Anesthesia - Quiz 4 Material

it reduces the chance of aspiration pneumonia from foreign materials in their mouth

Why is it important to rinse the horse mouth before anesthesia?

to help reduce foreign materials from entering the OR

Why is it important to clean the horse's hooves before anesthesia?

Mallard anesthesia machine (more reasonable cost).

What is the most used large animal anesthesia machine in vet med?

eye procedures such as laser, enucleation, and corneal ulcer treatments; minor orthopetic procedures like casting and xrays; laceration repairs; hoof trims

List 4 procedures that standing sedation would be used (horses)?

*separate answers with a semicolon

it helps ensure the horse sits and doesn't try to fall forward

During equine induction, someone is available to lift the patient’s head above the level of the rear. Why is it important to lift the head above the rear?

30 minutes at least

How long before anesthesia (before end of procedure) are you to stop a lidocaine CRI in equine anesthesia?

guaifenesin, Ketamine, Xylazine

Triple drip consists of what three medications?

*separate answers with a comma

true

T/F:

An equine patient under anesthesia can have a sluggish palpebral.

dorsal metatarsal artery, facial artery, transverse facial artery

What 3 arteries are normally used for invasive blood pressure monitoring in equine anesthesia?

*separate answers with a comma

to help prevent radial nerve paralysis

Why is it important to pull down the forelimb as cranial as possible when positioning an equine patient for anesthesia?

Phenylephrine

Which medication is used during equine recovery to assist with edema formed while being in dorsal recumbency?

8-12 hours

How long do calves, horses, sheep, and goats need to fast for prior to anesthesia

18-24 hours

How long do adult cattle need to fast for prior to anesthesia

Xylazine

Which premedication used in ruminant anesthesia is more potent in ruminants than other species?

Active regurg. can occur at induction; passive regurg. can occur throughout the procedure

Define the difference between active regurgitation and passive regurgitation.

butorphanol, buprenorphine, morphine, fentanyl

What are the four common opioids used in swine anesthesia?

it causes continuous muscle contraction and then a release of heat, up to 108-110 degrees F

What happens when a swine patient experiences malignant hyperthermia under anesthesia?

human error, equipment related issues, general anesthesia

What are the three common reasons for complications in anesthesia?

*separate answers with a comma

inadequate training; errors caused by fatigue, rushing, or inattention; failure to appropriately prepare patient for anesthesia

List three human error complications in anesthesia.

*separate answers with a semicolon

forgetting to open the pop-off valve after leak testing the machine, which creates a pneumothorax; failure to replace the sodasorb; failure to check the oxygen supply

List three equipment related complications in anesthesia.

*separate answers with a semicolon

inappropriate anesthetic depth, hypotension, hypothermia

List three general anesthetic complications in anesthesia.

*separate answers with a comma

anesthetic depth too light

term that describes:

slight to moderate jaw tone, palpebral, and central eye position

*level of anesthetic depth

anesthetic dept too deep

term that describes:

absent palpebral and jaw tone, central eye position

*level of anesthetic depth

adequate anesthetic depth

term that describes:

absent palpebral and jaw tone, ventral eye position

*level of anesthetic depth

higher

Hypoventilation results in a higher or lower ETCO2?

C-section, Respiratory distress, GDV, sepsis, hemo-abdomen

List the common anesthetic emergencies in veterinary medicine

*separate answers with a comma

almost everything you give the mother will affect the babies

In c-section patients we provide an epidural using local anesthetics. Why is it important to not premedicate the patient prior to delivering the babies?

it delays onset of hypoxia, it extends safe apnea time, minimizes risk during difficult airways, protects vulnerable patients

Why is it so important to pre-oxygenate a patient in respiratory distress before administering pre-medication to the patient?

*separate answers with a comma

do not (it's generally only for patients who need to be intubated).

if doing standing sedation on a horse, you ____do/do not___ need to rinse their mouth out.

mallard, surgiVet, Tafonius

What are the three types of large animal anesthesia machines?

*separate answers with a comma

15-30 L

What is the general range for adult horses if you use a bag on any of the three types of large animal anesthesia machines?

head prop

It is important to use a _____________ or an assistant for standing sedation with equine; it holds the head in a neutral position to avoid nasal congestion (which could lead to respiratory obstruction)

tranquilizers like acepromazine; opioids like butorphanol; alpha2 adrenergic receptor agonists like xylazine or dexmedetomidine

What are the pre-meds for Equine general anesthesia?

*separate answers with a semicolon

lowering of the head, drooping of the lip, shifting weight-broad stand, not listening to surrounding (induction).

What are some signs your Equine patient is sedating?

*separate answers with a comma

push on the point of the elbow

What can you do to help prevent your patient from falling forward, in addition to pulling the head above the rear?

22-30 MM

When selecting an ET tube, keep in mind that adult horses generally range between ____________ in diameter.

PIVA/partial intravenous anesthesia

-inhalant combine with sedatives, analgesics and muscle relaxants to maintain anesthesia

- goal is to reduce the MAC of your inhalant

-typically performed in a hospital setting

Alpha-2 adrenergic receptor agonists, lidocaine, muscle relaxants, opioids, ketamine

What are the PIVA drugs?

*separate answers with a comma

bladder rupture

Why should we never give Alpha 2s to blocked animals?

TIVA/Total Intravenous Anesthesia

- no inhalant anesthetic

- this is reserved for quick procedures, under an hour (not for prolonged procedures)

- includes Triple drip

- commonly do this in the clinic for cases like CT scans and casting

- field anesthesia

Nystagmus

What is the best indicator for (decreased) anesthetic depth for Equine patient monitoring?

increased lacrimation/tear production, nystagmus, increased blood pressure, increased respiratory rate

What are 4 signs of decreased anesthestic depth to look out for while monitoring an Equine patient?

