Conditions for Surgical Anaesthesia

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Doctorate Anaesthesia Mindmap am Conditions for Surgical Anaesthesia, erstellt von melian.yates am 03/10/2013.
melian.yates
Mindmap von melian.yates, aktualisiert more than 1 year ago
melian.yates
Erstellt von melian.yates vor etwa 11 Jahre
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Zusammenfassung der Ressource

Conditions for Surgical Anaesthesia
  1. 1) Deep General Anaesthesia
    1. High doses of Injectable Propofol or Inhalant Isoflurane
      1. Causes:
        1. Hypotension, Hypoventilation, Hypothermia, laryngeal areflexia
      2. Can only be tolerated by young, healthy animals
      3. 2) Supported Deep General Anaesthesia
        1. High doses of Injectable Propofol or Inhalant Isoflurane, but adverse effects are monitored and compensated for by the anaesthetist using extrinsic support
        2. 3) Balanced Anaesthesia
          1. 3 Drug Clsses are used to achieve the needs of surgical anaesthesia
            1. 1) Anaesthetics/ hypnotics => Unconsciousness
              1. Using very low inspired concentrations of sevoflurane with N2O (will just keep animal unconscious)
              2. 3) Analgesics => Analgesia
                1. Supplied by one or all of these options:
                  1. Topical proxymetacaine local anaesthetic
                    1. Retrobulbar blockade w/ local anaesthetic
                      1. Opiods (e.g. pre-operative morphine and/or intra-operative alfentanil
                        1. Stops spontaneous breathing: mandates controlled ventilation
                    2. 2) Neuromuscular blocking agents => Muscle relaxation
                      1. Atracurium (non-depolarizing neuromuscular blocking agent)
                        1. Stops spontaneous breathing : mandates controlled ventilation
                      2. 2 Additional elements:
                        1. Arreflexia
                          1. DO2
                        2. Lower doses of Anaesthetics are needed (relieved of producing analgesia and muscle relaxation), so the vital centre activity is perserved
                          1. Most useful in patients with diminished cardiovascular reserve (very ill or very old)
                        3. Selection of Optimum Surgical Technique
                          1. 1) Patient (Specific) Factors
                            1. Ex. Ethological (Temperment), Anatomical, Physiological, Pharmacological
                            2. 2) Patient (Individual) Factors
                              1. Ex. Size, Temperament, Breed, Health status, Age, Concurrent medication, Reproductive status, Function (avoid long-acting drugs in training athletes)
                              2. 3) Surgical Procedure
                                1. Ex. Duration, Invasivness, Location
                                2. 4) Micellaneous factors
                                  1. Ex. Cost, convenience, availability, familiaraity

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