Anaesthesia-related Risk Factors in Unwell Patients or Trauma Patients and Anaesthetic Drug Selection: Cats and Dogs

Year 2018, Volume: 44 Issue: 3, 128 - 135, 02.09.2018

Özlem Güzel

Abstract

DOI:
10.26650/actavet.2019.18013

Safe anaesthesia requires careful
monitoring and good knowledge of the effects of various anaesthetic drugs on
different organ systems. The safest approach in the anaesthesia of critical
patients is to select drugs whose effects are easily reversible and to take
great care with the dosage. Deaths occurring in the perioperative period are
generally caused due to preexisting diseases, anaesthesic drugs, surgical
interventions, or a combination of these factors. Prolonged surgical interventions,
hypothermia, fluid loss, and excessive fluid intake are also factors that
increase patient deaths. When anaesthetizing an unwell patient, individual
requirements are evaluated. Therefore, it is not possible to present a single
overall anaesthesia protocol applicable to all patients. There is a series of
principles for the administration of anaesthesia to high-risk patients. This
review discusses anesthesia administrations required for both diagnostic and
surgical interventions in trauma patients and unwell patients. The risk factors
and the various complications that may be encountered by clinicians while
performing sedation and anaesthesia in such patients and their treatment
methods have been explained in detail.

Keywords

Anesthesia, cat, dog, risk factors, trauma

References

• Alef, M., Praun, F., Oechtering, G., 2008. Is routine pre-anaesthetic haematological and biochemical screening justified in dogs. Veterinary Anaesthesia and Analgesia 35, 132-140. Armitege-Cahn, E.A., Wetmore, L.A., Chan, D.L., 2007. Anesthetic management of the head trauma patient. Journal of Veterinary Emergency and Critical Care 17, 5-14. Bednarski, R., 2011. Anesthesia Management of Dogs and Cats. In: Grimm, K.A., Tranquilli, W.J., Lamont, L.A. (Eds.), Essentials of Small Animal Anesthesia and Analgesia. Iowa, Willey-Blackwell, pp. 274-299. Bednarski, R., Grimm, K., Harvey, R., Lukasik, V.M., Penn, W.S., Sargent, B., Spelts, K., 2011. AAHA Anesthesia guidelines for dogs and cats. Journal of the American Animal Hospital Association 47, 377-385. Biboulet, P., Abus, P., Dubourdieu, J., Rubenovitch, J., Capdevila, X., d’Athis, F., 2001. Fatal and nonfatal cardiac arrest related to anesthesia. Canadian Journal of Anaesthesia 48, 326-332. Bille, C., Auvigne, V., Libermann, S., Bomassi, E., Durieux, P., Rattez, E., 2012. Risk of anaesthetic mortality in dogs and cats: an observation cohort study of 3546 cases. Veterinary Anaesthesia and Analgesia 39, 59-68. Bille, C., Auvigne, V., Bomassi, E., Durieux, P., Libermann, S., Rattez, E., 2014. An evidence-based medicine approach to small animal anaesthetic mortality in a referral practice: the influence of initiating three recommendations on subsequent anaesthetic deaths. Veterinary Anaesthesia and Analgesia 41, 249-258. Brodbelt, D.C., Hammond, D., Tuminaro, D., Pfeiffer, D.U., Wood, J.L.N., 2006. Risk factors for anaesthetic-related death in referred cats. Veterinary Record 158, 563-564. Brodbelt, D.C., Pfeiffer, D.U., Young, L.E., Wood, J.N., 2007. Risk factors for anaesthetic-related death in cats: results from the confidental enquiry into perioperative small animal fatalities (CEPSAF). British Journal of Anaesthesia 99, 617-623. Brodbelt, D.C., Blissitt, K.J., Hammond, R.A., Neath, P.J., Young, L.E., Pfeiffer, D.U., Wood, J.L.N., 2008. The risk of death: the confidental enquiry into perioperatif small animal fatalities. Veterinary Anaesthesia and Analgesia 35, 365-373. Brodbelt, D., 2009. Perioperative mortality in small animal anaesthesia. The Veterinary Journal 182, 152-161. Brodbelt, D., 2010. Feline anesthetic deaths in veterinary practice. Topics in Companion Animal Medicine 25, 189-194. Brodeur, A., Wright, A., Cortes, Y., 2017. Hypothermia and targeted temperature management in cats and dogs. Journal of Veterinary Emergency and Critical Care 27, 151-163. Campbell, V.L., 2005. Anesthetic protocols for common emergencies. The Veterinary Clinics of North America: Small Animal Practice 35, 435-453. Carroll, G.L., Martin, D.D., 2007. Trauma and Critical Patients. In: Tranquilli, W.J., Thurmon, J.C., Grimm, K.A. (Eds.), Lumb & Jones’ Veterinary Anesthesia and Analgesia. Iowa, Blackwell, pp. 969-984. DeLay, J., 2016. Perianesthetic mortality in domestic animals: A retrospective study of postmortem lesions and review of autopsy procedures. Veterinary Pathology 53, 1078-1086. Demirkan, I., Atalan, G., Gokce, H.I., Ozaydin, I., Celebi, F., 2002. Comparative study of butorphanol-ketamin hcl and xylazineketamin hcl combinations for their clinical and cardiovascular/respiratory effects in healthy dogs. Turkish Journal of Veterinary and Animal Sciences 26, 1073-1079. Devey, J.J., 2013. Surgical considerations in the