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Equine veterinary journal2020; 53(4); 682-689; doi: 10.1111/evj.13338

Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis.

Abstract: Opioid epidural analgesia has been shown to provide effective analgesia in horses. There is a lack of evidence regarding the effect of opioid epidural analgesia on quality of recovery in horses. Objective: Identify whether opioid epidural analgesia influences quality of recovery in horses undergoing general anaesthesia required for management of hindlimb synovial sepsis. Methods: Single-centre retrospective cross-sectional study. Methods: Data were obtained from the clinical records of horses which had undergone arthroscopic or tenoscopic surgery for management of hindlimb synovial sepsis over a 9-year period in a referral hospital population. Multivariable logistic regression analysis was used to identify the perioperative factors that impact on quality of recovery. Results: Records from 149 horses, undergoing 170 general anaesthetics were included. Multivariable logistic regression analysis showed that opioid epidural analgesia (OR 3.0, 95% CI 1.2 to 7.2, P = .02) was associated with good quality of recovery, whereas Cob breeds (OR 0.16, 95% CI 0.06 to 0.46, P = .001), age (in years) (OR 0.90, 95% CI 0.83 to 0.97, P = .004) increasing intraoperative dosages (in mg/kg) of thiopental (OR 0.64, 95% CI 0.46 to 0.90, P = .01) or ketamine (OR 0.42, 95% CI 0.18 to 0.98, P = .04) were associated with poor quality of recovery. Conclusions: Certain variables that may influence quality of recovery, such as patient temperament and hindlimb orthopaedic co-morbidities were not recorded. The clinical prediction model obtained is only applicable to the specific facilities, population and perianaesthetic management practiced at our institution. Conclusions: Opioid epidural analgesia is significantly associated with good quality of recovery in horses undergoing general anaesthesia required for management of hindlimb synovial sepsis. Other risk factors, such as increasing age, cob breed, use of higher intraoperative dosages (in mg/kg) of ketamine and/or thiopental, were associated with poor quality of recovery.
© 2020 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2020-09-23 PubMed ID: 32852063DOI: 10.1111/evj.13338Google Scholar: Lookup
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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 studies how opioid epidural analgesia influences the quality of recovery in horses that undergo general anaesthesia for the treatment of hindlimb synovial sepsis. The study found that opioid epidural analgesia was significantly associated with good quality of recovery, while other factors like increasing age, specific breed, and high dosages of certain medications were linked to poor recovery quality.

Study Objective and Methodology

  • The research aimed to determine if opioid epidural analgesia impacts the quality of recovery in horses that have been put under general anaesthesia for the treatment of hindlimb synovial sepsis.
  • The researchers conducted a retrospective cross-sectional study using data from clinical records of horses that had undergone arthroscopic or tenoscopic surgery for hindlimb synovial sepsis in a referral hospital over a nine-year period.
  • The study used multivariable logistic regression analysis to identify perioperative factors that could have an effect on the quality of recovery.

Findings of the Study

  • Data from the records of 149 horses undergoing 170 general anaesthetics were included.
  • The analysis revealed that opioid epidural analgesia was associated with a good quality of recovery (OR 3.0, 95% CI 1.2 to 7.2, P = .02).
  • On the other hand, the Cob breed (OR 0.16, 95% CI 0.06 to 0.46, P = .001), increasing age (OR 0.90, 95% CI 0.83 to 0.97, P = .004), and increasing intraoperative dosages of thiopental (OR 0.64, 95% CI 0.46 to 0.90, P = .01) or ketamine (OR 0.42, 95% CI 0.18 to 0.98, P = .04) had poor recovery outcomes.

Conclusions and Limitations

  • The study concluded that opioid epidural analgesia significantly improved the quality of recovery in horses undergoing general anaesthesia for the management of hindlimb synovial sepsis.
  • The risk factors for poor recovery include increasing age, being of a Cob breed, and higher intraoperative dosages of ketamine and/or thiopental.
  • The research acknowledged that the study did not record certain variables that might influence recovery quality, such as patient temperament and hindlimb orthopaedic co-morbidities.
  • The researchers noted that their clinical prediction model is only applicable to the specific facilities, population, and anaesthetic management practiced at their institution.

Cite This Article

APA
Louro LF, Milner PI, Bardell D. (2020). Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis. Equine Vet J, 53(4), 682-689. https://doi.org/10.1111/evj.13338

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 4
Pages: 682-689

Researcher Affiliations

Louro, Luís F
  • Institute of Veterinary Science, University of Liverpool, Neston, UK.
Milner, Peter I
  • Institute of Veterinary Science, University of Liverpool, Neston, UK.
Bardell, David
  • Institute of Veterinary Science, University of Liverpool, Neston, UK.
  • Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, Liverpool, UK.

MeSH Terms

  • Analgesics, Opioid / therapeutic use
  • Animals
  • Cross-Sectional Studies
  • Hindlimb
  • Horse Diseases / drug therapy
  • Horse Diseases / surgery
  • Horses
  • Models, Statistical
  • Prognosis
  • Retrospective Studies
  • Sepsis / veterinary

Grant Funding

  • University of Liverpool

References

This article includes 46 references
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Citations

This article has been cited 4 times.
  1. Marzok M, Almubarak AI, Babiker H, Kandeel M, El-Hawari SF, El-Khodery S. Comparative evaluation of sedative and anti-nociceptive effects of epidural romifidine, romifidine-lidocaine, and lidocaine in donkeys (Equus asinus). Front Vet Sci 2022;9:966715.
    doi: 10.3389/fvets.2022.966715pubmed: 36570502google scholar: lookup
  2. Douglas H, Midon M, Shroff K, Floriano D, Driessen B, Hopster K. Caudal epidural catheterization for pain management in 48 hospitalized horses: A descriptive study of demographics, complications, and outcomes. Front Vet Sci 2022;9:995299.
    doi: 10.3389/fvets.2022.995299pubmed: 36387394google scholar: lookup
  3. Cummings CO, Krucik DDR, Price E. Clinical predictive models in equine medicine: A systematic review. Equine Vet J 2023 Jul;55(4):573-583.
    doi: 10.1111/evj.13880pubmed: 36199162google scholar: lookup
  4. Gozalo-Marcilla M, Ringer SK. Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature. Animals (Basel) 2021 Jun 14;11(6).
    doi: 10.3390/ani11061777pubmed: 34198637google scholar: lookup
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