Analyze Diet

Effect of anesthesia duration on the quality of recovery in horses undergoing elective and emergency surgeries using the same anesthetic protocol.

Abstract: The objective of this study was to investigate the effect of anesthesia duration on the quality of recovery in horses. The medical records of horses that were anesthetized and underwent surgery for elective and emergency soft tissue and orthopedic conditions from 2013 to 2019 were reviewed. Horses included in the study (N = 305) fulfilled the following requirements: all had the same premedication/induction protocol and the same balanced anesthesia for maintenance and were anesthetized by the same, experienced Board-certified anesthesiologist. A standardized anesthetic recovery score was completed for all horses to evaluate their recovery and the following interactions were assessed: age, body weight, breed, sex, American Society of Anesthesiologists status, type of surgical procedure, occurrence of hypotension, use of dobutamine, number of additional doses of xylazine/ketamine after isoflurane discontinuation, anesthesia duration, post-anesthetic sedation, and end-tidal isoflurane concentration during maintenance and at the time of transfer to the recovery room. These interactions were assessed based on the quality of recovery score using logistic regression. Duration of anesthesia ( = 0.021) and age ( = 0.003) negatively affected the quality of recovery. The odds of a worse recovery score were increased by 1.20-fold (1.03, 1.41; lower and upper limits) for every additional 30 min of anesthesia duration, while the odds of a worse recovery score were increased by 1.09-fold (1.03, 1.16) for every additional 1 y of age. In conclusion, the results of this retrospective study indicate that increasing the anesthesia duration negatively affects the quality of recovery in horses undergoing routine and emergency surgical procedures. L’objectif de cette étude était d’étudier l’effet de la durée de l’anesthésie sur la qualité de la récupération chez les chevaux. Les dossiers médicaux des chevaux qui ont été anesthésiés et ont subi une intervention chirurgicale élective et d’urgence des tissus mous et orthopédique de 2013 à 2019 ont été examinés. Les chevaux inclus dans l’étude (N = 305) remplissaient les conditions suivantes : tous avaient le même protocole de prémédication/d’induction et la même anesthésie équilibrée pour l’entretien et ont été anesthésiés par le même anesthésiste expérimenté et certifié par le . Un score de récupération anesthésique standardisé a été réalisé pour tous les chevaux afin d’évaluer leur récupération et les interactions suivantes ont été évaluées : âge, poids corporel, race, sexe, statut , type d’intervention chirurgicale, survenue d’hypotension, utilisation de dobutamine, nombre de doses supplémentaires de xylazine/kétamine après l’arrêt de l’isoflurane, la durée de l’anesthésie, la sédation post-anesthésique et la concentration d’isoflurane en fin d’expiration pendant l’entretien et au moment du transfert en salle de réveil. Ces interactions ont été évaluées sur la base de la qualité du score de récupération en utilisant la régression logistique. La durée de l’anesthésie ( = 0,021) et l’âge ( = 0,003) ont affecté négativement la qualité de la récupération. Les probabilités d’un pire score de récupération ont été multipliées par 1,20 (1,03, 1,41; limites inférieure et supérieure) pour chaque 30 min supplémentaire de durée d’anesthésie, tandis que les chances d’un pire score de récupération ont été multipliées par 1,09 (1,03, 1,16) pour chaque année d’âge supplémentaire. En conclusion, les résultats de cette étude rétrospective indiquent que l’augmentation de la durée de l’anesthésie affecte négativement la qualité de la récupération chez les chevaux subissant des interventions chirurgicales de routine et d’urgence.(Traduit par Docteur Serge Messier).
Publication Date: 2021-07-13 PubMed ID: 34248263PubMed Central: PMC8243802
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article studied the impact of anesthesia duration on the quality of recovery in horses that have undergone elective and emergency surgeries. The data from the study shows that an increase in age and duration under anesthesia negatively impacts the quality of recovery.

About the Study

  • The data was collected retrospectively from the medical records of horses, which underwent surgeries from 2013 to 2019, under the care of an experienced Board-certified anesthesiologist.
  • The study included a total of 305 horses that underwent soft tissue or orthopedic surgery, either elective or emergency.
  • All the horses were subjected to the same premedication/induction protocol and balanced anesthesia for maintenance.

Methodology

  • The recovery of the horses was assessed using a standardized recovery score system.
  • The researchers took into account various factors including age, body weight, breed, sex, type of surgical procedure, American Society of Anesthesiologists status, occurrence of hypotension, use of dobutamine, number of doses of xylazine/ketamine after discontinuation of isoflurane, anesthesia duration, post-anesthetic sedation, and end-tidal isoflurane concentration during maintenance and transfer to the recovery room.
  • The quality of recovery was evaluated using these factors in a logistic regression model.

