Preparation for anaesthesia

Question 1

What are the aims of pre-op assessments?

Answer 1

To check that owner, nurse and vet are all clear about exactly what procedure is to be performed

To gather all relevant patient history and information

To check body systems specifically affected by anaesthesia and general health

To categorise the risk of anaesthesia to the patient

Question 2

There are 5 classes of anaesthetic risk. Describe an animal in class 1 (minimal risk) and give examples of a procedure

Answer 2

Normal healthy animal
No underlying disease

Spey, castration
Radiograph for hip dysplasia

Question 3

There are 5 classes of anaesthetic risk. Describe an animal in class 2 (slight risk) and give examples of a procedure

Answer 3

Animals with slight to mild systemic disturbances
Animals able to compensate
No clinical signs of disease

Neonates, geriatrics
Fracture without shock
Well controlled diabetes

Question 4

There are 5 classes of anaesthetic risk. Describe an animal in class 3 (moderate risk) and give examples of a procedure

Answer 4

Animals with moderate systemic disturbances
Mild clinical signs

Anaemia
low grade renal disease
low grade heart murmur

Question 5

There are 5 classes of anaesthetic risk. Describe an animal in class 4 (high risk) and give examples of a procedure

Answer 5

Animals with pre-existing systemic disease or disturbances of a severe nature

Dehydration, shock
Uraemia, pyrexia
Uncompensated cardiac disease

Question 6

There are 5 classes of anaesthetic risk. Describe an animal in class 5 (grave risk) and give examples of a procedure

Answer 6

Life-threatening disease or disturbance
Includes all moribund animals not expected to survive 24 hrs

Severe GDV
Advanced cardiac disease
Severe shock

Question 7

What does a pre-op assessment include?

Answer 7

1) Signalment(age, sex, species, breed, weight)
2) History (previous/ongoing conditions)
3) Physical examination
4) Pre-anaesthetic blood tests
5) further diagnostic tests such as ultrasonography, ECG

Question 8

What is checked during a physical examination?

Answer 8

General body condition

Cardiovascular:
H.R. , pulse, auscultation, mms, CRT

Respiratory:
auscultation, R.R., upper airway conformation

Temperature

Hydration status

Mentation/behaviour (for any CNS problems, and also assess temperament!)

Question 9

What does the RBC count (PCV) analysis test?

Answer 9

oxygen carrying capacity

Question 10

What does the ALT/ALP analysis test?

Answer 10

Liver function

Question 11

What does the urea/creatinine analysis test?

Answer 11

Kidney function

Question 12

What does the glucose analysis test?

Answer 12

Diabetes/stress

Question 13

What does the albumin/TP analysis test?

Answer 13

Low levels are potential anaesthetic risk

Question 14

What factors can affect anaesthetic risk?

Answer 14

Conditions affecting oxygen uptake/transport

Inability to metabolise and excrete anaesthetic drugs

Toxins predisposing to shock and cardiac arrhythmias

Hypothermia

Unfamiliarity: “there is no such thing as a safe anaesthetic, only a safe anaesthetist”