Donnington Grove Veterinary Group, Newbury, UK.
Department of Pathobiology and Population Sciences, Royal Veterinary College, Hatfield, UK.
J Vet Emerg Crit Care (San Antonio). 2024 May-Jun;34(3):245-251. doi: 10.1111/vec.13374. Epub 2024 May 29.
To determine the effect of a single intraoperative dose of dexamethasone on the risk of postoperative reflux (POR) in horses undergoing small intestinal surgery and to investigate its association with incisional complications and short-term survival.
Retrospective cohort study over an 11-year period (2008-2019).
UK-based private referral center.
Two hundred and forty client-owned horses >6 months of age undergoing exploratory laparotomy for treatment of a small intestinal lesion.
Ninety-seven horses received a single intraoperative dose of dexamethasone (0.1 mg/kg, IV).
Of 97 horses that received dexamethasone, 52 (53.6%) required small intestinal resection. Of 143 horses that did not receive dexamethasone, small intestinal resection was performed in 78 (54.5%). A total of 70 horses (29%) developed POR. There was no difference in the risk of POR between horses that received dexamethasone (25/97; 26%) and those that did not (45/143; 31%, P = 0.34). Risk factors associated with the development of POR included small intestinal resection (odds ratio [OR]: 4.55, 95% confidence interval [CI]: 2.27-9.11, P < 0.001), a PCV >40% 24 hours postoperatively (OR: 4.11, 95% CI: 2-8.45, P < 0.001), and a WBC count >10 × 10/L on admission (OR: 3.29, 95% CI: 1.47-7.41, P = 0.004). Dexamethasone was not associated with the odds of POR. Horses undergoing repeat laparotomy had a higher risk of incisional infection (OR: 8.07, 95% CI: 1.98-32.81, P = 0.004). Dexamethasone administration was not associated with incisional infection. The development of POR was negatively associated with short-term survival (OR: 0.07, 95% CI: 0.03-0.17, P ≤ 0.001). Dexamethasone administration was not retained in the final multivariable model for survival.
Intraoperative dexamethasone was not associated with the development of POR in this study population, nor did it have an effect on postoperative survival or incisional infection in horses undergoing surgical management of small intestinal disease.
确定术中单次给予地塞米松对接受小肠手术的马匹术后反流（POR）风险的影响，并探讨其与切口并发症和短期生存的关系。
回顾性队列研究，研究时间为 11 年（2008-2019 年）。
英国私人转诊中心。
240 匹年龄大于 6 个月的患小肠病变的客户所有马。
97 匹马接受了术中单次剂量的地塞米松（0.1mg/kg，静脉注射）。
在接受地塞米松的 97 匹马中，52 匹（53.6%）需要进行小肠切除术。在未接受地塞米松的 143 匹马中，有 78 匹（54.5%）进行了小肠切除术。共有 70 匹马（29%）发生了 POR。接受地塞米松的马匹（25/97；26%）与未接受地塞米松的马匹（45/143；31%，P=0.34）发生 POR 的风险无差异。与 POR 发生相关的风险因素包括小肠切除术（比值比 [OR]：4.55，95%置信区间 [CI]：2.27-9.11，P<0.001）、术后 24 小时 PCV>40%（OR：4.11，95% CI：2-8.45，P<0.001）和入院时白细胞计数>10×10/L（OR：3.29，95% CI：1.47-7.41，P=0.004）。地塞米松与 POR 的发生无关。接受重复剖腹术的马匹切口感染的风险更高（OR：8.07，95% CI：1.98-32.81，P=0.004）。地塞米松的使用与切口感染无关。POR 的发生与短期生存呈负相关（OR：0.07，95% CI：0.03-0.17，P≤0.001）。地塞米松的使用未被保留在最终的多变量生存模型中。
在本研究人群中，术中地塞米松的使用与 POR 的发生无关，也不会影响接受小肠疾病手术治疗的马匹的术后生存或切口感染。
