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Topic:Anesthesia
Anesthesia in horses involves the administration of drugs to induce a temporary loss of sensation or consciousness, facilitating surgical procedures and other medical interventions. This complex process requires a deep understanding of equine physiology and pharmacology to ensure the safety and well-being of the animal. Anesthesia in horses can be challenging due to their size, temperament, and unique anatomical and physiological characteristics. Common anesthetic agents used in equine practice include inhalants like isoflurane and sevoflurane, as well as injectable drugs such as ketamine and xylazine. The management of anesthesia in horses also involves careful monitoring of vital signs and the use of supportive measures to prevent complications such as hypotension, hypoventilation, and post-anesthetic myopathy. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, advancements, and clinical outcomes associated with anesthesia in equine medicine.
Agreement between invasive and oscillometric blood pressure measurements during controlled haemorrhage in anaesthetised horses. Defining the reliability of oscillometry (NIBP) for measuring mean arterial pressure (MAP) during normotension and hypovolaemic hypotension could help with cardiovascular monitoring and management in horses anaesthetised in dorsal recumbency. Objective: To assess agreement between NIBP and invasive MAP during normotension and hypovolaemic hypotension in dorsally-recumbent, anaesthetised horses. Methods: Prospective experimental study using 11 horses. Methods: Under isoflurane anaesthesia, blood was removed at 5 mL/kg bwt increments up to 25 mL/kg bwt and returned in a similar fashion. Pair...
Seizures and blindness onset zone in 7 horses undergoing radiographic myelography in lateral recumbency under inhalation anesthesia. Seizures and blindness are potential complications associated with myelography. Objective: Describe, classify, and determine onset zone of seizures and blindness in horses undergoing radiographic myelography in lateral recumbency. Methods: Seven young adult horses. Methods: Retrospective study. Horses with seizures or blindness associated with myelography were included. Results: Three horses with general proprioceptive ataxia and 4 neurologically normal horses (Warmblood = 4, Thoroughbred = 3), ages 9 (range, 3-16) years old. Iohexol (300 mg I/mL) from 50 to 60 mL (0.09-0.1 mL/kg) were ...
Intraoperative Mechanical Power and Post-Anesthetic Respiratory Outcomes in Horses: A Retrospective Cohort Study. Mechanical power (MP) represents the ventilatory-delivered energy to the respiratory system, integrating multiple variables into a single parameter. It has been linked to ventilator-induced lung injury and post-ventilation complications in human medicine, while clinical relevance in equine anesthesia remains insufficient. Objective: To evaluate the association between intraoperative mechanical power and postoperative respiratory outcomes in horses undergoing inhalant anesthesia. Methods: This retrospective cohort study analyzed anesthesia records from 843 adult horses anesthetized between 2023...
Intraoperative monitoring and anaesthetic complications in horses: A secondary analysis of the CEPEF4 multicentre cohort. CEPEF4 provides the most comprehensive contemporary dataset on perianaesthetic risk in horses. Intraoperative complications, monitoring and American Society of Anesthesiologists (ASA)-stratified associations with death remain incompletely described. Objective: To describe monitoring and complication incidence, assess associations with ASA physical status, and compare ASA-stratified mortality by complication status. Methods: Secondary analysis of a prospective, multicentre cohort study. Methods: Data from 47,371 equine general anaesthetics were analysed. Monitoring was described overall and by ...
[Puncture wounds of the equine hoof – a retrospective study of 96 cases – Part 2: Management and prognosis]. Puncture wounds are a common and potentially life-threatening injury in equine veterinary practice. The aim of this study was to systematically analyze data from horses presenting to the clinic with a puncture wound. Unassigned: A retrospective study was conducted on patient data from horses with a puncture wound in the period from September 2008 to August 2024. Analyzed data included medical management and surgical treatment, complications, duration and costs of hospitalization, short-term survival rate and treatment success. Unassigned: A total of 96 horses met the inclusion criteria. Seven ...
