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.
Application of the Ridden Horse Pain Ethogram to 150 Horses with Musculoskeletal Pain before and after Diagnostic Anaesthesia. The Ridden Horse Pain Ethogram (RHpE) was developed to facilitate the recognition of musculoskeletal pain. The aim of this study was to document changes in RHpE scores before and after diagnostic anaesthesia was performed to alleviate pain ± when the saddle was changed. One hundred and fifty horses underwent ridden exercise as part of an investigation of poor performance. The RHpE was applied before and after the interventions. Fifty-two (34.7%) horses exhibited a bilaterally symmetrical short step length and/or restricted hindlimb impulsion and engagement. Fifty-three (35.3%) horses had epis...
Assessment and comparison of microcirculation and macrocirculation in horses undergoing emergency exploratory celiotomy versus elective surgical procedures. To assess oral buccal microcirculation by hand-held videomicroscopy in horses during colic surgery, comparing microcirculation values with macrocirculatory parameters and with those of healthy elective surgical horses. Methods: Clinical prospective study. Methods: Client-owned horses (nine in the colic group; 11 in the elective group). Methods: In the colic group, buccal mucosal side stream dark-field microscopy (DFM) videos, cardiac output (CO), mean arterial pressure (MAP), and lactate were obtained at three timepoints under general anesthesia (30, 90, and 150 min after induction). Video a...
Cardiac output affects the response to pulsed inhaled nitric oxide in mechanically ventilated anesthetized ponies determined by CT angiography of the lung. To measure changes in regional lung perfusion using CT angiography in mechanically ventilated, anesthetized ponies administered pulsed inhaled nitric oxide (PiNO) during hypotension and normotension. Methods: 6 ponies for anesthetic 1 and 5 ponies for anesthetic 2. Methods: Ponies were anesthetized on 2 separate occasions, mechanically ventilated, and placed in dorsal recumbency within the CT gantry. Pulmonary arterial, right atrial, and facial arterial catheters were placed. During both anesthetics, PiNO was delivered for 60 minutes and then discontinued. Anesthetic 1: hypotension (mean arter...
Assessment of Magnetic Resonance Imaging Artefacts Caused by Equine Anaesthesia Equipment: A Cadaver Study. Acquisition of magnetic resonance images of the equine limb is still sometimes conducted under general anaesthesia. Despite low-field systems allow the use of standard anaesthetic equipment, possible interferences of the extensive electronic componentry of advanced anaesthetic machines on image quality is unknown. This prospective, blinded, cadaver study investigated the effects of seven standardised conditions (Tafonius positioned as in clinical cases, Tafonius on the boundaries of the controlled area, anaesthetic monitoring only, Mallard anaesthetic machine, Bird ventilator, complete electro...
Flow-controlled expiration reduces positive end-expiratory pressure requirement in dorsally recumbent, anesthetized horses. Equine peri-anesthetic mortality is higher than that for other commonly anesthetized veterinary species. Unique equine pulmonary pathophysiologic aspects are believed to contribute to this mortality due to impairment of gas exchange and subsequent hypoxemia. No consistently reliable solution for the treatment of peri-anesthetic gas exchange impairment is available. Flow-controlled expiration (FLEX) is a ventilatory mode that linearizes gas flow throughout the expiratory phase, reducing the rate of lung emptying and alveolar collapse. FLEX has been shown to improve gas exchange and pulmonary me...
Endoscopic-guided diagnosis of and interventional stent placement for nasolacrimal duct obstruction in a horse. To describe the successful use of endoscopy to visualize and place a soft canine ureteral stent to relieve a chronic nasolacrimal duct (NLD) obstruction in a horse. Methods: A 7-year-old, Quarter horse gelding. Methods: Under general anesthesia, retrograde nasolacrimal endoscopy was performed using an 8.5 Fr Storz Flex XC ureteroscope through the nasal punctum (NP). An obstructive web of fibrous tissue was visualized approximately 20 cm proximal to the NP. A 0.035″/150 cm hydrophilic guidewire was passed normograde from the ventral lacrimal punctum and used to puncture the stenotic tissu...