*separate answers with a comma

hypoxemia, hypotension, hypoventilation

What are 3 anesthetic complications typically seen with Equine?

*separate answers with a comma

radial nerve paralysis

During Equine patient positioning,

pull the down leg forward to help prevent _______________________.

facial nerve paralysis

During Equine patient positioning,

remove the halter intra-op to prevent ___________________.

cervical damage or dislocation

Be careful when pulling the head for Equine positioning, because if you hyper-extend the neck, it can cause __________________________.

myopathy

- occurs when there is inadequate blood flow to the muscles

(disorder from decreased perfusion)

- typically manifests in recoover as muscle weakness, pain, stiffness/hardness

neuropathy

- when nerves are damaged due to insufficient padding

- aka damage or disfunction due to increased pressure over a nerve for a prolonged period of time

Phenylephrine nasal spray

_______________ for recovery is great for vasoconstriction.

- It is helpful because horses can get a lot of edema from being in dorsal recumbency which can make it difficult for them to breath

swallowing/chewing; listening to surroundings, purposeful movements of the limbs, ears, and tail; blinking/palpebral reflex

What are some signs to watch for Equine recovery (from anesthesia procedure)?

*separate answers with a comma

NO

Is it okay for an Equine patient to stand with nystagmus?

20-30 minutes

Be cautious when administering xylazine during Equine anesthesia recovery, because it can prolong recovery for approx. how long?

false

T/F:

Eructation is NOT a normal bodily function for ruminants

acepromazine, xylazine, detomidine

Pre-meds used for Ruminant Light-moderate sedation...

*separate answers with a comma

Acepromazine, Xylazine, Detomidine, Midazolam, Butorphanol

Pre-meds used for Ruminant Moderate-Deep sedation...

*separate answers with a comma

Xylazine

- most used

- more potent in ruminants than other species (goats>cattle>sheep)

- causes hyperglycemia

- this is an a2 adrenergic receptor agonist

*PRE-MED for Ruminant

acepromazine

-class: phenothiazine

- increased risk of regurgitation under anesthesia

- associated with penile prolapse (so avoid this premed in breeding bulls)

*PRE-MED for Ruminant and Swine

detomidine

-provides sedation and analgesia

- this is an a2 adrenergic receptor agonist

*PRE-MED for Ruminant

benzodiazepines (midazolam)

-provides sedation without analgesia when used alone

- high doses will produce recumbency

*PRE-MED for Ruminant

butorphanol

- Mu antagonist, Kappa agonist

- provides sedation and mild analgesia

- often combined with xylazine as a premed

*PRE-MED for Ruminant

antagonist; agonist

Butorphanol is a Mu ________________ and a Kappa ______________.

*separate answers with a semicolon

ketamine, diazepam, double drip, propofol

What are drugs used in induction for Ruminants?

*separate answers with a semicolon

Ketamine

- immobilization without analgesia when given alone

- commonly combined with a sedative or a benzodiazepine

*induction agent for Ruminant

Diazepam

- provides muscle relaxation

- combined with ketamine will give a long enough duration for intubation

*induction agent for Ruminant

guaifenesin

-skeletal muscle relaxant

- improves induction quality when combined with ketamine

*induction agent for Ruminant

propofol

- provides smooth induction and recovery

- can cause apnea when injected to quickly

*induction agent for Ruminant

allow drainage of saliva and regurgitated material

When positioning ruminants, like cattle, the mouth should be positioned lower than the pharynx to ____________________________.

pig boards, snout snare

methods/restraint techniques used in swine anesthesia...

*separate answer with a comma

acepromazine, dexmedetomidine, ketamine, midazolam, butorphanol

What pre-meds are used in Swine?

*separate answer with a comma

isoflurane-face mask, sevoflurane-face mask, propofol, alfaxalone, ketamine

What induction agents are used in Swine?

*separate answer with a comma

propofol

most common induction agent for Swine is...

poor visibility, limited mouth opening, long soft palate, narrow dental arcade, laryngeal spasms, ventral laryngeal diverticulum

Intubation is challenging in swine because...

*separate answer with a comma

ear, medial aspect of carpus

When monitoring Swine anesthesia, where are the palpable cardiovascular pulses?

*separate answer with a comma

malignant hyperthermia

when an animal while under anesthesia gets abnormally hot for no reason;

can result in death if not treated soon enough

porcine stress syndrome

- genetic mutation present in pigs (associated with Ca channels on skeletal muscles which cause continuous muscle contraction and then release of heat)

- aka "malignant hyperthermia"

- can be induced by stress and or anesthetics

Pietran, Landrace, Spotted, Large white, Hampshire, Poland-China

What are the typical breeds that get Porcine stress syndrome/malignant hyperthermia?

*separate answer with a comma

MAP of about 60-100, ideal being 80

value for a normal anesthetized patient blood pressure

bair huggers, hotdog blankets, water blankets, warm towels, warm fluid bags

What is used as heat support for patients experiencing hypothermia?

*separate answer with a comma

vomiting

this requires active abdominal effort; a forceful expulsion of stomach contents followed by retching

regurgitation

this is the flow of stomach contents into the esophagus and mouth unaccompanied by retching

code 0/code red/red collar

...means DNR (do not resuscitate)

- can only reverse drugs

- chances they come back is very slim

code 1/code green/green collar

...means resuscitate

- full CPR