Effect of a constant rate infusion of lidocaine on the quality of recovery from sevoflurane or isoflurane general anaesthesia in horses

Abstract

Summary Reasons for performing study: Lidocaine constant rate infusions (CRIs) are common as an intraoperative adjunct to general anaesthesia, but their influence on quality of recovery has not been thoroughly determined. Objectives: To determine the effects of an intraoperative i.v. CRI of lidocaine on the quality of recovery from isoflurane or sevoflurane anaesthesia in horses undergoing various surgical procedures, using a modified recovery score system. Hypothesis: The administration of intraoperative lidocaine CRI decreases the quality of recovery in horses. Methods: Lidocaine (2 mg/kg bwt bolus followed by 50 μg/kg bwt/min) or saline was administered for the duration of surgery or until 30 mins before the end of surgery under isoflurane (n = 27) and sevoflurane (n = 27). Results: Horses receiving lidocaine until the end of surgery had a significantly higher degree of ataxia and a tendency towards significance for a lower quality of recovery. There was no correlation between lidocaine plasma concentrations at recovery and the quality of recovery. Conclusions: Intraoperative CRI of lidocaine affects the degree of ataxia and may decrease the quality of recovery. Potential relevance: Discontinuing lidocaine CRI 30 mins before the end of surgery is recommended to reduce ataxia during the recovery period.

Partial intravenous anaesthesia in 5 horses using ketamine, lidocaine, medetomidine and halothane

“…A potential complication of lidocaine and ketamine anaesthesia is ataxia and excitation during the recovery period. Lidocaine infusions are reported to cause ataxia in the recovery period 29 , while prolonged ketamine infusion may lead to muscle rigidity and excitation 19 . This problem can be overcome by discontinuing the lidocaine infusion 30 min prior to the end of surgery, decreasing the ketamine dose to 65 % after 50 min and discontinuing the ketamine infusion 15-20 min prior to the end of surgery 3,10,29 .…”

Horse: anaesthetic management for open castration of a Belgian draught horse with interventricular septum defect, aortic regurgitation and ventricular premature depolarisations

“…In this respect, the use of lidocaine fitted well in the multimodal analgesic approach that was used in the current case. On the other hand, Valverde and others (2005) reported that the administration of a lidocaine CRI influences the quality of recovery in horses. Disconnection of the infusion 30 minutes before the end of surgery is recommended to reduce ataxia during the recovery period.…”

Anaesthetic management of a Baringo giraffe (Giraffa camelopardalis rotschildi) undergoing mandibular fracture repair on two occasions

“…It has been shown to have an anaesthetic sparing effect in isoflurane anaesthetised calves (Vesal and others 2011). Lidocaine is suspected to induce ataxia in horses (Valverde and others 2005) but did not show any adverse effect in calves (Vesal and others 2011). It was not considered a major risk in the giraffe as the infusion rate of 33 µg kg/minute was below the studied rate of 50 µg kg/minute in the previously mentioned publications.…”