Anesthetic Risk & Pre-Anesthetic Assessment Flashcards
what are the common causes of death due to anesthesia in SA
cardiac and respiratory causes
what are the common causes of death due to anesthesia in equine
CV collapse, fractures in recovery, post-anesthetic myopathy
when does the timing of death usually occur
post op usually
what are the ASA grades
what are the 5 factors that contribute to anesthetic risk
- signalment
- disease
- experience
- procedure
- facilities
what are signalments (3)
- age
- breed
- body weight/condition
how does age affect anesthetic risk (3)
- older animals have reduced physiological reserves –> greater cardiorespiratory impact on anesthesia
- concurrent disease
- young animals are physiologically immature (< 12 weeks)
which breeds have increased risk of anesthesia
- brachycephalic –> small, collapsible airways that are prone to obstruction and severe impairement
- greyhounds: unexpected response
how does body weight/condition affect anesthetic risk
overweight animals: higher risk –> CV complications, resp complications, wound healing
how does the procedure affect anesthetic risk
- major vs. minor
- urgency
- duration
how do the facilities, experience and culture affect the anesthetic risk (4)
- ability to monitor/treat complications
- availability of drugs
- experience with procedure
- culture surrounding perioperative care
what are factors of increased risks in SA (10)
1, ASA grade
- procedural urgency
- major procedures
- duration of procedure
- extremes of weight
- increasing age
- fluid therapy (cats only)
- ET intubation (cats)
- halothane anesthesia
- mask inductions
what are reduces the risks (2)
- pulse palpation
- pulse oximetry
what are factors of increased risk in equines (7)
- pregnant mares
- foals
- colic surgery
- fracture surgery
- duration of procedure
- dorsal recumbency
- xylazine use
what factors decrease risk in equines (3)
- blood pressure monitoring
- acepromazine use
- total IV anesthesia
what are the aims of pre-anesthetic assessment
to identify disorders which may affect anesthetic risk
what are you primarily looking for when assessing the anesthetic risk
evidence of signaficant functional impairment of bodily systems –> these problems can be stabilized and result in anesthetic techniques or cancellation/change in procedure
what should assessment involve
thorough clinical exam and history
and/or
blood testing, radiography, ultrasonography, echocardiography, ECG
are blood tests needed for healthy patients
maybe
“never miss” a problem, litigation proof, practice revenue
what are the disadvantages of blood testing healthy patients (3)
- erroneous result
- vet evidence suggests ASA1 dogs who are less than 7 years old, testing is unnecessary
- precedent in human medicine not to test
what are the advantages to blood testing sick patients
establish disease presence, severity & monitor for response
what are the SAH protocols on blood testing (2)
- elective ASA 1 dogs for elective surgery (< 7 years): provided normal history and clinical exam no blood sample
- > 7 years, > ASA 1 or emergency cases: pre-anesthetic blood test
what does pre-anesthetic blood testing include
doesn’t always entail full profile of bloods
minimum: PCV, total proteins, urea/creatinine, electrolytes, glucose
what are the major disease factors influencing risk (8)
- cardiovascular
- respiratory
- hemopoietic
- endocrine
- GI
- renal
- neurological
- coagulation
what are pre-anesthetic questions to consider
