Corneal abrasion and microbial contamination in horses following general anaesthesia for non-ocular surgery

Scarabelli, Stefania; Timofte, Dorina; Malalana, Fernando; Bardell, David

doi:10.1016/j.vaa.2017.12.002

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…In terms of non‐fatal complications, mixed evidence is given by the different studies. An increase in technical difficulties and certain non‐fatal complications, such as facial nerve paresis, fracture of the first coccygeal vertebra and corneal ulcerations have been reported and associated with the use of head and tail rope recovery methods 27,93,94 . A similar incidence of non‐fatal complications, 2,3,29 but a higher frequency of technical problems resulting from head and tail rope recovery have been reported, 29 while others demonstrated a higher incidence of skin abrasions and post‐anaesthetic lameness in horses recovering unassisted, but similar incidence of technical problems between groups 92 …”

Section: Resultsmentioning

confidence: 89%

Recovery of horses from general anaesthesia: A systematic review (2000‐2020) of risk factors and influence of interventions during the recovery period

Loomes

Louro

2021

Equine Veterinary Journal

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Background In equine anaesthesia, the recovery period is a time of considerable risk and has been the focus of prolific research. Risk factors, including age, type and duration of procedure or temperament may influence recovery quality. Unfortunately, the anaesthetist is unable to control for these factors, therefore various pharmacological interventions and recovery methods have been developed with the objective of improving recovery quality. However, no consensus among anaesthetists has been reached for many of these interventions and their implications for recovery‐related mortality and morbidity. Objectives To conduct a systematic review of the published evidence relating to risk factors and interventions in the recovery period which may influence recovery quality from equine general anaesthesia (GA). Study design A systematic evaluation of the equine veterinary literature using the GRADE framework. Methods A literature search was performed and studies were assessed for eligibility by both authors utilising PRISMA guidelines. Studies meeting inclusion criteria were evaluated by both authors, categorically summarised and the quality of evidence for each sub‐topic was assessed using the GRADE framework. Results Thirty‐nine studies were identified which directly assessed the impact of risk factors and recovery interventions on recovery quality after equine GA. There was evidence to support that peri‐anaesthetic risk factors such as anaesthesia duration, American Society of Anesthesiologists (ASA) physical status and surgical procedure influenced recovery quality. We also identified sufficient evidence that administration of α‐2 adrenoreceptor agonists immediately prior to recovery, improves recovery quality. Main limitations The validity of the results of some studies may have been compromised by missing data and small sample sizes. Conclusions Recovery quality is influenced by factors including: anaesthesia duration, ASA physical status and surgical procedure. Recovery quality can be improved by the administration of an α‐2 adrenoreceptor agonist immediately prior to recovery.

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Section: Resultsmentioning

confidence: 89%

Recovery of horses from general anaesthesia: A systematic review (2000‐2020) of risk factors and influence of interventions during the recovery period

Loomes

Louro

2021

Equine Veterinary Journal

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“…Corneal erosions or ulcers can develop during general anaesthesia due to reduced tear production, abrasion or scratching during positioning (Hubbell et al 1988;Jago et al 2015;Mullen et al 2015). Clinically asymptomatic corneal erosions have been reported in almost 20% of anaesthetised horses despite routine use of eye lubrication and were associated with duration of anaesthesia and lateral recumbency (Scarabelli et al 2018). Cautious preparation for surgery or arterial cannulisation to avoid contamination of the eye with cleaning fluids and tissue glue, as well as careful identification of eye lubricant to prevent inadvertent use of the wrong, possibly irritant materials are recommended.…”

Section: Ocular Damagementioning

confidence: 99%

Mortality and morbidity in equine anaesthesia

Deutsch

Taylor

2021

Equine Veterinary Education

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Equine peri-anaesthetic mortality and morbidity are of interest to anaesthetists, practitioners, horse owners and insurance companies. The largest prospective study, 'The Confidential Enquiry into Perioperative Equine Fatalities' (CEPEF) was conducted more than 20 years ago. It included over 40,000 horses from multiple centres and reported mortality to be 1.9% that decreased to 0.9% when only elective cases were considered. This is in stark contrast to mortality rates in small animal (dogs: 0.17%, cats: 0.24%) and human anaesthesia (0.04-7/10,000). In spite of developments in understanding the pathophysiology of equine anaesthesia mortality has not decreased in the intervening years. The main contributors to peri-anaesthetic equine mortality are cardiac arrest, fractures and myopathy or neuropathy. Spinal cord myelopathy and cerebral necrosis are less common. Malignant hyperthermia and hyperkalaemic periodic paralysis are diseases associated with genetic mutations that can be triggered during general anaesthesia and may be fatal if not recognised and treated immediately. Morbidities are reported less frequently, presumably because often they do not cause permanent harm and may resolve within a short period of time. Complications in equine anaesthesia are numerous and include injuries at induction and recovery, damage to the airway associated with orotracheal or nasotracheal intubation, post-anaesthetic myopathy or neuropathy, regurgitation and aspiration of stomach contents, ocular injuries and complications associated with intravascular cannulation. Hypotension, hypoventilation, hypoxaemia, hypothermia and dysrhythmias may occur both during the maintenance phase of anaesthesia but also in recovery. Airway obstruction during recovery has repeatedly been reported over the years as causing pulmonary oedema, which is often fatal if the airway is not restored extremely quickly. This review summarises the literature on the risk of mortality and morbidity. Information has been gathered from single case reports as well as larger research studies.

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“…(3) Medial condylar fractures of the third metatarsal bone in horses [358] (4) Use of tension band wires in horses with fractures of the ulna: 22 cases (1980-1992) [359] ( (34) Influence of azaperone/metomidate in anesthesia on blood biochemistry in horse [389] (35) Ultrasonography of the equine triceps muscle before and after general anaesthesia and in post anaesthetic myopathy [390] (36) Metabolism during anaesthesia and recovery in colic and healthy horses: A microdialysis study [391] (37) Metabolic changes associated with anaesthesia and cherry poisoning in a pony [392] (38) The relationship of muscle perfusion and metabolism with cardiovascular variables before and after detomidine injection during propofol-ketamine anaesthesia in horses [393] Miscellaneous (39) A prospective clinical trial comparing metrizamide and iohexol for equine myelography [394] (40) Corneal abrasion and microbial contamination in horses following general anaesthesia for non-ocular surgery [395] (41) Electroacupuncture treatment for isoflurane induced hypotension in horses [396] Total other factors publications = 41…”

Section: Other Factors Loe Referencesmentioning

confidence: 99%

Section: Other Factorsmentioning

confidence: 99%

“…Our search also included three other publications classified as "miscellaneous" [394][395][396]. A good care of the eye needs to be taken in the anaesthetised horse, as corneal abrasion/ulceration may occur [395]. The importance of the recovery phase and the potential correlations with different recovery systems still needs to be investigated at this respect.…”

Section: Other Factorsmentioning

confidence: 99%

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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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Corneal abrasion and microbial contamination in horses following general anaesthesia for non-ocular surgery

Cited by 8 publications

References 19 publications

Recovery of horses from general anaesthesia: A systematic review (2000‐2020) of risk factors and influence of interventions during the recovery period

Recovery of horses from general anaesthesia: A systematic review (2000‐2020) of risk factors and influence of interventions during the recovery period

Mortality and morbidity in equine anaesthesia

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

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