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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.
Neuromuscular blocking agents and monitoring in the equine patient. This article briefly reviews the physiology of the neuromuscular junction and the pharmacologic mechanisms of neuromuscular blocking agents. The clinical use of modern agents is discussed. Monitoring techniques used to assess the level of neuromuscular block and to exclude residual paralysis at the end of an anesthetic procedure are reviewed.
Total intravenous anesthesia in horses. Total intravenous anesthesia (TIVA) is the mainstay of short-term (up to 60 minutes) and field anesthesia in horses. This article discusses the pros and cons of TIVA, commonly used TIVA protocols, and their use, monitoring during, and recovery from, TIVA.
Anesthesia for dystocia and anesthesia of the equine neonate. Equine anesthesia is complicated regardless of the procedure being performed. Anesthesia for the mare experiencing dystocia is complicated by the size of the fetus, positioning of the mare for the procedure, and concern over drug effect on the fetus through the neonatal period. Anesthesia of the neonate is complicated by multiple factors, specifically, sensitivity to the drugs administered. Ventilatory support, minimizing drugs administered, and minimizing anesthesia time are essential for a positive outcome.
Morbidity, mortality, and risk of general anesthesia in horses. General anesthesia in horses carries an increased risk of morbidity and mortality compared with other species. In recent years the number and complexity of epidemiologic studies in equine anesthesia has increased. The ability to interpret such studies and understand epidemiologic terminology is vital for veterinarians for them to make potential improvements to their anesthetic practice and to allow them to communicate effectively the findings of such studies to colleagues and owners. This article provides the equine clinician with a basic understanding of the methodologies that can be used in ...
Balanced anesthesia and constant-rate infusions in horses. Balanced anesthetic techniques are commonly used in equine patients, and include the combination of a volatile anesthetic with at least one injectable anesthetic throughout the maintenance period. Injectable anesthetics used in balanced anesthesia include the α2-agonists, lidocaine, ketamine, and opioids, and those with muscle-relaxant properties such as benzodiazepines and guaifenesin. Administration of these injectable anesthetics is best using constant-rate infusions based on the pharmacokinetics of the drug, which allows steady-state concentrations and predictable pharmacodynamic actions....
Use of continuous positive airway pressure (CPAP) to optimise oxygenation in anaesthetised horses–a clinical study. Hypoxaemia is a common problem during equine anaesthesia. Continuous positive airway pressure (CPAP) is a ventilation mode routinely employed in man to overcome hypoxaemia but has not been objectively assessed in horses. Objective: To test the effects of CPAP on oxygenation and its indices in anaesthetised horses in a clinical setting. Methods: Twenty-four healthy horses requiring anaesthesia in dorsal recumbency were anaesthetised using a standard protocol. Following orotracheal intubation and connection to an anaesthetic machine capable of applying CPAP, horses were randomly allocated to ven...
Excision of the deep branch of the lateral palmar nerve of horses to resolve lameness caused by proximal suspensory desmitis. To assess outcome after neurectomy of the deep branch of the lateral palmar nerve (DBLPaN) as a treatment for horses with persistent lameness associated with chronic proximal suspensory desmitis (PSD) of the thoracic limb. Methods: Case series. Methods: Adult, mixed-breed horses (n = 4), weighing 510-585 kg, used for amateur show-jumping. Methods: Records of 4 horses chronically lame because of PSD of one or both thoracic limbs that were treated by neurectomy of the DBLPaN were reviewed. The site of pain causing lameness was localized using regional anesthesia. The proximal aspect of the suspe...
Effects of action of proparacaine and tetracaine topical ophthalmic formulations on corneal sensitivity in horses. To compare the corneal anesthetic effects and duration of action of 2 ophthalmic anesthetic agents in horses. Methods: Prospective, randomized masked crossover study. Methods: 8 clinically normal adult horses. Methods: Corneal sensitivity was determined by measuring each eye's corneal touch threshold (CTT) with a Cochet-Bonnet esthesiometer. Each eye's baseline CTT was recorded prior to anesthetic instillation at 0 minutes and every 10 minutes thereafter for 60 minutes. Each eye was randomly assigned to receive 2 of 4 treatments: 0.5% aqueous proparacaine ophthalmic solution (aqueous proparaca...
