Evaluation of Dexamethasone for the Prevention of Post Operative Ileus

Abstract

Reasons for performing study Inflammation is key in the development of post operative ileus in rodents, with a similar pathogenesis likely occurring in other species. Dexamethasone reduces inflammation and therefore could help reduce post operative ileus in the horse. Objectives To determine if dexamethasone reduces post operative ileus in horses with small intestinal disease, and assess the effect on incisional health and short‐term survival. Study design Retrospective case series. Methods Fifteen horses that underwent small intestinal resection and anastomosis were given 0.1 mg/kg bwt dexamethasone intravenously during surgery (DEX). Data from a comparable number of horses that did not receive dexamethasone (NoDEX) was collected retrospectively and sequentially. Horses were matched for the type of resection performed. Fisher's Exact and Student's t tests were used for data analysis. Results There was no significant difference in the amount of nasogastric reflux (litres) (DEX 8.06 ± 17.12, NoDEX 10.02 ± 24.03, P = 0.39) produced or in the number of horses that produced nasogastric reflux post operatively. There was no difference in survival to discharge. The severity of incisional discharge/infection was significantly different between groups when scored 0–3 (0 being no discharge and 3 being severe discharge/infection), (P = 0.01), in favour of DEX (2/15 horses affected) vs. NoDEX (7/15). Conclusions Dexamethasone did not appear to have a beneficial effect on the incidence of post‐operative ileus. Administration of a single dose of dexamethasone does not appear to have a detrimental effect on short‐term survival or on incisional complications. Ethical animal research: Research ethics committee oversight not currently required by this conference: procedures were performed as part of clinical investigations. Explicit owner informed consent for participation in this study was not stated. Source of funding: None. Competing interests: None declared.

Incomplete Ileocecal Bypass for Ileal Pathology in Horses: 21 Cases (2012–2019)

“…In all cases, a single dose of dexamethasone was also administered at surgery to resolve the inflammation and the oedema encountered in both strangulating and non-strangulating obstructions. Under this perspective, this treatment can be viewed as a possibility to reduce post-operative ileus, as recently reported [ 17 ].…”