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Zhou D, Wang LK, Wu HY, Xiong GL, Yang XD. Lidocaine Spray for Acute Postsurgical Pain Control After Posterior Pharyngeal Flap Surgery. Laryngoscope 2024; 134:2438-2443. [PMID: 37991177 DOI: 10.1002/lary.31182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 10/03/2023] [Accepted: 11/03/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVES This study evaluated the use of lidocaine spray for acute postsurgical pain control after posterior pharyngeal flap surgery. METHODS Fifty patients aged 4 to 14 years who were scheduled to undergo elective posterior pharyngeal flap surgery were randomized to receive 2.4% lidocaine spray (Group L) or an identical volume of placebo spray (Group C) on the surgical field at the end of the surgery. The primary outcome was the maximum postoperative pain score in the postanesthesia care unit. RESULTS The maximum pain score in Group L was significantly lower than that in Group C (p = 0.001). The incidence of moderate-to-severe pain in the postanesthesia care unit was significantly lower in Group L than that in Group C (p < 0.001). In the postanesthesia care unit, more patients in Group C were prescribed rescue analgesics (p < 0.001). The time to the first rescue analgesic was also significantly shorter in Group L (p < 0.001). The incidence and maximum score of emergence agitation were lower in Group L than in Group C. Compared with Group C, Group L showed earlier postoperative fluid intake (p = 0.001). Moreover, the score for parental satisfaction with pain control was higher in Group L than in Group C (p < 0.001). CONCLUSIONS Our findings indicated that the use of 2.4% lidocaine aerosol spray on the surgical site at the end of the surgery could produce good analgesia for acute postoperative pain, reduce the incidence and severity of EA, and shorten the time to restore fluid intake. LEVEL OF EVIDENCE 2 Laryngoscope, 134:2438-2443, 2024.
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Affiliation(s)
- Dan Zhou
- Department of Anesthesiology, Peking University Hospital of Stomatology, Beijing, China
| | - Li-Kuan Wang
- Department of Anesthesiology, Peking University Hospital of Stomatology, Beijing, China
| | - Hai-Yin Wu
- Department of Anesthesiology, Peking University Hospital of Stomatology, Beijing, China
| | - Guo-Li Xiong
- Department of Anesthesiology, Peking University Hospital of Stomatology, Beijing, China
| | - Xu-Dong Yang
- Department of Anesthesiology, Peking University Hospital of Stomatology, Beijing, China
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Di Cesare F, Rabbogliatti V, Draghi S, Amari M, Brioschi FA, Villa R, Ravasio G, Cagnardi P. Pharmacokinetics of dexmedetomidine in anaesthetized horses following repeated subcutaneous administration and intravenous constant rate infusion. BMC Vet Res 2023; 19:264. [PMID: 38071301 PMCID: PMC10709979 DOI: 10.1186/s12917-023-03831-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The inclusion of dexmedetomidine (DEX) within a balanced general anaesthesia protocol is effective in improving the clinical outcome and recovery quality of anaesthesia in horses. This study aimed to determine the pharmacokinetic profile of DEX following repeated subcutaneous (SC) administration at 2 µg/kg every 60 min till the end of the procedure in comparison to intravenous constant rate infusion (CRI) at 1 µg/kg/h in anaesthetized horses undergoing diagnostic procedures up to the end of the diagnostic procedure. RESULTS In the CRI and SC groups DEX maximum concentrations (Cmax) were 0.83 ± 0.27 ng/mL and 1.14 ± 0.71 ng/mL, respectively, reached at a time (Tmax) of 57.0 ± 13.4 min and 105.5 ± 29.9 min. Mean residence time to the last measurable concentration (MRTlast) was 11.7 ± 6.2 and 55.8 ± 19.7 min for the CRI group and SC groups, respectively. The apparent elimination half-life was 18.0 ± 10.0 min in the CRI group and 94.8 ± 69.8 min for the SC group, whereas the area under the curve (AUC0-last) resulted 67.7 ± 29.3 and 83.2 ± 60.5 min*ng/mL for CRI and SC group, respectively. Clearance was 16.26 ± 8.07 mL/min/kg for the CRI group. No signs of adverse effects were recorded in both groups. CONCLUSIONS The pharmacokinetic profile of DEX following repeated SC administration in anaesthetized horses was comparable to intravenous CRI administration during the intranaesthetic period and beneficial during the recovery phase from general anaesthesia. The SC route could be considered as an alternative to CRI for improving the recovery quality of equine patients undergoing general anaesthesia.
