gpt ecc patient GA

Question 1

What is the principle of balanced anaesthesia and why is it essential in compromised patients?

Answer 1

• Uses multiple drugs in lower doses to achieve unconsciousness, muscle relaxation, and analgesia
• Minimizes side effects which are typically dose-dependent
• Essential for unstable or severely compromised patients to reduce risks such as hypotension or respiratory depression

Question 2

What are the priorities in managing circulatory compromise in emergency anaesthesia cases?

Answer 2

• Gain venous access
• Provide analgesia
• Administer fluids (shock dose: dogs 90 ml/kg, cats 40–60 ml/kg)
• Supply oxygen
• Consider blood transfusion if PCV is low and clinical signs are present

Question 3

When is permissive hypotension acceptable during anaesthesia?

Answer 3

• During surgery required to control haemorrhage
• Mild hypotension can be tolerated short-term to reduce bleeding risk

Question 4

How should upper airway compromise (e.g., BOAS, laryngeal paralysis) be managed in anaesthesia?

Answer 4

• Sedation to improve ventilation
• Oxygen supplementation (flow-by, nasal catheter, oxygen kennel, etc.)
• Gain IV access early
• Be prepared for emergency intubation
• Delay extubation and monitor for laryngeal oedema

Question 5

What are best practices for managing lower airway issues during anaesthesia (e.g., pneumothorax)?

Answer 5

• Perform thoracentesis before anaesthesia if possible
• Pre-oxygenate for 5+ minutes
• Use IPPV and PEEP during GA
• Monitor SPO2 and ABG
• Address hypovolaemia and support with inotropes if needed

Question 6

What considerations apply to bronchodilation in respiratory distress patients under anaesthesia?

Answer 6

• Bronchodilators: terbutaline, ketamine, alpha-2 agonists, anticholinergics
• Emergency drugs: adrenaline and dexamethasone for perioperative bronchoconstriction

Question 7

How are sodium imbalances managed in anaesthetised patients?

Answer 7

• Hypernatremia: treat with dextrose solutions; max correction 0.5 mmol/L/h (chronic), 1 mmol/L/h (acute)
• Hyponatremia: treat with 0.9% NaCl; correction rate should not exceed 0.5–1 mmol/L/h

Question 8

What are the signs and treatments for hyperkalaemia in anaesthetised patients?

Answer 8

• Signs: peaked T waves, bradycardia, QRS broadening, arrhythmias
• Treatment: fluids, dextrose with/without insulin, sodium bicarbonate if acidotic, calcium gluconate for membrane stabilization

Question 9

How is hypokalaemia managed during anaesthesia?

Answer 9

• Signs: arrhythmias, weakness, hypotension
• Treatment: potassium supplementation based on serum levels
• Max IV rate: 0.5 mmol/kg/h

Question 10

Describe clinical signs and treatment for calcium imbalances in anaesthesia.

Answer 10

• Hypercalcaemia: PU/PD, vomiting, seizures, arrhythmias; treat with NaCl, furosemide, bisphosphonates
• Hypocalcaemia: tetany, tachycardia, hypotension; treat with IV calcium slowly while monitoring ECG

Question 11

Why is hypoalbuminaemia a concern during anaesthesia and how should it influence management?

Answer 11

• Increases drug toxicity risk by reducing protein binding
• May cause oedema due to reduced oncotic pressure
• Prefer drugs with low protein binding; consider colloids and conservative fluid therapy