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71 Cards in this Set
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- Back
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What are the three TYPES of anesthesia?
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General, regional, local
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What are the four STAGES of anesthesia? How is each stage characterized?
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Stage 1 (voluntary movement) - from beginning of administration until loss of consciousness
Stage 2 (involuntary movement/delerium) - from loss of consciousness until onset of regular breathing Stage 3 (surgical anesthesia) - unconscious, depressed reflex, relaxation Stage 4 (excessive depth) - mydriasis, apnea, hypotension, death! |
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Which anesthetic stage has 3 planes? How are these 3 phases characterized?
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Planes of surgical (stage 3) anesthesia:
1) light; ocular movement 2) medium; progressive intercostal paralysis 3) deep; diaphragmatic breathing |
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Which of the following describe local anesthesia?
a) brachial plexus block b) paravertebral block c) epidural d) cornual nerve block |
b) paravertebral block
d) cornual nerve block |
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What is the major difference between tranquilization and sedation?
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Animal is still aware during tranquilization
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T or F:
All veterinary drugs are Schedule II (N) or below. |
True!
Unless you wanna give your dog LSD or heroin! |
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The combination of a tranquilizer/sedative + an analgesic agent describes:
a) multimodal analgesia b) hyperalgesia c) hypoalgesia d) neuroleptanalgesia |
d) neuroleptanalgesia
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What are the two major components of an anesthesia machine?
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1) Gas supply component
2) Patient component |
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Semi-open (non-rebreathing) systems are used in patients less than ____ kg.
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<7kg
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Which of the following are types of semi-open systems?
a) Ayres T-piece b) To-and-fro c) Circle d) Norman elbow e) Bain circuit |
a) Ayres T-piece
d) Norman elbow e) Bain circuit |
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What is an inexpensive and simple setup to allow mixed animal practices to anesthetize large animals?
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to-and-fro system
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Sizing of sodalime canister in a rebreathing circuit should be equal to or greater than....
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...tidal volume!
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Which type of anesthetic system DOES NOT require a gas supply component?
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Open system
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What is an issue with using Baralyme in the canister? How about with Sodasorb?
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Baralyme makes compound A with sevofluorine
Sodasorb's color change can revert back to white in the light |
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Match the color with the correct gas:
Green-----------CO2 Blue-------------N2 Gray------------Vacuum Yellow---------Medical Air Violet----------N2O White----------Waste gas Black----------O2 |
Green-----------O2
Blue-------------N2O Gray------------CO2 Yellow---------Medical Air Violet----------Waste gas White----------Vacuum Black----------N2 |
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Full O2 cylinders read what pressure?
What are the 3 types of O2 cylinders and how much does each hold at full pressure? |
2200psi max pressure;
D - 400L E - 660L H - 6900L |
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1L of liquid O2 is equivalent to__________ L of gas.
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1L of liquid O2 = 860L gas O2
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What is the max pressure of a N2O tank? What are the 3 types of N2O cylinders and how much does each hold when full?
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750psi max N2O pressure
D - 940L E - 1590L H - 15,800L |
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T or F:
Remaining amount of O2 and N2O can effectively be estimated by viewing the pressure gauge. |
False!
Pressure is a good indicator for O2 but weight is better for N2O! |
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T or F:
Measured flow vaporizers (like the Copper Kettle) can vaporize any anesthetic agent. |
True!
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What are some strategies to reduce anesthetic gas pollution?
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Routine maintenance
Tight-fitting mask Well-ventilated recovery area Fill machines at end of day Use low-flow techniques Use low solubility agents |
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What are some advantages to using an endotracheal tube in anesthetic induction/maintenance?
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Facilitates ventilation
Prevents aspiration Better administration of anesthetic agent |
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Why should PVC ET tubes for human use be shortened before use in veterinary patients?
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Reduce dead space
Prevent intubation of a single bronchus |
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What are two disadvantages to using silicone ET tubes?
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Large OD:ID ratio (thick walled);
EXPENSIVE!!! |
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What is a major disadvantage to a Rusch ET tube?
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Can't see "steaming up" indicating successful intubation; also they are $$$$$$$$$ with questionable durability
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Which ET tubes have NO CUFFS?
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Cole tubes
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What are some considerations for selecting and placing an ET tube?
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Go big or go home!
Tube tip should be in midcervical trachea to thoracic inlet Don't enter bronchus! |
What type of laryngoscope blades are depicted here?
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Miller blades
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Which laryngoscope blade type is depicted here?
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MacIntosh
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What type of laryngoscope blade is good for small ruminants?
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Wisconsin
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What are the ET routes used in equine intubation?
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Nasal
Oral Tracheotomy |
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What structure must be avoided when intubating swine?
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the Ventral Ventricle
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Which two species have a highly reactive larynx? How can this be overcome during intubation?
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Cats and pigs; use lidocaine spray
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What are some indicators that confirm successful intubation?
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"fogging" of ET tube
Chest/rebreathing bag synchrony CO2 in expired gas Squeeze-bulb re-expansion (LA) |
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What pressure should be used for an ET tube leak check for cuff inflation?
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20 mm H2O
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When should the following animals be extubated?
Horses? Cats? Dogs? Brachycephalic dogs? |
Horses - after swallowing returns
Cats - after ear flick returns Dogs - after 2 swallows Brachy - after awake! |
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What are the 3 main goals of anesthesia?
