Adshead S. Reducing the risk of anaesthetic complications in patients with brachycephalic obstructive airway syndrome. Vet Nurs. 2014; 5:(2)78-87

Appelgrein C, Hosgood G, Thompson M, Coiacetto F. Quantification of gastroesophageal regurgitation in brachycephalic dogs. J Vet Intern Med. 2022; 36:(3)927-934

British Veterinary Association. Brachycephalic dogs. 2018. (accessed 2 May 2023)

Balakrishnan A, Drobatz KJ, Silverstein DC. Retrospective evaluation of the prevalence, risk factors, management, outcome, and necropsy findings of acute lung injury and acute respiratory distress syndrome in dogs and cats: 29 cases (2011-2013). J Vet Emerg Crit Care (San Antonio). 2017; 27:(6)662-673

Clapham L. How to measure blood pressure: direct and indirect techniques. Vet Nurs. 2011; 2:(6)324-326

Crompton S, Hill P. Post-operative recovery of the surgical patient. Vet Nurs. 2011; 2:(4)190-198

Costa RS, Abelson AL, Lindsey JC, Wetmore LA. Postoperative regurgitation and respiratory complications in brachycephalic dogs undergoing airway surgery before and after implementation of a standardized perianesthetic protocol. J Am Vet Med Assoc. 2020; 256:(8)899-905

Devonshire A. Extended patient care report for anaesthetic management of a patient undergoing ovariohysterectomy for pyometra. Vet Nurs. 2016; 7:(1)48-52

Downing F, Gibson S. Anaesthesia of brachycephalic dogs. J Small Anim Pract. 2018; 59:(12)725-733

Fawcett A, Barrs V, Awad M Consequences and management of canine brachycephaly in veterinary practice: perspectives from Australian veterinarians and veterinary specialists. Animals (Basel). 2018; 9:(1)

Fenner JVH, Quinn RJ, Demetriou JL. Postoperative regurgitation in dogs after upper airway surgery to treat brachycephalic obstructive airway syndrome: 258 cases (2013-2017). Vet Surg. 2020; 49:(1)53-60

Post-op monitoring: what to look for in the recovering animal. 2007. (accessed 2 May 2023)

Gruenheid M, Aarnes TK, McLoughlin MA, Simpson EM, Mathys DA, Mollenkopf DF, Wittum TE. Risk of anesthesia-related complications in brachycephalic dogs. J Am Vet Med Assoc. 2018; 253:(3)301-306

Anesthesia and analgesia in brachycephalic dogs. 2022. (accessed 2 May 2023)

The immediate postoperative recovery of surgical patients. 2011. (accessed 2 May 2023)

Gyles C. Brachycephalic dogs - time for action. Can Vet J. 2017; 58:(8)777-780

Homer A. Cardiovascular monitoring of the canine gastric dilatation volvulus patient. Vet Nurs. 2020; 11:(1)24-28

Jones KL. How to accurately measure blood pressure. Vet Nurs. 2022; 13:(3)140-143

MSD Manual, Veterinary Manual. 2023. (accessed 9 May 2023)

Laborde S, Mosley E, Thayer JF. Heart rate variability and cardiac vagal tone in psychophysiological research - recommendations for experiment planning, data analysis, and data reporting. Front Psychol. 2017; 8

Ladlow J, Liu NC, Kalmar L, Sargan D. Brachycephalic obstructive airway syndrome. Vet Rec. 2018; 182:(13)375-378

Lindsay B, Cook D, Wetzel J-M, Siess S, Moses P. Brachycephalic airway syndrome: management of post-operative respiratory complications in 248 dogs. Aust Vet J. 2020; 98:(5)173-180

Providing supplemental oxygen to patients. 2018. (accessed 2 May 2023)

McLaughlin KA, Rith-Najarian L, Dirks MA, Sheridan MA. Low vagal tone magnifies the association between psychosocial stress exposure and internalizing psychopathology in adolescents. J Clin Child Adolesc Psychol. 2015; 44:(2)314-328

Perioperative management of brachycephalic dogs. 2015. (accessed 2 May 2023)

