Anesthesiology

Anesthesia has traditionally meant the condition of having the feeling of pain and other sensations blocked.  It is also sometimes described as reversible lack of awareness.  Loss of consciousness and pain allows patients to undergo surgery without the distress and pain they would otherwise experience.   There are several forms of anesthesia used as indicated by the procedure required, age and condition of the patient and level of the invasiveness of the procedure.  Anesthesia is achieved generally by drugs that work on the brain to to induce loss of consciousness, awareness and pain.  General anesthesia is the phase of anesthesia during which the patient cannot be aroused and may need airway support to breathe.  This level of anesthesia is necessary for major surgery and is usually induced with inhalational agents (gas) and/or intravenous drugs. 

Anesthesia can also include deep sedation/analgesia or a drug induced depression of consciousness during which the patient does respond to deep pain, moderate sedation/analgesic, a drug induced depression during which the patient can breathe on their own, and minimal sedation produced by giving drugs that cause the patient to respond fairly normally to commands but coordination and memory may be impaired.  The level of anesthesia achieved ranges on a continuum of depth of consciousness from minimal sedation top general anesthesia.  The depth of consciousness of a patient may change from one minute to the next! 

"There are no inherently absolutely "safe" anesthetic drugs, only safe anesthetists."  This axiom, taught to practicing doctors of all types, points out that "how" anesthesia is administered is far more important than "what" anesthetic drugs are actually given. This principle guides our approach to anesthesiology at Orchard Park Veterinary Medical Center.

Adherence to a strict protocol of precautionary measures ensures the maximum degree of safety possible. We believe no shortcut is worth risking the life of a pet. All pets who are anesthetic candidates must be physically examined prior to their contemplated procedure. This allows us to gage the overall health of the pet, listen to heart and lungs, screen for obvious health problems and make sure the pet is fit for anesthesia.

A tiered system of blood testing is employed to evaluate each pet individually, based upon its age, health and anticipated anesthesic procedure. Pets older than 7 years of age should have a complete blood chemistry profile, CBC (complete blood count) and urinalysis completed within the preceding 2-3 weeks prior to an elective anesthesia procedure, such as dental cleaning, mass removal or other surgery.  Younger pets should have, at minimum, a "Pre-op profile" of basic screening blood chemistries and packed cell volume to check for anemia completed prior to elective procedures such as castration, declawing, or ovariohysterectomy (spay).  Because we are open 24 hours per day, scheduling your pet to have blood drawn by one of our technicians can be at a time you chose that is convenient. 

All pets admitted for anesthesia administration will be monitored by a machine that can record an electrocardiogram as part of the monitoring system. Additionally, we recommend that all pets, including our youngest patients, have an intravenous catheter placed prior to anesthesia to allow ready access to the blood stream should any problem develop requiring immediate treatment.  Fluid therapy support during surgery is recommended for all our surgical patients as well, regardless of their age. This intraoperative fluid support assists the patient's ability to withstand the possible shock of surgery and speeds anesthetic and surgical recovery.   

After induction of anesthesia with injectable medications, most pets will be endotracheally (in the airway) intubated. This allows protection of the airway and provides for respiratory assistance with our ventilator should that be necessary. Pets are maintained under gas anesthesia with a carefully calibrated mixture of oxygen and  isoflurane or sevoflurane gases. These gases are commonly used in human medicine today and are extremely safe for birds, cats, dogs, reptiles, small mammals and many other species. The two gas anesthesia agents that we utilize are fast acting and known for their fast depletion in the animal, thus allowing for smooth, quick induction of anesthesia allowing for shorter time under anesthesia and quick recovery time for our patients. 

Patients that cannot tolerate injectable anesthesia for induction of anesthesia can also be anesthestized using gas anesthesia alone.  Very sick, very senior patients with several chronic problems, and sometimes dogs and cats that need to have a Caesarian section to deliver their babies are often those who need gas induction.  These patients can be "put under" using a mask or if small, placed in an induction chamber wherein anesthesia gas is introduced.  After induction the pet is entubated just as if an injectable anesthesia was used and the surgery proceeds. 

During anesthesia the pet's heart rate, respiratory rate, oxygen content of the blood, body temperature and electrocardiogram are continuously monitored. Some patients will also have continuous blood pressure monitoring as well.  This monitoring is provided by a licensed veterinary technician who accompanies the veterinarian into the surgical suite to manage anesthesia of the patient.

Each patient has one technician assigned to continuously monitor and record anesthetic progress during the anesthestic procedure. This person is given no other duties during this time and is therefore solely focused on your pet's progress and stability. The doctor is thus able to focus on the procedure being performed, confident that subtle changes in anesthetic depth, blood pressure, body temperature, heart function,  oxygenation, respiration,  and other factors will be noted immediately and adjustments made promptly.

Diligent attention to vital signs, hydration and adequacy of ventilation, and body temperature is maintained throughout anesthesia and recovery. Pain relieving medications are administered both before, and again after, surgical procedures  to minimize the amount of anesthetic medications required to maintain a surgical plane of anesthesia and to provide comfort and freedom from pain.  Close monitoring is maintained until patients are sitting upright and are aware of their surroundings. Recovered patients as fed as soon as possible and appropriate, additional pain relief medication administered as needed.
 
ANESTHESIOLOGY SERVICES 

• Pre-anesthetic evaluation
• Anesthetic preparation
• Anesthetic induction
• Anesthetic maintenance
• Anesthetic monitoring
• Anesthetic recovery
• pre-anesthetic pain control
• Post-anesthetic care