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Anesthesia-Monitoring Complications

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sihirlifil's version from 2017-05-09 02:42

Section 1

Question Answer
Too deep plane of anesthesia -->Hypoventilation
Apnea
Bradycardia
Hypotension
Too light plane of anesthesia -->Hyperventilation
Apnea
Tachycardia (sympathetic stim e.g. pain, awareness)
Hypertension (pain, awareness)
Hypothermia causes -->Hypoventilation
Apnea
Bradycardia
Hyperthermia causes -->Hyperventilaion
NMBA paralysis causes -->Hypoventilation
(Apnea)
Drugs can cause -->Hypoventilation (propofol, etomidate, ketamine)
Bradycardia (opioid, α2 agonist)
Hypotension ( (propofol, alfaxalone,) vasodilation via inhalants, Acepromazine)
Equipment failure causes -->Apnea (pop-off valve, ventilator)
Visceral traction by surgeon can cause -->Apnea
Hypoxemia causes -->(Apnea-if extreme)
Hyperventilation
Tachycardia
(Hypertension if mild)
Hypercapnea causes -->(Apnea-if extreme)
(Hyperventilation)
Tachycardia
Hypertension
CNS disease causes -->(Apnea)
Bradycardia (increased ICP)
(Metabolic alkalosis causes -->)(Apnea)
Metabolic acidosis causes -->Hyperventilation
(Open thorax causes) -->(Apnea)
High vagal tone causes -->Bradycardia
Hyperkalemia causes -->Bradycardia
Hypovolemia causes -->Tachycardia
Hypotension (hemorrhage, inadequate fluid admin)
Anemia causes -->Tachycardia
Myocardial disease causes -->Tachycardia
(Hypertension)
Vasodilation (via inhalants, Acepromazine, decreased cardiac output from IPPV/sx, severe bradycardia) causes -->Hypotension
(Pheochromocytoma causes -->)(Hypertension)
(Renal/Cardiac disease causes)(Hypertension)
memorize

Section 2

Question Answer
Decreasing the depth of anesthesia will help withHypoventilation
Bradycardia
Hypotension
Increasing anesthetic depth will help withHyperventilation (increase FGF / % of anesthetic agent, bolus injectable agent, ventilate)
When should you ET intubate?Patient is hypoventilating
When should you provide oxygen therapy?Patient is hypoventilating
When should you give IPPV? (What is it? What values?)Patient is hypoventilating (squeeze bag, heart and vessels constrict)
RR: 10-15 bpm (depending on ETCO2)
TV: 10-15(20)mL/kg
Inspiratory pressure: 10-15cmH2O (max 20!)
I:E ratio 1:2 (need longer expiratory to support preload)
(Pros/cons of IPPV?)Pros: improved oxygenation (SpO2, PaO2), improved ventilation (reduce hypercapnea), "free hands"
Cons: DECREASE CO (BP, perfusion), potential barotrauma
When would you warm your patient?Hypoventilating
Apnea (after checking patient and equipment)
When should you check the equipment?Apnea: pop-off valve, ventilator (after checking patient)
Hyperventilation: rebreathing bag, absorber granules, one-way valves, FGF, breathing circuit
Esophageal stethescope will help reconfirm:Bradycardia
When should you check blood pressure?Bradycardia
Administering an anticholinergic (atropine, glycopyrrolate) will help withBradycardia AND Hypotension IF TOGETHER!
Administering a β-blocker (esmolol, propanolol) will help withTachycardia
Surgery may be required to treat the underlying cause ofTachycardia
When would you want to give fluids? Which would you give?Hypotensive patient
Bolus LRS 10mL/kg
Colloid (Hetastarch) 5mL/kg then CRI
Hypertonic saline max 5mL/kg
Dopamine / Dobutamine treat (species diff?)Hypotension
Cats: dopamine
Horses: dobutamine
Dogs: either
memorize

Section 3

Question Answer
Patient's HR and BP both increase:Awareness/Pain
Patient's HR increases but BP decreases:Vasodilation/Hypovolemia & reflex tachycardia
Patient's HR decreases but BP increases:Vasoconstriction & reflex bradycardia
Patient's HR and BP both decrease:Anesthetic plane too deep
memorize

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