Anesthesia and Analgesia in Laboratory Animals: Chapter 1: Pharmacology of Injectable Anesthetics



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Chapter 8, Design of Surgical Suites and Post-surgical Care Units


 

Questions:



  1. What areas are included in the term, “surgical facility or complex”?

  2. What areas are included in the term “surgical suite”?

  3. What is the difference between an operating suite and an operating room?

  4. What are the laws outlined in the Animal Welfare Act that apply to surgery?

  5. What are the guidelines in the Guide for the Care and Use of Laboratory Animals that apply to surgery?

  6. What should be the primary responsibility of the architects and engineers designing a surgical facility?

  7. Whose needs must absolutely be met by the design specifications of a surgical facility?

  8. In deciding between centralized and decentralized surgical facilities, what should determine chosing a decentralized or centralized location?

  9. Are decentralized facilities MORE or LESS resource intensive than centralized?

  10. Are decentralized facilities MORE or LESS efficient than centralized?

  11. Is it proper for dedicated surgery areas to be used for multiple purposes?

  12. T/F. All survival surgeries, including those performed on rodent species, must be performed in dedicated surgical facilities.

  13. Rodent surgery suites are usually designed so that surgeons sit on the PERIMETER or CENTER of the room.

  14. What type of equipment is necessary in a surgical suite designed to conduct surgery on large farm animals?

  15. What are the most important materials that must be sterilized in a surgical suite?

  16. Name a few ways that the surgeon, staff or patient can lead to breaks in sterility during a surgery.

  17. What areas of the surgical facility should be physically separated?

  18. What is the function of the material preparation area in a surgical facility?

  19. Name two types of sterilization techniques that may be used in a surgical facilities that need special design considerations, why are these needed?

  20. What is the animal preparation area primarily used for?

  21. What are the three principle components of surgical preparation?

  22. How high should a surgical suite ceiling be?

  23. How high off the floor should a surgeon’s scrub sink be?

  24. How high should the electrical outlets and medical gas outlets be off the floor?

  25. What is special about the wiring of electrical outlets in a surgical facility?

  26. What is required if track lighting is installed in a surgical room ceiling?

  27. What is needed in a surgical facility in regards to communication?

  28. What is the post-operative care unit used for?

  29. Name some components of the post-operative care unit.

  30. Why is it advisable to keep a separate area for janitorial supplies in a surgical facility?

  31. What type of materials should a wall of a surgical suite be made of, if possible?

  32. What type of materials should a ceiling of a surgical suite be made of, if possible?

  33. Do modern facilities require conductive flooring? Why or why not?

  34. What is the ideal temperature of a surgical facility?

  35. What is the recommended air exchange of a surgical facility?

  36. What are the electrical requirements of a surgical facility?

  37. What type of lighting is recommended in a surgical facility?

  38. What are the three types of gas delivery systems which should be decided between in a surgical facility? Which is most reliable?

  39. Should an operating room be equipped with a floor drain?

  40. How big should doors to the surgical facility be? What if large animal species are used?


Chapter 9: Anesthesia and Analgesia in Rodents



Questions


  1. True or False: Newly arrived animals should be quarantined and allowed to re-hydrate and acclimate after shipping for at least 72 hours.




  1. True or False: Pre-anesthetic fasting should generally be limited to 6 hours in light of the high metabolic rate and rapid dehydration and blood glucose detriments that occur rapidly in animals with small body mass.




  1. Critical factors which must be considered when proposing parenteral drug delivery in rodents include.

    1. Drug volume to be delivered

    2. Site of drug delivery

    3. Irritating properties of compound

    4. Method of drug administration

    5. Rate of drug absorption

    6. All of the above




  1. True or False: IP drug administration to rodents requires positioning of animal so that it is held in a head-down position with the needle inserted into the lower left abdominal quadrant.




  1. Errors in intraperitoneal drug injections in rodents can be minimized by which of the following methods?

  1. Fasting the animal 4-8 hours prior to drug injection

  2. Fasting the animal 24 hours prior to drug injection

  3. Using a 20-22 gauge needle for injection

  4. Using a 25-26 gauge needle for injection

  5. A and C

  6. B and D




  1. Which of the following is FALSE concerning the use of ether in rodents?

  1. Induction of ether is unpleasant and existing respiratory disease will be exacerbated by its use.

  2. Carcasses of rodents anesthetized or euthanized with ether should be well ventilated prior to sealing them in airtight bags for disposal or incineration.

