Chemical Restraint and Sedation for Minor Procedures Flashcards
(29 cards)
what is chemical restraint?
adding a degree of immobility and a decrease in mental alertness to the sedated state (hypnosis)
general anesthesia encompasses
hypnosis, amnesia, analgesia and muscle relaxation
what is the biggest advantage of sedation and chemical restraint?
they maintain homeostatic reflexes: though blunted, patients generally can regulate blood pressure, heart rate and ventilation
what are the mainstay of chemical restraint in many patients?
alpha 2 agonists: xylazine, romifidine, detomidine, medetomidine, dexmed, clonidine
what are the most significant side effects of alpha 2s?
increase in vascular resistance and bradycardia
dont use in cardiac patients
advantages of acepromazine
fairly long duration of action, multiple routes of administration, a wide dose range, and minimal blunting of the autonomic reflexes
biggest disadvantage to using acepromazine
vasodilation
significant reductions in systemic vascular resistance and peripheral blood pressure
azaperone is used in what species?
swine and wildlife. less commonly used tranquilizer, a butyrphenone derivative
what drugs have minimal cardiovascular depression and should be a mainstay of sedation in a compromised patient?
opioids
what opioids do best in dogs? cats?
dogs: better with pure mu agonists.
cats: kappa agonists like butorphanol. get excited with mu agonists
biggest disadvantage to the use of opioids for sedation
dose dependent respiratory depression
Animals that have been sedated with even moderate doses of opioids should have supplemental oxygen administered, and this becomes more important as the altitude increases and barometric pressure decreases
T/F: benzodiazepines are poor sedatives
true. esp cats and horses see excitement
good to add in low doses to sedation protocl
in what age/species can benzodiazepines be used as primary sedatives?
very young foals, as well as camelids, goats, sheep
T/F: you should not give benzos to aggressive dogs
true. prone to exhibiting the disinhibitory effects of benzodiazepines, and may in fact become more aggressive and unpredictable after administration
what class of drugs are excellent muscle relaxants?
benzos
when needed for sx like hip luxation, very useful
T/F: benzos have very few systemic side effects
true. has minimal impact on CV and resp function and would make them good choice in a very compromised patient
T/F: benzodiazepines are great to use in a very sick patient
true: have very few systemic side effects and minimal impact on CV and resp fx
T/F: alfaxolone and propofol should not be used for chemical restraint
false- can be used for procedural sedation/chemical restraint, BUT are induction agents and need to carefully titrate to prevent induction of GA
what happens if you accicdentally give too much propoful when you just wanted chemical restraint
patient should be intubated to protect the airway and supplemental oxygen as well as a way to ventilate in case of apnea should be available and used as necessary.
what drug is a poor choice to use in patients that are fractious or aren’t healthy enough to compensate for CV depression?
propofol: IV only which causes decrease in SVR and BP
what do you use when the patient cannot tolerate large doses of alpha 2s
alfaxolone: administered any route and used in many scenarios and species
how do you induce chemical restraint with alfaxolone?
high doses in combo with opioids
T/F: in general propofol and alfaxolone shouldn’t be considered sedative agents
true, but with knowledge of side effects and possibility of bad things can be ok
what are the most common uses for ketamine and telazol
used for profound sedation/chemical restraint but are general anesthetics
used in TOTAL INTRAMUSCULAR PROTOCOLS where GA needs induced with a single muscular injection or are aggressive
