LAKEWOOD, COLO. — The American Animal Hospital Association (AAHA) released new guidelines for anesthetizing dogs and cats, covering everything from pre-anesthetic evaluation to recovery.
The guidelines, published in the November/December issue of the Journal of the American Animal Hospital Association, are meant to complement existing protocols from AAHA and related associations, like the American College of Veterinary Anesthesiologists.
In regard to preanesthetic evaluation, AAHA outlines the specific factors that should be addressed when developing an anesthetic plan. As might be expected, the guidelines call for a thorough history and complete physical examination factoring in age, breed and temperament. Those factors will assist the veterinarian in determining whether to use heavy sedation or general anesthesia. The choice depends on the procedure, patient temperament and the need for monitoring and support, according to the guidelines. Experience and qualifications of clinic personnel should also play a role in what type of anesthetic plan is selected, AAHA says.
Next, the guidelines address individual plans and patient preparation. Veterinarians must communicate the plan with clients, including information about medication changes and fasting times. Younger animals require shorter fasting times, AAHA notes, and sometimes—as with emergency procedures—fasting is not possible and special attention must be paid to airway management to reduce risk or regurgitation and aspiration.
The guidelines offer specific advice on crafting individual anesthetic plans, including the use of preanesthetic medication and pain management. Considerations are noted for comorbidities during anesthesia, such as diabetes, renal disease, cardiac disease and liver disease.
The guidelines also address varying opinions on the use of certain perianesthetic drugs, such as acepromazine and anticholinergics. For example, AAHA says there is no evidence to show that acepromazine increases the risk of seizures in epileptic patients. Lengthy discussion within the guidelines is devoted to the "controversial" use of anticholinergic drugs like atropine and glycopyrrolate.
The guidelines also offer specific steps for patient preparation with checklists for equipment and monitoring tools. Tips on anesthetic induction, maintenance and monitoring, as well as troubleshooting also are offered.
Anesthesia-related complications are responsible for a significant number of liability insurance claims, AAHA notes, with most anesthetic-associated deaths occurring during the first three hours of recovery. In fact, 47 percent of canine anesthesia deaths and 60 percent of feline anesthesia deaths occur during the postoperative period, the guidelines note.
Recovery guidelines are outlined specifically, and veterinary staff should be trained to recognize post-anesthesia complications.
The full guidelines are available at http://www.aahanet.org/Library/Anesthesia_Guidelines.aspx|~http://www.aahanet.org/Library/Anesthesia_Guidelines.aspx.