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Affiliation(s)
- Federica Di Cesare
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Vanessa Rabbogliatti
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Susanna Draghi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Martina Amari
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Roberto Villa
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giuliano Ravasio
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Petra Cagnardi
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
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Ruíz-López P, Cuypers C, Schauvliege S. Xylazine Infusion during Equine Colic Anesthesia with Isoflurane and Lidocaine: A Retrospective Study. Animals (Basel) 2023; 13:2902. [PMID: 37760302 PMCID: PMC10525755 DOI: 10.3390/ani13182902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
This retrospective study investigated the effect of a xylazine infusion on heart rate; mean arterial pressure; blood gases; anesthetic and dobutamine requirements; recovery quality and duration; percentage of death/survival; and days to die/discharge in horses after colic surgery under partial intravenous anesthesia with isoflurane and lidocaine infusion. Anesthetic records of equine colic surgery were reviewed from similar periods in 2020-2021 and 2021-2022. In both groups, after sedation with xylazine 0.7 mg/kg intravenously (IV) and induction with ketamine 2.2 mg/kg and midazolam 0.06 mg/kg IV, anesthesia was maintained with isoflurane and lidocaine (bolus 1.5 mg/kg IV, infusion 2 mg/kg/h). Group L (2020-2021, n = 45) received xylazine 0.2 mg/kg IV before recovery, group XL (2021-2022, n = 44) received xylazine 0.5 mg/kg/h IV intraoperatively. In group XL, minimal (p = 0.04) and average (p = 0.04) heart rate, intraoperative hematocrit (p = 0.001), minimal (p = 0.002) and maximal (p = 0.04) dobutamine administration rate, animals requiring ketamine top-ups (p = 0.04), and the number of days to discharge (p = 0.02), were significantly lower compared to group L. During recovery in group XL, the time to sternal recumbency (p = 0.03) and time to first attempt (p = 0.04) were significantly longer. This retrospective study suggests that a xylazine infusion may have beneficial effects on horses undergoing colic surgery. Further prospective studies are necessary.
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Affiliation(s)
- Patricia Ruíz-López
- Department of Large Animal Surgery, Anesthesia and Orthopedics, Faculty of Veterinary Medicine, University of Ghent, 9820 Merelbeke, Belgium;
| | | | - Stijn Schauvliege
- Department of Large Animal Surgery, Anesthesia and Orthopedics, Faculty of Veterinary Medicine, University of Ghent, 9820 Merelbeke, Belgium;
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Perioperative Brain Function Monitoring with Electroencephalography in Horses Anesthetized with Multimodal Balanced Anesthetic Protocol Subjected to Surgeries. Animals (Basel) 2022; 12:ani12202851. [PMID: 36290236 PMCID: PMC9597736 DOI: 10.3390/ani12202851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 10/07/2022] [Accepted: 10/18/2022] [Indexed: 11/29/2022] Open
Abstract
Simple Summary This study aimed to investigate the use of electroencephalography (EEG) and EEG-derived (processed) indices for detecting brain activity changes perioperatively in 12 anesthetized adult horses subjected to various surgery. Frontal electrodes together with Sedline/Root monitor were used on these horses from soon after anesthesia induction and continued until the horse first attempted to stand in recovery. The EEG waves were characterized by low-frequency high amplitude alpha, theta, and alpha waves during the isoflurane maintenance and surgery, which is commonly observed in profound anesthesia. The processed EEG indices including Patient State Index, Burst Suppression Ratio, and 95% Spectral Edge Frequency changed significantly between the stages (induction, surgery, and recovery) of anesthesia. Collectively, the presence of the slow EEG wave activities and the presence of burst suppression implies that these horses were profoundly unconscious during the anesthesia. We concluded that the use of EEG in conjunction with traditional cardiorespiratory monitoring provides clinically relevant information about perioperative brain state changes in the anesthetized horses. Abstract This study aimed to investigate the use of electroencephalography (EEG) for detecting brain activity changes perioperatively in anesthetized horses subjected to surgery. Twelve adult horses undergoing various surgeries were evaluated after premedication with xylazine and butorphanol, induction with ketamine, midazolam, and guaifenesin, and maintenance with isoflurane. The frontal EEG electrodes were placed after the horse was intubated and mechanically ventilated. The EEG data were collected continuously from Stage (S)1—transition from induction to isoflurane maintenance, S2—during surgery, S3—early recovery before xylazine sedation (0.2 mg kg IV), and S4—recovery after xylazine sedation. The Patient State Index (PSI), (Burst) Suppression Ratio (SR), and 95% Spectral Edge Frequency (SEF95) were compared across the stages. The PSI was lowest in S2 (20.8 ± 2.6) and increased to 30.0 ± 27.7 (p = 0.005) in S3. The SR increased from S1 (5.5 ± 10.7%) to S3 (32.7 ± 33.8%, p = 0.0001). The spectral power analysis showed that S3 had a significantly higher content of delta wave activity (0.1–4 Hz) in the EEG and lower relative power in the 3 Hz to 15 Hz range when compared to S1 and S2. A similar result was observed in S4, but the lower power was in a narrower range, from 3 Hz to 7 Hz, which indicate profound central nervous system depression potentiated by xylazine, despite the cessation of isoflurane anesthesia. We concluded that the use of EEG provides clinically relevant information about perioperative brain state changes of the isoflurane-anesthetized horse.
