question

Define LOCAL anesthesia.

answer

-drug used on sensory neurons to *disrupt nerve impulse transmission* causing loss of sensation.

question

When is LOCAL anesthesia indicated?

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-TRACTABLE animal -General anesthesia high risk or NOT available

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What are the *advantages of LOCAL* anesthesia?

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-LOW cardio *toxicity* -LOW *cost* -*P*ost-op *P*ain *C*ontrol fast -LOW Recovery Time

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MOA of LOCAL anesthetics?

answer

-Affect SENSORY NEURONS -Blocks *sodium channels* and prevents (generation of) electrical impulses (stops depolarization)

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List LOCAL anesthetics USED on SKIN & MM's.

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Lidocaine Procaine Bupivacaine

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List 2 LOCALS USED in *OPTHALMIC* exams.

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Tetracaine Proparacaine (Precious' eye)

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-USES of LOCALS in L.A.

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*NERVE BLOCKS* most common in L.A. -*LAMENESS* in HORSES -*BLOCKS for DEHORNING* cattle -*Paravertebral BLOCKS* in cattle -*C-section / OBSTETRICS* (they don't cross placenta!)

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MOA of a TOPICAL LOCAL anesthetic?

answer

Affect the *ANS*! -Affect neurons btwn *Brain, Blood vessels and Organs*

question

List the Clinical applications for LOCALS(I think).

answer

*Lidocaine patches* *Ethyl Chloride* spray *MM* application *Splash BLOCK* *Bupivacaine* thru chest tube

question

-Does *TOPICAL* application have a *Shorter or Longer* DOA than *INFILTRATION*? -*Less or More* Analgesia?

answer

*SHORTER DOA* *LESS* Analgesia

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MOA for LOCALS *by* INFILTRATION?

answer

Drug injected into tissues in proximity to TARGET NERVE

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What is one *FORM* of INFILTRATION?

answer

*Paravertebral anesthesia*- -for Standing Laparotomies as *alternative to L-Block*

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List 3 different *methods of INFILTRATION*.

answer

L- block NERVE block RING block

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Does *INFILTRATION provide Analgesia* for surgery?

answer

For surgery involving SUPERFICIAL tissues

question

Outline the procedure for administering a *LOCAL by INFILTRATION*.

answer

1.) Surgical prep 2.) Small-gauge needle (20 or 25 gauge) (cont'd?- can't see it)

question

Why is EPINEPHRINE added to LIDOCAINE *prior to injection*?

answer

-affects *Rate of Absorption*

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What are 2 things that affect DOA?

answer

1. Drug used 2. Rate of Absorption by local blood vessels

question

List the *INFILTRATION techniques*.

answer

*Paravertebral anesthesia*- -For Standing Laparotomies as an *alternative to an L-Block* -LOCAL BLOCKS the Dorsal & Ventral branches of spinal nerves *T13 - L12*

question

Define NERVE BLOCK.

answer

Injecting *LOCAL in proximity to a NERVE* to DESENSITIZE particular site

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What are the *advantages* of a NERVE BLOCK?

answer

-To DESENSITIZE particular site -*Decreases general anesthesia* needed -Provides Short-term Analgesia Post-Op

question

*Nerve Blocks are commonly used* in what animals?

answer

-*LARGE animals*

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List some USES of Nerve Blocks.

answer

-*DENTAL Blocks* (Dogs/Cats) -Intercostal Nerve Blocks for *chest surgery* -*Limb amputations* -*Declaws*

question

Define *LINE BLOCK*.

answer

*LINE of LOCAL* placed betwn *TARGET AREA and SPINAL CORD*

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Define *RING BLOCK*. -When is this USED?

answer

*LINE of LOCAL* that *completely ENCIRCLES* an area -USED in *FOOD animal and EQUINE Sx* - Tx *Teat or wound* (Sx/repair)

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Define L-BLOCK.

