Veteriner Anesteziyoloji Sorumlulukları ve Hayvan Refahı
Özet
Veteriner anestezi, ağrı ve stresi en aza indirerek teşhis ve tedavi sırasında hayvan güvenliği ve refahının sağlanmasında kritik bir rol oynar. Bu süreç, bilinç kaybı ile hayati fonksiyonların sürdürülmesi arasında hassas bir denge gerektirir. Veteriner hekimler, anestezik riskleri değerlendirme, ilaç uygulama ve perioperatif hasta bakımının en yüksek standartlarını sağlama sorumluluğu taşır. Anestezik riskin değerlendirilmesi, komplikasyonları en aza indirmek ve anestezi güvenliğini sağlayarak anestezik morbidite ve mortalite riskini önlemede oldukça önemlidir. Yüksek morbidite oranları, anestezi süreçlerinde hayvanların komplikasyonlara maruz kaldığını ve refahlarının yeterince korunmadığını işaret eder. Anestezi, insan hatasına açık karmaşık bir süreçtir ve insan hatası, hayvan güvenliği ve refahını doğrudan etkileyebilir. Yanlış dozajlamalar veya yetersiz izleme gibi hatalar ağrı, stres, uzamış uyanma ve hatta ölüme yol açabilir. Bu hataların önlenmesi için geliştirilen kontrol listeleri, anestezi öncesi hazırlığı, anestezi yönetimini ve sonrası bakım aşamalarını standartlaştırarak hasta güvenliğini ve refahını artırmayı hedefler. Bunların yanında hayvan sahiplerine anestezi ile ilişkili riskler hakkında şeffaf bir bilgilendirilmiş onam sunulması, prosedüre ilişkin risklerin anlaşılmasında ve bu risklerin kabul edilmesi veya reddedilmesi konusunda bilinçli bir karar mekanizması sağlar. Genel olarak, veteriner hekimler anestezi yönetiminde klinik, aynı zamanda etik ve iletişimsel boyutları da kapsayan çok yönlü bir sorumluluk üstlenmektedirler.
Veterinary anesthesia plays a critical role in ensuring animal safety and welfare during diagnostic and therapeutic procedures by minimizing pain and stress. This process requires a delicate balance between inducing unconsciousness and maintaining vital functions. Veterinarians have the responsibility of assessing anesthetic risks, administering drugs, and providing the highest standards of perioperative patient care. The assessment of anesthetic risk is of paramount importance in minimizing complications and preventing anesthetic morbidity and mortality, thereby ensuring anesthesia safety. High morbidity rates indicate that animals are exposed to complications during anesthetic procedures and that their welfare is not adequately protected. Anesthesia is a complex process susceptible to human error, which can directly impact animal safety and welfare. Errors such as incorrect dosages or inadequate monitoring can lead to pain, stress, prolonged recovery, or even death. To prevent such errors, checklists have been developed to standardize the pre-anesthetic preparation, anesthetic management, and post-anesthetic care phases, aiming to enhance patient safety and welfare. Furthermore, providing animal owners with informed consent regarding the risks associated with anesthesia ensures they understand the procedural risks and facilitates an informed decision-making process to accept or decline. Overall, veterinarians undertake a multifactorial responsibility in anesthesia management, encompassing not only clinical but also ethical and communicational dimensions.
Referanslar
AVA. The Association of Veterinary Anaesthetists’ Anaesthetic Safety Checklist Implementation Manual. (07/04/2025 tarihinde https://ava.eu.com/wp-content/uploads/2015/11/AVA-Checklist-Booklet-FINAL-Web-copy.pdf adresinden ulaşılmıştır).
Short CE. The Management of Animal Pain Where Have We Been, Where Are Now, and Where Are We Going? Vet J. 2003;165(2):101-103. doi:10.1016/S1090-0233(02)00241-1.
Langbein T, Sonntag H, Trapp D, et al. Volatile anaesthetics and the atmosphere: atmospheric lifetimes and atmospheric effects of halothane, enflurane, isoflurane, desflurane and sevoflurane. Br J Anaesth. 1999;82(1):66-73. doi:10.1093/bja/82.1.66.
Varughese S, Ahmed R. Environmental and Occupational Considerations of Anesthesia: A Narrative Review and Update. Anesth Analg. 2021;133(4):826-835. doi:10.1213/ANE.0000000000005504.
Mason DS, Tenney L, Hellyer PW, et al. Prescription Opioid Epidemic: Do Veterinarians Have a Dog in the Fight? Am J Public Health. 2018;108(9):1162-1163. doi:10.2105/AJPH.2018.304603.
United States Food and Drug Administration (FDA). The Opioid Epidemic: What Veterinarians Need to Know. (12/03/2025 tarihinde https://www.fda.gov/animal-veterinary/resources-you/opioid-epidemic-what-veterinarians-need-know adresinden ulaşılmıştır).
Johnson C. Endocrine disease. In: Seymour C, Gleed R (eds.) Manual of Small Animal Anaesthesia and Analgesia. Cheltenham, UK: BSAVA; 1999. p. 223-230.