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Rabbogliatti V, Amari M, Brioschi FA, Di Cesare F, Zani DD, De Zani D, Di Giancamillo M, Cagnardi P, Ravasio G. Use of dexmedetomidine repeated subcutaneous administration for balanced anaesthesia in horses. BMC Vet Res 2022; 18:269. [PMID: 35818051 PMCID: PMC9275161 DOI: 10.1186/s12917-022-03350-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 06/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background A balanced anaesthetic protocol is a common concept in modern veterinary anaesthesia and aims to maintain good intraoperative cardiopulmonary function. In horses, alpha-2-agonists produce sedation and analgesia and have been shown to reduce inhalational anaesthetic requirements when administered intravenously. Furthermore, these drugs can improve recovery quality. Preliminary investigations of subcutaneous dexmedetomidine administration in humans demonstrated a reduced haemodynamic impact if compared with the intravenous route suggesting that dexmedetomidine is adequately absorbed with both administration routes. The aim of the study was to compare two different dexmedetomidine (DEX) administration routes: intravenous constant rate infusion (CRI) versus repeated subcutaneous (SC) injections on cardiopulmonary function and recovery in anaesthetized horses. Results No significant differences between groups in heart rate and systolic arterial pressure were detected. A significantly higher mean and diastolic arterial pressure were detected in the SC group at T25 (p = 0.04; p = 0.02), T75 (p = 0.02; p = 0.009), and T85 (p = 0.001; p = 0.005). In SC group there was a significantly lower dobutamine infusion rate (p = 0.03) and a significantly higher urinary output (p = 0.02). Moreover, recovery quality was higher (p = 0.01). Conclusions Cardiopulmonary effects in both groups were comparable and within clinical ranges with less dobutamine requirement in the subcutaneous group. Recovery was of better quality with fewer attempts in horses receiving subcutaneous dexmedetomidine. The present study suggests that intravenous constant rate infusion and subcutaneous repeated administration of dexmedetomidine at indicated dosage can be useful in balanced anaesthesia without any systemic or local adverse effects; moreover, in healthy horses undergoing general anaesthesia, repeated subcutaneous dexmedetomidine administration may be a suitable alternative if constant rate infusion is not feasible.
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Affiliation(s)
- Vanessa Rabbogliatti
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Martina Amari
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | | | - Federica Di Cesare
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Davide Danilo Zani
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Donatella De Zani
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Mauro Di Giancamillo
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Petra Cagnardi
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy
| | - Giuliano Ravasio
- Department of Veterinary Medicine and Animal Sciences, Università Degli Studi Di Milano, Milan, Italy.
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Lloyd F, Dixon C, Kropf J, Murison P, Bellitto N. Suspected severe post‐anaesthetic myopathy or myelopathy in a Clydesdale horse resulting in euthanasia. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Ffion Lloyd
- School of Veterinary Medicine, University of Glasgow Glasgow UK
| | - Claire Dixon
- Glasgow Equine Hospital, University of Glasgow Glasgow UK
| | - Josephine Kropf
- School of Veterinary Medicine, University of Glasgow Glasgow UK
| | - Pamela Murison
- School of Veterinary Medicine, University of Glasgow Glasgow UK
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d'Anselme O, Robel M, Schwarzwald C, Ringer SK. Anaesthesia management of transvenous implantation of a single‐chamber, rate‐adaptive pacemaker in a donkey with high‐grade second and third degree atrioventricular block. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Olivia d'Anselme
- Section of Anaesthesiology Department of Clinical Diagnostics and Services Vetsuisse Faculty University of Zurich Zurich Switzerland
| | - Matthias Robel
- Clinic for Equine Internal Medicine Equine Department Vetsuisse Faculty University of Zurich Zurich Switzerland
| | - Colin Schwarzwald
- Clinic for Equine Internal Medicine Equine Department Vetsuisse Faculty University of Zurich Zurich Switzerland
| | - Simone Katja Ringer
- Section of Anaesthesiology Department of Clinical Diagnostics and Services Vetsuisse Faculty University of Zurich Zurich Switzerland
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Phillips V, Schauvliege S, Decloedt A, Van Steenkiste G, van Loon G. Anaesthetic management for cardiac 3D electro‐anatomical mapping and radiofrequency catheter ablation in a horse with sustained atrial tachycardia. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Victoria Phillips
- Willows Veterinary Centre and Referral Service Highlands Road Shirley UK
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Stijn Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Annelies Decloedt
- Equine Cardioteam Department of Large Animal Internal Medicine Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Glenn Van Steenkiste
- Equine Cardioteam Department of Large Animal Internal Medicine Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
| | - Gunther van Loon
- Equine Cardioteam Department of Large Animal Internal Medicine Faculty of Veterinary Medicine Ghent University Merelbeke Belgium
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Bennell AJ, Wright RJH, Malalana F, Senior JM. An analysis of risk factors for a fracture or luxation in recovery from general anaesthesia in horses: a single centre study. J Equine Vet Sci 2022; 112:103914. [PMID: 35218904 DOI: 10.1016/j.jevs.2022.103914] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 02/12/2022] [Accepted: 02/18/2022] [Indexed: 11/28/2022]
Abstract
Catastrophic fractures or luxations (FoL) sustained during recovery from general anaesthesia are a significant cause of mortality during equine anaesthesia. There is a lack of evidence regarding potential risk factors for a FoL occurring in the immediate anaesthetic recovery period. A single centre, retrospective, case-matched study was performed to identify risk factors for sustaining a catastrophic FoL during recovery from general anaesthesia. Clinical data were obtained for horses which sustained a catastrophic FoL when recovering from general anaesthesia from January 2011- June 2020 in a single centre referral population. Multivariable logistical regression analysis was performed to identify risk factors which were significant in horses where a FoL occurred. Statistically significant risk factors in our population of horses of sustaining a FoL in recovery included intra-operative administration of intra-tracheal salbutamol, intra-operative administration of ketamine and increasing age. Further research in this area, particularly with regards to salbutamol administration, is required.
