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 heparin treatment on colonic torsion-associated hemodynamic and plasma eicosanoid changes in anesthetized ponies. Large colon torsion frequently is a fatal condition in horses. The purpose of the study reported here was to determine systemic arterial pressure, plasma eicosanoid concentrations, colonic blood flow, vascular resistance, tissue pH, and morphologic features associated with large colon torsion and detorsion, and to evaluate the effects of sodium heparin (80 IU/kg of body weight, IV) treatment on these values. Values were determined in 20 anesthetized ponies that were randomly assigned into 4 equal groups: control; control/heparin; torsion; torsion/heparin. Torsions were created by a 720 degrees...
Severe hypercarbia resulting from inspiratory valve malfunction in two anesthetized horses. Severe hypercarbia was documented by arterial blood gas analysis in 2 adult horses anesthetized for exploratory laparotomy. Both horses appeared to be adequately anesthetized, but continued to breathe against the ventilator. In both cases, the inspiratory valve on the anesthesia machine was found to be stuck open, permitting expired CO2 to return to the inspiratory limb of the anesthetic circuit and to be inhaled with the next breath. Correction of the malfunctioning valve alleviated the hypercarbia. Problems with the flow valves of the anesthesia machine should be suspected when anesthetized ...
Effects of an infusion of dopamine on the cardiopulmonary effects of Escherichia coli endotoxin in anaesthetised horses. Horses with colic may be endotoxaemic and subsequently develop hypotension during anaesthesia for surgical operation. The aim of this study was to evaluate the efficacy of dopamine as a means to improve cardiovascular function in anaesthetised endotoxaemic horses. Nine horses (five in group 1 and four in group 2) were anaesthetised with thiopentone and guaifenesin and anaesthesia was maintained with halothane. After approximately one hour, facial artery pressure, heart rate, pulmonary artery pressure, cardiac output, temperature, pHa, PaCO2, PaO2, base excess, packed cell volume, plasma protei...
Prolongation of xylazine/ketamine induced recumbency time with temazepam in horses. Short term anaesthesia induced with xylazine and ketamine was compared to a combination of xylazine, ketamine and temazepam (a benzodiazepine) in six adult horses. Duration of recumbency was significantly prolonged when temazepam was administered with xylazine and ketamine. No significant differences in heart rate, respiratory rate, blood pressure or arterial pH, pCO2 and pO2 were seen between the xylazine and ketamine combination plus temazepam, and xylazine and ketamine combination only treated horses.
Prolongation of anesthesia with xylazine, ketamine, and guaifenesin in horses: 64 cases (1986-1989). On 74 occasions, 54 horses and 6 foals were anesthetized with xylazine and ketamine or xylazine, guaifenesin, and ketamine, with or without butorphanol. On 64 occasions, anesthesia was prolonged for up to 70 minutes (34 +/- 15 min) by administration of 1 to 9 supplemental IV injections of xylazine and ketamine at approximately a third the initial dosage. All horses except 5 were positioned in lateral recumbency, and oxygen was insufflated. In adult horses, the time from induction of anesthesia to the first supplemental xylazine and ketamine injection was 13 +/- 4 minutes and the time between s...
Clinical use of positive-pressure ventilation in the horse. Positive-pressure ventilation is used to provide improved ventilatory support during anesthesia in the horse. Because of the horse's size and the physiologic changes it undergoes during anesthesia, however, the use of positive-pressure ventilation does not always provide the improvement seen in smaller species. Careful attention to respiratory rate, inspiratory pressure, and I:E ratio minimizes the negative aspect of IPPV on the cardiovascular system. The goal of future ventilatory techniques will be to improve oxygenation without cardiovascular compromise and to do so at a reasonable cost to ...
Regional anesthesia. Organ toxicity from local anesthetic agents is rare. This makes these agents an attractive option in the high-risk patient. Complications associated with local anesthetics are related to overdosage. Overdosage with local anesthetic agents administered epidurally may cause motor paralysis and hind-limb weakness. Systemic signs of local anesthetic overdosage include changes in central nervous system activity (excitement or depression), muscle tremors, and hypotension. Because the dose required to produce these effects in the horse is high (12 mg/kg), this complication is uncommon. Few side effec...
Anesthetic complications in the horse. The basis for management of all complications is early recognition, preparation, and a problem-solving approach. Some anesthetic complications, such as equipment malfunction and injuries from endotracheal intubation or misplaced drug injections, are common to all animals and can be prevented almost entirely by careful management. Other problems, such as pulmonary dysfunction and cardiovascular depression, seem to occur more often in healthy horses than in healthy members of other domestic species. Postoperative myopathy-neuropathy, sometimes a devastating complication, seems to be peculiar to ...
Intravenous anesthesia. Anticholinergics, tranquilizers, and sedative-hypnotics are the usual agents used for preanesthetic sedation of the horse. Of these drugs, the anticholinergics are of little importance in the horse. Acepromazine is the most useful and widely used tranquilizer, whereas xylazine is a safe and popular sedative. A newer sedative recently made available to the veterinarian for clinical use in horses is detomidine. Thiobarbiturates are seldom used alone any longer but are still useful when combined with guaifenesin for induction and maintenance of anesthesia. Other, more contemporary drug combinatio...
