Nelson B B, Lordan E E, Hassel D M
Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, USA.
Equine Vet J Suppl. 2013 Dec(45):8-14. doi: 10.1111/evj.12162.
Gastrointestinal dysfunction occurs commonly following elective anaesthesia. Identification of risk factors may allow implementation of preventative measures to reduce the prevalence of colic following elective anaesthetic procedures.
To examine risk factors associated with gastrointestinal dysfunction or post anaesthetic colic for horses undergoing elective surgical or diagnostic procedures under general anaesthesia.
Retrospective case series.
Medical records were collected from adult horses undergoing general anaesthesia from 1 January 2008 to 31 December 2010 using a retrospective cohort design. Potential risk factors were examined using univariable logistic regression with a limit of a P<0.25. Through backward elimination, the final multivariate model was created to identify variables significantly associated with gastrointestinal dysfunction.
Colic or delayed faecal output was reported in 36 out of 416 (8.7%) horses undergoing general anaesthesia in the study period. In the final multivariable model, horse breed (P = 0.05), intraoperative peripheral blood lactate (P = 0.02), right lateral recumbency during general anaesthesia (P = 0.04), post anaesthetic rectal temperature (P = 0.03) and hours to first passage of faeces (P<0.01) were statistically significant between horses that exhibited colic compared with those that did not. Arabians were more likely to develop colic compared with other horse breeds (4/13, 30.8%). Horses that exhibited gastrointestinal dysfunction passed faeces later than those that did not (7.2 ± 0.8 h and 5.4 ± 0.2 h, respectively). As blood lactate increased at the end of anaesthesia, the odds of colic occurring also increased (odds ratio:1.4, 95% confidence interval: 1.04-1.83, P = 0.02).
This study demonstrated the prevalence of colic in horses undergoing elective general anaesthetic procedures in our hospital population. Arabian horses, increasing blood lactate and delayed passage of faeces were significantly associated with an increased risk of gastrointestinal dysfunction.
择期麻醉后常出现胃肠功能障碍。识别风险因素可能有助于采取预防措施，以降低择期麻醉手术后腹痛的发生率。
研究接受全身麻醉下择期手术或诊断性操作的马匹发生胃肠功能障碍或麻醉后腹痛的相关风险因素。
回顾性病例系列研究。
采用回顾性队列研究设计，收集2008年1月1日至2010年12月31日接受全身麻醉的成年马匹的病历。使用单变量逻辑回归分析潜在风险因素，P值<0.25为界限。通过向后排除法，建立最终的多变量模型，以识别与胃肠功能障碍显著相关的变量。
在研究期间接受全身麻醉的416匹马中，有36匹（8.7%）出现腹痛或排粪延迟。在最终的多变量模型中，与未出现腹痛的马匹相比，出现腹痛的马匹在品种（P = 0.05）、术中外周血乳酸水平（P = 0.02）、全身麻醉期间右侧卧位（P = 0.04）、麻醉后直肠温度（P = 0.03）以及首次排粪时间（P<0.01）方面存在统计学差异。与其他品种马匹相比，阿拉伯马发生腹痛的可能性更高（4/13，30.8%）。出现胃肠功能障碍的马匹排粪时间比未出现的马匹更晚（分别为7.2±0.8小时和5.4±0.2小时）。随着麻醉末期血乳酸水平升高，发生腹痛的几率也增加（比值比：1.4，95%置信区间：1.04 - 1.83，P = 0.02）。
本研究表明了我院接受择期全身麻醉手术的马匹中腹痛的发生率。阿拉伯马、血乳酸升高以及排粪延迟与胃肠功能障碍风险增加显著相关。
