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RUSVM Anesthesiology > Pregnancy and Cesarean Section > Flashcards

Pregnancy and Cesarean Section Flashcards

(48 cards)

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1
Q

cardiovascular changes in pregnant animals

A

CO increases 30-50%

  • heart rate
  • stroke volume: increased blood volume, decreased vascular resistance (afterload)
  • blood pressure unchanged
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2
Q

T/F RBC increase > plasma volume increase

A

False

plasma volume increase > RBC increase → decrease PCV

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3
Q

T/F aortocaval compression decreases venous return

A

True

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4
Q

pregnant patients have a decreased _______ reserve

A

cardiac

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5
Q

what is the progesterone effect on the the respiratory center

A

decreased PaCO2 - hyperventilation

≈ 30 mmHg at time of parturition

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6
Q

what is the cause of decreased pulmonary resistance in pregnant animals

A

progesterone → relaxation of bronchial smooth mm.

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7
Q

pregnant animals have a(n) increased/decreased functional residual capicity (FRC)

A

decreased

increased abdominal volume

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8
Q

GI changes in pregnant animals

A

delayed gastric emptying

increased gastric acidity

decreased lower esophageal sphincter tone

increased risk of reguritation/aspiration

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9
Q

causes of delayed gastric emptying

A

pressure from uterus

decreased gastric motility

increased progensterone

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10
Q

renal changes with pregnancy

A

increased GRF (increased CO)

decreased BUN and CREA

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11
Q

pharmacolic changes in the dam

A

decreased MAC
increased sensitivity to local anesthetics

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12
Q

pharmocologic considerations for the fetus

A

most drugs easily cross placenta

fetal drug metabolism is slow - immature hepatic microsomal enzyme system

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13
Q

what is the ideal drug protocol

A

maximize O2 delivery to fetus - maintain CO and oxygenation, avoid uterine contraction/vasoconstriction

minimize drug effects on fetus

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14
Q

sedative use in small animal

A

not recommended

  • acepromazine & benzodiazepines - fetal depression*
  • alpha 2 agonist - decrease CO*
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15
Q

T/F alpha 2 agonists are used routinely in mares despite increased uterine pressure and decreased O2 delivery to the fetus

A

True

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16
Q

which alpha 2 agonist may cause less of an increase in uterine tone compared to xylazine

A

detomidine

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17
Q

which sedative is commonly used with ketamine in large animals

A

benzodiazepines

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18
Q

how should opioids be given

A

administer to mom after pups out

can reverse pups as pull out

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19
Q

how long does fetal elimination of opioids take

A

2-6 days

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20
Q

which induction agent is preferred in small animals

Study These Flashcards
A

propofol

rapid metabolism in neonates, may be used as CRI instead of ISO/SEVO

21
Q

which other induction agents can be used

Study These Flashcards
A

Alfaxalone - safe and effective for C-sections in dogs

Etomidate - induction/recovery may not be as smooth

22
Q

T/F the use of ketamine in small animals is controversial but can be used safely in large animals

Study These Flashcards
A

True

  • small animals - increased mortality in K9 neonates*
  • large animals - limited options for induction in US*
23
Q

MAC in increased/decreased in pregnant patients

24
Q

what are the side effects of inhailed anesthestics in pregnant animals

Study These Flashcards
A

same

hypotension, hypoventilation

25
progesterone increases/decreases does requirements of local anesthetics
decreases
26
which local anesthetics are more likely to accumulate
**Amides** lidocaine, bupivacaine
27
T/F it is safe to use NSAIDs during pregnancy
**False** - not recommened for use during pregnancy
28
which NSAID did not increase risk of abortion in mares with colic
Flunixin
29
how can fetal O2 delivery be maintain during anesthesia
maintain maternal BP and oxygenation avoid - uterine contractiona and vascostriction: decrease fetal perfusion
30
underlying problems that need to be corrected in cases of emergency C-section
hypovolemia hypoGLU hypoCa
31
how long after membrane ruptured should foals be delivered
\<30 min almost none survive after \> 90 min
32
horse dystocia is a \_\_\_\_\_\_\_\_
**true emergency!**
33
T/F anesthesia is required for both controlled vaginal delivery (CVD) and C-section
**True** *CVD usually attempted first*
34
minimum database in non-emergent c-sections (generally dogs)
PCV/TP Glucose iCA lytes
35
technique for small animal non-emergent c-section
pre-oxygenate for 5 min +/- short acting opioid propofol or alfaxalone induction rapid control of airway ISO/SEVO/DES in O2 maintenance
36
which local blocks may be considered in combination with GA in small animal c-section
lumbosacral epidural line block * lidocaine or bupivacaine - consider duration of action* * for epidural - add morphine for prolonged analgesia*
37
what are some complications with epidurals
increased volume of epidural blood vessels and increased epidural fat **DECREASES** epidural space and **INCREASES** cranial spread of drug
38
epidural drugs volume should be decreased by _____ in pregnant patients d/t increased cranial spread (hypotension)
epidural drugs volume should be decreased by **_≈ 1/3_** in pregnant patients d/t increased cranial spread (hypotension)
39
animals should be positioned carefully to avoid \_\_\_\_
aortocaval compression
40
small animal neonatal care
clear oropharynx (DONT SWING) clamp and cut umbilicus towel dry reverse opioids (1-2 drops naloxone sublingually) heat support +/- O2 support
41
small animal analgesia
epidural with morphine (up tp 24 hours) Mu opioid agonist once neonates delivered acetaminophen for dogs (NO CATS!)
42
what should be monitored closely in large animals GA
PaCO2 and PaO2 hypoxemia and hypercapnia likely
43
which types of mechanical ventilation may be required in LA GA
PIP PEEP
44
why might recovery be more difficult in LA GA
extra weight exhaustion from labor ligament laxity
45
locoregional anesthesia in small ruminants
line block lumbosacral epidural same considerations as small animals
46
locoregional anesthesia in large ruminants
paravertebral block (proximal or distal) inverted "L" block
47
analgesia in horses
butorphanol - can reverse in foal if necessary NSAIDs - not recommended during pregnancy and lactation caudal epidural
48
analgesia in ruminants
opioids once neonate delivered L-S epidural with morphine (small) caudal epidural (cows) NSAIDs - Rimadyl approved for 1 dose in lactating cows

RUSVM Anesthesiology (39 decks)

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