monitoring and responding

Question 1

what do you do if you are monitoring an animal under anaesthesia and it has bradychardia

Answer 1

• consider what is the normal for that animal first
• is it causing a problem with perfusion and oxygen delivery
• check SPO2 and ABP to decide
• consider what might be causing it (drugs, toxaemia, vagus, heart problems, hypoxia, hypothermia
• if output is being compromised need to intervene

Question 2

what would you do if you had a patient under anaesthesia who was tachycardic

Answer 2

• consider what was normal for the animal
• is it causing a problem
• causes: sympathetic stimulation, PaCO2, PaO2, pH abnormalities, CNS disturbances, Low ABP or cardiac disease, drigs
• check depth of anaesthesia

Question 3

list common causes of ectopic beats under anaesthesia

Answer 3

• circulating catecholamines
• hypoxia or hypercapnia
• hypovolaemia or hypotension
• anaesthetic frugs
• myocardial inflammation or stimulation
• trauma
• CHF or HCM
• major organ dz

Question 4

what are the most common causes of hypotension under anaestheisa

Answer 4

• anaesthetic drugs (alpha 2 agonists or ACP)
• hypovolaemia and haemorrhage
• cardiac insufficiency

Question 5

how do you treat hypotension under anaesthesia

Answer 5

• reduce volatile agent
• increase IVFT
• check urine output if possible
• re check ABP
• consider using inotrope or vasopressor

Question 6

what are some common causes of hypercapnia

Answer 6

• depth of anaesthesia
• hypoventilation
• pyrexia
• rebreathing
• fresh gas flow rates too low
• exhaustion of soda lime
• changes in dead space

Question 7

what do you do if your anaesthetised patient is hypoxaemic

Answer 7

• reconnect breathing system if disconnected
• re-intubate if extubated or tube is blocked
• replace the pulse oximeter probe
• reduce the volatile agent
• improve perfusion and inotropes
• ventilate animal if there is hypoventilation/obesity
• investigate other causes (haemorrhage, pneumothorax)

Question 8

what issues may occur on recovery

Answer 8

• dysphoria and prolonged recovery are common
• discern is dysphoria is pain or hypoxia or emergence/confusion
• provide IV analgesia, oxygen or sedation as necessary
• delayed recovery is often hypothermia, can antagonize other drugs and also check glucose