2. Universidad Cardenal Herrera-CEU

Background: Patient safety is essential in small animal anaesthesia. Thisstudy aimed to assess anaesthesia-related deaths in cats worldwide, identifyrisk and protective factors and provide insights for clinical practice.Methods: A prospective multicentre cohort study of 14,962 cats from198 veterinary centres across different countries was conducted. Data onanaesthesia-related deaths, from premedication up to 48 hours postex-tubation, were collected. Logistic regression was used to analyse patientdemographics, American Society of Anesthesiologists (ASA) classification,procedure type and anaesthetic drugs.Results: The anaesthesia-related mortality was 0.63%, with 74.5% of deathsoccurring postoperatively. Cats with cachexia, a higher ASA status or whounderwent abdominal, orthopaedic/neurosurgical or thoracic proceduresexhibited elevated mortality. Mechanical ventilation use was associated withincreased mortality. Mortality odds were reduced by the use of alpha2 -agonistsedatives, pure opioids in premedication and locoregional techniques.Limitations: Limitations include non-randomised sampling, potentialbiases, unquantified response rates, subjective death cause classification andlimited variable analysis.Conclusions: Anaesthetic mortality in cats is significant, predominantlypostoperative. Risk factors include cachexia, higher ASA status, specificprocedures and mechanical ventilation. Protective factors include alpha2 -agonist sedatives, pure opioids and locoregional techniques. These findingscan help improve anaesthesia safety and outcomes. However, further researchis required to improve protocols, enhance data quality and minimise risks.

Background:Ensuring patient safety during small animal anaesthesia is cru-cial. This study aimed to assess anaesthetic-related deaths in dogs globally,identify risks and protective factors and inform clinical practice.Methods:This prospective cohort multicentric study involved 55,022 dogsfrom 405 veterinary centres across various countries. Data on anaesthesia-related deaths from premedication to 48 hours post-extubation werecollected. Logistic regression was used to analyse patient demographics,American Society of Anesthesiologists (ASA) classification, procedure typeand anaesthetic drugs used.Results:Anaesthetic-related mortality was 0.69%. Most deaths occurred post-operatively (81%). Age, obesity and a higher ASA classification score wereassociated with increased mortality. Urgent procedures, non-urgent butunscheduled anaesthesias and short procedures also had higher mortality.Some sedatives, systemic analgesics, hypnotics and the use of locoregionalanaesthesia were linked to a decrease in mortality.Limitations:The limitations of the study include the non-randomised sam-ple, potential selection bias, lack of response rate quantification, variable dataquality control, subjectivity in classifying causes of death and limited analysisof variables.Conclusion:Careful patient evaluation, drug selection and monitoring canbe associated with reduced mortality. These findings can be used to developguidelines and strategies to improve patient safety and outcomes. Furtherresearch is needed to refine protocols, enhance data quality systems andexplore additional risk mitigation measures.

Objectives: To evaluate the use of 0.7 mA as a fixed electrical current to indicate epidural needle placement and to confirm that 0.7 mA is greater than the upper limit of the minimal electrical threshold (MET) for sacrococcygeal epidural needle placement in dogs. Study design: Prospective clinical study. Animals: A group of 20 client-owned dogs. Methods: During general anaesthesia and with standard monitoring, the presence of the 3patellar reflex was confirmed in all dogs. An insulated needle was inserted through the sacrococcygeal intervertebral junction and absence of tail movement was confirmed when a fixed electrical current of 0.7 mA was applied. Then, the needle was further advanced towards the epidural space until the expected motor response was obtained – the 'nerve stimulation test' (NST). The NST was considered positive when a motor response of the muscles of the tail was elicited but not the perineal muscles, whereas it was considered negative when no movement of the tail was evoked. The electrical current was turned to 0 mA and then increased by 0.01 mA increments until tail movement was evoked, this was recorded as the MET. In the positive NST cases, 0.05 mL cm-1 occipitococcygeal length of 2% lidocaine or 0.25-0.5% bupivacaine was administered. Epidural blockade was confirmed by the loss of patellar reflex. Descriptive statistics were used to present data. Results: Sacrococcygeal epidural needle placement, corroborated by loss of the patellar reflex, was correctly predicted in 89.5% (95% confidence interval: 68.6%-97.1%) of the cases. The MET was 0.22 mA (0.11-0.36). Conclusions and clinical relevance: A current of 0.7 mA is approximately twice the upper limit of the MET for epidural placement. Therefore, this study demonstrates, with a success rate of 89.5%, the adequacy of using 0.7 mA as the fixed electrical current to detect sacrococcygeal epidural needle placement in dogs.