Use of physiologic and arterial blood gas variables to predict short-term survival in horses with large colon volvulus. To determine if preoperative physical examination and blood work values, intraoperative physiologic variables, and intraoperative treatments can be correlated with survival to anesthetic recovery and short-term survival to hospital discharge in horses that undergo exploratory celiotomy for large colon volvulus (LCV) with and without colon resection. Methods: Retrospective case series. Methods: Horses (n = 156) undergoing exploratory celiotomy for correction of LCV ≥ 360(ο) . Methods: Medical records (January 2000-December 2009) of horses that had surgical correction of LCV ≥ 360(ο) were ...
Anesthetic management of a horse with traumatic pneumothorax. A traumatic pneumothorax and severe hemorrhage were present in a mare with a large thoracic wall defect, lung perforation, and multiple rib fractures. General anesthesia was induced to allow surgical exploration. We describe the anesthetic technique, and discuss the management of the ventilatory, hemodynamic, and metabolic disturbances encountered. Gestion de l’anesthésie générale d’un cheval avec un pneumothorax d’origine traumatique. Nous décrivons le cas d’une jument présentée avec un important déficit de la paroi thoracique d’origine traumatique, une perforation pulmonaire...
Use of near-infrared spectroscopy to identify trends in regional cerebral oxygen saturation in horses. Alterations in cerebral haemodynamics may contribute to perianaesthetic complications in horses. Near-infrared spectroscopy (NIRS) is frequently used intraoperatively in man to provide information regarding cerebral perfusion. Objective: To determine whether NIRS can identify trends in regional cerebral oxygen saturation (rSO2) in horses and whether there is a correlation between rSO2 and venous oxygen tensions. Methods: A cerebral oximeter sensor recorded rSO2 from the dorsal sagittal sinus of 6 healthy horses. Values for rSO2, arterial and venous oxygen and carbon dioxide tensions (PaO2, PvO...
Surgical lesions of the small colon and post operative survival in a UK hospital population. There is limited information about risk factors and survival associated with disorders of the small colon requiring surgical management. Objective: 1) To document the types of surgical lesion in horses where pathology of the small (descending) colon was the primary cause of abdominal pain, 2) to describe the short- and long-term survival of these cases and identify factors associated with survival and 3) to identify preoperative variables associated with localisation of a lesion to the small colon. Methods: Clinical data and long-term follow-up were obtained for horses that underwent explorato...
Comparison of peritoneal fluid values after laparoscopic cryptorchidectomy using a vessel-sealing device (Ligasure™) versus a ligating loop and removal of the descended testis. To determine the effect of unilateral laparoscopic cryptorchidectomy and removal of the descended testis on peritoneal fluid values, and to compare effect between 2 methods for cryptorchid testis vessel hemostasis. Methods: Randomized clinical study. Methods: Stallions (n = 10) with unilateral abdominal cryptorchid testis. Methods: During standing laparoscopic cryptorchidectomy, blood vessels within the mesorchium of the cryptorchid testis were either sealed and transected with the LigaSure Atlas™ or 2 ligating loops were placed proximal to the testis and the tissue transected with laparosco...
Equine cytochrome P450 2B6–genomic identification, expression and functional characterization with ketamine. Ketamine is an anesthetic and analgesic regularly used in veterinary patients. As ketamine is almost always administered in combination with other drugs, interactions between ketamine and other drugs bear the risk of either adverse effects or diminished efficacy. Since cytochrome P450 enzymes (CYPs) play a pivotal role in the phase I metabolism of the majority of all marketed drugs, drug-drug interactions often occur at the active site of these enzymes. CYPs have been thoroughly examined in humans and laboratory animals, but little is known about equine CYPs. The characterization of equine CYP...
Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: a retrospective study. This study investigated associations between perioperative factors and probability of death and length of hospitalization of mares with dystocia that survived following general anesthesia. Demographics and perioperative characteristics from 65 mares were reviewed retrospectively and used in a risk factor analysis. Mortality rate was 21.5% during the first 24 h post-anesthesia. The mean ± standard deviation number of days of hospitalization of surviving mares was 6.3 ± 5.4 d. Several factors were found in the univariable analysis to be significantly associated (P < 0.1) with increased probabi...
Evaluation of growth models for follicle development and ovulation in Lusitano mares. Several growth models are commonly used in the biological sciences, to model the follicle growth occurring in the estrous cycle. The aim of this project was to find the model that best fit the follicular size growth data for Lusitano mares. Retrospective data collected from reproduction book records of n=84 mares and n=124 cycles was used to find the series to be fitted to the models. The exponential, Gompertz, logistic, von Bertalanffy, Richards and Weibull models were used, and the most parsimonious and best fit was achieved with the logistic model (r(2)=0.999). The logistic model fits the L...
