Troubleshooting During Anesthesia Part II
World Small Animal Veterinary Association World Congress Proceedings, 2015
C. Pacharinsak, DVM, MS, PhD, DACVAA
Stanford University School of Medicine, Stanford, CA, USA

Too Light Anesthetic Plane

Possible cause

 Low level of (empty) isoflurane and O2

 Excited animals during induction

 Endotracheal leaks

 Apnea

 Esophageal intubation

 Endobronchial intubation

Treatment

 Check isoflurane and O2 level

 Use effective premedication

 Change defective endotracheal tube

 Breathing for patients if apnea occurs

 Check positioning of endotracheal intubation

 Post anesthesia airway obstruction

Signs

 Stridor

 Excessive abdominal breathing

Cyanosis

Possible causes

 Upper airway swelling (trauma, prolonged head-down position, allergic reaction, etc.)

 Soft palate entrapment (i.e., brachycephalic breeds)

 Foreign bodies in the trachea

 Laryngeal paralysis

Possible treatment

 For airway swelling, steroid, (e.g., dexamethasone [0.25 mg/kg]) should be given.

 For brachycephalic breeds, maintain a gradual recovery and wait until the animal becomes very awake and tolerates the endotracheal tube in the trachea. Once extubated, monitor animals closely for 15–30 min.

 Examine and/or clean oral cavity before extubation.

Hypothermia

Possible causes

 Anesthetic drugs interfere with thermoregulation

 Use of non-rebreathing circuits with high O2 flow

 Large surgical prep area and very long procedures

 Cold fluid administration or cold fluid lavage

Treatments

 Provide heat sources (e.g., circulating heating pads, Bair Huggers, etc.)

 Use rebreathing circuits when possible

 Minimize excessive clipping area

 Reduce surgical and anesthesia time when possible

 Administer warm fluid (IV or lavage fluid)

 Keep OR room > 70°F (21°C)

 Monitor body temperature throughout surgery

Prolonged Recovery

Possible causes

 Deep anesthetic plane

 Hypothermia

 Hypoglycemia

 Effects of anesthetics

 Existing diseases

Treatment

 Communicate with surgeon and lighten anesthetic plane 15–20 min before finishing surgery if possible.

 For hypothermia, please see hypothermia.

 Check glucose level and treat accordingly.

 Treat existing diseases in advance when possible. Drug dosages may need to be reduced depending on patients' health status and other factors.

References

1.  Greene SA. Veterinary Anesthesia and Pain Management Secrets. Philadelphia, PA: Hanley & Belfus; 2002:1–43.

2.  Seymour C, Duke-Novakovski T. BSAVA Manual of Canine and Feline Anaesthesia and Analgesia. 2nd ed. Gloucester, UK: British Small Animal Veterinary Association; 2007.

  

Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

C. Pacharinsak, DVM, MS, PhD, DACVAA
Stanford University School of Medicine
Stanford, CA, USA


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