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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.
Evaluation of sedation for standing clinical procedures in horses using detomidine combined with buprenorphine. To examine the effect of including buprenorphine with detomidine for sedation of horses undergoing clinical procedures. Methods: Partially blinded, randomised, prospective clinical field trial. Methods: Eighty four client-owned horses scheduled for minor surgery or diagnostic investigation under standing sedation. Methods: The effects of buprenorphine (5 μg kg(-1) ) (Group B, n = 46) or placebo (5% glucose solution) (Group C, n = 38) in combination with detomidine (10 μg kg(-1) ) were compared in standing horses undergoing minor clinical procedures. The primary outcome measure was succ...
Effect of retrobulbar nerve block on heart rate variability during enucleation in horses under general anesthesia. Analysis of any effect of retrobulbar block during ocular surgery on heart rate variability and oculocardiac reflex. Methods: Prospective study. Methods: Horses (n = 16) undergoing eye enucleation due to chronic ophthalmologic diseases. Methods: Eye enucleation was performed under general anesthesia. The horses were randomly assigned to the first (inhalation anesthesia only, n = 10) or second group (inhalation and local retrobulbar anesthesia, n = 6). The retrobulbar block was performed using 12 mL of mepivacaine hydrochloride 2%. ECG data were taken by a Telemetric ECG before, during, and aft...
Postcastration analgesia in ponies using buprenorphine hydrochloride. Buprenorphine has recently obtained UK Marketing Authorisation for horses. The analgesic effects are long lasting, and have considerable potential for postoperative pain relief. This observer blinded, randomised study aimed to evaluate postsurgical analgesia in ponies premedicated with buprenorphine prior to castration under intravenous anaesthesia. Ponies received either 0.01 mg/kg bodyweight (BW) buprenorphine (group B) or an equivalent volume of 5 per cent glucose (group C) given intravenously before induction of anaesthesia. Pain was assessed and recorded using dynamic interactive visual a...
Prolonged anesthesia using sevoflurane, remifentanil and dexmedetomidine in a horse. A 10-year old Arabian mare had a slow-growing mass on the lower right mandible and required a large partial mandibulectomy. Methods: No abnormalities were detected apart from the mass. Results: A temporary tracheostomy was performed pre-operatively. Anesthesia was induced with xylazine followed by ketamine and diazepam. For 13 hours, anesthesia was maintained using sevoflurane, dexmedetomidine and remifentanil infusions, with the exception of surgical preparation time. Intra-operatively, ventilation was delivered through the cuffed tracheotomy tube. Heart and respiratory rates, ECG, arterial ...
Management of zebras and zebra hybrids (zebroids). Equine practitioners are sometimes asked to treat zebras or zebra-horse or zebra-donkey hybrids. Although these equids are subject to many of the same health issues as domestic horses, they cannot be handled like horses and generally require heavy sedation to full anesthesia, even for minor procedures. This usually necessitates the use of ultrapotent narcotics administered by remote delivery systems. This article discusses the handling, sedation, anesthesia, and common medical issues of zebras and zebra hybrids.
Effects of single hyperinflation using a sustained high pressure manoeuvre during inhalation anaesthesia in horses. The effect of a single hyperinflation using a sustained high-pressure manoeuvre (SHPM) during inhalation anaesthesia was evaluated in horses. Twenty-eight client-owned male horses were recruited; 14 were operated on in dorsal recumbency and 14 in lateral recumbency. For each category, horses were randomly allocated to either the 'breathing spontaneously' or 'mechanically ventilated' group. After 30 min of anaesthesia, baseline cardiorespiratory parameters were collected and a SHPM of 50 cmH2O during 50s was undertaken. In the group of horses breathing spontaneously and positioned in dorsal rec...
Effect of ephedrine and phenylephrine on cardiopulmonary parameters in horses undergoing elective surgery. To assess the cardiopulmonary effects of ephedrine and phenylephrine for management of isoflurane-induced hypotension in horses. Methods: Prospective randomized clinical study. Methods: Fourteen isoflurane-anesthetized horses undergoing digital palmar neurectomy. Methods: Ephedrine (EPH group; 0.02 mg kg(-1) minute(-1); n = 7) or phenylephrine (PHE group; 0.002 mg kg(-1) minute(-1); n = 7) was administered to all horses when mean arterial pressure (MAP) was <60 mmHg. The infusions were ended when the target MAP was achieved, corresponding to a 50% increase over the pre-infusion MAP (baseline)....
