Restoration of arterial oxygen tension in horses recovering from general anaesthesia.
Abstract: Arterial hypoxaemia is common in anaesthetised horses, but little information exists regarding restoration of arterial oxygen tension (PaO ) during recovery from anaesthesia, or if intra-operative management factors exert any longer-term effect. Objective: To evaluate PaO in horses recovering from general anaesthesia up to 1 h after resuming standing. Methods: Prospective observational clinical cohort study. Methods: Systemically healthy adult horses undergoing inhalational general anaesthesia for elective surgical procedures were studied. Arterial blood samples were obtained anaerobically prior to pre-anaesthetic medication, at end of anaesthesia, immediately following positioning in the recovery box, then at 10-min intervals until standing. Additionally, samples were taken when horses achieved sternal recumbency, at standing (STAND) and 1 h after standing (STAND+1). Data were analysed using ANOVA and mixed-effects linear regression, with significance set at P<0.05. Results: Data from one hundred and two horses were analysed. Forty horses received controlled mandatory ventilation (CMV) throughout anaesthesia, 47 breathed spontaneously (SV) and 15 initially breathed spontaneously before CMV was imposed (S-CMV). Overall, PaO , P(A-a)O and PaCO remained significantly lower than baseline at STAND+1 (P<0.01). CMV resulted in higher PaO at the end of anaesthesia (P = 0.03) and during early recovery (P<0.01) than SV. Only in group S-CMV did PaO , P(A-a)O and PaCO return to baseline values at STAND+1. Highest PaO values associated with CMV were also associated with early recovery apnoea. Conclusions: Non-standardised anaesthetic management, temporal and quantitative variation in oxygen delivery during early recovery and lack of control group where oxygen was electively withheld during recovery. Conclusions: Controlled mandatory ventilation results in better pulmonary function in horses as assessed by PaO , P(A-a)O and PaCO , an effect enhanced by an initial period of SV and still evident 1 h after standing. High PaO values may contribute to early recovery apnoea but this does not adversely affect outcome. The Summary is available in Portuguese - see Supporting Information.
© 2019 EVJ Ltd.
Publication Date: 2019-07-16 PubMed ID: 31216080DOI: 10.1111/evj.13142Google Scholar: Lookup
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- Journal Article
Summary
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This research investigates how arterial oxygen tension in horses restores after general anaesthesia. It studies the effects of different intra-operative management methods on the restoration process and found that controlled mandatory ventilation helps boost pulmonary function during and after anaesthesia.
Introduction and Objectives
- The study’s primary aim is to probe into the restoration of arterial oxygen tension (PaO) in horses that have undergone general inhalational anaesthesia. There is insufficient data regarding oxygen tension restoration post-anaesthesia, and the researchers also intended to see if various intra-operative management strategies had any long-lasting impact on this restoration.
Methods
- A prospective observational clinical cohort mechanism was employed to conduct this research. The test subjects were systemically healthy adult horses that underwent inhalational general anaesthesia for elective surgical procedures.
- Arterial blood samples from the horses were taken regularly: before the administration of the pre-anaesthetic medication, at the conclusion of the anaesthesia, immediately upon being moved to the recovery box, and every 10 minutes until the horses were standing.
- Additional samples were taken when horses achieved sternal recumbency, at the point of standing up (STAND) and 1 hour after standing (STAND+1).
- The study used ANOVA and mixed-effects linear regression for data analysis. The significance level was set at P<0.05.
Results
- The data collected from one hundred and two horses were analysed. Of these, forty horses had controlled mandatory ventilation (CMV) throughout the anaesthesia, 47 spontaneously breathed (SV) and 15 started with SV but switched to CMV later on.
- The results showed that, overall, the PaO, P(A-a)O and PaCO were significantly lower than baseline even at the STAND+1 timepoint (P<0.01).
- Among the three groups, horses under controlled mandatory ventilation had a higher PaO at the end of anaesthesia and during early recovery than horses that breathed spontaneously. The CMV group saw their PaO, P(A-a)O and PaCO return to baseline at STAND+1.
- Higher PaO values were associated with early recovery apnea in the horses that received controlled mandatory ventilation.
Conclusion
- The researchers concluded that non-standardised anaesthetic management, temporal and quantitative variation in oxygen delivery during early recovery and lack of control group where oxygen was electively withheld during recovery.
- The study found that controlled mandatory ventilation results in superior pulmonary function in horses as assessed by PaO, P(A-a)O and PaCO – an effect that is further boosted by a preliminary period of spontaneous ventilation and remains noticeable even 1 hour after standing.
- While higher PaO levels might contribute to early recovery apnea, the study found that this does not negatively impact the overall outcome of the anaesthesia.
Cite This Article
APA
Bardell D, Mosing M, Cripps PJ.
(2019).
Restoration of arterial oxygen tension in horses recovering from general anaesthesia.
Equine Vet J, 52(2), 187-193.
https://doi.org/10.1111/evj.13142 Publication
Researcher Affiliations
- Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK.
- Institute of Veterinary Science, University of Liverpool, Neston, Wirral, UK.
- Institute of Veterinary Science, University of Liverpool, Neston, Wirral, UK.
- Institute of Veterinary Science, University of Liverpool, Neston, Wirral, UK.
MeSH Terms
- Anesthesia, General / veterinary
- Animals
- Blood Gas Analysis / veterinary
- Cohort Studies
- Horses
- Oxygen
- Prospective Studies
Grant Funding
- University of Liverpool School of Veterinary Science Clinical Research
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Citations
This article has been cited 2 times.- 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).
- Cerullo M, Driessen B, Douglas H, Hopster K. Changes in Arterial Blood Pressure and Oxygen Tension as a Result of Hoisting in Isoflurane Anesthetized Healthy Adult Horses. Front Vet Sci 2020;7:601326.
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