Old anesth good to know notes

Question 1

Anesthetic drugs work at the level of ? to produce reversible CNS depression

Answer 1

Spinal cord

Question 2

Unconscious animals can produce complex movements at the level of the ? or ? when anesth

Answer 2

brainstem or spinal cord

Question 3

T/F pain is a conscious experience therefore anesthetized animals DO NOT feel pain

Answer 3

True

Question 4

What are the ASA stauses?

Answer 4

ASA 1- normal healthy p, routine procedure or simple fx
ASA 2- brachycephalic dog, has systemic issue but fully compensated and under control,
ASA 3- serious systemic illness, stable vital signs
ASA 4- involved, hospitalized, serious systemic dz not compensating at all
ASA 5- gonna die like GDV or perf/septic FB

Question 5

What are some factors increasing MAC???

Answer 5

hyperthermia, CNS stimulants, chronic drug use, red hair in humans

Question 6

Why is the amount of inhalant needed to produce unconsciousnes less than 1/2 the amount needed to produce immobility?

Answer 6

Because the primary site of anesthesia to produce immobility is in the SC not the Brain

Question 7

Low B:G means more or soluble or insoluble in blood?

Answer 7

INSOLUBLE

Question 8

T/F anesthetized p can do respond physiologically and anatomically to noxious stimuli?

Answer 8

T

Question 9

Can noxious stimulation cause movement in unconscious animals?

Answer 9

YESSS

Question 10

deep anesth will decrease what 3 things?

Answer 10

will decrease CO, BO, and tissue/organ perfusion

Question 11

Doppler is ___ but oscillometeric BP is ____

Answer 11

indirect; direct

Question 12

Blood pressure =

Answer 12

Q x R
Q is flow and R is resistance

Question 13

What are normals for adult animals systolic, diastolic, and MAP?

Answer 13

Systolic= 100-160
Diastolic= 60-90
MAP= 60-100

Question 14

Does oscillometric or doppler provide systolic, diastolic, MAP and HR?

Answer 14

Oscillometric BP

Question 15

Doppler only provides _____ valves

Answer 15

systolic

Question 16

Arterial BP =

Answer 16

HR x SV x SVR

Question 17

90% of SpO2 means ___ PaO2

Answer 17

60 PaO2

Question 18

Capnographs are accurate predictors of ____ in ventilated p

Answer 18

PCO2

Question 19

How do we know p is in stage 3?

Answer 19

loss of righting reflex

Question 20

What is a possible cause of VPC’s?

Answer 20

Catecholamine release from high stress patient

Question 21

propofol side effects?

Answer 21

Vasodilation/hypotension, bradycardia, impaired baroreceptors (p hypotensive and cannot compensate with increasing HR), decreased RR and TV (apnea)

Question 22

What is a good premed and induction choice for puppy ASA status 1?

Answer 22

Ace + methadone IM, IVC, induce with prop and maintain on Iso and O2

Question 23

premeds for healthy colt undergoing castration?

Answer 23

Premeds Xylazine and torb, induce with ketamine and midazolam IV and maintain on Sevo and O2

Question 24

What is the best induction for greyhounds?

Answer 24

Propofol

Question 25

T/F Pain is always subjective, unpleasant, detrimental to health and necessitates tx?

Answer 25

TRUE

Question 26

T/F one must be conscious to perceive pain.

Answer 26

Trueee

Question 27

What is the main MOA of opioids?

Answer 27

bind to opioid receptors and activate anti-nociceptive neurons

Question 28

What is the difference between full agonist opioids and partial agonist opioids??

Answer 28

Full agonist opioids- bind to and activate, without ceiling effects partial agoinst- activates some or all of the receptors, HAS A ceiling effect

Question 29

MAP = CO =

Answer 29

MAP= CO x SVR CO= HR x SV

Question 30

how can we increase MAP

Answer 30

1st- turn down inhalant if p too light 2nd- give IV fluid bolus of crystalloids (25% of 1 blood volume to start) 90 mL dog 60 mL cat

Question 31

use crystalloid bolus to increase ____ and use colloid bolus to increase _____

Answer 31

HR; vasculature

Question 32

unlike crystalloids, colloids increase ?

Answer 32

plasma oncotic pressure

Question 33

hypertonic saline is most useful in what situation? How does it work and how much do we need?

Answer 33

useful in acute hemorrhage; use small volume like 4mL/kg and causes rapid increase in plasma volume by pulling water from interstitial space into the vascular space BUT INTERSTITIAL SPACE NEEDS TO BE REPLACEDDD

Question 34

What if MAP is low and crystalloid, colloids, and hypertonic saline all do not work??

Answer 34

Start inotrope infusion (improves perfusion, may increase MAP by increasing heart contractility) dobutamine, dopamine are most commone

Question 35

Are iontropes and vasopressors the same thing? How are they different??