Results

  • The research found that anesthesia duration and age negatively affected the quality of recovery in horses.
  • Every additional 30 minutes of anesthesia increased the odds of a worse recovery score by 1.20 times, while every additional year of age raised these odds by 1.09 times.

Conclusion

  • The findings of this study suggest that the duration of anesthesia negatively impacts the quality of recovery in horses undergoing surgeries, highlighting the need for careful anesthetic management in older horses and procedures requiring longer durations of anesthesia.

Cite This Article

APA
Vermedal H, Valverde A, Sears W. (2021). Effect of anesthesia duration on the quality of recovery in horses undergoing elective and emergency surgeries using the same anesthetic protocol. Can J Vet Res, 85(3), 193-200.

Publication

ISSN: 1928-9022
NlmUniqueID: 8607793
Country: Canada
Language: English
Volume: 85
Issue: 3
Pages: 193-200

Researcher Affiliations

Vermedal, Hanna
  • Department of Equine Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, Ireland (Vermedal); Department of Clinical Studies (Valverde) and Department of Population Medicine (Sears), Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
Valverde, Alexander
  • Department of Equine Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, Ireland (Vermedal); Department of Clinical Studies (Valverde) and Department of Population Medicine (Sears), Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
Sears, William
  • Department of Equine Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin, Ireland (Vermedal); Department of Clinical Studies (Valverde) and Department of Population Medicine (Sears), Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.

MeSH Terms

  • Anesthesia Recovery Period
  • Anesthesia, General / adverse effects
  • Anesthesia, General / veterinary
  • Anesthetics / administration & dosage
  • Anesthetics / adverse effects
  • Anesthetics / pharmacology
  • Animals
  • Drug Administration Schedule
  • Emergencies / veterinary
  • Horses
  • Time Factors