Mitze S, Barrs VR, Beatty JA, Hobi S, Bęczkowski PM. Brachycephalic obstructive airway syndrome: much more than a surgical problem. Vet Q. 2022; 42:(1)213-223

Nutbrown-Hughes D. Brachycephalic ocular syndrome. Vet Nurs. 2020; 11:(8)354-362

O'Dwyer L. How to perform central venous pressure measurement. Vet Nurs. 2011; 2:(10)600-603

O'Dwyer L. Brachycephalic breeds - preparing for the worst. Vet Nurs. 2019; 10:(3)123-123

O'Neill DG, Sahota J, Brodbelt DC, Church DB, Packer RMA, Pegram C. Health of Pug dogs in the UK: disorder predispositions and protections. Canine Medicine and Genetics. 2022; 9:(1)

Packer RMA, Tivers M. Strategies for the management and prevention of conformation-related respiratory disorders in brachycephalic dogs. Veterinary Medicine: Research and Reports. 2015; 6:(6)219-232

Perfusion deficits and fluid resuscitation: a more in-depth look. 2021. (accessed 2 May 2023)

Blood gas analysis, pt 4: respiratory acidosis and alkalosis. 2022. (accessed 9 May 2023)

Anaesthesia of the brachycephalic patient. 2019. (accessed 2 May 2023)

Scales C, Clancy NJ. Brachycephalic anaesthesia, part 1: the pre-anaesthetic period. Veterinary Nursing Journal. 2019a; 34:(6)146-150

Scales C, Clancy NJ. Brachycephalic anaesthesia, part 2: the peri-anaesthetic period. Veterinary Nursing Journal. 2019b; 34:(10)260-265

Scales C, Clancy N. Brachycephalic anaesthesia, part 3: the post-anaesthetic period. Veterinary Nursing Journal. 2020; 35:(1)16-18

The veterinary nurse's role in reading blood gases. 2021. (accessed 2 May 2023)

Woodlands C. Perioperative care of the brachycephalic patient and surgical management of brachycephalic obstructive airway syndrome. Vet Nurs. 2018; 9:(10)532-538

Postoperative care of brachycephalic patients: airway management and cardiovascular support

02 May 2023
12 mins read
Volume 14 · Issue 4
Figure 1. Electrocardiogram showing sinus arrest


The ownership of brachycephalic pets has increased significantly in recent years. Anatomical abnormalities, alongside a higher incidence of inherited disorders, have contributed to an everincreasing brachycephalic caseload in veterinary practice. With postoperative complications commonplace in such patients, it is essential that the veterinary nurse is familiar with nursing care provision and interventions catering specifically for the brachycephalic patient to improve standards of care and treatment outcomes. Intensive airway management and cardiovascular support are essential for these high-risk patients in the immediate postoperative period. A review of the literature has highlighted the lack of research available for the postoperative care of brachycephalic patients and further studies are recommended.

This article evaluates the current literature sur-rounding the veterinary nurse's role in the post-operative care of the brachycephalic patient – specifically airway management and cardiovascular support.

In recent years, there has been a dramatic increase in ownership of brachycephalic breeds (British Veterinary Association, 2018). The exaggerated morphological features and related health concerns, alongside a higher incidence of inherited disorders, has contributed to an ever-increasing caseload of brachycephalic patients in practice (O'Neill et al, 2022). Surgical interventions are commonly required in the treatment of disorders such as brachycephalic obstructive airway syndrome (BOAS), dystocia, dental disease and intervertebral disc disease (Gyles, 2017).

It is well-documented in the literature that complications following surgery in the brachycephalic patient are most likely to occur in the postoperative period (Grubb, 2022) – with higher rates of mortality associated with the performance of airway surgery (Downing and Gibson, 2018). As death is most likely to occur postoperatively within the initial 3 hours of recovery, close monitoring of the patient during this time may reduce mortality rates, while also improving nursing care provision (Crompton and Hill, 2011).

Register now to continue reading

Thank you for visiting The Veterinary Nurse and reading some of our peer-reviewed content for veterinary professionals. To continue reading this article, please register today.