Equine perioperative fatalities associated with general anaesthesia at a private practice – a retrospective case series

Bidwell, Lori A.; Bramlage, L. R.; Rood, William A

doi:10.1111/j.1467-2995.2005.00283.x

Cited by 182 publications

(204 citation statements)

References 17 publications

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“…Das Anästhesierisiko ist bei Pferden viel höher als bei anderen domestizierten Tierarten oder beim Menschen (Bidwell et al 2007, Senior 2013. Die Ventilation des Pferdes während der Anästhesie ist dabei ein zentrales Problem (Edner et al 2005).…”

Section: Einführungunclassified

Evaluation of tidal volume measurements of the anaesthesia device Tafonius® in vitro and in vivo

Kobler

Hartnack

Sacks

et al. 2016

PHK

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The anaesthesiologic risk is higher in horses than in other domesticated animal species and thereby ventilation is a vital problem. The aim of this study was to evaluate the accuracy of the anaesthesia device Tafonius ® tidal volume measurements in vitro as well as in vivo. In an in vitro study the whole system was flushed by air to reduce the air moisture to a minimum. The preparation of the anaesthesia device was exactly the same, as if there was a surgery on a patient. But instead of a horse, a seven liter calibration syringe was connected to the Y-piece of the anaesthesia device and the whole system was flooded by pure oxygen. By touch screen on the monitor of the anaesthesia device, a CPAP (Continuous Positive Airway Pressure), a tidal volume of 20 liters and an airway pressure of 20 cmH 2 O were adjusted. The leakage test was repeated and the connections tightened until the leak was 168 mL gas per minute. All the measurements were made randomly, without breaks or changes of the adjustments. For tidal volume measurements a seven liter calibration syringe was used. A connecting piece was specially manufactured, to attach the syringe to the Tafonius ® without gas leakage.14 different tidal volumes were evaluated in a random order, covering the range from 500 mL to 7000 mL using 500 mL steps. To imitate respiration during anaesthesia, three respiratory rates were simulated: 30, 15 and 6 times per minute. All the measurements were performed in duplicate, once with NICO ® interconnected and once without it. The respiratory rates and tidal volumes were chosen in random order, as well as whether the flow meter was interconnected or not. In a in vivo study twenty-one patients with a mean weight of 516 kilograms submitted for elective surgery were included. All of them received a balanced anaesthesia regime (inhalation anaesthesia with isoflurane and constant rate infusion with medetomidine (3.5 mcg/kg/h) and controlled mechanical ventilation. 16 horses were positioned in dorsal and five in lateral recumbency. The flow meter NICO ® was connected ones a steady state in the plane of anaesthesia was reached. The flow meter was left during 38 to 190 breaths. A total of 2368 breaths were measured. Mean tidal volumes reached from 4107 mL to 8964 mL. In vitro data were analysed by descriptive statistics to determine measurement accuracy. Bland-Altman plots with limits of agreement (loa) were used to analyze in vivo data. The mean difference between the volume given by the calibration syringe and the volume shown on the Tafonius ® screen was -19.45 % (standard deviation 11%). The data stored on the computer showed an average difference of -20.5 % (standard deviation 15.57 %). Whether NICO ® was interconnected or not resulted in a change in accuracy of 0.36 % in the volume measurement of the Tafonius ® . The mean difference of the volume produced with the calibration syringe and the measured volume of the NICO ® was 0.73 % (standard deviation 4.3 %). The Bland-Altman analysis from NICO ® to Tafonius ® gave a lower limit of a...

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Section: Einführungunclassified

Evaluation of tidal volume measurements of the anaesthesia device Tafonius® in vitro and in vivo

Kobler

Hartnack

Sacks

et al. 2016

PHK

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“…A large-scale, multicenter study -CEPEF (Confidential enquiry of perioperative equine fatalities) reported a death rate from non-colic-related anaesthetics of 0.9% (Johnston et al 1995), while the perianaesthetic mortality rate at a single, equine surgical practice seemed to be more favourable with 0.12%, because of preponderance of short procedures (Bidwell et al 2007). Thirty percent of all equine perioperative deaths are related to severe injury of the musculoskeletal system including fractures during the recovery phase, making recovery a critical part of equine anaesthesia (Johnston et al 1995, Johnston et al 2002, Johnston et al 2004, Bidwell et al 2007). …”

