Crafting the Perfect Protocol: Anesthesia for the ASA I
Anesthesia involves inherent risks, even in the healthiest of patients. The goal of a safe anesthetic event is best described by the saying that "there are no safe anesthetic agents, there are no safe anesthetic procedures, there are only safe anesthetists". This safety is achieved by breaking down the anesthetic procedure into 3 different parts: before, during, and after the patient is unconscious.
The risk is lowest for a patient classified as ASA 1—a normal, healthy patient undergoing an elective procedure, but an individualized and structured approach is still critical. Though many of our protocols will be the same, we should still consider each patient before implementing our protocol.
Part Ia: Preanesthetic Planning and Patient Preparation
The anesthetic protocol begins with careful preanesthetic planning.
Preanesthetic Evaluation: Begin with a complete preanesthetic evaluation, including history, physical examination, and pre surgical diagnostics to identify any risk factors for the patient.
Although ASA 1 patients are healthy, diagnostic testing may reveal abnormal changes in in seemingly healthy patients. So don’t forget, if you don’t look, you won’t find anything! Check out our blog posts on preoperative bloodwork, taking a good history, and taking physical exam for more details on this.
Preparation and Instrumentation: Preanesthetic preparation starts at home with the owner administering prophylactic drugs (gabapentin and/or trazodone are often good choices) and fasting the pet. Recent guidelines suggest that shorter fast times are appropriate for healthy adult patients, and water generally need not be withheld until 2 hours before anesthesia.
At some point pre-induction, placement of an intravenous (IV) catheter is essential for almost all anesthetic procedures, regardless of length, for administering medications, fluids, or as a critical lifeline during emergencies.
