recovery and special techniques

list 4 things that lead to a longer recovery time for patients

• longer anesthetic times

• Underlying disease

• Type of drug and route, longer recovery with IM anesthetic than IV

• Hypothermia

• Breed

An 11 month old female poodle wakes up from anesthesia screaming, paddling and trying to bite. What is this stage and why does it happen

Emergence delirium/dysphoria. It happens when patient passes back through the excitement phase as they recover from anesthesia

How many minutes of oxygen is ideal for patients to receive after turning off the inhalant

Minimum 5 minutes

What are signs that the patient is ready to be extubated

• swallowing

• Voluntary movement

• Chewing

Give one example of local blocks administered in each of the following routes

• topically

• Infiltration

• Nerve block

• Line block

• Regional anesthesia

• Topically- lidocaine for laryngospasms, proparacaine for tonometry readings, lidocaine on urinary catheter, topical wound sprays and lidocaine patches

• Infiltration- used for skin biopsies, removal of small skin tumors and repairs of minor lacerations

• Nerve block- Dental blocks in dogs and cats (infraorbital, mental and mandibular), Intercostal nerve blocks for chest surgery, Brachial Plexus Block for limb amputation, Declawing cats, Paravertebral blocks for abdominal surgery and c-sections, Diagnostic nerve blocks for horses

• Line block- Used for wound repair, teat surgery in cattle and laparotomy in ruminants

• Regional Anesthesia- paravertebral, epidural, spinal and brachial plexus blocks

Why is epinephrine added to some local blocks

• causes constriction of blood vessels

• Decreases the rate of drug absorption

• Prolongs the effects by approximately 50%

What is the difference between manual and mechanical ventilation

Manual ventilation is bagging/sighing patient. Mechanical ventilation is controlled by ventilator

What happens to the patient if they are unable to exhale their CO2 completely

Builds up in blood leading to hypercapnia causing respiratory acidosis

When manually ventilating or sighing a dog or cat, what is the maximum pressure that can be applied

20 cmH2O

How does a neuromuscular block work

Causes paralysis with no analgesia, sedation, or anesthesia

When does the postoperative period begin for the surgical patient

On discontinuation of anesthesia

Approximately half of all anesthetic related deaths occur during which phase of the procedure

Recovery

After discontinuing the inhalant at the end of a procedure, how many minutes of oxygen should be administered to the patient

5 minutes

What extra steps are involved when recovering a brachycephalic dog

Delay extubation if possible

Prior to regaining consciousness, what patient care steps should be preformed

• remove restraining ties

• Complete bandages or urinary catheter placement

• Remove monitoring devices

How do local anesthetics treat pain

Prevents neurons from conducting pain signals

Which drug is not considered a local anesthetic

Meperidine

To prolong the duration of action because of vasoconstriction, lidocaine is often available in combination with

Epinephrine

Which of the following characteristics of a local anesthetic are beneficial for debilitated patients

Minimal cardiovascular/respiratory effects

An epidural is an example of regional anesthesia

True

🔴an epidural is most commonly administered where in the dog

Between L7 and the sacrum

🔴What is the positive pressure ventilation (PPV)

🔴what signals the brain that it is time to take a breath

What is the normal tidal volume for an awake patient (ml/kg)

10-15

Term atelectasis

Collapse of the alveoli

What is the most common acid base abnormality in anesthetized patients

Respiratory acidosis

🔴If the anesthetists sighs their patient three times in a row, what will happen to the patients ETCO2

What is a risk of using the ventilator

Blood pressure may be decreased with too much positive pressure

🔴what is the effects of using a neuromuscular blocking agent

🔴what muscle type that is most affected by neuromuscular blocking agents is