  3. C57BL/6 mice were found to be the most resistant strain.

  4. Use of ether in guinea pigs is considered unsafe as they tend to hold their breath and salivate profusely.

  5. None of the above are FALSE.




  1. Which mouse strain is the most sensitive to the anesthetic effects of ether?

    1. ICR

    2. DBA/2

    3. BALB/c

    4. C3H/He




  1. Which mouse strain is the most resistant to the anesthetic effects of ether?

    1. C57BL/6

    2. ICR

    3. DBA/2

    4. BALB/c

    5. C3H/he




  1. Which of the following is FALSE concerning the use of carbon dioxide as an anesthetic in rodents?

  1. Exposure to 100% carbon dioxide is a reliable and appropriate form of anesthesia.

  2. 70% carbon dioxide and oxygen is the optimal concentration, based on practicality and humane acceptability.

  3. Carbon dioxide is readily available, inexpensive, and safe for personnel and produces rapid recovery.

  4. Lower concentrations (50%) of carbon dioxide produce an excessive time of induction, with frequent and severe side effects with moderate distress and discomfort for the animals.

10. True or False: Carbon dioxide anesthesia alters corticosterone, lutenizing hormone (LH), follicle stimulating hormone (FSH), and prolactin.


11. Which of the following is TRUE concerning methoxyflurane anesthetic in rodents?

  1. Methoxyflurane is poorly soluble in blood and tissues such that inductions are prolonged, making it particularly useful in neonates.

  2. Methoxyflurane is exhaled by the lung but greater than 40% is metabolized and excreted in feces.

  3. A diabetes insipidus like syndrome has been observed in F344 rats.

  4. A and C

12. Which of the following are TRUE concerning halothane anesthesia in rodents?



  1. Hepatotoxicity has been associated with halothane exposure in some rodents.

  2. The guinea pig is an animal model for acute halothane-associated hepatotoxicity.

  3. Halothane is specifically a very useful anesthetic in guinea pigs, a species in which reliable anesthesia is very difficult to obtain.

  4. A and B are TRUE

  5. All of the above are TRUE

13. Which of the following statements concerning inhalant anesthesia is TRUE?



  1. Sevoflurane has blood solubility similar to nitrous oxide.

  2. Sevoflurane is degraded by soda lime in a temperature dependent manner creating a breakdown product called olefin, which is lethal in rodents at high concentrations.

  3. Isoflurane has been reported to cause transient postoperative immunosuppression in humans, which also occurs in mice.

  4. A and B are TRUE

  5. All of the above are TRUE




  1. Which of the following statements concerning parenteral anesthetic use in rodents is TRUE?

  1. Thiobarbiturates are irritating intravascularly and infrequently used in rodents due to difficulties in obtaining vascular access.

  2. Female mice are more sensitive to pentobarbital than male mice.

  3. EMTU, ethyl malonylthiourea, is commonly known as Avertin.

  4. A and C are TRUE

  5. All of the above are TRUE




  1. The most common dissociative anesthetic used in rodents is?

    1. Tiletamine-Zolazepam (Telazol)

    2. Ketamine

    3. Xylazine

    4. Acetylpromazine




  1. True or False: Neuroleptanalgesics are combinations of opioid agonist or mixed agonist/antagonist with tranquilizers.




  1. Which of the following statements concerning neuroleptanalgesics is TRUE?

  1. Hypnorm is a combination of fentanyl and fluanisone while Innovar Vet is a combination of fentanyl and droperidol.

  2. Droperidol is a butyrophenone tranquilizer.

  3. Innovar Vet has an irritant nature which may cause tissue necrosis and self trauma to the digits following intramuscular dosing.

  4. Innovar Vet can cause muscle necrosis at the injection site in hamsters.

  5. All of the above are TRUE




  1. In rats, which of the following are associated with the use of -Chloralose?

  1. Seizures

  2. Thick, mucoid oral-nasal discharge

  3. Poor analgesia even at the highest dose range

  4. All are associated with chloralose




  1. Which of the following statements is FALSE concerning the use of Althesin in rodents?

  1. Composed of alphaxalone and alphadolone.

  2. This combination is categorized as a neuroleptanalgesic.

  3. Repetitive boluses are contraindicated in all species of rodents because it causes respiratory distress and pulmonary edema.

  4. A and C are FALSE

  5. B and C are FALSE

20. Which of the following are TRUE concerning anesthesia in rodents?



  1. Classically, -chloralose has been associated with gastric mucosal injury, peritonitis and adynamic ileus with intraperitoneal administration.

  2. The use of ethyl carbamate is discouraged due to its proven status as a carcinogen and mutagen in rodents and should generally be limited to nonsurvival procedures.

