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CVSOH BVSc3 > LS Anaesthesia > Flashcards

LS Anaesthesia Flashcards

(104 cards)

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1
Q

What is the definition of pain?

A

An unpleasant sensory and emotional experience associated with (actual or potential) tissue damage

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2
Q

What is the definition of nociception?

A

The neural process of encoding noxious stimuli

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3
Q

What is the difference between nociception and pain?

A

Nociception is the wiring part

Pain is how the patient interprets nociception

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4
Q

What is nociceptive pain?

A

Pain that arises from damage to non-neural tissue that activates nociceptors

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5
Q

What is neuropathic pain?

A

Pain caused by a lesion or disease of the somatosensory nervous system

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6
Q

What is hyperalgesia?

A

Increased pain from a stimulus that normally provokes pain

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7
Q

What is allodynia?

A

Pain due to a stimulus that does not normally provoke pain

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8
Q

What are the physiological signs associated with pain?

A

Increased HR, BP, temp, resp, stress hormones

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9
Q

What are behavioural signs of pain in cats and dogs?

A

Hunched
Pain face
Lack of grooming
Inappetence

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10
Q

What are different behavioural signs of pain in dogs?

A

Cats hide, dogs seek attention

Cats have fear aggression, dogs are submissive

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11
Q

What are behavioural signs of pain in rabbits?

A

Immobile, hunched
Depression and isolation
Eyes shut

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12
Q

What are behavioural signs of pain in horses?

A 
Low head
Vocalisation
Tail swishing and restless
Lame/limb lifting 
Hunched
Sweating
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13
Q

What are methods of scoring pain?

A

Composite pain scales
Numerical rating scale
Visual analogue scale
Simple descriptive scale

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14
Q

What is a method of monitoring chronic pain?

A

Client specific outcome measures - client chooses activities animal usually does

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15
Q

What is preventative analgesia?

A

Analgesia given before, during and after the surgery/procedure

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16
Q

Why do you give preventative analgesia?

A

To prevent upregulation of the nervous system from noxious stimuli

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17
Q

What is multimodal analgesia?

A

Using different classes of analgesic agents to block pain pathways

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18
Q

Why do you give multimodal analgesia?

A

More effective analgesia

Lower doses needed

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19
Q

What are the main analgesic agents?

A

Opioids
NSAIDS
a2 agonists - analgesic sedatives

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20
Q

What category of controlled drugs are opioids?

A

Full opioid agonists - schedule 2

Partial - schedule 3

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21
Q

What receptor do opioids target for analgesia?

A

Mu (backwards u) opioid receptor in the brain and spinal cord

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22
Q

What type of pain are opioids best for treating?

A

More for acute

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23
Q

What does potency mean?

A

The amount of drug needed to have an effect

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24
Q

What does efficacy mean?

