A retrospective report (2003–2013) of the complications associated with the use of a one-man (head and tail) rope recovery system in horses following general anaesthesia

Abstract

BackgroundThe mortality rate of horses undergoing general anaesthesia is high when compared to humans or small animal patients. One of the most critical periods during equine anaesthesia is recovery, as the horse attempts to regain a standing position. This study was performed in a private equine practice in Belgium that uses a purpose-designed one-man (head and tail) rope recovery system to assist the horse during the standing process.The main purpose of the retrospective study was to report and analyse complications and the mortality rate in horses during recovery from anaesthesia using the described recovery system. Information retrieved from the medical records included patient signalment, anaesthetic protocol, duration of anaesthesia, ASA grade, type of surgery, recovery time and complications during recovery. Sedation was administered to all horses prior to recovery with the rope system. Complications were divided into major complications in which the horse was euthanized and minor complications where the horse survived. Major complications were further subdivided into those where the rope system did not contribute to the recovery complication (Group 1) and those where it was not possible to determine if the rope system was of any benefit (Group 2).ResultsFive thousand eight hundred fifty two horses recovered from general anaesthesia with rope assistance. Complications were identified in 30 (0.51%). Major complications occurred in 12 horses (0.20%) of which three (0.05%) were assigned to Group 1 and nine (0.15%) to Group 2. Three horses in Group 2 suffered musculoskeletal injuries (0.05%). Eighteen horses (0.31%) suffered minor complications, of which five (0.08%) were categorised as failures of the recovery system.ConclusionsThis study reports the major and minor complication and mortality rate during recovery from anaesthesia using a specific type of rope recovery system. Mortality associated with the rope recovery system was low. During recovery from anaesthesia this rope system may reduce the risk of lethal complications, particularly major orthopaedic injuries.

The ASA Physical Status Classification: What Is the Evidence for Recommending Its Use in Veterinary Anesthesia?—A Systematic Review

“…Accordingly, in veterinary medicine, a study with 235 dogs undergoing general anesthesia indicated that the ASA PS status was the only factor associated with the duration of ICU care (the higher ASA PS, the longer ICU stay), which, in turn, was a feature associated with an increase in the cost of hospitalization ( 34 ). In addition, the ASA PS classification could identify an increased frequency and severity of perioperative complications in human patients ( 52 ), dogs and cats ( 21 , 22 ); a long ICU stay in dogs ( 34 ), and a poor recovery quality from anesthesia in horses ( 37 , 38 ). Dogs ASA III, IV and V, were 3.4, 7.1, and 18.8 times, respectively, more likely to develop severe perianesthetic complications than those ASA I-II ( 21 ).…”

“…In veterinary medicine, to the authors' knowledge, one of the first prospective publications mentioning the association between the ASA PS classification and the anesthesia-related risk of death was from Clarke and Hall ( 19 ). Since then, several studies associating the ASA PS to anesthesia-related risk of death were published for dogs and cats ( 20 – 34 ), rabbits ( 24 , 35 ), pigs ( 36 ), and horses ( 37 , 38 ) with different outcomes and definitions. However, whether veterinary patients with a high ASA PS score are at an increased risk of death and development of complications associated with anesthesia remains unknown.…”

Epidural administration of opioid analgesics improves quality of recovery in horses anaesthetised for treatment of hindlimb synovial sepsis

“…In previous studies, breed has been associated with poorer recovery scores and shorter recovery duration. [29][30][31] Welsh cobs have been reported to be considerably more excitably and anxious than other types. 32 Other authors demonstrated that horses with higher subjective temperament scores, anaesthetised for MRI scans, displayed worse recoveries, suggesting that temperament may be an important factor associated with poor quality of recovery scores.…”

Highlights of recent clinically relevant papers

“…This retrospective study by Maria Chie Niimura Del Barrio and colleagues in Ireland, Qatar, Belgium and the UK reports the complications associated with the use of a one‐man rope recovery system in horses following general anaesthesia .…”