Canis ISSN: 2398-2942

Anesthesia: for cardiovascular insufficiency

Synonym(s): Anesthesia in heart failure

Contributor(s): John Dodam

Introduction

Alternatives
  • Neuroleptanalgesia, eg for radiography.
  • Neuroleptanalgesia with local anesthesia, eg for minor/superficial surgical procedures.

    Often much safer to give a carefully planned and monitored general anesthetic than a heavy sedation for radiography and minor procedures
PreparationRisk assessment

Standard preoperative preparation

  • Stabilise any conditionaffecting animal's fitness for anesthesia (and surgery), eg pulmonary edema via diuresis Furosemide , pericardial effusion via pericardiocentesis Thoracocentesis , under local anesthesia Local anesthesia: overview , possibly guided by ultrasonography.
  • Pre-oxygenatefor 5 mins, using mask, naso-pharyngeal tube Nasal oxygen administration , or chamber (for small breeds).


    Value decreased if animal struggles
    If animal too large for chamber and struggling with mask, try Elizabethan collar enclosed in clingfilm or polythene with oxygen supplied from caudal aspect, tube fed in between collar and neck. Seal at neck improved by applying collar onto a folded towel placed round patient's neck
    Oxygen is a fire hazard
  • Place intravenous catheter Cephalic catheterization (largest bore convenient), to ensure reliable venous access. In critical cases, place a central venous catheter to also monitor central venous blood pressure and infuse large volumes of fluid rapidly if required.
  • Prepare surgical site, without stressing the patient, before anesthetic induction.

Requirements

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Procedure - premedication

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Procedure - induction

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Procedure - maintenance and monitoring

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Procedure - recovery

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Further Reading

Publications

Refereed papers
  • Garrod et al(1999)Anesthetic agents in trauma patients. Comp Cont Educ21, 800.

Other sources of information

  • Day T K (1999)Intravenous anesthetic techniques for emergency and critical care patients.In: Current Veterinary Therapy XIIIpp 122.
  • Bedford P G C (1991)Small Animal Anesthesia. The Increased Risk Patient.London: Bailliere Tindall. pp 72. (Thorough consideration of anesthesia for small animals with cardiac disease.)
  • Hellebrekers L J & Sap R (1991)Sufentanil-Midazolam Anesthesia in the Dog. Proceedings of the 4th International Congress of Veterinary Anaesthesia.(Brief paper on this technique, listing further references for narcotic infusion techniques.)
  • Stoelting R K & Miller R D (1984) In:Basics of Anesthesia.New York: Churchill Livingstone. pp 257. (Selecting anesthetic techniques suited to the severity of the cardiac condition.)
  • Edwards N J & Tilley L P (1981) In:Pathophysiology in Small Animal Surgery.Philadelphia: Lea and Febiger. pp 155. (Detailed discussion of medical and surgical considerations for common cardiac disorders.)


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