Anesthesia: Keeping close watch on blood pressure, ventilation vital during surgery - DVM
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Anesthesia: Keeping close watch on blood pressure, ventilation vital during surgery


Monitoring through recovery

The concern over the horse's standing up after surgery highlights the importance of monitoring through the recovery period, both experts say.

Various clinics differ in their recovery procedures. A swimming pool, for example, was used during Barbaro's recovery. At Ohio State, head and tail ropes are used during surgical recoveries. At Colorado State, Wagner notes that surgeons close the door and use a bit of sedation to keep the patient quiet during recovery.

"There are a lot of different ways of managing recovery, but I don't think people have found the perfect solution for every case. That is still an area that probably needs more investigation," she says.

"I think we do a pretty good job of getting the horse induced, anesthetized and monitored but once we get into recovery there is a lot of uncertainty. I've been to a few equine practices where once they get the horse into recovery, everybody just slams the door and walks away. They really didn't pay a lot of attention (to the recovering patient), and I think that's a real mistake. I would just encourage people to understand that the procedure is not over until the horse is standing, extubated and safe," Wagner says. "Recovery can be one of the most risky times.

"It would be great if we could come up with a drug you could give at the end of surgery that would magically make the horse lie quietly until fully awakened, then stand straight up with no problem, but I don't think we're there yet," she adds.

Help and documentation

"Another thing that is advisable is to have someone specifically assigned to monitor the anesthesia," Hubbell says. "Take a friend, so that the veterinarian is not trying to do the surgery and the anesthesia at the same time.

"All drugs administered — and the dose, time and route of administration — should be recorded regularly, along with other monitored variables, to complete the anesthetic record," Hubbell explains.

Keeping a good record is critical even from a legal aspect, the experts say. That means all details — the physical exam, what anesthetics were used, each response — should be well documented.

"As a profession, we're not as good at that as we need to be. We have to get better at documenting what we do," Hubbell says.

Kane is a Seattle author, researcher and consultant in animal nutrition, physiology and veterinary medicine, with a background in horses, pets and livestock.


Source: DVM360 MAGAZINE,
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