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Anaesthesia Flashcards

(122 cards)

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1
Q

True or false:

If there is no dangerous amount of fluid in the oral cavity, remove the tube with the inflated cuff

A

False

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2
Q

True or false:

Stadium analgesia = Maximal pupil dilation, no corneal tension

A

False

Maximum pupil dilation + no corneal tension = Stadium asphyxia

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3
Q

True or false:

For Acepromazine we can use higher doses, because lower doses notably elongates the duration of action

A

False

Dose increase = Duration increase (4 —> 48h)

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4
Q

True or false:

The general dose of Propofol is 0,5 mg / bwkg IV

A

False

Dose = 5 mg/bwkg IV

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5
Q

What is the general dosage of propofol?

A

5 mg/bwkg IV

SLOWLY

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6
Q

What is the Inhalation : Exhalation ratio when the patient is on ventilation?

A

1:2 - 1:3

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7
Q

True or false:

Lidocaine administered IV to an anaesthetised hope increases the risk of post-operative ileus

A

False

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8
Q

True or false:

The parameters of ventilation is:
Inhalation : Exhalation time ratio 1:2 - 1:8

A

False

It’s 1:2 - 1:3

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9
Q

True or false:

Pain sensation is not influenced by fear or stress

A

False

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10
Q

True or false:

Pain management is not very important in young animals, but it is in adults

A

False

Equally important

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11
Q

True or false:

Phenothiazine is good for pain management

A

False

Does not have any analgesic or hypnotic properties

Good for calming, antihistamine effect, antiemetic, anticholinergic
Neuroleptanalgesia in combination with opioids

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12
Q

True or false:

Dantrolene of a good antagonist of propofol

A

False

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13
Q

True or false:

The blood/brain barrier is less permeable, so puppies until 4 weeks of age require higher doses

A

False

They require lower doses

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14
Q

True or false:

Older patients have an increased vital capacity, respiratory frequency, and compliance

A

False

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15
Q

True or false:

Opioids cannot be administered intraoperatively

A

False

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16
Q

True or false:

During epidural analgesia 10% Lidocaine is most frequently used

A

False

2% Lidocaine is used

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17
Q

What is the % of Lidocaine used during epidural analgesia?

A

2%

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18
Q

True or false:

Phenothiazines are given most frequently to colic horses to reduce visceral pain

A

False

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19
Q

True or false:

Most postoperative complications can be manifested using balanced anaesthesia (PIVA)

A

False

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20
Q

True or false:

Only the indirect measurement of the arterial blood pressure is available in anaesthetised horses

A

False

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21
Q

True or false:

Ketamine cannot be given to a standing horse to relieve pain

A

False

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22
Q

True or false:

Neonatal have a lower MAC for inhalational anaesthetics than older foals / adults

A

True

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23
Q

True or false:

Benzodiazepines can be used for premedication in bovines

A

False

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24
Q

Which drug(s) are Greyhounds sensitive to?

