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Arrhythmias

Arrhythmias commonly occurring perioperatively include sinus tachycardia, sinus bradycardia, atrioventricular block, and ventricular arrhythmias.

Tachycardia

Tachycardia , HR >180 bpm in cats 3 and HR >150– 190 bpm for large and small dogs, respectively, 44 during anesthesia deserves special mention, because it should prompt the anesthetist to run through a list of rule-outs and not simply assume it is a response to inadequate anesthetic depth.

Hypertension

Hypertension , defined as a mean arterial pressure >120–140 mm Hg or a systolic arterial pressure >160–180mm Hg, 44 is uncommon in the adequately anesthetized patient, even in patients with primary hypertension, because of the negative cardiovascular effects of inhalant anesthetics.

Hypoventilation

Hypoventilation can be estimated by observing respiratory rate and depth (very subjective) and can be quantified using capnometry. Hypoventilation can cause hypercarbia, with subsequent respiratory acidosis, and hypoxemia. Thus, hypoventilation should be corrected.

Hypothermia

Hypothermia , core body temperature <98°F, can result in a myriad of adverse effects, including delayed drug metabolism, cardiovascular dysfunction, impaired perfusion, respiratory compromise, cerebral depression, increased incidence of wound infection, etc.

GER and regurgitation

GER and regurgitation can cause esophagitis and aspiration pneumonia and can lead to esophageal stricture in extreme cases. When noted, suction of the esophagus is recommended followed by lavage with saline or tap water, with concurrent endotracheal tube protection of the airway.

Step 1: Preanesthetic Evaluation and Plan Considerations

The preanesthetic patient evaluation is critical for patient safety as it promotes identification of individual risk factors and underlying physiologic changes or pathologic compromise that will impact the anesthetic plan.

Step 1: Anesthesia Begins at Home

The pet owner begins the continuum of anesthesia with fasting the pet and administering medications as directed by the anesthesia team.

Step 2: Equipment Preparation

Prior to the start of any general anesthesia or sedation-only procedure, it is critical to ensure that all equipment and monitors are turned on, are functioning, and have undergone appropriate safety checks.

Step 3: Patient Preparation

The patient should be stabilized before anesthesia as anesthesia and surgery can exacerbate pre-existing physiologic compromise.

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