Inadvertent Perianesthetic Hypothermia in Small Animal Patients

Clark‐Price, Stuart C.

doi:10.1016/j.cvsm.2015.04.005

Cited by 43 publications

(46 citation statements)

References 42 publications

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“…Low body temperatures should be prevented and treated by using various heating methods (i.e. passive and active surface rewarming, and active core rewarming) [2] since hypothermia can lead to arrhythmias, coagulopathies and reduced oxygen delivery to tissue, among other negative effects [11]. Prevalence of hypothermia in cats has been associated with duration of anesthesia, the reason for anesthesia (abdominal versus orthopedic surgery) and the anesthetic risk (high-risk cats show lower temperature than low-risk cats) [25].…”

Section: Discussionmentioning

confidence: 99%

A retrospective study of anesthesia for subcutaneous ureteral bypass placement in cats: 27 cases

Luca

Monteiro

Dunn

et al. 2017

The Journal of Veterinary Medical Science

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The goals of this retrospective clinical case series study were to describe the management of anesthesia, and to report perioperative complications in cats undergoing subcutaneous ureteral bypass (SUB) placement due to ureteral obstruction. Medical records of client-owned cats with ureteral obstruction and anesthetized for SUB placement between 2012 and 2015 in a veterinary teaching hospital were reviewed. Twenty-seven cases were identified. Duration of anesthesia and surgery (mean ± standard deviation) were 215 ± 42 min and 148 ± 36 min, respectively. Hypothermia was the most common intraoperative complication. Hypotension, hypocapnia, hypertension and bradycardia were also frequently observed. Out of 22 cats who experienced intraoperative hypotension, 17 received inotropes and vasopressors. There was a significant decrease in creatinine (P=0.008) and total solids (P=0.007) after SUB placement when compared with baseline values. Postoperative complications included pain, anorexia, nausea, hypertension, and urinary tract-related problems. No death occurred in the postoperative period. Successful management of anesthesia for SUB placement involves rigorous anesthetic monitoring and immediate treatment of complications. Perioperative complications appear to be common. This study could not identify risk factors associated with this procedure.

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Section: Discussionmentioning

confidence: 99%

A retrospective study of anesthesia for subcutaneous ureteral bypass placement in cats: 27 cases

Luca

Monteiro

Dunn

et al. 2017

The Journal of Veterinary Medical Science

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“…The study was limited to a single volatile anesthetic; therefore, the role of pre-warming during injectable anesthetic drug use remain unknown. There was no measurement of air humidity or velocity in the warming chamber; both factors affect heat loss through evaporation [49]. Any adverse effects of the transient increase in core temperature to 40˚C are unknown as neurological outcomes were not studied following recovery; however, no overt changes in behavior or body condition were noted in the weeks following the study.…”

Section: Limitationsmentioning

confidence: 99%

Pre-warming before general anesthesia with isoflurane delays the onset of hypothermia in rats

Rufiange

Leung

Simpson³

et al. 2020

PLoS ONE

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General anesthesia causes hypothermia by impairing normal thermoregulatory mechanisms. When using inhalational anesthetic agents, Redistribution of warm blood from the core to the periphery is the primary mechanism in the development of hypothermia and begins following induction of anesthesia. Raising skin temperature before anesthesia reduces the temperature gradient between core and periphery, decreasing the transfer of heat. This prospective, crossover study (n = 17 adult male and female SD rats) compared three treatment groups: PW1% (pre-warming to increase core temperature 1% over baseline), PW40 (pre-warming to increase core temperature to 40˚C) and NW (no warming). The PW1% group was completed first to ensure tolerance of pre-warming. Treatment order was then randomized and alternated after a washout period. Once target temperature was achieved, anesthesia was induced and maintained with isoflurane in oxygen without further external temperature support. Pre-warming was effective at delaying the onset of hypothermia, with a significant difference between PW1% (12.4 minutes) and PW40 (19.3 minutes, p = 0.0044 (95%CI -12 to -2.2), PW40 and NW (7.1 minutes, p < 0.0001 (95%CI 8.1 to 16.0) and PW1% and NW (p = 0.003, 95%CI 1.8 to 8.7). The rate of heat loss in the pre-warmed groups exceed that of the NW group: PW1% versus NW (p = 0.005, 95%CI 0.004 to 0.027), PW40 versus NW (p < 0.0001, 95%CI 0.014 to 0.036) and PW1% versus PW40 (p = 0.07, 95%CI -0.021 to 0.00066). Pre-warming alone confers a protective effect against hypothermia during volatile anesthesia; however, longer duration procedures would require additional heating support. OPEN ACCESSCitation: Rufiange M, Leung VSY, Simpson K, Pang DSJ (2020) Pre-warming before general anesthesia with isoflurane delays the onset of hypothermia in rats. PLoS ONE 15(3): e0219722.

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“…Drug metabolism relies on enzymatic reactions that may be altered by hypothermia. Hypothermia can therefore prolong recovery time ( 27 ).…”

Section: Introductionmentioning

confidence: 99%

Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse

2018

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Horses are susceptible to developing large areas of pulmonary atelectasis during recumbency and anesthesia. The subsequent pulmonary shunt is responsible for significant impairment of oxygenation. Since ventilation perfusion mismatch persists into the post-operative period, hypoxemia remains an important concern in the recovery stall. This case report describes the diagnosis and supportive therapy of persistent hypoxemia in a 914 kg draft horse after isoflurane anesthesia. It highlights how challenging it can be to deal with hypoxemia after disconnection from the anesthesia machine and how life-threatening it can become if refractory to treatment. Furthermore, it stresses the point on the interactions between hypoxemia and other factors, such as residual drug effects and hypothermia, that should also be considered in the case of delayed recovery from general anesthesia.

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Inadvertent Perianesthetic Hypothermia in Small Animal Patients

Cited by 43 publications

References 42 publications

A retrospective study of anesthesia for subcutaneous ureteral bypass placement in cats: 27 cases

A retrospective study of anesthesia for subcutaneous ureteral bypass placement in cats: 27 cases

Pre-warming before general anesthesia with isoflurane delays the onset of hypothermia in rats

Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse

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