A Commitment to Quality Anesthesia

Explore Banfield’s anesthesia standards and protocols, and together we can strive to deliver safe, high quality healthcare to every pet, every time.

Use these resources and reference materials for anesthetic procedures in your clinical practice. Checklists and quick guides serve as reminders for delivering key behaviors for every pet, every time.

Job Aids

Help your veterinary team improve concordance with established guidelines.

Preanesthetic Evaluation

A complete evaluation should entail a physical examination, a review of patient history, clinical pathology testing and determination of ASA status. Use this outline of key procedural and reference materials to get the support you need during the clinical decision process.

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Induction & Intubation

The induction phase of general anesthesia is a critical time, so it’s imperative that the team member(s) providing anesthesia have all the necessary equipment ready and properly checked.

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Monitoring

Keep these monitoring essentials readily accessible for your teams to reference intraoperatively for information on appropriate interventions based on patient needs.

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Recovery

Most post-operative mortality occurs within the first three hours of recovery from anesthesia, and continuous monitoring will help you quickly identify complications and intervention.

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ALS & CPA

Cognitive aids (checklists, algorithm and dosing charts) have been shown to improve compliance with CPR guidelines. Use this job aid to help you deliver Advanced Life Support and care Post-Cardiopulmonary Arrest in the event of an emergency.

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Protocols

Protocols have been developed from an evaluation of the current literature of board-certified veterinary specialists (anesthesiology and internal medicine). Note that these materials are never meant to be followed blindly and the anesthesia team remains responsible for making decisions in the best interest of each patient.

Quick Reference Guide

Click through to explore this sampling of unique patient circumstances that impact anesthetic protocols. Please see Anesthesia and Analgesia for the Veterinary Practitioner: Canine and Feline for complete information on protocol selection and individualized patient care.

Brachycephalic
What is different about this patient?
- Small nares, elongated soft palates and hypoplastic tracheas create a very abnormal upper airway.
- Stress increases respiratory rate and can cause serious complications such as hyperthermia or respiratory collapse.
- All sedatives and anesthetic drugs impair respiratory function by central (neurologic) depression and relaxation of muscles needed for maintaining an airway. Patients must be carefully monitored from premedication through recovery.

Dental Prophylaxis
What is different about this patient?
- Patients may often have comorbidities or be geriatric that prompt additional considerations for their care and protocol selection.
- Performing sterile procedures under the same anesthesia as a dental prophylaxis is not recommended due to concerns of contamination.

Geriatric
What is different about this patient?
- Carefully evaluate for, and consider, all other medication that may interact with anesthesia.
- Patients often have physiologic decline in most organ functions; titrate drug doses accordingly.

Stressed/fractious
What is different about this patient?
This patient will have extremely high levels of circulating catecholamines (epinephrine, norepinephrine), which can make the patient prone to sudden cardiovascular collapse (e.g., hypotension, cardiac arrhythmias, shock, organ dysfunction), especially when sedatives and anesthetics are added.
- Stressed/fractious patients may be impossible to handle for a physical exam.
- The presence of serious disease may be masked by this physiologic “fight or flight” state, making these patients prone to crash after sedation or induction when the full extent of underlying disease becomes known.
- Most aggressive behavior is a result of underlying fear or pain. Provide analgesic therapy as medically indicated.
- If the patient struggles for more than three seconds, release and reposition. If struggling for more than three seconds occurs two to three times, consider chemical restraint or abort the procedure.
- Do not use the Stressed/Fractious pet protocol if acepromazine has already been administered.

Soft tissue (elective)
What is different about this patient?
Elective soft tissue surgery patients would include those with normal organ function as determined by clinical pathology data and unremarkable physical examination results, undergoing planned anesthesia.
- Elective soft tissue surgery patients would include those with normal organ function as determined by clinical pathology data and unremarkable physical examination results, undergoing planned anesthesia.
- Routine ovariohysterectomy (OVH) with elective gastropexy might be expected to require more analgesic therapy than a routine OVH alone.
- Consider the use of multimodal therapy for analgesic needs, including the use of local and regional analgesia.
- Due to concerns of potential surgical site contamination with bacteremia associated with dental prophylaxis, sterile soft tissue procedures should not be combined with elective dental prophylaxis.
- All sterile soft tissue surgeries are to be performed in the surgical suite.

Cardiac
What is different about this patient?
- Increased risk for clinical decompensation, fluid overload and cardiac arrhythmias.
- Thorough evaluation for comorbidities is essential.

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CPR

Keeping charts and other resuscitation aids accessible and visible in areas where CPA may occur is recommended. Print this poster and display it in procedure areas and surgery suites as initial guides for urgent intervention.

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