General Anesthesia

The definition of anesthesia is a state of ___

unconciousness

Anesthetized patient should lack ___ and ___, have ___ ___, depressed ___. It should be ___ and ___

sensation, memory, motor responses, reflexes, controlled reversible

Components of anesthesia: ___, ___, ___, and ___

preanesthesia, induction, maintenance, recovery

Recovery is the ___ of drugs, and that can consist of ___, ___, ___ and ___

metabolism, redistribtion, exhalation, or reversal

Anesthesia can affect ___ ___ as it is a controlled poisoning

vital centers

Anesthesia affects the vital centers including ___, ___, and ___

CNS, cardiovascular, thermoregulation

minimize the risk of anesthesia with ___ ___, ___, ___, ___ ___, and use the ___ ___ required

MBD results, stabilize, preanesthetics, drug identification, minimum dose

The minimum dose required is given via ___

titration

The response to anesthesia has ___ ___, and ___

individual variation, factors

factors that can affect anesthesia response: ___, ___, ___ ___, ___ and ___

age, breed, physical condition, preanesthetic, metabolism

Anesthesia stages is the ___ of ___

description of depth

There are ___ anesthesia stages

4

There are ___ planes in stage III anesthesia

four

Anesthesia stage I they are ___ but ___ and all ___ are present

concious, disoriented, reflexes

Anesthesia stage II: is the ___ stage but they aren’t ___ and have decreased ___ input. This stage can be bypassed with ___ or ___ ___

excitement, concious, inhibitory, preanesthetics, rapids induction

Anesthetic stage III plane 1 is ___, has ___ ___ ___, some reflexes are ___, respirations are ___ about ___-___ rpm, BP is ___, and the rate is greater than ___

light, good muscle tone, depressed, regular, 12-20, strong, 90

during anesthesia stage III plane 1 some reflexes will be present: ___ and ___, and the eyes will be ___ with ___

palpebral, pedal, central, nystagmus

Anesthesia Stage III plane 2 is considered ___, has ___ ___ tone , ___ reflexes, the eyes are ___, respirations are ___ but more ___, BP is ___, and the HR is greater than ___

surgical, relaxed muscle, fewer, ventral, regular, shallow, decreased, 90

Anesthesia Stage III plane 2 have the ___ and ___ reflexes

corneal, palpebral

Anesthesia stage III plane 3 is ___, and has ___to ___ tone, reflexes are ___, the eyes are now ___, the respirations are ___ and less than ___ rpm, BP is ___, and the rate is ___-___, and the CRT is ___

deep, minimal to no, minimal, central, shallow, 12, weak, 60-90, increased

Anesthesia stage III plane four is ___, has ___ ___, ___ reflexes, the eyes are ___, respirations are ___ and ___, the BP is ___, CRT is ___, MM are ___, and the HR is <___

excessive, flaccid muscles, no, central, irregular, shallow, decreased, increased, pale, 60

Anesthesia stage IV is ___/___, has ___ ___, ___ reflexes, the eyes are ___, ___ respirations,and cardiovascular ___

moribund/dying, flaccid muscles, no, central, no, collapse

Cautions to take with anesthesia stages: it isn’t ___ ___, the stages can be ___, the ___ can alter it, and ___ variation.

well defined, mixed, agents, individual

IV induction is ___, can bypass stage ___, the agent can be ___, the ___ can vary, can ___ dosing, can do ___ ___, and also ___ in emergency

rapid, II, titrated, duration, repeat, constant infusion, rescue

IM induction has ___ agents available, is indicated if it is difficult to do ___; Some characteristics include ___ dose, it is difficult to ___, has a longer ___, and longer ___

fewer, IV, increased, titrate, onset, recovery

An IM induction agent: ___

ketamine

Indications to induce IM: if the animal is ___, or ___

small, uncontrollable

IM induction requires _-___ the dose of IV induction

2-3x

Inhalation induction has ___ agents, allows for ___ ___ of depth, and has different ___ methods, but there will be ___ gas ___, may cause ___, or ___

variable, rapid control, delivery, waste, pollution, stress, emesis

Delivery methods of inhalation induction: ___ which they may fight or ___ where you can’t monitor

mask, chamber

Stress during inhalation induction may increase ___

epinephrine

Oral induction is very ___, usually ___-___ use, and used in ___ ___

rare, extra-label, fractious cats

When monitoring induction remember the __ of anesthesia, and check the ___, ___, ___/___, ___ and ___ ___

stages, HR, respiration, CRT/MM, reflexes, muscle tone

The airway can be controlled with ___ ___

endotracheal intubation

Endotracheal intubation allows for efficient ___ ___, reduces ___ ___, delivers ___, and protects ___

gas delivery, dead space, O2, airways

intubation allows for efficient gas delivery leading to decreased ___ ___, and decreases ___

waste gas, cost

intubation reduces dead space aka the are of ___ ___

no exchange

IPPV or ___ ___ ___ ___

intermittent positive pressure ventilator

PPV is ___ ___ ___

positive pressure ventilation

IPPV can be done via ___ ___

resevoir bag

PPV can be done via ___

ventilator

The airways can be protected when intubated with a ___ ___ ___

cuffed ET tube

Hazards of ET intubation: ___ ___, ___ ___, ___ ___ ___, ___ of ___, ___ ___, ___, ___ ___, ___ ___ and ___

vagal stimulation, traumatize larynx, excessive tube length, level of difficulty, pressure necrosis, obstruction, recovery monitoring, disease fomite, irritation

