Peri-anesthesia Monitoring and Complications VI

Altered thermoregulatory function

Radiation, conduction, convection from skin

Evaporation from abdomen

What are causes of hypothermia?

Reduction of anesthesia

Prolonged recovery

reversible coagulopathy

What can hypothermia cause?

Restrictive polymer electric heating (hot dog)

Forced warming air

What are some preventions for hypothermia?

Thermal burns

What must you be careful of when preventing hypothermia?

Opioids: Hydromorphone and buprenorphine

What drugs most commonly cause opioid induced hyperthermia in cats?

Self limiting (Less than 105)

Remove heat, fan

How do you tx opioid induced hyperthermia in cats?

Humans and pigs

Malignant hyperthermia is most common in what animals?

Inherited ryanodine receptor gene (RYR1 mutation) - uncontrolled Ca+ efflux from sarcoplasmic reticulum

What causes malignant hyperthermia?

Highly fatal

Malignant hyperthermia is highly ____?

Regurgitate

Animals are more likely to ____ under anesthesia?

Aspiration pnemonia

Ulcerative esophagitis or stricuture

Nasopharyngeal irritation

What are three things regurgitation can cause?

Fasting

Seal airway, verify repeatedly

-dont deflate too soon

How is aspiration pneumonia prevented?

Ruminants

Megaesophagus

Brachycephalic dogs

GI obstructions

What animals are at risk of aspiration pneumonia (4)?

-Have suction ready (b4 intubation)

-If regurge hold muzzle down and allow drainage

-Pass tube in stomach to drain

How do you handle a patient w/ GI obstruction to prevent aspiration pneumonia?

Ruminants (8-12 hours)

What animal is it important to withhold water prior to sx?

GI obstructions

We should not use gastroprokinetics on what patients?

Metacloparmide (D2 antagonists)

Cisapride ( 5-HT4 agonists)

What two gastroprokinetics can we use to prevent regurgitation?

Lower the muzzle

Double check airway is sealed

Check pH of regurgitant

Lavage!!!

Instill and leave sodium bicarbonate in pH was less than 4

What do you do if there is regurgitation?

Most common in cats

ET tube cuff overinflation

Dental procedures

Multi position changes

Stylets

What can cause tracheal tears?

Sq emphysema

pneumomediastinum

What are consequences of tracheal tears?

4hr- 14 days

When can you dx Sq emphysema?

Mild: O2 therapy, cage rest

Severe: Sx repair w/ progressive dyspnea

How do you tx for Sq emphysema?

Careful inflation of the cuff

Disconnect ET tube/ breathing circuit when changing positions or moving pts.

How do you prevent tracheal tears?

Swelling/ edema - Will see after extubation - can occlude airways

What can irritation cause?

Agressive intubation

Downsize ET tube - if too tight

Don't move ET tube after inflammation

How do you avoid airway irritation?

Dexamethasone SP b4 extubation

If you are concerned about airway inflammation what should you do?

Compressions - better recovery if under anesthesia

What should you do if cardiac arrest occurred under anesthesia?

Turn off anesthetics and analgesia

Ventilate - dont hyperventilate

Reverse anything that can be reversed

Record everything

What should you do in addition to compressions if Cardiac arrest occurs?