Comparison of Hemodynamic Effects of Dobutamine and Ephedrine Infusions in Isoflurane-Anesthetized Horses. The objective of this study was to compare the hemodynamic effects of dobutamine and ephedrine during the management of anesthesia-related hypotension in healthy horses. Thirteen horses underwent general anesthesia with isoflurane and were randomly divided into two different groups, one of which received a dobutamine constant rate infusion (CRI) (1 µg/kg bwt/min) and the other received an ephedrine CRI (20 µg/kg bwt/min) when hypotension (<60 mmHg) was identified, following up to 15 min after the blood pressure reached 70 mmHg. All horses were equipped with a pulmonary artery catheter and a ...
Evaluation of Three Methods of Sensory Function Testing for the Assessment of Successful Maxillary Nerve Blockade in Horses. Maxillary nerve blocks (MNBs) commonly facilitate dental surgeries in standing horses. The goal of this prospective, blinded, cross-over design trial including 15 client-owned horses was to evaluate 3 methods of sensory function testing for confirming a successful MNB. Testing was performed bilaterally before sedation, 5 min after sedation, and 15 and 30 min after MNB with 0.5% bupivacaine and involved a needle prick dorsal to each naris, hemostat clamping of each nostril, and gingival algometry (measuring sensitivity to pain). Responses to stimulation were numerically scored and scores were s...
Blind Versus Ultrasound-Guided Low-Volume Perineural Injection of Tibial and Fibular Nerves in Equine Cadaver Limbs. Techniques for local anesthesia of the tibial (TN) and superficial and deep fibular nerves (FNs) in horses are well established. Ultrasound-guided perineural blocks can identify the nerve location, reduce the anesthetic volume needed and avoid needle misplacement. The aim of this research was to compare the success of blind perineural injection technique (BLIND) to ultrasound-guided technique (USG). Fifteen equine cadaver hindlimbs were divided into two groups. Perineural injection of the TN and FNs was performed using a mixed solution of radiopaque contrast, saline and food dye. BLIND (n = ...
Effect of end-inspiratory pause on airway and physiological dead space in anesthetized horses. To evaluate the impact of a 30% end-inspiratory pause (EIP) on alveolar tidal volume (V), airway (V) and physiological (V) dead spaces in mechanically ventilated horses using volumetric capnography, and to evaluate the effect of EIP on carbon dioxide (CO) elimination per breath (Vcobr), PaCO and the ratio of PaO-to-fractional inspired oxygen (PaO:FiO). Methods: Prospective research study. Methods: A group of eight healthy research horses undergoing laparotomy. Methods: Anesthetized horses were mechanically ventilated as follows: 6 breaths minute, tidal volume (V) 13 mL kg, inspiratory-to-expir...
Short-Term Survival and Postoperative Complications Rates in Horses Undergoing Colic Surgery: A Multicentre Study. The occurrence of colic could be influenced by the characteristics of a population, geographical area, and feeding management. The aim of this study was to report the short-term postoperative complications and survival rates and to identify factors that might affect the outcome of horses that underwent colic surgery in three Italian surgical referral centres. Data of horses subjected to colic surgery in three referral centres (2018-2021) were analysed. Comparisons of the outcomes were performed using a Mann-Whitney or a Chi square test. Areas under the receiver operating characteristic (ROC) c...
Intrathecal mepivacaine after general anesthesia is an effective method of equine euthanasia when compared to intravenous pentobarbital. This study aims to assess intrathecal mepivacaine for euthanasia in anesthetized horses and compare it to a traditional euthanasia method using a single intravenous injection of pentobarbital in sedated horses. Methods: Client-owned horses and horses requiring euthanasia due to involvement in concurrent research projects were used. Horses were randomly assigned to 1 of 2 groups: intrathecal mepivacaine after anesthesia or intravenous pentobarbital after sedation. All horses had normal vital parameters and no signs of infectious disease at the time of euthanasia. Methods: The intrathecal mepiva...
