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.
Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse. Horses are susceptible to developing large areas of pulmonary atelectasis during recumbency and anesthesia. The subsequent pulmonary shunt is responsible for significant impairment of oxygenation. Since ventilation perfusion mismatch persists into the post-operative period, hypoxemia remains an important concern in the recovery stall. This case report describes the diagnosis and supportive therapy of persistent hypoxemia in a 914 kg draft horse after isoflurane anesthesia. It highlights how challenging it can be to deal with hypoxemia after disconnection from the anesthesia machine and how lif...
Efficacy of an alveolar recruitment maneuver for improving gas exchange and pulmonary mechanics in anesthetized horses ventilated with oxygen or a helium-oxygen mixture. OBJECTIVE To evaluate efficacy of an alveolar recruitment maneuver (ARM) with positive end-expiratory pressures (PEEPs) in anesthetized horses ventilated with oxygen or heliox (70% helium and 30% oxygen). ANIMALS 6 healthy adult horses. PROCEDURES In a randomized crossover study, horses were anesthetized and positioned in dorsal recumbency. Volume-controlled ventilation was performed with heliox or oxygen (fraction of inspired oxygen [Fio] > 90%). Sixty minutes after mechanical ventilation commenced, an ARM with PEEP (0 to 30 cm HO in steps of 5 cm HO every 5 minutes, followed by incremental s...
Comparison of oxidative stress under different propofol administration protocols in Thoroughbred racehorses by bOS and bAP assessment. It is desirable to reduce surgery-induced oxidative stress (OS) because it can cause immune suppression and delayed wound healing. Propofol is known to have antioxidant potential and to reduce OS in humans, but there have been no studies of this issue in horses. This study was conducted to evaluate OS under three different propofol administration protocols in Thoroughbred racehorses undergoing arthroscopic surgery with sevoflurane anesthesia. Blood oxidative stress (bOS) and blood antioxidant power (bAP) were used as OS biomarkers. Both bOS and bAP significantly decreased after surgery in all ...
How to score sedation and adjust the administration rate of sedatives in horses: a literature review and introduction of the Ghent Sedation Algorithm. To summarize the different methods used to assess sedation and/or adjust the dose or administration rate of alpha-2 agonists in horses and to propose an algorithm to adjust the administration rate of a constant rate infusion of an alpha-2 agonist in horses. Methods: PubMed and Web of Science; search terms: horse, sedation and score. Conclusions: Most authors distinguish between sedation depth, sedation quality and degree of ataxia. These three features are evaluated using scoring systems similar to those classically used to assess pain, i.e. simple descriptive scales, numerical rating scales (...
Minimally invasive, compartmentalized, modified open castration technique with primary closure in equids. OBJECTIVE To describe use of a modified open castration technique with a scrotal approach and primary closure in equids. DESIGN Prospective case series. ANIMALS 38 client-owned, sexually intact male equids. PROCEDURES With owner consent, elective castration was performed with a modified open technique on patients (1 pony, 1 miniature horse, and 36 horses of other breeds) under general anesthesia. The procedure included minimal dissection into the scrotal region for removal of testes, with cremaster muscles left intact and the parietal vaginal tunic closed in place. Primary closure of surgical ...
Colon constipation in horses after sustained-release buprenorphine administration. To investigate the pharmacological profile and side effects of buprenorphine administered as a sustained-release formulation in horses. Methods: Pilot trial. Methods: A total of four experimental horses, aged 18-27 years and weighing 508-578 kg. Methods: Buprenorphine (0.1 mg kg) was mixed as a freshly prepared sterile solution with a sustained-release drug carrier. It was administered by the subcutaneous (n = 2) or intramuscular (n = 2) route. During the experiment, the horses were closely monitored, equipped with a step counter and blood samples were collected for quantification of bup...
Effect of topical application of 0.5% proparacaine on corneal culture results from 33 dogs, 12 cats, and 19 horses with spontaneously arising ulcerative keratitis. To investigate the effect of topically applied proparacaine on bacterial and fungal culture results and to compare cytologic and culture results in patients with ulcerative keratitis. Methods: Corneal samples were collected from 33 dogs, 19 horses, and 12 cats with spontaneously arising ulcerative keratitis. Samples for bacterial (dogs, cats, horses) and fungal (horses) cultures were collected prior to and following application of 0.5% proparacaine or saline. All patients then received a topical anesthetic, and samples were collected for cytology. Frequency of cultivatable bacteria before (Swa...