The Effect of Different Extenders and Testicular Anaesthesia During Orchiectomy on Post-Thawed Spermatological Parameters of Stallion Epididymal Spermatozoa. Cryopreservation of epididymal stallion spermatozoa is a valuable tool for fertility preservation, particularly after orchiectomy. However, the potential interactions between local anaesthesia and extender composition on post-thaw spermatozoal quality remain poorly understood. This study investigated the effects of intratesticular lidocaine injection and the efficacy of various extender (egg yolk [EY] vs. lecithin [LC]) and cryoprotectant (glycerol [GLY] vs. dimethyl sulfoxide [DMSO]) combinations on stallion epididymal spermatological parameters. Using a paired factorial design, epididymal s...
Comparison of xylazine-ketamine-guaifenesin and xylazine-tiletamine-zolazepam protocols for constant rate infusion anesthesia in horses undergoing field castration. The common use of "triple drip" (xylazine, ketamine, and guaifenesin; XKG) is a popular protocol for constant rate infusion (CRI) in equine practice. However, due to restrictions on ketamine and guaifenesin in many countries, tiletamine-zolazepam (TZ) could serve as an alternative. To date, there have been limited studies evaluating the use of xylazine in combination with TZ (XTZ) administered via CRI to maintain surgical anesthesia in equine field practice. Objective: To compare the effectiveness and safety of XTZ infusion with the classical XKG protocol for field anesthesia. Methods: Twelve ...
An observational study evaluating the environmental impact of equine arthroscopy. Human pressures on Earth's life‒support systems have exceeded multiple planetary boundaries, highlighting the need for sectors, including veterinary healthcare, to reduce environmental impacts. Methods: A prospective convenience sample of 10 horses undergoing arthroscopy at a UK equine hospital between January and March 2025 was studied. Data were collected on anaesthesia, volatile capture, pharmaceuticals, single-use consumables, waste, building energy and travel by horses and staff. Carbon emissions (kgCOe) were calculated using published conversion factors. A hybrid methodology combined b...
Effect of lingual gauze swab placement and light exclusion on pulse oximeter agreement with arterial haemoglobin-oxygen saturation derived from blood-gas analysis in healthy anaesthetised horses. To compare peripheral arterial haemoglobin-oxygen saturation values obtained using pulse oximetry (SpO) with and without a lingual gauze swab under ambient light and light-exclusion conditions, with arterial haemoglobin-oxygen saturation derived from arterial blood-gas analysis (SaO). Methods: Prospective method-comparison study. Methods: A group of 60 healthy adult horses undergoing elective general anaesthesia. Methods: In American Society of Anesthesiologists (ASA) physical status classification I-II horses, SpO readings were obtained under six conditions during anaesthesia: no swab, no swa...
Hoist failure during recovery transfer in an anaesthetised horse: a near miss analysed through a Safety-II lens. A 660 kg, 11-year-old Irish Sport Horse gelding underwent general anaesthesia for an out-of-hours emergency exploratory laparotomy. After approximately 5 hours of anaesthesia, transfer to the recovery box began, using a ceiling-mounted hoist. As the horse crossed the theatre-recovery interface, the hoist failed due to mechanical disengagement. This resulted in loss of electrical power, leaving the anaesthetised horse suspended approximately 150 cm above the floor for approximately 10 minutes. The horse could not be advanced, reversed, or lowered using standard controls. Activity was paused, an...
USE OF GUAIFENESIN-KETAMINE-XYLAZINE INFUSION FOR MAINTENANCE OF ANESTHESIA IN CAPTIVE PREZEWALSKI HORSES (EQUUS FERUS PRZEWALSKI ): A CASE SERIES. This case series documents the use of triple drip, a combination of IV guaifenesin, ketamine, and xylazine (GKX) to extend the length of anesthesia in zoo-owned Przewalski horses (). In three separate procedures involving two different animals, GKX was used to prolong and deepen the plane of anesthesia for 90 to 120 min beyond an initial induction dart containing ketamine, butorphanol, azaperone, and medetomidine. The depth of anesthesia was sufficient to permit surgical excision of SC abscesses and other procedures. Throughout the anesthetic events, the horses breathed spontaneously and maint...
