Term
| major effects of propofol |
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Definition
- CNS depression ranging from sedation to gen anesthesia
- bradycardia, decreased cardiac output, and hypotension
- resp depression incl apnea
- muscle twitching during induction
- muscle relaxation |
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Term
| major adverse effects of propofol |
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Definition
- transient excitement, muscle tremors, and seizure-like activity during induction
- significant and prolonged hypotension in some pts
- apnea after rapid injection
- pain from IV injection |
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Term
| to do to reduce the transient apnea associated with Propofol. |
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Definition
| Prevention of hypoxia by delivering o2 to the pt by face mask for 3 – 5 min before inducing anesthesia w/ propofol. If apnea last more than 1 min or SPO2 less than 95%, pt should be intubated and ventilated |
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Term
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Definition
5 mg/kg
given IV slowly over 1 - 2 min until desired anes depth reached. IM inj may cause mild sedation/ataxia but does not induce anes because the drug is metabolized too rapidly. Effective induction method is to give one quarter of the calculated dose every 30 sec until desired plane of anes reached. the dose and duration of anes depend on type of premed used. Also don't give too slowly as can cause paradoxic excitement |
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Term
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Definition
| one disadvantage of propofol is poor storage. contains soybean oil, egg lecithin, and glycerol which supports bacterial growth. handle in strictly aseptic manner. discard unused w/in 6 hrs to avoid contamination. Cost approx 4 x ket/val and 2 x thiopental |
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Term
| in which pts should propofol be used cautiously? |
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Definition
| significant hypoptoeinemia since propofol is highly protein-bound |
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Term
Dissociative anesthetics
Major effects |
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Definition
Major effects:
- cataleptoid state
- intact reflexes
- eyes open, pupils central and dilated
- normal or increased muscle tone
- analgesia (primarily somatic)
- sensitivity to sensory stimuli
- increased heart rate, cardiac output, and mean arterial pressure (MAP) secondary to SNS stimulation
- apneustic respiration at higher doses |
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Term
Dissociative anesthetics
Major adverse effects |
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Definition
Major adverse effects
- exaggerated response to touch, light, and sound during recovery
- seizure-like activity
- nystagmus
- decreased inotropy
- increased salivary and resp tract secretions
- pain after IM injection |
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Term
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Definition
may be given IM or IV
One limitation is lack of an effective reversal |
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Term
| ketamine use in feral cats |
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Definition
| can be administered PO at 100mg/5 kg squirted into mouth |
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Term
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Definition
Ketamine-diazepam combo
Popular mix for IV induction of cats/dogs incl sighthounds
Premed with opioid and/or tranq
Ket/Val IV at 1mL/20lb (equivalent to 0.28 mg Diazepam/kg and 5.5 mg ketamine/kg
Loss of consciousness w/in 30 to 90 seconds and remains suffiently deeply anesthetized for intubation or minor sx for 5 to 10 min. followed by a 30 – 60 min recovery period.
Advantages:
- minimal cardiac depression
- good muscle relaxation
- superior recovery
- some analgesia
Disadvantage
- resp depression may be greater than with ketamine alone |
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Term
| Know the problems associated with recovery from tiletamine-zolazepam. |
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Definition
Long and difficult recoveries seen in some animals
As w/ ketamine, ataxia and increased sensitivity to stimuli are commonly observed during recovery. Tremors, muscle rigidity, seizure activity and hyperthermia can also be seen, esp in dogs given tiletamine-zolazepamat labeled doses by the IM route. IV diazepam admin may be helpful in some animals. In cats, recovery may be prolonged (up to 5 hrs after IM inj), particularly if high doses are administered. Because drug metabolized by liver and excreted via the kidneys, prolonged recovery should be expected in animals w/ liver or kidney dysfunction.
Should be avoided in animals with a ASA physical status class of P3 or greater and in animals with CNS signs, hyperthyroidism, cardiac dz, pancreatic or renal dz, pregnancy, glaucoma, or penetrating eye injuries |
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Term
| Know and be able to describe the vapor pressures of the inhalant anesthetics. |
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Definition
Vapor pressure is a measure of the tendency of a liquid anesthetic to evaporate and is significant to the anesthetist because it determines whether a precision or nonprecision vaporizer is used to deliver the agent.
Agents with a high vapor pressure, such as isoflurane, sevoflurane, desflurane, amd halothane, are described at volatile because they evaporate easily |
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Term
| Know and be able to describe the blood-gas parturition coefficient of the inhalant anesthetics. |
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Definition
| A measure of the solubility of an inhalant anesthetic in blood as compared with alveolar gas. It is significant because it indicates the speed of induction and recovery one should expect for a given inhalant anesthetic. The lower the blood-gas partition coefficient, the faster the expected induction and recovery. |
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Term
| Know what MAC is and be able to describe the MAC of the inhalant anesthetics. |
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Definition
The MAC of an anesthetic agent is the lowest concentration at which 50%of pts show no response to a painful stimulus. It is significant because it is a measure of the potency of the agent and is used to determine the average setting that must be used to produce surgical anesthesia.
For any inhalation anes, a vaporizer setting of approx 1 x MAC =light sx anes
1.5 x MAC = moderate sx anes
2 x MAC deep sx anes
only a rough guide, many factors alter potency
response to an anesthetic depends on the concentration of the anes in the pt’s brain, which is not always the same as that idicated by the dial, esp early in induction period
Isoflurane MAC ~ 2 % maint
Halothane MAC ~ 1 – 1.5% maint
Sevoflurane MAC ~ 3.5% maint |
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Term
| . Know the specific factors that will influence the MAC of inhalant anesthetics in patients |
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Definition
- age
- metabolic activity
- body temp
- dz
- pregnancy
- obesity
- use of other agents |
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