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Flashcards in Anaesthesia - SA Deck (94)
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1

desc the basic ASA grading

I - normal healthy
II - mild systemic dz
III - severe systemic dz
IV - severe dz, constant threat to life
V - moribund, expected to die wo sx
E - emergency

2

what are the basic aims of pre-anaesth assessment

to establish how suitable the patient is
any deviation that the GA will effect or create

3

should you take pre-op bloods

yes- baseline, defence in court if dies, predict complications, O reassurance, baseline for individual
no - cost, acquiring, are they necessary

4

what are the recocm for food/water with-holdin

feed wet food - quicker digested
starve 8hrs, withold water when brought in
if starve any more = inc chance of regurg

5

what considerations need to be made before dosing calculated

weight - obese animals dont need that much
body SA better method
breed - some more sensititive
other dz - eg if hypotensive DONT give ACP
hx

6

what sedatives/pre-op meds are there

- ACP
- A2 agonist
- BZD
- Opioids
- Ketamine
- Alfaxalone
- Azaparone

7

what is the diff bw sedation and pre-med

premed= calm
sedation = for procedures (eg needs more)

8

whya re sedative risks high

no airway control
poorer monitoring

9

desc the perfect sedative

many admin routes
wo SE
quick and good DoA
any spp
reasonable volume

10

desc features of ACP

ONset - 30m
DoA - 4-8hrs
analgesia? NO
uses - bonfire night (NOT an anxiolytic); horses with pre-med
effects - vasodil (blocked a1 adrenoR) - so keep warm!; reduced sympathetic tone (can help some symp-induced arrhythmias); muscle relaxation; reduces PCV; anti-spasmodic and anti-emetic

11

desc the features of an A2 agonist

onset - 10m
DoA - short
analgesia? YES - centrally acting, activates desc inhib and good + opioids
uses - sedation (LA are ++ sensitive to touch though, watch out! - hence why w ketamine normally)
effects -
- severe CV: reduced symp tone, vasocon, reflex bradycardia, hypOtension, look grey-ish
- resp: depressed
- other: muscle relaxation; diuresis (consider in blocked cats etc); hyperglycaemia (reduced insulin prod and response); mydriasis; CI - pregn
reversal = atipamezole (antiseden) - NOT iv or crazy cats. reverses analgesia too.

12

name 4 types of a2 agonists and their basic properties

1. xylazine - fastes/quickest. most relaxation + visceral analgesia. colic +
2. detomidine - horses IM, most potent
3. medetomidine - good sed++
4. romifidine - longest DoA, weakest

13

what are the basic properties of BZ (benzodiazepines)

examples - Diazepam and midazolam - neither licensed in vet spp
uses - anti-convulsant, sedation (but may cause excitement). co-induction agent (aim to lower other drug doses and utilise the muscle relaxant property)
good bits - minor vasodil (keep warmer), CV or resp depression = ++recom for neonates and geriatric patients and muscle relaxation

14

desc the basics of opioids

uses - sedative, analgesic
effects - minimal CV depression; sign resp depression tho

15

name 4 types of opioid

1. buprenorphine - 6hrs DOA, good for sx (feisty cats++)
2. butorphenol - 1-2hrs DOA, best sedation (eg for xray)
3. methadone - 4hrs DOA, quick, good sed + analgesia, not emetic (cats++)
4. morphine - 4hrs DOA, need to be glucorinated (sorry cats)

16

desc the basic propertes of phencyclidine - ketamine

uses - induction agents + BZ - choice in LA; or in combos (ket, medatom and opioid) - SA, analgesia++

properties - dissociative, painful IM (pH-4)

effect - inc muscle tone, analgesic in v low doses. good for aggressive animals, apneustic breathing (min vol maintained tho), noise hypersensitivity, active CN reflexes (protect cornea)

17

what are the properties of propofol

DoA - short
uses - induction, maintenance, can titrate up to req effect
effects - CV - depression, hypotension; resp - depression and apnoea. indicated for cerebro-protection ++
properties - IV only as need high conc.
analgesia? NONE
metab by glucorinidation + hydroxylation - can give cats induction but not CRI
SE - heinz-body anaemia (C), CI in pancreatitis

18

what is a dog and cats circulating volume

d - 90mls
c - 60ml

19

what is pain

processing and perception of nociception

20

what is nociception

noxious stimulus received and relayed to CNS, but not cortex

21

name the 4 types of sensory perception and what sensory receptors sense it in the dermis

- pressure - meissner corpuscle
- vibrations - pacinian corpuscles
- stretch - ruffini endings
- light touch - merkel disls

22

what is allodynia

pain from light touch

23

what is hyper-algesia

inc sensitivity to pain

24

desc the difference bw somatic pain R and visceral pain R

somatic - many, widespread, small and precise
visceral - few each with large area. sensitive to distention, ischaemia or inflm. stimulus proportional to size of area, not severity

25

what duration classes as chronic pain

>3mths

26

what does neuroplasticity mean

CNS and PNS can adapt to a pain event both fct'ally and anatomically. results in allodynia, and hyperalgesia

27

state the 4 stages of pain signal transmission

transduction
modification
transmission
perception

28

what is peripheral sensitisation

+++ inflm mediators, nociceptors threshold is reduced. this signals 'silent/redundant' nociceptors to become active (c-fibres and Ad fibres) since there is apparent tissue injury. Anything that inc cAMP, induces hyperalgesia (bradykinins, SubP - vasodil, NA, aa's)

29

how do NSAIDs work

MoA - targets transduction (inflm) and modulation (CNS), blocks effect of PG synth due to COX blocked (1 = constitutive; 2 = inducible)

30

where else is cox2 seen which means its not great to be blocking all the time?

cns, kidney, eye, repro constitutively