Effects of flow-controlled expiration on oxygenation and early recovery in horses undergoing general anaesthesia. FLow-controlled EXpiration (FLEX) has been shown to significantly enhance oxygenation in horses under clinical and experimental conditions. Objective: To compare pulmonary gas exchange during early recovery following general anaesthesia in horses ventilated with FLEX compared with conventional intermittent positive pressure ventilation (IPPV) and to assess recovery characteristics between ventilation modes. Methods: Randomised, crossover in vivo experiments. Methods: Six adult horses underwent two 2-h anaesthetic episodes in a randomised crossover design (FLEX vs. IPPV), separated by a two-wee...
Fatalities within seven days after equine standing sedation: A prospective, multicentre study. Information regarding mortality associated with standing procedures in horses is sparse. Objective: To report data from >12,000 standing sedations. Methods: Confidential, observational, prospective, multicentre, cohort study. Methods: We collected records of horses/ponies undergoing standing sedation for surgery or advanced diagnostic imaging using at least one top-up or controlled rate infusion (CRI). Procedures were either NON-COLIC or COLIC. Outcome at seven days was recorded as (i) ALIVE, (ii) EUTHANASIA or (iii) DEAD. Data were collected with a portable document format (PDF) questionn...
Continuous Bluetooth pulse oximetry monitoring in conscious and anesthetized horses: a pilot study. To assess the feasibility, patient tolerance, and accuracy of a wireless Bluetooth pulse oximeter sensor system on horses for an extended period. Unassigned: A prospective, case-control, unblinded study involved 7 horses at risk of hypoxemia and 7 healthy controls. A wireless Bluetooth transmission sensor was attached to their nostril for a prolonged period. Sensor retention time, patient tolerance, and sensor performance in capturing valid monitoring points were recorded. During the monitoring, 4 samples of arterial blood were collected, and paired measurements (SaO2) and estimations (SpO2) o...
Cervical spinal cord compression may affect anesthetic recovery quality and seizure incidence in horses after myelography. To compare anesthetic recovery quality and seizure incidence after cervical myelography in horses with or without cervical spinal cord compression. Unassigned: Anesthesia and medical records from January 2017 to December 2022 of horses anesthetized for myelography were retrieved. Patients with incomplete records, equine protozoal myeloencephalitis diagnosis, or an anesthetic protocol outside an established standard were excluded. Demographic analysis, ataxia score, and anesthetic management variables were recorded in an observational retrospective fashion. Each variable was compared between gr...
Morbidity associated with inhalation anesthesia in horses: the role of opioid use in a university teaching hospital. Despite concerns among equine practitioners, the effects of opioid administration on intraoperative complications during inhalation anesthesia remain incompletely characterized. This retrospective study evaluated intraoperative complications and perianesthetic mortality in horses undergoing inhalation anesthesia according to opioid use. Medical records from a university veterinary hospital were reviewed (2014-2025) and grouped based on opioid inclusion in anesthetic protocols and surgery type (colic vs. non-colic). Intraoperative hypotension (MAP < 70 mmHg), hypothermia (temperature 65 mmH...
Mitigating and addressing complications in equine laparoscopy. The purpose of this article was to report a condensed overview of current strategies for mitigating and managing complications in equine laparoscopic surgery. Minimally invasive surgical techniques have become standard in equine surgery for a variety of diagnostic and therapeutic procedures, with purported advantages including reduced postoperative pain, expedited recovery, fewer incisional complications, and enhanced visual imagery for the surgeon compared to traditional open approaches. Despite these benefits, complications can arise, and the literature demonstrates variability in definition...
