Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse

Dupont, Julien; Serteyn, Didier; Sandersen, Charlotte

doi:10.3389/fvets.2018.00235

Cited by 12 publications

(7 citation statements)

References 53 publications

(63 reference statements)

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“…Our study also showed an increase in respiratory complications associated with heavy weight. Body weight as well as body shape influence arterial oxygenation and alveolar arterial oxygen gradient, increasing the risk of hypoxemia (27).…”

Section: Explanatory Factors For Respiratory Complicationsmentioning

confidence: 99%

Risk Factors of Anesthesia-Related Mortality and Morbidity in One Equine Hospital: A Retrospective Study on 1,161 Cases Undergoing Elective or Emergency Surgeries

2020

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A retrospective analysis was performed to determine mortality and morbidity rates for elective and emergency cases in an equine university teaching hospital. It investigated the effect of horse-, anesthetic-, timing, and clinician experience-related variables on anesthetic complications. In total, 1,161 horses undergoing general anesthesia between January 2012 and December 2016 were included in the study. Patient information and details of the anesthetic, recovery period and immediate complications were retrieved from an archival database. Statistical analysis of qualitative and quantitative factors affecting anesthetic complications was performed using an univariable and multivariable ordinal logistic regression. Odds ratio of variables primarily affecting mortality and complications were calculated. Statistical significance was set at p < 0.05. General anesthesia-related global mortality rate was 1.4% (95% CI [7.1-10.4]) but was only 0.96% (95% CI [0.44-1.82]) for non-colic cases. The complication rate was 17.5% (n = 204; 95% CI [15.2-20.0]) of which 46.9% [39.4-54.5] were neuromuscular, 22.6% [16.7-29.5] were respiratory, 15.8% [10.8-22.0] were systemic, 13.6% [8.9-19.5] were cardiovascular, 1.1% [0.1-4.0] were other complications. Ninety two percent of complications occurred during recovery. Major risk factors for mortality and complications included high weight, surgeon experience, increasing age, high ASA score, long duration of anesthesia, quality of induction, lateral recumbency, orthopedic surgery, and hypotension. In these models, colic surgery did not influence the rate of any complications.

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Section: Explanatory Factors For Respiratory Complicationsmentioning

confidence: 99%

Risk Factors of Anesthesia-Related Mortality and Morbidity in One Equine Hospital: A Retrospective Study on 1,161 Cases Undergoing Elective or Emergency Surgeries

2020

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“…In this case the duration to standing was considerably longer than is typical at the present institution where most horses stand within 60 minutes. A recent case report about equine anaesthetic recovery suggested that hypoxaemia, residual drug effects and hypothermia may have contributed to a delayed recovery in a nine‐year‐old Boulonnais gelding 12. In the present case these factors were all considered but were deemed unlikely.…”

Section: Discussionmentioning

confidence: 77%

Delayed recovery from general anaesthesia associated with pre‐existing neurological disease in a horse

Lord

Hahn

Pollock

et al. 2019

Vet Record Case Reports

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A seven-year-old gelding presented for surgical management of right-sided olecranon bursitis. Preanaesthetic examination revealed a right-sided head tilt which had been present since birth. General anaesthesia and surgery went smoothly without incident. Recovery was prolonged and the horse made no attempt to stand despite regaining motor function consistent with recovery from general anaesthesia. Increasingly loud auditory stimuli and mild physical stimuli yielded no attempt to move into sternal recumbency or stand. After over two hours in the recovery box an equine neurologist suggested a diagnosis of vestibular disease and proposed that without a horizon the horse would not be able to orientate itself, therefore advising that the horse be shown the horizon. The outside recovery box door was opened allowing the horse to see the horizon, on which the horse made an immediate coordinated attempt to stand, standing successfully on its first attempt.

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“…There is evidence that intraoperative hypoxaemia might prolong recovery [ 31 , 33 ] and have a negative effect on recovery quality [ 25 ], particularly in horses undergoing emergency laparotomy due to colic where intraoperative hypoxaemia increased fatality rate [ 31 ]. The present study did not find that intraoperative hypoxaemia affected recovery score, but the use of intraoperative salbutamol did.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis

Kälin

Henze

Ringer

et al. 2021

Animals

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Medetomidine partial intravenous anaesthesia (PIVA) has not been compared to xylazine PIVA regarding quality of recovery. This clinical retrospective study compared recoveries following isoflurane anaesthesia balanced with medetomidine or xylazine. The following standard protocol was used: sedation with 7 µg·kg−1 medetomidine or 1.1 mg·kg−1 xylazine, anaesthesia induction with ketamine/diazepam, maintenance with isoflurane and 3.5 µg·kg−1·h−1 medetomidine or 0.7 mg·kg−1·h−1 xylazine, and sedation after anaesthesia with 2 µg·kg−1 medetomidine or 0.3 mg·kg−1 xylazine. Recovery was timed and, using video recordings, numerically scored by two blinded observers. Influence of demographics, procedure, peri-anaesthetic drugs, and intraoperative complications (hypotension, hypoxemia, and tachycardia) on recovery were analysed using regression analysis (p < 0.05). A total of 470 recoveries (medetomidine 279, xylazine 191) were finally included. Following medetomidine, recoveries were significantly longer (median (interquartile range): 57 (43–71) min) than xylazine (43 (32–59) min) (p < 0.001). However, the number of attempts to stand was similar (medetomidine and xylazine: 2 (1–3)). Poorer scores were seen with increased pre-anaesthetic dose of xylazine, intraoperative tetrastarch, or salbutamol. However, use of medetomidine or xylazine did not influence recovery score, concluding that, following medetomidine–isoflurane PIVA, recovery is longer, but of similar quality compared to xylazine.

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Prolonged Recovery From General Anesthesia Possibly Related to Persistent Hypoxemia in a Draft Horse

Cited by 12 publications

References 53 publications

Risk Factors of Anesthesia-Related Mortality and Morbidity in One Equine Hospital: A Retrospective Study on 1,161 Cases Undergoing Elective or Emergency Surgeries

Risk Factors of Anesthesia-Related Mortality and Morbidity in One Equine Hospital: A Retrospective Study on 1,161 Cases Undergoing Elective or Emergency Surgeries

Delayed recovery from general anaesthesia associated with pre‐existing neurological disease in a horse

Comparison of Recovery Quality Following Medetomidine versus Xylazine Balanced Isoflurane Anaesthesia in Horses: A Retrospective Analysis

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