Sixty years of equine anaesthesia – are we getting better at it?

Overview

• This article reviews the progress made in equine anaesthesia over the past six decades, highlighting improvements in safety while acknowledging ongoing risks and areas for further research.

Background and Purpose

• The article summarizes a presentation given at the 2024 meeting of the Association of Veterinary Anaesthetists, celebrating 60 years of advances in horse anaesthesia.
• It is a narrative review rather than a formal systematic review, drawing on multiple literature databases and key studies.
• The primary data source includes the 4th Confidential Enquiry into Equine Perioperative Fatalities (CEPEF4), which investigates risk factors related to horse anaesthesia mortality.

Historical Context

• Equine anaesthesia began in the 19th century almost concurrently with the development of human anaesthesia.
• Awareness of the relatively high risk of mortality associated with horse anaesthesia has existed since the 1980s, when formal documentation began.

Risk and Mortality Rates

• Horses have a significantly higher risk of death related to general anaesthesia compared to other domestic species and humans.
• Over time, advances in veterinary anaesthesia have contributed to a gradual reduction in mortality risk.
• Reported mortality rates for healthy horses dropped from approximately 1% in 2002 to about 0.6% by 2025.

Advancements Contributing to Improved Outcomes

• Development of new anaesthetic drugs that are safer and more effective in horses.
• Improved techniques for administering drugs to optimize dosage and reduce complications.
• Enhanced monitoring technologies providing real-time data on the horse’s physiological status during surgery.
• Refined handling and recovery procedures aimed at minimizing stress and injury during anaesthetic recovery.

Current Challenges and Future Directions

• Despite improvements, the mortality risk remains significant and warrants continued attention.
• CEPEF4 results have identified specific areas where safety can be improved through changes in practice and further research.
• The next phase of research, potentially embodied in the upcoming CEPEF5, aims to address these gaps and reduce mortality even further.

Conclusions

• Equine anaesthesia has become safer over the past 60 years, but ongoing vigilance is necessary.
• Continuous innovation and research are essential to further reduce risks associated with horse anaesthesia.
• Collaborative efforts such as the CEPEF studies play a vital role in improving understanding and guiding clinical practice.