L11: Peri-operative management of LA (Morton) Flashcards Preview

Surgery (Spring 2015) > L11: Peri-operative management of LA (Morton) > Flashcards

Flashcards in L11: Peri-operative management of LA (Morton) Deck (24):
1

which breed prone to hyperkalemic periodic paralysis (HYPP)

American Quarter Horse

2

broodmares susceptible to osteopenia

:)

3

how long should adult ruminants be fasted?

48hrs, NPO 24hrs.
*horses typically NOT NPO before sx!*
-do not fast neonate ruminants (rumen not functional)

4

pre-op patient assessment

-PE including re-breathing and thorough MS system exam
-hydration status

5

2-3 sec. skin tent -->

4-6% dehydration

6

3-5 sec. skin tent -->

7-9% dehydration

7

>5 sec. skin tent -->

>9% dehydration

8

death rate for healthy horses in anesthesia

1/1000

9

factors influencing anesthetic risk

age
type/duration of sx
time of day
weight

10

anesthesia risks

fractures
myopathy
neuropathy
anesthetic death

11

Fast horses?

-only for certain elective procedures (ie. laparoscopy)
-never in neonates unless dz indicates
-access to water unless refluxing (restriction can predispose impactions)
-minimal risk of aspiration

12

nasogastric tube

-indwelling during induction and sx of horses w/ gastric distention/reflux
-decreases risk of gastric rupture/aspiration
-removed for recovery

13

Pre-op fracture stabilization:

-rads
-Modified Robert Jones
-Kimsey splint for fractures/luxations of the fetlock and distad
-fractures of metacarpal/metatarsal bones and proximad require alternative splinting

14

induction of anesthesia

-flush mouth w/ water to remove food
-pre-sedate to achieve 5 legged stance
-position against wall
-calm/quiet area

15

myopathy results from:

ischemia

16

neuropathy results from:

excessive pressure or stretch applied to peripheral nerve

17

proper lateral recumbency**

dependent forelimb pulled forward**
support weight of upper limbs
protect down eye

18

proper dorsal recumbency

hind limbs flexed
should trough well padded

19

most dangerous time for patient

post-op recovery

20

post-op daily monitoring

-manure production (dec. production sign of impaction colic)
-NSAIDs and Abx to dec. risk for GI disease (ie. colitis, gastritis)
-intense monitoring of splints and casts

21

common sources of colitis

right dorsal colitis
salmonellosis

22

who is most likely to get gastritis?

foals

23

post-op exercise

-usually stall rest
-cross tie to prevent lying down
-daily grazing
-trotting good for post-op castration

24

Main considerations overall

-owner consent and prep
-jugular acces
-hydration and acid/base status
-gastric distention
-duration
-positioning
-potential sx procedures/complications
-recovery: head and tail ropes
-post-op therapies and complications