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Flashcards in Anaesthesia - SA Deck (94)
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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


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


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


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


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


what sedatives/pre-op meds are there

- A2 agonist
- Opioids
- Ketamine
- Alfaxalone
- Azaparone


what is the diff bw sedation and pre-med

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


whya re sedative risks high

no airway control
poorer monitoring


desc the perfect sedative

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


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


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.


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


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


desc the basics of opioids

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


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)


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)


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


what is a dog and cats circulating volume

d - 90mls
c - 60ml


what is pain

processing and perception of nociception


what is nociception

noxious stimulus received and relayed to CNS, but not cortex


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


what is allodynia

pain from light touch


what is hyper-algesia

inc sensitivity to pain


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


what duration classes as chronic pain



what does neuroplasticity mean

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


state the 4 stages of pain signal transmission



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)


how do NSAIDs work

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


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

cns, kidney, eye, repro constitutively