CEPEF4: update and plan

Gozalo-Marcilla, Miguel; Redondo, J. I.; Johnston, Mark; Taylor, Polly; Bettschart‐Wolfensberger, Regula

doi:10.1016/j.vaa.2020.08.004

Cited by 5 publications

(5 citation statements)

References 6 publications

(8 reference statements)

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“…Intra-anesthetic awakening: rapid nystagmus or movement requiring additional anesthetic drugs ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT

Brumund,

Wittenberg-Voges,

Rohn

et al. 2024

Front. Vet. Sci.

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IntroductionAn accurate risk score that can predict peri-anesthetic morbidity and mortality in equine patients could improve peri-operative management, outcome and client communication.Materials and methodsThree hunded horses underwent pre-anesthetic risk assessment using the American Society of Anesthesiologists-Physical Status augmented with equine-specific diseases (ASA-PS-Equine), a multifactorial 10-part rubric risk scale (10-RS), and a combination of both, the Combined horse anesthetic risk identification and optimization tool (CHARIOT). Intra-and post-anesthetic complications, the recovery phase and mortality were recorded over a period of 7 days following general anesthesia. To compare the utility and predictive power of the 3 scores, data were analyzed using binominal logistic regression (p ≤ 0.05) and receiver operating characteristic curve analysis. In addition, inter-observer reliability, speed, safety, ease of use and face validity of the ASA-PS-Equine and the 10-RS were analyzed based on five hypothetical patients.ResultsAll scores showed statistically significant associations with various intra-anesthetic complications and parameters of the recovery phase. The discriminant ability of the scores related to the occurrence of intra-anesthetic (AUC = 0.6093–0.6701) and post-anesthetic (AUC = 0.5373–0.6194) complications was only low. The highest diagnostic accuracy for all scores was observed for overall mortality (AUC = 0.7526–0.7970), with the ASA-PS-Equine differentiating most precisely (AUC = 0.7970; 95% CI 0.7199–0.8741). Inter-observer reliability was fair for the 10-RS (κ = 0.39) and moderate for the ASA-PS-Equine (κ = 0.52). Patient assignment to the CHARIOT was predominantly rated as rather easy and quick or very quick.Limitations and conclusionThe main limitations of the study are the monocentric study design and failure to obtain the full range of points. In conclusion, all 3 scores provide useful information for predicting the mortality risk of equine patients undergoing general anesthesia, whereas intra-and postoperative complications cannot be predicted with these scores.

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“…Intra-anesthetic awakening: rapid nystagmus or movement requiring additional anesthetic drugs ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT

Brumund,

Wittenberg-Voges,

Rohn

et al. 2024

Front. Vet. Sci.

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“…3 of (1) Preparation of the questionnaire A user-friendly, online questionnaire used in small animals [21] was adapted for this equine study using the feedback received from a group of researchers and clinicians with special interest in equine anaesthesia and analgesia [22]. It was designed to be used to compile information for both general anaesthesia and standing sedation.…”

Section: Methodsmentioning

confidence: 99%

“…(4) Recruitment of collaborating centres Recruitment included an abstract presented at the AVA Spring meeting in Dublin 2020 [23], and Correspondence to the Editor published in peer reviewed journals targeting equine practitioners [24] and veterinary anaesthetists [22], respectively. Finally, we also used our professional network and contacted several centres personally.…”

Section: Methodsmentioning

confidence: 99%

Data Collection for the Fourth Multicentre Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4) Study: New Technology and Preliminary Results

Gozalo-Marcilla

Bettschart‐Wolfensberger

Johnston³

et al. 2021

Animals

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It is almost 20 years since the largest observational, multicentre study evaluating the risks of mortality associated with general anaesthesia in horses. We proposed an internet-based method to collect data (cleaned and analysed with R) in a multicentre, cohort, observational, analytical, longitudinal and prospective study to evaluate peri-operative equine mortality. The objective was to report the usefulness of the method, illustrated with the preliminary data, including outcomes for horses seven days after undergoing general anaesthesia and certain procedures using standing sedation. Within six months, data from 6701 procedures under general anaesthesia and 1955 standing sedations from 69 centres were collected. The results showed (i) the utility of the method; also, that (ii) the overall mortality rate for general anaesthesia within the seven-day outcome period was 1.0%. In horses undergoing procedures other than exploratory laparotomy for colic (“noncolics”), the rate was lower, 0.6%, and in “colics” it was higher, at 3.4%. For standing sedations, the overall mortality rate was 0.2%. Finally, (iii) we present some descriptive data that demonstrate new developments since the previous CEPEF2. In conclusion, horses clearly still die unexpectedly when undergoing procedures under general anaesthesia or standing sedation. Our method is suitable for case collection for future studies.

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“…Data of Johnston et al, (2002) [1] is now more than 20 years old and there is an obvious need for an update [4], as things have evolved and numbers might have changed as several variables did. Hopefully, results of an ongoing multicentre CEPEF4 study will come up in the following years and will give us more information about the current situation in equine anaesthesia in general, and recovery in particular [5,6]. In the meantime, narrative reviews focussing on the recovery phase do exist that compile many of the studies published up to that date [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

Gozalo-Marcilla

Ringer

2021

Animals

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Recovery remains the most dangerous phase of general anaesthesia in horses. The objective of this publication was to perform a structured literature review including levels of evidence (LoE) of each study with the keywords “recovery anaesthesia horse”, entered at once, in the search browsers PubMed and Web of Science. The two authors independently evaluated each candidate article. A final list with 444 articles was obtained on 5 April 2021, classified as: 41 “narrative reviews/expert opinions”, 16 “retrospective outcome studies”, 5 “surveys”, 59 “premedication/sedation and induction drugs”, 27 “maintenance with inhalant agents”, 55 “maintenance with total intravenous anaesthesia (TIVA)”, 3 “TIVA versus inhalants”, 56 “maintenance with partial intravenous anaesthesia (PIVA)”, 27 “other drugs used during maintenance”, 18 “drugs before/during recovery”, 18 “recovery systems”, 21 “respiratory system in recovery”, 41 “other factors”, 51 “case series/reports” and 6 “systems to score recoveries”. Of them, 167 were LoE 1, 36 LoE 2, 33 LoE 3, 110 LoE 4, 90 LoE 5 and 8 could not be classified based on the available abstract. This review can be used as an up-to-date compilation of the literature about recovery after general anaesthesia in adult horses that tried to minimise the bias inherent to narrative reviews.

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CEPEF4: update and plan

Cited by 5 publications

References 6 publications

Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT

Risk assessment in equine anesthesia: a first evaluation of the usability, utility and predictivity of the two-part CHARIOT

Data Collection for the Fourth Multicentre Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4) Study: New Technology and Preliminary Results

Recovery after General Anaesthesia in Adult Horses: A Structured Summary of the Literature

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