Careful pre-anesthetic evaluation plays a crucial role in selecting appropriate anesthetic agents and determining monitoring requirements for patients across different age groups, species, and health conditions. Factors such as patient size, recent feeding, activity levels, and pre-surgical laboratory tests impact anesthesia decisions. Understanding the anaesthetic risk based on the ASA physical status classification is vital for ensuring the safe delivery of anesthesia and surgery. This comprehensive guide by Dr. Rajesh Kumar, Assistant Professor in the Department of Surgery, provides valuable insights into key considerations for anesthesia administration.
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Presentation Transcript
VSR 411 Anaesthesiology Pre-anaesthetic consideration By Dr. Rajesh Kumar Assistant Professor Department of Surgery
Pre-anaesthetic consideration Careful pre-anesthetic evaluation is essential for selection of anaesthetic agents, monitoring requirement and other supportive measures Depends on Species Breeds
Age Neonates metabolizes and excrete drugs less efficiency than adult Geriatric patient have decreased anesthetic requirement and slowly metabolized and excrete injectable agent Sex- In male the basal metabolic rate is nearly 7% higher than female History Duration and nature of illness determines the duration and type of anesthesia required
Size of patients Smaller animal has higher metabolic rate Recent feeding Fasting of animal is recommended for 24-48 hrs in large animal 10 -12 hrs in small animal. Activity and biological rhythum Aggressive animals are at greater anesthetic risk
Pre Surgical Laboratory Test At least Packed cell volume (PCV) and plasma protein (PP) concentrations should be evaluated
Hyper proteinemia can indicate haemo-concentration and dehydration Drug responses can be affected by hypoproteinemia It has been recommended that pre operative PCV be 27-30% intra operative and post operative PCV be kept above 20%.
Anaesthetic Risk Potentiality to surviving anaesthesia and surgery According to ASA physical status of animal classified into five classes (I to V) Patient is a completely healthy Patient has mild systemic disease Patient has severe systemic disease that is not incapacitating. Patient has incapacitating disease that is a constant threat to life. A moribund patient who is not expected to live 24 hour with or without surgery.
Pre-anaesthetic agent: Agent who are usually given to prepare the patient for administration of anesthetic agent. Uses To reduce the amount of general anaesthetic To calm the patient so that anesthesia can be administrated without bright and struggling. To reduce gastric and intestinal motility and prevent vomiting while the patient is under anesthesia.
