Veterinary Anesthesia Overview
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Questions and Answers

What is the difference between analgesia and anesthesia?

  • Analgesia refers to the loss of sensation in a body part or the entire body, while anesthesia refers to the absence of pain sensitivity.
  • Analgesia refers to the absence of pain sensitivity, while anesthesia refers to the loss of sensation in a body part or the entire body. (correct)
  • Analgesia refers to the depression of the central nervous system, while anesthesia refers to relaxing the patient so they are aware of surroundings but don't care.
  • Analgesia refers to the combination of a sedative/tranquilizer and an opioid, while anesthesia refers to the study of what the body does to drugs.
  • Which of the following is NOT considered part of a patient evaluation prior to anesthesia?

  • Previous medical history (correct)
  • Physical examination
  • Temperament assessment
  • Blood and urine samples
  • What does the abbreviation 'Pk' stand for in relation to drugs?

  • Pharmacokinetic (correct)
  • Pharmacodynamic
  • Post-anesthetic
  • Pre-anesthetic
  • Which type of drip set is typically used for cats and smaller dogs?

    <p>Micro drip set (A)</p> Signup and view all the answers

    What is the conversion factor for milligrams (mg) to micrograms (mcg)?

    <p>1 mg = 1000 mcg (B)</p> Signup and view all the answers

    What is the Bispectral Index (BI) used for in veterinary medicine?

    <p>Monitoring the depth of anesthesia (D)</p> Signup and view all the answers

    Which of the following is NOT a sign of adequate anesthetic depth in an animal?

    <p>Active palpebral reflex (C)</p> Signup and view all the answers

    What is the primary benefit of using an esophageal stethoscope?

    <p>Assessing respiratory rate and effort (B)</p> Signup and view all the answers

    Which of the following factors can influence the accuracy of Doppler blood pressure measurements?

    <p>Cuff size and placement (C)</p> Signup and view all the answers

    Which of the following is NOT a common sign of hypothermia in anesthetized patients?

    <p>Increased heart rate (C)</p> Signup and view all the answers

    What is the primary reason for using a Murphy's "murphy's eye" endotracheal tube?

    <p>Offers a safety feature in case of tube occlusion. (D)</p> Signup and view all the answers

    Which of the following is NOT a sign of Stage II anesthesia?

    <p>Regular breathing pattern (A)</p> Signup and view all the answers

    What is the primary reason for checking the palpebral reflex during anesthesia?

    <p>To confirm the effectiveness of the anesthetic. (B)</p> Signup and view all the answers

    Which plane of anesthesia is ideal for most surgical procedures?

    <p>Plane II (C)</p> Signup and view all the answers

    What is the primary reason for avoiding excessive cuff inflation during endotracheal tube placement?

    <p>It can cause damage to the tracheal lining. (A)</p> Signup and view all the answers

    What is meant by "dead space" in terms of the respiratory system?

    <p>Areas where gas exchange does not occur. (D)</p> Signup and view all the answers

    What is the most common way to confirm endotracheal tube placement during anesthesia?

    <p>Auscultation of lung sounds. (B)</p> Signup and view all the answers

    Which of the following is NOT a factor that can influence the monitoring of a patient's anesthesia depth?

    <p>Ambient temperature in the room. (C)</p> Signup and view all the answers

    What is the primary goal of monitoring a patient's clinical signs during anesthesia?

    <p>To prevent complications from the anesthesia. (B)</p> Signup and view all the answers

    What is the approximate oxygen flow rate used during the maintenance phase of anesthesia?

    <p>22 ml/kg/min (C)</p> Signup and view all the answers

    What is the normal range for end-tidal carbon dioxide (ETCO2) in a healthy anesthetized patient?

    <p>35-45 mmHg (A)</p> Signup and view all the answers

    Which of the following is NOT a common sign of mild hypothermia in an anesthetized patient?

    <p>Bradycardia (B)</p> Signup and view all the answers

    Which of the following is the most common cause of iatrogenic hyperthermia during anesthesia?

    <p>Excessive use of heating devices (B)</p> Signup and view all the answers

    Which of the following is the best predictor of systolic arterial pressure (SAP) in patients?

    <p>Oscillometric readings (B)</p> Signup and view all the answers

    Which of the following contributes MOST to heat loss in an animal?