Dexmedetomidine Has Differential Effects on the Contractility of Equine Jejunal Smooth Muscle Layers In Vitro. α2 agonists are frequently used in horses with colic, even though they have been shown to inhibit gastrointestinal motility. The aim of this study was to determine the effect of dexmedetomidine on small intestinal in vitro contractility during different phases of ischaemia. Experimental segmental jejunal ischaemia was induced in 12 horses under general anaesthesia, and intestinal samples were taken pre-ischaemia and following ischaemia and reperfusion. Spontaneous and electrically evoked contractile activity of the circular and longitudinal smooth muscles were determined in each sample with a...
Establishment of a sequential dual tracer 18 F-NaF/18 F-FDG PET protocol for imaging the equine foot. The combination of F-Sodium Fluoride ( F-NaF) and F-FluoroDeoxyGlucose ( F-FDG) for positron emission tomography (PET) imaging of the equine foot is appealing for detection of both osseous and soft tissue lesions in a single scan. As the combination of tracers could lead to a loss of information, a sequential approach, consisting in imaging with one tracer prior to injecting the second tracer, might be valuable. The goals of this prospective, methods comparison, exploratory study were to establish the order of tracer injection and timing for imaging. Six research horses were imaged under...
Antinociceptive effects of bupivacaine injected within the internal abdominis rectus sheath in standing healthy horses. To evaluate a regional anesthetic technique for blocking the abdominal midline in horses. Methods: Anatomical description and prospective, crossover, placebo-controlled, blinded study. Methods: Adult horses; two cadavers, six healthy animals. Methods: In stage 1, 0.5% methylene blue with 0.25% bupivacaine (0.5 mL kg) was injected using ultrasonography into the internal rectus abdominis sheath (RAS) of two cadavers with a one-point or two-point technique. The dye spread was described after the dissection of the abdomens. In stage 2, each horse was injected with 1 mL kg of 0.9% NaCl (treatment P...
Three-dimensional electro-anatomical mapping and radiofrequency ablation as a novel treatment for atrioventricular accessory pathway in a horse: A case report. We describe the diagnosis and treatment of an atrioventricular accessory pathway (AP) in a horse using 3-dimensional electro-anatomical mapping (3D EAM) and radiofrequency catheter ablation (RFCA). During routine evaluation of the horse, intermittent ventricular pre-excitation was identified on the ECG, characterized by a short PQ interval and abnormal QRS morphology. A right cranial location of the AP was suspected from the 12-lead ECG and vectorcardiography. After precise localization of the AP using 3D EAM, ablation was performed and AP conduction was eliminated. Immediately after recovery ...
Hypoxia signaling in the equine small intestine: Expression and distribution of hypoxia inducible factors during experimental ischemia. Hypoxia inducible factors (HIF) are widely researched in human medicine for their role in different disease processes. The aim of this study was to investigate the expression and distribution of HIF in experimental small intestinal ischemia in the horse. Unassigned: In 14 horses under general anesthesia, segmental jejunal ischemia with 90% reduction in blood flow was induced. The horses were randomly divided into two groups of seven horses, one subjected to ischemic postconditioning (IPoC) by delayed reperfusion, and a control group (group C) undergoing undelayed reperfusion. Intestinal sample...
Successful surgical removal of a pheochromocytoma in a mare via trans-costal approach. Pheochromocytomas have been previously reported in horses, but successful antemortem diagnosis and surgical removal without recurrence of clinical signs have not been described. Objective: To report the clinical presentation, diagnostic evaluation, surgical technique, anaesthetic management and post-operative care of a mare diagnosed with pheochromocytoma. Methods: Clinical case report. Methods: An 18-year-old Quarter Horse mare presented for recurrent episodes of colic, profuse sweating, muscle fasciculations and agitation over a 2-month period. Clinical, clinicopathologic and ultrasonographi...