Thoracoscopic diaphragmatic hernia repair in a warmblood mare. To describe successful repair of a diaphragmatic hernia in a standing sedated horse using a minimally invasive thoracoscopic technique. Methods: Clinical report. Methods: Warmblood mare with a diaphragmatic hernia. Results: An 18-year-old Warmblood mare with severe colic was referred for surgical treatment of small intestinal strangulation in a diaphragmatic defect. Twelve days after initial conventional colic surgery, left-sided laparoscopy in the standing sedated mare for diaphragmatic herniorrhaphy failed because the spleen obscured the hernia. One week later, a left-sided thoracoscopy was ...
Effect of pressure support ventilation during weaning on ventilation and oxygenation indices in healthy horses recovering from general anesthesia. To determine if pressure support ventilation (PSV) weaning from general anesthesia affects ventilation or oxygenation in horses. Methods: Prospective randomized clinical study. Methods: Twenty client-owned healthy horses aged 5 ± 2 years, weighing 456 ± 90 kg. Methods: In the control group (CG; n = 10) weaning was performed by a gradual decrease in respiratory rate (fR ) and in the PSV group (PSVG; n = 10) by a gradual decrease in fR with PSV. The effect of weaning was considered suboptimal if PaCO2 > 50 mmHg, arterial pH < 7.35 plus PaCO2 > 50 mmHg or PaO2 < 60 mmHg were observed at any tim...
The effects of pulse-delivered inhaled nitric oxide on arterial oxygenation, ventilation-perfusion distribution and plasma endothelin-1 concentration in laterally recumbent isoflurane-anaesthetized horses. Anaesthetized horses commonly become hypoxaemic due to ventilation/perfusion (V·A/Q·) mismatch and increased pulmonary shunt fraction (Qs·/Qt·). Pulse-delivered inhaled nitric oxide may improve oxygenation but may increase plasma concentration of the potent vasoconstrictor, endothelin-1 (ET-1). Objectives: Study 1) compare arterial oxygen concentration (PaO2) and saturation (SaO2), calculated Qs·/Qt· and ET-1 concentration; and Study 2) assess V·A/Q· matching and measured Qs·/Qt· in isoflurane-anaesthetized horses in left lateral recumbency receiving pulse-delivered inhaled nitric ox...
Comparison of phenylephrine administration and exercise versus phenylephrine administration and a rolling procedure for the correction of nephrosplenic entrapment of the large colon in horses: 88 cases (2004-2010). To compare the outcome of horses with nephrosplenic entrapment of the large colon (NSELC) that were treated nonsurgically by IV administration of phenylephrine and exercise with that of horses treated by IV administration of phenylephrine and a rolling procedure under general anesthesia. Methods: Retrospective case series. Methods: 88 horses with NSELC. Methods: Horses examined between 2004 and 2010 because of acute abdominal pain that had NSELC on the basis of findings on abdominal palpation per rectum, abdominal ultrasonography, or both were included. Medical records were reviewed to obtain ...
Near-fatal misuse of medical tape around an endotracheal tube connector during inhalation anesthesia in a horse. A 7-year-old gelded Irish sports horse weighing 650 kg was anesthetized on 2 consecutive days for lavage of a septic right radio-carpal joint. On both occasions the endotracheal tube connector, which had been bound in medical tape to produce an airtight seal, functioned as a unidirectional valve during mechanical ventilation, retarding expiration, imposing positive end expiratory pressure (PEEP), and probably continuous positive airway pressure (CPAP). The equipment dysfunction was not identified on either occasion despite close inspection prompted by progressive increases in airway pressure a...
Incidence, management, and outcome of complications of castration in equids: 324 cases (1998-2008). To determine the incidence of complications and identify risk factors associated with development of complications following routine castration of equids. Methods: Retrospective case series. Animals-311 horses, 10 mules, and 3 donkeys. Methods: Medical records of equids undergoing routine castration were reviewed. Age, breed, surgical techniques (closed vs semiclosed castration and use of ligatures), anesthesia method (general IV anesthesia vs standing sedation with local anesthesia) and repeated administration of IV anesthetic agents, administration of antimicrobials and anti-inflammatory dru...