    <p>Radiation and convection (D)</p> Signup and view all the answers

    Which of the following is NOT considered one of the '4 H's' in anesthetic complications?

    <p>Hyperglycemia (C)</p> Signup and view all the answers

    What is the normal range for heart rate in an adult horse?

    <p>28-50 bpm (C)</p> Signup and view all the answers

    Which of the following is NOT a sign of severe hypothermia?

    <p>Increased respiratory rate (D)</p> Signup and view all the answers

    What are the potential complications associated with using ice packs to cool a patient?

    <p>Vasoconstriction and alcohol absorption through footpads (B)</p> Signup and view all the answers

    What is the primary organ in the central nervous system responsible for regulating body temperature?

    <p>Hypothalamus (B)</p> Signup and view all the answers

    Which of the following is NOT a recommended method for actively warming a hypothermic patient?

    <p>Electric heating pad (B)</p> Signup and view all the answers

    What is the recommended temperature to stop active cooling of a hyperthermic patient?

    <p>104 degrees F (B)</p> Signup and view all the answers

    What is the recommended oxygen flow rate for a patient recovering from anesthesia?

    <p>50-100 ml/kg/min (A)</p> Signup and view all the answers

    What is the recommended procedure for disconnecting a patient from the anesthesia machine?

    <p>Disconnect the patient before turning them into sternal or lateral recumbency (B)</p> Signup and view all the answers

    What is the primary difference between fever and hyperthermia?

    <p>Fever is a regulated increase in body temperature, while hyperthermia is an uncontrolled increase (D)</p> Signup and view all the answers

    When monitoring a patient's temperature during recovery, how often should rectal temperature be taken?

    <p>Every 15-30 minutes (B)</p> Signup and view all the answers

    What is the recommended fasting period for equines before surgery?

    <p>4-12 hours (C)</p> Signup and view all the answers

    Which animal species should NOT be fasted before surgery?

    <p>Birds (A)</p> Signup and view all the answers

    Which of the following is a common anesthetic concern in obese animals?

    <p>Hypoventilation (D)</p> Signup and view all the answers

    What is the ASA Physical Status classification for a patient with severe systemic disease, fever, anemia, and renal dysfunction?

    <p>III (B)</p> Signup and view all the answers

    What is the capillary refill time (CRT) associated with a hyperdynamic state and possible shock?

    <p>Less than 1 second (C)</p> Signup and view all the answers

    What is the recommended fasting period for small ruminants before surgery?

    <p>12-18 hours (C)</p> Signup and view all the answers

    Which of the following is NOT a common anesthetic concern?

    <p>Hypertension (B)</p> Signup and view all the answers

    What is the primary difference between a PISS and a DISS?

    <p>PISS uses a threading system, while DISS uses a pin-and-hole system. (A)</p> Signup and view all the answers

    Flashcards

    Anesthesia

    Insensibility or loss of sensation in a body part or the whole body.

    Analgesia

    Absence of sensitivity to pain, often induced by certain drugs.

    Sedation

    Depression of the CNS that keeps the patient calm but not fully unconscious.

    Pharmacokinetics

    The study of what the body does to drugs, like metabolism and half-lives.

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    Patient Evaluation

    Assessment performed by the veterinarian before anesthesia, including history and diagnostics.

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    Anesthetic Monitoring

    The process of observing vital signs and responses in an anesthetized patient.

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    Bispectral Index (BI)

    An EEG analysis tool used to measure the depth of anesthesia; a BI of 60 means adequate anesthesia.

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    Ventral Medial Eye Rotation

    An eye position indicating deeper anesthesia; eyes rotate ventrally during relaxation.

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    Noninvasive Blood Pressure Measurement

    Techniques like Doppler and oscillometric methods to measure blood pressure without invading the body.

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    Pulse Oximetry (SPO2)

    Measures oxygen saturation in the blood through light absorption; uses non-hairy skin areas.

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    Fasting Times - Small Animals

    Food withhold period is 6-12 hours before surgery; water until premed.

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    Fasting Times - Small Ruminants

    Food withhold is 12-18 hours; water withheld for 8-12 hours.

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    Fasting Times - Equines

    Food withhold range is 4-12 hours; water until premed is given.

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    Fasting Times - Cattles

    Food withhold period is 18-24 hours; water for 12-18 hours.