  3. Tribromoethanol should be stored at 4C under dark conditions to avoid decomposition.

  4. A and C are TRUE

  5. B and C are TRUE

21. True or False: Classically, Chloral hydrate has been associated with gastric mucosal injury, peritonitis and adynamic ileus with intraperitoneal administration.


22. True or False: Improperly stored Tribromoethanol (Avertin) decomposes into dibromoacetaldehyde and hydrobromic acid which are potent gastrointestional irritants. These adverse effects are particularly prominent in mice following a second exposure to the compound.
23. Which of the following statements concerning analgesia in rodents is TRUE?

  1. Oral acetaminophen in a gelatin formulation can be used orally in rats and provides potent analgesia.

  2. Buprenorphine in gelatin actually enhanced the inflammatory response and treated rats showed enhanced footpad swelling and lameness.

  3. All of the above are TRUE

24. True or False: Xylazine is a 2-andrenergic agonist.


25. True or False: Fentanyl is a synthetic opioid agonist agonist that is estimated to be 60 times more potent than morphine.
26. Which of the following has not been used as bolus parenteral analgesic therapy in rodents?

  1. Flunixin meglumine

  2. Phenylbutazone

  3. Tricyclic antidepressants

  4. Morphine

  5. All of the above have been used

27. True or False: Pregnant rats can be anesthetized with no adverse effects on gestation or the fetuses with Ketamine/Xylazine.




  1. Which of the following is an appropriate form of anesthetic for neonatal rodents?

  1. Inhalation anesthesia

  2. Hypothermia

  3. Carbon dioxide

  4. A and B



Chapter 10. Anesthesia and Analgesia in Rabbits.

Questions:



  1. Why are rabbits considered difficult to anesthetize?




  1. The pulmonary insufficiency that occurs with pasteurella pneumonia can complicate anesthesia because of what issue?




  1. T or F. The estrus cycle of does may lead to cyclic hormone changes that can affect the anesthetic response.




  1. What is the recommended length of time for acclimation prior to anesthesia?




  1. What tranquilizer can cause an increase in blood glucose and should be avoided in diabetics?




  1. List several reasons why preoperative food deprivation in rabbits is controversial.




  1. What is the effect of parasympatholytics?




  1. What is the enzymatic function of atropinesterase?




  1. Describe detection of atropinesterase?




  1. T or F. In rabbits with atropinesterase, parasympatholytics are not useful.




  1. Give examples of phenothiazine tranquilizers.




  1. Why is acepromazine commonly employed in rabbit phlebotomy?




  1. How does chlorpromazine improve anesthesia when used in combination with pentobarbital?




  1. Given examples of benzodiazepine tranquilizers.




  1. Select the correct answer.

    1. Midazolam is lipid soluble and more potent than diazepam

    2. Midazolam is lipid soluble and less potent than diazepam

    3. Midazolam is water soluble and more potent than diazepam

    4. Midazolam is water soluble and less potent than diazepam




  1. T or F. Midazolam with xylazine-alfentanil has no undesired effects in the rabbit.




  1. Give examples of α2-adrenergic agonist tranquilizers and agents used for reversal of the α2-adrenergic agonists.




  1. Why is xylazine commonly used for rabbits?




  1. Which α2-adrenergic agonist is reported to cause hyperacusia at high doses?




  1. Which α2-adrenergic agonist is reported to cause anorexia and myocardial necrosis at high doses?




  1. Which antibiotics have been associated with fatal clostridial enterotoxemias in the rabbit?




  1. Which drug might reduce the mortality associated with clostridial enterotoxemia due to antibiotic administration?




  1. What is the recommend procedure for intramuscular (IM) injections in the rabbit?




  1. What drug or drug combination when given IM has been associated with myonecrosis, vasculitis and axonal degeneration?




  1. List 2 drugs with vasodilatory action which is useful during phlebotomy.




  1. The use of benzocaine topical anesthetic to minimize laryngospasm has been associated with what clinical pathology finding:

    1. Hypoglycemia

    2. Hyperglycemia

    3. Hemoglobinemia

    4. Myoglobinemia




  1. What are the advantages and disadvantages of injectable anesthetics when compared to inhalants?




  1. List barbiturates that have been used in the rabbit.




  1. Why is pentobarbital infrequently used?




  1. What is the Hering- Breuer reflex?




  1. What are the effects of pentobarbital on the cardiovasculature?




  1. What are the components of Equi-Thesin?




  1. T or F. Pentobarbital is associated with tachyphylaxis in the rabbit.




  1. List dissociative agents that are used in rabbits.

  2. What are some of the physiologic effects of ketamine-xylazine?




  1. What are the components of Telazol and why is it not recommended for use in rabbits?




  1. What 2 classes of drugs are required for neuroleptanalgesia?




  1. What are the components of the neuroleptanalgesic compounds Innovar-Vet and Hypnorm?




  1. What drugs are available for use to reverse the respiratory depression associated with neuroleptanalgesics? What is the term for reversal with a select drug class following neuroleptanalgesics?




