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.
Effects of xylazine and adrenaline combinations: Preliminary clinical application for non-surgical protocols of nephrosplenic entrapment in horses. The medical treatment of horses with nephrosplenic entrapment (NSE) of the large colon through administrating phenylephrine and rolling during general anesthesia was effective and less expensive than surgical treatment. However, the selection of drugs for non-surgical treatment of NSE is not a usual method for clinical practice. This study aimed to identify the effects of combined drugs on the cardiac and splenic response in horses and provide information on the NSE of the large colon for clinical application. Methods: Six healthy Thai native crossbred horses were enrolled in this study. Horse...
Comparison of two doses of ketamine for induction of anaesthesia in ponies undergoing field castration. Ketamine-based total intravenous anaesthesia techniques are commonly used in equine practice for ponies requiring short procedures such as castration in field conditions. When a longer duration of recumbency than provided by the initial dose of anaesthetic agents is required, administration of supplementary 'top-up' doses of anaesthetic agents is required. Ideally, a single dose of anaesthetic agents would reliably achieve a longer duration of action whilst maintaining adequate anaesthetic, surgical and recovery qualities. Objective: This prospective, randomised and blinded study aimed to comp...
Continuous measurement of arterial oxygenation in mechanically ventilated horses. The possibility of accurately and continuously measuring arterial oxygen partial pressure (PaO2 ) in horses may facilitate the management of hypoxaemia during general anaesthesia. Objective: The aim of this study was to evaluate the ability of a novel fibreoptic sensor to measure PaO2 (PaO2Sensor ) continuously and in real time in horses undergoing ventilatory manoeuvres during general anaesthesia. Methods: In vivo experimental study. Methods: Six adult healthy horses were anaesthetised and mechanically ventilated in dorsal recumbency. A fibreoptic sensor was placed in one of the facial arteri...
Risk factors associated with hypoxaemia in horses undergoing general anaesthesia: A retrospective study. Hypoxaemia is a common concern during equine general anaesthesia. The prevalence and predictors of hypoxaemia in horses undergoing elective anaesthesia in particular are poorly documented. Objective: To determine and compare the prevalence of hypoxaemia (defined as PaO2 ≤ 80 mm Hg, on the lowest value recorded) in horses undergoing anaesthesia for exploratory laparotomy and elective procedures, and to identify risk factors in both subpopulations. Methods: Retrospective cohort study. Methods: Data were collected from 774 records of 708 horses undergoing general anaesthesia between April 2...
Dexmedetomidine prolongs the duration of action of mepivacaine on anesthesia of the palmar digital nerves of horses. To determine whether palmar digital nerve (PDN) blockade in horses with a combination of dexmedetomidine and mepivacaine would block the response to mechanical force applied to the digit longer than would anesthetizing these nerves with mepivacaine alone or dexmedetomidine alone. Methods: 8 mares with no signs of lameness. Methods: In a randomized, crossover, blinded, experimental study, both PDNs of the same forelimb of each horse were anesthetized by perineural injection with either 30 mg mepivacaine alone, 250 µg of dexmedetomidine alone, or 30 mg mepivacaine combined with 250 µg of dexme...
Development of a method to measure regional perfusion of the lung in anesthetized ponies using computed tomography angiography and the maximum slope model. To develop a method based on CT angiography and the maximum slope model (MSM) to measure regional lung perfusion in anesthetized ponies. Methods: 6 ponies. Methods: Anesthetized ponies were positioned in dorsal recumbency in the CT gantry. Contrast was injected, and the lungs were imaged while ponies were breathing spontaneously and while they were mechanically ventilated. Two observers delineated regions of interest in aerated and atelectatic lung, and perfusion in those regions was calculated with the MSM. Measurements obtained with a computerized method were compared with manual measurement...
Suspected vagal reflex and hyperkalaemia inducing asystole in an anaesthetised horse. A 10-year-old 466 kg mustang gelding presented to an equine referral hospital for surgical repair of nasal, frontal and lacrimal bone fractures from an unknown trauma. Surgical repair was performed under general anaesthesia, including a right-sided maxillary regional anaesthetic block with mepivacaine hydrochloride. Progressive hyperkalaemia was documented perianaesthetically (T-3 mins; 134 mins after induction; potassium 6.4 mmol/L (ref 3.5-5.1 mmol/L). Perianaesthetic bradycardia was attributed to alpha -2 agonist infusion administration, and other characteristic ECG changes (flattened ...