A

Thiopental

No fatty tissue for redistribution

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25
Which drug(s) are Dobermans sensitive to?
ACP ``` Dilatational cardiomyopathy (DCMP) Blood clotting disorders ```
26
Which drug(s) are Staffies / Greyhounds / Halflingers sensitive to?
Alpha-2 agonists
27
Which drug(s) are Boxers sensitive to?
Phenothiazine Causes hypotension
28
What is important to remember when anaesthetising Brachyocephalic breeds?
1. Pre-oxygenation 2. Short induction 3. Fast intubation 4. (Extra) Late extubation
29
What are large breeds / individuals sensitive to during anaesthesia?
Hypoxia
30
What are warm-blood type and individuals sensitive to during anaesthesia?
Higher metabolic rate: decreased effect of sedatives
31
What are the positive effects of premedication?
1. Decreased pain, stress, fear, accident risk 2. Decreased anaesthetic drug dosage, side effects, material expenditure, and costs 3. Elimination of excitation stage, balanced anaesthesia
32
What do we use vein cannulation for (IV access) during induction / surgery?
1. Drug administration 2. Fluid therapy 3. Emergencies
33
Which veins are used for cannulation (IV) in small animals?
V. cephalica V. saphena (V. jugularis)
34
What are some characteristics we want from the drugs we use for induction (Injectable / inhalational)?
Moderate / no side effects Rapid onset Short duration Counteractable
35
What is the aim of induction?
For the patient to reach an unconscious, intubatable state
36
What are some characteristics of elderly patients?
Lengthened circulation time (delayed anaesthetic effect) Decreased water content of cells Increased fat content Lower compensation capacity
37
What are the stages of narcosis?
1. Analgesia (Induction phase) 2. Exitationis (Excitatory phase) 3. Tolerantiae (Surgical narcosis) 3a. Superficial 3b. Surgical tolerance 3c. Deep 4. Asphyxiae (Overdose, asphyxiation)
38
What is the antagonist of opioids?
Naloxone (/Naltrexone) | Mainly used in human medicine!!
39
What is the antagonist of Aplha-2 drugs?
Atipamezole (/ Yohimbine)
40
What is the antagonist of benzodiazepines?
Flumazenil
41
What is the definition of recovery (stage of surgery)?
1. Ending anaesthetic administration (elimination) | 2. Extubation (after the return of swallowing and coughing reflexes - later in brachyocephalic breeds!)
42
What is a Capnograph?
A graphic display of values on a time chart. CO2 determination of the exhaled air Used to supervise the respiratory frequency, etCO2 and inhalant anaesthetic concentration, circuit pressure, and tidal minute volume (et = End Tidal)
43
What do we use a Capnograph for?
Used to supervise the respiratory frequency, etCO2 and inhalant anaesthetic concentration, circuit pressure, and tidal minute volume (et = End Tidal)
44
True or false: End tidal CO2 level correlates with arterial CO2 pressure (paCO2); paCO2 > etCO2
True
45
What is the paCO2 : etCO2 difference in small animals?
5 mmHg
46
What is the paCO2 : etCO2 difference in horses?
5-20 mmHg
47
True or false: paCO2 : etCO2 difference can be measured both from the mainflow and from the sideflow
True
48
True or false: Most inhalational anaesthetics are liquid (volatile)
True
49
What is required to convert a liquid inhalational anaesthetic drug to a gas?
Vaporiser! Temperature dependent (stronger at higher temperatures) Requires energy (takes heat from environment)
50
What are vaporisers dependent on?
1. Temperature (stronger at higher temperatures) | 2. Energy (takes heat from environments)
51
True or false: Different inhalational anaesthetic drugs require different gas pressures (purpose-built vaporisers)
True
52
True or false: anaesthetic administration of modern vaporisers is not influenced by flow rate, surrounding environmental temperature, air pressure, temperature fluctuations during vaporising, or pressure fluctuations during respiration of ventilation
True
53
What are the two main types of vaporisers?
1. Injectable | 2. Variable-bypass
54
What is the definition of pain?
Complex, multidimensional negative experience (subjective)
55
True or false: There is no linear correlation between the degree of pathological changes and the intensity of pain