  1. What drugs are found in Saffan/Althesin? Do these compounds provide analgesia?




  1. What are the physiologic effects of alphaxalone-alphadolone anesthesia?




  1. What drug class is propofol and what are the cardiovascular effects seen with propofol?




  1. What are the advantages and disadvantages noted in the use of urethane (ethyl carbamate) for anesthesia?




  1. Select the correct answer. Chloralose-urethane combination anesthesia is useful in preserving:

    1. Superficial but not deep pain response

    2. Heart rate

    3. Baroreceptor reflexes

    4. Vasoconstriction in response to stimulus




  1. List the inhalation anesthetic circuits that have been used in rabbits.




  1. List the advantages and disadvantages in using isoflurane (in comparison to other inhalants).




  1. What is the formula to calculate the cardiac anesthetic index?




  1. Select the correct answer. List the anesthetics in order of increasing MAC.

    1. Isoflurane < halothane < enflurane

    2. Halothane < isoflurane < enflurane

    3. Enflurane < isoflurane < halothane

    4. Enflurane < halothane < isoflurane




  1. List the physiologic effects of halothane.




  1. What is recommended to counteract the diffusion hypoxia induced by nitrous oxide?




  1. T or F. Nitrous oxide decreases cerebral blood flow.




  1. Select the correct answer. List in increasing duration of motor blockade the following epidural anesthetics:

    1. amethocaine < bupivacaine < lidocaine < procaine

    2. bupivacaine < lidocaine < procaine < amethocaine

    3. procaine < lidocaine < bupivicaine < amethocaine

    4. lidocaine < bupivicaine < amethocaine < procaine




  1. List the methods by which epidural anesthesia can be provided in the rabbit.




  1. What are the physiologic features of hypnosis in rabbits




  1. List important criteria that should be considered when selecting an anesthetic protocol for ophthalmic procedures.




  1. What reflex is being circumvented when an anticholinergic (atropine or glycopyrrolate) is given during ophthalmic surgery?




  1. What topical anesthetic agent has been used during surgery involving the cornea?




  1. Of the following agents, select the one that causes the least fetal or maternal loss:

    1. barbiturates

    2. ether

    3. halothane




  1. What are the 3 components of patient monitoring during anesthesia?




  1. Select the correct answer. Rank the commonly assessed reflexes in order of most accurate to least accurate in the rabbit:

    1. pinna reflex > pedal withdrawal > corneal reflex > palpebral reflex

    2. palpebral reflex > corneal reflex > pedal withdrawal > pinna reflex

    3. pedal withdrawal > corneal reflex > palpebral reflex > pinna reflex

    4. pedal withdrawal > pinna reflex > corneal reflex > palpebral reflex




  1. What is the effect of hypothermia on MAC of inhalants?




  1. T or F. Ablation of the autonomic response (assessed by respiration and cardiovascular parameters) provides evidence that there is adequate depth of anesthesia, but the absence of ablation does not necessarily indicate inadequate anesthesia depth.




  1. List several methods or equipment used to assess respiratory rate.




  1. List several methods or equipment used to assess adequacy of ventilation.




  1. What are the routinely monitored cardiovascular parameters in the rabbit?




  1. List several methods or equipment used to assess the heart rate




  1. List two methods used to assess arterial blood pressure




  1. List several methods or equipment used to assess pulse rate and character.




  1. Why are rabbits prone to hypothermia during most anesthetic protocols?




  1. List several treatments available for anorexia in rabbits




  1. List signs of pain and/or distress in the rabbit.




  1. What methods of analgesiometry have been developed in the rabbit?




  1. Select the correct answer. Which of the opiods causes significant respiratory depression?

    1. Mixed agonist/antagonist opiods (butorphanol, pentazocine, nalbuphine)

    2. Partial agonist opiods (buprenorphine)

    3. µ agonists (fentanyl)




  1. What are the physiologic effects of morphine in the rabbit?




  1. What detrimental effect has been associated with meperidine in the rabbit?




  1. Select the correct answer. What dose of aspirin was shown to cause lethality

    1. 1 mg/kg SC

    2. 10 mg/kg SC

    3. 20 mg/kg SC

    4. 300 mg/kg IV


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