Introduction: Compared to other species, anesthesia in the equine is thought to be associated with much more complications. The goal of the present study was to assess perianesthetic morbidity and mortality in an equine academic hospital population and to identify contributing factors. Material and methods: Records of all equine patients (including foals) that underwent general anesthesia at the University of Pennsylvania over a 10‐year period (1999–2009) were searched for cases of fatal or non‐fatal perianesthetic complications. Demographic and anesthetic data were analyzed and foals < 1 year of age were studied separately. Eligible risk factors were analyzed statistically as a case‐control study by means of 2 2 contingency tables and chi‐squared test (Epi InfoTM). Significance was set at P < 0.05. Results: In the population of 8623 anesthetized horses and ponies (including foals), the ‘spontaneous’ (due to cardiorespiratory arrest) perianesthetic mortality rate was 0.13% with no difference between adults and foals. Fatal complications requiring postanesthetic euthanasia occurred only in 0.27% of the adult horses, yielding an overall perianesthetic fatality rate of 0.37%. Irreparable injuries to the musculoskele- tal system accounted for >90% of the observed fatal complications and for 61% of the overall perianesthetic fatality rate. 1.02% of the adult animals and 0.51% of the foals experienced serious but non‐fatal complications such as neuropathies, soft tissue trauma and myopathies, predominantly in the recovery period. In adult horses, after‐ hour anesthesia’s were associated with a higher risk for perianesthetic complications (P < 0.001). Discussion/Conclusion: The ‘spontaneous’ perianesthetic mortality determined in this equine population coincides with mortality rates currently reported in small animal anesthesia (0.1%). Nevertheless, recovery from general anesthesia remains a potentially life‐threatening event in flight animals such as the horse and a challenge for the anesthetist, even when expert anesthetic and surgical management is routine. This explains the observed three times higher overall perianesthetic fatality rate in equine compared to small animal populations and calls for a continued search for improved anesthesia techniques that help reduce self‐inflicted injuries.
Perianesthetic morbidity and mortality in the equine: a retrospective study
BERTOLOTTI, Luigi;ZARUCCO, Laura
2013-01-01
Abstract
Introduction: Compared to other species, anesthesia in the equine is thought to be associated with much more complications. The goal of the present study was to assess perianesthetic morbidity and mortality in an equine academic hospital population and to identify contributing factors. Material and methods: Records of all equine patients (including foals) that underwent general anesthesia at the University of Pennsylvania over a 10‐year period (1999–2009) were searched for cases of fatal or non‐fatal perianesthetic complications. Demographic and anesthetic data were analyzed and foals < 1 year of age were studied separately. Eligible risk factors were analyzed statistically as a case‐control study by means of 2 2 contingency tables and chi‐squared test (Epi InfoTM). Significance was set at P < 0.05. Results: In the population of 8623 anesthetized horses and ponies (including foals), the ‘spontaneous’ (due to cardiorespiratory arrest) perianesthetic mortality rate was 0.13% with no difference between adults and foals. Fatal complications requiring postanesthetic euthanasia occurred only in 0.27% of the adult horses, yielding an overall perianesthetic fatality rate of 0.37%. Irreparable injuries to the musculoskele- tal system accounted for >90% of the observed fatal complications and for 61% of the overall perianesthetic fatality rate. 1.02% of the adult animals and 0.51% of the foals experienced serious but non‐fatal complications such as neuropathies, soft tissue trauma and myopathies, predominantly in the recovery period. In adult horses, after‐ hour anesthesia’s were associated with a higher risk for perianesthetic complications (P < 0.001). Discussion/Conclusion: The ‘spontaneous’ perianesthetic mortality determined in this equine population coincides with mortality rates currently reported in small animal anesthesia (0.1%). Nevertheless, recovery from general anesthesia remains a potentially life‐threatening event in flight animals such as the horse and a challenge for the anesthetist, even when expert anesthetic and surgical management is routine. This explains the observed three times higher overall perianesthetic fatality rate in equine compared to small animal populations and calls for a continued search for improved anesthesia techniques that help reduce self‐inflicted injuries.
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