Comparison of efficacy and duration of effect on corneal sensitivity among anesthetic agents following ocular administration in clinically normal horses. To compare efficacy and duration of effect on corneal sensitivity of 0.5% proparacaine hydrochloride, 0.5% bupivacaine hydrochloride, 2% lidocaine hydrochloride, and 2% mepivacaine hydrochloride solutions following ocular administration in clinically normal horses. Methods: 68 clinically normal horses. Methods: 60 horses were assigned to receive 1 anesthetic agent in 1 eye. For each of another 8 horses, 1 eye was treated with each of the anesthetic agents in random order with a 1-week washout period between treatments. Corneal sensitivity was assessed via corneal touch threshold (CTT) measurem...
Large segmental mandibulectomy for treatment of an undifferentiated sarcoma in a horse. To describe a large segmental (sub-total) mandibulectomy for removal of an undifferentiated sarcoma in a horse. Methods: Clinical report. Methods: A 10-year-old mare. Methods: A combination of methods including computed tomography (CT) were used to diagnose a large undifferentiated sarcoma of the right mandible. A large segmental mandibulectomy extending from 3 cm below the right temporomandibular joint to immediately caudal to tooth 407 was used to perform an en-bloc resection of the mass under general anesthesia. Results: Surgery time was 11 hours and 35 minutes and total anesthesia time, 12...
Postoperative septic arthritis after elective equine arthroscopy without antimicrobial prophylaxis. To determine the frequency of postoperative septic arthritis after elective arthroscopy in the absence of prophylactic antimicrobial therapy and to report complication rate of 444 consecutive equine arthroscopies. Methods: Retrospective case series. Methods: Horses (n = 444). Methods: Medical records of 444 consecutive elective equine arthroscopies (2008-2010) were reviewed. Horses that had septic arthritis on admission or those admitted for tenoscopy and bursoscopy, or had arthroscopic assisted internal fracture fixation were not included. Age and sex of horse, duration of anesthesia, joint e...
Hemodynamic effects of 6% hydroxyethyl starch infusion in sevoflurane-anesthetized thoroughbred horses. To determine hemodynamic effects of hydroxyethyl starch (HES) infusion during anesthesia in horses, incremental doses of 6% HES were administered to 6 healthy Thoroughbred horses. Anesthesia was induced with xylazine, guaifenesin and thiopental and maintained with sevoflurane at 2.8% of end-tidal concentration in all horses. The horses were positioned in right lateral recumbency and administered 3 intravenous dose of 6% HES (5 ml/kg) over 15 min with 15-min intervals in addition to constant infusion of lactated Ringer's solution at 10 ml/kg/hr. Hemodynamic parameters were measured before and e...
General anesthesia in horses on fluid and electrolyte therapy. The purpose of this article is to update the community of veterinarians performing general anesthesia in horses on fluid therapy. The rationale behind intraoperative fluid therapy, fluid dynamics, and various fluid options (crystalloids, hypertonic saline, colloids) is discussed. Additionally, electrolytes (calcium, potassium, and sodium) are included in the discussion in relation to general anesthesia and intraoperative fluid management.
Influence of detomidine and xylazine on spleen dimensions and on splenic response to epinephrine infusion in healthy adult horses. To compare the changes in splenic length and thickness and in packed cell volume (PCV) following detomidine or xylazine administration and subsequent epinephrine infusion. Objective: Spleen relaxation occurs following xylazine or detomidine administration and interferes with subsequent splenic contractile response to epinephrine. Methods: Randomized non-blinded crossover experimental study. Methods: 6 healthy adult mares. Methods: The mares received an intravenous (IV) epinephrine infusion (1 μg kg(-1 ) minute(-1) over 5 minutes) one hour after IV administration of detomidine (0.01 mg kg(-1) ...
Mechanical ventilation and respiratory mechanics during equine anesthesia. The mechanical ventilation of horses during anesthesia remains a crucial option for optimal anesthetic management, if the possible negative cardiovascular side effects are managed, because this species is prone to hypercapnia and hypoxemia. The combined use of capnography and pitot-based spirometry provide complementary information on ventilation and respiratory mechanics, respectively. This facilitates management of mechanical ventilation in conditions of changing respiratory system compliance (ie, laparoscopy) and when investigating new ventilatory strategies including alveolar recruitment m...
