Monitoring, Complications and Recovery

How would you assess depth of anaesthesia in dog?

• eye position - should be ventromedial

• palpebral responses - shouldn’t be moving when touched

• jaw tone - should be slack and easy to open

• HR and RR - can’t assess depth with just this, the lighter the animal the closer to normal the HR will be

• limb withdrawal

• anal sphincter tone

How can you manually monitor the CVS in dogs?

• HR

• blood pressure

• pulse

• mucous membrane colour

• capillary refill time

• temperature of extremities

Mucous membrane colours

• white - hypovolaemia or anaemia

• red - vasodilation, or CO2 induced

• brown - paracetamol or

• purple -

• blue - anaemia

What monitoring equipment can be sued to assess CVS?

• blood pressure monitor

• ECG - electrical activity of heart (HR and rhythm)

• stethoscope - oesophageal and auscultation

• pulse oximeter

• capnograph - for cardiac output

How would you treat a second degree AV block with sinus complex?

• if blood pressure normal (above 60) - don’t need to treat

• if blood pressure decreased (below 60) - treat with atropine (anticholinergic - reduces PNS)

What monitoring equipment is used to assess the respiratory system?

• visual - look at chest

• capnograph

• pulse oximeter

• stethoscope

What is the normal range of CO2 in a dog?

• 35-45 mmHg (start to worry about it at 60)

• keeps pH 7.35-7.45

How would you treat hypocapnia due to rebreathing?

increase the fresh flow of gas

What to do in recovery if temperature is 35.8 degrees C?

• warm them up - e.g. blanket

What is the most likely reason for a low pulse oximetry reading?

• (should be above 95)

• weak signal from pulse oximeter (poor trace) - due to being cold, or being given drugs causing vasoconstriction

How can we fix a low pulse oximetry reading?

• warm up the theatre

• use a heat mat

• use circle breathing system instead

What do you do if patient in recovery is howling, reactive to pressure on surgical site?

• (patient in pain or emergence delerium)

• give analgesia

• give sedative

Why does hypotension matter

• need perfusion to heart, brain and muscles (kidneys are the 3rd in SA)

• perfusion to muscles important horses at risk of getting myopathy

What are concerns for recovery in horses?

• myopathy

• fractures

• pain

• colic

How can we decrease risks of problems in recovery for horses?

• sedation - make sure they don’t try and stand up prematurely

• tie ropes to help support the horse when they do stand up

In a cow in lateral recumbency, what can cause hypoventilation?

• rumen is compressing on lungs - due to bloat

• isoflurene too high - too deep into the anaesthesia

How to fix hypoventilation due to rumen bloat?

pass a tube via the oesophagus into the rumen to release gas causing bloat

What are main concerns for ruminants under general anaesthesia?

• neuropathy

• regurgitation

• bloat

What are the main concerns for recovery in ruminants?

• ruminants usually deal with recovery well