References

This article includes 27 references
  1. Johnston GM, Taylor PM, Holmes MA, Wood JL. Confidential enquiry of perioperative equine fatalities (CEPEF-1): preliminary results.. Equine Vet J 1995 May;27(3):193-200.
  2. Johnston GM, Eastment JK, Wood J, Taylor PM. The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2.. Vet Anaesth Analg 2002 Oct;29(4):159-170.
  3. Brodbelt DC, Blissitt KJ, Hammond RA, Neath PJ, Young LE, Pfeiffer DU, Wood JL. The risk of death: the confidential enquiry into perioperative small animal fatalities.. Vet Anaesth Analg 2008 Sep;35(5):365-73.
  4. Dugdale AH, Obhrai J, Cripps PJ. Twenty years later: a single-centre, repeat retrospective analysis of equine perioperative mortality and investigation of recovery quality.. Vet Anaesth Analg 2016 Mar;43(2):171-8.
    pubmed: 26081190doi: 10.1111/vaa.12285google scholar: lookup
  5. Young SS, Taylor PM. Factors influencing the outcome of equine anaesthesia: a review of 1,314 cases.. Equine Vet J 1993 Mar;25(2):147-51.
  6. Valverde A, Rickey E, Sinclair M, Rioja E, Pedernera J, Hathway A, Cruz A. Comparison of cardiovascular function and quality of recovery in isoflurane-anaesthetised horses administered a constant rate infusion of lidocaine or lidocaine and medetomidine during elective surgery.. Equine Vet J 2010 Apr;42(3):192-9.
  7. Valverde A, Gunkelt C, Doherty TJ, Giguère S, Pollak AS. Effect of a constant rate infusion of lidocaine on the quality of recovery from sevoflurane or isoflurane general anaesthesia in horses.. Equine Vet J 2005 Nov;37(6):559-64.
    pubmed: 16295936doi: 10.2746/042516405775314772google scholar: lookup
  8. Hosmer DW, Lemeshow S. Applied Logistic Regression. 2nd ed. New York, New York: John Wiley & Sons; 2000. Assessing the fit of the model; pp. 147–155.
  9. Bidwell LA, Bramlage LR, Rood WA. Equine perioperative fatalities associated with general anaesthesia at a private practice--a retrospective case series.. Vet Anaesth Analg 2007 Jan;34(1):23-30.
  10. Grandy JL, Steffey EP, Hodgson DS, Woliner MJ. Arterial hypotension and the development of postanesthetic myopathy in halothane-anesthetized horses.. Am J Vet Res 1987 Feb;48(2):192-7.
    pubmed: 3826855
  11. Whitehair KJ, Steffey EP, Willits NH, Woliner MJ. Recovery of horses from inhalation anesthesia.. Am J Vet Res 1993 Oct;54(10):1693-702.
    pubmed: 8250395
  12. Johnston GM, Eastment JK, Taylor PM, Wood JL. Is isoflurane safer than halothane in equine anaesthesia? Results from a prospective multicentre randomised controlled trial.. Equine Vet J 2004 Jan;36(1):64-71.
    pubmed: 14756374doi: 10.2746/0425164044864723google scholar: lookup
  13. Wagner AE. Complications in equine anesthesia.. Vet Clin North Am Equine Pract 2008 Dec;24(3):735-52, x.
    pubmed: 19203709doi: 10.1016/j.cveq.2008.10.002google scholar: lookup
  14. Ragle C, Baetge C, Yiannikouris S, Dunigan C, Schneider R, Keegan R. Development of equine post anaesthetic myelopathy: Thirty cases (1979–2010). Equine Vet Ed 2011;23:630–635.
  15. Rioja E, Cernicchiaro N, Costa MC, Valverde A. Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: a retrospective study.. Can Vet J 2012 May;53(5):502-10.
    pmc: PMC3327588pubmed: 23115362
  16. Parviainen AK, Trim CM. Complications associated with anaesthesia for ocular surgery: a retrospective study 1989-1996.. Equine Vet J 2000 Nov;32(6):555-9.
    pubmed: 11093632doi: 10.2746/042516400777584659google scholar: lookup
  17. Donaldson LL, Dunlop GS, Holland MS, Burton BA. The recovery of horses from inhalant anesthesia: a comparison of halothane and isoflurane.. Vet Surg 2000 Jan-Feb;29(1):92-101.
  18. Valverde A, Black B, Cribb NC, Hathway A, Daw A. 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.. Vet Anaesth Analg 2013 Jan;40(1):3-12.
  19. Platt JP, Simon BT, Coleman M, Martinez EA, Lepiz MA, Watts AE. The effects of multiple anaesthetic episodes on equine recovery quality.. Equine Vet J 2018 Jan;50(1):111-116.
    pubmed: 28772349doi: 10.1111/evj.12728google scholar: lookup
  20. Santos M, Fuente M, Garcia-Iturralde R, Herran R, Lopez-Sanroman J, Tendillo FJ. Effects of alpha-2 adrenoceptor agonists during recovery from isoflurane anaesthesia in horses.. Equine Vet J 2003 Mar;35(2):170-5.
    pubmed: 12638794doi: 10.2746/042516403776114117google scholar: lookup
  21. Arndt S, Hopster K, Sill V, Rohn K, Kästner SBR. Comparison between head-tail-rope assisted and unassisted recoveries in healthy horses undergoing general anesthesia for elective surgeries.. Vet Surg 2020 Feb;49(2):329-338.
    pubmed: 31705685doi: 10.1111/vsu.13347google scholar: lookup
  22. Rüegg M, Bettschart-Wolfensberger R, Hartnack S, Junge HK, Theiss F, Ringer SK. Comparison of non-assisted versus head and tail rope-assisted recovery after emergency abdominal surgery in horses. Pferdeheilkunde 2016;32:469–478.
  23. Kästner SBR. How to manage recovery from anaesthesia in the horse — to assist or not to assist?. Pferdeheilkunde 2010;26:604–608.
  24. Mee AM, Cripps PJ, Jones RS. A retrospective study of mortality associated with general anaesthesia in horses: emergency procedures.. Vet Rec 1998 Mar 21;142(12):307-9.
    pubmed: 9569498doi: 10.1136/vr.142.12.307google scholar: lookup
  25. Donaldson LL. Retrospective assessment of dobutamine therapy for hypotension in anesthetized horses.. Vet Surg 1988 Jan-Feb;17(1):53-7.
  26. Suthers JM, Christley RM, Clutton RE. Quantitative and qualitative comparison of three scoring systems for assessing recovery quality after general anaesthesia in horses.. Vet Anaesth Analg 2011 Jul;38(4):352-62.
  27. Clark-Price SC, Lascola KM, Carter JE, da Cunha AF, Donaldson LL, Doherty TJ, Martin-Flores M, Hofmeister EH, Keating SCJ, Mama KR, Mason DE, Posner LP, Sano H, Seddighi R, Shih AC, Weil AB, Schaeffer DJ. Assessment of agreement among diplomates of the American College of Veterinary Anesthesia and Analgesia for scoring the recovery of horses from anesthesia by use of subjective grading scales and development of a system for evaluation of the recovery of horses from anesthesia by use of accelerometry.. Am J Vet Res 2017 Jun;78(6):668-676.
    pubmed: 28541154doi: 10.2460/ajvr.78.6.668google scholar: lookup

Citations

This article has been cited 0 times.