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-*Line Block for LAPAROTOMY Sx* in RUMINANTS

question

Define *Intraarticular* INFILTRATION.

answer

LOCALS injected directly into JOINT

question

Define REGIONAL anesthesia.

answer

LOCAL injected into a *NERVE PLEXUS* or proximal to SPINAL CORD (affects larger area like an entire limb)

question

-Define *Paravertebral anesthesia*. -What spp?

answer

For Standing LAPAROTOMIES as an *alternative to an L-Block* *RUMINANTS ONLY*

question

Define *Epidural anesthesia*. What does it affect?

answer

A *REGIONAL BLOCK of SENSATION and MOTOR control* of rear, abdomen, pelvis, tail, pelvic limbs and perineum

question

When could an EPIDURAL be USED?

answer

TAIL amputation ANAL SAC removal PERIANAL surgery Urethrostomies

question

What determines the drug USED in an EPIDURAL?

answer

The *PROCEDURE*

question

List the drugs USED in an EPIDURAL.

answer

-*2% Lidocaine or 0.5% Bupivicaine* -- LOCAL -*OPIOID (Morphine)*-- POST-OP Pain control -*OPIOID & LOCAL mixture* -- Anesthesia, Analgesia -*OPIOID & ALPHA2-AGONIST mixture*-- Epidural in Horses and Cattle

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*Where is an EPIDURAL* administered?

answer

Epidural space btwn *Spinal Cord and Vertebrae* -*Dogs*: btwn the *last Lumbar Vertebra (L7) and the Sacrum*

question

-Define *Bier Block*. -What drug is USED?

answer

*IV REGIONAL anesthesia* -Lidocaine ONLY

question

What does a *Bier Block* provide?

answer

Short-term *LOCAL to a LIMB*

question

-Outline the procedure for a BIER BLOCK. -How long do the effects last?

answer

-*Tourniquet* applied to *PROXIMAL superficial vein* -*Lidocaine* injected into *DISTAL superficial vein* -Lasts *< 1 hour*

question

What is the benefit of *Systemic Constant Rate Infusion* of Lidocaine?

answer

*LESS anesthesia or analgesia* required

question

What are the *Adv. Effects* of LOCALS?

answer

-LOSS of *motor neuron function* -LOSS of *nerve function* w/ DIRECT injection -*Paresthesia* during Recovery -*Allergic rx* --from rash or hives to anaphylactic shock

question

List the 3 different types of VENTILATION.

answer

*"PAC"* *Positive-Pressure* Ventilation (PPV) *Assisted* Ventilation *Controlled* Ventilation

question

Define *Assisted ventilation*.

answer

-Anesthetist delivers an *INCREASED VOLUME of air or Oxygen/Anesthetic* to patient -*PATIENT INITIATES inspiration*

question

Define *Controlled ventilation*.

answer

-Anesthetist delivers *ALL AIR REQUIRED* by the patient -*ANESTHETIST CONTROLS* Resp Rate and Volume & Pressure of gas

question

Define *Normal ventilation*.

answer

Physical *movement of air into and out of the lungs and upper respiratory* passageways

question

Outline the *Active Phase* of Normal ventilation.

answer

*INHALATION* -*Increased PaCO detected* by Respiratory center in the Brain -*Thoracic muscle movement* causes thoracic cavity to expand -Air is pulled into the breathing passages and goes to the alveoli

question

Outline the *Passive Phase* of Normal ventilation.

answer

*EXHALATION* -*No active muscle movement* -PaCO begins to rise until respiratory center starts inhalation again -*2x's as long* as inspiration -Normal tidal volume = *10-15 mL/kg*

question

How does Ventilation in *anesthetized animals* differ from an *awake animal*?

answer

*REDUCED amount of air* entering and leaving the lungs

question

How do *tranquilizers and general anesthetics* affect ventilation?

