"Anaesthesia 101: What do I do when..."

There are no safe anaesthetic agents, there are no safe anaesthetic procedures, there are only safe anaesthetists. The veterinary surgeon, veterinary nurse and anaesthesia team has a crucial role of identifying patient comorbidities and procedure risks to minimise any detrimental effects of general anaesthesia, perioperative pain and stress in order to provide safe anaesthesia for each patient in our care. The anaesthesia period is not limited to when the patient is unconscious but is a continuum of care that begins before the patient leaves home and ends when the patient is returned home.

 
As veterinary professionals, we should be striving to make our patients visits to the veterinary practice a positive one. Pets that have negative experiences during veterinary visits are
likely to be fearful and distressed during their next visit. Low stress environments and handling, alone, may not significantly lower anxiety, but the addition of behavioural medications may aid in reducing anxiety and fear associated with veterinary visits. Practicing fear free techniques improves veterinary visits for patients, clients, the veterinary team, and decreases risk patients may pose to veterinary staff.
In this presentation, we will discuss how to be confident in preparing for, and practicing safe sedation and general anaesthesia in our veterinary patients. We will learn how we can reduce stress for our patients, and how to implement low stress techniques for premedication. We will cover the importance of how to maximise safety during induction of anaesthesia and securing the airway must never be underestimated. The brachycephalic patient is a higher risk patient at induction of anaesthesia, and they are regular visitors to the veterinary environment. Being aware of the risks, putting protocols in place, and being prepared to address the complications reduces the risk for these patients at such a critical time of the anaesthesia period. During general anaesthesia, it is not uncommon to have complications such as hypotension and hypoventilation. If these complications are not addressed, they can have a detrimental impact on our patients. Interventions for common complications for the anaesthetised patient should be implemented on a case to case basis, and we will discuss some of the options available.

 
Following the procedure, we need to be thinking forward and be planning for smooth recoveries. When a balanced anaesthesia drug protocol has been utilised the majority of our patients will wake up smoothly from general anaesthesia. However, despite our best efforts, there will be times when a patient wakes up and displays a rough recovery. Rough recoveries can be behaviours such as excessive vocalization, paddling, head bobbing or head thrashing, agitation and disorientation. The three most likely causes of a rough recovery are pain, emergence delirium and dysphoria. We will discuss how to approach the recovery period, and try to optimise the recovery period for our patients.

• Be confident in preparing for & practicing safe sedation & general anaesthesia
• Know techniques for tress free premedication
• Know how to maximise safety during induction of anaesthesia and securing the airway
• Be aware of common complications and interventions for the anaesthetised patient
• Know how to achieve smooth recoveries