Effects of 12 and 17 cmH2O positive end-expiratory pressure applied after alveolar recruitment maneuver on pulmonary gas exchange and compliance in isoflurane-anesthetized horses. To compare static compliance (C) and alveolar-arterial oxygen tension difference [P(a-a)O] between positive end-expiratory pressures (PEEP) of 7, 12 and 17 cmHO applied after an alveolar recruitment maneuver (RM) in isoflurane-anesthetized horses. Methods: Prospective, randomized, clinical study. Methods: A group of 30 healthy adult horses undergoing arthroscopic surgery. Methods: Animals in dorsal recumbency and mechanically ventilated with a tidal volume of 14 mL kg and 7 cmHO PEEP (control; n = 6) were subjected to an RM by increasing PEEP from 7 to 22 cmHO in 5 cmHO increments at 5 minute...
Clinical evaluation of constant rate infusion of alfaxalone-medetomidine combined with sevoflurane anesthesia in Thoroughbred racehorses undergoing arthroscopic surgery. Alfaxalone has a number of pharmacological properties which are desirable for constant rate infusion (CRI). Previously, the co-administration of alfaxalone and medetomidine is shown to be suitable for short-term anesthesia in horses. However, the use of alfaxalone-medetomidine CRI with inhalational anesthesia under surgical procedures have not been investigated in clinical cases. The aim of the present study was to evaluate the clinical efficacy of alfaxalone-medetomidine CRI in sevoflurane-anesthetized Thoroughbred racehorses undergoing arthroscopic surgery. Sevoflurane requirement, cardiovas...
Influence of changing lateral recumbency and mode of ventilation on the alveolar-arterial oxygen tension gradient and selected laboratory analytes in adult isoflurane anesthetized horses. This study investigated the influence of changing recumbency and mode of ventilation over repeated anesthesias on the alveolar to arterial oxygen tension gradient (PO) and laboratory analytes in eight horses during a year-long imaging study. Anesthesia was induced with xylazine, diazepam or guaifenesin, and ketamine and maintained with isoflurane. Horses were positioned in right or left lateral recumbency for computed tomography. Ventilation was controlled during 47% of the anesthetics. Blood was sampled from an arterial catheter prior to (30 ± 5 min from connection to anesthetic circuit), wi...
Monitoring of tidal ventilation by electrical impedance tomography in anaesthetised horses. Electrical impedance tomography (EIT) is a method to measure regional impedance changes within the thorax. The total tidal impedance variation has been used to measure changes in tidal volumes in pigs, dogs and men. Objective: To assess the ability of EIT to quantify changes in tidal volume in anaesthetised mechanically ventilated horses. Methods: In vivo experimental study. Methods: Six horses (mean ± s.d.: age 11.5 ± 7.5 years and body weight 491 ± 40 kg) were anaesthetised using isoflurane in oxygen. The lungs were mechanically ventilated using a volume-controlled mode. With an end-tidal...
Cardiopulmonary effects and recovery characteristics of horses anesthetized with xylazine-ketamine with midazolam or propofol. To evaluate cardiopulmonary and recovery characteristics of horses administered total intravenous anesthesia (TIVA) with xylazine and ketamine combined with midazolam or propofol. Methods: Randomized crossover study. Methods: A group of eight adult horses, aged 7-22 years, weighing 493-740 kg. Methods: Horses were administered xylazine (1 mg kg) intravenously (IV), and anesthesia was induced with ketamine (2.2 mg kg) IV. Anesthesia was maintained for 45 minutes via IV infusion of xylazine (0.016 mg kg minute) and ketamine (0.03 mg kg minute) combined with midazolam at 0.002 mg kg minute (MKX),...
The use of cerclage wire for surgical repair of unilateral rostral mandibular fracture in horses. Fractures of the rostral mandible in horses are the most common type of jaw fractures. The present study was performed for stabilization of rostral mandibular fracture with cerclage wire. In a retrospective case series, six client-owned horses with unilateral mandibular fractures were admitted to our clinic and suffered from a major gingival wound at rostral part of mandible. Rostral mandibular fracture was diagnosed through clinical examination and radiography. Fractured region was repaired by cerclage wire under the effect of general anesthesia and wires were maintained for 6-12 weeks. The r...
Comparison of complication rates following elective arthroscopy performed as inpatient versus outpatient surgery in horses. OBJECTIVE To report complication rates following elective arthroscopy in horses and determine whether postoperative complication rates are higher for outpatient procedures, compared with inpatient procedures. DESIGN Retrospective cohort study. ANIMALS 357 client-owned horses that had undergone 366 elective arthroscopic procedures between January 2008 and February 2015. PROCEDURES Medical records were retrospectively reviewed. Data collected included signalment, travel time to the hospital, clinical signs, joints treated, lesions diagnosed, medications administered, anesthesia and surgery times...
