Anesthesia safety: Face your clients' main concern about dentistry - DVM
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Anesthesia safety: Face your clients' main concern about dentistry


DVM360 MAGAZINE


While venous blood gas is not as sensitive for measuring respiratory function, it can give valuable information about a patient's acid/base status. Acid/base condition is affected by both respiratory and cardiovascular function and as such is a valuable indicator in the anesthetized patient. Look for acidosis when CO2 accumulates due to compromised respiratory function, or when cardiovascular compromise leads to poor tissue perfusion. Analyzing the values also will indicate the degree the patient has compensated for the abnormality.

When the PCO is increasing (pH decreasing) and PO2 is dropping, the patient needs to be ventilated and the endo-tracheal tube evaluated for patency as well as the soda lime checked for expiration. If PCO2 is too low (and PH increasing), then the patient is over ventilating.

Temperature monitoring

Temperature control and monitoring is important for dental patients. Dental procedures often last hours, during which the animal may be exposed to air conditioning and water irrigation. As the patient temperature decreases, so does the blood pressure and heart rate. Temperature monitors can be as straightforward as a technician inserting a rectal thermometer every 15 minutes and recording results, to a real-time constant digital evaluation.

Putting it all together....

Molly, a 16-year-old Poodle was presented to our office for dental care. Her owners, two general surgeons, could not tolerate her breath; even guests in their homes complained. As soon as I entered the exam room, I knew this dog was in dental trouble; the odor was intolerable.

Why did these highly educated, loving pet owners let poor Molly suffer so long? For the first 10 years of her life, they were afraid of anesthesia, and for the last six, three veterinarians said she was too old to safely perform dental care.

This story has a good ending. After age- and condition-appropriate blood and urine tests, radiographs and electrocardiogram, she was placed under three hours of general anesthesia for extraction of 26 teeth. Two weeks post procedure, her owners were ecstatic to have a "new dog".

How can we as veterinarians allay our client's fear of anesthesia for dental procedures? The answer is threefold: choose the correct patient, the correct anesthesia protocol, and proper monitoring during and after the procedure, so everyone wins.

Dr. Bellows owns Hometown Animal Hospital and Dental Clinic in Weston, Florida. He is a diplomate of the American Veterinary Dental College and the American Board of Veterinary Practitioners. He can be reached at (954) 349-5800; e-mail,
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Source: DVM360 MAGAZINE,
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