Several decades ago anesthesia (in particular) and surgery were somewhat risky businesses. Fortunately, that has changed a great deal. Modern techniques and drugs have made anesthesia and surgery generally very safe (although of course some procedures are much riskier than others). Modern anesthetic protocols have reduced complications dramatically, but I doubt that medicine will ever achieve 100% safety with anesthetic procedures.
Surgical and anesthetic safety tactics come in three stages. The first stage occurs before the procedure. The most important step to improve safety during this time is a comprehensive physical exam to assess fitness for anesthesia and surgery. Blood tests also should be run to assess the function of the liver and kidneys, as well as to assess for syndromes (such as diabetes) that can complicate anesthesia but aren’t always physically evident. Blood pressure measurement helps to assess the function of the heart and vascular system. Blood clotting profiles (and sometimes crossmatches for transfusions) are appropriate before procedures with a high risk of hemorrhage. Animals with questionable heart or organ status should undergo further testing, such as electrocardiography, ultrasound, radiology, or advanced blood tests.
Animals should undergo anesthesia only after they have been fully assessed in a favorable manner as described above.
The second stage of anesthesia safety involves the procedure itself. Pain killing drugs should be administered before anesthesia if there is any chance the procedure will cause pain. IV fluids should be administered to support blood pressure and circulation. Experienced and competent clinicians and technicians should be involved in the procedure. Thermal support should be administered to prevent or reduce hypothermia. Careful patient monitoring should occur — this involves the observations of an experienced anesthetist as well as the use of equipment to measure heart rate, blood oxygenation, blood pressure, and other vital statistics. A carefully thought out anesthetic protocol should involve modern anesthetic agents that have superior safety protocols, and the patient’s level of anesthesia should be appropriate for the procedure (not too deep, nor too light). Breed-specific sensitivities (such as a general intolerance for some anesthetic agents in sighthounds) should be considered.
The final stage of anesthesia is the recovery period. During this time, ongoing fluid administration, thermal support, and patient monitoring are necessary. Appropriate pain control should be continued. Once a pet has recovered sufficiently to go home, the owners should be provided with detailed instructions about what to expect for the next several days. Instructions also should detail any necessary activity or diet restrictions. Pain killers should be continued at home. Medication instructions and side effects, as well as instructions for follow-up care or suture removal should be carefully discussed.
How can you know whether your vet is doing as much as possible to make anesthesia and surgery safe? Your only option is to ask him or her. Any good veterinarian takes anesthesia and surgery seriously. And any good veterinarian will be happy to discuss the tactics he or she uses to keep pets safe during procedures.
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