[Prospective assessment of circulatory sufficiency of the patients after 3F equine pericardial stentless bioprosthesis replacement]. During years more and more advanced Technologies are used for treatment of severe aortic stenosis. One of them is equine pericardial stentless bioprothesis. Objective: the aim of the study was prospective assessment of circulatory sufficiency of the patients after 3F equine pericardial stentless bioprothesis replacement (ATS-Medtronic, Inc, Minneapolis, USA). Methods: Patients qualified to valve replacement were qualified to the study. The procedures were performed in general anesthesia and medial thoracothomy. The New York Heart Association (NYHA) scale was analyzed to estimate clinical resul...
Efficacy of epidural lidocaine combined with tramadol or neostigmine on perineal analgesia in the horse. Short duration of analgesia is among the limitations of a single epidural injection with lidocaine in horses. Objective: To evaluate the effectiveness and safety of epidural lidocaine in combination with either tramadol or neostigmine for perineal analgesia in horses. Methods: Epidural catheters were placed in 6 saddle horses that then were given 3 treatments: 2% lidocaine (0.2 mg/kg bwt) alone, 2% lidocaine (0.2 mg/kg bwt) plus tramadol (0.5 mg/kg bwt), and 2% lidocaine (0.2 mg/kg bwt) plus neostigmine (1.0 μg/kg bwt). The order of treatments was randomised. Haemodynamic variables, respirato...
Minimally invasive repair of a calcaneus fracture in a Standardbred foal. A 4-month-old Standardbred colt was examined because of a fractured right calcaneus of 8 days' duration with increased distraction of the fracture fragment evident on sequential radiographs. Results: The foal was severely lame with diffuse periarticular tarsal swelling. Radiographically, a complete, displaced long oblique fracture of the right calcaneal body was evident. Because the fracture gap was increasing with time and lameness remained severe, despite medical management, surgical repair was recommended. Results: The foal was anesthetized, and minimally invasive fracture reduction and int...
Anesthetic and cardiorespiratory effects of propofol, medetomidine, lidocaine and butorphanol total intravenous anesthesia in horses. Anesthetic and cardiorespiratory effects of medetomidine, lidocaine, butorphanol and propofol total intravenous anesthesia (MLBP-TIVA) were evaluated in horses undergoing an experimental surgery. Ten horses were premedicated with an intravenous injection (IV) of medetomidine (5 µg/kg) and butorphanol (20 µg/kg). Anesthesia was induced by administration of 1% propofol (3 mg/kg, IV) at a rate of 1 mg/kg/min (n=5, group-1) or 2% propofol administered at a rate of 6 mg/kg/min (n=5, group-2) following administration of lidocaine (1 mg/kg, IV) and then maintained by infusions of propofol, medetomi...
The effects of a loading dose followed by constant rate infusion of xylazine compared with romifidine on sedation, ataxia and response to stimuli in horses. To compare xylazine and romifidine constant rate infusion (CRI) protocols regarding degree of sedation, and effects on postural instability (PI), ataxia during motion (A) and reaction to different stimuli. Methods: Blinded randomized experimental cross-over study. Methods: Ten adult horses. Methods: Degree of sedation was assessed by head height above ground (HHAG). Effects on PI, A and reaction to visual, tactile and acoustic stimulation were assessed by numerical rating scale (NRS) and by visual analogue scale (VAS). After baseline measurements, horses were sedated by intravenous loading dos...
Sevoflurane inhibits equine myeloperoxidase release and activity in vitro. To investigate the effects of the volatile anaesthetic sevoflurane on the release of total and active myeloperoxidase (MPO) by non-stimulated and stimulated polymorphonuclear neutrophils (PMNs) in whole blood from healthy horses. Methods: In vitro experimental study. Methods: Adult healthy horses. Methods: Samples of whole venous blood were collected and incubated in air or in air plus 2.3% or 4.6% sevoflurane for 1 hour. PMNs were stimulated with N-formyl-methionyl-leucyl-phenylalanine (fMLP), with a combination of cytochalasin B (CB) and fMLP or with phorbol myristate acetate (PMA). Total an...