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    No Fasting - Rodents, Rabbits, Birds

    These animals cannot be fasted due to high metabolism & hypoglycemia risk.

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    Dehydration Clinical Signs

    Signs not detectable if dehydration is less than 5%. 12-15% leads to shock.

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    ASA Physical Status Scale

    Rates patient surgical risk from I (healthy) to V (not expected to survive).

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    Medical Gas Safety Mechanisms

    Color-coding: Oxygen (green), N2O (blue); PISS and DISS systems prevent mix-ups.

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    ET Tube Sizing

    Measured from nose tip to shoulder; based on internal diameter.

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    Murphy ET Tube

    Most common type with a bevel and a 'Murphy's eye' for occlusion safety.

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    Capnograph Reading

    High CO2 values confirm proper ETT placement during anesthesia.

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    Dead Space

    Areas of air presence without gas exchange, such as trachea and mouth.

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    Cuff Inflation Technique

    Inflate cuff, initiate manual breath; no gas should escape.

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    Anesthesia Flow Rate

    Oxygen flow rate is 44 ml/kg/min at start and 22 ml/kg/min during anesthesia.

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    Stage II Anesthesia

    Stage of delirium with exaggerated reactions; avoid intubation too soon.

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    Surgical Plane of Anesthesia

    Stage III where vital signs stabilize; various planes exist from light to deep.

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    Factors Influencing Monitoring

    Factors like ketamine and propofol that affect anesthetic depth monitoring.

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    Stage IV Anesthesia

    Extreme CNS depression indicating overdose; signs include apnea and pale mucous membranes.

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    Fever

    A body temperature exceeding 107.6°F due to inflammation.

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    Hyperthermia

    Elevated body temperature due to external factors, not illness.

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    Heat Sensation Pathway

    The process where heat is sensed and communicated to the CNS.

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    Methods for Warming

    Safely increasing body temperature using passive and active techniques.

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    Cooling Techniques

    Methods to reduce body temperature, especially in hyperthermia.

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    Recovery Steps from Anesthesia

    Procedure to safely wake up a patient post-surgery.

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    Monitoring Temperature Post-Anesthesia

    Check rectal temperature continually until normalized.

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    Pyrexia vs Hyperthermia Treatment

    Different treatment approaches for fever and overheating.

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    ECG

    Measures electrical activity of the heart, indicating heart function.

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    P wave

    Represents atrial depolarization in an ECG.

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    Normal PaO2

    Normal arterial oxygen level should be > 95%, indicating good oxygenation.

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    Mild hypothermia

    Body temperature between 89.6-98.6°F with some physiological responses.

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    4 H's of anesthesia

    Common complications: Hypothermia, Hypoxemia, Hypotension, Hypoventilation.

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    Convection

    Heat loss through air or water molecules moving across the skin.

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    ST segment

    Represents ventricular repolarization on the ECG.

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    Study Notes

    Anesthesia Learning Objectives

    • Anesthesia is the loss of sensation in a body part or the whole body
    • Local anesthesia is different from general anesthesia
    • Analgesia is the absence of pain sensitivity
    • Sedation is a depression of the central nervous system, not unconsciousness
    • Tranquilization is a state where the patient is awake but not aware of their surroundings
    • Neuroleptanalgesia combines sedative/tranquilizer and opioid drugs for general premedication
    • Pharmacokinetics study how the body metabolizes drugs, including half-lives
    • Pharmacodynamics studies how drugs affect the body
    • Fluid drip rates vary between macro and micro drip sets, depending on the size of the animal
      • Macro drip sets (10 and 15 drops per mL) are for larger dogs
      • Micro drip sets (60 drops per mL) are for smaller animals like cats and exotics
      • 1mg = 100 mcg (ug)

    Patient Evaluation Before Anesthesia

    • Veterinarians perform patient evaluation before anesthesia
    • Evaluation includes species, breed, age, sex, medical history, physical exam, blood and urine samples, temperament assessment, mentation, pain, and stress level
    • Patient's condition before and after surgery is evaluated.
    • Advanced diagnostics are considered in the evaluation.