Impact of Trendelenburg (head down) and reverse Trendelenburg (head up) position on respiratory and cardiovascular function in anaesthetized horses. To describe the cardiorespiratory effects of a change in table position in anaesthetized horses. Methods: Prospective, crossover, randomized, experimental study. Methods: Six adult horses (mean body weight 621 ± 59 kg, aged 13 ± 4 years). Methods: The horses were anaesthetized twice in dorsal recumbency. They were either placed in the Trendelenburg position (head down; HD) followed by reverse Trendelenburg position (head up; HU) or in reverse order. Every position was maintained for 90 minutes. The order of positions was randomly assigned at initial anaesthesia. Extensive cardiorespiratory m...
Recovery of horses from general anesthesia after induction with propofol and ketamine versus midazolam and ketamine. OBJECTIVE To evaluate quality of recovery from general anesthesia in horses after induction with propofol and ketamine versus midazolam and ketamine. DESIGN Prospective randomized crossover study. ANIMALS 6 healthy adult horses. PROCEDURES Horses were premedicated with xylazine (1.0 mg/kg [0.45 mg/lb], IV), and general anesthesia was induced with midazolam (0.1 mg/kg [0.045 mg/lb], IV) or propofol (0.5 mg/kg [0.23 mg/lb], IV), followed by ketamine (3.0 mg/kg [1.36 mg/lb], IV). Horses were endotracheally intubated, and anesthesia was maintained with isoflurane. After 60 minutes, horses were giv...
Total intravenous anesthesia using a midazolam-ketamine-xylazine infusion in horses: 46 cases (2011-2014). This study evaluated use of midazolam, ketamine, and xylazine (MKX) for total intravenous (IV) anesthesia (TIVA) in horses. Medical records of 46 horses undergoing a clinical procedure using MKX for TIVA were reviewed. Age, breed, procedure, heart rate (HR), respiratory rate (RR), pre-anesthetic drugs, induction drugs, and total volume of MKX were recorded. Duration of anesthesia, time to standing, number of attempts to stand, and recovery score were also recorded. All horses were premedicated with an alpha-2 adrenoceptor agonist and anesthesia was induced with ketamine and midazolam. Duration...
Advanced Atrio-Ventricular Blocks in a Foal Undergoing Surgical Bladder Repair: First Step to Cardiac Arrest? A 3-day-old Swiss Warmblood colt was diagnosed with uroabdomen after urinary bladder rupture. The foal had classical electrolyte abnormalities (hyponatremia, hypochloremia and hyperkalemia) on presentation. The foal was supported prior to surgery with intravenous fluids and the electrolyte abnormalities were treated with physiologic saline, glucose and insulin. Urine could not be drained from the abdomen prior to surgery because the omentum was continuously occluding the drainage cannula and due to progressive abdominal distension, it was decided to pursue surgery without further correction of...
Effects of hetastarch 130/0.4 on plasma osmolality, colloid osmotic pressure and total protein in horses anaesthetised for elective surgical procedures. Effects of lactated Ringer's solution (LRS) and hetastarch 130/0.4 (HES) on colloid osmotic pressure (COP), plasma osmolality (OSM) and total protein (TP) were investigated in 18 inhalational-anaesthetised healthy horses. Horses received 4-6 ml/kg LRS (LRS; n=9) or HES (HES; n=9) from anaesthesia induction through 60 min, after which all were administered LRS. COP, TP and OSM were measured before premedication (baseline), postinduction and 30 (n=18), 60 (n=18), 90 (n=18) and 120 (n=12) minutes. Baseline COP, OSM and TP were not different between groups. TP decreased in both groups at all t...
Influence of caudal epidural analgesia on cortisol concentrations and pain-related behavioral responses in mares during and after ovariectomy via colpotomy. To determine the influence of epidural detomidine and morphine on serum corticosteroid concentrations and pain-related behavioral responses in mares during and after ovariectomy via colpotomy. Methods: Blinded prospective study. Methods: Nine university-owned mares. Methods: Five of 9 horses received caudal epidural detomidine hydrochloride (0.01 mg/kg) and morphine sulfate (0.1 mg/kg) prior to surgery. All horses received local anesthetic around the ovarian pedicle, 0.02 mg/kg butorphanol IV at the start of the procedure and after first ovary removal, were sedated as required throughout the p...
Unilateral cervical plexus block for prosthetic laryngoplasty in the standing horse. Locoregional anaesthetic techniques can facilitate certain surgeries being performed under standing procedural sedation. The second and third spinal cervical nerves (C2, C3) are part of the cervical plexus and provide sensory innervation to the peri-laryngeal structures in people; block of these nerves might permit laryngeal lateralisation surgery in horses. Objective: To describe the anatomical basis for an ultrasound-guided cervical plexus block in horses. To compare this block with conventional local anaesthetic tissue infiltration in horses undergoing standing prosthetic laryngoplasty. Met...
