Editorial: Exploring Anesthetic Risk: Challenges and Solutions in Veterinary Medicine

Karine Portier ^1* Mark Senior ²

• ¹ Equine Department, Université de Lyon, Lyon, France
• ² University of Liverpool, Liverpool, North West England, United Kingdom

The field of veterinary anesthesia is continually evolving, yet anesthetic risk remains a critical concern for veterinarians and pet owners alike. While the need for surgical interventions continues to grow, so does the necessity to refine anesthetic protocols, minimize complications, and enhance patient safety.No surgical/ anesthetic intervention is completely benign, and so to enhance patient safety we need to evaluate the potential benefit of an intervention with the risk. Understanding anesthetic risk, in simple terms, means understanding the possibility of something bad happening related to anesthesia, and that something bad normally means a morbidity or a fatality. Assessing anesthetic risk involves multiple factors, including species-specific responses, drug interactions, and pre-existing conditions.The studies presented in this research topic explore anesthetic risk through a breadth of topics including providing information on the efficacy and safety of drugs in uncommonly anaesthetized/ exotic species, uncommon complications in commonly anaesthetized species using commonly administered drugs, structured risk assessment methods, and novel strategies for mitigating adverse effects.One of the significant challenges in veterinary anesthesia is the assessment of pain and analgesic efficacy across diverse species. The study on hydromorphone administration in American alligators (https://doi.org/10.3389/fvets.2025.1520172) sheds light on pain management in reptiles, a field where research remains limited. By demonstrating the efficacy of hydromorphone with minimal adverse effects, this research expands our knowledge of species-specific analgesia and highlights the importance of tailored pain management strategies in non-mammalian patients.In wildlife and conservation medicine, anesthesia is essential for capture and both medical and research purposes. The study on snow leopard immobilization with ketamine-xylazine (https://doi.org/10.3389/fvets.2025.1492640) provides valuable insights into the physiological responses of free-ranging animals under emergency conditions. The documented safety and efficacy of this anesthetic combination reinforce its viability in field settings, offering a benchmark for future anesthetic protocols in large wild felids.Anesthetic-induced complications remain a significant concern, as evidenced by the case report on hyperkalemia in a domestic cat under general anesthesia (https://doi.org/10.3389/fvets.2024.1398128). The suspected link to propofol infusion syndrome (PRIS) highlights the importance of vigilance in recognizing and managing intraoperative metabolic disturbances. This case serves as a reminder of the unpredictable nature of anesthetic reactions and the need for continuous monitoring and preparedness for rapid intervention.Risk assessment tools play a vital role in pre-anesthetic evaluations. The introduction of the CHARIOT scoring system for equine anesthesia (https://doi.org/10.3389/fvets.2024.1384525) provides a structured approach to predicting peri-anesthetic morbidity and mortality. While the study indicates that CHARIOT demonstrates moderate predictive accuracy, refining and validating risk assessment tools remains an ongoing priority to enhance anesthetic safety in horses.Pharmacological formulations significantly impact anesthetic safety, as illustrated by the study on etomidate in propylene glycol in minipigs (https://doi.org/10.3389/fvets.2024.1376604). The observed adverse effects, including hemolysis and laryngeal edema, raise concerns about the formulation's suitability. This study underscores the necessity of evaluating drug formulations across different species to mitigate unforeseen complications.Long-term analgesic management also warrants careful consideration. The study on enflicoxib, a COX-2 selective NSAID, explores its efficacy and safety in managing osteoarthritis in dogs (https://doi.org/10.3389/fvets.2024.1349901). The sustained analgesic benefits and lack of significant adverse effects over an extended period suggest that enflicoxib may offer a viable long-term pain management solution for osteoarthritic canine patients.Lastly, the comparative study of propofol and alfaxalone on canine electrocardiographic parameters highlights the potential cardiac effects of anesthetic agents (https://doi.org/10.3389/fvets.2023.1330111).The findings suggest that both drugs prolong the QTc interval, raising concerns about their proarrhythmic potential. This research underscores the importance of selecting anesthetic agents based on individual patient risk profiles, particularly in animals with pre-existing cardiac conditions.Together, these studies contribute to a more comprehensive understanding of anesthetic risk across a range of species and clinical scenarios. By addressing key challenges in anesthetic management, from species-specific analgesia to risk assessment tools and pharmacological considerations, this research topic fosters advancements in veterinary anesthesia. Moving forward, continued research and interdisciplinary collaboration will be essential to refining anesthetic protocols, minimizing risks, and enhancing patient outcomes in veterinary medicine.