A

The magnitude of the effect of a drug

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25
What opioid has the highest potency and efficacy?
Fentanyl
26
What opioids are full mu agonists?
Fentanyl | Methadone
27
What opioids are partial agonists?
Buprenorphine | Butorphanol
28
What opioid is the longest acting?
Buprenorphine
29
What opioid is the shortest acting?
Fentanyl
30
What are side effects of opioids?
Resp depression Sedation/excitation Nausea and vomiting
31
What do NSAIDs inhibit?
Cyclooxygenase which inhibits prostaglandin production (inflammatory mediators)
32
Where are NSAIDs metabolised?
In the liver
33
What is the most common NSAID?
Meloxicam
34
What are side effects of NSAID use?
GI ulceration Renal ischaemia Vomiting and diarrhoea
35
What is always the ending of local anaesthetics?
-caine
36
How do local anaesthetics work?
Block voltage gated Na+ channels in nerves
37
What are the two types of linkages in local anaesthetics?
Ester | Amide
38
How can you tell if the local anaesthetic is an ester or an amide?
Esters have no i in the name before the caine whereas amides do
39
Which type of local anaesthetic is more stable?
Amide
40
Which type of local anaesthetic has a short plasma half life?
Ester
41
What are some side effects of local anaesthetics?
CNS toxicity CV toxicity Due to high doses
42
What local anaesthetics are used in small animals?
Lidocaine and bupivicaine
43
What local anaesthetic is used in large animals?
Procaine
44
What kind of drug is tramadol?
Centrally acting analgesic with multimodal action
45
How should tramadol be used?
In dogs Only injected Co-analgesic - not alone
46
What is amantadine sued for?
Antihyperalgesic
47
What is epidural anaesthesia?
Anaesthetic injected into the epidural space
48
What is spinal anaesthesia?
Anaesthetic injected directly into cerebrospinal fluid
49
How are ester local anaesthetics metabolised?
Hydrolysis of ester link by plasma esterases
50
How are amide local anaesthetics metabolised?
Broken down by cytochrome P450 enzymes
51
What are the different formulations of local anaesthetics?
Solutions Aerosol sprays Topical patches
52
What is baricity?
Weight of one substance compared to the same volume of another
53
When is baricity an issue?
Need local anaesthetic to be heavier than cerebrospinal fluid so it doesnt spread up the epidural space too far so add glucose
54
What is used to prolong the duration of action, reduce systemic absorption and reduce toxicity of local anaesthetics?
Adrenaline - vasoconstrictor
55
What reduces plasma protein binding?
Lower pH
56
How is toxicity linked to plasma protein binding?
Better binding to plasma proteins means longer duration of action and lower risk of toxicity
57
What are used to help with seizures due to CNS toxicity?
Benzodiazepines
58
Why are premeds used?
Balanced anaesthesia | Reduce stress and injury
59
Which premed drugs have an analgesic action?
A2 agonists | Opioids
60
What premed drugs work as a dopamine receptor antagonist?
Phenothiazines - ACP
61
What premed drugs act on the GABA receptor?
Benzodiazepines
62
What is ACP usually given with? Why?
Opioid | Provides analgesia as ACP doesnt
63
How is ACP administered?
Subcut injection
64
What effect does ACP have?
Sedation | Anxiolysis
65
What is a potential side effect of ACP?
Fall in body temp as peripheral vasodilation | Decrease in blood pressure
66
What is the duration of action of ACP?
4-6 hours - long
67
How long does ACP take to have a clinical effect?
30-40 mins
68
What is the antagonist of a2 agonists?
Atipamezole
69
What effect do a2 agonists have on CV function?
Bradycardia | Reduced CO
70
What effect do a2 agonists have on GI function?
Depress GI activity | Emetic - vomit
71
What effect do a2 agonists have on pregnant animals?
Increase uterine contractility - abortion | Avoid in near term animals
72
How long do a2 agonists take to have an effect?
5 mins - rapid
73
What are the clinical effects of benzodiazepines?
Muscle relaxation Anticonvulsant Minor tranquilliser
74
When should you give benzodiazepines as sedation?
Good in sick or young animals | Unreliable in healthy animals - excitement
75
How are benzodiazepines administered?
Slow IV
76
What is the reversal agent of benzodiazepines?
Flumazenil
77
How does flumazenil work as a reversal agent?
Competitively antagonises benzodiazepines binding site
78
What is an example of a butyrophenone?
Fluanisone
79
How must fluanisone be administered?
In combination with opioid fentanyl
80
What is the combination fluanisone and fentanyl licenced in?
Rabbits and small furries
81
When is fluanisone and fentanyl used?
Minor surgery and diagnostic techniques - poor muscle relaxation
82
What premeds are given to ASA grade 1 and 2?
ACP + opioid | a2 agonist + opioid
83
What premeds are given to ASA grade 4 and 5?
Benzodiazepines + opioid BDZ + ket Opioid alone
84
What are some safety issues with sedation?
NO control over airway | No option to deepen sedation without going to full GA
85
What are two examples of a2 agonists?
(Dex)medetomidine
86
What kind of sedation is the most likely to be reversed?
a2 agonists
87
What should you do if there is a low SpO2 from pulse oximeter?
Check pulse ox Check correctly intubated, no leak from cuff Check breathing pattern - may need ventilation Check for obstruction Check machine works
88
What are some causes of tachycardia in anaesthesia?
Inadequate depth of anaesthesia Hypercapnia (increased CO2) Hypovolaemia - need fluids Drugs - directly
89
What are some causes of bradycardia during anaesthesia?
Deep anaesthesia Opioids and a2 agonists Hypothermia
90
What counts as hypotension?
Mean arterial pressure below 60mmHg
91
What can cause hypotension during anaesthesia?
Drugs Blood loss Pre-existing condition
92
What local anaesthetic is used for eye examination?
Proparacaine
93
What local anaesthetic is used for an intratesticular block for castration?
Lidocaine
94
What is used for topical anaesthetic on the larynx?
Lidocaine
95
How is procaine licenced for administered in large animals?
Subcut injection
96
What is the withdrawal period for procaine?
Zero
97
What can be an issue with cornual nerve block in goats?
Have two branches of nerves - cornual nerve and cornual branch of intratrochlear nerve Toxicity levels in kids
98
What are the 3 different techniques of abdominal flank surgery local anaesthesia?
Paravertebral Inverted L block Local infiltration along incision site
99
What nerves are desensitised in paravertebral block?
T13, L1 and L2
100
What is found between the dorsal and ventral branches of the spinal nerves in a paravertebral block?
Intertransverse ligament
101
How do you identify the first transverse process?
Count back from L5 transverse process
102
Which way do you walk the needle off the transverse processes?
Forward off L1 Back off L1 Back off L2
103
What are the disadvantages of an inverted L block?
Large amount of LA | Not as effective analgesia
104
Where do you inject for a sacrococcygeal epidural?
Most movable space if pump tail up and down - sa5-co1

CVSOH BVSc3 (60 decks)

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