Use of halothane and isoflurane in the horse. When compared with halothane, isoflurane has several distinct characteristics. Vaporizer settings are higher because of its lower potency. Respiratory rates will be slower, and intraoperative changes in depth and recovery from surgical depth of anesthesia will be more rapid, although total recovery times frequently will not be different. Halothane and isoflurane appear similar in their effects on ocular reflexes and mean arterial blood pressure. Recovery from isoflurane should be managed to provide added sedation or physical support if the horse attempts to stand prematurely.
Neuromuscular blocking agents in equine anesthesia. In summary, neuromuscular blocking agents can be used safely and to advantage in equine anesthesia. Muscle-relaxant use in equine anesthesia has been helped by the development of new relaxants such as atracurium, which has a reliable and reproducible duration of action. There are certain cases that benefit particularly by the use of relaxants but their use is not limited to these cases. These cases involve horses that experience persistent movement and hypotension during anesthesia, are undergoing ophthalmic or abdominal surgery or fracture repair, or are severely ill. Horses receiving muscle ...
Equipment for inhalation anesthesia. Inhalation anesthesia has three requirements: delivery of oxygen, delivery of an appropriate concentration of a volatile anesthetic agent, and removal of carbon dioxide. Halothane and isoflurane are the most commonly used anesthetic agents. They are usually delivered with a semiclosed circle system using an out-of-the-circuit vaporizer. Carbon dioxide is eliminated by chemical absorption and by flow of excess oxygen and waste anesthetic agent through the pop-off valve. These gases should be scavenged to prevent room contamination. A variety of ancillary equipment is available to assist the ane...
Chemical restraint and analgesia in the horse. Chemical restraint in the standing horse is used for a variety of procedures in veterinary medicine. The choice of agent depends on the physical status, temperament, and size of the patient; the procedure to be performed; and safety for the patient, veterinarian, and owner. The combination of certain agents may provide more desirable restraint and analgesia than does the use of individual agents. The use of analgesics in the horse is not without side effects, some of which may be detrimental to the patient's condition. Analgesics should be chosen with these untoward effects in mind. Draft bree...
Monitoring equine anesthesia. In conclusion, monitoring the depth of anesthesia plays an integral role in the anesthetic regimen. Although the use of sophisticated monitoring equipment has replaced some of the art of anesthesia and made assessment of depth of anesthesia more precise, a vigilant clinician still needs to serve as the animal's advocate. He or she must gather the data that are generated by machines, acquire data that monitoring equipment cannot obtain, assimilate all the facts, and make appropriate changes in anesthetic management.
General anesthesia for horses with specific problems. We have discussed anesthetic techniques, special considerations, and expected complications involved in anesthetizing horses for abdominal, orthopedic, and head and neck surgery, and myelography and have described expected physiologic dysfunction that may require changes in anesthetic technique or supportive measures. The objective is high-quality patient care and reduction in anesthesia-related morbidity and death.
Supportive therapy in the anesthetized horse. In conclusion, vigilant supportive care is necessary to prevent morbidity and death in the anesthetized horse. Because some of the equipment and drugs are specialized and the consequences of some postanesthetic complications are severe, availability of those items must be confirmed prior to anesthesia. Proper positioning and padding will help to reduce the incidence of postanesthetic myopathy-neuropathy syndrome in these large patients. Adequate tissue perfusion is important and can be achieved by controlling anesthetic depth, increasing intravascular volume with fluid administration, and by a...
Management of anesthesia in the foal. Several unique pharmacologic and physiologic factors must be considered when attempting to anesthetize premature or neonatal foals. Juvenile foals are similar to adults in their physiology and metabolism. Anesthetic drug and protocol selection should reflect the differences between these two age groups. Neonates are best anesthetized using an inhalation technique, whereas older foals can be safely anesthetized with either parenteral or inhalation anesthetic agents. Careful monitoring is absolutely essential when anesthetizing foals. The clinician should plan to routinely administer fluids and ...
General clinical considerations for anesthesia of the horse. The peculiarities of the equine species present a number of unique situations that must be addressed when horses are anesthetized. Perhaps the most troublesome situation is related to the horse's size. Though the horse's large lungs are responsible in part for its sustainable athletic ability, they are detrimental to effective ventilation when the horse is anesthetized and placed in a recumbent position. Of major concern is depression of ventilation and cardiovascular function. Hypercapnia and hypoxemia usually result from hypoventilation, and with time all anesthetized horses suffer from some...
Attenuated Hering-Breuer inflation reflex 4 years after pulmonary vagal denervation in ponies. The purpose of this study was to determine whether there was any recovery of the Hering-Breuer inflation reflex in ponies between 2-4 wk and 3-4 yr after hilar nerve denervation (HND). Under anesthesia and before HND, airway occlusion after a 3-liter lung inflation lengthened the subsequent occluded breath by nearly 10 times the control breath duration. Between 2 wk and 3-4 yr after HND, this maneuver increased the duration of the occluded breath by only 2.5 times the control breath duration. Also under anesthesia, the airway was occluded at end expiration. This maneuver increased the duration...