Local mepivacaine before castration of horses under medetomidine isoflurane balanced anaesthesia is effective to reduce perioperative nociception and cytokine release. In horses castration with primary intention healing is usually performed under balanced inhalation anaesthesia. To optimise analgesia, the use of local anaesthesia was tested. Objective: To investigate the effect of local mepivacaine before castration with first intention healing under balanced medetomidine-isoflurane anaesthesia and flunixin meglumine, morphine analgesia on perioperative cytokine levels and pain in horses. Methods: Prospective blinded clinical study. Methods: Twenty stallions were randomly assigned to control or mepivacaine groups. Flunixin meglumine was administered before s...
Cardiorespiratory effects of a 7° reverse Trendelenburg position in anaesthetized horses: a randomized clinical trial. To evaluate the cardiorespiratory effects of a 7° reverse Trendelenburg position (RTP) in anaesthetized horses. Methods: Randomized, non-blinded clinical trial. Methods: A total of 125 horses undergoing elective surgery in dorsal recumbency. Methods: Horses were allocated to one of three weight classes and assigned to be positioned either on a horizontal table or on a table in 7° RTP, according to a randomized block design. In all horses, anaesthesia was maintained with isoflurane in oxygen and a constant rate infusion of romifidine. All horses were mechanically ventilated throughout anaesth...
Comparison of desflurane and propofol at equipotent doses in combination with a constant rate infusion of dexmedetomidine on global and peripheral perfusion and oxygenation in horses. OBJECTIVE To determine global and peripheral perfusion and oxygenation during anesthesia with equipotent doses of desflurane and propofol combined with a constant rate infusion of dexmedetomidine in horses. ANIMALS 6 warmblood horses. PROCEDURES Horses were premedicated with dexmedetomidine (3.5 μg•kg, IV). Anesthesia was induced with propofol or ketamine and maintained with desflurane or propofol (complete crossover design) combined with a constant rate infusion of dexmedetomidine (7 μg•kg •h). Microperfusion and oxygenation of the rectal, oral, and esophageal mucosa were measured bef...
Comparison of different methods to calculate venous admixture in anaesthetized horses. The aim of this study was to compare different methods to determine venous admixture (Q˙/Q˙) in anaesthetized horses. The first objective was to estimate Q˙/Q˙ using jugular venous blood oxygen content (Q˙/Q˙), and a fixed value for the oxygen extraction (F-shunt). The second objective was to assess the influence of blood pressure and positioning on oxygen extraction. The third objective was to perform regression analysis between jugular and mixed venous blood oxygen tensions. Methods: Prospective, experimental trial. Methods: The study was performed with seven warmblood horses that were...
Factors associated with postoperative complications in healthy horses after general anesthesia for ophthalmic versus non-ophthalmic procedures: 556 cases (2012-2014). OBJECTIVE To compare complications between healthy horses undergoing general anesthesia for ophthalmic versus non-ophthalmic procedures and identify potential risk factors for the development of complications. DESIGN Retrospective case series. ANIMALS 502 horses (556 anesthetic procedures). PROCEDURES Medical records from January 2012 through December 2014 were reviewed to identify horses undergoing general anesthesia. Signalment, body weight, drugs administered, patient positioning, procedure type (ophthalmic, orthopedic, soft tissue, or diagnostic imaging), specific procedure, procedure time...
Agreement between invasive blood pressure measured centrally and peripherally in anaesthetized horses. To determine the agreement of invasive blood pressure measured in the facial, metatarsal and carotid arteries, and evaluate the effects of two haemodynamic conditions on agreement. Methods: Prospective randomized study. Methods: A group of eight horses aged 7 (4-23) years with a body weight of 493 ± 33 kg. Methods: Horses were anaesthetized and positioned in dorsal recumbency. Invasive blood pressure was measured simultaneously via catheters placed in the facial, metatarsal and carotid arteries. Cardiovascular function and agreement between arteries was assessed before and during administr...
Role of the equine CYP3A94, CYP3A95 and CYP3A97 in ketamine metabolism in presence of medetomidine, diazepam and methadone studied by enantioselective capillary electrophoresis. The anesthetic ketamine is often combined with analgesics and benzodiazepines in equine medicine. Therefore, drug-drug interactions are possible. Enzyme kinetics for ketamine N-demethylation were determined using equine CYP3A94, CYP3A95 and CYP3A97, and the effect of medetomidine, diazepam and methadone on the ketamine metabolism was studied in vitro. Ketamine was incubated with the CYPs or equine liver microsomes (ELM) alone or in presence of medetomidine, diazepam and/or methadone for different times. Norketamine levels were determined using enantioselective capillary electrophoresis (CE) wi...