
How do dissociatives affect light and sound sensitivity, muscle tone, and heart rates?
Cause sensitivity to light and sound Cause increased muscle tone and heart rate
83
Why is tracheal intubation in swine difficult?
A combination of the pig's small oral cavity, yet long and mobile larynx, laryngospasms, and potential pharyngeal diverticula
84
What are the symptoms of Porcine Stress Syndrome?
AKA Malignant Hyperthermia Muscle/tail tremors or rigidity Dyspnea Blanching and reddening of the skin Cyanosis Death
85
What may be used to intubate small patients such as ferrets or birds? Why?
Cole tubes They are 2.5mm in diameter and have a tapered end, making it a good choice for small animals and birds
86
When compared to other species, horses are more likely to develop what conditions during the maintenance phase of anesthesia?
Hypoxemia Hypotension Hypoventilation
87
What are common locations for arterial lines in horses?
Dorsal pedal Facial artery Transverse artery
88
What is the first-line drug for correcting anesthetic hypotension in horses?
Dobutamine
89
How much lidocaine can be administered to the glottis to aid in intubation in cats, pigs, sheep and goats?
Cats: 0.1 mL Pigs/sheeps/goats: 1-2 hours
90
What does treatment of malignant hyperthermia in pigs entail?
Removal of stress External cooling IV dantrolene sodium - blocks the sarcoplasmic reticulum's release calcium release from skeletal muscles, causing muscle relaxation
91
What is dysphoria most often associated with?
Excessive dose or intolerance of opioids
92
What is the maximum expected oxygen flow level for patients under 30 kgs?
1 to 3 liters per minute
93
What is the maximum expected oxygen flow level for patients over 30 kgs?
3 to 4 liters per minute
94
What is the maximum expected oxygen flow level for large animals?
10 liters per minute
95
What should the pressure-limiting valve be placed to?
1-2 cm of H2O
96
What are the reasons for fluid therapy under anesthesia?
Ensure adequate blood volume Ensure proper tissue perfusion Maintain adequate cardiac output - not increase or decrease it
97
At what rate does the oxygen flush valve deliver fresh oxygen?
35-75 L/min
98
What is anesthetic dead space?
Breathing tubes and passages that convey fresh oxygen to the alveoli but where no gas exchange occurs
99
What are the most common complications that occur from failing to provide padding and positioning of large animal patients under anesthesia?
Myocarditis and radial nerve paralysis
100
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