True
56
True or false: Pain sensation is strengthened by fear and stress
True
57
True or false: Parallel nociceptive effects add up (superposition)
True
58
What are the characteristics of pain?
1. Physiological (to prevent injury) 2. Pathological (due to actual injury) 3. Origin can be organic (somatic, visceral, neuropathic, or psychogenic 4. Duration of the sensation can be acute or chronic 5. Localisation (unusually sensitive = Tooth pulp, cornea, serous membranes, thorax, perineum, periosteum) 6. Modality (quality; mechanical, temperature, chemical)
59
What is Hyperalgesia?
Small pain provocation results in large pain sensation
60
What is Allodynia?
No pain provocation, but pain sensation occurs
61
What is the ideal SpO2 value?
100%
62
What is the normal O2 saturation of Hb?
100-97%
63
At what % of Hb O2 saturation do we say that a patient has reached hypoxia?
>90%
64
What is the normal etCO2?
35-45 mmHg
65
Which drugs do we use for sedation / premedication in neonatal foals?
Benzodiazepines (Diazepam, midazolam)
66
Which drugs do we use for sedation / premedication in foals?
Alpha-2 agonists | Xylazine, Detomidine, Medetomidine, Romifidine
67
Which drugs do we use for light induction in foals?
Inhalational or IV | Ketamine + Diazepam
68
Which drugs do we use for deep induction in foals?
Ketamine + Diazepam, alpha-2 agonist, or Propofol
69
Which drugs do we use for maintenance in foals?
Inhalationals PIVA: Isofluorane + Ketamine + Lidocaine TIVA (Total IV anaesthetics)
70
Can cattle and horses get the same drugs?
Yes
71
Name some premedication drugs (combos or single)
1. Acepromazine + Butorphanol 2. Medetomidine + Butorphanol 3. Medetomidine + Ketamine + Butorphanol 4. Midazolam + Butorphanol 5. Diazepam + Butorphanol 6. Fentanyl
72
What is the most dangerous with anaesthesia in the horse?
That the horse is recumbent on it’s back for so long The danger in lying down and waking / getting up
73
What does ASA stand for?
American Society of Anaesthesiologists
74
Describe the ASA 1
Healthy, symptom free And / or 6 weeks - 5 years
75
Describe the ASA 2
Mild systemic disease, no functional disorder apparent And or: 6 weeks - 5-8 years
76
Describe the ASA 3
Severe systemic disease with visible functional impairment, but not life-threatening And / or 8-10 years
77
Describe the ASA 4
Severe systemic disease, constant threat to patient’s life And / or 0-3 days, 10+ years
78
Describe the ASA 5
Moribund (dying) status. | Patient is likely do die within 24 hours with or without surgical intervention
79
Describe the ASA E
Emergency No time for classification (CEPOD 1)
80
Name some induction drugs (combos or otherwise)
Propofol IV, Ketamine + Diazepam IV Ultra-short acting barbiturates, steroids (and inhalationala) are also used for induction Inhalational: Isofluorane, Sevofluorane (Desofluorane) Total IV: Propofol + Fentanyl
81
What are the pre-operative antibiotics procedures?
Indicated in orthopaedic surgery 30 minutes prior to surgery, single dose to reach sufficient tissue levels, second dose lasting for 3 hours
82
When to use antibiotics (during surgery)?
1. In surgeries longer than 90 minutes 2. Implantations 3. Infections 4. Orthopaedics 5. Oesophageal involvement 6. “Dirty” surgeries (e.g. faecal or urine contamination), etc.
83
What is important to keep in mind when anaesthetising young / paediatric patients?
Heart: Immature innervation, low min volume, weak vasomotor, low BP Lung: Decreased alveolar surface area, increased respiration rate and min tidal volume
84
What is important to keep in mind when anaesthetising old / geriatric patients?
Avoid Alpha-2 agonists and Ketamine Decreased respiration Venous reflux from abdominal organs Heart: Decreased min volume and BP Lengthened circulation time (delayed anaesthetic effect —> easy to overdose!)
85
What is the consequence of pCO2 reacting >60mmHg?
Cyanosis, brain damage
86
True or false: One of the side effects of NSAIDs in increased intracellular pressure
False
87
True or false: Intubation is more difficult in cattle than in horses
True
88
Which drugs should not be used in liver patients?
