Vet 267 inhalants and anesthetic induction – Flashcards
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what are inhalant anesthetics
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inhalant anesthetics can be used as induction agents as well as for the maintenance stage of anesthesia
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what inhalant anesthetics are used?
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sevoflurane, isoflurane, Nitrous Oxide, Halothane
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what color is nitrous oxide color coded?
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blue
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what are the advantages of using inhalants as induction agents?
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quick recovery time, NOT metabolized by liver or kidneys
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what are the disadvantages of using inhalants as induction agents?
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periods of excitement, regurgitation, aspiration, airway obstruction
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what are the risks of mask induction?
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potential for waste gas, patient may become overly stressed, struggling releases epinephrine and predispose the animal to cardiac arrhythmias, should only be used on calm or sedated patients, bad choice for animals that are excited or aggressive
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what systems of the body are most affected by mask induction?
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respiratory, cardiovascular
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what is the proper way to induce with a mask?
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place snug mask on face, start at just oxygen for several minutes to increase O2 in blood, slowly increase the amount of gas anesthetic
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what are the advantages of chamber induction?
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used for fractious or fearful animals, keeps staff safe
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what are disadvantages of chamber induction?
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cannot access in an emergency, epinephrine release, employee exposure, potential for airway exposure, smaller patients
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what is MAC?
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Minimum alveolar concentration
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what is MAC used for?
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used to determine the potency of the inhalant gases
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what is the surgical depth of MAC?
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1.5x MAC
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lower MAC means what?
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lower % is needed to cause anesthesia
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what are the side effects of Isoflurane?
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respiratory depression, hypotension, dose-dependent, irritation of larynx upon mask induction
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what are advantages of Isoflurane?
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induction and recovery is rapid, minimal metabolism by the liver, maintains CO (heart will keep beating as strong as before), good muscle relaxation
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disadvantages to using Isoflurane?
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employee exposure to gas through exhalation when waking and at induction, no analgesia
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what color is Isoflurane coded?
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purple
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what is the MAC of iso?
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MAC 1.3%
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what is the induction % for iso?
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3-5%
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what is the maintenance for iso?
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1.5-2.5%
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what is Sevoflurane?
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fastest acting inhalant because it is less soluble
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what is the MAC of Sevoflurane?
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MAC 2.3%
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what is the color code of sevo?
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yellow
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how are iso and sevo different in dogs?
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Dogs > iso 1.3% vs Sevo 2.3%
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what is a big difference between iso and sevo?
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needs higher concentration of sevoflurane vs. isoflurane to achieve appropriate depth of anesthesia
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what is nitrous oxide color coded?
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blue
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what is the induction rate of sevo?
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4-6% (when used alone)
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what is the maintenance dose of sevo?
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2.5-4%
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what side effect is halothane most commonly associated with?
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hepatic necrosis, and with Malignant hyperthermia
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what color code is Halothane?
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red
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what is the MAC of halothane?
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0.9%
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what are the difference between IM and IV induction?
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IM has a longer onset of action, IM has a longer duration, IM has a slower recovery
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what is anesthetic induction?
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process by which an animal leaves the normal conscious state and enters an unconscious state
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what is the key points to patient care during induction?
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position patient comfortably during anesthetic event, lubricate eyes, if one lung is abnormal then place the normal side up, do not move patient while connected to the machine
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IV induction is usually given?
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to effect; s/a propofol
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how do you give an IV injection for induction?
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use smallest dose necessary, give till effect, keep light but deep enough to intubate
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with Ket/Val how do you give it IV?
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given much slower than propofol, may not use as much
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what drugs CANNOT be given IM?
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Diazepam, thiopental, propofol
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examples of injectable induction drugs
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ket/val, telazol, propofol, etomidate, barbiturates
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what do you avoid with Thiopental?
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avoid in sighthounds and other thin animals, patients w/ low TP, underweight, high glucose, acidosis
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actions of thiopental?
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non analgesia
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what is thiopental infused with?
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lidocaine and saline
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thiopental administration?
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use catheter, infuse with saline if leak occurs to decrease risk
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why is apnea sometimes prolonged after barbiturates are administered too rapidly?
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barbiturates suppress the respiratory center, making it insensitive to CO2
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what drug can be safely used in sight hounds?
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Methohexital
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what in Pentobarbitol?
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used for euthanasia, intermediate acting
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what is phenobarbital?
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used for seizures, long acting
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commen agents of Cyclohexamines?
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ketamine and tiletamine
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MOA of cyclohexamines?
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disrupts nerve impulses by stimulating some parts of CNS and depressing others
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effects of Cyclohexamines
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profound amnesia superficial analgesia, catalepsy, psychosomatic effects such as hallucinations, confusion, agitation and fear
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what goes with Catalepsy?
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cyclohexamines
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what is another word for cyclohexamine?
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dissociative anesthesia
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what gets increased with cyclohexamine?
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heart rate, blood pressure, salivation, CSF pressure, apneustic breathing system
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what species are cyclohexamines most popular
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cats, many exotic species, and intractable patients
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how are cyclohexamines metabolized?
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by the liver and excreted by the kidneys
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contraindications of cyclohexamines?
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major organ dysfunction, heart disease, seizures, increased CSF or intraocular pressure
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what is Ketamine-Diazepam dosed at?
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1mL per 20lbs
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advantages of Ketamine-Diazepam?
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muscle relaxation of diazepam offsets muscle rigidity of ketamine
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disadvantages of Ketamine-diazepam?
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must be given IV
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what is Tiletamine combined with?
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combined with zolazepam (Telazol)
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what does Zolazepam do?
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reduce the risk of seizures during recovery, provides some skeletal muscle relaxation
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what is Xylazine reversed with?
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Yohimbine
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when using xylazine/ketamine combo, the smallest dose of xylazine per kg is required in what species?
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ruminants
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Is ketamine an analgesia?
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not an adequate analgesia by itself
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what does propofol look like?
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the resultant milky-white compound is a very good medium for bacterial growth
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Propofol blue lasts how long?
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6hr - 1 day
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Propofol 28 green has a shelf life of how long?
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28 days
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cardiovascular effect of propofol?
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bradycardia
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is propofol an analgesia?
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No, it does not provide analgesia
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how often can propofol bolus be repeated?
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IV every 3-5 minutes to maintain anesthesia for up to 20 mins
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what is TIVA?
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total intravenous anesthesia
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contraindications of propofol?
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respiratory disease
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key things to know for Etomidate?
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short acting, minimal changes RR + HR, NOT AN ANALGESIC, it is an induction agent
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what is Alfaxalone?
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a neuroactive steroid - analogue of progesterone, used as an induction agent
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shelf life of Alfaxalone?
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6 hrs
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what does TIVA mean?
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Total intravenous anesthesia
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what does CRI stand for?
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Constant Rate Infusion
