Equis ISSN 2398-2977

Anesthesia: peri-operative complications

Contributor(s): Kate Baker, Louise Clarke, G Mark Johnston, Mark Senior

Introduction

  • Generally accepted that equine patients have an increased risk of morbidity/mortality associated with general anesthesia compared with other species.
  • There are potential hazards at all stages of anesthesia from induction to recovery and even including the week after anesthesia.
  • A peri-operative complication is any complication associated with anesthesia/recumbency or surgery that occurs within the peri-operative period. Most people regard the first 24 h from the beginning of the anesthesia as the peri-operative period.
  • Particular types of complications associated with specific types of surgery, eg recurrent colic after emergency colic surgery or prosthesis failure on recovery from fracture repair will not be discussed here.

Discuss risk of anesthesia with owner prior to surgery. Must state that the risk of death within 7 days of general anesthesia is 0.9%.

Causes of peri-operative complications

  • Failure to anticipate or prevent complications.
  • Failure to recognize impending problems.
  • Failure to manage complications.

Types of complications

  • Pertaining to patient's physiologic status and temperament.
  • Related to drug administration.
  • Related to anesthetic technique.
  • Equine peri-operative complications can be divided into pre-, intra- and post-operative complications.

Reasons for increased risk of peri-operative complications

Pre-operative complications

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Intra-operative complications

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Complications occurring during maintenance phase

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Complications associated with maintenance of anesthesia

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Complications occurring during recovery

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Senior J M (2005) A review of post-anaesthetic pulmonary oedema in horses. Vet Anaesthesia Analgesia 32 (4), 193-200 PubMed.
  • Bradbury L A, Archer D C, Dugdale A H A, Senior J M & Edwards G B (2005) Suspected venous air embolism (VAE) secondary to catheter misadventureVet Rec 156 (4), 109-111.
  • Barr E D, Clegg P D, Senior J M & Singer E R (2005) Destructive lesions of the proximal sesamoid bones as a complication of dorsal metatarsal artery catheterization in three horses. Vet Surg 34 (2), 159-166.
  • McKay J S et al (2002) Post anaesthetic cerebral necrosis in five horses. Vet Rec 150, 70-74.
  • Johnston G M, Eastment J K, Wood J L N & Taylor P M (2002) The confidential enquiry into perioperative equine fatalities (CEPEF): mortality results of Phases 1 and 2. Vet Anaesth Anal 29, 159-170.
  • Coumbe K (1998) Anesthestic emergencies and complications - Part 2. Equine Vet Educ 10 (3), 161-168.
  • Smith R K, Dyson S J, Head M J & Butson R J (1996) Ultrasonography of the equine triceps muscle before and after general anaesthesia and in post anaesthetic myopathy. Equine Vet J 28, 311-319 PubMed.
  • Naylor J M (1994) Equine hyperkalemic periodic paralysis: review and implications. Can Vet J 35, 279-285 PubMed.
  • Hodgson D S & Steffey E P (1993) Intra-operative cardiac arrest: routes to recovery. Equine Vet J 25, 259-260 PubMed.
  • Robertson S A, Green S L, Carter S W et al (1992) Postanesthetic recumbency associated with hyperkalemic periodic paralysis in a quarter horse. JAVMA 201, 1209-1212 PubMed.
  • Bertone A L (1991) The decision process. Standing surgery versus general anesthesia and recumbency. Vet Clin North Am Equine Pract 7, 485-488 PubMed.
  • Klein L V (1990) Anesthetic complications in the horse. Vet Clin N Am Equine Pract (3), 665-692 PubMed.
  • Johnston G M, Taylor P M, McGee M A, Holmes M A, Wood J L N (1990) Confidential enquiry into periopertive equine fatalities (CEPEF-1), preliminary results. Equine Vet J 27, 193-200 PubMed.
  • Taylor P M, Rest R J, Duckham T N & Wood E J (1988) Possible potentiated sulphonamide and detomidine interactions. Vet Rec 122,143 PubMed.


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