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对于接受择期骨科 MRI 检查而全身麻醉的马,不建议使用抗菌预防。

Antimicrobial prophylaxis is not indicated for horses undergoing general anaesthesia for elective orthopaedic MRI.

机构信息

Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, Gainesville, Florida, USA.

出版信息

Equine Vet J. 2024 May;56(3):475-483. doi: 10.1111/evj.13978. Epub 2023 Aug 2.

Abstract

BACKGROUND

Post-anaesthetic fever is a known complication of general anaesthesia, however, its incidence in horses undergoing elective magnetic resonance imaging (MRI) is unknown.

OBJECTIVE

To determine the incidence of post-anaesthetic fever in horses undergoing elective orthopaedic MRI and determine whether prophylactic antimicrobial therapy would be associated with a reduction in the incidence of post-anaesthetic fever. We hypothesised that prophylactic antimicrobials would be associated with a reduction in the incidence of post-anaesthetic fever.

STUDY DESIGN

Retrospective cross-sectional study.

METHODS

This retrospective study included 791 elective orthopaedic MRIs in systemically healthy horses between June 2006 and March 2020 that recovered from general anaesthesia and did not undergo surgery or intensive medical therapy soon after recovery. Potential factors associated with post-anaesthetic fever were evaluated using multivariable logistic regression. Case signalment, travel time, preanaesthetic haematology and fibrinogen abnormalities, use of prophylactic antimicrobials, peri-anaesthetic nonsteroidal anti-inflammatories, anaesthesia time and recovery time were all evaluated for association with post-anaesthetic fever.

RESULTS

Of 791 MRI cases, 44 (5.6%) developed a post-anaesthetic fever. Horses that received prophylactic antimicrobials were [odds ratio (OR) 3.8, 95% confidence interval (CI) 1.98-7.46; p ≤ 0.001] more likely to develop a post-anaesthetic fever than those that did not receive antimicrobials. Young horses (1-4 years of age) were (OR 2.8, 95% CI 1.26-6.17; p = 0.01) more likely to develop fever compared with adult horses (≥5 years of age).

MAIN LIMITATIONS

Limitations of this study pertain to retrospective analysis including nonrandomised case selection and incomplete data records.

CONCLUSIONS

While fever may indicate infection, the majority of early post-anaesthetic fevers resolved before discharge from the hospital with no identified cause. The use of prophylactic antimicrobials to reduce the risk of post-anaesthetic fever for elective MRI is not supported by this study.

摘要

背景

麻醉后发热是全身麻醉的已知并发症,然而,其在接受择期磁共振成像(MRI)的马中的发生率尚不清楚。

目的

确定接受择期骨科 MRI 的马中麻醉后发热的发生率,并确定预防性抗菌治疗是否与麻醉后发热发生率的降低相关。我们假设预防性使用抗生素会降低麻醉后发热的发生率。

研究设计

回顾性横断面研究。

方法

本回顾性研究纳入了 2006 年 6 月至 2020 年 3 月期间全身健康的 791 例接受择期骨科 MRI 的马,这些马在全身麻醉后恢复并在恢复后不久未进行手术或强化药物治疗。使用多变量逻辑回归评估与麻醉后发热相关的潜在因素。评估病例特征、旅行时间、麻醉前血液学和纤维蛋白原异常、预防性使用抗生素、围麻醉期非甾体抗炎药、麻醉时间和恢复时间与麻醉后发热的关系。

结果

在 791 例 MRI 病例中,有 44 例(5.6%)出现麻醉后发热。接受预防性抗生素治疗的马比未接受抗生素治疗的马更有可能出现麻醉后发热(比值比[OR]3.8,95%置信区间[CI]1.98-7.46;p ≤ 0.001)。年轻马(1-4 岁)比成年马(≥5 岁)更有可能发热(OR 2.8,95%CI 1.26-6.17;p = 0.01)。

主要局限性

本研究的局限性在于回顾性分析,包括非随机病例选择和数据记录不完整。

结论

尽管发热可能表明存在感染,但大多数早期麻醉后发热在出院前自行消退,没有明确的病因。本研究不支持使用预防性抗生素来降低择期 MRI 后麻醉后发热的风险。

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