ET intubation be stimulate the ___ nerve leading to parasympathetic affects like ___ and ___

vagus, bradycardia, hypotension

If during intubation the larynx is damaged it can cause ___ in cats

laryngospasm

Excessive tube length increases ___ ___, which is why ___ ___ may occur to eliminate excessive length

dead space, bronchial intubation

The difficuly of intubation can be effected by ___ or ___

species, breed

Another complication of intubation is ___ ___ which can be prevented with a hiss test

pressure necrosis

The primary goal of maintenenance is ___, and maintaining the ___ ___

monitoring, proper depth

Monitoring should be done q ___, and if they are high risk should be ___, ___ should be taken, and ___ should be acessesed

5 min, continuous, vitals, reflexes

Reflexes give information about ___ during anesthesia

depth

Dogs HR during anesthesia should be > than ___

60

Cat HR during anesthesia should be >___ bpm

100

Monitors for HR and rhythmn: ___ ___, ___ ___, and ___

esophageal stethoscope, pulse palpation, ECG

CRT indicates ___ but isn’t always accurate

perfusion

MM color checks for ___ or ___

pallor, cyanosis

Cyanosis of the MM indicates decrease in ___ as it requires adequate Hb about _ __/___

oxygen, 5 g/dl

Blood loss on the floor about 12×12 inches is ___ ___

100 mls

Sponges that are 4×4 hold about _-_ ml

5-10

3×3 sponges hold about _-_ ml

5-6

laparatomy hold about ___ ml

50

Blood loss can be calculated by ___ x ___/ ___ ___

PCV x volume/ animal PCV

Pulse strength is a ___ ___ of BP

rough estimate

Locations to palpate BP is ___, ___, ___, and ___ ___

lingual, femoral, carotid, dorsal pedal

Pulse pressure is the diffrence between ___ and ___

systolic, diastolic

Respiration is about ___ control

CO2

If the respiratory rate is below ___ is risky

8

Respiration sounds: ___ ___, ___ and ___

harsh noise, whistle, wheeze

The depth of respiration depends on the ___ ___. It can decrease by ___ during anesthesia.

tidal volume, 25%

If the depth of respiration isn’t sufficient can lead to ___

atelectasis

Hypoventilating leads to decreased ___ and ___

rate, volume

hyperventilation leads to ___ and increased ___

tachypnea, volume

Inspirations last about _-__ s

1-1.5 s

Exhalation last about _-__

2-3 s

An apneustic is when there is a ___ before and exhalation

pause

Temperature will always ___ during anesthesia

falls

Reasons why temperature can fall includes: ___, ___, and ___

drugs, preparation, procedure

The procedure can affect temperature due to ___ ___, ___ or decreased ___

open cavity, prolonged, metabolism

potential problems with temperature: decreased ___ ___, decreased ___ ___, or ___

anesthetic requirements, hepatic metabolism, shivering

shivering leads to increased ___ demand

oxygen

Temperature can be montored via ___, ___ or ___

palpate, rectal, probes

Some probes that can measure temperature: ___ or ___

aural, esophageal

Prevent hypothermia with ___ ___, ___, ___/___. ___ ___, but avoid ___ heaters

heat blankets, warmies, plastic/foil, bair hugger, electric

The best monitor for anesthesia is a skilled ___

anesthetist

An arterial catheter is for ___ ___ of status

direct measurement

An arterial catheter can be attached to a ___ or ___ ___

manometer, pressure transducer

What readings do arterial catheters provide: ___, ___, ___ and ___ ___

systolic, diastolic, mean, ABG measurements

probles with arterial catheters: ___ problems

clotting

Methods to measure indirect BP is ___, or ___

doppler, oscillometric

A doppler requires a ___, a ___ ___ and ___ ___ ___

sphagnomanometer, pressure cuff, doppler flow probe

Doppler flow probe requires contact over the ___

artery

Principles of indirect measurement: occluding ___ ___, gradually ___, ___ ___, and ___ ___

arterial flow, return, audible signal, pressure reading

Errors with the dopplers BP measure: ___ ___, ___ ___ ___, ___ ___, only ___ ___, and___ ___

understimates cats, wrong cuff size, coupling gel, systolic measurement, intermittent readings

Oscillometric detects ___ ___, and ___ ___

limb distension, computer calculation

Oscillometric measurement detects when the limb distends from the ___ ___, and the cuff ___ changes

artery pulsation, pressure

Oscillometric measurement uses computer calculations to measure. It measures ___, ___, and ___. It can be inaccurate due to ___ patients and ___

systolic, mean, diastolic, small, hypotension

A jugular catheter can be used to measure ___ ___ ___

central venous pressure

Jugular catheter allows to monitor ___ ___, and ___ ___ ___

monitor fluid therapy, right heart failure

Normal central venous pressure is less than ___ ___ ___

8 cm H2O

Excessive central venous pressure is above ___ ___ ___

10 cm H2O