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8 岁以上猫和犬的麻醉前血液检查:麻醉师的预测和围麻醉期变化。

Preanaesthetic blood tests in cats and dogs older than 8 years: anaesthetists' prediction and peri-anaesthetic changes.

机构信息

Animal Health Trust, Newmarket, UK.

Department of Clinical Sciences and Services, Royal Veterinary College, Hatfield, UK.

出版信息

Vet Anaesth Analg. 2021 Nov;48(6):854-860. doi: 10.1016/j.vaa.2021.04.010. Epub 2021 Aug 3.

Abstract

OBJECTIVE

To evaluate the anaesthetist's ability to predict abnormalities in preanaesthetic blood test results obtained from cats and dogs older than 8 years and to describe the impact of these preanaesthetic blood test results on the American Society Anesthesiologists (ASA) physical status classification, anaesthetic protocol and procedures.

STUDY DESIGN

Observational, prospective, clinical multi-centre study.

ANIMALS

A total of 333 cats and dogs.

METHODS

After a clinical examination and review of the animal´s clinical history the anaesthetist completed the first part of a set of questions including ASA status and anticipated abnormalities in blood tests. After this, blood results were presented, and the anaesthetist completed the second part of the set of questions, including changes in ASA status or anaesthetic protocol, and procedure delay or cancellation. Preanaesthetic blood tests included: haematocrit, total proteins, electrolytes, glucose, lactate, urea and creatinine. Examiners were classified as senior clinicians, clinicians, anaesthesia residents or nurses, and interns. For statistical analysis, the chi-square test was used. A p value < 0.05 was considered significant.

RESULTS

The ASA status increased in three dogs and one cat (1.2%); in two of them abnormalities were not expected by the examiner. The anaesthetic protocol changed in seven animals (2.1%); the most common change related to fluid therapy. Anaesthesia was delayed in two dogs (0.6%) to administer intravenous fluid therapy. No cases were cancelled. Abnormalities were more commonly found [37 out of 58 assessments (approximately 64%)] when the anaesthetist predicted them compared to when they were unexpected [49 of 275 assessments (approximately 18%); p < 0.001].

CONCLUSIONS AND CLINICAL RELEVANCE

Routine non-targeted blood tests in cats and dogs older than 8 years led to few changes in the anaesthetic management, and anaesthetists correctly predicted blood test results in most cases.

摘要

目的

评估麻醉师预测 8 岁以上猫和狗的术前血液检查结果异常的能力,并描述这些术前血液检查结果对美国麻醉师协会(ASA)体格状况分类、麻醉方案和程序的影响。

研究设计

观察性、前瞻性、临床多中心研究。

动物

共 333 只猫和狗。

方法

在进行临床检查和回顾动物临床病史后,麻醉师完成了一组问题的第一部分,包括 ASA 状况和预计血液检查异常。之后,呈现血液检查结果,麻醉师完成了一组问题的第二部分,包括 ASA 状况或麻醉方案的变化,以及延迟或取消麻醉程序。术前血液检查包括:红细胞压积、总蛋白、电解质、血糖、乳酸、尿素和肌酐。检查者分为高级临床医生、临床医生、麻醉住院医师或护士以及实习生。统计分析采用卡方检验。p 值<0.05 被认为具有统计学意义。

结果

有三只狗和一只猫(1.2%)的 ASA 状况增加;其中两只有异常但检查者未预期。七只动物(2.1%)的麻醉方案发生改变;最常见的改变与液体治疗有关。两只狗(0.6%)因需要静脉输液而延迟麻醉。没有病例被取消。当麻醉师预测到异常时,发现异常的情况更为常见[37 次评估中的 58 次(约 64%)],而当异常未被预测到时,发现异常的情况较少[275 次评估中的 49 次(约 18%);p<0.001]。

结论和临床相关性

8 岁以上猫和狗的常规非靶向血液检查导致麻醉管理很少发生变化,麻醉师在大多数情况下正确预测了血液检查结果。

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