What's new in small animal veterinary anesthesia? (Proceedings)
The purpose of this presentation is to review several articles published in veterinary journals over the last three years and to present them in a way that is relevant to the practicing veterinarian.
Mortality and CPCR: Obviously, the veterinarian wants to avoid anesthetic-related mxortality. The only way to effectively do that is to understand the factors associated with anesthetic mishaps. The three articles summarized below provide some valuable information of the practitioner:
Brodbelt et al. The risk of death: the confidential enquiry into perioperative small animal fatalities. Vet Anaes Analg 2008.What they did: The authors performed a prospective case-control stud of anesthetic-related mortality in 117 veterinary practices and evaluated nearly 100,000 dogs, 80,000 cats, and 8,200 rabbits. They evaluated deaths that occurred within 48 hours of anesthesia or sedation.
What they found:
o The overall death rate for dogs, cats, and rabbits was 0.17%, 0.24%, and 1.39%, respectively.
What you need to know: This comprehensive study proved a few things that we already suspected (sicker animals are at higher risk for anesthetic death), and perhaps revealed a few things that we didn't know. For example, the first three hours after the end of anesthesia were associated with a significant percentage of anesthesia related deaths. This implies that we need to assess our patients more aggressively in the immediate postoperative period. The risk of anesthetic-related death is higher in cats than in dogs, and it appears that the risk of death from sedation alone MAY NOT be different from the risk associated with general anesthesia.
Hofmeister et al. Prognostic indicators for dogs and cats with cardiopulmonary arrest (CPA) treated by cardiopulmonary cerebral resuscitation (CPCR) at a university teaching hospital. JAVMA 2009.
What they did:
The authors reviewed records from all animals that suffered CPA during a 60 month period .
What they found:
o 6% of the animals that had in-hospital CPA survived to discharge. (35% of dogs and 44% of cats had a return of spontaneous circulation—successful CPCR).
What you need to know:
CPCR is not a practice builder!!! It has a low success rate