1. Ketamine in dogs 2. Diazepam 3. Methoxyflurane 4. Halothane (completely forbidden for all)
89
Which opioid is recommended in liver patients?
Fentanyl
90
Which drug do we use in case of spinal injuries?
Methylprednisolone
91
Which part is not included in the anaesthesia machine? Mixing system or pulse-oximeter?
Pulse-oximeter
92
What is pulseoximetry influenced by?
1. Bilirubinaemia 2. Env. Temperature 3. Peripheral circulation 4. Hypovolaemia 5. Poor tissue perfusion 6. Hypotension 7. Shock 8. Vasoconstriction 9. Movement 10. Direct pressure on the sensor 11. Hair 12. Pigment 13. Thick tissue 14. Carbohaemoglobin (measures as oxyhemoglobin) 15. Methaemoglobin
93
True or false: Fenotiazine and Butorphanone derivates are good for preoperative analgesia
False
94
True or false: NSAIDs, opioids, and alpha-2 agonists are good for preoperative analgesia
True
95
True or false: It is important to prevent hypothermia and hypoglycaemia in the anaesthetised neonatal foal
True
96
True or false: Benzodiazepines are prohibited for use in food producing animals
True
97
True or false: Propofol can be used for induction in young foals
True
98
Why do we not use propofol in adult horses?
Too expensive!
99
True or false: We should not use alpha-2 agonists in foals less than 12 weeks of age
True
100
What is the volume of the ballon used in neonatal foals?
5L
101
What is the volume of the ballon used in 1-2 year old horses?
15L
102
What are some characteristics of Stadium analgesiae (induction phase)?
1. Strongly influenced by condition and temperament 2. Transition towards an unconscious state 3. Increasing immobilisation, ataxia, lying down 4. At the end of the stage, pain sensation ceases 5. Excitation, resistance, increased heart rate 6. Irregular breathing pattern, increased respiration rate 7. Dilated pupils, salivation, urination, defecation 8. Prolapsed third eyelid, yawning, vocalisation 9. Reflexes retained, reaction may be delayed 10. Coughing reflex present, intubation NOT possible 11. Only lasts a few seconds during IV induction
103
True or false: Isofluorane / sevofluorane / desofluorane are only used for intraoperative anaesthesia maintenance
True
104
What should we NOT give to patients with decreased kidney perfusion?
Alpha-2 agonists
105
What anaesthetic drugs can we give to patients with a decreased kidney perfusion?
Propofol and inhalational anaesthetics
106
True or false: General anaesthetics causes rigidity in the muscles
False
107
Which patients should NOT be given Ketamine?
Patients with: 1. Heart problems 2. Glaucoma 3. Head trauma 4. Hyperthyroidism
108
What are swine susceptible to when it comes to anaesthesia?
1. Ventricular arrhythmias 2. Fragile pulmonary tissue 3. Stress Very risky with anaesthesia!
109
What drug do we NOT give to diabetic patients?
Xylazine
110
What do we NOT give to cats with kidney failure?
Ketamine
111
What do we NOT give to dogs with liver failure?
Ketamine
112
True or false: 90% paO2 is physiological
False (hypoxia) Should be 97-100% ideally
113
Which os the following statements is false regarding opioids? 1. Major analgesics 2. Even though they bind the receptors with different affinity, they have the same effect 3. Last-option drugs 4. Antagonised by Naloxone
3. Last-option drugs
114
True or false: We use premedication to increase the excitability in the patient
False
115
True or false: 80-100 breaths per minute are normal parameters for ventilation in the horse
False 10-15 breaths per minute
116
How big should the balloon be in adult horses?
~30L | 5x the respiratory volume
117
What should the volume of the balloon be in small animals?
5x the respiratory volume 0.5L in small patients 5L in large patients
118
In the case of artificial ventilation, what is the pressure limit?
20-30 cmH2O
119
What is the respiration rate in cats and dogs during anaesthesia?
10-15 breaths per minute
120
What is the tidal rate in cats and dogs during anaesthesia?
10-15
121
How much O2 do mammals need per minute?
5-10 ml / kg
122
For which patients is a semi-open system recommended?
For patients under 8 kg Very small animals Newborn cats and dogs

Surgery (4 decks)

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