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Questions and Answers
Questions and Answers
What is the defining characteristic of Stage I anesthesia?
What is the defining characteristic of Stage I anesthesia?
- Muscle relaxation and analgesia
- Suppression of the stress response
- The time from the start of induction drugs until loss of consciousness (correct)
- Complete loss of consciousness and sensation
Which of the following is NOT considered a component of general anesthesia?
Which of the following is NOT considered a component of general anesthesia?
- Hypnosis
- Analgesia
- Increased blood pressure (correct)
- Muscle relaxation
During Stage I anesthesia, a patient may exhibit which of the following signs?
During Stage I anesthesia, a patient may exhibit which of the following signs?
- Complete loss of consciousness
- Apnea
- Uncontrolled muscle spasms
- Progressive ataxia (correct)
Which plane of anesthesia is most desirable for surgery?
Which plane of anesthesia is most desirable for surgery?
What is the primary factor that can affect the monitoring of anesthetic depth?
What is the primary factor that can affect the monitoring of anesthetic depth?
What is 'balanced anesthesia'?
What is 'balanced anesthesia'?
Which stage of anesthesia is characterized by the loss of consciousness and the onset of a regular breathing pattern?
Which stage of anesthesia is characterized by the loss of consciousness and the onset of a regular breathing pattern?
What is the primary sign that differentiates Stage III, Plane I from the other stages?
What is the primary sign that differentiates Stage III, Plane I from the other stages?
Which animal species is most likely to exhibit laryngospasm in Stage II anesthesia?
Which animal species is most likely to exhibit laryngospasm in Stage II anesthesia?
According to the provided content, which of the following signs is NOT characteristic of Stage II anesthesia?
According to the provided content, which of the following signs is NOT characteristic of Stage II anesthesia?
Which stage of anesthesia is considered suitable for minimally invasive procedures?
Which stage of anesthesia is considered suitable for minimally invasive procedures?
What is the primary reason for the increased heart rate and irregular breathing pattern in Stage II anesthesia?
What is the primary reason for the increased heart rate and irregular breathing pattern in Stage II anesthesia?
Which of the following is a species-specific sign to look for when assessing anesthetic depth in horses?
Which of the following is a species-specific sign to look for when assessing anesthetic depth in horses?
What is a common problem associated with using ketamine as an anesthetic agent that makes assessing anesthetic depth difficult?
What is a common problem associated with using ketamine as an anesthetic agent that makes assessing anesthetic depth difficult?
Which of the following reflexes is abolished in Stage III, Plane 2?
Which of the following reflexes is abolished in Stage III, Plane 2?
What is the most significant characteristic that distinguishes Stage III from Stage IV?
What is the most significant characteristic that distinguishes Stage III from Stage IV?
Which of the following is NOT a factor that can make monitoring anesthetic depth difficult?
Which of the following is NOT a factor that can make monitoring anesthetic depth difficult?
What is the key characteristic of a patient in the surgical anesthesia plane?
What is the key characteristic of a patient in the surgical anesthesia plane?
Which of the following reflexes is NOT typically assessed during anesthetic depth monitoring?
Which of the following reflexes is NOT typically assessed during anesthetic depth monitoring?
What is a common concern with anesthetic depth in cats?
What is a common concern with anesthetic depth in cats?
Which stage involves a decrease in heart rate and slow, shallow abdominal breathing pattern?
Which stage involves a decrease in heart rate and slow, shallow abdominal breathing pattern?
What is a defining characteristic of Stage III, Plane II in terms of muscle relaxation?
What is a defining characteristic of Stage III, Plane II in terms of muscle relaxation?
Which stage is characterized by a progressively dilated pupil and a central position?
Which stage is characterized by a progressively dilated pupil and a central position?
What is a key indicator that an anesthetic overdose has occurred, leading to Stage IV?
What is a key indicator that an anesthetic overdose has occurred, leading to Stage IV?
Which of these is NOT a characteristic of Stage III, Plane IV?
Which of these is NOT a characteristic of Stage III, Plane IV?
What is the key distinction between Stage III, Plane II and Stage III, Plane III?
