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Intended duration of the procedure
· The longer the procedure is, the higher the odds of anesthesia-related complications are.
Injectable versus inhalant
· Studies are showing that when inhalant anesthetics are used in cats the chances of having a complica- tion increases. However, the authors explain that other co-factors are associated with this observation. For instance, the use of inhalant anesthetics with-
out any co-morbidity is not associated with higher mortally rates. Usually inhalants are used for more complicated and longer procedures and, at the same time, maintenance of anesthesia with injectable an- esthetics are often used during short, uncomplicated procedures. Therefore, the length and complexity of the procedure are more important than the anesthet- ic choice itself.
Endotracheal intubation in cats
· Endotracheal intubation in cats is associated with higher mortality rates. Even though cats are more difficult to intubate than dogs and there are higher chances of tracheal tear in any very small animal, these is not the explanations. Actually it is explained similarly as the previous factor. In the majority of the available studies in cats, endotracheal intubation was associated with longer and more complicated proce- dures. For example, for a simple castration, inhalants are not necessary usually used.
Fluid administration in cats
· Fluid administration in cats is associated with higher mortality rates. Same as both previous items. Cats receive fluids only when they are undergoing longer and/or more complicated procedures. Which are associated with higher mortality rate.
Obesity
· Obese patients have higher odds of suffering a com- plication under anesthesia than slim patients. While under anesthesia, obese patients are more likely to suffer from respiratory depression, overdoses, ther- moregulatory issues and prolonged recovery.
Brachycephalic
· Brachycephalic patients have higher chances of dying after anesthesia. Usually the brachycephalic patients have stenotic nares, prolonged soft palate, inverted sacules and stenotic trachea. That leads to possible respiratory obstruction and arrest.
Therefore avoiding those previous mentioned factors will help you to decrease the anesthetic related mortality rates in your clinic.
The next paragraphs will then review the factors that have been recognized as important factors to DECREASE the odds of anesthetic-related death. In another words, those are the factors that should be promoted:
Equipment check with protocol and checklist
· Many anesthesia-related complications are related to equipment failure or failures to proper test the equipment. Check lists are available to remind the personnel of all important steps for the safety of the patient been anesthetized.
· Documentation of equipment check also helps to reduce the equipment related anesthetic complica- tion. Knowing exactly when and what happened to the equipment helps to identify reoccurring problems that need to be corrected.
Directly available anesthesiologist + full time nurse
· The availability of well-trained personnel helps to decrease mortality rates when the team is able to treat complications earlier even before they become dangerous to the patient.
No change of anesthetics during the procedure
· When changing personnel during a procedure make sure the information regarding the patient is trans- ferred or possible mistakes can happen. Common examples are: administration of incompatible drugs, implementation of treatments that did not work previously, over dose of fluids and other drugs. Well- trained teams uses standard transfer sheets to help team members to remember the important factors about the patient.
Two persons available during emergency
· The evidence shows that multiple team members should manage CPR events in order to improve survival rates.
Postoperative pain management
· The large majority of anesthesia related compli- cations occur during the recovery of anesthesia. Providing post operative pain management helps to reduce the complications rate.
Pulsoximeter
· Early recognition of complications is the key to im- prove survival outcomes. The pulsoximeter is usually the first parameter that displaying errors associated with cardio-respiratory complications.
Monitoring
· Most of the anesthesia related mortality and morbid- ity studies show that monitoring saves lives. Again early recognition and early treatment for anesthesia related complication is the key to decrease the odds of having a complication under general anesthesia
References are available upon request
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43RD WORLD SMALL ANIMAL VETERINARY ASSOCIATION CONGRESS AND 9TH FASAVA CONGRESS

































































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