Standing Surgical Management of Splint Bone Fractures in 13 Horses: A Comparison to Management Under General Anaesthesia. The aim of this article was to describe the technique and outcomes of standing surgical management of splint bone fractures and to compare outcome variables and hospitalization cost to a group with similar fractures treated under general anaesthesia. Methods: It is a single-institution retrospective study. Surgical technique, surgical time, hospitalization cost and complications were retrieved from the medical records of horses treated surgically for splint bone fractures (2008-2020). Owner telephone follow-up provided data about athletic outcome, client satisfaction and cosmetic appeara...
General anesthesia does not induce ultrasonographic changes in the pleura of healthy adult horses anesthetized for elective magnetic resonance imaging. To compare thoracic ultrasonographic findings in healthy horses before and after general anesthesia for elective MRI utilizing a recently developed ultrasonographic scoring system to aid clinicians in the early identification of pneumonia following anesthesia. 13 adult horses > 3 years of age. Prior to anesthesia, horses underwent a thorough physical examination, CBC, thoracic radiography, and thoracic ultrasonography. Horses were then anesthetized for elective MRI, and thoracic ultrasonography was repeated within 3 hours after recovery. Thoracic ultrasonographic findings were scored utilizing...
Treatment of corneal ulceration and bullous keratopathy using a nictitating membrane flap in two horses. The aim of this study was to describe placement of a nictitating membrane flap as a treatment for corneal ulceration and bullous keratopathy in two horses. Methods: A 13-year-old American Saddlebred mare presented for severe corneal edema, superficial stromal ulceration, and a central bulla of the left eye. A 4-year-old Trakhener stallion also presented with a large axial bulla of the left eye with concurrent severe corneal edema and a deep stromal ulcer. Methods: A complete ophthalmic examination was performed. Samples were obtained for corneal cytology, and both horses were started on aggres...
Standing surgery among equine board certified surgeons: Survey regarding current use and trends. Publications about equine standing surgery are flourishing, however, information regarding its use and prevalence among surgeons is still limited. Objective: To determine the current use and recent trends for equine standing surgery among board certified surgeons and to identify the main reasons and limitations for performing a procedure standing. Methods: Cross-sectional survey. Methods: A 139-item questionnaire was sent by email to 733 large animal surgery Diplomates (ACVS and ECVS) from November 2020 to February 2021. The survey collected demographic information and general data regarding s...
Arterial blood gas tensions during recovery in horses anesthetized with apneustic anesthesia ventilation compared with conventional mechanical ventilation. To compare PaO2 and PaCO2 in horses recovering from general anesthesia maintained with either apneustic anesthesia ventilation (AAV) or conventional mechanical ventilation (CMV). Methods: Randomized, crossover design. Methods: A total of 10 healthy adult horses from a university-owned herd. Methods: Dorsally recumbent horses were anesthetized with isoflurane in oxygen [inspired oxygen fraction = 0.3 initially, with subsequent titration to maintain PaO2 ≥ 85 mmHg (11.3 kPa)] and ventilated with AAV or CMV according to predefined criteria [10 mL kg-1 tidal volume, PaCO2 40-45 mmHg (5.3-6.0 kP...
Effect of Volumes of Solutions on Intraocular Pressure During Intravitreal Injection of Low Dose Gentamicin in Horses With Recurrent Uveitis: A Randomized Controlled Study. Horses with recurrent uveitis can be treated by intravitreal injection of low dose gentamicin under sedation and after local anesthetic techniques including the retrobulbar nerve block. Since it is reported that retinal degeneration can be secondary to an acute increase of intraocular pressure (IOP), the current randomized controlled study was carried out in order to investigate the changes in IOP following retrobulbar anesthesia, with two different volumes of local anesthetic (lidocaine) solution (10 and 5 mL), and intravitreal injection of 6 mg gentamicin in two different volumes of solution...
