School of Veterinary Science, Leahurst Campus, University of Liverpool, Neston, Wirral, UK.
North Downs Specialist Referrals, Bletchingley, UK.
Equine Vet J. 2022 Sep;54(5):875-884. doi: 10.1111/evj.13516. Epub 2021 Oct 19.
In equine anaesthesia, the recovery period is critical, accounting for most anaesthesia-related fatalities reported. Horses may recover unassisted or may be assisted, for example, using a head and tail rope recovery method.
To compare the impact of head and tail rope and unassisted recovery method on quality of recovery in horses undergoing colic surgery under general anaesthesia (GA).
Single centre retrospective cross-sectional study, with prospective model performance analysis.
Clinical data were obtained from horses undergoing emergency exploratory laparotomy over a 6-year period. Multivariable logistic regression analysis was used to identify the perioperative factors that affect quality of recovery. The final prediction model was assessed prospectively.
Records from 502 general anaesthetics (490 horses) were included. Multivariable logistic regression analysis showed that head and tail rope recovery (OR 2.2, 95% CI 1.4-3.3, P < .001) and sevoflurane administration (OR 1.6, 95% CI 1.2-2.3, P = .02) were associated with better quality of recovery when compared with unassisted recovery and isoflurane administration respectively. Increasing GA duration (OR 1.0, 95% CI 0.99-1.0, P = .03), increasing intraoperative dosages (in mg/kg) of thiopental (OR 0.85, 95% CI 0.75-0.98, P = .02) or ketamine (OR 0.67, 95% CI 0.46-0.99, P = .04) were linked to poor quality of recovery. No statistically significant difference was found between recovery groups in terms of mortality.
The clinical prediction model obtained is only applicable to the specific facilities, recovery methodology, referral population and anaesthetic protocols practiced at our institution.
Head and tail rope recovery is significantly associated with better quality of recovery, compared with unassisted recovery, in horses undergoing emergency exploratory laparotomy. Sevoflurane administration, in detriment of isoflurane, was associated with better quality of recovery. Other risk factors, such as increasing GA duration, the use of higher intra-operative dosages of ketamine and/or thiopental, were associated with poor quality of recovery.
在马的麻醉中，恢复期至关重要，占报告的大多数与麻醉相关的死亡。马可以在没有辅助的情况下恢复，也可以使用头绳和尾绳的恢复方法进行辅助恢复。
比较在全身麻醉（GA）下进行疝痛手术的马使用头绳和尾绳与不辅助恢复方法对恢复质量的影响。
单中心回顾性交叉研究，具有前瞻性模型性能分析。
从 6 年内接受急诊剖腹探查术的马获得临床数据。使用多变量逻辑回归分析来确定影响恢复质量的围手术期因素。对最终预测模型进行前瞻性评估。
记录了 502 次全身麻醉（490 匹马）。多变量逻辑回归分析显示，与不辅助恢复和异氟醚给药相比，头绳和尾绳恢复（OR 2.2，95%CI 1.4-3.3，P<.001）和七氟醚给药（OR 1.6，95%CI 1.2-2.3，P=.02）与更好的恢复质量相关。GA 持续时间增加（OR 1.0，95%CI 0.99-1.0，P=.03）、术中使用的硫喷妥钠（OR 0.85，95%CI 0.75-0.98，P=.02）或氯胺酮（OR 0.67，95%CI 0.46-0.99，P=.04）的剂量增加与恢复质量差有关。在死亡率方面，各组之间没有发现统计学上的显著差异。
所获得的临床预测模型仅适用于我们机构的特定设施、恢复方法、转诊人群和麻醉方案。
与不辅助恢复相比，在接受急诊剖腹探查术的马中，头绳和尾绳恢复与更好的恢复质量显著相关。与异氟醚相比，七氟醚的使用与更好的恢复质量相关。其他风险因素，如 GA 持续时间增加、术中使用更高剂量的氯胺酮和/或硫喷妥钠，与恢复质量差有关。
