Risk factors for equine postoperative ileus and effectiveness of prophylactic lidocaine.
Abstract: Postoperative ileus (POI) is a frequent and often fatal complication of colic surgery. Reliably effective treatments are not available. Objective: To determine risk factors and protective factors associated with POI, and to assess the effect of lidocaine IV on short-term survival. Methods: One hundred and twenty-six horses that underwent small intestinal colic surgery and that survived for at least 24 hours postoperatively. Methods: Retrospective cross-sectional study. The association of 31 pre-, intra-, and postoperative variables with POI and the association of lidocaine treatment with short-term survival were investigated. Associations were evaluated with univariable logistic regression models, followed by multivariable analysis. Results: Significant associations of high heart rate (odds ratio [OR] = 1.05, 95% confidence interval [CI] 1.03-1.08), the presence of more than 8 L of reflux at admission (OR = 3.02, 95% CI 1.13-8.02) and the performance of a small intestinal resection (OR = 2.46, 95% CI 1.15-5.27) with an increased probability of POI were demonstrated. Prophylactic lidocaine treatment was significantly associated with a reduced incidence of POI (OR = 0.25, 95% CI 0.11-0.56). Lidocaine treatment was also significantly associated with enhanced short-term survival (OR = 0.30, 95% CI 0.09-0.98). Conclusions: The variables associated with an increased risk of POI can be useful in identifying horses at risk of POI and in providing a more accurate prognosis. The results are supportive for lidocaine IV as an effective prokinetic treatment after small intestinal colic surgery.
Publication Date: 2009-04-21 PubMed ID: 19422470DOI: 10.1111/j.1939-1676.2009.0311.xGoogle Scholar: Lookup
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- Journal Article
Summary
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The research investigates the risk factors associated with postoperative ileus in horses after small intestinal colic surgery, and the impact of lidocaine treatment on survival. The study finds that high heart rate, large amount of reflux at admission and small intestinal resection are significant risk factors, whereas lidocaine treatment significantly reduces the incidence of postoperative ileus and improves short-term survival.
Understanding Postoperative Ileus and The Study Objective
- Postoperative ileus (POI) is a common and potentially fatal complication following small intestinal colic surgery in horses.
- Currently, there isn’t a reliable, effective treatment for POI available.
- This study aimed to identify the risk factors and protective factors associated with POI, testing the hypothesis that intravenous (IV) lidocaine might improve short-term survival rates.
Methodology
- The study was retrospective, using past medical records from 126 horses that had undergone small intestinal colic surgery and survived for at least 24 hours post-operation.
- The researchers studied 31 different variables, collected before, during, and after surgery, to identify any correlations with POI.
- These variables were analysed using univariable logistic regression models first and then through multivariable analysis to capture the possible interactions between different variables.
Results of the Study
- The study found three factors significantly associated with a higher likelihood of POI — high heart rate, initial high volume of reflux (more than 8 liters), and small intestinal resection.
- Prophylactic treatment with lidocaine, a local anaesthetic drug, was significantly correlated with a lower incidence of POI.
- Moreover, lidocaine treatment was also found to improve short-term survival post surgery.
Significance and Conclusion
- Identifying variables that increase POI risk can help veterinarians in making an efficient prognosis and providing timely interventions.
- The results from this study suggest that lidocaine IV could be effective as a preventive treatment strategy after small intestinal colic surgery in horses.
- However, the authors caution that more research is required to substantiate these results, especially considering the retrospective nature of the study and the limited number of variables.
Cite This Article
APA
Torfs S, Delesalle C, Dewulf J, Devisscher L, Deprez P.
(2009).
Risk factors for equine postoperative ileus and effectiveness of prophylactic lidocaine.
