recovery

Risk factors for dogs +cats

Age, weight, high ASA status, emergency procedures, nature of procedure, breed

Risk factors for horses

ASA status, age, surgery type, length of anaesthesia, OOH surgery

Common causes of anaesthesia associated mortality in horses

Cardiopulmonary arrest, fractures, myopathy, SC malacia, neuropathies, airway obstruction

Factors affecting quality of recovery in horses

Anaesthesia time, OOH, surgery type (standing vs GA), inc age, temperament, high body weight, ASA status, recumbent, orthopaedics, hypotension, hypoxaemia, time to stand

Why is recovery dangerous

Less physiological support (airway, oxygen, fluids), less monitoring, delayed onset

Common recovery problems

Hypothermia, hypoxaemia, hypotension, hypertension, emergence delirium

Which is the most common anaesthetic related morbidity in SA

Hypothermia

Consequences of hypothermia

Reduced MAC, delayed recovery, shivering (inc O2 consumption), potential delayed healing

How to prevent hypothermia

Done sooner, proactive active/passive warming (pads, forced air blankets, warm fluids)

No direct contact between skin + heat

Emergence delirium

State of dissociation of consciousness → incoherent, inconsolable, irritable, uncooperative

More obvious in social + non prey species

How to prevent + treat emergence delirium

Chemical + physical restraint, reduce stimulation, analgesia

Causes of hypoxia

Airway obstruction, inadequate ventilation, poor gas’s exchange

CS of hypoxia

Cyanotic mm, tachypnoea/dyspnoea, stertor/stridor, reduced consciousness

When to extubate patient

When can maintain airway patency

Species related complications - SA

Regurgitation + pneumonitis (inc in brachycephalic, repeated anaesthetics, frequent recumbent change, orothopaedic, large breeds, barrel chested)

Airway obstruction

Blindness (hypotension + altered blood flow → cerebral Ischaemia)

Species related complications - horses

Colic, myopathy, neuropathy, fractures

Species related complications - ruminants

regurgitation, aspiration, bloating

Species related complications - pigs

Resp obstruction, hyperthermia, sunburn

How to reduce recovery problems

Monitor (HR, RR, pulse, oximetry), anticipation, rapid recognition + intervention