Effects of postanesthetic sedation with romifidine or xylazine on quality of recovery from isoflurane anesthesia in horses. To test the hypothesis that postanesthetic sedation with romifidine would dose-dependently improve recovery quality of recovery from isoflurane anesthesia in horses more than postanesthetic sedation with xylazine. Methods: Prospective, randomized, blinded clinical trial. Methods: 101 healthy adult horses examined at the University of California-Davis Veterinary Medical Teaching Hospital from 2007 to 2009. Methods: Horses were sedated with xylazine, and anesthesia was induced with guaifenesin, diazepam, and ketamine via a standardized drug protocol. Anesthesia for surgical or diagnostic procedu...
Drugs for cardiovascular support in anesthetized horses. Despite the use of balanced anesthesia and fluids, drugs for cardiovascular support are often needed in anesthetized horses. Antimuscarinics can be used to treat bradycardia unrelated to hypertension. Vasopressors can be useful when hypotension is caused by vasodilation and/or when the effect of fluids and inotropes is insufficient. In most cases, however, inotropes, including sympathomimetics, calcium salts, and phosphodiesterase inhibitors, are preferred. Of the β-sympathomimetics, dobutamine remains the agent of choice. Calcium salts are mainly useful in hypocalcemic patients. Phosphodiest...
Effects of inspired oxygen concentration on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses. To compare the effects of 2 fractions of inspired oxygen, 50% and > 95%, on ventilation, ventilatory rhythm, and gas exchange in isoflurane-anesthetized horses. Methods: 8 healthy adult horses. Methods: In a crossover study design, horses were assigned to undergo each of 2 anesthetic sessions in random order, with 1 week separating the sessions. In each session, horses were sedated with xylazine hydrochloride (1.0 mg/kg, IV) and anesthesia was induced via IV administration of diazepam (0.05 mg/kg) and ketamine (2.2 mg/kg) Anesthesia was subsequently maintained with isoflurane in 50% or > 95% o...
Inhaled anesthetics in horses. Inhaled agents represent an important and useful class of drugs for equine anesthesia. This article reviews the ether-type anesthetics in contemporary use, their uptake and elimination, their mechanisms of action, and their desirable and undesirable effects in horses.
Anesthesia for ophthalmic procedures in the standing horse. Effective delivery of local anesthesia is essential for successful standing surgical procedures in the horse. Local anesthesia can be used to facilitate examination of the eye, diagnostic procedures, therapeutic techniques, and surgical procedures. Understanding the relevant clinical anatomy and techniques for performing local anesthesia is critical to delivering successful local and regional anesthesia and analgesia.
Anesthesia for the horse with colic. This article discusses anesthesia for horses with colic from acute gastrointestinal disease. Emphasis is placed on new developments in pre-, intra-, and immediate postoperative management over the last decade, including early goal-directed therapy (EGDT) in the resuscitation of septic patients, the controversy over the optimal fluid type to administer, and the management of complications, such as cardiovascular depression, hypoventilation and hypoxemia, and decreased colloid oncotic pressure (COP). An update on analgesia is also provided; older drugs such as ketamine and lidocaine are increasi...
Recovery of horses from anesthesia. Recovery from anesthesia can be one of the most dangerous and unpredictable elements of providing anesthesia to horses. Strategies to quiet, control, and improve the quality of recovery of horses can be implemented in most situations and circumstances. This article provides an overview of the recovery period and areas where interventions may be practical to clinicians to provide improved care for their equine patients.
Cardiac output monitoring in horses. Cardiac output (CO) is the volume of blood pumped out by the heart in 1 minute. Monitoring of CO can guide therapy and improve clinical outcome in critically ill patients and during anesthesia. Although there is increasing research into clinically useful methods of monitoring CO in equine patients, there are limitations to the available methods. There are 4 basic methods of measuring CO: (1) indicator methods, (2) a derivation of the Fick principle, (3) arterial pulse wave analysis, and (4) imaging diagnostic techniques. This article discusses the importance of CO, available technology, and ch...
