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surgical research

anesthetist

QuestionAnswer
dexter right side
alb white
levo left side
year Paracelsus makes ether 1540
1800 Sir David discovers nitrous oxide
1831 Liebig discovers chloroform
1842 ether first used for human anesthesia
1847 chloroform first used for human anesthesia by Dr. Simpson
1975 American College of Vet Anesthesiologists formed
loss of sensation to the entire or part of the body anesthesia
loss of sensation in a defined body area local anesthesia
loss of sensation to a larger though limited body area than with local anesthesia regional anesthesia
Drug induced unconsciousness that is characterized by controlled reversible depression of the CNS and analgesia General anesthesia
induced by a multiple drug approach in which drugs are targeted to specifically attenuate individual components of the anesthetic state (consciousness, analgesia, muscle relaxation and autonomic reflexes. Balanced anesthesia
Induced by drugs that dissociate the thalamocortic and limbic systems and which is characterized by a cataleptoid state in which the eyes remain open and swallowing reflexes remain functional Dissociative anesthesia
Unless a sedative or muscle relaxant has been given skeletal muscle hypertonus persists
The plane/stage of general anesthesia that provides unconsciousness, muscular relaxation, and analgesia sufficient for painless surgery Surgical anesthesia
A state of behavioral change wherein anxiety is relieved and the patient is relaxed although aware of his surroundings Tranquilization
State characterized by central depression accompanied with drowsiness where the patient is unaware of its surroundings Sedation
Drug induced state of deep sleep from which the patient cannot be easily aroused Narcosis
condition of artificially induced sleep, or a trance resembling sleep resulting from moderate depression of the CNS from which the patient is readily aroused Hypnosis
Type of anesthesia where anesthetic gasses or vapors are inhaled in combination with oxygen inhalation
type of anesthesia where anesthetic agents are administered IV, IM, SC, IP and IT injectable
Type of anesthesia where anesthetic agents are administered into the openings of the GI tract Oral and/or Rectal
Type of anesthesia where anesthetic agents are topically or locally injected into or around a surgical site or a large nerve trunk supplying a specific region Local and Conduction
Passing an electric current through the cerebrum to induce deep narcosis is called electronarcosis
When local analgesia is induced with low intensity high frequency electric stimulation of the skin via surface electrodes it is called Transcutaneous Electric Nerve Stimulation or TENS
an ancient chinese system of analgesia using fine needles at predetermined locations is called acupuncture
When the local or general body temperature is lowered to supplement anesthesia and decrease analgesic drug administration in neonate and cardiovascular procedures it is called Hypothermia
true or false: anesthesia is a reversible process True
True or false: anesthetic dosed are based on the "average" animal although there is no true "average" animal True
true or false: The anesthetist does not need to modify the regimen based on experience and the individual animals' responses. False
true or false: response to anesthetic agents relies on metabolism, uptake and distribution of the anesthetic, and pre-existing disease or pathology true
true or false: General anesthesia results from interaction of the drug and the CNS true
what type of anesthesia: Enters the blood stream for transport to target tissues, requires redistribution, detoxified in the liver and is excreted by the kidneys and gives less control of the elimination process injectable
what type of anesthesia enters the blood stream from the lungs, is eliminated via the lungs, gives more control over the process inhalation
What is Minimum Alveolar Concentration?(MAC) the amount of inhaled anesthetic required to keep 50% of dogs from gross movement in reaction to a painful stimulus
true or false: small animals have a higher basal metabolism rate (BMR) per unit of surface area than larger animals true
true or false: small animals require smaller doses of anesthetic and analgesic agents per kg of body weight false
yes or no: Does BMR rate increase with activity? Yes
does disease or pathology lower metabolic rate? yes
do adult and geriatric animals have higher BMR's than adolescent and young adults? no
newborns have lower BMR's than adolescent and young adults true
Is the BMR of the male or female ~7% higher? male
do fatter animals have slower BMR's and require less anesthetic? yes
anesthetic agent absorption in adipose tissue may result in less anesthetic agent freely available in the bloodstream true
adipose tissue may require more anesthetic early on due to absorption into fat but may result in longer recovery times due to prolonged discharge of anesthetic agents back into the bloodstream from fat true
ataxic means loss of coordination
tachypnea means rapid breathing
hyperventilation is faster deeper breathing