Liposomal bupivacaine is both safe and effective when administered via local infiltration at surgical site and mesovarium for laparoscopic ovariectomy in mares. Liposomal local anaesthetic solutions may provide extended-duration analgesia postoperatively but have not been assessed following intra-peritoneal local infiltration in any species. Objective: To evaluate two doses of 1.33% liposomal bupivacaine (LB) versus 0.75% bupivacaine HCL (BHCl) for analgesia following laparoscopic ovariectomy in mares. Methods: Prospective cohort study. Methods: Fifteen healthy Quarter Horse mares (age 2-20 years) with normal bilateral ovarian palpation and appearance were enrolled. Horses were restrained in standing stocks and administered an α-2 agonist, butorpha...
Pain Assessment and Acute Phase Response in Donkeys Submitted to Inguinal Orchiectomy. In most animals, pain can compromise physiological functions and delay healing so, rapid detection of pain through behavior and inflammatory reaction with biomarkers are necessary. This study aimed to evaluate pain, physiological variations and Acute Phase Proteins (APP) in donkeys undergoing orchiectomy technique by inguinal access. For this research, 15 male northeastern donkeys kept in extensive management were selected, with a mean age of 4.5±3.1 years. All animals had the same anesthetic protocol, using dissociative anesthesia and local block with lidocaine, followed by orchiectomy by in...
Comparison of Four Arteries for Invasive Blood Pressure Measurements and Dixtal 2010 Oscillometric Values in Horses Anesthetized With Isoflurane: Does the Artery Matter? This study evaluated the agreement between invasive blood pressure (IBP) values measured in three different arteries and by an oscillometric device (NIBP) with the ones from the transverse facial artery (FA). Six horses (424.2 ± 40.7 kg) were sedated with xylazine (0.6 mg/kg IV), induced with ketamine (2 mg/kg IV) and midazolam (0.1 mg/kg IV), and maintained with isoflurane (1.2 MAC) for 90 minutes in lateral recumbency. FA, auricular artery (AA), lateral digital artery (LDA), and metatarsal artery (MA) were catheterized, and a standard adult cuff was placed on the tail. IBP and NIBP values w...
Minimally invasive removal of obstructive ureteral stones by intracorporeal lithotripsy in horses: 3 patients. Three client-owned horses diagnosed with obstructive ureteral stones were referred and treated in a minimally invasive manner by retrograde ureteroscopy in conjunction with electrohydraulic lithotripsy (EHL) or laser Holmium:YAG lithotripsy (HYL). For all 3 horses, additional tests revealed variable degrees of azotemia and ureteral obstruction. Ultrasound examination (2 horses) revealed a loss of cortico-medullary distinction consistent with a chronic nephropathy. Ultrasound-guided biopsy of the right kidney in 1 horse revealed moderate glomerulosclerosis and lymphoplasmacytic nephritis. A sta...
Immediate pre-operative computed tomography for surgical planning of equine fracture repair: A retrospective review of 55 cases. Fracture configuration is often more complex than is radiographically appreciable. The objective of this study is to describe the influence of pre-operative computed tomography (CT) for surgical planning in a variety of fracture types. This has not been described in previous studies. All cases with pre-operative radiographs, admitted for CT and surgical repair of a suspected limb fracture from January 2010-December 2020 were reviewed. CT was acquired under general anaesthesia in a multi-slice helical scanner; any surgery was then performed immediately. Three diplomates (two surgical; one diagn...
A multicenter retrospective case-cohort study on the prevalence of incisional morbidities in late pregnant mares following exploratory celiotomy (2014-2019): 579 cases. To report the prevalence and risk factors for incisional morbidities in late pregnant and nonpregnant/early pregnant control mares following colic surgery. Methods: Multicenter, retrospective, cohort study from January 2014 to December 2019. Methods: Two university teaching hospitals and 1 private referral center. Methods: Five hundred and seventy-nine fillies and mares ≥2 years old that underwent celiotomy. Pregnant mares (n = 54) were >240 days in gestation from the last known breeding date and were compared to control females (n = 525) undergoing colic surgery. Methods: None. Resu...