    Labwork for Healthy and Older/Unhealthy Pets

    • Routine labwork for healthy pets includes PCV, TP, Glucose, and BUN.
    • Older/unhealthy pets require additional labwork like CBC, chemistry, and urinalysis

    Safety Mechanisms for Oxygen Delivery

    • Safety mechanisms ensure the correct medical gas is used during oxygen delivery
    • Oxygen is green, Nitrous oxide is blue
    • DISS and PISS are specific threading for oxygen and other gases

    Oxygen Cylinders

    • Common oxygen cylinders are steel or aluminum
    • Large cryogenic liquid oxygen containers are also used in some facilities.
    • Portable "big thermo bottle" oxygen tanks are used in hospitals and clinics.
    • Oxygen concentrators absorb nitrogen from air to increase oxygen concentration.

    Anesthesia Machine Leak Test

    • Occlude patient end of Y piece (ONLY time the APL valve is closed)
    • Pressurize to 30 cmH20
    • Observe pressure gauge for 30s

    Anesthesia Machine Safety Concerns

    • Patients become hypoxemic (decrease in oxygen levels)
    • Environmental pollution
    • Improper use of rebreathing or non rebreathing systems

    Scavenging Systems

    • Systems that remove waste products from anesthetic gases
    • Passive systems use charcoal absorption for halogenated anesthetics

    Types of Endotracheal Tubes (ET Tubes)

    • ET tube size is important for fitting the patient safely
    • Murphey’s tube is a common ET tube with an oval hole positioned on the bevel facing the opening, providing an occlusion safety feature
    • Magill or coles tubes are less common.
    • Methods for confirming proper placement include capnography readings, auscultation of bilateral breaths

    Oxygen Flow Rate Calculations

    • Calculate remaining oxygen and time until empty.
    • P1/V1=P2/V2

    Safety Concerns With Anesthesia Equipment

    • Environmental pollution
    • Patient hypoxemia
    • Use of rebreathing or non-rebreathing systems: pros and cons

    Bispectral Index (BI)

    • Measures EEG values from the brain
    • Value of 60 means adequate anesthesia
    • Value of 0 = flat line, and 100 = awake

    Normal Vital Limits During Anesthesia

    • PaO2 > 95%
    • ETCO2 = 35-45 mmHg
    • MAP = 60-100 mmHg ( > 70 in Equines)
    • SAP = 90-120 mmHg
    • RR = 10-20 bpm
    • Temperature = 98-102.5°F
    • Species variations in heart rate exist (ranging from 50-160 BPM depending on animal)

    Mechanisms of Heat Loss

    • Radiation: electromagnetic waves
    • Convection: air or water molecules
    • Conduction: contact between objects.
    • Evaporation: changing water to gas (sweat)

    Common Complications of Anesthesia

    • Hypothermia is a common complication
    • Decrease in RR, renal tubular function
    • Elevated serum amylase
    • GI disruption
    • Hyperkalemia
    • Absent neuro reflexes.
    • Moderate hypothermia (82.4-89.6⁰F) = Bradycardia, Slow RR, low BP.
    • Severe hypothermia (<82.4⁰F)= decreased HR+RR, absence of PLR, arrhythmias, unconscious, muscle rigidity.

    Four Most Common Issues with Anesthesia ("4 H's")

    • Hypothermia
    • Hypoxemia
    • Hypotension (decreased cardiac output)
    • Hypoventilation (increased CO2)
    • Hyperthermia

    Pitfalls during Anesthesia

    • Don't use electric pads for cooling.
    • Remove all non-essential monitors before releasing from anesthesia.
    • Avoid keeping inhalant (vaporizer) on until completely out of surgery.
    • Turn oxygen flow to 50-100 ml/kg/min
    • Disconnect ET tube after 1-2 swallows in cats, and 2 swallows in dogs (laryngeal reflux noted before deflating cuff).
    • Monitor all vitals until P fully awake. Assess potential pain meds after P is fully awake.

    Difference Between Pyrexia and Hyperthermia

    • Pyrexia: the body's attempt to fight an infection (Don't cool)
    • Hyperthermia: excessive heat that needs to be actively cooled (Cool)

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    Anesthesia SG E1 PDF

    Description

    This quiz covers essential learning objectives related to anesthesia in veterinary practice. It includes distinctions between local and general anesthesia, explores sedatives and analgesics, and highlights the importance of pharmacokinetics and pharmacodynamics. Additionally, it addresses patient evaluation techniques crucial for safe anesthesia administration.

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