Application of locking compression plates as type 1 external fixators to treat unilateral mandibular fractures in four equids and one dromedary. To describe a novel fixation of open, unstable, unilateral mandibular fractures applying a locking compression plate as an external skeletal fixator (ESF-LCP). Methods: Four horses and one dromedary. Methods: Short case series. Methods: Animals presented with unstable, open, unilateral fractures of the mandible. Fracture fixation was performed under general anesthesia. A 4.5/5.5 narrow LCP was applied externally above the level of the skin and combined with intraoral tension band wiring. Results: Fracture fixation was achieved successfully using an ESF-LCP. Minimal tissue manipulation was requ...
Recovery of horses from general anaesthesia: A systematic review (2000-2020) of the influence of anaesthetic protocol on recovery quality. 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 influenc...
Cervical Epidural Spinal Analgesia for Acute Management of Severe Unilateral Forelimb Lameness: Case Report. A 20-year-old Quarter Horse gelding was presented with severe right forelimb lameness (5/5 AAEP Lameness Scale) due to a tear of the superficial digital flexor muscle which was diagnosed via palpation of swelling and ultrasonography revealing major muscle fiber disruption and hematoma formation. When traditional systemic therapy (non-Steroidal anti-inflammatories) did not restore clinically acceptable comfort and the risk of supporting limb laminitis became a reasonable concern, a cervical epidural catheter was placed between the first and second cervical vertebrae in the standing, sedated pat...
Retrospective study of the prevalence of factors contributing to successful standing at first attempt in horses recovering from general anesthesia. Several factors affect the quality of recovery from general anesthesia in horses. These can increase the likelihood of injury. Body and limb position during recovery may correlate with successful standing. The objective of this study was to identify the prevalence of and the factors associated with successful standing at the first attempt in horses undergoing general anesthesia. Methods: Retrospective study. Methods: Video of recovery and anesthetic records from 221 equine patients were reviewed by six veterinary students. Cases with poor video quality or incomplete anesthetic records were exc...
Comparison of image quality of corneal and retinal optical coherence tomography using sedation and general anesthesia protocols with or without retrobulbar anesthesia in horses. To compare image quality and acquisition time of corneal and retinal spectral domain optical coherence tomography (SD-OCT) under 3 different sedation-anesthesia conditions in horses. Methods: 6 middle-aged geldings free of ocular disease. Methods: 1 randomly selected eye of each horse was evaluated via SD-OCT under the following 3 conditions: standing sedation without retrobulbar anesthetic block (RB), standing sedation with RB, and general anesthesia with RB. Five regions of interest were evaluated in the cornea (axial and 12, 3, 6, and 9 o'clock positions) and fundus (optic nerve head). Thre...
Comparison of single-breath continuous positive airway pressure manoeuvre with inhaled salbutamol to improve oxygenation in horses anaesthetized for laparotomy. To compare the efficacy of single-breath continuous positive airway pressure manoeuvre (CPAP-M) with inhaled salbutamol, and a combination of both. Methods: Randomized, clinical study. Methods: A total of 62 client-owned horses (American Society of Anesthesiologists status III-V) anaesthetized for laparotomy. Methods: Horses were premedicated with intravenous (IV) xylazine (0.4-0.6 mg kg), anaesthesia was induced with midazolam (0.06 mg kg IV) and ketamine (2.2 mg kg IV) and maintained with isoflurane in oxygen using volume-controlled ventilation without positive end-expiratory pressure. If Pa...
Head and tail rope-assisted recovery improves quality of recovery from general anaesthesia in horses undergoing emergency exploratory laparotomy. In equine anaesthesia, the recovery period is critical, accounting for most anaesthesia-related fatalities reported. Horses may recover unassisted or may be assisted, for example, using a head and tail rope recovery method. Objective: To compare the impact of head and tail rope and unassisted recovery method on quality of recovery in horses undergoing colic surgery under general anaesthesia (GA). Methods: Single centre retrospective cross-sectional study, with prospective model performance analysis. Methods: Clinical data were obtained from horses undergoing emergency exploratory laparotomy ov...
Recovery of horses from general anaesthesia: A systematic review (2000-2020) of risk factors and influence of interventions during the recovery period. In equine anaesthesia, the recovery period is a time of considerable risk and has been the focus of prolific research. Risk factors, including age, type and duration of procedure or temperament may influence recovery quality. Unfortunately, the anaesthetist is unable to control for these factors, therefore various pharmacological interventions and recovery methods have been developed with the objective of improving recovery quality. However, no consensus among anaesthetists has been reached for many of these interventions and their implications for recovery-related mortality and morbidity. Obj...