uncontrolled tightening of vocal cords is laryngeal spasm
voluntary movement, tachycardia, irregular respiration, pupils dilate, some analgesic effects present in what stage of anesthesia? stage one
delirium, cns depressed, loss of voluntary control, relexes exaggerated, struggling, cardiac arrythmias, palpebral reflex present, vocalization, salivation, perhaps a laryngeal spasm is in what stage of anesthesia? stage two
surgical anesthesia, pulse rate returns to normal, muscles relax, swallowing and vomiting reflex lost, stage three
lowered heart rate, cyanosis, dilated pupil unresponsive to light, flaccid muscle tone jaw tone and sphincter control lost overdose
begin to die, slow respirations, all reflexes and tone lost, heart begins to stop etc stage four
what is the carrier for all anesthetic agents to the CNS not administered directly into the CSF? blood plasma
partial pressure gradients molecules are always in motion moving in random directions
both sides have an equal number of molecules with both sides having some moving to the other in equal amounts is called equilibrium
true or false: IV anesthesia allows quick onset of anesthesia true
what is hypocarbia? low co2 levels in blood
what is hypercarbia? hight co2 levels in blood
the four most important systems to be considered before anesthesia are: nervous, cardiopulmonary, hepatic and renal
fasting is generally done for how many hours? 12
fasting is not advised for : small mammals, birds, neonates rabbits
hypoglycemic low blood sugar
why is fasting not recommended in ruminants and horses? due to possible rumen shutdown
what should be withheld from horses to reduce the chance of rupture and distension? and for how long? water for 12-24 hours
surgical procedures and procedures may lead to what problem with fluids? dehydration
what is necessary for cell metabolism, intra and extra cellular transport and life itself? Fluid in body
what four ways can fluids be administered? IV, SQ, IO (intraosseous) and orally
should iv fluids be warmed? why? yes, to 37c to prevent hypothermia.
what is IO administration used for? severely dehydrated or traumatized patients with poor or inaccessible veins/arteries that need rapid fluid absorption into the blood.
what is the common maintenance rate for LRS/Isotonic saline ? 10 to 20 mL/kg/hr
procedures that involve opening a major body cavity due to dehydration while the organs are exposed should receive how much fluid? 20 to 30 mL/kg/hr
which solution is isotonic so that it does not induce fluid shifts? Lactated Ringers Solution
what is the word for rapid sodium replenishment hyponatremia
what is essential for successful anesthesia? an open airway
what happens when the airway is blocked? death
what if the airway is partly occluded? a decrease in available oxygen to the lungs
what is the easiest method to maintain a patent airway? animal positioning
Laryngoscopes have two main styles of blade.They are: Miller, and Bizarri-Guiffrida. Which is straight and which is curved? Miller is straightBizzari-Guiffrida is curved.
atelectasis means lack of gas exchange in the alveoli
true or false: Most anesthetic agents depress the thermoregulatory centers and metabolism which leads to accelerated heat loss. True
True or false: Most preanesthetic agents cause CV depression. True
Most preanesthetic and anesthetic agents do or do not cause pulmonary depression. do
Care should be taken in using Nitrous Oxide due to it's effect on the pneumothorax
Pneumothorax means collapsed lung
ICP stands for intracranial pressure
CBF stands for cerebral blood flow
renal disease affects the kidneys
hepatic disease afftects the liver
obtund dull or deaden or make less intense
atropine sulfate should not be used in ruminants (because of bloat) and rodents (because of their rapid HR)
atropine sulfate and glycopyrrolate are anticholinergics
anticholinergics reduce secretions and helps bradycardia
relieve anxiety, reduce vomiting, smoother anesthesia recovery is due to use of tranquilizers
acepromazine maleate is a tranquilizer
droperidol is a tranquilizer primarily used with fentanyl (InnovarVet)
Diazapam (Valium) is a tranquilizer (should not be mixed with other agents, painful IM, not for injection in artery (venous thrombosis)
Midazolam is tranquilizer,can be given IM, can be mixed with other agents, may cause behavioral changes in dogs and cats,
Flumazenil reverses valium and midazolam
Opioids depress CNS, addictive, DEA controlled
Morphine sulfate opioid
Meperidine hydrochloride opioid(Demerol, Pethidine) used 30 minutes before anesthesia. one tenth the effect of morphine, does not cause vomiting.
Methadone hydrochloride synthetic opioid unrelated to morphine, lasts 2 to 6 hours, stimulates respiration rate (Methadone, Dolophine)
oxymorphone hydrochloride (Numorphan) semisynthetic opioid ten times more potent than morphine effective epidural analgesia
Fentanyl citrate opioid, 250 more potent than morphine, rapid onset, short duration, depresses respiration, exaggerates response to loud noises
Carfentanil citrate opioid, 10,000 times more potent than Morphine, used for capture of wild animals, can be administered by applying to buccal or nasal mucosa.