Answer 35

Intropes are to improve heart contractility whereas vasopressors are used to change the pipe/vessel size pressors are ephedrine, phenylephrine, vasopressin, norepi, high doses of dopamine intropes are dobutamine and dopamine

Question 36

The abdomen is filling w blood, what do we do?

Answer 36

Maintain circulating volume with quick crystalloid infusion, prolong crystalloid with colloid, blood transfusion if needed

Question 37

Hypoventilation is PaCO2 less than __mmHg Hypoxemia is SPO2 less than _____; PaCO2 less than ____ mmHg Hypotension is MAP less than ___ mmHg

Answer 37

Hypoventilation is PaCO2 less than 45mmHg Hypoxemia is SPO2 less than 85-90% PaCO2 less than 60-80 mmHg Hypotension is MAP less than 60mmHg

Question 38

What is brachycephalic syndrome?

Answer 38

Stenotic nares. elongated soft palate, everted laryngeal saccules, hypoplastic trachea, high vagal tone, excessive pharyngeal tissues

Question 39

premeds and induction agents for larpar dog:

Answer 39

Ace and torb Induce with prop

Question 40

___ is better to increase BP than ____ (fluids)

Answer 40

Colloids; crystalloids

Question 41

Plan to tx hypotension!! ***

Answer 41

**** Decrease inhalant give crystalloid bolus (3-10ml/kg) repeat x1 if necessary then give colloids (5ml/kg) over 5-10 minutes if that did not help and P DID NOT lose any blood, give a vasopressor (ephedrine. phenylephrine)

Question 42

Avoid ____ (a drug) in Boxer dogs

Answer 42

Acepromazine

Question 43

how is the neonatal circulatory system different than adults?

Answer 43

low pressure, volume, and peripheral resistance

Question 44

What drug does not have much affect on neonatal p?

Answer 44

Atropine (reverse the drug if causing too low of HR)

Question 45

neonatal BP is lower or higher than adults?

Answer 45

Lower

Question 46

what are the negative consequences of hypothermia?

Answer 46

Bradycardia, decreased CO and BP, prolonged recovery and drugs are not as effective usually

Question 47

Cardiac ____ progressively decreases with older age but ___ stays the same

Answer 47

cardiac output; contractility

Question 48

premeds of geriatric p:

Answer 48

Opioids +/- low dose ace or benzo Alpha 2 agonists low dose ket in cats

Question 49

in heart disease DOGS DO NOT use this drug but can use in CATS with HCM

Answer 49

Alpha-2's

Question 50

T/F all anesthetic meds are nephrotoxic but dexmed is able to protect against AKI (having said this most injectable drugs do not directly affect the kidneys)

Answer 50

Trueeee

Question 51

How do inhalant anesth agents acutely affect renal function?

Answer 51

no direct effect but indirectly reduces GFR and RBF

Question 52

T/F urine output is normal in anesth. dogs and does not reflect decreased renal profusion

Answer 52

T

Question 53

What are the ECG effects of high K+?

Answer 53

Brady, atrial standstill, T wave may or may not be large

Question 54

What e'lyte can be administered to counteract K+?

Answer 54

calcium salts

Question 55

target MAP around __ of baseline of awake BP in neonatal p

Answer 55

80%

Question 56

What do we assess to test the synthesis of liver function? What about regulation?

Answer 56

Plasma proteins, coagulation factors, glucose; urea, BUN, lactate

Question 57

Liver failure may be present w normal liver enzymes, instead what factors will be abn in reduced liver function?

Answer 57

Albumin, glucose, BUN, bile acids, coag.

Question 58

what is the main liver test?

Answer 58

serum albumin

Question 59

DO NOT use what drug(s) with hepatic encephalopathy?

Answer 59

Benzos (mid/diazepam)

Question 60

Anesthetic rules of thumb for p with CV issues-->

Answer 60

avoid increased myocardial oxygen demand, avoid fluid overload, maintain adequate oxygen delivery, maintain HR, inotropes are great for poor contractility, do not change cardiac meds suddenly

Question 61

Do not use ___ or ____ or ______ in p with HCM or CHF

Answer 61

acepromazine or dissociatives (ketamine in high doses); positive inotropes

Question 62

What are good drugs for p with CV issues?

Answer 62

Benzos (mid/diazepam), opioids, local anesth.

Question 63

Good anesthetic plan for DCM p:

Answer 63

opioid and benzo preoxygente prop or fent or ketamine/diazepam induction

Question 64

Puppy with PDA plan

Answer 64

opioid + low dose ace or benzo anticholinergics to maintain HR Induction with low dose propofol or ketamine/diazepam intercostal block with bup