Anaesthetic and nursing considerations for fracture repair in a brachycephalic patient: a case report

Abstract

The rise in popularity of brachycephalic breeds has led to an increased demand for veterinary teams to understand their complex anatomical and physiological needs. These patients present unique challenges when undergoing general anaesthesia. This nursing care report discusses the perioperative management of a one-year-old French Bulldog following a road traffic accident that resulted in tibial and fibular oblique fracture. A multimodal analgesic plan was implemented, including a fentanyl constant rate infusion and bupivacaine epidural, with consideration of opioid-free anaesthesia protocols and their minimum alveolar concentration sparing benefits. Key anaesthetic considerations included airway management, gastroesophageal reflux risk and maintaining cardiovascular stability and normothermia. The importance of pre-anaesthetic planning, vigilant intraoperative monitoring and collaborative decision-making between the registered veterinary nurse and veterinary surgeon is emphasised. This case highlights how RVNs can apply evidence-based practice to optimise analgesia, minimise anaesthetic risks, and advocate for improved outcomes in brachycephalic patients.