emergent small animal patient. The Veterinary Clinics of North America: Small Animal Practice 43, 899-914. Dyson, D.H., 2008. Analgesia and Chemical Restraint for the Emergent Veterinary Patient. The Veterinary Clinics of North America: Small Animal Practice 38, 1329-1352. Evans, A.T., Wilson, D.V., 2007. Anesthetic Emergencies and Procedures. In: Tranquilli, W.J., Thurmon, J.C., Grimm, K.A. (Eds.), Lumb & Jones’ Veterinary Anesthesia and Analgesia. Iowa, Blackwell, pp. 1033-1048. Evans, A.T., Wilson, D.V., 2011. Anesthetic Emergencies and Accidental. In: Grimm, K.A., Tranquilli, W.J., Lamont, L.A. (Eds.), Small Animal Anesthesia and Analgesia. Iowa, Blackwell, pp. 509-527. Guzel, O., 2003. Effects of anesthetic agents used in cats and dogs on the heart. Kafkas Üniversitesi Veteriner Fakültesi Dergisi 9, 215-218. Guzel, O., Erdikmen, D.O., Yildar, E., Ekici, A., Saroglu, M., Ekiz, B., 2013b. The effects of propofol and a diazepam/alfentanil combination in dogs aged 10 years and above on heart rate, respiratory rate, pulse oximetry data, intraocular pressure, and body temperature. Turkish Journal of Veterinary and Animal Sciences 37, 170-176. Guzel, O., Perk, E.C., 2002. Köpeklerde genel anestezi prosedürü ve intraoperatif periyotta rastlanan kardiyak ritm bozukluklarının tanı ve sağaltımı. İstanbul Üniversitesi Veteriner Fakültesi Dergisi 28, 381-401. Guzel, O., Perk, E.C., Devecioglu, Y., 2006. Electrocardiographic and oxygen saturation studies during propofol and etomidate anaesthesia in dogs. The Indian Veterinary Journal 83, 288-289. Guzel, O., Yildar, E., Karabagli, G., Erdikmen, D.O., Ekici, A., 2013a. Comparison of the effects of spontaneous and mechanical ventilation on blood gases during general anaesthesia in dogs. Kafkas Üniversitesi Veteriner Fakültesi Dergisi 19 (Suppl-A), 19-25. Haskins, S.C., 2007. Monitoring Anesthetized Patients. In: Tranquilli, W.J., Thurmon, J.C., Grimm, K.A. (Eds.), Lumb & Jones’ Veterinary Anesthesia and Analgesia. Iowa, Blackwell, pp. 533-558. Hosgood, G., Scholl, D.T., 2002. Evaluation of age and American Society of Anesthesiologists (ASA) physical status as risk factors for perianesthetic morbidity and mortality in the cat. Journal of Veterinary Emergency and Critical Care 12, 9-16. Itami, T., Aida, H., Asakawa, M., Fujii, Y., Lizuka, T., Imai, A., Iseri, T., Ishizuka, T., Kakishima, K., Kamata, M., Miyabe-Nishiwaki, T., Nagahama, S., Naganobu, K., Nishimura, R., Okano, S., Sano, T., Yamashita, K., Yamaya, Y., Yanagawa, M., 2017. Association between preoperative characteristics and risk of anaesthesia-related death in dogs in small-animal referral hospitals in Japan. Veterinary Anaesthesia and Analgesia 44, 461-472. Jones, R.S., 2001. Comparative mortality in anaesthesia. British Journal of Anaesthesia 87, 813-815. Koc, B., Sarıtas, Z.K., 2004. Veteriner Anesteziyoloji ve Reanimasyon. Medipres, Ankara. Liao, P.T., Sinclair, M., Valverde, A., Mosley, C., Chalmers, H., Mackenzi, S., Hanna, B., 2017. Induction dose and recovery quality of propofol and alfaxalone with or without midazolam coinduction followed by total intravenous anesthesia in dogs. Veterinary Anaesthesia and Analgesia 44, 1016-1026. Mathews, K.A., Dyson, D.H., 2005. Analgesia and chemical restrain for the emergent patient. The Veterinary Clinics of North America: Small Animal Practice 35, 481-515. Muir, W.W., Haskins, S.C., Papich, M.G., 2007. Patient Evaluation and Risk Management. In: Tranquilli, W.J., Thurmon, J.C., Grimm, K.A. (Eds.), Lumb & Jones’ Veterinary Anesthesia and Analgesia. Iowa, Blackwell, pp. 3-14. Pachtinger, G., 2013. Monitoring of the emergent small animal patient. The Veterinary Clinics of North America: Small Animal Practice 43, 705-720. Pekcan, Z., 2016. How can better anaesthetic combinations be performed? A review of current knowledge. Kafkas Üniversitesi Veteriner Fakültesi Dergisi 22, 631-638. Perkowski, S.Z., 2000. Anesthesia for the emergency small animal patient. Veterinary Clinics of North America: Small Animal Practice 30, 509-530. Redondo, J.I., Rubio, M., Soler, G., Serra, I., Soler, C., Gomez-Villamandos, J., 2007. Normal values and incidence of cardiorespiratory complications in dogs during general anaesthesia. A review of 1281 cases. Journal of Veterinary Medicine. A, Physiology, Pathology, Clinical Medicine 54, 470-477. Rozanski, E.A., Rush, J.E., 2007. Anesthesia and Analgesia for Critical Care Patients. In: Rozanski, E.A., Rush, J.E. (Eds.), A Color Handbook of Small Animal Emergency and Critical Care Medicine. London, Manson, pp. 222-229. Quandt, J., 2013. Anesthesia, and chemical restraint in the emergent small animal patient. The Veterinary Clinics of North America: Small Animal Practice 43, 941-953. Thurmon, J.C., Short, C.E., 2007. History and Overview of Veterinary Anesthesia. In: Tranquilli, W.J., Thurmon, J.C., Grimm, K.A. (Eds.), Lumb & Jones’ Veterinary Anesthesia and Analgesia. Iowa, Blackwell, pp. 3-6.