Section: Introductionmentioning

confidence: 99%

“…Head and tail ropes are able to stabilize a horse during its attempts to rise, however, it is evident that they cannot prevent fractures during standing up (Johnston et al 2002, Bidwell et al 2007) as they do not have a weight neutralizing function. For this reason several systems with lifting or weight neutralizing function mainly for recovery after fracture repair have been developed.…”

Section: Introductionmentioning

confidence: 99%

Management der Aufwachphase- mit oder ohne Hilfe?

Kästner¹

2010

PHK

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“…values for regional cerebral oxygen saturation, recorded from each of the 6 horses during the 8 recording periods……….……………………….50 Equine anaesthesia carries a high risk of mortality or serious morbidity, with the recovery period being a time of particular concern [1][2][3][4][5][6] . Recently, a UK-based enquiry into perioperative equine fatalities identified a mortality rate, defined as death within seven days of general anaesthesia, of 1.9% 3 ; a significantly higher rate than that which is reported in humans (0.008%) 5 or dogs and cats (0.2%) 6 . Recovery from equine general anaesthesia is considered precarious and injuries sustained during this period account for 25-50% of anaestheticassociated deaths 7 .…”

mentioning

confidence: 99%

Use of near‐infrared spectroscopy to identify trends in regional cerebral oxygen saturation in horses

McConnell

Rioja

Bester

et al. 2012

Equine Veterinary Journal

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Summary Reasons for performing study Alterations in cerebral haemodynamics may contribute to perianaesthetic complications in horses. Near‐infrared spectroscopy (NIRS) is frequently used intraoperatively in man to provide information regarding cerebral perfusion. Objectives To determine whether NIRS can identify trends in regional cerebral oxygen saturation (rSO2) in horses and whether there is a correlation between rSO2 and venous oxygen tensions. Methods A cerebral oximeter sensor recorded rSO2 from the dorsal sagittal sinus of 6 healthy horses. Values for rSO2, arterial and venous oxygen and carbon dioxide tensions (PaO2, PvO2, PaCO2 and PvCO2 respectively), along with arteriovenous oxygen saturations (SavO2) were recorded in unsedated (recording period [RP] 1), sedated (RP2) and anaesthetised horses (RP3–5) and during recovery (RP6–8). During anaesthesia, horses were ventilated to achieve states of normo‐ (RP3), hyper‐ (RP4) and hypocapnoea (RP5). Data were evaluated descriptively and analysed using linear mixed‐effects models and Pearson's correlation coefficient. Results Overall mean ± s.d. values for rSO2, PaO2, PvO2, PaCO2, SavO2 and mean arterial pressure varied significantly by RP (P<0.001). Significant decreases in rSO2 were identified between RP1 and the post anaesthetic periods (P<0.001). No significant differences in rSO2 values were identified between RP1 and the intra‐anaesthesia periods or between RP3, RP4 and RP5. Significant correlations were identified between rSO2 and PaO2 (r = 0.448, P<0.001), rSO2 and PvO2 (r = 0.512, P<0.001) and rSO2 and SavO2 (r = 0.469, P<0.001). Conclusions This is the first study to identify trends in rSO2 in horses using NIRS. A positive correlation was identified between rSO2 and PvO2, suggesting that alterations in cerebral oxygenation may be reflected in PvO2. Potential relevance Near‐infrared spectroscopy may be used to monitor trends in rSO2 during equine anaesthesia. Decreasing rSO2 values may act as an early warning signal, alerting clinicians to potential cerebral desaturation events and indicating a need for intervention.

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Equine perioperative fatalities associated with general anaesthesia at a private practice – a retrospective case series

Cited by 182 publications

References 17 publications

Evaluation of tidal volume measurements of the anaesthesia device Tafonius® in vitro and in vivo

Evaluation of tidal volume measurements of the anaesthesia device Tafonius® in vitro and in vivo

Management der Aufwachphase- mit oder ohne Hilfe?

Use of near‐infrared spectroscopy to identify trends in regional cerebral oxygen saturation in horses

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