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Equine veterinary journal2021; 54(5); 875-884; doi: 10.1111/evj.13516

Head and tail rope-assisted recovery improves quality of recovery from general anaesthesia in horses undergoing emergency exploratory laparotomy.

Abstract: In equine anaesthesia, the recovery period is critical, accounting for most anaesthesia-related fatalities reported. Horses may recover unassisted or may be assisted, for example, using a head and tail rope recovery method. Objective: To compare the impact of head and tail rope and unassisted recovery method on quality of recovery in horses undergoing colic surgery under general anaesthesia (GA). Methods: Single centre retrospective cross-sectional study, with prospective model performance analysis. Methods: Clinical data were obtained from horses undergoing emergency exploratory laparotomy over a 6-year period. Multivariable logistic regression analysis was used to identify the perioperative factors that affect quality of recovery. The final prediction model was assessed prospectively. Results: Records from 502 general anaesthetics (490 horses) were included. Multivariable logistic regression analysis showed that head and tail rope recovery (OR 2.2, 95% CI 1.4-3.3, P < .001) and sevoflurane administration (OR 1.6, 95% CI 1.2-2.3, P = .02) were associated with better quality of recovery when compared with unassisted recovery and isoflurane administration respectively. Increasing GA duration (OR 1.0, 95% CI 0.99-1.0, P = .03), increasing intraoperative dosages (in mg/kg) of thiopental (OR 0.85, 95% CI 0.75-0.98, P = .02) or ketamine (OR 0.67, 95% CI 0.46-0.99, P = .04) were linked to poor quality of recovery. No statistically significant difference was found between recovery groups in terms of mortality. Conclusions: The clinical prediction model obtained is only applicable to the specific facilities, recovery methodology, referral population and anaesthetic protocols practiced at our institution. Conclusions: Head and tail rope recovery is significantly associated with better quality of recovery, compared with unassisted recovery, in horses undergoing emergency exploratory laparotomy. Sevoflurane administration, in detriment of isoflurane, was associated with better quality of recovery. Other risk factors, such as increasing GA duration, the use of higher intra-operative dosages of ketamine and/or thiopental, were associated with poor quality of recovery.
© 2021 EVJ Ltd.
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Publication Date: 2021-10-19 PubMed ID: 34541712DOI: 10.1111/evj.13516Google Scholar: Lookup
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Summary

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The research article discusses how the method of recovery, specifically the use of head and tail rope, impacts the quality of recovery in horses after surgery. It examined factors such as anesthesia duration, type of anesthesia used, and medications administered during operation. Based on a study of 490 horses over a six-year period, the researchers discovered that rope-assisted recovery, especially along with the use of a particular type of anaesthetic (sevoflurane), enhanced the quality of recovery in horses undergoing emergency exploratory laparotomy.

Objective and Methods

  • The goal of the study was to investigate how different recovery methods, specifically the unassisted and rope-assisted (head and tail rope) methods, impact post-surgical recovery in horses. They also measured the effect of varying anaesthetic types and operation-related factors.
  • The study was conducted retrospectively, where data was collected from previous cases and analysed. Specifically, data from horses that underwent emergency exploratory laparotomy over a six-year period was acquired.
  • Using multivariable logistic regression analysis, likely factors affecting the quality of recovery were identified. Subsequently, the prediction model derived from the analysis was tested prospectively.

Results

  • Records of 490 horses were analysed. The results indicated that the use of head and tail rope in recovery (odds ratio OR 2.2), and the administration of sevoflurane anaesthetic (OR 1.6) yielded a better quality of recovery compared to unassisted recovery and administration of isoflurane respectively.
  • Furthermore, longer anaesthesia duration and higher intraoperative doses of certain drugs (ketamine and thiopental) led to a poorer recovery quality.
  • It was noted that there was no significant difference in mortality rates between the two recovery methods.

Conclusion

  • The researchers cautioned that the prediction model is particular to the conditions of their institution, including the facilities, recovery methods, referral population, and anaesthetic protocols used.
  • They concluded that rope-assisted recovery is significantly related to better recovery quality compared to unassisted recovery. Additionally, using sevoflurane led to better recovery than using isoflurane.
  • They also highlighted other risk factors including longer anaesthesia duration and higher doses of ketamine and thiopental were connected to poor recovery quality.

Cite This Article

APA
Louro LF, Robson K, Hughes J, Loomes K, Senior M. (2021). Head and tail rope-assisted recovery improves quality of recovery from general anaesthesia in horses undergoing emergency exploratory laparotomy. Equine Vet J, 54(5), 875-884. https://doi.org/10.1111/evj.13516

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 54
Issue: 5
Pages: 875-884

Researcher Affiliations

Louro, Luís Filipe
  • School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral, UK.
Robson, Katherine
  • School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral, UK.
Hughes, Jodie
  • North Downs Specialist Referrals, Bletchingley, UK.
Loomes, Kate
  • Rainbow Equine Hospital, Malton, UK.
Senior, Mark
  • School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral, UK.

MeSH Terms

  • Anesthesia Recovery Period
  • Anesthesia, General / veterinary
  • Animals
  • Cross-Sectional Studies
  • Horses
  • Isoflurane
  • Ketamine
  • Laparotomy / veterinary
  • Models, Statistical
  • Prognosis
  • Retrospective Studies
  • Sevoflurane
  • Tail
  • Thiopental

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Citations

This article has been cited 4 times.
  1. 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
  2. Vandaele Z, Van den Broeke C, Merchiers A, Schauvliege S. The Use of an Air-Inflated Pillow for Assisted Recovery After General Anaesthesia in Horses: A Preliminary Study. Animals (Basel) 2025 Feb 15;15(4).
    doi: 10.3390/ani15040564pubmed: 40003045google scholar: lookup
  3. Isgren CM, Pinchbeck GL, Salem SE, Hann MJ, Townsend NB, Cullen MD, Archer DC. Evaluation of a stent dressing and abdominal bandage on surgical site infection following emergency equine laparotomy: A randomised controlled trial. Equine Vet J 2025 Nov;57(6):1466-1477.
    doi: 10.1111/evj.14482pubmed: 39967458google scholar: lookup
  4. Brumund L, Wittenberg-Voges L, Rohn K, Kästner SBR. Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT. Front Vet Sci 2024;11:1384525.
    doi: 10.3389/fvets.2024.1384525pubmed: 38846780google scholar: lookup
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