First do no harm - anaesthetising the challenging patient
Our veterinary patient population has changed as our medical skills have progressed and we have become capable of supporting patients with advanced disease and advancing age. All tranquilizers, induction drugs and inhalant drugs cause CNS depression and most cause some degree of dose-dependent physiologic dysfunction. In healthy patients, many of the physiologic effects of anesthetic drugs are well tolerated or can be counteracted by routine measures such as administration of oxygen or intravenous (IV) fluids. In compromised patients, these effects can be exacerbated, further contributing to the demise of the patient. Successful anesthesia in compromised patients is highly dependent on adequate patient stabilization, diligent patient support and monitoring, and the use of appropriate anesthetic/analgesic drugs at appropriate dosages. We will discuss drug protocols and care for the challenging patient.
- At the end of this lecture the delegate will be able to:
- •Describe the physiologic impact of anesthetic drugs and the impact of disease-mediated physiologic changes on drug selection.
- •Understand the impact of pain on comorbidities.
- •Understand the criticality of appropriate physiologic monitoring and support.
- •Develop anesthetic/analgesic protocols for patients with select comorbidities.