answer

-*DECREASE responsiveness of breathing center to CO2 levels so inhalation doesn't occur as often*; (why CO2 is important in breathing!) -*Relax intercostals muscles and diaphragm* so the chest doesn't fully expand (Vt is reduced)

question

List *3 MAJOR PROBLEMS associated with ventilation of anestheized animals*.

answer

HYPERCARBIA HYPOXEMIA ATELECTASIS

question

Define HYPERCARBIA.

answer

Breakdown of *CO2 → Bicarbonate ions and H+ ions* -can lead to *respiratory acidosis*

question

Define HYPOXEMIA.

answer

LESS Oxygen entering the lungs to be absorbed into blood

question

Define ATELECTASIS.

answer

DECREASED Vt so *alveoli don't fully expand on inhalation*, which can lead to *collapse of the alveoli* in some sections of the lung

question

Outline *Positive Pressure Ventilation*.

answer

-Pt. *intubated and connected to anesthetic machine -*Manual ventilation or bagging* (bags patient every *2-5 minutes*) -Pt. *REQUIRES bagging*

question

Outline *Manual Ventilation*.

answer

-*Lungs are filled* with oxygen by pressure of gas entering airways -Anesthetist *squeezes reservoir bag* -*Pop-off valve* is fully or partially CLOSED -Passive Exhalation occurs when Positive Pressure STOPS and pop-off valve is OPENED -- *allows lungs to empty* -Bag *1-2 breaths every 2-5 minutes* (sighs) -Bag squeezed for 1-1.5 seconds (INHALATION time) Pressure manometer reading: *<20 cm HO* (small animals); Pressure manometer reading: *<40 cm HO* (L.A.) (right)?????????????

question

Outline *Mechanical Ventilation*.

answer

Lungs are filled with oxygen by pressure of gas from a ventilator

question

List the risks of CONTROLLED ventilation.

answer

-Ruptured alveoli -Decreased cardiac output -Respiratory alkalosis -Ventilator delivers more inhalant anesthetic to patient -Anesthetist monitoring

question

Define Neuromuscular BLOCKING agents.

answer

*Muscle-paralyzing* agents

question

What *surgical procedures* are Neuromuscular BLOCKERS USED for?

answer

-*LIMITED USE in Vet Med*- -*Orthopedic & Ophthalmic* sx -*C- section*

question

What is the *MOA of a depolarizing* NM BLOCKING agent?

answer

*Interrupt normal impulse transmission* from motor neuron to muscle synapse

question

List *1 depolarizing NM BLOCKING agent*.

answer

*Succinylcholine*

question

-Does *Succinlycholine* have a Short or Long DOA? -What procedure is it USED for?

answer

*SHORT* DOA -*RAPID intubation*

question

What is the *MOA of a NONdepolarizing* NM BLOCKING agent?

answer

(The *SAME*?) Interrupt normal impulse transmission from motor neuron to muscle synapse - Block receptors at end plates - No initial surge of activity

question

List *NONdepolarizing* NM BLOCKING agents.

answer

Gallamine Pancuron*ium* Atracur*ium* Besylate

question

What may *affect potency* of NM BLOCKING agents?

answer

Use with OTHER drugs

question

How are NM BLOCKING agents administered?

answer

*SLOW IV* injection

question

How *fast are the effects seen* from NM BLOCKING agents and what is the *DOA*?

answer

-Effect seen *within 2 minutes* -Lasts *10-30 minutes*

question

What may be *difficult to assess* in NM BLOCKING agents ?

answer

Anesthetic depth

question

What is a *Reversal agent* of NONdepolarizing NM BLOCKING agents?

answer

*Anticholinesterase* agent

question

List 3 *Anticholinesterase agents.*

answer

Pyridostig*mine* Neostig*mine* (Reversals for *NONdepolarizing* NM BLOCKERS) (ANTI--antagonist!)

question

--What should the patient be *pretreated with to prevent adverse effects*?

answer

-Atropine or Glycopyrrolate What type of drugs are these?

question

Do Depolarizing agents have a *REVERSAL*?

answer

NO

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