Risk of anesthesia-related complications in draft horses: a retrospective, single-center analysis

O’Donovan, Kathrin A.; Aarnes, Turi K.; Hubbell, J. A. E.; Parker, Elizabeth M.; Mollenkopf, Dixie F.; Lerche, Phillip; Pereira, Carolina H. Riccó; Bini, G; Bednarski, Richard M.

doi:10.1016/j.vaa.2022.12.002

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…The association between the ASA grade and peri-operative mortality in dogs and cats ( 27 , 35–37 ), rabbits ( 35 ), and horses ( 1 , 38 ) is well documented. The same can be verified for the ASA-PS-Equine in the present study.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Additionally, anesthetic recoveries that were graded as poor versus excellent were predictive for a higher risk of postoperative complications. Equine anesthesia is generally associated with a greater risk of morbidity and mortality compared to humans and companion animals (1% versus 0.001-0.1%) [76][77][78] and horses presenting for colic or other emergency surgery, for procedures occurring outside regular working hours or for longer anesthetic periods, which is often the case for emergency celiotomies, have been previously reported to have a higher risk of mortality associated with general anesthesia [77][78][79][80][81][82]. Due to the retrospective nature of this study, it is not possible to distinguish whether recoveries assessed as poor resulted simply from the severity of disease status in which case a higher rate of complications could be anticipated or whether recovery quality itself affected complication rate (e.g., musculoskeletal injury, corneal laceration), or a combination of both.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Antimicrobial Protocols and Other Perioperative Factors on Postoperative Complications in Horses Undergoing Celiotomy: A Retrospective Analysis, 2008–2021

Rockow,

Griffenhagen,

Landolt

et al. 2023

Animals

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Recognition of antimicrobial resistance in equine practice has increased over the past decade. The objective of this study was to provide an updated retrospective review of antimicrobial regimens in one tertiary referral hospital and to evaluate the association with postoperative complications. A secondary objective was to evaluate other perioperative factors including surgical procedure, anesthetic and recovery parameters, and the effect of perioperative medications on complications and outcomes. A computerized search of medical records was performed to identify horses undergoing exploratory celiotomy from 1 January 2008 to 31 December 2021. A total of 742 celiotomies were performed (608 completed, 134 terminated intraoperatively). Factors recorded were evaluated using logistic regression for the presence of either incisional infection, postoperative ileus, or other complications postoperatively. Antimicrobial type or timing (pre-, intra-, or postoperative) were not associated with decreased risk of incisional infection or postoperative ileus; however, the duration of NSAID use was positively associated with incisional infection (OR 1.14 per day). Lidocaine and alpha-2-agonist administration postoperatively were also associated with increased incidence of postoperative ileus (OR 21.5 and 1.56, respectively). Poor recovery quality (OR 4.69), the addition of other antimicrobials besides penicillin/gentamicin postoperatively (OR 3.63), and an increased number of different NSAID classes used (OR 1.46 per additional) were associated with other complications. Implementation of enterotomy was associated with decreased risk of other complications (OR 0.64). These findings provide an updated summary of factors associated with postoperative complications in horses undergoing celiotomy.

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“…For horses, heavy patient sedation and general anesthesia are typical ( 49 ) as the patients react unfavorably to the intense muscle stimulation. General anesthesia is inherently risky in horses ( 61 , 62 ) as it increases the overall risk of morbidity and mortality from fractures ( 63–65 ), cardiovascular failure ( 63–65 ), respiratory complications (airway obstruction, poor ventilation, hypoxia, etc.) ( 64 ), postanesthetic myopathy ( 63 , 64 , 66 ), and abdominal complications (peritonitis, colitis, etc.)…”

Section: Introductionmentioning

confidence: 99%

Investigation of integrated time nanosecond pulse irreversible electroporation against spontaneous equine melanoma

Fesmire,

Peal,

Ruff

et al. 2024

Front. Vet. Sci.

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IntroductionIntegrated time nanosecond pulse irreversible electroporation (INSPIRE) is a novel tumor ablation modality that employs high voltage, alternating polarity waveforms to induce cell death in a well-defined volume while sparing the underlying tissue. This study aimed to demonstrate the in vivo efficacy of INSPIRE against spontaneous melanoma in standing, awake horses.MethodsA custom applicator and a pulse generation system were utilized in a pilot study to treat horses presenting with spontaneous melanoma. INSPIRE treatments were administered to 32 tumors across 6 horses and an additional 13 tumors were followed to act as untreated controls. Tumors were tracked over a 43–85 day period following a single INSPIRE treatment. Pulse widths of 500ns and 2000ns with voltages between 1000 V and 2000 V were investigated to determine the effect of these variables on treatment outcomes.ResultsTreatments administered at the lowest voltage (1000 V) reduced tumor volumes by 11 to 15%. Higher voltage (2000 V) treatments reduced tumor volumes by 84 to 88% and eliminated 33% and 80% of tumors when 500 ns and 2000 ns pulses were administered, respectively.DiscussionPromising results were achieved without the use of chemotherapeutics, the use of general anesthesia, or the need for surgical resection in regions which are challenging to keep sterile. This novel therapeutic approach has the potential to expand the role of pulsed electric fields in veterinary patients, especially when general anesthesia is contraindicated, and warrants future studies to demonstrate the efficacy of INSPIRE as a solid tumor treatment.

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Risk of anesthesia-related complications in draft horses: a retrospective, single-center analysis

Cited by 5 publications

References 15 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

The Effects of Antimicrobial Protocols and Other Perioperative Factors on Postoperative Complications in Horses Undergoing Celiotomy: A Retrospective Analysis, 2008–2021

Investigation of integrated time nanosecond pulse irreversible electroporation against spontaneous equine melanoma

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