Use of Intraperitoneal Lidocaine in Horses Undergoing Laparotomy for Colic. Perioperative lidocaine is widely used in horses with acute abdomen for its analgesic, prokinetic, anti-inflammatory, and anti-endotoxic effects, although evidence of its visceral analgesic efficacy remains inconclusive. Given the potential of alternative routes of administration for local anaesthetics, this prospective, randomised, unblinded clinical trial evaluated whether intraperitoneal (IP) lidocaine improves early postoperative recovery, including recovery from anaesthesia and the first 24 h after laparotomy for colic. A Multifactorial Numerical Rating Composite Pain Scale for equines wa...
A Surgical Technique for Removal of Setaria digitata From the Anterior Chamber Under Standing Sedation: Outcomes in 12 Horses. To describe a rapid surgical technique for removal of the intraocular nematode Setaria digitata from the anterior chamber of horses under standing sedation and to report clinical outcomes. Methods: Twelve client-owned horses (2021-2026) presented with a motile intracameral worm. Methods: All surgeries were performed under field conditions using standing sedation (xylazine 1.1 mg kg and butorphanol 0.1 mg kg IV), regional nerve blocks (lidocaine 2%), and topical anesthesia (proparacaine). A 2.8 mm uniplanar oblique (~45°) corneal incision was created ventrolaterally approximately 2â€...
Novel imaging protocol enables myelography of the cervical vertebral column using computed tomography with flexion and extension comparable to x-ray. Radiographic myelography is the traditional diagnostic method for detecting cervical spinal cord compression in horses but it is limited by superimposition and restriction to sagittal plane imaging. Computed tomography (CT) and CT myelography overcome many of these limitations yet previous CT protocols have not allowed dynamic imaging in flexion and extension comparable to radiographs. Objective: To describe and evaluate a novel CT myelography protocol that enables imaging of the equine cervical vertebral column (C to C/T) in flexion, neutral, and extension, and to compare intervertebral angle...
Dexmedetomidine infusions improve cardiovascular and renal function in anaesthetised, experimentally endotoxaemic horses. Dexmedetomidine infusions are beneficial in anaesthetised endotoxaemic horses when administered concurrent to endotoxin, but post-conditioning effects are unknown. Objective: To evaluate whether a dexmedetomidine infusion is beneficial in horses administered Escherichia coli O55:B5 lipopolysaccharides (LPS) endotoxin prior to anaesthesia. Methods: Randomised controlled in vivo experiment. Methods: Ten systemically healthy horses were instrumented for acquisition of cardiac index (CI) using thermodilution. Horses received IV LPS (0.1 μg/kg bwt) immediately prior to anesthesia. Horses receive...
Historical perspectives guide advances in equine minimally invasive soft tissue surgery. Equine minimally invasive soft tissue surgical techniques have increased in demand and frequency with concurrent expansion of training programs under the oversight of the American College of Veterinary Surgeons. Benefits of recent advances in laparoscopic techniques include reduced cost and risk associated with general anesthesia and anesthetic recovery, improved visualization of the surgical field relative to open procedures, and more rapid return to performance, further improving patient welfare and limiting economic loss to the industry following surgical interventions. The evolution of lap...
Effects of vatinoxan in horses sedated with detomidine and butorphanol for gastroscopy: a randomized clinical study. The peripheral alpha2-adrenoceptor antagonist vatinoxan attenuated the side effects of alpha2-adrenergic sedatives in experimental studies in horses. This clinical study investigated the effects of vatinoxan in horses sedated for gastroscopy with detomidine and butorphanol. Client-owned horses were randomly allocated to receive one of the following two intravenous treatments: detomidine hydrochloride (HCl) (12μg/kg) + butorphanol tartrate (12μg/kg) (DB; n=11) or DB + vatinoxan HCl (200μg/kg) (DBV; n=11). Borborygmi score and heart rate were recorded by auscultation. Sedation level was evalu...
