Chelonian sedation and anesthesia-a retrospective assessment of protocols, outcomes, and challenges in 250 cases...

To assess the anesthetic events of chelonians at a university hospital, identify shortcomings with record-keeping, and evaluate anesthesia-related mortality.

This retrospective study evaluated medical records of sedated or anesthetized chelonians between March 2000 and October 2023. Anesthetic parameters were analyzed using cases with complete anesthesia records. Compiled information included patient details, health status, procedure(s), anesthetic agents, anesthesia times, and vitals.

220 of the 250 anesthetic events identified had detailed records available for analysis. Comprehensive review of the reports highlighted areas needing improvement with record-keeping and identified the most commonly employed anesthetic agents. Alfaxalone, hydromorphone, dexmedetomidine/medetomidine, midazolam, and ketamine were the most popular for premedication, while propofol and, more recently, alfaxalone were the most common for induction. For maintenance, most cases relied on inhalants, with a preference toward isoflurane, while alfaxalone was favored for injectables. Of the 250 cases reviewed, 237 recovered, 8 were humanely euthanized, and 5 failed to recover. The latter all had preexisting pathology identified at necropsy.

Since 2020, data showed a growing trend toward the use of maintenance alfaxalone constant rate infusions over inhalants. Over time, the quality of record-keeping improved, aside from time record-keeping. Standardizing anesthesia sheets with a designated area for research-related values, paired with implementing an automated vitals recording system, is suggested to improve record-keeping.

General anesthesia can be safely and effectively performed in healthy chelonians. Suggestions for improvement include consistently performing preanesthetic bloodwork to screen for preexisting disease, clearly defining anesthesia start and end times, and reducing subjectivity in record-keeping.