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Loomes K, Louro LF. Recovery of horses from general anaesthesia: A systematic review (2000-2020) of the influence of anaesthetic protocol on recovery quality. Equine Vet J 2021; 54:219-261. [PMID: 34668220 DOI: 10.1111/evj.13524] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 09/30/2021] [Indexed: 12/26/2022]
Abstract
BACKGROUND The recovery phase after equine general anaesthesia (GA) is a time of considerable risk and therefore has been the subject of extensive research over the last 20 years. Various pharmacological interventions have been developed and studied with the objective of improving recovery quality and reducing anaesthetic-related mortality and morbidity. Nevertheless, some controversy remains regarding the influence of anaesthetic protocol choice on recovery quality from GA and its implications for recovery-related mortality and morbidity. A systematic review of the literature investigating the influence of anaesthetic protocol choice on recovery quality is currently lacking. OBJECTIVES To perform a detailed evaluation of the equine veterinary literature investigating the effect of anaesthetic protocol choice on equine recovery quality utilising the GRADE framework. STUDY DESIGN A systematic evaluation of the equine veterinary literature was performed using the GRADE framework. METHODS A literature search was performed and studies were assessed for eligibility by both authors utilising PRISMA guidelines. Studies meeting inclusion criteria were evaluated by both authors, categorically summarised and the quality of evidence for each sub-topic was assessed using the GRADE framework. RESULTS A total of 124 studies were identified which directly assessed the impact of anaesthetic protocol choice on recovery quality after GA in horses. Evaluation of the available evidence indicated that certain partial intravenous anaesthesia (PIVA) agents, cessation of intravenous lidocaine 30 minutes prior to recovery and provision of adequate analgesia improves recovery quality. MAIN LIMITATIONS The validity of the results of some studies may have been compromised by missing data and small sample sizes. CONCLUSIONS There is evidence to indicate that certain PIVA agents, cessation of intravenous lidocaine 30 minutes prior to recovery and provision of adequate analgesia improves recovery quality.
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Data Collection for the Fourth Multicentre Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4) Study: New Technology and Preliminary Results. Animals (Basel) 2021; 11:ani11092549. [PMID: 34573515 PMCID: PMC8472153 DOI: 10.3390/ani11092549] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/23/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022] Open
Abstract
Simple Summary New technologies allow researchers to improve the methods for immediate, accurate data collection, cleaning and analysis, with minimal geographical limitations. Although much has improved in the field of equine anaesthesia in recent years, we are still far from reducing anaesthetic-related mortality in this species in comparison with small animal anaesthesia. The aim of this multicentre study was to probe the usefulness of an internet-based method that utilised an electronic questionnaire and statistical software to show the data and report outcomes from horses undergoing general anaesthesia and certain procedures using standing sedation. Within six months, 8656 cases from 69 centres were collected: 6701 procedures under general anaesthesia and 1955 under standing sedation. The results demonstrated (i) the utility of the method and (ii) that some horses died unexpectedly when undergoing not only general anaesthesia, but also standing sedation. Finally, (iii) we present some descriptive data that outline the current anaesthesia practice compared with the previous CEPEF2. We concluded that our internet-based method is suitable for this type of study. New techniques may reduce the mortality rate. However, the results presented here should be interpreted cautiously as these are only preliminary data with lower numbers than CEPEF2. Abstract It is almost 20 years since the largest observational, multicentre study evaluating the risks of mortality associated with general anaesthesia in horses. We proposed an internet-based method to collect data (cleaned and analysed with R) in a multicentre, cohort, observational, analytical, longitudinal and prospective study to evaluate peri-operative equine mortality. The objective was to report the usefulness of the method, illustrated with the preliminary data, including outcomes for horses seven days after undergoing general anaesthesia and certain procedures using standing sedation. Within six months, data from 6701 procedures under general anaesthesia and 1955 standing sedations from 69 centres were collected. The results showed (i) the utility of the method; also, that (ii) the overall mortality rate for general anaesthesia within the seven-day outcome period was 1.0%. In horses undergoing procedures other than exploratory laparotomy for colic (“noncolics”), the rate was lower, 0.6%, and in “colics” it was higher, at 3.4%. For standing sedations, the overall mortality rate was 0.2%. Finally, (iii) we present some descriptive data that demonstrate new developments since the previous CEPEF2. In conclusion, horses clearly still die unexpectedly when undergoing procedures under general anaesthesia or standing sedation. Our method is suitable for case collection for future studies.
