Veterinary Medicine - January 2009 - (Page 16)

Research Updates study recaps and comments Examining the risk factors for anesthetic-related deaths n small animals, anesthetic-related death rates have been reported to range between 0.1% and 0.24%. Previous (1998 or earlier) studies identiﬁed poor patient health, use of xylazine, and increased age as factors associated with increased perioperative deaths, while premedication with acepromazine and atropine reduced the risk of mortality. Risk factors associated with anesthetic-related deaths were examined in this case study involving 117 private and referral practices in England. Information from 98,036 anesthesia and sedation events over a two-year period was obtained. Two groups of animals were statistically evaluated: 148 dogs that died or were euthanized within 48 hours after anesthesia or sedation, and 487 randomly selected control dogs that did not die within 48 hours after anesthesia or sedation. An independent review panel of veterinary anesthesiologists and a surgeon classiﬁed the deaths as anesthetic related or not. Sedation was used in eight of the 148 dogs that died and 36 of the 487 control dogs and was most commonly achieved with a combination including medetomidine; speciﬁc drugs were not listed. Anesthesia was induced in the remaining 140 dogs that died and 451 control dogs. Most dogs were premedicated before anesthesia with combinations of acepromazine, medetomidine, or a benzodiazepine or opioid. Anesthesia was induced with propofol or thiopentone or by administering inhalant anesthetic through a face mask. Anesthesia was maintained with isoﬂurane, halothane, sevoﬂurane, or injectable drugs (not listed). Results revealed that a higher risk of an anesthetic-related death was related to increased American Society of Anesthesiologists physical status, increased urgency and duration of the procedure, and patient age (> 12 years). Decreased body weight (< 5 kg), anesthesia for a major procedure, injectable induction agents and halothane, and inhalant anesthetics alone were also all associated with an increased risk of death. The authors concluded that knowledge of these factors should encourage better perioperative patient management and anesthetic monitoring and help reduce the risk of mortality associated with sedation and anesthesia. COMMENTARY I The information in “Research Updates” was provided by Veterinary Medicine Editorial Advisory Board member Joseph Harari, MS, DVM, DACVS, Veterinary Surgical Specialists, 21 E. Mission Ave., Spokane, WA 99202. Examining the risk factors for anesthetic-related deaths 16 Using a scrotal mesh graft to repair degloving injuries 17 Spinal fractures and luxations: Most common causes, most common outcomes 17 Is hypotonic water effective as an adjuvant therapy for canine mast cell tumors? 18 Delineating histologic prognostic factors for feline osteosarcoma 18 This study reviews cases from numerous clinics and statistically evaluates newer sedatives and anesthetics such as medetomidine, propofol, sevoﬂurane, and isoﬂurane. Unfortunately, not all of the injectable sedatives and anesthetic drug combinations used in the animals are listed. The data reveal useful information for veterinarians and their clients about risk factors for an anesthetic-related death. Undoubtedly, this information will serve as an important reminder—and lawsuit deterrent—that hospital admission and the use of sedative and anesthetic drugs in veterinary patients always carry a potential for a life-threatening complication. Brodbelt DC, Pfeiffer DU, Young LE, et al. Results of the conﬁdential enquiry into perioperative small animal fatalities regarding risk factors for anesthetic-related death in dogs. J Am Vet Med Assoc 2008;233(7):1096-1103. 16 January 2009 VETERINARY MEDICINE

Table of Contents Feed for the Digital Edition of Veterinary Medicine - January 2009

Veterinary Medicine - January 2009 Contents Leading Off Letters Research Updates Idea Exchange A Modified Subconjunctival Enucleation Technique in Dogs and Cats Local and Regional Anesthesia Techniques Author Guidelines Product Preview CE Form/Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - January 2009

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.