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Assure pt safety/survival
Pain management Optimize surgical conditions |
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What are the 6 steps to an anesthetic procedure?
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1) evaluate pt health
2) plan! 3) premedicate 4) induce 5) maintain 6) recover |
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What are 5 basic reasons to premedicate in an anesthetic protocol?
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1) analgesia
2) decrease anxiety/stress 3) sedation/chemical restraint 4) minimize autonomic reflex 5) decrease anesthetic maintenance dose requirement |
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What are the major classes of drugs available for preanesthesia?
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Anticholinergics
Phenothiazine tranquilizers Benzodiazepines Alpha-2 adrenergic agonists Opioids |
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What are the majore routes of administration for preanesthetic drugs?
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IV & IM
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What are examples of anticholinergics used in preanesthesia?
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Atropine
Glycopyrrolate |
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Which drugs are mainly used to treat bradyarrhythmias in a preanesthetic protocol?
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Atropine
Glycopyrrolate |
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What is the most often used example of a major tranquilizer?
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Acepromazine
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What are the major mechanisms of action for phenothiazines? What is a major example of a phenothiazine?
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Acepromazine blocks the inhibitory DA receptors in basal ganglia; blocks the CRTZ; peripherally blocks alpha-1-adrenergics; mild antihistiminic effects
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What is a major complication to acepromazine use?
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HYPOTENSION
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Characterize acepromazine in terms of:
Analgesia Anti anxiety Sedation/restraint Decreased anesthetic requirements Decreased autonomic reflex |
NO Analgesia
YES Anti anxiety SOME Sedation/restraint YES Decreased anesthetic requirements NO Decreased autonomic reflex |
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What is the MOA for the benzodiazepines? What are some examples of benzodiazepines?
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Potentiate GABA effects;
Diazepam, Midazolam, Zolazepam |
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Characterize the benzodiazepines in terms of:
Analgesia Anti anxiety Sedation/restraint Decreased anesthetic requirements Decreased autonomic reflex |
NO Analgesia
YES Anti anxiety SOME Sedation/restraint YES Decreased anesthetic requirements NO Decreased autonomic reflex |
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What are the major physiologic effects of the alpha 2 agonists?
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Inhibit NE release in CNS providing a sedative/anxiolytic effect;
activate nonadrenergic receptors on dorsal horn causing analgesia; activate receptors on endothelium causing vasoconstricion |
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What is a major drawback to using the alpha 2 agonists?
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PROFOUND cardiovascular effects (hypertension + bradycardia);
Some respiratory depression |
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What are fairly unique effects of alpha 2 agonists on cats? On cattle?
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Cats (emesis)
Cattle (abortion w/xylazine) |
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What are the alpha 2 agonist reversal agents?
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Yohimbine
Tolazoline Atipamezole |
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Put the following in order of alpha 2 affinity from lowest to greatest:
Romifidine Detomidine Medetomidine Xylazine Dexmedetomidine |
Xylazine (least selective)
Detomidine Romifidine Medetomidine Dexmedetomidine (most selective) |
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What are the opioid receptors? Which are the most important for analgesic effect?
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Mu, Kappa, and Delta
(blocking of Mu and Kappa provide analgesic effect) |
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What are the four types of opioids?
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Agonist
Partial agonist Agonist/antagonist Antagonist |
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T or F:
Opioids can be found in every scheduled class of drugs. |
True!
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What are cardiovascular effects of the opioids? Respiratory effects?
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CV - bradyarrhythmia (manageable w/anticholinergics)
Resp - mild depression |
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The use of opioids in patients with ____________ tumors must be judicious due to the opioid effect of _____________ release.
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MAST CELL TUMORS; HISTIMINE RELEASE
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T or F:
All mu agonists are schedule II narcotics and provide marked sedation and profound analgesia. |
True!
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Arrange these opioids from shortest to longest duration:
Hydromorphone Buprenorphine Morphine Tramadol Butorphanol Fentanyl |
Fentanyl (shortest, 15min)
Butorphanol (1-2h) Morphine (4-6h) Hydromorphone (4-6h) Tramadol (4-6h) Buprenorphine (longest; 6-12h) |
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Choose opioid agonist, partial agonist, agonist/antagonist, or antagonist...
...provides maximal analgesic efficacy. |
Agonist
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Choose opioid agonist, partial agonist, agonist/antagonist, or antagonist...
...morphine, fentanyl. |
Agonist
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Choose opioid agonist, partial agonist, agonist/antagonist, or antagonist...
...longest acting. |
Partial agonist (buprenorphine)
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Choose opioid agonist, partial agonist, agonist/antagonist, or antagonist...
...provides moderate efficacy. |
Partial agonist
Agonist/antagonist |
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T or F:
Only true neuroleptic agent in vet med is acepromazine. |
True!
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Which opioid should be used in endoscopy and why?
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Butorphanol doesn't constrict the pyloric sphincter
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Which premeds are best at providing analgesia?
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Opioids and alpha 2 agonists
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Which premeds decrease anxiety?
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Benzodiazapines, Alpha 2 agonists, opioids, and phenothiazines
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Which of the premeds DOES NOT decrease anesthetic dose?
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Anticholinergics
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Which of the premeds decreases autonomic activity?
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Anticholinergics
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