24 -6 Anesthesia and Gastrointestinal Disease in Small Animal Patients (😭💀🫦🥵🙂‍↔️🌶 2+2 =the square root of 16 please help)

True

T/F In healthy patients, the effects of most anesthetic agents on the GIT are usually short-lived and normal function returns with the decline of drug levels But patients with GIT disease may have prolonged abnormal functions

change in saliva production

vomiting

ileus

regurgitation

gastroesophageal reflux

constipation

reduced secretion of digestive fluids

aerophagia (associated with panting)

what are some possible GI effects of anesthetic agents? (8)

dehydration

hypovolemia

hypotension

What fluid status abnormalities can occur in patients with GIT disease that may affect the overall stability of the patient? (3)

chill

Patients with GIT diseases may have anemia, protein loss, electrolytes abnormalities, acid-base derangements, hyoxemia, myocardial dysfunction, and vomiting and aspiration that may affect the overall stability of the patient

chill?

vomiting

what is a common side effect of many anesthetic drugs because blood born substances can stimulate the chemoreceptor trigger zone (CRTZ) and the neural pathway can activate the vomiting center (VC)?

true

T/F the vomiting center can be stimulated by the CRTZ, histamine, acetylcholine, dopamine, serotonin, neurokinin-I, opioids, and a2 agonists

hyperproteinemia

anemia

what are two systemic conditions that are associated with GIT disease that are pre anesthetic considerations with endoscopy of the upper or lower GIT?

opioids

a2 agonists

what two drug classes may constrict GIT sphincters and therefore, make passing endoscopes difficult so should be avoided for GIT endoscopy?

what drug should be used to sedate these patients instead?

hypotension

hypoventilation

vagal response

puts pressure on diaphragm (which puts pressure on lungs -> hypoventilation)

what can happen when the GIT is over inflated during endoscopy? Why?

gagging

swallowing

regurgitation

The patient should be in an appropriate plane of anesthesia for endoscopy, what are signs that they are not at an appropriate plane? (3)

emergency situations

GDV

intestinal obstruction

hemo-abdomen

neoplasia

septic peritonitis

biopsy

patients undergoing anesthesia for exploratory laparotomy are some of the most unstable patients. What are some examples of indications for exploratory laparotomy? (7)

patient stabilization

fluids!!!

gastric decompression

blood transfusion

antimicrobial therapy

pain management

what is key to successful anesthesia for exploratory laparotomy?

how can this be achieved? (5)

volume replacement

electrolyte therapy

acid-base normalization

what are some things fluids can be used for? (3)

hypoproteinemia

you should be cautious with fluid therapy in patients that have what abnormality?

hypotension

arrhythmias

hypoventilation

what complications should you be prepared for/expect during an exploratory laparotomy? (3)

opioids

the anesthetic protocol for exploratory laparotomy patients should be built around what class of drugs?

MAC reduction

analgesia

minimal effects on cardiovascular system

Why should the anesthetic protocol for exploratory laparotomy patients be built around opioids? What are the benefits? (3)

cardiovascular

a2 agonists

acepromazine

you should minimize dosages of drugs that have large effects on the ___________ system when developing an anesthetic protocol for exploratory laparotomy patients

what are two drugs you should minimize dosages of in these patients?

premedication: opioid

induction: propofol or alfaxalone or opioid/benzodiazepine

maintenance: inhalants or opioid infusion, or lidocaine infusion (+/-)

opioid/benzodiazepine (very unstable patients)

what is the typical anesthetic protocol for exploratory laparotomy patients? premedication (1), induction agents (2), and maintenance drugs (3)

which induction agents should be used in very unstable patients?

lidocaine

what sodium channel blocker is the only local anesthetic that can be given IV, is anti reperfusion injury, MAC reducing, and helps treat arrhythmias (VPCs)?

VPC

what is the most common arrhythmia in abdominal patients?

crystalloid fluids

blood pressure support

what adjunctive therapies should be considered for exploratory laparotomy patients? (2)

Dopamine

norepinephrine

vasopressin

dobutamine

phenylephrine

what are some drugs that could be used for blood pressure support? (5)

Alpha

vascular tone

beta

contractility

Dopamine primarily works on (choose one: alpha/beta) receptors to improve (choose one: vascular tone/contractility)

while dobutamine primarily works on (choose one: alpha/beta) receptors to improve (choose one: vascular tone/contractility)

False, it is extensive and intensive

T/F anesthesia monitoring for exploratory laparotomy patients is pretty chill

ECG

blood pressure

ETCO2

SPO2

arterial blood gas and electrolyte analysis

what monitoring tools should be used to monitor anesthesia in exploratory laparotomy patients? (5)

VPCs

V-tach

what two arrhythmias are we most concerned about with exploratory laparotomy patients?

Direct

a (choose one: direct/indirect) blood pressure should be used in very unstable patients

true

T/F exploratory laparotomy patients frequently require assisted ventilation

hypoxemia

what are we monitoring for with SPO2?

true

T/F arterial blood gas and electrolyte analysis may be necessary for ongoing therapeutic decisions