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Anaesthesia in Surgery (How can we Effect Cardiovascular System Through…
Anaesthesia in Surgery
How can we Effect Cardiovascular System Through Surgery
Hydration Status
Massive decrease in cardiac output occurs at 2% dehydration which is undetectable on normal clincal examination of MM
Assess Hydration status
Bun/Creatine
Mucous membrane
USG
Measures renal function not exactly hydration status but can be used in unison with other measurments to build a case
Heart Rate
opioids
Alpha -2s
Isoflurane
Alfaxalone
Vasodilators
Ace promazine
Isoflurance
Alfaxalone
Myocardial contractility
Isoflurance (decreases)
Baroreceptors
Some of these drugs inhibit the barorecetpr reflex to low blood pressure
Haemorrhage
Combatting Hypotension (MAP <60mmHg) (SAP < 90mmHg)
Too Deep
Yes
Turn down Isoflurane%
No
Low HR
Atropine
Substitutes
Dopbutamine
Dopamine
Functions as a B1
Blocks muscarinic receptors
Reduces vagal tone to heart
+ve inotrope
Functions as B1
Increases heart contractility
Substitutes
Dopamine
Dobutamine
Pressor
Functions as a A1
Causes Vasoconstriction
Places Peripheral tissue at risk
Don't use as first line of defence
Drugs that can be substituted
Dopamine
Phenylene
Noradrenaline
Clenbutarol
Functions as B2
Bronchi/vasodilator
Turn Iso% down
this could be at the expense of the animal becoming light however can anaesthetic plane can be maintained by using opioids
Low BP
Fluid Bolus
reassess after administration to see if it creates desirable effect
or emergency rate 60ml/kg for 10 minutes
10ml/kg (over 10 min)
Blood Pressure
Cardiac Output (Q)
Stroke volume (SV)
Afterload
Preload
Contractility (optimum fibre stretch)
Heart Rate (HR)
Systemic Vascular Resistance (SVR)
Sympathetic Nervous System
Alpha
Alpha 1 (Vasoconstriction generic)
Basic vasoconstrictor throughout tissue
Activated by Adrenaline/Noradrenaline
Targets constriction of arteries /arterioles/ spleen
Alpha 2 (vasoconstriction with specific pathways turned off)
targets vasoconstriction of arterioles
Decrease pain
Decrease GIT mobility as blood flow is going to be shut down
Beta
Beta 1 (cardiac)
Cardiac Output
Heart rate
Increase contraction
Beta 2 (Dilation)
Bronchi dilation
Skeletal muscle dilation
Mixed message from Alpha/Beta to dilate/constrict vessels other mediators such as metabolites swing the decision