International online survey to assess current practice in equine anaesthesia

Abstract

SummaryReasons for performing study: Multicentre Confidential Enquiries into Perioperative Equine Fatalities (CEPEF) have not been conducted since the initial CEPEF Phases 1-3, 20 years ago. Objectives: To collect data on current practice in equine anaesthesia and to recruit participants for CEPEF-4. Study design: Online questionnaire survey. Methods: An online questionnaire was prepared and the link distributed internationally to veterinarians possibly performing equine anaesthesia, using emails, posters, flyers and an editorial. The questionnaire included 52 closed, semiclosed and open questions divided into 8 subgroups: demographic data, anaesthetist, anaesthesia management (preoperative, technical equipment, monitoring, drugs, recovery), areas of improvements and risks and motivation for participation in CEPEF-4. Descriptive statistics and Chi-squared tests for comparison of categorical variables were performed. Results: A total of 199 questionnaires were completed by veterinarians from 14 different countries. Of the respondents, 43% worked in private hospitals, 36% in private practices and 21% in university teaching hospitals. In 40 institutions (23%) there was at least one diplomate of the European or American colleges of veterinary anaesthesia and analgesia on staff. Individual respondents reported routinely employ the following anaesthesia monitoring modalities: electrocardiography (80%), invasive arterial blood pressures (70%), pulse oximetry (60%), capnography (55%), arterial blood gases (47%), composition of inspired and expired gases (45%) and body temperature (35%). Drugs administered frequently or routinely as part of a standard protocol were: acepromazine (44%), xylazine (68%), butorphanol (59%), ketamine (96%), diazepam (83%), isoflurane (76%), dobutamine (46%), and, as a nonsteroidal anti-inflammatory drug, phenylbutazone (73%) or flunixin meglumine (66%). Recovery was routinely assisted by 40%. The main factors perceived by the respondents to affect outcome of equine anaesthesia were the preoperative health status of the animal and training of the anaesthetist. Conclusions: Current practice in equine anaesthesia varies widely, and the study has highlighted important topics relevant for designing a future prospective multicentre cohort study (CEPEF-4).

Equine anaesthesia-associated mortality: where are we now?

“…However, during the recent online survey conducted prior to CEPEF‐4, a notable 40% of questionnaire respondents recorded the provision of some form of assistance during the recovery process (Wohlfender et al. ).…”

“…, , )] led to plans for a further study [(CEPEF 4 (Bettschart & Johnston ; Gent & Bettschart‐Wolfensberger ; Wohlfender et al. )], the final results of which are eagerly awaited. Until those results become available, however, it is appropriate to review the mortality associated with equine anaesthesia and to investigate the developments that have occurred over the two decades since the publication of the first reports.…”

Perioperative pain management in horses

“…; Wohlfender et al . ). Pre‐emptive administration of NSAIDs may help to reduce the likelihood of development of central sensitisation as has been shown with opioid and NSAID administration in other species (Lascelles et al .…”

“…In an international survey of veterinarians who perform equine anaesthesia, 81.2% of respondents used methadone and 77% morphine ‘rarely’ or ‘not at all’ (Wohlfender et al . ). The tendency towards older analgesics is also highlighted with 69% of equine veterinarians using Phenylbutazone or Flunixin either ‘as standard’ or ‘frequently’ (Wohlfender et al .…”

“…The tendency towards older analgesics is also highlighted with 69% of equine veterinarians using Phenylbutazone or Flunixin either ‘as standard’ or ‘frequently’ (Wohlfender et al . ), with 95% of UK equine veterinary surgeons prescribing phenylbutazone or flunixin. This is in contrast to small animal practice where there is a move towards more recently licensed treatments (Hunt et al .…”