Figure 1 (above). Doppler blood pressure monitors are relatively inexpensive and provide systolic blood pressure readings if used with a properly sized cuff, but they have the disadvantage of not being able to provide diastolic or mean arterial blood pressure readings.
General anesthesia is a “necessary evil” in daily practice arising from the constant need to provide sensory deprivation to noxious surgical and dental stimuli while maintaining normal blood pressure and perfusion to prevent end-organ damage. Too frequently, however, hypotension, hypoperfusion, and potential end-organ damage are not recognized in anesthetized patients as a result of the unavailability of monitoring equipment, improper use of that equipment, or failure to recognize inherent limitations in its technology (Figure 1).
The American College of Veterinary Anesthesiologists (ACVA) has established guidelines for basic evaluation of circulation, tissue perfusion, oxygenation, and ventilation for all animals placed under heavy sedation or general anesthesia.1,2 Incorporating these monitoring techniques in practice not only helps ensure better outcome on an individual patient basis, it raises the standards of care across the profession.
Figure 2. Monitoring decreases the risk for anesthesia-related complications in both young and old patients. In many general practices, the bulk of anesthesia is performed on healthy young animals for elective spays or neuters or on aged patients, such as this Pomeranian with Cushing’s disease and mitral insufficiency.