Early experience with continuous positive airway pressure (CPAP) in 5 horses — a case series. This case series is the first report of the use of CPAP (continuous positive airway pressure) ventilation in adult horses. Two horses and 3 ponies anesthetized for orthopedic procedures in lateral recumbency received 10 cm H(2)O CPAP. During anesthesia, arterial oxygen partial pressure tended to increase and arterial carbon dioxide pressure tended to increase despite increased minute ventilation index. The measured cardiovascular parameters were within physiologic limits. Cette série de cas est le premier rapport sur l’utilisation de la ventilation spontanée en pression positive continue ...
Assessment of unassisted recovery from repeated general isoflurane anesthesia in horses following post-anesthetic administration of xylazine or acepromazine or a combination of xylazine and ketamine. To compare the effects of sedative doses of acepromazine, xylazine or xylazine/ketamine administered to horses after isoflurane anesthesia on the quality of recovery and anesthesia recovery times. To determine if recovery scores improve after repeated consecutive anesthetic episodes. Methods: Prospective, randomized, crossover study. Methods: Fifteen adult research horses, 6.5±3.4 years old and weighing 499±40 kg. Methods: Horses undergoing three anesthetic episodes with isoflurane for magnetic resonance of the forelimbs were administered acepromazine (0.02 mg kg(-1) i.v.) or xylazine (0.3 m...
The effects of perineural and intrasynovial anaesthesia of the equine foot on subsequent magnetic resonance images. Artefacts caused by regional anaesthesia can influence image interpretation of ultrasonography and nuclear scintigraphy. Perineural and intrasynovial anaesthesia are commonly performed prior to magnetic resonance imaging (MRI); and the effects on MR images, if any, are unknown. Objective: To determine if perineural and intrasynovial anaesthesia of structures in the equine foot cause iatrogenic changes detectable with MRI. Methods: A baseline MRI examination of both front feet was performed on 15 horses, 2-6 days prior to mepivacaine injection adjacent to the lateral and medial palmar digital n...
Alfaxalone and medetomidine intravenous infusion to maintain anaesthesia in colts undergoing field castration. The use of alfaxalone and medetomidine administered as an i.v. infusion to maintain anaesthesia has not previously been reported in the horse. Objective: To investigate the use of alfaxalone in hydroxpropyl-beta-cyclodextrin (Alfaxan) and medetomidine infusion as a field anaesthetic for short-term surgical procedures in the horse. Objective: Alfaxalone-medetomidine anaesthesia is suitable for short-term field anaesthesia in horses. Methods: Eleven healthy colts underwent 45 min of anaesthesia with an i.v. infusion of alfaxalone (2 mg/kg bwt/h) and medetomidine (5 μg/kg bwt/h) for routin...
Survival of horses following strangulating large colon volvulus. The pattern of long-term survival and specific factors associated with long-term survival have not previously been evaluated in horses with a strangulating large colon volvulus (LCV). Objective: To provide data on the long-term survival of horses with LCV and to identify pre-, intra- and post operative variables associated with survival. Methods: Clinical data and long-term follow-up information were obtained from 116 horses with a strangulating LCV (≥360°) undergoing general anaesthesia. Two multivariable Cox proportional hazards models for post operative survival time were developed: Mode...
Efficacy of concurrent epidural administration of neostigmine and lidocaine for perineal analgesia in geldings. To evaluate perineal analgesic effects of 3 doses of neostigmine coadministered epidurally with lidocaine to geldings. Methods: 6 healthy geldings. Methods: A few days before each treatment, a catheter was inserted between the first and second coccygeal vertebrae via the caudal approach in each gelding; the catheter tip was threaded approximately 10 cm cranial into the midsacral region. Each horse received 4 epidural treatments: 2% lidocaine (0.2 mg/kg) alone and 3 doses of neostigmine (0.5, 1, or 2 μg/kg) coadministered with that same dose of lidocaine. Horses were restrained in stocks in a ...
Lithium dilution, pulse power analysis, and continuous thermodilution cardiac output measurements compared with bolus thermodilution in anaesthetized ponies. This study compares cardiac output (CO) measurements obtained by lithium dilution (LiDCO), pulse power analysis (PulseCO), and continuous thermodilution (CTD) with bolus thermodilution (BTD) in ponies. Methods: Eight isoflurane-anaesthetized Shetland ponies received xylazine, ketamine, and midazolam infusions (0.3, 1.2, and 0.018 mg kg(-1) h(-1), respectively). CO was measured with BTD, CTD, LiDCO, and PulseCO. Lithium was injected into the jugular vein and blood was sampled from the facial artery for lithium detection and this artery was also used for PulseCO. Measurements were obtained durin...
