Which of the following poses the greatest danger during anesthesia? Which local anesthetic has the longest duration of effect? Which local anesthetic is ineffective when applied topically?
Which method of noninvasive monitoring is necessary in this patient? The complete blood count and serum chemistry results are within normal limits. To confirm your suspicions of an intracranial mass, computerized tomography CT scan is necessary. The procedure requires general anesthesia. Local anesthetics exert their effect by: a. Which pair of drugs are "amide" types of local anesthetics? Preoperative blood studies are normal. Morphine and atropine are given as premedicants.
Anesthesia is induced with intravenous thiopental to effect and maintained with isoflurane in oxygen. A morphine epidural is administered to help manage pain during and after surgery. Patient monitoring includes electrocardiography. Systolic blood pressure is initially mm Hg and diastolic pressure is 55 mm Hg. However, as surgery progresses, the systolic pressure drops to 70 mm Hg and diastolic pressure to 30 mm Hg; blood pressure continues to fall. A large pool ofbloody fluid on the floor under the surgery table is rapidly increasing in size.
What is the mean arterial blood pressure initially? At what mean arterial blood pressure would you begin to suspect inadequate perfusion of vital organs? BOmmHg b. SOmmHg e. The mean arterial pressure does not indicate this problem. What is the mean arterial blood pressure after the decrease in blood pressure is observed? SOmmHg b. It cannot be determined from the information given.
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What is the estimated blood volume of this dog? Intraoperatively, blood should be administered when the packed cell volume falls below: a. A kg dog is seen after acute loss ofblood, and you decide to administer intravenous fluids as. Which of the following is most appropriate as the initial fluid therapy to prevent vascular colfapse? Midazolam is classified in the same category as: a. Approximately how many milliliters of red blood cells have been lost when this critical packed cell volume is reached?
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BOO mI In a patient with which of the following blood values would it be appropriate to administer only a colloidal solution e. Medetomidine is classified as: a.
Anesthesiology 25 Answers 1. This competition can be overcome by increasing the concentration of acetylcholine at receptor sites as seen following administration of anticholinesterases.
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Working stallions are at higher risk for these problems. It has no recognized analgesic properties and so should not be used as a sole agent for restraint for surgery. This method of limiting the drug's action is known as Hoffman elimination.
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It has a short duration of action because it is metabolized by plasma cholinesterase. Atracurium is a non depolarizing blocker and causes relaxation alone. Some muscle groups are more susceptible e. This increases preganglionic muscarinic activity, slowing the heart rate. Atropine 0.
Hyperglycemia, increased urine output, and increased intrauterine pressure also occur. Respiratory function is depressed because of sedation. An " z-adrenergic antagonist, such as yohimbine, would only partially antagonize the bradycardia and decrease the sedative-analgesic desirable effects of xylazine. Human patients may still be aware of the pain without being in pain.
The drug is usually administered in combination with diazepam. The induction is slow 2 to S minutes and causes respiratory depression.
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Therefore it should be preceded by S minutes of preoxygenation via face mask. Thls does not usually cause clinical problems in healthy patients. Therefore there is rapid recovery of consciousness after a single anesthetic dose. Hypoproteinemia, dehydration, acidosis and hypothermia all exacerbate this problem. Giving 2 or 3 normal breaths per minute ensures that the patient remains oxygenated and receives some halothane; it also allows the arterial carbon dioxide to rise to a level sufficient to stimulate spontaneous ventilation. If no halothane were administered, this dog would be awake in 10 to 15 minutes.
Propofol also causes postinduction apnea. They produce relatively good muscle relaxation at anesthetic doses. This effect is exacerbated by dehydration. Propofol does not directly alter the heart rate or myocardial contractility.
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Patients are quickly ambulatory and not ataxic. In part, recovery is due to rapid metaboHsm. It is stable at room temperature but contains no preservative agents. In addition, rapid recovery is desirable. Although not producing the fastest induction and smoothest recovery thiopental or propofol would be better , ketamine would be acceptable.
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Tiletamine is the dissociative agent in Telazol tiletamine-zolazepam. Because they have high lipid solubility and are poorly ionized, they are metabolized by the liver before excretion. Ketamine is excreted without metabolism via the kidney in dogs and cats. The longest duration of effect is from bupivacaine, whlch lasts 4 to 6 hours.
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This is because ofits high protein binding in maternal blood. This is not the situation for local anesthetics administered into the cerebrospinal fluid. Although the volume of drug administered epidurally is important hence the different concentrations , this is not the only reason that the solution is packaged in a vial.
It is one sixth as potent as methoxyflurane and two thirds as potent as halothane. Propofol is not an inhalation agent. Other agents have minimal metaboHsm.