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Pre‐anaesthetic clinical examination influences anaesthetic protocol in dogs undergoing general anaesthesia and sedation
Author(s) -
Louro L. F.,
Maddox T.,
Robson K.,
Alderson B.
Publication year - 2021
Publication title -
journal of small animal practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 67
eISSN - 1748-5827
pISSN - 0022-4510
DOI - 10.1111/jsap.13348
Subject(s) - medicine , sedation , anesthesia , analgesic , american society of anesthesiologists , physical examination , general anaesthesia , confidence interval , odds ratio , general anaesthetic , surgery
Objectives Identify whether pre‐anaesthetic clinical examination influences anaesthetic and analgesic agents and techniques protocol in dogs presented for general anaesthesia and sedation at a large referral hospital. Materials and Methods In this prospective clinical audit, 554 dogs, undergoing general anaesthesia or sedation for surgical, diagnostic or imaging procedures were included. Multiple attending anaesthetists completed a questionnaire divided into four sections (American Society of Anesthesiologists physical status classification, anaesthetic and analgesic agents and techniques protocol, pre‐anaesthetic clinical examination findings and changes made to the anaesthetic protocol). The attending anaesthetist was able to review the patient's history before planning the anaesthetic and analgesic agents and techniques protocol. The patients were examined and changes in American Society of Anesthesiologists physical status classification or anaesthetic protocol were recorded. Results The initial anaesthetic and analgesic agents and techniques protocol was altered in 23.3% (n=129/554) of cases following a pre‐anaesthetic clinical examination, but American Society of Anesthesiologists physical status reclassification occurred in only 8.0% (n=37/464) of cases. Multivariable logistic regression analysis showed that pre‐anaesthetic clinical examination performed by European College of Veterinary Anaesthesia and Analgesia diplomates (odds ratio 5.8, 95% confidence interval 2.0 to 17.2), compared to anaesthesia interns, and the presence of an audible heart murmur (odds ratio 2.4, 95% confidence interval 1.4 to 4.4) were factors linked to changes in anaesthetic and analgesic agents and techniques protocol, whereas for each one kilogram increase in patient's weight, the odds of a change in anaesthetic and analgesic agents and techniques protocol to occur decreased by 1.7% (odds ratio 0.98, 95% confidence interval 0.97 to 1.0). Clinical Significance Pre‐anaesthetic clinical examination has impact on American Society of Anesthesiologists physical status classification, therefore estimation of patient's anaesthetic risk, and influences anaesthetic and analgesic agents and techniques protocol choice.