Anesthesia is a word that tends to create fear and anxiety in most people. When general anesthesia and surgery is recommended, the benefits associated with the procedures must outweight the risks - which are statistically very low. Modern anesthesia has improved in leaps and bounds over the last 15 years, and we strive to provide the most safe and up-to-date anesthetic practices. Here's how:
The Pre-Anesthetic Period
Before your pet has a surgical procedure, pre-anesthetic labwork will be drawn at least 24 hours - but no more than 45 days - before the scheduled appointment. This allows us to take a look at internal functions such as kidney, liver and other metabolic functions, look for signs of anemia, infection and inflammation, and also check a clotting profile to be sure your pet's blood can clot appropriately.
The morning of your pet's procedure, a pre-anesthetic examination is performed. This allows us to give your pet an overall check-up prior to administering anesthesia. This helps us to identify any new abnormalities that may have emerged such as a heart murmur, evidence of a tumor or mass, a change in breathing character, or development of a fever. If elected, your pet will also have an electrocardiogram (ECG) recorded and sent over the internet to a board certified cardiologist. An ECG allows is to take a brief look at the heart's electrical conduction, flagging us to hidden heart conditions that may need corrected before performing anesthesia.
Once your veterinarian has determined that your pet is a good candidate for anesthesia, your veterinary team will formulate an anesthesia protocol, taking any disease your pet may have into account. We approach anesthesia with a balanced, multi-modal approach to be sure your pet is as comfortable as possible while still ensuring their safety. Anti-inflammatory medications may be administered before the procedure is performed to control inflammatory pain before it is produced. This helps to keep pain at a minimum during the recovery period. You will also be sent home with an anti-inflammatory to give your pet for a few days following surgery.
Before inducing, or putting your pet under anesthesia, an injection of general sedative and opioid pain medication are typically administered. This will help to reduce your pet's anxiety and pain, as well as help achieve the lowest dose of anesthetic drug required to keep your pet comfortable and safe during their procedure.
All surgical patients have an intravenous (IV) catheter placed to give rapid access to their circulatory system. This catheter is used to administer fluids, injectable induction drugs, and allows immediate access in the case of an emergency situation.
Prior to anesthesia, the surgical site is prepped by shaving and performing a general cleaning before moving into the surgery suite.
Induction and The Anesthetic Period
Now it's time to bring your pet into a surgical plane of anesthesia. This is typically accomplished by giving a combination of induction drugs through the intraveneous catheter that was placed. Using smaller amounts of multiple medications throughout the pre-anesthesia period helps to minimize the side effects of larger doses of the drugs while maximizing the beneficial effects.
After induction, a tube will be carefully placed in your pet's trachea/windpipe. This tube will secure safe access to deliver oxygen and specialized anesthetic gases to maintain your pet in an appropriate plane of anesthesia. The endotracheal tube also helps protect the airway against potential aspirated material, such as gastric contents and water, during the procedure.
Once your pet is induced, they will be placed on several electronic monitoring devices, including: EKG, or electrocardiogram - to help monitor heart rate and appropriate rhythm; Pulse oximetery - to measure oxygen saturation of blood; End-Tidal CO2 - to monitor respirations and the amount of carbon dioxide being breathed out; Oscillometric blood pressure; and Thermometer. A registered veterinary technician experienced in anesthesia will also manually monitor heart rate, respiration rate, mucus membrane color, capillary refill time, core temperature, blood pressure, and several reflexes on a continuous basis.
In order to further control pain, your veterinary team may choose to administer local nerve blocks prior to procedures such as dental extractions and declaws. Some procedures, such as orthopedic surgery performed on a pet's back leg, will benefit from epidural administration, which blocks pain signals from being able to reach the brain during a surgical procedure. Using local anesthesia and epidurals help us to increase the safety of the anesthetic event by decreasing the amount of other medications and gases needed to maintain your pet's comfort.
Post-Surgery Period and Recovery from Anesthesia
Following completion of the surgical procedure, laser therapy is typically warranted to stimulate faster healing of your pet's incision your pet will enter the post-operative or post-anesthetic period. The post-anesthetic period is critical to monitor, as this is the period when complications are most likely to occur. In the first 10 to 30 minutes after surgery, your pet will be monitored constantly until conscious. We will be monitoring the heart rate, respiration rate, capillary refill times, mucus membrane color, and level of pain. Once your pet is adequately conscious, we will carefully remove the tube from their trachea and close monitoring will continue until they are standing up and responding to us. Once your patient is safely recovered and completely aware of their surroundings, we will call and inform you of how the entire procedure went and to arrange for a time to come pick up your pet. Most procedures done at our clinic are out-patient, meaning the pet is discharged/sent home the same day and left to your care for further monitoring that evening. Unfortunately we are not staffed at the clinic all night, but there is an emergency number you can call to speak with our doctor or head technician and discuss any concerns that may arise. If your pet requires overnight care, we will refer you to a 24-hour ICU for continued monitoring.
Overall, we want to be sure you are as comfortable as possible with the recommended procedures for your pet. If there are any questions about a procedure or anesthesia, beyond what is explained here, please do not hesitate to ask and have them answered.