Ultrasound-guided injection of bupivacaine into the cricoarytenoid dorsalis muscle as a novel technique for transiently inducing laryngeal hemiplegia in horses. In clinical research, laryngeal hemiplegia (LH) is induced by temporarily supressing recurrent laryngeal nerve function; however, the technique is challenging. The aim was to develop a novel method to induce LH by injecting bupivacaine directly into the cricoarytenoid dorsalis (CAD) muscle with ultrasound guidance. Unassigned: 5 cadaver larynges and 9 Thoroughbreds with normal laryngeal function. Unassigned: Part 1: A high-frequency (6.5- to 13.0-MHz) linear ultrasound probe was used to inject methylene blue (5 mL) into the CAD of 5 cadaver larynges. Part 2: The left side of the larynges of 9 ...
Pharmacokinetics of 2 mg/kg Bupivacaine in a Rectus Abdominis Sheath Block in Horses. Administering large volumes of bupivacaine in the rectus abdominis sheath (RAS) block in horses could cause local anesthetic toxicity. This study aimed to evaluate the pharmacokinetics of 2 mg/kg bupivacaine in RAS blocks and the associated toxicity risk. Six healthy adult horses were sedated with xylazine and received an ultrasound-guided bilateral 2-point RAS block. Plasma samples were collected at baseline and from 5 min to 24 h after the block and analyzed using liquid chromatography-tandem mass spectrometry. A noncompartmental analysis was performed to determine the maximum concentr...
Nitric oxide and its role in the management of hypoxaemia in the anaesthetised horse-a narrative review. To outline historical aspects of nitric oxide, including its discovery and biological effects, to describe the current use of inhaled nitric oxide (iNO) in human healthcare, and to review the available evidence on the use of pulsed iNO (PiNO) for the management of hypoxaemia in anaesthetised horses. Methods: Google Scholar and PubMed databases were searched using the search terms nitric oxide, PiNO, environment, discovery, acute respiratory distress syndrome, COVID-19, SARS-CoV-2, horse, pony, hypoxaemia, and anaesthesia. Conclusions: Inhaled NO is licensed in the management of hypoxic respira...
Preliminary Investigation of a Transcutaneous Ultrasound-Guided Technique for Pudendal Nerve Block in Six Horse Cadavers. Regional anaesthesia of the equine anogenital tract is limited to local infiltration, extradural, blind palpation and nerve stimulator-guided techniques which risk iatrogenic damage, recumbency and ataxia. This study aimed to describe and assess the feasibility of transcutaneous ultrasound-guided (USG) pudendal nerve staining in equine cadavers. An initial pilot phase used two fresh equine cadavers and one standing unsedated horse to image the intrapelvic anatomy using ultrasound. One fixed equine cadaver specimen was also dissected to identify the pudendal nerve and refine the dissection appr...
Ultrasound-guided intralesional tendon and ligament injections in the horse. To describe principles of ultrasound-guided injection techniques for intralesional delivery of regenerative orthobiologics into equine tendon and ligament core lesions. Unassigned: A university-owned horse and equine cadaver forelimbs. Unassigned: A reproducible protocol for ultrasound-guided injection is demonstrated with the superficial digital flexor tendon used as an example. Following diagnosis of the lesion, the horse should be sedated and the affected limb desensitized with perineural anesthesia. The lesion is identified ultrasonographically in transverse and longitudinal planes, marked...
Equine lameness detection and monitoring during diagnostic anaesthesia with an instrumented hoof boot. Ground reaction forces are accepted as gold standard for objective assessment of weightbearing lameness but measurements at the hoof are limited to experimental devices. This study aimed to evaluate whether innovative instrumented hoof boots (IHBs) could detect and monitor lameness in horses during diagnostic anaesthesia. Twenty-six horses referred for lameness examination (15 front limbs, 17 hindlimbs) were equipped with IHBs and body mounted inertial sensors. Data were collected simultaneously before and after diagnostic anaesthesia until objectively considered positive. Recorded IHB data i...
