When tiletamine-zolazepam is included in a Fear Free protocol, the patient should be treated as undergoing anesthesia and monitored.

• A. The patient is undergoing general anesthesia and requires monitoring
• B. The protocol is safe without monitoring
• C. The patient is ASA I
• D. The drugs have no adverse effects

Answer: (A)

Tiletamine-zolazepam is a dissociative anesthetic combination that can produce anesthesia-like effects, including sedation, analgesia, and potential respiratory or cardiovascular changes. Because of these risks, when it’s used in a Fear Free protocol you should treat the patient as if they’re undergoing anesthesia and monitor them accordingly. This means continuing vital monitoring (e.g., heart rate, respiratory rate, oxygen saturation, and blood pressure) and being prepared for airway support or emergency intervention if needed. Even healthy patients (ASA I) can experience adverse effects with these drugs, so monitoring isn’t optional. The drugs do have potential adverse effects, so assuming they’re completely safe without monitoring isn’t appropriate.