Anesthetic Risks: When Complacency Sets In!

Adverse events during anesthesia in otherwise young and healthy patients is a rare occurrence, however, with low incidence of adverse events could come an increased risk of complacency on the part of the veterinary team.

Take the following case as an example:

“Clicky” is a young and healthy cat that underwent a routine dental prophylaxis procedure. A few days after the procedure, she developed respiratory difficulties and presented to our emergency clinic. She was diagnosed as having severe subcutaneous emphysema, most likely from a tracheal wall compromise that would have occurred as an adverse event from tracheal intubation. 

We need to handle cats very gently while they are intubated as their tracheas are nowhere near as robust as their canine counterparts. Over inflating the cuff is another cause of tracheal necrosis. What we think happened was that this patient was re-positioned during the dental procedure and the endotracheal tube was twisted in the process, causing either ischaemic compromise to a portion of the trachea or direct damage to the trachea.

Thankfully, “Clicky” made a full recovery, but this case certainly highlights that we must never be complacent when it comes to handling our anesthesia cases. Low incidence does not mean no incidence, and individualised anesthetic plans, along with in-depth training for the anesthetist (who most often are the veterinary technicians and nurses), will help reduce the chances of adverse events occurring.