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全面麻醉前评估对犬猫ASA分级及手术取消率的影响:一项回顾性观察研究

Influence of Comprehensive Pre-Anaesthetic Assessment on ASA Classification and Surgical Cancellations in Dogs and Cats: A Retrospective Observational Study.

作者信息

Cañón Pérez Ariel, Marti-Scharfhausen Sánchez María De Los Reyes, Sevilla Ureba Antonio, Hernández Magaña Eva Zoe, Viscasillas Monteagudo Jaime, Martínez Albiñana Agustín, Redondo José I

机构信息

Experimental Surgery Unit, Vall d'Hebron Institut de Recerca (VHIR), Pg. de la Vall d'Hebron 129, Horta-Guinardó, 08035 Barcelona, Spain.

Anicura Indautxu Hospital, San Mamés Zumarkalea 36-38, 48010 Bilbao, Spain.

出版信息

Vet Sci. 2025 Jun 23;12(7):612. doi: 10.3390/vetsci12070612.

DOI:10.3390/vetsci12070612
PMID:40711272
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12298058/
Abstract

Anaesthesia carries an inherent risk of morbidity and mortality in veterinary patients, yet the clinical impact of comprehensive pre-anaesthetic assessment (PAA) is insufficiently quantified. We retrospectively reviewed 350 PAAs including 267 dogs and 83 cats, performed at a small-animal teaching hospital in 2021. Signalment, history, physical examination findings, complementary diagnostics, initial ASA physical status (ASA-i), final ASA status after test review (ASA-f) and procedural outcomes were recorded. Complementary diagnostics-predominantly haematology, serum biochemistry, thoracic radiography, and electrocardiography-were requested in 82-86% of cases. ASA-f differed from ASA-i in 7.5% (11/306) of animals: +1 in 3.6%, +2 in 1.0%, -1 in 2.9%; no patient shifted by more than two classes. Fifty-seven planned procedures (16.2%) were cancelled following PAAs, chiefly abdominal (43.9%) and minor soft-tissue surgeries (31.6%). Internal-medicine abnormalities (47%) and cardiac findings (19%) were the leading causes; in 46% of cancellations, the trigger was an abnormal test result absent from the physical examination. Sixty-three percent of cancelled interventions were later completed after further evaluation or treatment. These data demonstrate that structured PAA substantially alters perioperative decision-making in small-animal practice and supports selective yet rigorous diagnostic test use to enhance patient safety and optimise theatre utilisation.

摘要

麻醉在兽医患者中存在发病和死亡的固有风险,但全面的麻醉前评估(PAA)的临床影响尚未得到充分量化。我们回顾性分析了2021年在一家小动物教学医院进行的350例PAA,其中包括267只狗和83只猫。记录了动物信息、病史、体格检查结果、补充诊断、初始美国麻醉医师协会身体状况(ASA-i)、检查复查后的最终ASA状况(ASA-f)以及手术结果。82%-86%的病例进行了补充诊断,主要是血液学、血清生化、胸部X光和心电图检查。11/306(7.5%)的动物ASA-f与ASA-i不同:3.6%的动物升高1级,1.0%的动物升高2级,2.9%的动物降低1级;没有患者的分级变化超过两级。57例计划手术(16.2%)在PAA后取消,主要是腹部手术(43.9%)和小型软组织手术(31.6%)。内科异常(47%)和心脏检查结果(19%)是主要原因;在46%的取消手术病例中,触发因素是体格检查中未出现的异常检查结果。63%的取消手术在进一步评估或治疗后后来完成。这些数据表明,结构化的PAA在很大程度上改变了小动物临床中的围手术期决策,并支持有选择但严格地使用诊断检查,以提高患者安全性并优化手术室利用率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53aa/12298058/60ddd20910ef/vetsci-12-00612-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53aa/12298058/bbdee9bf8b35/vetsci-12-00612-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53aa/12298058/60ddd20910ef/vetsci-12-00612-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53aa/12298058/bbdee9bf8b35/vetsci-12-00612-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53aa/12298058/60ddd20910ef/vetsci-12-00612-g002.jpg

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本文引用的文献

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Anaesthetic mortality in cats: A worldwide analysis and risk assessment.猫的麻醉死亡率:全球分析和风险评估。
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Can Vet J. 2018 Jul;59(7):773-778.
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J Am Vet Med Assoc. 2017 Mar 15;250(6):655-665. doi: 10.2460/javma.250.6.655.
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