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Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis. Animals (Basel) 2021; 11:ani11082440. [PMID: 34438896 PMCID: PMC8388745 DOI: 10.3390/ani11082440] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/11/2021] [Accepted: 08/13/2021] [Indexed: 02/02/2023] Open
Abstract
Simple Summary Recovery from general anaesthesia poses the most critical phase of equine anaesthesia and is the main cause for the relatively high anaesthetic mortality rate compared to other species. It is, therefore, essential to identify anaesthetic protocols that promote safe recoveries. This retrospective study compared the quality of 470 recoveries following general anaesthesia with the anaesthetic gas isoflurane combined with a constant rate infusion of two different alpha-2 adrenergic agonists (xylazine or medetomidine). On the basis of video recordings, recovery quality was scored by two observers unaware of animal details, procedure, or drugs used. Additionally, factors that may affect recovery (e.g., breed, age, procedure, duration of anaesthesia, and intraoperative complications) were taken into consideration. Horses needing higher doses of xylazine to sedate prior to anaesthesia, the intraoperative use of tetrastarch for cardiovascular support, and the use of salbutamol to improve inadequate blood oxygenation during general anaesthesia were related to poorer recovery scores. Whilst recoveries of horses treated with medetomidine took significantly longer compared to xylazine, the attempts to stand and the overall quality of recovery were similar for both groups, indicating that both anaesthetic protocols promote similarly safe recoveries. Abstract Medetomidine partial intravenous anaesthesia (PIVA) has not been compared to xylazine PIVA regarding quality of recovery. This clinical retrospective study compared recoveries following isoflurane anaesthesia balanced with medetomidine or xylazine. The following standard protocol was used: sedation with 7 µg·kg−1 medetomidine or 1.1 mg·kg−1 xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg−1·h−1 medetomidine or 0.7 mg·kg−1·h−1 xylazine, and sedation after anaesthesia with 2 µg·kg−1 medetomidine or 0.3 mg·kg−1 xylazine. Recovery was timed and, using video recordings, numerically scored by two blinded observers. Influence of demographics, procedure, peri-anaesthetic drugs, and intraoperative complications (hypotension, hypoxemia, and tachycardia) on recovery were analysed using regression analysis (p < 0.05). A total of 470 recoveries (medetomidine 279, xylazine 191) were finally included. Following medetomidine, recoveries were significantly longer (median (interquartile range): 57 (43–71) min) than xylazine (43 (32–59) min) (p < 0.001). However, the number of attempts to stand was similar (medetomidine and xylazine: 2 (1–3)). Poorer scores were seen with increased pre-anaesthetic dose of xylazine, intraoperative tetrastarch, or salbutamol. However, use of medetomidine or xylazine did not influence recovery score, concluding that, following medetomidine–isoflurane PIVA, recovery is longer, but of similar quality compared to xylazine.
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Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021; 11:ani11061777. [PMID: 34198637 PMCID: PMC8232193 DOI: 10.3390/ani11061777] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 06/03/2021] [Accepted: 06/08/2021] [Indexed: 12/26/2022] Open
Abstract
Simple Summary Recovery is the most dangerous phase of general anaesthesia in horses. Numerous publications have reported about this phase, but structured reviews that try to reduce the risk of bias of narrative reviews/expert opinions, focussing on the topic are missing. Therefore, the aim of the present article was to publish the first structured review as a summary of the literature focussing on the recovery phase after general anaesthesia in horses. The objective was to summarise the available literature, taking into account the scientific evidence of the individual studies. A structured approach was followed with two experts in the field independently deciding on article inclusion and its level of scientific evidence. A total number of 444 articles, sorted by topics and classified based on their levels of evidence, were finally included into the present summary. The most important findings were summarised and discussed. The present structured review can be used as a compilation of the publications that, to date, focus on the recovery phase after general anaesthesia in adult horses. This type of review tries to minimise the risk of bias inherent to narrative reviews/expert opinions. Abstract Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords “recovery anaesthesia horse”, entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 “narrative reviews/expert opinions”, 16 “retrospective outcome studies”, 5 “surveys”, 59 “premedication/sedation and induction drugs”, 27 “maintenance with inhalant agents”, 55 “maintenance with total intravenous anaesthesia (TIVA)”, 3 “TIVA versus inhalants”, 56 “maintenance with partial intravenous anaesthesia (PIVA)”, 27 “other drugs used during maintenance”, 18 “drugs before/during recovery”, 18 “recovery systems”, 21 “respiratory system in recovery”, 41 “other factors”, 51 “case series/reports” and 6 “systems to score recoveries”. Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.