What is the key distinction between Stage III, Plane II and Stage III, Plane III?
Which of these is NOT a reliable objective sign for monitoring anesthetic depth?
Which of these is NOT a reliable objective sign for monitoring anesthetic depth?
What is the primary reason for placing lubrication ointment in the eyes of an animal under anesthesia?
What is the primary reason for placing lubrication ointment in the eyes of an animal under anesthesia?
Which statement is TRUE regarding anesthetic depth monitoring?
Which statement is TRUE regarding anesthetic depth monitoring?
Which of these is indicative of a severely depressed neurological system?
Which of these is indicative of a severely depressed neurological system?
Questions and Answers
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Flashcards
Flashcards
Premed effect
Premed effect
Initial reactions like struggling, breath holding, and increased heart rate due to epinephrine release.
Stage II of anesthesia
Stage II of anesthesia
Variable stage marked by struggling, irregular breathing, and potential vomiting.
Signs of Stage II
Signs of Stage II
Includes breath holding, increased heart rate, salivation, and possible laryngospasm.
Dilated pupils
Dilated pupils
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Stage III of anesthesia
Stage III of anesthesia
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Plane I of Stage III
Plane I of Stage III
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Loss of jaw tone
Loss of jaw tone
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Epinephrine release
Epinephrine release
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Signs of Anesthetic Depth
Signs of Anesthetic Depth
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Surgical Plane of Anesthesia
Surgical Plane of Anesthesia
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General Anesthesia Characteristics
General Anesthesia Characteristics
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Balanced Anesthesia
Balanced Anesthesia
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Classical Stages of Anesthesia
Classical Stages of Anesthesia
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Stage I Anesthesia
Stage I Anesthesia
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Surgical Anesthesia Plane
Surgical Anesthesia Plane
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Species Specific Signs
Species Specific Signs
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Pedal Reflex
Pedal Reflex
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Factors Affecting Monitoring
Factors Affecting Monitoring
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Anesthetic Gas Analyzer
Anesthetic Gas Analyzer
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Depth Measurement Challenges
Depth Measurement Challenges
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Stage III, Plane II
Stage III, Plane II
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Intercostal paralysis
Intercostal paralysis
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Deep Plane of Anesthesia
Deep Plane of Anesthesia
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Diaphragmatic respiration
Diaphragmatic respiration
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Stage III, Plane IV
Stage III, Plane IV
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Anesthetic overdose
Anesthetic overdose
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Ocular reflexes
Ocular reflexes
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Palpebral reflex
Palpebral reflex
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Corneal reflex
Corneal reflex
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Jaw tone
Jaw tone
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Study Notes
Study Notes
Monitoring Anesthetic Depth
- The lecture objectives are to recognize signs associated with anesthetic planes, describe patient appearance in surgical planes, and list factors affecting patient depth monitoring.
What is General Anesthesia?
- General anesthesia involves losing consciousness and sensation, and includes muscle relaxation, analgesia, stress response suppression, and hypnosis.
- It's a reversible process.
- It can be induced using one drug or a combination.
- Drug effectiveness can vary depending on the species and procedure.
Classical Stages and Planes of Anesthesia
- The table details anesthetic levels, surgical stimulation reaction, palpebral reflex, eye and pupil reflex, jaw tone, heart rate, and respiratory rate.
- Stage I involves voluntary movement, some analgesia, and progressive ataxia leading to recumbency. It can be erratic.
- Stage II is characterized by struggling, vomiting, regurgitation, increased heart rate, and active reflexes, laryngospasm and dilated pupils
- Stage III, Plane I is minimal anesthesia, maintaining eye movements, suitable for minimally invasive procedures.
- Stage III, Plane II a medium plane where most surgeries are performed, having stabilized respiration and heart rate, strong corneal reflex and relaxed muscles.
- Stage III, Plane III is a deep plane described by decreased heart rate, slow, shallow abdominal breathing. Absence of jaw tone, no response to stimulation, and weak reflexes like palpebral and corneal.
