Recovery From Anaesthesia
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Introduction
The post operative period is an important stage within an anaesthetic procedure, both immediately after the anesthetic and once the patient is back in wards/stables etc.
Immediately Post Anaesthetic
The major concern after any anaesthetic procedure is the airway of the patient. Commonly the anaesthetic agent is turned off, if inhalation agents have been used, or the infusion is stopped in cases of total intravenous anaesthetic procedures, the animal is maintained on oxygen for a short period of time. This also allows the anaesthetist to ventilate the patient, if intubated, if they are not spontaneously breathing. Once happy that the patient is breathing spontaneously and has received sufficient oxygen the oxygen is turned off and the patient is allowed to breath room air. This is important in patients that have received nitrous oxide during a procedure, or patients with known airway disease. Oxygenation of these patients should be monitored closely with a pulse oximeter or, if available, blood gas analysis
Endotracheal Tube removal
The time of endotracheal (ET) tube removal varies between species. In any patient , however, close monitoring should continue before and after removal of the ET tube. In dogs, it is possibly to leave the tube in until the dog is sitting in sternal as many dogs will tolerate ET tube placement. However, it can be removed when the patient is swallowing spontaneously. Many practices will remove it to prevent the paitent chewing on the tube and thereby damaging it. In cats, ET tubes should be removed before the animal rouses as laryngeal spasm may occur, which may lead to laryngeal oedema and obstruction. In horses, ET tubes may be removed early to prevent damage, and a nasal tube can be placed if there are concerns.
Temperature
On concern with patients undergoing anaesthesia is hypothermia. this make it important to monitor temperatures of patients during and after any anaesthetic. This allows for implementation of methods to try and prevent further temperature loss and to try warm up the patient.
Post Operative Analgesia
Post operative analgesia is often forgotten but it of great importance in any anaesthetic procedure. A variety of agents can be used. The patient should be closely monitored after the procedure and pain assessed regularly to adjust the analgesic protocol appropriately.