J Vet Intern Med, 23(3), 606-611.
https://doi.org/10.1111/j.1939-1676.2009.0311.x Publication
Researcher Affiliations
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke-Ghent, Belgium. sara.torfs@ugent.be
MeSH Terms
- Animals
- Colic / surgery
- Colic / veterinary
- Cross-Sectional Studies
- Female
- Gastrointestinal Agents / administration & dosage
- Gastrointestinal Agents / therapeutic use
- Horse Diseases / drug therapy
- Horse Diseases / prevention & control
- Horses
- Intestinal Pseudo-Obstruction / complications
- Intestinal Pseudo-Obstruction / pathology
- Intestinal Pseudo-Obstruction / prevention & control
- Intestinal Pseudo-Obstruction / veterinary
- Intestine, Small / pathology
- Lidocaine / administration & dosage
- Lidocaine / therapeutic use
- Male
- Multivariate Analysis
- Postoperative Complications / pathology
- Postoperative Complications / prevention & control
- Postoperative Complications / veterinary
- Postoperative Period
- Retrospective Studies
- Risk Factors
Citations
This article has been cited 13 times.- Patton ME, Andrews FM, Bogers SH, Wong D, McKenzie HC 3rd, Werre SR, Byron CR. Effects of Bit Chewing on Gastric Emptying, Small Intestinal Transit, and Orocecal Transit Times in Clinically Normal Horses. Animals (Basel) 2023 Aug 4;13(15).
- Yau K, Halleran J, Boileau M, Foster D. Retrospective study on the use of lidocaine constant rate infusions for the treatment of ileus in ruminants and camelids. J Vet Intern Med 2021 Nov;35(6):2933-2936.
- Cuevas-Ramos G, Domenech L, Prades M. Small Intestine Ultrasound Findings on Horses Following Exploratory Laparotomy, Can We Predict Postoperative Reflux?. Animals (Basel) 2019 Dec 9;9(12).
- St James ML, Kosanovich DL, Snyder LB, Zhao Q, Jones BG, Johnson RA. Effects of acupuncture at Pericardium-6 and Stomach-36 on nausea, sedation and gastrointestinal motility in healthy dogs administered intravenous lidocaine infusions. PLoS One 2019;14(12):e0226065.
- Smith JS, Zhou X, Merkatoris PT, Klostermann CA, Breuer RM. Medical Management of Hemorrhagic Bowel Syndrome in a Beef Bull. Case Rep Vet Med 2019;2019:9209705.
- Isgren CM, Salem SE, Townsend NB, Timofte D, Maddox TW, Archer DC. Sequential bacterial sampling of the midline incision in horses undergoing exploratory laparotomy. Equine Vet J 2019 Jan;51(1):38-44.
- Dholakia U, Clark-Price SC, Keating SCJ, Stern AW. Anesthetic effects and body weight changes associated with ketamine-xylazine-lidocaine administered to CD-1 mice. PLoS One 2017;12(9):e0184911.
- Salem SE, Proudman CJ, Archer DC. Has intravenous lidocaine improved the outcome in horses following surgical management of small intestinal lesions in a UK hospital population?. BMC Vet Res 2016 Jul 27;12(1):157.
- Torfs SC, Maes AA, Delesalle CJ, Pardon B, Croubels SM, Deprez P. Plasma serotonin in horses undergoing surgery for small intestinal colic. Can Vet J 2015 Feb;56(2):178-84.
- Elfenbein JR, Robertson SA, MacKay RJ, KuKanich B, Sanchez L. Systemic and anti-nociceptive effects of prolonged lidocaine, ketamine, and butorphanol infusions alone and in combination in healthy horses. BMC Vet Res 2014;10 Suppl 1(Suppl 1):S6.
- Stahl J, Kietzmann M. The effects of chemical and physical penetration enhancers on the percutaneous permeation of lidocaine through equine skin. BMC Vet Res 2014 Jun 20;10:138.
- Rockow M, Griffenhagen G, Landolt G, Hendrickson D, Pezzanite L. The Effects of Antimicrobial Protocols and Other Perioperative Factors on Postoperative Complications in Horses Undergoing Celiotomy: A Retrospective Analysis, 2008-2021. Animals (Basel) 2023 Nov 19;13(22).
- Ruíz-López P, Cuypers C, Schauvliege S. Xylazine Infusion during Equine Colic Anesthesia with Isoflurane and Lidocaine: A Retrospective Study. Animals (Basel) 2023 Sep 13;13(18).
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