Hemodynamic effects of carbon dioxide during intermittent positive-pressure ventilation in horses. The hemodynamic effects of high arterial carbon dioxide pressure (PaCO2) during anesthesia in horses were studied. Eight horses were anesthetized with xylazine, guaifenesin, and thiamylal, and were maintained with halothane in oxygen (end-tidal halothane concentration = 1.15%). Baseline data were collected while the horses were breathing spontaneously; then the horses were subjected to intermittent positive-pressure ventilation, and data were collected during normocapnia (PaCO2, 35 to 45 mm of Hg), moderate hypercapnia (PaCO2, 60 to 70 mm of Hg), and severe hypercapnia (PaCO2, 75 to 85 mm of H...
Bilateral arytenoid cartilage paralysis after inhalation anesthesia in a horse. An 8-year-old Quarter Horse gelding was anesthetized for surgical exploration and debridement of a chronic draining wound in the intermandibular space. Anesthesia was without complication other than persistently low PaO2. Severe airway obstruction was evident immediately after extubation, requiring tracheostomy. Endoscopic diagnosis was bilateral arytenoid paralysis, which gradually resolved over the next 7 days. Compression, trauma, or tension of the recurrent laryngeal nerves are the postulated causes of idiopathic laryngeal hemiplegia in horses. The extremely extended position of the head a...
Cardiorespiratory responses to electrical stimulation of the buccal mucosa in ponies. The cardiovascular and respiratory responses to electrical stimulation of the buccal mucosa under general anaesthesia in ponies were measured in order to provide some insight into the cardiorespiratory effects of anaesthesia in equidae. This knowledge may be useful for reducing morbidity during clinical anaesthesia in horses. Anaesthesia was induced with intravenous thiopentone and maintained with 1.3 per cent inspired halothane in oxygen. Arterial blood pressure, heart rate, minute volume, tidal volume, respiratory rate, arterial blood gas tensions and clinical signs of anaesthetic depth were...
Cardiopulmonary effects of epidurally administered xylazine in the horse. This study was designed to determine whether the epidural administration of an alpha2 agonist, xylazine, would produce measurable changes in arterial blood pressure, electrocardiographic (ECG) activity and arterial blood gas values in horses. Six horses were given each of four treatments: epidural xylazine, intravenous xylazine, epidural lidocaine and epidural saline. A carotid artery catheter was used to measure arterial blood pressure and to collect samples for blood gas analysis before treatment and at intervals post treatment. Heart rate, arterial pressures, ECG activity and respiratory ra...
A comparison of xylazine-diazepam-ketamine and xylazine-guaifenesin-ketamine in equine anesthesia. After sedation with xylazine (0.3 mg/kg intravenously [IV]), anesthesia was induced in six healthy horses with ketamine (2.0 mg/kg IV) and guaifenesin (100 mg/kg IV), diazepam (0.05 mg/kg IV), or diazepam (0.10 mg/kg IV). Anesthesia was maintained with halothane for 30 minutes. Heart rate, respiratory rate, direct arterial blood pressure, arterial blood gas, and pH measurements were made before, and at set intervals after, induction of anesthesia. Quality and characteristics of induction and recovery were evaluated objectively by an independent observer unaware of the protocol used. There were...
Effects of five hours of constant 1.2 MAC halothane in sternally recumbent, spontaneously breathing horses. Circulatory and respiratory effects of five h of constant 1.06 per cent alveolar halothane in oxygen were identified in eight healthy horses, which breathed spontaneously, were otherwise unmedicated and positioned in sternal recumbency. Only a few important significant (P less than 0.05) changes occurred with time. Total peripheral resistance was about 15 per cent lower after two hours of constant dose halothane than after 30 mins of constant dose (P less than 0.05) and accounted for the significant 10 per cent reduction in mean carotid arterial blood pressure. By 5 h, the reduction in resista...
Prophylactic use of dantrolene associated with prolonged postanesthetic recumbency in a horse. Dantrolene, a drug used in the prevention and treatment of malignant hyperthermia, was believed responsible for prolonged postanesthetic recumbency in a horse. Prophylactically, dantrolene was given orally before induction of anesthesia. Dantrolene has been recommended for use in horses at risk of developing postanesthetic myopathy. Side effects, including ataxia, may result from dantrolene administration.
Intra-osseous pressure and pressure pulse gradients along the equine third metatarsal bone. Intra-osseous pressure measurements in the third metatarsal bone of anesthetised young and mature ponies demonstrated that a pressure gradient exists along the bone, the pressure being highest at the level of the nutrient foramen and decreasing distally and proximally from this point. The height of the intra-osseous pressure pulse also decreased toward the bone ends. It is concluded that the sites of measurement of the intra-osseous pressure in clinical and experimental studies should be standardized.
Equine post-anesthetic lameness. A retrospective study. The incidence of post-anesthetic lameness in 655 horses undergoing 733 anesthetic episodes over a 3 year period was 6.4%. Nineteen factors previously reported or proposed to play a role in the development of post-anesthetic lameness were evaluated statistically. Only hypotension and the duration of the anesthetic period were significant factors.