Relevance of assisting horses in recovery after gerneral anesthesia for osteosynthesis?

Relevanz der Verwendung eines Assistenzsystems in der Aufwachphase von Pferden nach einer Osteosynthese?

Schrimpf R, Tichy A, Stanek C

DOI: 10.21836/PEM20110405
Year: 2011
Volume: 27
Issue: 4
Pages: 393-399

According to recent literature, the use of various types of recovery systems in horses undergoing general anesthesia for osteosynthesis is crucial, whether it be simple head and tail ropes or the more sophisticated sling and pool recoveries. Recovery techniques depend upon several factors, including the clinician’s personal preference, the amenities of the hospital, and the overall patient population. The aim of this survey is to determine the status quo of the commonly used recovery systems in German-speaking equine hospitals in Europe with the help of a questionnaire. Furthermore, this survey seeks to determine additional factors that influence the selection of recovery systems, and it analyzes the outcomes of the post-surgical period, as a result of these various techniques. This allows for an adequate evaluation and comparison of anesthetic recovery protocols in the European equine medical field. Exactly 100 electronic and hard copy questionnaires were distributed, resulting in a total of 29 compliant equine private practices and veterinary university participants involved in the survey. The head and tail ropes were found to be the most frequently used systems for assisted recovery 14/26 (54%), followed by no assistance 11/ 26 (42%). Five hospitals preferred to use a specially-padded recovery box or the recovery boxes ranged in size. For most of the participating equine hospitals, it was not economically feasible to acquire a sling or a pool system for recovery. Only two hospitals were using a pool for recovery and four hospitals were using a sling recovery system. There is extensive evidence in literature correlating smoother recoveries with the anesthetic drugs used pre-, intra- and post surgically. This survey found that many of these drugs that are associated with positive outcomes are used widely and can be considered the European gold standard for anesthetic protocols. For pre-medication, a2 agonists were used the most frequently (8/21 Xylazine (40%), 6/21 Romifidine (30%)), followed by opioids and acepromacine. As confirmed by the literature, sedation using a2 agonists and opioids during the recovery period is very useful to improve the quality of recovery. In recovery, a2 agonist were used most frequently (57% (12/21) Xylazine, 28% (6/21) Romifidine) followed by opioids. Other factors involved in a clinic’s decision to perform assisted recovery are as follows: The number of horses undergoing osteosynthesis per year, localization of the fracture, and the age of the patient upon presentation. On the average, 8.05 osteosynthesis patients are operated on yearly. The proximal phalanx turned out to be the most frequently fractured bone (80%). Approximatley 60% of the horses were adults. The vast variety of recovery systems used has significant forensic implications when fatalities occurduring recovery.