Peri-anesthesia Monitoring and Complications

Fasting

Stabilization

Hydration

Medications

Understand pts status

What should be done for patient preparation?

Post anesthesia period

When is the highest anesthesia mortality rate?

Balancing degree of stimulation w/ level of pain management

ie Comfortable - not stressed or painful, and immobilized / hypnotized

What is the goal for depth of anesthesia?

Good analgesia is provided

Usually you can provide a light to medium anesthetic if?

Drug induced loss of consciousness in which patients wont be aroused even by painful stimuli

Define anesthesia?

Stage three

What stage is typically used for surgical anesthetic?

Stage 4

What stage is more dangerous and is typically associated w/ death?

Rxn to sx stim

jaw tone (or muscles)

Palpebral reflex

Eye position

What are a few things we check in Guedels classifications of depth of anesthesia?

Stage 3 medium

At what point do we see a loss of palpebral reflex?

Medioventral Rotation (medium depth)

What is typical globe position for most animals under anesthetics?

Stays in center but may rove

What is the typical globe position for the horse?

Either awake or dead

What is the depth?

Light - III-1

What is the depth?

Lighter medium - III- 1/2

What is the depth?

Medium - 3 stage - 2

What is the depth?

Light anesthesia - give IV anesthesia

In a horse what does a nystagmus suggest?

Decrease

Wide open

Eyelids muscle tone will ___ under anesthesia but horses will still be ____?

Gently touch edge of eyelid/ eyelashes - if you keep touching could desensitize

How do you perform palpebral reflex?

Stage 4 - dont lose means death :O

When would you lose corneal reflex?

Increased at lighter depth and decreases w/ deeper depths

How will lacrimal tearing in horses change as they get into a greater depth of anesthesia?

Small - not useful in large - too big muscles too tight

Jaw tone is typically used in what animals?

SK muscles - Neck, eye lids

Anal sphincter tone

What other muscles could you check for depth of anesthesia?

Respiratory patterns/ rates

What monitoring perameter will change first and is most sensitive to changes in depths of anesthesia?

Together

HR and BP will change ____ if becoming lighter or feeling pain?

Give more breaths - increase inhalant that is delivered

Consider adding analgesics (reduces MAC needed)

Increase vaporization -

If your patients are a little light how would you correct it?

Roughly 5 mins

How long does changes in vaporizations usually take to reflect a change?

25%

You should not increase vaporizations more than ___ at a time?

Give IV anesthetic w/ deep breaths

Add analgesics or hypnotics (Mac sparring)

Increase vaporizations

If your patient is way to light and about to wake up how would you correct it?

The status of the procedure - is it needed on where we are at in the procedure?

What should you consider when adding analgesics of hypnotics?

Grab muzzle to protect ET tube!!!!!

If the patient is really waking up it is important to do what?