Anaesthesia: Recovery and Anaesthesia Emergencies Flashcards
Which period carries the highest risk of anaesthetic related morbidities and mortalities?
The recovery period
What % of anaestetic deaths occured during recovery?
43%
What is the most common anaesthetic related morbidity in smaller animals?
Hypothermia- 32% dogs, 70% cats
Why is the recovery period the most dangerous phase?
Mobidities- most anaesthetic related morbidities are identified during the recovery period- can vary from transient to severe to life changing
Several common morbidities that can occur in veterinary species
Why is the recovery phase so dangerous?
The level of physiolgical support is often greatly reduced as well as the level of monitoring
Some problems often manifest after a day so animals can deteriorate after appearing healthy
What are some common recovery problems?
Hypothermia
Emergence delirium
Hypoxaemia
Hypotension/hypertension
What are the causes of hypothermia during the recovery period?
What are the consequences of hypothermia during recovery?
How can it be prevented?
Causes: drugs, clipping, surgical spirit, open body cavity
Consequences: reduced MAC requirment, delayed recovery, shivering, prolems with wound healing
Prevention- proactive steps to reduce heat loss, heat pads, forced air blankets, flush body cavities with warmed fluids
WARNING- injudicious use of warming aids can result in hyperthermia and burns- monitor temp and don’t allow direct contact to the skin
What is emergence delirium?
How is it prevented and treated?
In people- state of disociation of consciousness, the patient is incoherent, inconsolable irritable and uncooperative
5-15 min risk of injury to animal and handlers
Occurs in animals- more obvious with social or non-prey species
Prevention/treatment- chemical sedation or physical restraint, reduce stimulation, noise and light level, ensure adequate analgesia
What are the causes of hypoxaemia during recovery?
What are the clinical signs?
What is the treatment/prevention?
Airway obstruction, inadequate ventilation, poor gas exchange
Clinical signs- cyanotic mucous membranes, tachypnoea/dyspnoea, steror/stridor, reduced level of consciousness
Treatment- ensure patient airway, ventilate, O2 brachiocephalics usually dont mind being ET tubed, additional therapy
Prevention- only extubate when the animal can protect its own airway
What is the problem with hypotension/hypertension during recovery and how is it prevented and treated?
Problem- not routinely measured during recovery, however it is likely that animals have abnormal blood pressures
Prevention/treatment- utulise fluid therapy/vasoactive drugs during and after anaesthesia
How do you generally reduce recovery problems and when is the recovery phase over?
Monitor animals
Communication
Anticipation
rapid reconition/intervention
Is it ever over?
What is common in dogs and cats during the recovery period?
Gastric reflux
Regurgitation
Aspiration
Stricture
Occurs in 1 out of 6 cats and dogs
What is the gastric reflux protocol?
Check ET tube cuff
Head down and suction of oropharynx
Check pH of regurgitate
Place stomach tube and lavage stomach and oesopagus until clear fluid comes out
Give bicarbonare and sucralfate
What can happen in cats during recovery and how is it prevented?
Tracheal tear and rupture:
Related to over inflation of ET tube cuffs
Predominatly occurs in dental cases
Prevention- consider pharyngeal packing as alternative
Blindness: related to cerebral ischaemia through hypertension or altered blood flow through mouth gags
What problems occur to horses during recovery of anaesthesia?
Colic- post anaesthetic colic- drugs that cause ilias and stress caused
Myopathy/Neuropathy- neuropahty pressure on nerves, myopathy when muscles cannot function after bad perfusion
Fracture- classic horse
