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Home / Equine Research Bank / BMC Vet Res / Has intravenous lidocaine improved the outcome in horses fol...
BMC veterinary research2016; 12(1); 157; doi: 10.1186/s12917-016-0784-7

Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population?

Abstract: Perioperative lidocaine treatment is commonly used in horses that undergo surgical treatment of colic, to prevent or treat postoperative ileus and reduce the effects of intestinal ischaemia-reperfusion injury. However, its clinical efficacy has not been evaluated in a large population of horses undergoing small intestinal surgery. The aim of the current study was to evaluate whether systemic lidocaine administration reduced the prevalence, volume and duration of postoperative reflux and improved rates of survival following surgical treatment of small intestinal lesions. Data were collected as a part of two prospective studies investigating postoperative survival of surgical colic patients admitted to a UK equine referral hospital during the periods 2004-2006 and 2012-2014. Kaplan-Meier plots of cumulative probability of survival and the log-rank test were used to compare survival between horses that did or did not receive lidocaine. The Wilcoxon rank-sum test was used to compare the total reflux volume and duration of reflux between the groups. A multivariable Cox proportional hazards model was used to identify pre- and intraoperative risk factors for non-survival. Results: Data from 318 horses were included in the final analysis. The overall prevalence of postoperative reflux was 24.5 %. This was significantly higher (34.8 %) in horses admitted in 2012-2014 compared to the 2004-2006 cohort (16.7). Perioperative lidocaine treatment had no effect on total reflux volume, duration of reflux or rates of postoperative survival nor was it a risk factor associated with altered postoperative survival. Variables identified to be associated with increased risk of postoperative mortality included packed cell volume on admission (hazard ratio [HR] 1.03 95 %, 95 % confidence interval [CI] 1.004-1.06, p = 0.024), heart rate on admission (HR 1.014, 95 % CI 1.004-1.024, p =0.008) and duration of surgery (HR 1.007, 95 % CI 1.002-1.01, p = 0.008). Conclusions: Lidocaine therapy had no effect on the prevalence of postoperative reflux, total reflux volume and duration of reflux nor did it have any effect on postoperative survival in horses undergoing surgical management of small intestinal disease for treatment of colic. There is a need for a well-designed multicentre, prospective randomised controlled trial to fully investigate the efficacy of lidocaine across different hospital populations.
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Publication Date: 2016-07-27 PubMed ID: 27459996PubMed Central: PMC4962447DOI: 10.1186/s12917-016-0784-7Google 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.

This research study examines the impact of using lidocaine, a common perioperative treatment for horses undergoing surgery for colic, specifically around small intestinal lesions. The study finds that the use of lidocaine did not significantly improve postoperative conditions or survival rates in horses.

Background and Objectives of the Research

  • The study set out to investigate if the use of systemic lidocaine, a treatment commonly used in horses undergoing surgical treatment for colic, would reduce postoperative reflux and improve survival rates following surgery on small intestinal lesions.
  • Despite the common application of this treatment in practice, its clinical efficacy had not been extensively tested in a large population undergoing such specific surgeries.

Research Methodology

  • Information for this study came from two prospective studies investigating the postoperative survival rates of surgical colic patients. The horses were admitted to an equine referral hospital in the UK between 2004-2006 and 2012-2014.
  • The study took into account whether or not the horses received lidocaine and performed survival comparison using Kaplan-Meier plots and log-rank tests.
  • The researchers used the Wilcoxon rank-sum test to evaluate differences between reflux volume and reflux duration for the study groups.
  • A multivariable Cox proportional hazards model was utilized to pinpoint risk factors for non-survival both before and during the operation.

Research Findings

  • 318 horses were part of the final analysis. The overall prevalence of postoperative reflux across all subjects was 24.5%.
  • The percentage of horses with postoperative reflux was notably higher in the 2012-2014 cohort (34.8%) compared to those admitted between 2004-2006 (16.7%).
  • The results found lidocaine treatment did not have a significant impact on total reflux volume, reflux duration, or survival rates following surgery. Furthermore, it was not identified as a risk factor linked with altered postoperative survival.
  • The study identified risk factors that were associated with an increased chance of postoperative mortality. These were: packed cell volume on admission, heart rate on admission, and duration of surgery.

Conclusions and Recommendations

  • The research concluded that lidocaine treatment does not have a notable effect on the prevalence of postoperative reflux, total reflux volume, reflux duration, or even postoperative survival rates in horses undergoing surgical treatment for small intestinal disease related to colic.
  • The authors suggest the requirement for a comprehensive, well-designed, multicenter randomised controlled trial to completely explore the efficacy of lidocaine across varied hospital populations.

Cite This Article

APA
Salem SE, Proudman CJ, Archer DC. (2016). Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population? BMC Vet Res, 12(1), 157. https://doi.org/10.1186/s12917-016-0784-7

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 12
Issue: 1
Pages: 157
PII: 157

Researcher Affiliations

Salem, Shebl E
  • Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK.
  • Department of Surgery, Faculty of Veterinary Medicine, Zagazig University, Zagazig, Egypt.
Proudman, Chris J
  • School of Veterinary Medicine, University of Surrey, Guildford, GU2 7TE, UK.
Archer, Debra C
  • Institute of Infection and Global Health, Department of Epidemiology and Population Health, University of Liverpool, Wirral, CH64 7TE, UK. darcher@liverpool.ac.uk.
  • Philip Leverhulme Equine Hospital, School of Veterinary Science, University of Liverpool, Wirral, CH64 7TE, UK. darcher@liverpool.ac.uk.

MeSH Terms

  • Administration, Intravenous
  • Anesthetics, Local / administration & dosage
  • Animals
  • Colic / drug therapy
  • Colic / surgery
  • Colic / veterinary
  • Gastroesophageal Reflux / prevention & control
  • Gastroesophageal Reflux / veterinary
  • Horse Diseases / drug therapy
  • Horse Diseases / surgery
  • Horses
  • Intestine, Small / pathology
  • Intestine, Small / surgery
  • Kaplan-Meier Estimate
  • Lidocaine / administration & dosage
  • Postoperative Complications / prevention & control
  • Prospective Studies
  • Risk Factors
  • Treatment Outcome

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Citations

This article has been cited 5 times.
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