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23 spring anesthesia > Test 2: 17 monitoring > Flashcards

Test 2: 17 monitoring Flashcards

1
Q

5 basic goals of anesthesia

A

Unconsciousness
Amnesia
Immobility
Analgesia
Blunted autonomic responses
* Cardiovascular
* Respiratory
* Endocrine
* Immune

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2
Q

stage 1 of anesthetic depth

A

awake to unconcious

Stage of voluntary movement

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3
Q

stage 2 of anesthetic depth

A

excitatory

stage of delirium or involuntary movement

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4
Q

stage 3 plane 1 of anesthetic depth

A

light anesthesia

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5
Q

stage 3 plane 2 anesthetic depth

A

moderate anesthesia

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6
Q

stage 3 plane 3 anesthetic depth

A

moderate-deep anesthesia

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7
Q

stage 3 plane 4 anesthetic depth

A

deep anesthesia

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8
Q

stage 4 anesthetic depth

A

stage of extreme CNS depression

results in death if not controlled

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9
Q

stage 1 is characterized by

A

voluntary movement:
* Initial administration to loss of consciousness
* Some analgesia (deeper phases)
* Breath-holding in excited, stressed animals
* Tachycardia
* Pupillary dilation
* Salivation
* Urination
* Defecation
*Ataxia
* Recumbency

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10
Q

stage 2 Anesthetic depth characteristics

A

delirium or involuntary movement (excitatory)
* Loss of consciousness to onset of regular breathing pattern
* Loss of voluntary control
* CNS depression -> reflexes more primitive and exaggerated
* External stimuli -> reflex struggling, breath holding, tachypnea, hyperventilation
* Tachycardia, tachyarrhythmias
* Pupil dilation
* Palpebral and eyelash reflexes prominent
* Nystagmus (horses)
* Vocalization
* Salivation (ruminants, cats)
* Vomiting (dogs, cats, goats)
* Laryngospasm (pigs, cats)

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11
Q

stage 3 anesthetic depth characteristics

A

surgical anesthesia

  • Unconsciousness
  • Progressive depression of reflexes
  • Muscle relaxation
  • Ventilation slow and regular
  • Vomiting and swallowing reflexes lost

Classification

  • Planes 1-4
  • Light, medium, deep
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12
Q

stage 4 anesthetic depth characteristics

A

extreme CNS depression → death
* Respirations cease
* Heartbeat slows then stops
* Blood pressure at shock level
* Capillary refill markedly delayed
* Pupils widely dilated
* Death unless immediate resuscitation

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13
Q

eyeball position and rotation during anesthesia for ruminants

A
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14
Q

eyeball position and rotation during anesthesia for cats and dogs

A
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15
Q

eyeball position and rotation during anesthesia for horses

A
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16
Q

what are some things that might prevent change in eyeball position and rotation during anesthesia

A
  • Ketamine → Eye does not typically rotate
  • Neuromuscular blockade
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17
Q

nystagmus during anesthetic depth for horses

A
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18
Q

changes in nystagmus during anesthesia for ruminants and swine

19
Q

what are some things that effect nystagmus during anesthesia

A
  • Small animals – nystagmus not normally present under surgical anesthesia
  • Ketamine
  • Neuromuscular blockade
20
Q

how does palpebral reflex change during anesthesia

21
Q

how does jaw tone change during anesthesia

22
Q

how does sphincter tone change during anesthesia

23
Q

Gag and swallow reflexes indicate — level of anesthesia in nearly all species

24
Q

— reflex lost at deeper planes

25
Response depends on --- and ---
stimulus intensity and anesthetic depth
26
when using ketamine, some laryngeal reflexes may persist but ---
are not coordinated need to intubate
27
Focal facial or neck muscle twitching, myoclonus can be seen with what drugs?
propofol etomidate
28
Loss of consciousness occurs before or after loss of spontaneous movement and physiologic response
before pt can start to move when still unconscious
29
--- movement reliable sign of light level of anesthesia
Spontaneous
30
Any single measure defines ---. Assess all available parameters to form ---
only itself composite estimate of system
31
what happens to CV system during anesthesia
* Decreased contractility * Decreased systemic vascular resistance * Reduced blood pressure Autonomic response to noxious stimulus * Increased arterial blood pressure * Increased heart rate CV system may not be reliable way to assess anesthetic depth based on opposite effects of pain and anesthesia
32
what are some confounding factors to CV system during anesthesia
some drugs effect CV system physiologic status: hypovolemia, temp, hypoventilation Disease states: hemorrhage, anemia, cardiovascular disease Co-morbidities species
33
two important questions about respiratory system during anesthesia
how is animal ventilating? how is animal oxygenating?
34
Autonomic response of respiratory system to noxious stimulus
* Increased respiratory rate * Change in respiratory pattern (irratic, panting) * Patient-ventilator dyssynchrony (fight ventilation)
35
how to measure inhalant gas delivery
End-tidal concentration of volatile anesthetic agent Minimum Alveolar Concentration (MAC) will be proportional to the amount of drugs getting to the brain * Inter- and intra-individual variability
36
what is target controlled infusions
way to monitor injectable anesthetics based off pharmodynamic and pharmokinetic parameters to form model that you can use to adjust rate of infusion limitations: * need a bunch of blood samples→ not practical in small animals * drug interactions * patient variability- some pts need more drugs then others
37
how does EEG monitoring work
computer processes brain activity to give number that correlates to how deep a pt is EEG changes * Low amplitude, high-frequency wave pattern during awake state * High amplitude, low-frequency pattern during anesthesia -> burst suppression -> electrical silence (deep levels of anesthesia)
38
what are some EEG devices
Bispectral Index TM (BISTM) Cerebral state index (CSI) NarcotrendTM monitor
39
EEG do not reflect --- properties of drugs
analgesic
40
response to noxious stimulus at light plane will result in
* Movement! * Rapid increase in heart rate and blood pressure * Increase in respiratory rate or erratic respiratory pattern → Patient-ventilator dyssynchrony * Pupil dilation * Increased jaw tone, anal tone Horses: * Lacrimation * CAUTION: May see movement before ANY autonomic changes (BE VIGILANT!)*
41
Response to noxious stimulus at a deep plane
* No movement * Minimal-to-absent changes in heart rate * Minimal-to-absent changes in respiratory rate * Pupil dilation * Very relaxed jaw tone, anal tone
42
Monitoring --- can be used in conjunction with physical patient assessment.
anesthetic drug delivery
43
--- is emerging but cannot supplant physical patient assessment and monitoring.
Electroencephalography technology (EEG)
44
Assess all available information and clinical picture to judge ---
anesthetic depth.

23 spring anesthesia (40 decks)

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