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Wiederkehr A, Barbarossa A, Ringer SK, Jörger FB, Bryner M, Bettschart-Wolfensberger R. Clinical Randomized Comparison of Medetomidine and Xylazine for Isoflurane Balanced Anesthesia in Horses. Front Vet Sci 2021; 8:603695. [PMID: 33959647 PMCID: PMC8093396 DOI: 10.3389/fvets.2021.603695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 03/22/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: To assess drug plasma levels, preanesthetic sedation, cardiopulmonary effects during anesthesia and recovery in horses anesthetized with isoflurane combined with medetomidine or xylazine. Study design: Prospective blinded randomized clinical study. Animals: Sixty horses undergoing elective surgery. Methods: Thirty minutes after administration of antibiotics, flunixine meglumine or phenylbutazone and acepromazine horses received medetomidine 7 μg kg−1 (group MED) or xylazine 1.1 mg kg−1 (group XYL) slowly intravenously (IV) and sedation was assessed 3 min later. Anesthesia was induced with ketamine/diazepam and maintained with isoflurane in oxygen/air and medetomidine 3.5 μg kg−1 h−1 or xylazine 0.69 mg kg−1 h−1. Ringer's acetate 10 mL kg−1 h−1 and dobutamine were administered to maintain normotension. All horses were mechanically ventilated to maintain end-tidal carbon dioxide pressures at 45 ± 5 mmHg (5.3–6.7 kPa). Heart rate (HR), invasive arterial blood pressures, inspired and expired gas compositions, pH, arterial blood gases, electrolytes, lactate and glucose were measured. For recovery all horses received intramuscular morphine 0.1 mg kg−1 and medetomidine 2 μg kg−1 or xylazine 0.3 mg kg−1 IV. Recovery was timed and scored using three different scoring systems. Plasma samples to measure medetomidine and xylazine concentrations were collected at predetermined timepoints. Repeatedly measured parameters were analyzed using a two-way repeated-measures analysis of variance for differences between groups and over time; p < 0.05 was considered statistically significant. Results: Mean arterial blood pressures (MAP) stayed within normal ranges but were higher (p = 0.011) in group XYL despite significant lower dobutamine doses (p = 0.0003). Other measured parameters were within clinically acceptable ranges. Plasma levels were at steady state during anesthesia (MED 2.194 ± 0.073; XYL 708 ± 18.791 ng mL−1). During recovery lateral recumbency (MED 42.7 ± 2.51; XYL 34.3 ± 2.63 min; p = 0.027) and time to standing (MED 62.0 ± 2.86; XYL 48.8 ± 3.01 min; p = 0.002) were significantly shorter in group XYL compared to group MED. Recovery scores did not differ significantly between groups. Conclusion and Clinical Relevance: In horses anesthetized with isoflurane and medetomidine or xylazine, xylazine maintained higher MAP, reduced the dobutamine consumption and recovery time, whilst overall recovery quality was unaffected.
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Affiliation(s)
- Alexandra Wiederkehr
- Section Anesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Andrea Barbarossa
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Simone K Ringer
- Section Anesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Fabiola B Jörger
- Section Anesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Marco Bryner
- Clinic for Equine Surgery, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Regula Bettschart-Wolfensberger
- Section Anesthesiology, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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15
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Gittel C, Schulz-Kornas E, Sandbaumhüter FA, Theurillat R, Vervuert I, Larenza Menzies MP, Thormann W, Braun C. Pharmacokinetics and pharmacodynamics of l-methadone in isoflurane-anaesthetized and mechanically ventilated ponies. Vet Anaesth Analg 2020; 48:213-222. [PMID: 33423953 DOI: 10.1016/j.vaa.2020.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 04/05/2020] [Accepted: 04/24/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the pharmacokinetics and selected pharmacodynamic effects of a commercially available l-methadone/fenpipramide combination administered to isoflurane anaesthetized ponies. STUDY DESIGN Prospective single-group interventional study. ANIMALS A group of six healthy adult research ponies (four mares, two geldings). METHODS Ponies were sedated with intravenous (IV) detomidine (0.02 mg kg-1) and butorphanol (0.01 mg kg-1) for an unrelated study. Additional IV detomidine (0.004 mg kg-1) was administered 85 minutes later, followed by induction of anaesthesia using IV diazepam (0.05 mg kg-1) and ketamine (2.2 mg kg-1). Anaesthesia was maintained with isoflurane in oxygen. Baseline readings were taken after 15 minutes of stable isoflurane anaesthesia. l-Methadone (0.25 mg kg-1) with fenpipramide (0.0125 mg kg-1) was then administered IV. Selected cardiorespiratory variables were recorded every 10 minutes and compared to baseline using the Wilcoxon signed-rank test. Adverse events were recorded. Arterial plasma samples for analysis of plasma concentrations and pharmacokinetics of l-methadone were collected throughout anaesthesia at predetermined time points. Data are shown as mean ± standard deviation or median and interquartile range (p < 0.05). RESULTS Plasma concentrations of l-methadone showed a rapid initial distribution phase followed by a slower elimination phase which is best described with a two-compartment model. The terminal half-life was 44.3 ± 18.0 minutes, volume of distribution 0.43 ± 0.12 L kg-1 and plasma clearance 7.77 ± 1.98 mL minute-1 kg-1. Mean arterial blood pressure increased from 85 (±16) at baseline to 100 (±26) 10 minutes after l-methadone/fenpipramide administration (p = 0.031). Heart rate remained constant. In two ponies fasciculations occurred at different time points after l-methadone administration. CONCLUSIONS AND CLINICAL RELEVANCE Administration of a l-methadone/fenpipramide combination to isoflurane anaesthetized ponies led to a transient increase in blood pressure without concurrent increases in heart rate. Pharmacokinetics of l-methadone were similar to those reported for conscious horses administered racemic methadone.
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Affiliation(s)
- Claudia Gittel
- Department for Horses, University of Leipzig, Leipzig, Germany; Queen's Veterinary School Hospital, University of Cambridge, Cambridge, UK.