Sufentanil 5 to 10 times as potent as Fentanyl
Alfentanyl 1/5th to 1/10th as potent as fentanyl, 80 to 100 times more potent than morphine, used to capture wild animals primarily
Butorphanol tartrate (Torbugesic) synthetic opioid, 3 to 5 times as potent as morphine, less resp depression than morphine, excellent analgesic when combined with xylazine or detomidine for cattle/horses
buprenorphine (Buprenex) 25 to 30 times as potent as morphine, slow onset, IM lasts 6 to 8 hours
Pentazocine lactate (Talwin) one third as effective as morphine
Alpha 2 Andrenergic Agonist non-addictive, anticonvulsant, produce sedation, muscle relaxation and analgesia.
example of alpha 2 andrenergic agonist is guaifenesin (glyceryl guaiacolate)
Neuromuscular (Blocking) paralytic agents interfere with transmission of signal from motor neuron to muscle
Depolarizing Neuromuscular Paralytic Agents keeps the motor neuron from repolarizing and firing again
succinylcholine must be refrigerated, rapid onset, excellent relaxation, twitch for 30 minutes
fasciculation means twitching
nondepolarizing blocks may not be reversible
xylazine hydrochloride (Rompun) sedative, analgesic, not for swine, causes emesis in dogs and cats, wide margin of safety
mydriasis dilation of pupils
Detomidine developed for horses and cattle, may be used as a pre-anesthetic or combined with ketamine for anesthesia
Medetomidine more potent and longer lasting than other alpha 2 adrenergic agonists
alpha 2 andrenergic antagonists used for reversal agent for injectable anesthetics
Yohimbine reverses xylazine, ketamine
tolazoline reverses xylazine
atipamezole selectivity ratio 200 to 300 times higher than yohimbine; rapid IV dose may cause death
paralytic (Muscle relaxants) provide superior muscle relaxation as an adjunct to general anesthesia, allows easier intubation, less muscle tension
muscle relaxants do not provide analgesia or unconsciousness
steroid analogs pancuronium,vecuronium,pepecuronium,rocuronium
benzylisoquinoliniums curare, tubocurarine, motocurine, gallamine, atracurium, doxacurium and mivacurium
reversal agents are most effective when spontaneous recovery of muscle strength has begun
injectable anesthesia generally requires a combination of drugs to affect all necessary bodily systems adequately
inhalant anesthesia increase or decrease all components of anesthesia at the same time
what type of barbituates are used for clinical anesthesia? short or ultra short duration
Used for fish and amphibians anesthesia Tricaine Methanesulfonate (MS222)
name two dissociative anesthetics Ketamine, Telazol
physical methods of anesthesia include: hypothermia, electronarcosis,acupuncture
examples of local and regional anesthesia to be used on topical mucous membranes are lidocaine, benzocaine, tetracaine butacaine
injected into muscles that will be cut, separated or subject to extensive manipulation during surgery general muscle block
the most common type of anesthesia machine is VOC (Vaporizer out of circuit)
system that does not allow precise control of the agent concentration is the VIC (Vaporizer in Circuit)(no longer produced in the USA
movement of gas in and out of the alveoli in the lungs ventilation
the total process whereby oxygen is supplied to and utilized by body cells and co2 is eliminated by means of concentration gradients respiration
ordinary quiet breathing eupnea
dyspnea labored breathing
tachypnea increased breathing rate
hyperpnea fast and deep breathing
polypnea rapid and shallow panting breathing
hypopnea slow and shallow breathing
apnea transient or longer cessation of breathing
cheyne-stokes respirations initial increase in rate and depth, followed by slowing followed by brief periods of apnea.
Biot's respirations sequence of gasping, apnea, and several deep gasps
kussmaul's respirations regular deep respirations without pause
apneustic respirations long, gasping respirations with several ineffective exhalations
Tidal volume (VT) volume of air inspired or expired in a single breath
inspiratory reserve volume (IRV) volume of air that can be inspired over and above the normal tidal volume
Expiratory reserve volume (ERV) amount of air that can be expired by forceful expiration after a normal expiration
residual volume (RV) air remaining in the lungs after the most forceful expiration
Minute respiratory volume or minute ventilation tidal volume times respiratory frequency
Created by: madmax