Abstract
Objective
To develop, test and refine an ‘intervention-based’ system for the surveillance of
adverse events (AEs) during small animal anaesthesia.
Study design
Prospective, voluntary reporting audit.
Animals
A total of 1386 consecutive small animal anaesthetics (including 972 dogs and 387
cats).
Methods
Adverse events were defined as undesirable perianaesthetic events requiring remedial
intervention to prevent or limit patient morbidity. Using previous reports, 11 common
AEs were selected and ‘intervention-based’ definitions were devised. A voluntary reporting
audit was performed over 1 year at a university teaching hospital. Data on AEs were
collected via paper checkbox forms completed after each anaesthetic and were assimilated
using an electronic database. Interventions were performed entirely at the discretion
of the attending anaesthetist. Comparisons between dogs and cats were made using Fisher's
exact tests.
Results
Forms were completed for 1114 anaesthetics (a compliance of 80.4%), with 1001 AEs
reported in 572 patients. The relative frequency of AEs reported were as follows:
arousal or breakthrough pain (14.9%), hypoventilation (13.5%), hypotension (10.3%),
arrhythmias (5.8%), hyperthermia/hypothermia (5.0%), airway complications (4.8%),
recovery excitation (4.6%), aspiration risk (4.5%), desaturation (2.8%), hypertension
(1.7%) and ‘other’ (3.7%). Canine anaesthetics (57.3%) were more likely to involve
AEs than were feline anaesthetics (35.5%, p < 0.01). Escalation in postanaesthetic care was required in 20% of cases where an
AE was reported (8% of anaesthetics overall). In 6% of cases (2% overall), this involved
management in an intensive care unit. There were six intra-anaesthetic fatalities
(0.43%) during this period. The tool was widely accepted, being considered quick and
easy to complete, but several semantic, logistical and personnel factors were encountered.
Conclusions and clinical relevance
Simple intervention-based surveillance tools can be easily integrated into small animal
anaesthetic practice, providing a valuable evidence base for anaesthetists. A number
of considerations must be addressed to ensure compliance and the quality of data collected.
Keywords
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Article info
Publication history
Accepted:
May 15,
2015
Received:
March 21,
2014
Footnotes
Chaseview Veterinary Clinic Ross-on-Wye, UK
Identification
Copyright
© 2016 Association of Veterinary Anaesthetists and American College of Veterinary Anesthesia and Analgesia. Published by Elsevier Inc. All rights reserved.
