Phases of Anesthesia

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  1. What are the 5 different phases of anesthesia?
    • patient assessment
    • premedication
    • induction
    • maintenance
    • recovery
  2. What do we need to do for patient assessment?
    • get a history
    • physical exam
    • signalment
    • lab evaluation
  3. What do we look for in a history?
    • previous anesthesia episodes
    • medical problems that could affect anesthesia
  4. What is the purpose of the physical exam?
    assess current condition of patient
  5. Why do we need a signalment?
    • different breeds may have different issues with anesthesia
    • age
    • size
  6. What kinds of lab tests can we run for before anesthesia?
    • CBC
    • chem (pap or full panel)
    • clotting times (PT, PTT, ACT, BMBT)
    • UA (especially specific gravity)
    • EKG
    • imaging
    • 4DX
    • combo test
    • fecal
  7. What is the purpose of premeds?
    • helps decrease induction and maintenance meds
    • reduces pain (takes more meds to chase pain than to prevent it)
    • anxiety relief for patient, owner, and staff
    • reduces side effects of other drugs
  8. What are the three types of premeds?
    • analgesics
    • sedatives
    • anticholinergics
  9. What are the three types of analgesics?
    • opioids
    • NSAIDS
    • alpha 2 agonists
  10. What are the different types of opioids?
    • morphine
    • oxymorphine
    • hydromophine
    • fentanyl
    • buprenophine
    • butorphanol
  11. Which opioids are mu agonists?
    • morphine
    • oxymorphine
    • hydormorphine
    • fentanyl
  12. Which opioids are partial mu agonists?
    buprenorphine
  13. Which opioids are kappa agonist/mu antagonists?
    butorphanol
  14. What is the onset time of buprenophine?
    • IV:  5 - 10 minutes
    • SQ and IM:  45 - 60 minutes
  15. What is the indication for opioids?
    analgesia first and then sedative
  16. What is the duration of morphine, oxy, and hydro?
    4 - 6 hours
  17. What is the duration of the fentanyl patch?
    3 days
  18. What is the duration of buprenophine?
    6 - 12 hours
  19. What is the duration of burtorphanol?
    1 - 2 hours
  20. What are the main side effects of opioids?
    • bradycardia
    • respiratory depression
  21. What is the duration for carprofen (Rimadyl, Novox)?
    12 - 24 hours
  22. What is the duration for meloxicam, deracoxiv, firocoxib, ketoprofen, etodolac, robenacoxib?
    24 hours
  23. What are the different types of NSAIDS?
    • carprofen
    • meloxicam
    • deracoxiv
    • firocoxib
    • ketoprofen
    • etodolac
    • robenacoxib
  24. What is the side effects of NSAIDS during anesthesia?
    • renal perfusion - need to maintain using fluids
    • monitor blood pressure for hypotension
  25. What are the alpha 2 agonists?
    • xylazine
    • dexmedetomidine (dexdomitor)
  26. What are the side effects of alpha 2 agonists?
    bradycardia
  27. What are the main types of sedatives?
    • phenothiazine tranquilizer
    • benzodiazepine
    • alpha 2 agonist opioid
  28. What is the phenothiazine tranquilizer we use?
    acepromazine
  29. What are the benzodiazepines that we use?
    • diazepam
    • midazolam
  30. What are the alpha 2 agonists we can use for sedatives?
    • xylazine
    • dexmedetomidine (dexdomitor)
  31. What are the side effects of phenothiazine tranquilizers (acepromazine)?
    hypotension and hypothermia due to vasodilation
  32. What side effect are we concerned with when using diazepam?
    hypotension
  33. What are the different types of anticholinergics?
    • atropine
    • glycopyrrolate
  34. What do anticholinergics do?
    • decrease secretions
    • increase heart rate
  35. Which anticholinergic has a quicker onset time?
    atropine
  36. Which anticholinergic has a longer duration?
    • glycopyrrolate (1.5 - 2 hours)
    • atropine only lasts for 1 hour
  37. What is the side effect of anticholinergics?
    tachyarrhythmias
  38. What are the different induction agents?
    • propofol
    • inhalants
    • dissociatives
    • barbiturates
  39. What are the different inhalants?
    • isoflurane
    • sevoflurane
  40. What are the different dissociatives?
    • ketamine
    • tiletamine
  41. What is tiletamine?
    Telazol
  42. What are the different barbiturates?
    • methonexital
    • thiopental
  43. What is the duration of propofol?
    very short - 5 minutes
  44. What are the side effects of propofol?
    • apnea
    • hypotension
  45. What do we have to do when administering propofol?
    carefully titrate
  46. What is the onset time for inhalants as an induction agent?
    onset depends on the premeds and size of patient
  47. What can the patient go through when masking them down with inhalants?
    can go through the excitement phase
  48. What are the side effects of using inhalants as an induction agent?
    • cardiovascular depression
    • respiratory depression
    • unable to secure an airway right away
  49. Do we titrate inhalants when we are using them as an induction agent?
    yes
  50. What do we usually combine ketamine with when using it as an induction agent?
    benzodiazepine (diazepam)
  51. Which dissociative is safer, ketamine/diazepam or Telazol?
    ketamine/diazepam
  52. Do dissociatives have a lot of side effects?  What are the side effects?
    • no
    • increased heart rate, increased cardiac output
  53. Do we have to titrate dissociatives when using them as an induction agent?
    no
  54. What are the side effects of barbiturates?
    • major apnea (lasting 20 minutes)
    • cardiovascular depression
  55. Do we need to titrate barbiturates?
    yes, carefully
  56. What do we use for maintenance?
    inhalants or CRIs
  57. What does CRI stand for?
    constant rate infusion
  58. Why do we usually use inhalants as maintenance?
    • east to titrate
    • fast recovery
  59. What can we use as CRIs?
    • dissociatives (ketamine)
    • propofol
    • fentanyl
  60. What do we combine with ketamine for maintenance?
    • MLK - morphine, lidocaine, ketamine
    • put in an IV bag to have it constantly flowing in
  61. What can dissociatives cause?
    stormy recovery
  62. What is pulse dosing?
    give them more when they start to wake up (we do this if we were using propofol)
  63. What is the primary goal for recovery?
    have a smooth recovery
  64. What is the secondary goal for recovery?
    avoid a prolonged recovery
  65. What are the reversable drugs for the alpha 2 agonists?
    • dexmedetomidine:  atipamazole
    • xylazine:  yohimbine
  66. What is the reversing agent for opioids?
    naloxone
  67. What is the reversing agent for benzodiazepines?
    flumazenil
  68. What is tramadol?
    synthetic opioid like drug
  69. What is the duration of tramadol?
    8 - 12 hours
  70. What are considered controlled drugs?
    • opioids
    • dissociatives
    • benzodiazepines
    • barbiturates
  71. What are the 4 analgesics that we can use other than for premeds?
    • opioids
    • NSAIDS
    • alpha 2 agonists
    • dissociatives

Card Set Information

Author:
 kris10leejmu
ID:
 167987
Filename:
 Phases of Anesthesia
Updated:
2012-09-04 02:44:45
Tags:
Surgery
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Surgery
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