Canada survey highlights need for anesthesia/analgesia education
Researchers in Quebec have discovered significant gaps between standards of practice for anesthesia and analgesia as recommended by international guidelines and the care provided in veterinary practices in Canada.
Veterinarians were surveyed about procedures used to evaluate and manage anesthetic risk, anesthesia procedure, monitoring, and safety. One survey addressed veterinarians in French-speaking Quebec, and another targeted English-speaking veterinarians in other provinces, primarily Ontario, Alberta and British Columbia.
The researchers then compared published guidelines for small animal anesthesia and analgesia to care actually provided. Results were published in PLOS One.
The goal was to gauge the effectiveness of university curriculum and continuing education or whether changes are needed, according to the study’s corresponding author, Éric Troncy, Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), and professor, Faculty of Veterinary Medicine, Université de Montréal.
“We know that pain management and animal welfare have been prominent in the veterinary curriculum for the last decade, we know the new generation of veterinarians over the same period are highly sensitive to these topics, and we wanted to test the integration [of anesthesia and analgesia standards of care] in clinical practice, both in Quebec (French-speaking veterinarians) and in other Canadian provinces (English-speaking veterinarians),” Troncy said.
“As academics, we put a lot of effort into keeping our knowledge in the field up-to-date, and to transmit it during the veterinary curriculum and in continuing education,” he said. “Does it pay? That was the point we wanted to address,” he added.
“Several results did not surprise me, but disappoint me,” Troncy said. For example, about one-third of general practices treat analgesia as optional for routine surgeries, allowing clients to decide whether it is necessary. That “really shocked me,” he said.
Also troubling was the use of standard, premixed premedication (mixed ahead of time, same dosage for all patients) by 31% of veterinarians in Quebec and 22% of veterinarians in other provinces. “These results, I would have expected them below 5%,” Troncy said. “That was my hope.”
Reactions to the study have varied. North American colleagues were not surprised by the results, Troncy said, but the response from Europe was “OMG, I was sure Canada would be at the forefront of pain management and animal welfare.”
One reason international standards are not followed may be that the profession itself uses the wrong measure of quality care. “The success rate in anesthesia/analgesia remains, unfortunately, related to mortality and does not involve morbidity and animal welfare,” he said.
Going forward, the key question is, how can anesthesia and analgesia care be transformed in individual veterinarians’ practices? Troncy is hopeful.
“By exchanging with professional colleges [through university and continuing education], we could succeed in promoting improved standards of care, in accordance with the international guidelines,” he said.
The surveys were conducted in 2016 by researchers at Centre Vétérinaire Rive-Sud, a referral and emergency center in Brossard, Québec, and Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, Québec.
The bovine unit of Boehringer Ingelheim Animal Health also participated in the research.
Learn about AAHA's anesthesia protocols in the 2020 AAHA Anesthesia and Monitoring Guidelines for Dogs and Cats.
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