A systematic review of the prevalence of post-operative complications after general anaesthesia in adult horses (2000-2023).
Authors: Loomes Kate, de Grauw Janny, Gozalo-Marcilla Miguel, Redondo José I, Bettschart-Wolfensberger Regula
Journal: Equine veterinary journal
Summary
# Editorial Summary Post-operative complications remain a substantial clinical challenge in equine anaesthesia, yet systematic assessment of their true prevalence has been limited. Loomes and colleagues conducted a comprehensive systematic review of 67 peer-reviewed studies published between 2000 and 2023, analysing prevalence data for eight commonly reported post-operative morbidities using weighted mean analysis and statistical comparison between surgical types. The findings reveal a stark disparity in complication rates: elective and non-abdominal procedures carry an overall complication prevalence of 17.48%, whilst colic surgery substantially elevates this risk to 55.62% (odds ratio 6.63). Post-operative colic emerged as the most frequently documented complication, occurring in 7.45% of elective cases but rising to 26.46% following colic surgery, with surgical site complications, laminitis, diarrhoea/colitis, fever, jugular thrombophlebitis and respiratory issues all significantly more prevalent after emergency colic procedures. For equine practitioners, these findings underscore the critical importance of rigorous post-operative monitoring protocols for colic cases, particularly regarding gastrointestinal and infectious complications, whilst also highlighting that myopathy and neuropathy represent consistent concerns regardless of surgical type—information essential for informed client communication and evidence-based perioperative planning.
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Practical Takeaways
- •Colic surgery patients have over 6 times the risk of post-operative complications compared to elective procedures—set owner expectations accordingly and implement intensive post-operative monitoring protocols
- •Post-operative colic is the most common morbidity; vigilant monitoring for abdominal pain and appropriate prophylactic strategies should be prioritized in immediate post-operative care
- •Laminitis, diarrhoea/colitis, and fever/pyrexia occur significantly more after colic surgery—tailor preventive measures (anti-inflammatory therapy, digestive support, antimicrobials) based on surgery type
Key Findings
- •Post-operative complications occur in 17.48% of horses after elective/non-abdominal surgery and 55.62% after colic surgery (OR 6.63)
- •Post-operative colic is the most commonly reported morbidity at 7.45% after elective/non-abdominal surgery, rising to 26.46% after colic surgery (OR 4.11)
- •Seven complications (colic, surgical site complications, laminitis, diarrhoea/colitis, fever/pyrexia, jugular thrombophlebitis/thrombosis, respiratory complications) were significantly higher after colic surgery
- •Myopathy/neuropathy prevalence was not significantly different between colic and elective/non-abdominal surgery groups