Anaesthesia & Analgesia
The CityU Veterinary Medical Centre (CityU VMC) Anaesthesia Service is a team that works very closely with the other specialty and first opinion services to provide the highest quality anaesthesia care, using the most up-to-date techniques and equipment. The service is expanding so we can continue to grow our anaesthetic capability for your pets. We pride ourselves in providing bespoke care for each patient and ensuring that the process of anaesthesia is as smooth as possible. We have many years of specialist level anaesthesia experience within the team and we provide anaesthesia for the very routine to the most complicated cases, as well as for sick and compromised patients and emergencies.
Our Services include:
- Full pre-anaesthetic evaluation which may include requests for additional blood test and diagnostic imaging
- Tailored anaesthetic protocol to the individual patient taking into account the disease process, the clinical exam and diagnostic test findings and the procedure being performed
- Comprehensive analgesia plan to ensure your pets comfort during its stay in our centre and if required at home.
- Loco-regional anaesthesia (nerve blocks) where indicated, to prevent the pain sensation reaching the brain – more comfort and quicker recovery
- Advice to colleagues on anaesthesia and pain management where necessary
What to Expect
Upon arriving at the CityU VMC, you will be met by the primary service caring for your pet. They will let you know (usually before arriving at the practice) if your pet is likely to need anaesthesia. Your pet will need to have been fasted prior to arrival. This is to prevent vomiting during anaesthesia as this increases the risk of complications. The primary service will also present you with an anaesthesia fact and consent sheet, explaining in detail the different procedures and risks of anaesthesia. When you have agreed to the procedure required for your pet, with the primary service, they will contact the anaesthesia department to confirm. We will then examine your pet in detail, note any additional results (such as blood tests or radiographs) and then decide on a combination of medications and techniques to ensure the more appropriate sedation or anaesthesia for your pet.
Anaesthesia evaluations will include a full physical examination, possibly some additional blood tests and, for example, if a heart murmur is discovered then chest x-rays and possibly a request for further cardiac evaluation if our cardiology specialists are available and have time in their consultation list. We only request additional tests if we feel your pet specifically requires them, as the additional information they provide will allow us to make a more informed and safer anaesthetic plan. If you wish to discuss the anaesthesia for your pet in detail with one of the anaesthesiologists, then you would need to book a consult with them specifically.
What should I bring to my consultation?
As for any service, we need to know your pet’s previous medical history, any drug allergies and also any anaesthetic complications encountered before .
How long will my pet’s appointment take?
If your pet needs to be anaesthetized, then anaesthesia is only a part of the visit and so the length of the visit will vary considerably. After anaesthesia, and even after sedation, it is prudent to keep your pet in hospital for a period of observation to ensure they are fully awake, warm and fit to leave the hospital, even if no other procedure has been performed.
What is General Anaesthesia?
This is a state of controlled and reversible unconsciousness; your pet is made unaware of anything that is happening to it and is the most common anaesthetic in veterinary practice. This may be necessary for non-painful procedures, such as diagnostic imaging, where movement would affect image diagnostic quality. General anaesthesia (GA) is absolutely essential for surgical procedures, to prevent your pet being aware of the procedure, it also reduces stress and assists in the recovery of your pet from its surgery. General anaesthesia is usually performed with a combination of injectable drugs (sedatives, analgesics, and then anaesthetic drugs) followed by inhalation agents delivered with oxygen via a tube in the airway to maintain unconsciousness. Alone, GA does not prevent pain, which is why we also give analgesics to your pet. General anaesthesia and sedation are not the same thing.
What is Sedation?
Sedation is the use of sedatives or small amounts of anaesthetic drugs to make your pet is a bit ‘sleepy’. Your pet will be physically and mentally relaxed, and less responsive, so minor procedures can be performed. Your pet can still be roused and may still react to procedures.
What is Loco-regional Anaesthesia?
This is where a local anaesthetic drug is used on the skin, around a nerve, or an area of tissue sub- cutaneously, to anaesthetise a specific part of the skin or limb or part of the body. Performing a local anaesthetic block prevents the sensation of pain as it prevents the pain signals reaching the brain. This allows the use of lower doses of sedative and general anaesthesia drugs to help minimize potential side effects of those drugs.
Local anaesthetic drugs are injected close to larger bundles or ganglia of nerves to block larger or deeper areas of the body, sometimes using a peripheral nerve locator or ultrasound to find the nerve. Another type of regional anaesthetic technique, an epidural, involves injecting local anaesthetic drug into the epidural space of the spinal column. This provides pain relief, as it desensitizes the perineum and tail area (caudal epidural) or the whole hind limb area (lumbo- sacral epidural). If combined with analgesic drugs, it will further reduce pain in the region. Epidural anaesthesia or analgesia can provide analgesia for abdominal and even thoracic surgery.
How safe is anaesthesia?
Each sedation or anaesthetic carries some risk of morbidity and mortality, regardless of the animal. In general, the risk is quite low (although not as low as in people).
The largest statistical study shows the risk as:
|Dogs||0.05% (1:1849)||1.33% (1:75)||0.17% (1:601)|
|Cats||0.11% (1:895)||1.4% (1:71)||0.24% (1:419)|
(Brodbelt et al, 2008. The Risk of Death: The Confidential Enquiry into Perioperative Small Animal Fatalities. Veterinary Anaesthesia and Analgesia)
We provide a bespoke service for your pet to mitigate these risks and do not use standardized protocols for that reason. Your pet will have a specific protocol, although this will not reduce the risk to zero.