Anaesthetic complications and emergencies preparedness part 2: intraoperative and recovery period complications
Abstract
This is a straightforward reference guide designed to assist in diagnosing and treating anaesthetic complications and emergency situations in the perioperative period. Each complication is presented with its risk factors, signs for recognition and differential diagnoses when indicated. Management is presented in a step-by-step manner. Whenever possible, advice on how to prevent these situations from occurring is also provided. This second part focuses on complications more commonly observed in the intraoperative and postoperative period. It includes common situations, such as spontaneous/seizure-like movement or agitation; rare but life-threatening emergencies, such as malignant hyperthermia; and postoperative conditions less recognised in veterinary medicine, such as nausea and severe pain. The complications are presented in alphabetic order in each section (intraoperative and postoperative periods) for easy, rapid consultation.
Many complications may arise besides hypothermia, hypotension and hypoventilation in small animal anaesthesia. The aim of this article is to point out some critical situations and emergencies that may be encountered from premedication to recovery, and to provide advice on how to prevent, recognise and manage them. Anaesthetic complications are presented in the time frame in which they are most likely to happen. Part 1 of this 2-part series (Marotto et al, 2018) focused mainly on life-threatening emergencies involving the cardiovascular and respiratory system during the preoperative and intraoperative period, whereas this second part concentrates on other complications of the intraoperative and postoperative period. As the most recent multi-centre enquiry on small animal perioperative mortality (CEPSAF) identified the postoperative period as the one with the highest incidence of mortality (Brodbelt, 2009), a strong focus has been placed on the management of critical events that may happen during this time, such as variations of body temperature or blood pressure, and prolonged recovery. Immediate recognition of failing respiratory and renal systems, and how to deal with these life-threatening complications, is also presented.
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