| | - Ellen Schulz-Kornas
- Max Planck Weizmann Center for Integrative Archaeology and Anthropology, Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany
| | - Friederike A Sandbaumhüter
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Regula Theurillat
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Ingrid Vervuert
- Institute of Animal Nutrition, Nutrition Diseases and Dietetics, University of Leipzig, Leipzig, Germany
| | - M Paula Larenza Menzies
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Vetmeduni Vienna, Vienna, Austria
| | - Wolfgang Thormann
- Clinical Pharmacology Laboratory, Institute for Infectious Diseases, University of Bern, Bern, Switzerland
| | - Christina Braun
- Clinical Unit of Anaesthesiology and Perioperative Intensive-Care Medicine, Vetmeduni Vienna, Vienna, Austria
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16
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Morris TB, Lumsden JM, Dunlop CI, Locke V, Sommerauer S, Hurcombe SDA. Clinical Assessment of an Ipsilateral Cervical Spinal Nerve Block for Prosthetic Laryngoplasty in Anesthetized Horses. Front Vet Sci 2020; 7:284. [PMID: 32582775 PMCID: PMC7280443 DOI: 10.3389/fvets.2020.00284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Accepted: 04/27/2020] [Indexed: 12/13/2022] Open
Abstract
The nociceptive blockade of locoregional anesthesia prior to surgical stimulation can decrease anesthetic agent requirement and thereby potential dose-dependent side effects. The use of an ipsilateral second and third cervical spinal nerve locoregional anesthetic block for prosthetic laryngoplasty in the anesthetized horses has yet to be described. Anesthetic records of 20 horses receiving locoregional anesthesia prior to laryngoplasty were reviewed and compared to 20 horses of a similar patient cohort not receiving locoregional anesthesia. Non-blocked horses were 11 times more likely to require adjunct anesthetic treatment during surgical stimulation (P = 0.03) and were 7.4 times more likely to receive partial intravenous anesthesia in addition to inhalant anesthesia (P = 0.01). No horse in the blocked group received additional sedation/analgesia compared to the majority of non-blocked horses (75%) based on the anesthetist's perception of anesthetic quality and early recovery movement. No difference in recovery quality was observed between groups (P > 0.99). Cervical spinal nerve locoregional anesthesia appears well-tolerated and useful in reducing cumulative anesthetic agent requirement and may decrease the need for additional sedation/analgesia in horses undergoing anesthetized prosthetic laryngoplasty.
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Affiliation(s)
- Tate B Morris
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States
| | | | | | | | - Sophia Sommerauer
- Department for Companion Animals and Horses, Equine Clinic, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Samuel D A Hurcombe
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, PA, United States
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17
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Abstract
Lidocaine, as the only local anesthetic approved for intravenous administration in the clinic, can relieve neuropathic pain, hyperalgesia, and complex regional pain syndrome. Intravenous injection of lidocaine during surgery is considered as an effective strategy to control postoperative pain, but the mechanism of its analgesic effect has not been fully elucidated. This paper intends to review recent studies on the mechanism of the analgesic effect of lidocaine. To the end, we conducted an electronic search of the PubMed database. The search period was from 5 years before June 2019. Lidocaine was used as the search term. A total of 659 documents were obtained, we included 17 articles. These articles combined with the 34 articles found by hand searching made up the 51 articles that were ultimately included. We reviewed the analgesic mechanism of lidocaine in the central nervous system.
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Affiliation(s)
- Xi Yang
- Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University
- Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital
| | - Xinchuan Wei
- Department of Anesthesiology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital
| | - Yi Mu
- National Office for Maternal and Child Health Surveillance of China, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qian Li
- Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University
| | - Jin Liu
- Department of Anesthesiology, Translational Neuroscience Center, West China Hospital, Sichuan University
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18
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Mosing M, Senior JM. Maintenance of equine anaesthesia over the last 50 years: Controlled inhalation of volatile anaesthetics and pulmonary ventilation. Equine Vet J 2018; 50:282-291. [DOI: 10.1111/evj.12793] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 11/24/2017] [Indexed: 01/06/2023]
Affiliation(s)
- M. Mosing
- Murdoch University School of Veterinary and Life Sciences; Murdoch Western Australia Australia
| | - J. M. Senior
- Department of Equine Clinical Science; Institute of Veterinary Science; University of Liverpool; Neston Cheshire UK
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19
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Gozalo-Marcilla M, Gasthuys F, Luna SPL, Schauvliege S. Is there a place for dexmedetomidine in equine anaesthesia and analgesia? A systematic review (2005-2017). J Vet Pharmacol Ther 2017; 41:205-217. [PMID: 29226340 DOI: 10.1111/jvp.12474] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 11/17/2017] [Indexed: 12/26/2022]
Abstract
The objective of this review was to perform a literature compilation of all the equine publications that used dexmedetomidine as the first article on this topic was published, in 2005. We also aimed to answer the question whether the use of dexmedetomidine can currently be justified. For that, we compiled information from databases, such as PubMed, Google Scholar and Web of Science and the proceedings of the last veterinary anaesthesiology meetings. Dexmedetomidine is an attractive drug to be used in horses, mainly due to its pharmacokinetic profile and pharmacodynamics that favour its use as intravenous constant rate infusion (CRI). Nowadays, its clinical use is popular for sedation in prolonged standing procedures and during partial intravenous anaesthesia (PIVA) and total intravenous anaesthesia (TIVA). However, legal requirements for its use should be taken into account.
