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      Management of veterinary anaesthesia and analgesia in small animals: A survey of English-speaking practitioners in Canada

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          Abstract

          Objective

          To describe how small animal anaesthesia and analgesia is performed in English-speaking Canada, document any variation among practices especially in relation to practice type and veterinarian’s experience and compare results to published guidelines.

          Design

          Observational study, electronic survey.

          Sample

          126 respondents.

          Procedure

          A questionnaire was designed to assess current small animal anaesthesia and analgesia practices in English-speaking Canadian provinces, mainly in Ontario, Alberta and British Columbia. The questionnaire was available through SurveyMonkey ® and included four parts: demographic information about the veterinarians surveyed, evaluation and management of anaesthetic risk, anaesthesia procedure, monitoring and safety. Year of graduation and type of practice were evaluated as potential risk factors. Exact chi-square tests were used to study the association between risk factors and the association between risk factors and survey responses. For ordinal data, the Mantel-Haenszel test was used instead.

          Results

          Response rate over a period of 3 months was 12.4% (126 respondents out of 1 016 invitations). Current anaesthesia and analgesia management failed to meet international guidelines for a sizable number of participants, notably regarding patient evaluation and preparation, safety and monitoring. Nearly one third of the participants still consider analgesia as optional for routine surgeries. Referral centres tend to follow guidelines more accurately and are better equipped than general practices.

          Conclusions and clinical relevance

          A proportion of surveyed Canadian English-speaking general practitioners do not follow current small animal anaesthesia and analgesia guidelines, but practitioners working in referral centres are closer to meet these recommendations.

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          Most cited references28

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          Response rates and nonresponse errors in surveys.

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            A Meta-Analysis of Response Rates in Web- or Internet-Based Surveys

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              The risk of death: the confidential enquiry into perioperative small animal fatalities.

              To estimate the risks of anaesthetic and sedation-related mortality in companion animals in the UK. (The Confidential Enquiry into Perioperative Small Animal Fatalities, CEPSAF). A prospective cohort study with nested case-control study. All small animals anaesthetized and sedated at participating centres between June 2002 and June 2004. Patient outcomes at 48 hours (alive, dead and killed) were recorded. Anaesthetic and sedation-related death was defined as death where surgical or pre-existing medical causes did not solely cause death. Species-specific risks of anaesthetic-related death and 95% confidence intervals (95% CI) were calculated. Risks were also estimated in the sub-sets of dogs, cats and rabbits that were either healthy or sick (ASA 1-2 and 3-5, respectively). One hundred and seventeen veterinary practices participated in the study and 98 036 dogs, 79 178 cats and 8209 rabbits were anaesthetized and sedated. Overall risks of anaesthetic and sedation-related death in dogs were 0.17% (1 in 601, 95% CI 0.14-0.19%), in cats 0.24% (1 in 419, 95% CI 0.20-0.27%) and in rabbits 1.39% (1 in 72, 95% CI 1.14-1.64%) within 48 hours of the procedure. In healthy dogs, cats and rabbits, the risks were estimated to be 0.05% (1 in 1849, 95% CI 0.04-0.07%), 0.11%, (1 in 895, 95% CI 0.09-0.14%) and 0.73% (1 in 137, 95% CI 0.54-0.93%), respectively. In sick dogs, cats and rabbits, the risks were 1.33%, (1 in 75, 95% CI 1.07-1.60%), 1.40% (1 in 71, 95% CI 1.12-1.68%) and 7.37% (1 in 14, 95% CI 5.20-9.54%), respectively. Postoperative deaths accounted for 47% of deaths in dogs, 61% in cats and 64% in rabbits. Most other small animal species had higher mortality risks. Small animal anaesthesia appears to be increasingly safe. Greater patient care in the postoperative period could reduce fatalities.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: InvestigationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ResourcesRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: ResourcesRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                28 September 2021
                2021
                : 16
                : 9
                : e0257448
                Affiliations
                [1 ] Centre Vétérinaire Rive-Sud, Brossard, Québec, Canada
                [2 ] Centre Vétérinaire Laval, Laval, Québec, Canada
                [3 ] Faculty of Veterinary Medicine, Groupe de Recherche en Pharmacologie Animale du Québec (GREPAQ), Université de Montréal, Saint-Hyacinthe, Québec, Canada
                Texas A&M University College Station, UNITED STATES
                Author notes

                Competing Interests: The authors have read the journal’s policy and the authors of this paper have the following competing interests: ArthroLab Inc., as partner in a funding grant. The joint ArthroLab – NSERC funding only participated indirectly by covering partially the salary of COT. The specific roles of this author are articulated in the ‘author contributions’ section. The authors received support from the company Dispomed Inc., i.e. to deliver the electronic survey to their clients. This has been detailed in the text. The funders, either governmental (NSERC and MITACS) or commercial (ArthroLab Inc., Dispomed Inc.) had no role in the present study. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products to declare.

                Author information
                https://orcid.org/0000-0003-0209-5261
                Article
                PONE-D-21-05375
                10.1371/journal.pone.0257448
                8478190
                34582482
                081b85bd-ba5a-4ee5-b7ea-6ebe7e4fb64b
                © 2021 Lalonde et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 17 February 2021
                : 1 September 2021
                Page count
                Figures: 4, Tables: 8, Pages: 21
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100000038, natural sciences and engineering research council of canada;
                Award ID: 441651–2013
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100000038, natural sciences and engineering research council of canada;
                Award ID: 491953–2016
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/501100004489, mitacs;
                Award ID: IT11643
                Award Recipient :
                There was not proprietary interest or funding directly provided for this project. This work was indirectly supported (ETR) by a Discovery grant (#441651–2013, supporting salaries) and a Collaborative Research and Development grant (#RDCPJ 491953–2016 supporting operations and salaries in partnership with ArthroLab Inc.) from the Natural Sciences and Engineering Research Council of Canada. COT is a recipient of a MITACS Canada Elevation postdoctoral scholarship (#IT11643). The authors got support from the company Dispomed Inc., i.e. to deliver the electronic survey to their clients. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Anesthesiology
                Anesthesia
                Medicine and Health Sciences
                Pharmaceutics
                Drug Therapy
                Anesthesia
                People and Places
                Population Groupings
                Professions
                Veterinarians
                Biology and Life Sciences
                Veterinary Science
                Veterinary Medicine
                Veterinary Surgery
                Medicine and Health Sciences
                Epidemiology
                Medical Risk Factors
                Medicine and Health Sciences
                Pharmaceutics
                Drug Therapy
                Analgesia
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Biology and Life Sciences
                Organisms
                Eukaryota
                Animals
                Vertebrates
                Amniotes
                Mammals
                Cats
                Biology and Life Sciences
                Zoology
                Animals
                Vertebrates
                Amniotes
                Mammals
                Cats
                Medicine and Health Sciences
                Anesthesiology
                Anesthesiology Monitoring
                Custom metadata
                All relevant data are within the paper and its Supporting information files.

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