Effect of Fentanyl Infusion on Heart Rate Variability and Anaesthetic Requirements in Isoflurane-Anaesthetized Horses. Controversy continues to surround the use of opioids in equine anaesthesia, with variable effects reported. This blinded clinical study aimed to investigate the influence of a low-dose fentanyl continuous rate infusion (CRI) on isoflurane requirements, parasympathetic tone activity (PTA), and anaesthetic parameters in horses during general anaesthesia. All of the twenty-two horses included in the research underwent a standard anaesthetic protocol. Eleven horses in the fentanyl group (Group F) received a loading dose of fentanyl at 6 µg/kg, followed by a CRI of 0.1 µg/kg/min during anaesthesi...
Standing flank laparotomy for colic: 37 cases. Standing flank laparotomy can be an alternative to ventral midline laparotomy in horses with colic. Standing flank laparotomy avoids general anaesthesia, provides excellent access to some regions of the abdominopelvic cavity and costs less than ventral midline laparotomy. Objective: To report a series of cases of peritoneal and intestinal diseases other than SC diseases managed with standing flank laparotomy. Methods: Retrospective case series. Methods: Records from equids with colic subjected to standing flank laparotomy at five hospitals (2003-2020) were reviewed. Descriptive data analysis w...
Cardiopulmonary effects and recovery characteristics associated with 2 sedative protocols for assisted ventilation in healthy neonatal foals. Neonatal foals may require prolonged sedation to permit ventilatory support in the first few days of life. The objective of this study was to evaluate and compare the cardiopulmonary effects and clinical recovery characteristics of 2 sedative/analgesia protocols in healthy foals receiving assisted ventilation. Foals were randomized to receive dexmedetomidine, butorphanol, and propofol (DBP) or midazolam, butorphanol, and propofol (MBP) during a 24-hour period. Infusion rates of dexmedetomidine, midazolam, and propofol were adjusted and propofol boluses administered according to set protocols t...
Minimally invasive cranial ostectomy for the treatment of impinging dorsal spinous processes in 102 standing horses. To describe a minimally invasive cranial ostectomy for the treatment of impingement of dorsal spinous processes (DSPs) in the standing horse. Methods: Retrospective study. Methods: One hundred two horses with impinging DSPs. Methods: The case records of all horses that had the described technique between 2011 and 2019 were reviewed. All sites of impinging DSPs were treated under standing sedation and local anesthesia. The minimally invasive cranial ostectomy of the caudal DSP was performed with bone rongeurs through multiple small incisions. Results: Of the 102 horses treated with this techniq...
Effect of thermodilution injectate volume and temperature on the accuracy and precision of cardiac output measurements for healthy anesthetized horses. To compare the accuracy and precision of cardiac output (CO) measurements derived from 4 thermodilution protocols that used different injectate temperatures and volumes in healthy adult horses. Methods: 8 healthy adult horses. Methods: Horses were anesthetized and instrumented with Swan-Ganz catheters. The CO was derived from each of 4 thermodilution protocols (IV injection of physiologic saline [0.9% NaCl] solution chilled to < 5 °C at volumes of 1 mL/15 kg of body weight [protocol A; control], 1 mL/25 kg [protocol B], and 1 mL/35 kg [protocol C] or maintained at 17 °C at a volume of 1 m...
Measurement of Tissue Oximetry in Standing Unsedated and Sedated Horses. Near infrared spectroscopy (NIRS) noninvasively measures peripheral tissue oxygen saturation (StO) and may be useful to detect early changes in StO in anaesthetized and critically ill horses. This study aimed to identify the muscle belly that provided the highest percentage of successful StO readings and the highest mean StO value. Fifty adult horses were enrolled in a prospective controlled study. StO was measured at six different muscles in each horse, for each intervention: hair overlying the muscle was clipped (post clipping: PC), clipped skin was cleaned with chlorhexidine (post-surgical ...
Impact of endotracheal tube size and cuff pressure on tracheal and laryngeal mucosa of adult horses. To assess the effects of two sizes of silicone endotracheal tubes with internal diameter 26 mm (ETT) and 30 mm (ETT) inflated to minimum occlusive volume on tracheal and laryngeal mucosa of adult horses anesthetized for 2 hours with isoflurane. Methods: Prospective, randomized, blinded, crossover experimental study. Methods: A total of eight healthy adult mares. Methods: Upper airway endoscopy and ultrasound measurements of internal tracheal diameter were performed the day before anesthesia. Horses were anesthetized and orotracheally intubated with ETT or ETT. Ease of intubation was scored. Th...
