Colleges, private practice show disparity in anesthesia methods

Colleges, private practice show disparity in anesthesia methods

Despite readily available drug protocols, private practitioners prefer familiar to new drug on the block, study says
Feb 01, 2003

A Colorado State University-commissioned survey of regional small animal practitioners was designed to enhance academic faculty's understanding of the anesthetic techniques employed in private practice.
Private practitioners favor less anesthetic drugs, perform more outpatient procedures and rarely check blood pressure in anesthetized animals compared to their public university counterparts.

Those are the findings of a study conducted by Colorado State University faculty and published in the Autumn 2002 edition of the Journal of Veterinary Medical Education.

Two anesthesia faculty members sat down with 20 Colorado-based small animal veterinary practices, drilling veterinarians and technical staff on their use of anesthesia for the study, "Observations of Private Veterinary Practices in Colorado, with an Emphasis on Anesthesia."

Drug overload Despite widespread access to an array of anesthetic drugs, private practitioners, at least those surveyed, tend to revert to old stand-bys traditionally.

Dr. Ann E. Wagner
"The biggest difference for us (in the findings) was the difference between what private practitioners do and what we tend to do in a teaching veterinary hospital where we have access to a whole variety of anesthetic drugs for specific situations," says Dr. Ann E. Wagner, diplomate of the American College of Veterinary Anesthesologists (ACVA), co-author and CSU professor.

"What we found was practitioners tend to get very comfortable with one or very few drug protocols, use those very routinely and get very accustomed to them. We in the academic world tend to select different drugs for a wide variety of different patients," she says.

Use of few anesthetic drugs can be attributed to economic factors, the unfeasibility of stocking little-used drugs that will most likely expire before use as well as the familiarity of drugs shown to be effective.

Background Although the findings were recently released, the genesis of the project dates to 1998, when Wagner and co-author Dr. Peter Hellyer, dipl. ACVA, sent questionnaires to members of the Colorado Veterinary Medical Association, receiving 300 responses. Practitioners were questioned on the types of procedures conducted, what drugs they used, and how they managed patients during anesthesia.

Some CSU study highlights
The study was conducted in part "to provide academic faculty a better understanding of the anesthetic techniques used by veterinarians in private practice, in order to enhance their teaching of anesthesiology to veterinary students," the study authors report.

At the end of the survey veterinarians were asked if they would be willing to have CSU conduct a follow-up practice visit. CSU selected 20 from the affirmative responses based on convenience and proximity to the college, and interviewed them.

Indirect bonus Although the study was designed with academia in mind, Wagner says private practitioners may have benefitted from the chance to visit with a trained anesthesiologist discussing how they used anesthesia and new options available.

"We did provide some continuing education, so to speak," says Wagner. "(But) we didn't really promote it in that way."

The research, instead, enabled CSU to get a leg up on what students and faculty should know about private practice's use of anesthesia prior to graduation.

Less is more Based on results indicating that practitioners stick to a bare minimum in anesthesia drugs, Wagner decided to test the finding in the classroom.

"One of the exercises I give the senior students is that I give them five drugs and have them tell me how they'd use those five drugs to anesthetize a wide variety (of animals) from the dog having a gastric dilatation volvulus to a cat that's in for a dystocia C-section," says Wagner.

"Students find that daunting because they think you have to have all these different drugs and then they realize that it's really not the drugs that are safe but it's the anesthetist knowing how to use them that makes it safe for the patient."