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Affiliation(s)
- M Gozalo-Marcilla
- Department of Veterinary Surgery and Anaesthesiology, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - F Gasthuys
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - S P L Luna
- Department of Veterinary Surgery and Anaesthesiology, School of Veterinary Medicine and Animal Science, São Paulo State University (UNESP), Botucatu, SP, Brazil
| | - S Schauvliege
- Department of Surgery and Anaesthesia of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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20
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Sacks M, Ringer SK, Bischofberger AS, Berchtold SM, Bettschart-Wolfensberger R. Clinical comparison of dexmedetomidine and medetomidine for isoflurane balanced anaesthesia in horses. Vet Anaesth Analg 2017; 44:1128-1138. [PMID: 29037800 DOI: 10.1016/j.vaa.2016.12.061] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 11/29/2016] [Accepted: 12/01/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To compare the effects of two balanced anaesthetic protocols (isoflurane-dexmedetomidine versus medetomidine) on sedation, cardiopulmonary function and recovery in horses. STUDY DESIGN Prospective, blinded, randomized clinical study. ANIMALS Sixty healthy adult warm blood horses undergoing elective surgery. METHODS Thirty horses each were sedated with dexmedetomidine 3.5 μg kg-1 (group DEX) or medetomidine 7 μg kg-1 (group MED) intravenously. After assessing and supplementing sedation if necessary, anaesthesia was induced with ketamine/diazepam and maintained with isoflurane in oxygen/air and dexmedetomidine 1.75 μg kg-1 hour-1 or medetomidine 3.5 μg kg-1 hour-1. Ringer's lactate (7-10 mL kg-1 hour-1) and dobutamine were administered to maintain normotension. Controlled mechanical ventilation maintained end-tidal expired carbon dioxide pressures at 40-50 mmHg (5.3-6.7 kPa). Heart rate, invasive arterial blood pressure, inspired and expired gas composition and arterial blood gases were measured. Dexmedetomidine 1 μg kg-1 or medetomidine 2 μg kg-1 was administered for timed and scored recovery phase. Data were analysed using two-way repeated-measures analysis of variance and chi-square test. Significance was considered when p≤0.05. RESULTS In group DEX, significantly more horses (n=18) did not fulfil the sedation criteria prior to induction and received one or more supplemental doses, whereas in group MED only two horses needed one additional bolus. Median (range) total sedation doses were dexmedetomidine 4 (4-9) μg kg-1 or medetomidine 7 (7-9) μg kg-1. During general anaesthesia, cardiopulmonary parameters did not differ significantly between groups. Recovery scores in group DEX were significantly better than in group MED. CONCLUSIONS AND CLINICAL RELEVANCE Horses administered dexmedetomidine required more than 50% of the medetomidine dose to reach equivalent sedation. During isoflurane anaesthesia, cardiopulmonary function was comparable between the two groups. Recovery scores following dexmedetomidine were better compared to medetomidine.
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Affiliation(s)
- Muriel Sacks
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland.
| | - Simone K Ringer
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Andrea S Bischofberger
- Clinic for Equine Surgery, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Sabrina M Berchtold
- Section of Anaesthesiology, Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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21
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Taffarel MO, Luna SPL, Cardoso GS, de Oliveira FA, Alonso JDM, Gozalo-Marcilla M. Preemptive Analgesia, Including Morphine, Does Not Affect Recovery Quality and Times in Either Pain-Free Horses or Horses Undergoing Orchiectomy. J Equine Vet Sci 2017. [DOI: 10.1016/j.jevs.2016.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Dugdale AHA, Taylor PM. Equine anaesthesia-associated mortality: where are we now? Vet Anaesth Analg 2016; 43:242-55. [PMID: 26970940 DOI: 10.1111/vaa.12372] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 01/12/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To review the literature concerning mortality associated with general anaesthesia in horses and to assess whether there is evidence for a reduction in mortality over the 20 years since the Confidential Enquiry into Perioperative Equine Fatalities (CEPEF). DATABASES USED PubMed, Scopus, Google Scholar. Search terms used: horse; pony; equine; anaesthesia; anesthesia; recovery; morbidity, and mortality. CONCLUSIONS The most recent studies, in which isoflurane and sevoflurane have been more commonly used for anaesthesia maintenance, report fewer intraoperative cardiac arrests than older studies in which halothane was favoured. Catastrophic fractures, however, have become the greatest cause of recovery-associated mortality.
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Affiliation(s)
- Alexandra H A Dugdale
- Faculty of Health and Life Sciences, Institute of Veterinary Science, University of Liverpool, Neston, UK
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Nannarone S, Vuerich M, Moriconi F, Moens Y. Hot Peritoneal Lavage Fluid as a Possible Cause of Vasovagal Reflex During Two Different Surgeries for Bladder Repair in a Foal. J Equine Vet Sci 2016. [DOI: 10.1016/j.jevs.2015.10.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Sleiman M, Dinev D, Simeonovа G. The Effects of Dexmedetomidine Continuous Rate Infusion (CRI) on Isoflurane Anaesthesia in Healthy Horses. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/ijcm.2016.76040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fischer B, Clark-Price S. Anesthesia of the Equine Neonate in Health and Disease. Vet Clin North Am Equine Pract 2015; 31:567-85. [DOI: 10.1016/j.cveq.2015.09.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
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26
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Gozalo-Marcilla M, Gasthuys F, Schauvliege S. Partial intravenous anaesthesia in the horse: a review of intravenous agents used to supplement equine inhalation anaesthesia. Part 2: opioids and alpha-2 adrenoceptor agonists. Vet Anaesth Analg 2015; 42:1-16. [DOI: 10.1111/vaa.12196] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 09/13/2013] [Indexed: 01/04/2023]
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