Accuracy and trending capability of haemoglobin measurement by noninvasive pulse co-oximetry in anaesthetized horses. To assess the accuracy and trending capability of continuous measurement of haemoglobin concentration [Hb], haemoglobin oxygen saturation (SaO) and oxygen content (CaO) measured by the Masimo Radical-7 pulse co-oximeter in horses undergoing inhalational anaesthesia. Methods: Prospective observational clinical study. Methods: A group of 23 anaesthetized adult horses. Methods: In 23 healthy adult horses undergoing elective surgical procedures, paired measurements of pulse co-oximetry-based haemoglobin concentration (SpHb), SaO (SpO), and CaO (SpOC) and simultaneous arterial blood samples were co...
The effects of xylazine or detomidine when used as a pre-anesthetic sedative on recovery quality and duration in horses undergoing elective equine castration. The purpose of this prospective, blinded, randomized clinical trial was to compare the effects of low dose detomidine to xylazine on recovery quality and duration in a castration procedure. Horses were administered either detomidine [0.015 mg/kg body weight (BW)] or xylazine (1.1 mg/kg BW) intravenously (IV) before IV induction with ketamine (2.2 mg/kg BW) and diazepam (0.05 mg/kg BW). Two anesthesiologists who were unaware of treatment allocation scored the recoveries using a simple descriptive scale (with a low number representing the most desirable recovery) and recoveries were timed. Horse...
Evaluation of noninvasive blood pressure in anesthetized horses: Bias, limits of agreement, and comparative detection of a predetermined mean blood pressure warranting treatment. Oscillometric blood pressure monitoring may be a practical tool for short procedures or those performed outside of the operating room. Oscillometric and direct blood pressure values in 30 juvenile and adult horses in a clinical setting using mixed effect models were compared. The limits of agreement and percentage errors were also calculated. We evaluated the sensitivity and false positive rate for the oscillometric method to trigger an intervention for treating blood pressure [direct mean arterial pressure (MAP) < 70 mmHg]. Oscillometric MAP and diastolic arterial pressure (DAP) differed f...
Demographic, preoperative and anaesthesia-related risk factors for unsatisfactory recovery quality in horses undergoing emergency abdominal surgery. To determine demographic, preoperative and anaesthesia-related variables that may be associated with unsatisfactory recovery quality in horses undergoing emergency abdominal surgery (colic) in an equine teaching hospital. Methods: Retrospective case series. Methods: A total of 313 horses. Methods: The anaesthetic records of horses admitted for surgical treatment of colic between 2005 and 2018 were examined. Overall quality of recovery was assessed as dangerous, poor, fair, good or excellent. The following categories were constructed as a dichotomic variable: unsatisfactory recovery (poor and d...
Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction. While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the ...
Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis. 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 medetomidine or 1.1 mg·kg xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg·h medetomidine or 0.7 mg·kg·h xylazine, and sedation after anaesthesia with 2 µg·kg medetomidine or 0.3 mg·kg xylazine. Recovery was timed and, using vi...
Diagnostic and Treatment Challenges for Diaphragmatic Hernia in Equids: A Concise Review of Literature. Diaphragmatic hernia (DH) represents an acute abdominal crisis, but respiratory symptoms may be occurring. Different types of diaphragmatic hernias (DHs) like typical DH, Morgagni hernia, hiatal hernia and diaphragmatic diverticulum have been recorded in equids. These DHs have various clinical presentations and prognoses. Early diagnosis and prompt surgical repair are highly recommended in order to diminish the ischemic changes to thoracic and abdominal viscera, thus improving the overall prognosis of equids with DH. Over last decade, the prognosis of DH in equids was better than previously be...
Neuromuscular blockade with atracurium for ophthalmic surgery in horses-Effects on surgical and anesthetic characteristics and recovery quality. To study the surgical, anesthetic and recovery qualities of horses receiving either a neuromuscular blocking agent (atracurium) or intravenous lidocaine (treatment groups A and L, respectively). Methods: A total of thirty horses presented for ocular surgery were used in this study. Methods: Horses were randomly assigned to receive either atracurium (group A) or a lidocaine constant rate infusion (group L). Surgical quality was graded on a scale from 1 (excellent)-5 (poor). While anesthetized, the heart rate, oxygen saturation and mean arterial blood pressure, and end-expiratory carbon dioxide ...