Intravenous anesthesia and analgesia Flashcards
TIVA
Total intravenous anesthesia- induction and maintenance of anesthesia using only IV agents
PIVA
Partial intravenous anesthesia- induction and maintenance of anesthesia using both IV and inhalant agents
Balanced anesthesia
Combination of drugs/techniques
CRI
Constant rate induction
Inhalation anesthetic things
- Equipment demanding
- No cummulation
- Easier to monitor and control anesthetic depth
- Safe airways, 100% O2 mechanical ventilation
TIVA things
- Easier technique
- Drugs may cummulate
- More difficult to monitor and control anesthetic depth
Does TIVA mean you don’t give O2?
NO always beneficial regardless of anesthetic technique and agent choice
Drug administration strategies
Classical - give half of calculated dose slowly IV then bolus to effect
Bolus dosing- only small boluses up to effect as needed, not expected to be harmful
Advantages of bolus/digital system
May induce anesthesia with smaller doses
Disadvantages of bolus/digital system
First bolus may be too little
may give double dose initially if indicated
Drug administration strategies for TIVA
IV boluses or CRI
T/F: Elimination half-life of an agent after long CRI increases
True, accounts for cummulation effect
Depends on duration of CRI
Ideal agent for TIVA
- Short acting
- Non-cummulating
- No active metabolites
- Wide theraputic window
- Provides smooth recovery
Alphalaxonoe TIVA
- Does not cummulate if CRI is not super long
- Excessive doses may lead to prolonged recovery and dysphoria esp in cats
- Should combine opioid analgesics
Etomidate TIVA
- Quick metabolism no cummulation
- Inhibtiion of cortisol secretion
- DO NOT USE