- Stage III, Plane IV entails dilated pupils, hypotension possibly progressing to shock, slow irregular respirations and the lack of muscle tone and anal sphincter tone.
- Stage IV represents severe CNS depression, indicated by extreme pallor, prolonged CRT, respiratory arrest, absence of ocular reflex and flaccid muscle tone. Recovery in this stage requires urgent intervention.
Stage I
- Defined as the time from administering induction drugs until loss of consciousness.
- Characterized by voluntary movement, ability to turn or lift head, and some analgesia.
- Patients may exhibit signs like progressive ataxia, excitement, struggling, breath holding, and increased heart rate.
Stage II
- Marked by an exaggerated response to stimuli, vomiting or regurgitation, salivation, laryngospasm, and dilated pupils.
- This stage might feature increased heart rate, irregular breathing patterns, breath holding, and involuntary movement, potentially leading to delirium
Stage III
- Characterized by progressive loss of consciousness, reflexes, and muscle tone.
- Breathing patterns become slower and more regular. Vomiting and swallowing reflexes are abolished, and jaw tone is lost.
Stage III, Plane I
- Also known as a "light" plane, this stage continues until eyeball movement stops.
- Suitable for minimally invasive, or painful procedures.
Stage III, Plane II
- Usually a "medium" plane where most surgical procedures are performed.
- Characterized by progressive intercostal paralysis, and stabilized heart and respiratory rates.
Stage III, Plane III
- Considered a "deep" plane.
- Show a decrease in heart rate and slow, shallow abdominal breathing.
- The anesthetic level has minimized responses to surgical stimulation and caused profound muscle relaxation.
Stage III, Plane IV
- Marked by pupil dilation, and progressing towards hypotension, shock if not quickly reversed.
- Slow, irregular respirations along with the loss of anal sphincter tone.
Stage IV
- Represents profound CNS depression, possibly leading to death without immediate intervention.
- Key indicators include pale to white mucous membranes, prolonged CRT (>3 seconds), respirations cease and it is followed by cardiac arrest.
Summary of Monitoring Depth
- Check for palpebral reflex, eye position (ventral), lacrimation, nystagmus, corneal reflex, jaw tone, anal reflex, pedal reflex, and overall muscle tone. These can vary significantly between species.
What is the Goal for a Surgical Anesthesia Plane?
- Relaxed jaw tone easily opens with two fingers
- Mild to no palpebral reflex
- Ventral medial eye rotation
- Relaxed anal tone
- Smooth, regular respiratory pattern
- Normal heart rate
- Absence of swallowing, coughing, vomiting or laryngospasm.
Species Specific Signs
- Rodents: Observe feet, ears, and muzzle for pallor or cyanosis. Pedal reflex (pinching toes).
- Poultry: Examine comb and wattle for pallor; vent reflex.
- Rabbits: Use color of light reflected from the eye to assess circulation.
- Horses: Lacrimating, eye stays central, medial eye rotation, and corneal reflex persists.
- Cats: Potential for laryngospasm, retained cough, swallow/vomiting reflex.
- Cattle: Consistent and reliable eyeball rotation.
Factors Affecting Monitoring Depth
- Drugs, Ketamine, Propofol, Oxygenation adequacy,CO₂ retention and physical status are primary difficulty factors. Ketamine may exhibit less typical eye signs and still show blinking and swallowing reflexes, Propofol doesn't produce analgesia and can cause apnea.
Other Methods to Measure Anesthesia Depth
- Anesthetic gas analyzers can measure minimum alveolar concentration (MAC), although they are not always readily available.
Bispectral Index (BIS)
- BIS analyzes EEG values from the brain to assess the depth of anesthesia in animals or humans. A BIS of 60 or greater often indicates appropriate anesthetic level. BIS is frequently used in research.
Recovery
- Recovery progresses in reverse order of the anesthetic stages and species and patient responsiveness are different.
- Post-operative pain in horses can be severe due to delirium/dysphoria, especially when transitioning from inhalant anesthesia.
- Anesthetized patients require monitoring for a suitable time, depending on the species.
Resources
- Key readings include various veterinary anesthesia handbooks and manuals.
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