Anaesthesia in animals with pre-existing disease Flashcards

Question

What is important to consider in patients being anaesthetised who have an oesophageal foreign body?

Answer 1

Tube may be damaged during surgery or need to be removed Stabilisation before Dehydration( not been able to drink) Potential for regurgitate and aspiration Pre-oxygenation Suction available Keep the head elevated until the ET tube is inserted and cuff inflated Possible rupture of the oesopagus Analgesia

Answer 2

``` Fluid balance disruptions hypovolamia acid base electrolytes dehydration Avoid vomiting inducing drugs Potential regurgitate and aspiration Slow release of fluid from the abdomen Hypothermia Monitor respiratory rate carefully ```

Answer 3

``` Shock, stabilise first fluids Decompress stomach Arrhythmias Careful monitoring cardiovascular system Hypotension Pressure on the diaphragm from distended viscous Clotting abnormalities Possible pneumothorax Intensive post-op care ```

Answer 4

``` Electrolyte and acid base imbalance Hypovolameia shock Dehydration Cardiovascular arrhythmia Very painful! Analgesia-NSAIDs, Xylazine, opioids Decompress stomach Distended viscera pressure on the lungs risk of rupture Endotoxamia Fluids-Hartmanns, 7.5% Nacl, colloids ```

Answer 5

Acute liver failure Portosystemic shunt Billary tract obstruction/trauma Chronic disease

Answer 6

``` Clotting factors Production plasma proteins Drug and hormone bio transformation Bilirubin excretion Urea production 80% of the blood supply passes through the portal vein ```

Answer 7

Hypothermia Hypoglycemia Haemorrhage Increased free fraction of drugs (less plasma proteins to bind to) Decreased hepatic clearance of drugs Water and sodium retention, potassium loss

Answer 8

Hypotension-decreased perfusion Hepatotoxicity Enzyme induction

Answer 9

``` Liver enzymes Bile acids Clotting function Urea Plasma proteins Glucose ```

Answer 10

``` Thermoregulation Medical management encephalopathy Monitor blood glucose Blood pressure Maintain adequate renal perfusion Monitor blood loss Avoid hypoxia and hyopercapnia CVP Use of short acting drugs Monitor individual animal response ```

Answer 11

``` Monitor glucose 5% dextrose infusion Pain!! Medical management-prednisalone, diaoxide, glucose Avoid hyperglycaemia and hypoglycemia May consider NMB agent Post-operative pancreatitis ```

Answer 12

Stabilise prior to surgery- ketosis, dehydration, weight loss, fatty liver Feed asap after surgery Postpone fasting for as long as possible Glucose infusion if required Avoid hypoglycemia and hyperglycaemia Monitor temperature Give half dose insulin before the procedure then half dose once eaten afterwards Know the routine at home (favourite food) 1st patient of the day Fluids include glucose Avoid medetomidine(hyperglycemia) Good analgesia Short acting drugs Poss 2nd iv

Answer 13

``` Difficult to handle Easily stressed IM sedation then IV Sedation with opioids and ACP Avoid ketamine and medetomidine Iv induction Consider chamber Iv fluids Monitor ECG Fast metabolism Prone to hypothermia PUPD Thin Muscle weakness Hypertrophic cardiomyopathy ```

Answer 14

``` Monitor blood pressure Monitor other parameters for depth of anaesthesia as surgery located at the head end Potential laryngeal paralysis post op Monitor for hypocalcemia Keep Iv in and patent ```

Answer 15

``` Prone to hypothermia May have megaoesophagus Decreased GI motility Obesity Lethargy Bradycardia and hypotension Slow biotransofrmation of drugs ```

Answer 16

``` Cushings Poor muscle tone Overweight Lethargic Poor thermoregulation Bruising Risky of pulmonary thromboembolism Hypercoagulability PUPD sodium retention potassium excretion Risk of wound infection and dehiscence ```

Answer 17

``` Addisions Lack of cortisol production. Hyperkalaemia Dehydration Bradycardia Weight loss Weakness Lethargy Stabilise before anaesthetic ```

Answer 18

Neohrotoxic

Answer 19

More free fraction of drugs | Albumin binds the anaesthetic drugs

Answer 20

Reduced hepatic perfusion | Hepatocellular compromise

Answer 21

Pethidine usually lasts 1-2 hours can last up to 24 hours in a hepatic compromised patient

Answer 22

Arrhythmia

Answer 23

Ventilation compromised | Regurgitate and aspiration

Answer 24

Mount a stress responses