GI anaesthesia Flashcards
(27 cards)
what relays the sensory innervation of the head
mostly trigeminal nerve CN V
What nerve is the infraorbital nerve a branch of
Maxillary branch of the trigeminal nerve CN 5
An infraorbital block blocks what
rostral maxillary soft tissues
what is the risk of introducing a needle into the intraorbital foramen in cats and brachys
globe penetration
what is the SAN
superior alveolar nerve
where does the SAN innervate
teeth and the bone adjacent to the teeth within the maxilla
in the extra oral approach, where is the LA deposition on the maxillary nerve?
where it crosses the pterygopalatine fossa
why is the extraoral approach preferred to the intra oral approach?
increased accuracy with no evidence of macroscopic damage
what does the mandibular block target
the inferior alveolar nerve (IAN) is a branch of the mandibular nerve
where is the rostral mandibular block placed
in the opening of the mental foramen of within it
Tongue anaesthesia may occur with bilateral mandibular blocks and tongue trauma is possible, how would you identify this and how can it be prevented?
- use unilateral blocks instead
- short anaesthesia
- keep the tongue moist
Local anaesthesia mixtures can be used (lidocaine plus bupivacaine) what are the advantages?
- Lidocaine has quicker onset and bupivacaine last longer
- Reduce volitale agent needed
- Better pain scoring
What is the treatment for local anaesthesia toxicity?
IV lipid plus CPR
What is the maximum volume of 2% lidocaine to administer to a 30 kg greyhound requiring extensive extractions on all dental arcades?
dose of lidocain in 2-4mg/kg
toxic dose = >4
4x 30 = 120mg in 2 %
2% = 2g per 100ml = 2000g in 100ml = 20mg per ml
120mg/20mg = 6ml
what is the extra oral caudal mandibular block aiming for?
mandibular foramen for the inferior alveolar enrves
Your colleague asks your opinion about the suitability of performing a extra oral caudal mandibular block for removal of the fractured PM1 & PM 2 on this lower arcade.
what would you say
No
Recently you undertook 12 cat dentals over several days for a local rehoming centre. At the end of the week the centre call you to say 2 of the cats seem blind. What is the likely cause of this complication?
stretching of the maxillary artery- potntially from overstretching the jaw
A 41kg male entire GSD is due in for evaluation of anal furunculosis under GA. The dog has a bite history, and cannot be examined in the consult room. Which of the following approaches do you employ
chill protocol - 3 drug the night before (trazodone, melatonin and gabapentin) then gabapentin in the morning with ACP
Your team have successfully undertaken a partial rostral hemimandibulectomy on this shepherd dog . On the morning of day 3 the ward team report the dog is still reluctant to eat its normal kibble even with gravy. The dog is receiving meloxicam. The wound looks fine but the dog resists examination.
What do you suggest?
Offer frankfurter sausages and IM buprenorphine
You have anaesthetised a ‘spicy’ cat (history of inappetence) for an exploratory laparotomy, and taken multiple biopsies from the GI tract, enlarged lymph nodes and an abnormal looking section of the liver. The cat received maropitant and methadone and dexmedetomidine for premed, alfaxalone for induction and sevoflurane for maintenance of anaesthesia. What post-operative analgesia regime do you decide to use. You have decided to keep the cat on intravenous fluid therapy over night.
IV as already has a cannula
- buprenorphine for good analgesia
Barney the labrador has had vomiting and diarrhoea for several days. You decide Barney needs an exploratory laparotomy. What fluid do you decide to administer to him in the perioperative period?
Lactated Ringers Solution/ Hartmanns
During Barney’s the labrador’s anaesthesia, the blood pressure drops to 88/38 (55) multiparameter monitor. You have moved the pulse oximeter probe and the value remains at 93%.
What do you do?
- reduce inhalation agent
- lactated ringer solution over 10 mins
note: give around 300ml
Lucky is a 10 year old English Springer Spaniel with a recent history of lethargy, polydipsia and polyuria and dyschezia. Clinical examination, haematology and biochemistry are relatively unremarkable other than an elevated ionised calcium. Which of the following is most likely?
Anal sac adenocarcinoma
Lucky has a Anal sac adenocarcinoma
Lucky is scheduled for thoracic and abdominal imaging and bilateral anal sacculactomy in the morning. What is the most appropriate overnight treatment fluids and why?
Saline -> Hartmanns/ LRS has calcium and already hypercalcaemic
