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

Authors: Valverde A, Gunkelt C, Doherty T J, Giguère S, Pollak A S

Journal: Equine veterinary journal

DOI: 10.2746/042516405775314772 PubMed: 16295936Log in to save

Summary

# Editorial Summary: Lidocaine CRI and Equine Anaesthetic Recovery Whilst lidocaine constant rate infusions are routinely used during equine general anaesthesia for their analgesic and anti-inflammatory properties, their impact on recovery quality had not been systematically evaluated. Researchers administered either a lidocaine bolus (2 mg/kg) followed by a continuous infusion (50 µg/kg/min) or saline control to 54 horses undergoing surgery under isoflurane or sevoflurane, with infusions either continued to the end of surgery or stopped 30 minutes pre-closure, using a modified recovery scoring system to assess outcomes. Horses receiving lidocaine throughout the operative period demonstrated significantly greater ataxia during recovery and a trend towards poorer overall recovery quality, despite no correlation between measured plasma lidocaine concentrations at recovery and recovery grade. The findings suggest that discontinuing lidocaine infusions approximately 30 minutes before surgical completion may minimise post-operative ataxia and improve recovery characteristics, practical guidance that warrants consideration when planning operative protocols and managing intra-operative analgesic strategies in equine surgery.

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Practical Takeaways

•If using intraoperative lidocaine infusions during equine surgery, discontinue at least 30 minutes before the end of anaesthesia to minimize post-operative ataxia and improve recovery quality
•Expect increased ataxia in recovery if lidocaine is continued until the end of surgery, regardless of the volatile anaesthetic used (isoflurane or sevoflurane)
•Plasma lidocaine concentrations at recovery do not predict recovery quality, so timing of discontinuation matters more than absolute drug levels

Key Findings

•Horses receiving intraoperative lidocaine CRI until end of surgery had significantly higher degree of ataxia compared to control group
•Lidocaine CRI showed tendency towards decreased quality of recovery overall
•No correlation existed between lidocaine plasma concentrations at recovery and recovery quality
•Discontinuing lidocaine 30 minutes before end of surgery reduced ataxia during recovery period

Conditions Studied

recovery from general anaesthesiapost-operative ataxia

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