Clarke KW, Hall LW, Trim CM. Veterinary Anaesthesia. 11th ed. London, UK: WB Saunders; 2014.
Mitchell K, Barletta M, Quandt J, et al. Effect of routine pre-anesthetic laboratory screening on pre-operative anesthesia-related decision-making in healthy dogs. Can Vet J Rev Veterinaire Can. 2018;59(7):773-778.
Alef M, Von Praun F, Oechtering G. Is routine pre-anaesthetic haematological and biochemical screening justified in dogs? Vet Anaesth Analg. 2008;35(2):132-140. doi:10.1111/j.1467-2995.2007.00364.x.
Davies M, Kawaguchi S. Pregeneral anaesthetic blood screening of dogs and cats attending a UK practice. Vet Rec. 2014;174(20):506-506. doi:10.1136/vr.102211.
Toews AR, Campbell JR. Influence of preoperative complete blood cell counts on surgical outcomes in healthy horses: 102 cases (1986-1996). J Am Vet Med Assoc. 1997;211(7):887-888.
Dyson D, Maxie M, Schnurr D. Morbidity and mortality associated with anesthetic management in small animal veterinary practice in Ontario. J Am Anim Hosp Assoc. 1998;34(4):325-335. doi:10.5326/15473317-34-4-325.
Nicholson A, Watson A. Survey on small animal anaesthesia. Aust Vet J. 2001;79(9):613-619. doi:10.1111/j.1751-0813.2001.tb10780.x.
Gaynor J, Dunlop C, Wagner A, et al. Complications and mortality associated with anesthesia in dogs and cats. J Am Anim Hosp Assoc. 1999;35(1):13-17. doi:10.5326/15473317-35-1-13.
Hosgood G, Scholl DT. Evaluation of age and American Society of Anesthesiologists (ASA) physical status as risk factors for perianesthetic morbidity and mortality in the cat. J Vet Emerg Crit Care. 2002;12(1):9-15. doi:10.1046/j.1534-6935.2002.00002.x.
Bille C, Auvigne V, Libermann S, et al. Risk of anaesthetic mortality in dogs and cats: an observational cohort study of 3546 cases. Vet Anaesth Analg. 2012;39(1):59-68. doi:10.1111/j.1467-2995.2011.00686.x.
Bille C, Auvigne V, Bomassi E, et al. An evidence-based medicine approach to small animal anaesthetic mortality in a referral practice: the influence of initiating three recommendations on subsequent anaesthetic deaths. Vet Anaesth Analg. 2014;41(3):249-258. doi:10.1111/vaa.12116.
Brodbelt DC, Hammond R, Tuminaro D, et al. Risk factors for anaesthetic‐related death in referred dogs. Vet Rec. 2006;158(16):563-564. doi:10.1136/vr.158.16.563.
Gil L, Redondo JI. Canine anaesthetic death in Spain: a multicentre prospective cohort study of 2012 cases. Vet Anaesth Analg. 2013;40(6):e57-e67. doi:10.1111/vaa.12059.
Itami T, Aida H, Asakawa M, et al. Association between preoperative characteristics and risk of anaesthesia-related death in dogs in small-animal referral hospitals in Japan. Vet Anaesth Analg. 2017;44(3):461-472. doi:10.1016/j.vaa.2016.08.007.
Portier K, Ida KK. The ASA Physical Status Classification: What Is the Evidence for Recommending Its Use in Veterinary Anesthesia?—A Systematic Review. Front Vet Sci. 2018;5:204. doi:10.3389/fvets.2018.00204.
Brodbelt DC, Blissitt KJ, Hammond RA, et al. The risk of death: the Confidential Enquiry into Perioperative Small Animal Fatalities. Vet Anaesth Analg. 2008;35(5):365-373. doi:10.1111/j.1467-2995.2008.00397.x.
Matthews NS, Mohn TJ, Yang M, et al. Factors associated with anesthetic-related death in dogs and cats in primary care veterinary hospitals. J Am Vet Med Assoc. 2017;250(6):655-665. doi:10.2460/javma.250.6.655.
Dave CB, Derek F, Glenn RP. Anesthetic Risk and Informed Consent. In: Kurt A, Grimm LA, Lamont WJ, et al. (eds.) Veterinary Anesthesia and Analgesia. 5th ed. Ames, Iowa: John Wiley & Sons, Inc.; 2015. p. 11-23.
Runciman W, Hibbert P, Thomson R, et al. Towards an International Classification for Patient Safety: key concepts and terms. Int J Qual Health Care. 2009;21(1):18-26. doi:10.1093/intqhc/mzn057.
James JT. A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care. J Patient Saf. 2013;9(3):122-128. doi:10.1097/PTS.0b013e3182948a69.
Clarke KW, Hall LW. A survey of anaesthesia in small animal practice: AVA/BSAVA report. J Assoc Vet Anaesth G B Irel. 1990;17(1):4-10. doi:10.1111/j.1467-2995.1990.tb00380.x.
Reason J. Human Error. Cambridge, UK: Cambridge University Press; 1990.