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There are many preconceptions about anaesthesia, but what’s the latest information that you need to know?
Every procedure we perform in veterinary medicine and surgery carries risk. As far as anaesthesia is concerned, as specialists we are not only aware of the risks, we are at the forefront of ensuring we do everything we can to minimize risk and make the anaesthetic as safe as possible for your pet.
You may think that sedation is safer than anaesthesia. When we appraise the evidence this is unlikely to be true. So what are some of the factors to take into account?
If any one drug were proven to be unsafe it would be removed from the market. There is a pre-conception that certain drugs should not be used in certain breeds. Current evidence tells us that it is difficult to make breed-specific recommendations and we do not find that one breed is more difficult than another with anaesthesia.
‘There are no safe drugs only safe anaesthetists’
Familiarity of the drugs we use and the techniques required for anaesthesia is of paramount importance. This is only acquired through experience – gained through our busy caseload as well as our past experience.
It is clear from the latest study into anaesthesia mortality that health status is one of the main predictors of complications under anaesthesia. Approximately 1:1900 healthy dogs and 1:900 healthy cats die under anaesthesia. If we take sick cases into account the chance of dying drops dramatically to 1:70 for both dogs and cats. The good news is that these figures have improved compared to earlier studies.
Pre-GA blood tests
The latest research would suggest that in a fit and healthy animal, a pre anaesthetic blood test does not improve safety. We know that in dogs over 8 years old there is a benefit and this has shaped our clinical approach. Where we have any suspicion from examining an animal that further information is necessary we will take a blood sample. This decision should always be made by a veterinary surgeon and you should never have the decision placed upon you, the owner. Being a specialist referral centre many of the animals presenting us are sick and so we do have the facilities to run these tests in-house prior to anaesthesia.
As a specialist referral centre every anaesthetised case is monitored by a Registered Veterinary Nurse under the supervision of a specialist anaesthetist. The specialist plans the anaesthetic for every individual patient, taking into account the patient’s history, presenting condition and procedure to be conducted. We have full monitoring at every anaesthetic station to alert us immediately if any parameter changes. Should a problem occur under anaesthesia we are best equipped to react to any change. A nurse dedicated to that pet records parameters every 5 minutes.
We know that monitoring does not stop at the end of the anaesthetic. The recovery period actually carries the greatest risk and during this period we continue a high level of monitoring. If necessary, we have the knowledge and experience to provide intensive care to those pets in the greatest need.
A definitive link between pain and anaesthesia safety is yet to be documented but we certainly find very painful cases are more difficult to manage under anaesthesia. In this regard our anaesthetists constantly strive to prevent pain before, during and after surgery so you can rest assured this is one of our utmost concerns with every surgical procedure.
For more information on what happens during anaesthesia, you can read a separate article written by our anaesthesia specialist Matt Gurney.
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Blog author: Matthew Gurney, RCVS & European Specialist in Veterinary Anaesthesia & Analgesia.