Platt J P, Simon B T, Coleman M, Martinez E A, Lepiz M A, Watts A E
Comparative Orthopedics and Regenerative Medicine Laboratory, Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA.
Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA.
Equine Vet J. 2018 Jan;50(1):111-116. doi: 10.1111/evj.12728. Epub 2017 Sep 1.
Although rare, 70% of equine fatalities during recovery from general anaesthesia (GA) are due to catastrophic fractures from poor recovery quality.
To determine the effect of repeated GA recovery on GA recovery quality.
Experimental blinded trial.
Eight adult horses underwent six GA events on sevoflurane for distal limb MRI examination over a 14-week period. Prior to GA recovery, xylazine was administered. Randomly ordered video-recorded GA recoveries were scored by three blinded board certified veterinary anaesthesiologists, unaware of patient identity or GA event number, for nine parameters using a 100 mm visual analogue scale (VAS) where 0 = worst and 100 = best. The number of attempts to stand, duration of lateral and sternal recumbency, total recovery duration and physiologic parameters during each GA event were recorded. Repeated measures ANOVA were used to detect differences. Agreement between observer VAS scores was determined via inter-rater reliability using an intraclass correlation.
With GA recovery experience, VAS scores for balance and coordination, knuckling, and overall quality of recovery were improved and the duration of lateral recumbency was increased. There were no differences in total recovery duration, number of attempts to stand, physiologic parameters other than heart rate during GA, or VAS scores for activity in lateral recumbency, move to sternal, move to stand, or strength.
Each GA event was relatively short and there was no surgical stimulation. The same results may not occur if there was surgical stimulation and pain during each GA event.
Recovery from GA improves with multiple anaesthetic episodes in horses. Clinicians can advise clients that horses are likely to have better GA recovery on repeated GA recovery due to improved balance and coordination and reduced knuckling. Additionally, there is no change in anaesthetic morbidity with six repeated GA events over a 14-week period.
尽管罕见，但在全身麻醉（GA）恢复过程中，70%的马死亡是由于恢复质量差导致的灾难性骨折。
确定重复GA恢复对GA恢复质量的影响。
实验性盲法试验。
8匹成年马在14周内接受了6次七氟醚全身麻醉，用于远端肢体MRI检查。在GA恢复前，给予赛拉嗪。由3名不知情的、获得委员会认证的兽医麻醉师对随机排序的GA恢复视频记录进行评分，他们不知道患者身份或GA事件编号，使用100毫米视觉模拟量表（VAS）对9个参数进行评分，其中0 =最差，100 =最佳。记录每次GA事件中站立的尝试次数、侧卧和胸骨卧位的持续时间、总恢复持续时间和生理参数。采用重复测量方差分析来检测差异。通过组内相关系数的评分者间信度确定观察者VAS评分之间的一致性。
随着GA恢复经验的增加，平衡与协调、关节屈曲以及整体恢复质量的VAS评分有所提高，侧卧持续时间增加。总恢复持续时间、站立尝试次数、GA期间除心率外的生理参数，或侧卧活动、转为胸骨卧位、转为站立或力量的VAS评分没有差异。
每次GA事件相对较短，且没有手术刺激。如果每次GA事件中有手术刺激和疼痛，可能不会出现相同的结果。
马在多次麻醉后GA恢复情况有所改善。临床医生可以告知客户，由于平衡和协调能力的提高以及关节屈曲的减少，马在重复GA恢复时可能会有更好的GA恢复。此外，在14周内进行6次重复GA事件，麻醉发病率没有变化。
